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hypersplenism

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https://www.readbyqxmd.com/read/29273377/incidence-and-risk-factors-associated-with-a-high-comprehensive-complication-index-score-after-splenectomy-in-cirrhotic-patients-with-hypersplenism
#1
Zhaoqing Du, Jian Dong, Jia Zhang, Jianbin Bi, Zheng Wu, Yi Lv, Xufeng Zhang, Rongqian Wu
BACKGROUND: Postoperative complications after splenectomy are not rare and can be serious in cirrhotic patients. The purpose of this study was to assess postoperative complications using the comprehensive complication index (CCI) after splenectomy in cirrhotic patients and identify risk factors for those who developed a high postoperative CCI score. MATERIALS AND METHODS: This retrospective study included 208 adult patients with viral hepatitis-related cirrhosis, who underwent elective splenectomy at our hospital from January 2002 to June 2012...
February 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29260002/profile-of-extrahepatic-portal-venous-obstruction-among-children-in-central-india
#2
Mayank Jain, Jenisha Jain, Gauri Rao Passi, Kamna Jain, Shikhar Jain
Introduction: There is a paucity of data regarding the clinical profile of children with extrahepatic portal venous obstruction (EHPVO) from Central India. Material and methods: Retrospective analysis of 30 children with EHPVO treated between 2002 and 2012. Results: The median age of presentation was 12.5 years (range 5-14 years) and median duration of symptoms was 3.2 years (range 0.3-10 years). Home delivery was noted in 30 cases (100%), umbilical sepsis in 8 (27%) and history of cow dung application over the umbilical cord in 2 cases (6...
December 2017: Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29249783/-utility-of-partial-splenic-embolization-prior-to-lung-resection-in-patients-demonstrating-platelet-transfusion-refractoriness-due-to-hypersplenism
#3
Yusuke Tanaka, Isao Matsumoto, Daisuke Saito, Syuhei Yoshida, Seiichi Kakegawa, Masaya Tamura, Hirofumi Takemura
It is often difficult to control perioperative bleeding in patients with liver cirrhosis and concurrent thrombocytopenia and coagulation factor deficiency. Partial splenic embolization (PSE), an auxiliary treatment strategy in management of liver cirrhosis and hepatocellular carcinoma, can not only increase platelets but also improve liver function. With advances in interventional radiology, PSE is a safer and more reliable procedure compared to a splenectomy. We present the case of a 69-year-old man diagnosed with left lung cancer, with thrombocytopenia, and hepatitis C virus-related cirrhosis...
December 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29217866/airway-management-of-a-paediatric-patient-with-temporomandibular-joint-ankylosis-with-extra-hepatic-portal-vein-obstruction-splenomegaly-hypersplenism-and-obstructive-sleep-apnoea-for-shunt-surgery-a-unique-challenge
#4
Shiv Akshat, Shikha Jain, Puneet Khanna, Ravinder Kumar Batra
No abstract text is available yet for this article.
November 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29199112/-management-of-patients-with-major-beta-thalassemia-in-a-paediatric-department-in-the-south-of-tunisia-about-26-cases
#5
I Maaloul, O Laaroussi, I Jedidi, L Sfaihi, S Kmiha, T Kamoun, H Aloulou, M Hachicha
AIM: Our objectives were to assess the management of patients with major thalassemia and identify the various complications and monitoring means. PATIENTS AND METHODS: A retrospective study was conducted on 26 β-thalassemic patients in the department of paediatrics, Hédi Chaker hospital, Sfax, Tunisia during a period of 25 years (from 1 January 1990 to 31 December 2014). RESULTS: The mean age of the beginning of transfusion was 11.5 months...
