Dynamic computed tomography (CT) and real-time/pulsed Doppler ultrasonography were performed in 13 patients following a distal end-to-side splenorenal shunt (Warren procedure). The results were correlated with angi-ography. The anastomotic site was demonstrated by CT in all patients. Coin-cident enhancement of the distal splenic vein and left renal vein as demon-strated by dynamic CT was an accurate predictor of shunt patency. Ultrasound studies were performed using a transplenic coronal imaging approach. Al-though the proximal splenic vein and left renal vein could be identified, it was not possible to directly evaluate the anastomotic site in any patients. Dynamic CT evaluation of splenorenal shunts may be a useful technique for monitoring shunt patency during long term follow-up and for evaluating patients who later rebleed. © 1983 Raven Press, Ltd.