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https://www.readbyqxmd.com/read/28511440/portal-venous-thrombosis-eosinophilic-vasculitis
#1
Vasanthi Natarajan, David Jose, Kevin John, Ashok Kumar Das
Portal Vein Thrombosis (PVT) is caused by various thrombophilic states. PVT secondary to underlying vasculitis especially Churg-Strauss disease is among the rarest presentation. Here, we report a case of peripheral eosinophilia, eosinophilic ascitis and venous thrombosis involving portal vein and superior mesenteric vein diagnosed as Churg-Strauss Syndrome (CSS). He was managed with steroids and anticoagulants. Following initiation of steroids, eosinophilia and eosinophilic ascitis improved.
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28508279/the-coexistence-of-both-replaced-proper-hepatic-and-gastroduodenal-arteries-due-to-the-common-hepatic-artery-absence
#2
Konstantinos Natsis, Maria Piagkou, Nikolaos Lazaridis, Georgios Koimtzis, Stylianos Apostolidis
Anatomical variants of the celiac trunk (CT) branches and especially these of hepatic arteries (HAs) are among the most common variants of the arterial tree. The knowledge of the wide variability in hepatic arterial supply is of paramount importance in hepatobiliary, pancreatic, gastric, and esophageal surgery, as well as in liver transplantations. The purpose of this case report is to describe a rare variant discovered during abdominal dissection of a 74-year-old male cadaver of Greek origin, in which the common hepatic artery was absent and its branches, the proper hepatic artery (PHA) and the gastroduodenal artery (GDA) had an aberrant and separate origin...
May 15, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28489536/dual-frequency-piezoelectric-endoscopic-transducer-for-imaging-vascular-invasion-in-pancreatic-cancer
#3
Brooks D Lindsey, Jinwook Kim, Paul A Dayton, Xiaoning Jiang
Cancers of the pancreas have the poorest prognosis among all cancers, as many tumors are not detected until surgery is no longer a viable option. Surgical viability is typically determined via endoscopic ultrasound imaging. However, many patients who may be eligible for resection are not offered surgery due to diagnostic challenges in determining vascular or lymphatic invasion. In this article, we describe the development of a dual-frequency piezoelectric transducer for rotational endoscopic imaging designed to transmit at 4 MHz and receive at 20 MHz in order to image microbubble-specific superharmonic signals...
May 8, 2017: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
https://www.readbyqxmd.com/read/28483615/severe-mesenteric-ischemia-in-a-pregnant-woman-with-antiphospholipid-syndrome
#4
Andrea Padricelli, Anna Maria Giribono, Doriana Ferrara, Flavia Spalla, Umberto Bracale, Luca Del Guercio, Giuseppe Servillo, Carlo Ruotolo, Umberto Marcello Bracale
The antiphospholipid syndrome (APS), either primary or secondary form, is considered an autoimmune disease with presence of at least one clinical and one laboratory abnormalities as defined by The Sydney criteria. Clinical criteria include vascular thrombosis of venous, artery, small vessel in any organ and recurrent pregnancy pathologies. Mesenteric ischemia is a rare and threatening manifestation of APS. We herein report a case of 34-years old pregnant woman referred to our Emergency Room with thoracic and abdominal acute pain...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28481004/tips-and-pitfalls-in-direct-ligation-of-large-spontaneous-splenorenal-shunt-during-liver-transplantation
#5
Hyeyoung Kim, Kyung Chul Yoon, Kwang-Woong Lee, Nam-Joon Yi, Hae Won Lee, YoungRok Choi, Dongkyu Oh, Hyo-Sin Kim, Suk Kyun Hong, Sung Woo Ahn, Kyung-Suk Suh
Patients with large spontaneous splenorenal shunt (SRS) prove challenging during liver transplantation (LT), irrespective of organizing portal vein (PV) thrombosis. Here, we detail the clinical outcomes of 26 patients who underwent direct ligation of large SRS during LT. Direct ligation of large SRS was applied in poor portal flow during LT. We performed temporary test clamping of the SRS before direct ligation and applied PV pressure monitoring in patients who showed signs of portal hypertension, such as bowel edema...