November 30, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/29198895/portal-to-right-portal-vein-bypass-for-extrahepatic-portal-vein-obstruction
#6
Li Long, Zhang Jinshan, Chen Zhen, Li Qi, Dong Ning, Diao Mei, Cheng Wei
OBJECTIVE: Rex shunt (mesenteric-to-left portal vein bypass) is considered a more physiologically rational treatment for EHPVO than other portosystemic systemic shunts in children. However, about 13.6% of children with EHPVO do not have usable left portal veins and up to 28.1%. Rex operations in children are not successful. Hence, a Rex shunt in these children was impossible. This study reports a novel approach by portal-to-right portal vein bypass for treatment of children with failed Rex shunts...
November 4, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29196972/proximal-total-splenic-artery-embolization-for-refractory-hepatic-encephalopathy
#7
Harufumi Maki, Junichi Kaneko, Junichi Arita, Nobuhisa Akamatsu, Yoshihiro Sakamoto, Kiyoshi Hasegawa, Sumihito Tamura, Hidemasa Takao, Eisuke Shibata, Norihiro Kokudo
A Japanese woman with a history of Kasai operation for biliary atresia had living-donor liver transplantation at the age of 22. The first episode of refractory HE and late cellular rejection was treated by a high dose of methylprednisolone. The second episode of refractory HE was treated by balloon-occluded retrograde transvenous obliteration for a spleno-renal shunt. However, the third episode of refractory HE occurred 11 years after liver transplantation. The liver cirrhosis and hypersplenism were present with a Child-Pugh score of C-10...
December 1, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29142151/two-cases-of-liver-cirrhosis-treated-with-lusutrombopag-before-partial-splenic-embolization
#8
Masashi Fujita, Kazumichi Abe, Manabu Hayashi, Ken Okai, Atsushi Takahashi, Hiromasa Ohira
Lusutrombopag, a small molecule thrombopoietin receptor agonist, has been approved for the treatment of chronic liver disease-associated thrombocytopenia due to hypersplenism in patients scheduled to undergo elective invasive procedures in Japan. We performed partial splenic embolization (PSE) after administration of lusutrombopag in two patients with thrombocytopenia due to cirrhosis. Case 1 involved a 50-year-old man who developed cirrhosis due to hepatitis B virus (HBV) infection and alcohol consumption...
November 15, 2017: Fukushima Journal of Medical Science
https://www.readbyqxmd.com/read/29101567/vagus-nerve-preserving-versus-conventional-laparoscopic-splenectomy-and-azygoportal-disconnection
#9
Dou-Sheng Bai, Ping Chen, Sheng-Jie Jin, Jian-Jun Qian, Guo-Qing Jiang
BACKGROUND: Conventional open and conventional laparoscopic splenectomy and azygoportal disconnection (CLSD) result in poor quality of life because of damage to the vagal nerve. We have developed vagus nerve-preserving laparoscopic splenectomy and azygoportal disconnection (VLSD). This study aimed to evaluate whether VLSD is effective and safe, and to determine whether a reduction in the incidence of postoperative complications improves postoperative quality of life compared with CLSD...
November 3, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29019252/hypersplenism-secondary-to-splenoportal-axis-compression-by-a-giant-hepatic-cyst
#10
Leire Parapar Álvarez, Sonia Antón García, Carmen Argüelles Martínez de la Vega, Manuel Crespo Sánchez
Simple hepatic cysts (SHCs) are formations that contain serous fluid surrounded by normal hepatic parenchyma with no communication with intrahepatic bile ducts. Symptoms develop as a result of their size or complications such as bleeding, rupture, intracystic infection or compression of adjacent structures.
October 11, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28918404/combined-caesarean-with-splenectomy-in-pregnancy-with-portal-hypertension-defining-plausibility
#11
Manjunath Maruti Pol, Latika Uniyal Chawla, Yashwant Singh Rathore, Ritesh Goel
24-year-old woman at 28 weeks gestation was referred from peripheral hospital with diagnosis of pregnancy with portal hypertension. She had received multiple transfusion for pancytopaenia in the past and had undergone endoscopic sclerotherapy for oesophageal varices. Initially, she was admitted in our hospital at 28 weeks gestation for blood transfusion and was evaluated by multispecialty team of doctors. She was advised splenectomy for transfusion-dependent pancytopaenia secondary to hypersplenism in non-cirrhotic portal hypertension...
