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Portal hypertension (PH) is a devastating sequelae of several pathologic entities, with alcoholic cirrhosis being the most common cause in the western world and endemic schistosomiasis worldwide. A much less common aetiology of non-cirrhotic PH is nodular regenerative hyperplasia (NRH) of the liver. The hallmark of NRH is a benign remodeling of the hepatic parenchyma into regenerative nodules in the absence of fibrosis (1). A Warren-Zeppa Distal Splenorenal Shunt (DSRS) was performed in a young patient with NRH of the liver to alleviate PH. This procedure was chosen due to its low postoperative rates of hepatic insufficiency and high durability.

Portal hypertension from nodular regenerative hyperplasia of the liver treated with distal splenorenal shunt