May 8, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28480180/streamline-flow-of-the-portal-vein-affects-the-lobar-distribution-of-colorectal-liver-metastases-and-has-a-clinical-impact-on-survival
#6
Jinsoo Rhu, Jin Seok Heo, Seong Ho Choi, Dong Wook Choi, Jong Man Kim, Jae-Won Joh, Choon Hyuck David Kwon
PURPOSE: It is believed that blood from the superior mesenteric vein and splenic vein mixes incompletely in the portal vein and maintains a streamline flow influencing its anatomic distribution. Although several experimental studies have demonstrated the existence of streamlining, clinical studies have shown conflicting results. We investigated whether streamlining of portal vein affects the lobar distribution of colorectal liver metastases and estimated its impact on survival. METHODS: Data of patients who underwent hepatectomy for colorectal liver metastases were retrospectively collected...
May 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28473083/acr-appropriateness-criteria-%C3%A2-radiologic-management-of-mesenteric-ischemia
#7
Nicholas Fidelman, Ali F AbuRahma, Brooks D Cash, Baljendra S Kapoor, M-Grace Knuttinen, Jeet Minocha, Paul J Rochon, Colette M Shaw, Charles E Ray, Jonathan M Lorenz
Mesenteric vascular insufficiency is a serious medical condition that may lead to bowel infarction, morbidity, and mortality that may approach 50%. Recommended therapy for acute mesenteric ischemia includes aspiration embolectomy, transcatheter thrombolysis, and angioplasty with or without stenting for the treatment of underlying arterial stenosis. Nonocclusive mesenteric ischemia may respond to transarterial infusion of vasodilators such as nitroglycerin, papaverine, glucagon, and prostaglandin E1. Recommended therapy for chronic mesenteric ischemia includes angioplasty with or without stent placement and, if an endovascular approach is not possible, surgical bypass or endarterectomy...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28464576/-laparoscopic-pancreaticoduodenectomy-with-a-novel-artery-first-and-uncinate-process-first-approach-through-treitz-ligament
#8
W T Gao, C H Xi, M Tu, X L Dai, F Guo, J M Chen, J S Wei, Z P Lu, J L Wu, K R Jiang, Y Miao
Objective: To explore the clinical effect of a novel artery first and uncinate process first approach for laparoscopic pancreaticoduodenectomy(LPD), emphasizing the left lateral and posterior dissection of uncinate process (UP) via Treitz ligament approach. Methods: From April to November 2016, 18 patients received LPD with a novel approach in Pancreas Center of the First Affiliated Hospital with Nanjing Medical University. All patients were diagnosed as pancreatic head or peri-ampulla tumor, without major vessel invasion nor distant metastasis...
May 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28462646/primary-giant-aggressive-amelanotic-duodenal-melanoma
#9
R Kilambi, A N Singh, N R Dash, K S Madhusudhan, P Das
Primary malignant melanoma of the gastrointestinal tract is extremely rare. A 35-year-old man presented with complaints of abdominal pain and weight loss. Contrast enhanced computed tomography showed a large mass involving the duodenum and the superior mesenteric vessels. Upper gastrointestinal endoscopy demonstrated a large, friable mass along the duodenal wall and biopsy was suggestive of malignant melanoma. A detailed physical examination and whole body imaging (positron emission tomography and computed tomography) did not reveal any other lesion...
May 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28462645/spontaneous-central-venous-thrombosis-and-shunt-occlusion-following-peritoneovenous-shunt-placement-for-intractable-ascites
#10
D Hariharan, E A Wilkes, G P Aithal, S J Travis, D N Lobo
A 43-year-old man had a peritoneovenous shunt inserted for the treatment of chylous ascites secondary to myelofibrosis. Despite being on anticoagulation for superior mesenteric vein thrombosis, he developed shunt dysfunction within two weeks of insertion. Superior venacavography showed multiple filling defects in the right axillary vein, no filling of the right brachiocephalic and right subclavian vein, and thrombotic occlusion of the internal jugular veins bilaterally. The shunt was removed 11 days after insertion, and there was extensive thrombosis of the venous end of the shunt and the compressible pump chamber...
