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https://www.readbyqxmd.com/read/30086576/long-term-results-after-diversion-surgery-in-extrahepatic-portal-vein-obstruction
#1
Paloma Triana Junco, Ana Alvarez, Mariela Dore, Javier Jimenez Gomez, Alba Sánchez Galán, Alejandra Vilanova-Sánchez, Ane Andres, Jose Luis Encinas, Leopoldo Martinez, Francisco Hernandez, Manuel Lopez Santamaria
AIM:  Extrahepatic portal vein obstruction (EHPVO) is a frequent cause of noncirrhotic portal hypertension in children. The aim of this study is to analyze long-term results after diversion surgery. PATIENTS AND METHODS:  Retrospective review of EHPVO patients who underwent diversion surgery analyzing number of platelets, leukocytes, prothrombin activity, splenomegaly, and gastrointestinal bleeding 10 years after surgery. RESULTS:  Thirty-three patients were evaluated, mostly males (64%) and presenting with gastrointestinal bleeding (46%)...
August 7, 2018: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29936618/portal-hypertension-and-hypersplenism-in-extrahepatic-portal-venous-obstruction-are-they-related
#2
Ragini Kilambi, Anand Narayan Singh, Kumble Seetharama Madhusudhan, Sujoy Pal, Renu Saxena, Shalimar, Nihar Ranjan Dash, Peush Sahni
BACKGROUND AND AIMS: Portal hypertension (PHT) due to extrahepatic portal venous obstruction (EHPVO) is common in developing countries. Hypersplenism is a near-constant feature of EHPVO, but its significance, unlike in cirrhotics, is unknown. We aimed to study the relationship between hypersplenism and the severity of PHT in patients with EHPVO. METHODS: This prospective study was done at a tertiary care center from January 2014 to August 2015. All patients with EHPVO who underwent a splenectomy and a shunt or devascularization were included...
June 23, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29546610/surgical-treatment-for-rebleeding-caused-by-bypass-failure-after-rex-shunt-re-rex-shunt-or-warren-shunt
#3
Jin-Shan Zhang, Long Li, Wei Cheng
PURPOSE: Although Rex shunt is an effective treatment for extrahepatic portal venous obstruction (EHPVO), 4-20% children develop rebleeding postoperatively. This study was used to evaluate the surgical treatment of rebleeding after Rex shunt in our center. METHOD: From June 2008 to Jan 2017, 12 of 122 children with EHPVO underwent a second operation due to graft stenosis and occlusion after Rex shunt in our center. The abdominal ultrasound and computed tomography (CT) showed the occlusion of bypass vein in nine children, stenosis of bypass vein in two children, and the patency of bypass vein in one child with dysplasia of intrahepatic portal vein...
May 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29464506/idiopathic-portal-hypertension-and-extrahepatic-portal-venous-obstruction
#4
REVIEW
Rajeev Khanna, Shiv Kumar Sarin
BACKGROUND: Idiopathic portal hypertension (IPH) and extrahepatic portal venous obstruction (EHPVO) are non-cirrhotic vascular causes of portal hypertension (PHT). Variceal bleed and splenomegaly are the commonest presentations. AIM: The present review is intended to provide the existing literature on etiopathogenesis, clinical profile, diagnosis, natural history and management of IPH and EHPVO. RESULTS: IPH and EHPVO are both characterized by normal hepatic venous pressure gradient, moderate to massive splenomegaly with preserved liver synthetic functions...
February 2018: Hepatology International
https://www.readbyqxmd.com/read/29433861/metabolic-profile-of-children-with-extrahepatic-portal-vein-obstruction-undergoing-meso-rex-bypass
#5
Timothy B Lautz, Simon Eaton, Lisa Keys, Joy Ito, Mario Polo, Jonathan C K Wells, Agostino Pierro, Riccardo A Superina
BACKGROUND: Extrahepatic portal vein obstruction (EHPVO) in children is often associated with growth restriction, which improves after the restoration of portal venous flow with a meso-Rex bypass, but the physiologic mechanism is unknown. The purpose of this study was to investigate the mechanism of growth delay in children with EHPVO by detailing the metabolic and nutritional profile before and after meso-Rex bypass. METHODS: Twenty consecutive children with EHPVO were prospectively studied before and 1 year after meso-Rex bypass...
March 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29373442/stroop-test-validation-to-screen-for-minimal-hepatic-encephalopathy-in-pediatric-extrahepatic-portal-venous-obstruction
#6
Meera Vyshni Suresh, Barath Jagadisan, Preeti Kandasamy, Gandhipuram Periyasamy Senthilkumar
OBJECTIVES: Minimal hepatic encephalopathy (MHE) has been reported in children with extrahepatic portal vein obstruction (EHPVO). MHE assessment is restricted to research situations as neuropsychiatric tests are time-intensive. Computerized Stroop Test (CST) has been used in cirrhotic adults for MHE screening. The study aims to assess MHE frequency in young Indian children with EHPVO and validate CST for MHE screening in pediatric EHPVO. METHODS: Thirty-seven children with EHPVO between 7 and 12 years of age and 37 age- and sex-matched controls were enrolled...