September 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28846949/splenic-hamartoma-associated-with-thrombocytopenia-a-case-report
#12
Toshiaki Komo, Jun Hihara, Mikihiro Kanou, Toshihiko Kohashi, Ichiro Ohmori, Masanori Yoshimitsu, Takuhiro Ikeda, Akira Nakashima, Masashi Miguchi, Ichiko Yamakita, Hidenori Mukaida, Naoki Hirabayashi, Mayumi Kaneko
INTRODUCTION: Hamartomas are rare, benign tumors of the spleen. Few cases of splenic hamartomas associated with thrombocytopenia have been reported. PRESENTATION OF CASE: An asymptomatic 64-year-old man with myelodysplastic syndrome was found to have a splenic tumor. Laboratory tests were significant for thrombocytopenia, with a platelet count of 7.8×10(4)/μL. Ultrasonography showed splenomegaly (10.8×6.6cm), and a hypoechoic splenic mass (8.0×7.0cm). Color doppler ultrasound revealed blood flow within the mass, and the mass density was homogeneous on abdominal computed tomography (CT)...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28811901/perioperative-safety-analysis-of-transcatheter-arterial-chemoembolization-for-hepatocellular-carcinoma-patients-with-preprocedural-leukopenia-or-thrombocytopenia
#13
Lin Zhou, Lin-Zhi Zhang, Jing-Yan Wang, Yong-Wu Li, Hai-Dong Hu, Xiao-Ming Peng, Yun Zhao, Xi-Ming Wang, Hui Xie, Chun-Zi Liu, Hua-Ming Wang
Patients with hepatocellular carcinoma (HCC) exhibit a high incidence of concomitant cirrhosis with leukopenia and/or thrombocytopenia. In the present study, perioperative changes in the white blood cell (WBC) and platelet (PLT) counts and associated complications were investigated to assess the safety of transcatheter arterial chemoembolization (TACE) for HCC patients with preprocedural leukopenia or thrombocytopenia. The records of 1,461 HCC patients who received TACE between January 2012 and December 2013 were retrospectively reviewed...
September 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28689488/modified-laparoscopic-pyloroplasty-during-laparoscopic-splenectomy-and-azygoportal-disconnection-for-the-prevention-of-postoperative-gastroparesis
#14
Guoqing Jiang, Dousheng Bai, Jianjun Qian, Ping Chen, Shengjie Jin
BACKGROUND: Gastroparesis is a common complication after splenectomy and azygoportal disconnection, remaining a chronic debilitating disorder with considerable treatment challenges. To minimize postoperative gastroparesis, we have developed a new modified laparoscopic pyloroplasty (LP) technique for use during laparoscopic splenectomy and azygoportal disconnection (LSD). METHODS: We retrospectively evaluated the outcomes of 31 cirrhotic patients with portal hypertensive bleeding and secondary hypersplenism who underwent synchronous LSD with modified LP (n = 14) or LSD without modified LP (n = 17) between January 2015 and August 2015...
August 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28643575/combined-rex-bypass-shunt-with-pericardial-devascularization-alleviated-prehepatic-portal-hypertension-caused-by-cavernomatous-transformation-of-portal-vein
#15
Ruo-Yi Wang, Jun-Feng Wang, Qian Liu, Nan Ma, Wei-Xiu Chen, Jin-Liang Li
OBJECTIVE: To evaluate the effects of combined Rex-bypass shunt and pericardial devascularization on prehepatic portal hypertension secondary to cavernomatous transformation of portal vein (CTPV). METHODS: Forty-two patients aged from 3 years to 49 years (divided into 3 groups), 26 cases male and 16 female, with prehepatic vascular hepertention were treated with Rex-bypass shunt combined with pericardial devascularization. In each patient, preoperative assessment included ultrasound and computed tomographic angiography of the portal vein and blood analysis...