May 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28447976/method-of-direct-segmental-intra-hepatic-delivery-using-a-rat-liver-hilar-clamp-model
#11
Eliza W Beal, Curtis Dumond, Jung-Lye Kim, Khalid Mumtaz, Don Hayes, Ken Washburn, Bryan A Whitson, Sylvester M Black
Major hepatic surgery with inflow occlusion, and liver transplantation, necessitate a period of warm ischemia, and a period of reperfusion leading to ischemia/reperfusion (I/R) injury with myriad negative consequences. Potential I/R injury in marginal organs destined for liver transplantation contributes to the current donor shortage secondary to a decreased organ utilization rate. A significant need exists to explore hepatic I/R injury in order to mediate its impact on graft function in transplantation. Rat liver hilar clamp models are used to investigate the impact of different molecules on hepatic I/R injury...
April 2, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28443583/retrograde-cerebral-air-embolism-in-a-patient-with-intestinal-necrosis-a-case-report
#12
Onur Taydaş, Mehmet Ruhi Onur, Erhan Akpınar
BACKGROUND: Cerebral venous air embolism (CVAE) is a severe clinical condition related to unfavoured outcome in patients with neurological impairment. CVAE may occur secondary to arterial or venous interventions. A rare mechanism of CVAE is retrograde embolism that is characterized by gas flow in a direction opposite to that of the normal blood flow. CASE REPORT: A 69-year-old female was admitted to our hospital with shortness of breath and abdominal pain. Abdominal computed tomography (CT) revealed intramural gas in the bowel and free gas in the mesenteric veins and portal vein...
April 13, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28427822/reassessment-of-the-clinical-significance-of-portal-superior-mesenteric-vein-invasion-in-borderline-resectable-pancreatic-cancer
#13
S Hoshimoto, S Hishinuma, H Shirakawa, M Tomikawa, I Ozawa, S Wakamatsu, S Hoshi, N Hoshi, K Hirabayashi, Y Ogata
OBJECTIVE: The principal objective of this study is to clarify the prognostic significance of borderline resectable pancreatic cancer (BRPC). The second objective is to evaluate the prognostic impact of the depth of pathological venous invasion. METHODS: The study included 122 pancreatic cancer patients who underwent curative surgery. All computed tomography scans of the patients were retrospectively interpreted and classified according to the NCCN guidelines, version 1...
April 8, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28427231/histopathologic-tumor-invasion-of-superior-mesenteric-vein-portal-vein-is-a-poor-prognostic-indicator-in-patients-with-pancreatic-ductal-adenocarcinoma-results-from-a-systematic-review-and-meta-analysis
#14
Ailin Song, Farong Liu, Lupeng Wu, Xiaoying Si, Yanming Zhou
BACKGROUND: The impact of histopathologic tumor invasion of the superior mesenteric vein (SMV)/portal vein (PV) on prognosis in patients with pancreatic ductal adenocarcinoma (PDAC) after pancreatectomy remains controversial. A meta-analysis was performed to assess this issue. RESULTS: Eighteen observational studies comprising 5242 patients were eligible, of whom 2199 (41.9%) patients received SMV/PV resection. Histopathologic tumor invasion was detected in 1218 (58...
May 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28424043/nutcracker-syndrome-case-report-on-the-management-of-recurrent-stenosis-after-stenting
#15
Natasha Hansraj, Abdul Hamdi, Ali Khalifeh, Eric Wise, Rajabrata Sarkar, Shahab Toursavadkohi
Nutcracker syndrome is a clinical entity leading to renal venous hypertension due to extrinsic compression of the left renal vein by the superior mesenteric artery. Current surgical therapy involves placement of an oversized renal vein stent with partial protrusion into the inferior vena cava (IVC) to relieve stenosis and prevent stent migration. Here, we present a patient with intractable pain and hematuria secondary to nutcracker syndrome who underwent left renal vein stent placement and developed recurrent symptoms due to flow-limiting kinking at the left renal hilum, with partial obstruction of the IVC from pseudointimal hyperplasia...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28417289/reporting-the-margin-in-pancreaticoduodenectomies-r0-versus-r1
#16
Chandralekha Shyamsunder Tampi, Somesh Nilkanth, Palepu Jagannath
AIM: This study was conducted to analyze the changes in margin positivity in pancreaticoduodenectomies, on using a standardized protocol, which bread loafs the pancreas and duodenum in the axial plane for adenocarcinomas arising in the pancreatic head, ampulla, terminal common bile duct (CBD), and duodenum, and then to assess whether these tumor subsets involve the margins in different ways. METHODS: The analysis was performed on 70 consecutive specimens, the pre-protocol specimens serving as the control group...
March 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28409377/laparoscopic-radical-antegrade-modular-pancreatosplenectomy-for-left-sided-pancreatic-cancer-using-the-ligament-of-treitz-approach
#17
Yusuke Ome, Kazuki Hashida, Mitsuru Yokota, Yoshio Nagahisa, Okabe Michio, Kazuyuki Kawamoto
BACKGROUND: Laparoscopic distal pancreatectomy (Lap-DP) for benign lesions or those with low malignant potential has been proven safe and effective, and its performance is now widespread [1-3]. Lap-DP for left-sided pancreatic cancer (PC) is also being increasingly performed. According to some reports, Lap-DP has superior short-term outcomes (blood loss, postoperative hospital stay) and comparable oncological outcomes and overall survival with those of open distal pancreatectomy (Op-DP) [4-6]...
April 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28400112/endothelial-specific-deletion-of-autophagy-related-7-atg7-attenuates-arterial-thrombosis-in-mice
#18
Jonathan W Yau, Krishna K Singh, Yan Hou, Xi Lei, Azza Ramadan, Adrian Quan, Hwee Teoh, Wolfgang M Kuebler, Mohammed Al-Omran, Bobby Yanagawa, Heyu Ni, Subodh Verma
BACKGROUND: Thrombosis persists as a leading cause of morbidity and mortality. Given that endothelial cells (ECs) play a central role in regulating thrombosis, understanding the molecular endothelial cues that regulate susceptibility or resistance to thrombosis have important translational implications. Accordingly, we evaluated the role of endothelial autophagy in the development of thrombosis. METHODS: We generated mice in which the essential autophagy-related 7 (ATG7) gene was conditionally deleted from ECs (EC-ATG7(-/-) mice)...
March 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28396581/coil-embolization-of-spontaneous-splenic-arteriovenous-fistula-for-treatment-of-portal-hypertension
#19
H Edward Garrett, Lamar Mack
BACKGROUND Splenic arteriovenous fistula (AVF) is a rare cause of portal hypertension which may manifest with abdominal pain, diarrhea, ascites, and/or hematemesis. Fistula formation may be traumatic or spontaneous. Eighty-six percent of spontaneous splenic AVFs occur in women, and 55% are associated with a preexisting splenic artery aneurysm. CASE REPORT A 64-year-old Caucasian female with unremarkable past medical history presented with new onset of left lower quadrant abdominal pain and persistent diarrhea...
April 11, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28395789/functional-testing-in-the-diagnosis-of-chronic-mesenteric-ischemia
#20
REVIEW
Desirée van Noord, Jeroen J Kolkman
Chronic mesenteric ischemia (CMI) results from insufficient oxygen delivery or utilization to meet metabolic demand. Two main mechanisms may lead to mesenteric ischemia: occlusion in the arteries or veins of the gastrointestinal tract, or reduced blood flow from shock states or increased intra-abdominal pressure, so-called non-occlusive mesenteric ischemia. Severe stenoses in the three main mesenteric vessels as demonstrated with CT-angiography or MR-angiography are sufficient to proof mesenteric ischemia, for example in patients who present with weight loss, postprandial pain and diarrhea...
February 2017: Best Practice & Research. Clinical Gastroenterology
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