September 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28640110/case-report-of-a-modified-meso-rex-bypass-as-a-treatment-technique-for-late-onset-portal-vein-cavernous-transformation-with-portal-hypertension-after-adult-deceased-donor-liver-transplantation
#16
Dongdong Han, Rui Tang, Liang Wang, Ang Li, Xin Huang, Shan Shen, Jiahong Dong
RATIONALE: Portal vein thrombosis is a complication after liver transplantation and cavernous transformation of the portal vein (CTPV) is a result of portal vein thrombosis, with symptoms of portal hypertension revealed by an enhanced CT scan. Meso-Rex bypass is an artificial shunt connecting the left portal vein to the superior mesenteric vein and is mainly used for idiopathic cavernomas. This technique is also used for post-transplant portal vein thrombosis in pediatric patients thereby bypassing obstructed sites of the extrahepatic portal vein...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28585786/-results-of-the-mesoportal-bypass-rex-shunt-in-the-treatment-of-idiopathic-extrahepatic-portal-vein-obstruction-in-children
#17
E Domínguez Amillo, C De la Torre Ramos, A Andrés Moreno, J L Encinas Hernández, F Hernández Oliveros, M López Santamaría
BACKGROUND: Extrahepatic portal vein obstruction (EPVO) is the principal cause of portal hypertension in children. The objective of this study was to analyze the capacity of the surgical technique that creates a mesoportal shunt to treat changes caused by EPVO. METHODS: Retrospective review of patients with idiopathic EPVO who underwent a mesoportal shunt and analysis of the changes in the number of leucocytes, platelets, prothrombin time and spleen size one year after the surgery...
January 25, 2017: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28583895/the-early-prevention-and-treatment-of-pvst-after-laparoscopic-splenectomy-a-prospective-cohort-study-of-130-patients
#18
Yu-Yuan Qian, Kun Li
BACKGROUND: After laparoscopic splenectomy (LS) in patients with cirrhotic and hypersplenism, there is highly risk of suffering from portal vein system thrombosis (PVST) complication. This study is aimed to investigate the risk factors of PVST and study the anticoagulation effect on the prevention of PVST after LS. MATERIALS AND METHODS: We retrospectively observed 130 patients who performed LS from February 2009 to December 2016. Patients were classified into the anticoagulation group (73 patients) and the non-anticoagulation group (57 patients)...
June 3, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28576121/proximal-spleno-renal-shunt-with-retro-aortic-left-renal-vein-in-a-patient-with-extra-hepatic-portal-vein-obstruction-first-case-report
#19
Sundeep Jain, Mukesh Kalla, Adil Suleman, Alok Verma
BACKGROUND: Presence of retro-aortic left renal vein poses special challenge in creating spleno-renal shunt potentially increasing the chance of shunt failure. The technical feasibility and successful outcome of splenectomy with proximal spleno-renal shunt (PSRS) with retro-aortic left renal vein is presented for the first time. The patient was treated for portal hypertension and hypersplenism due to idiopathic extra-hepatic portal vein obstruction. CASE PRESENTATION: A twenty year old male suffering from idiopathic extra-hepatic portal vein obstruction presented with bleeding esophageal varices, portal hypertensive gastropathy, asymptomatic portal biliopathy and symptomatic hypersplenism...
June 2, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28566882/platelets-in-liver-disease-cancer-and-regeneration
#20
REVIEW
Tomohiro Kurokawa, Nobuhiro Ohkohchi
Although viral hepatitis treatments have evolved over the years, the resultant liver cirrhosis still does not completely heal. Platelets contain proteins required for hemostasis, as well as many growth factors required for organ development, tissue regeneration and repair. Thrombocytopenia, which is frequently observed in patients with chronic liver disease (CLD) and cirrhosis, can manifest from decreased thrombopoietin production and accelerated platelet destruction caused by hypersplenism; however, the relationship between thrombocytopenia and hepatic pathogenesis, as well as the role of platelets in CLD, is poorly understood...
May 14, 2017: World Journal of Gastroenterology: WJG
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