May 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29315156/bleeding-risk-of-variceal-band-ligation-in-extrahepatic-portal-vein-obstruction-is-not-increased-by-oral-anticoagulation
#7
Maeva Guillaume, Camille Christol, Aurélie Plessier, Michèle Corbic, Jean-Marie Péron, Agnès Sommet, Pierre-Emmanuel Rautou, Yann Consigny, Jean-Pierre Vinel, Charles-Dominique Valla, Christophe Bureau
BACKGROUND AND OBJECTIVES: Noncirrhotic nontumoral extrahepatic portal vein obstruction (EHPVO) is the second leading cause of portal hypertension (PHT) and is mainly related to prothrombotic disorders. Patients with EHPVO often require prolonged oral anticoagulation therapy (OAT) together with variceal band ligation (VBL) to prevent thrombosis recurrence and PHT-related bleeding, respectively. The benefit-risk balance of VBL in this context remains unknown. We aimed to assess upper gastrointestinal bleeding (UGB) risk and variceal eradication efficacy in EHPVO patients undergoing a VBL program without stopping OAT...
May 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29260002/profile-of-extrahepatic-portal-venous-obstruction-among-children-in-central-india
#8
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/29234198/long-term-outcomes-of-patients-with-significant-biliary-obstruction-due-to-portal-cavernoma-cholangiopathy-and-extra-hepatic-portal-vein-obstruction-ehpvo-with-no-shuntable-veins
#9
Akash Shukla, Amit Gupte, Vedant Karvir, Prashant Dhore, Shobna Bhatia
Aims: The natural history of portal cavernoma cholangiopathy (PCC) in patients with significant biliary obstruction (SBO) who cannot undergo shunt surgery, is not known. We therefore, analyzed data of patients of extra-hepatic portal venous obstruction (EHPVO) with PCC. Methods: Prospectively recorded details of 620 (age 21.2 [11.4] years; 400 [65%] males) patients with primary EHPVO were reviewed. Outcomes (hepatic decompensation/mortality) of patients with PCC and SBO without shuntable veins were noted at follow up of 7 [4-11] years...
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29198895/portal-to-right-portal-vein-bypass-for-extrahepatic-portal-vein-obstruction
#10
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...
July 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29037349/the-optimal-procedure-of-modified-rex-shunt-for-the-treatment-of-extrahepatic-portal-hypertension-in-children
#11
Jin-Shan Zhang, Long Li, Wei Cheng
OBJECTIVE: Since 2008, the modified Rex shunt has been used for the treatment of extrahepatic portal venous obstruction (EHPVO) in our center, and satisfactory results were initially achieved. However, the postoperative recurrence rate gradually increased. We therefore performed a retrospective study to evaluate the outcome and identify the optimal procedure. METHODS: Between October 2008 and March 2016, 79 children with EHPVO underwent the Rex shunt in our hospital: 48 underwent the gastroportal shunt (GP), 26 underwent the portal cavernoma-Rex shunt with interposition of grafted portal vessel (PP), and 5 underwent a spleen-preserving splenoportal bypass (SP)...
November 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28694570/extrahepatic-portal-vein-obstruction-in-children-role-of-preoperative-imaging
#12
Shashidhar Achar, Hemonta Kumar Dutta, Rudra Kanta Gogoi
AIM: Extrahepatic portal vein obstruction (EHPVO) is characterized by features of recent thrombosis or portal hypertension with portal cavernoma as a sequel of portal vein obstruction. Imaging of spleno-portal axis is the mainstay for the diagnosis of EHPVO. The aim of this study is to analyze the role of imaging in the preoperative assessment of the portal venous system in children with EHPVO. MATERIALS AND METHODS: A hospital-based cross-sectional study was conducted on twenty children with EHPVO aged between 1 and 18 years over a period of 1 year...
July 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28663672/gastric-varices-in-cirrhosis-vs-extrahepatic-portal-venous-obstruction-and-response-to-endoscopic-n-butyl-2-cyanoacrylate-injection
#13
Barjesh C Sharma, Shivakumar Varakanahalli, Jatinder P Singh, Siddharth Srivastava
BACKGROUND: Gastric varices (GV) are found in patients with portal hypertension. Incidence of bleeding from GV is relatively low, but is severe, and associated with higher mortality. AIMS AND OBJECTIVES: To compare the types of GV in cirrhosis vs. extrahepatic portal venous obstruction (EHPVO) and the results of endoscopic N -butyl-2-cyanoacrylate (NBC, glue) injection. METHODS: Four hundred and fifty-four patients undergone glue injection of GV for primary prophylaxis or control of bleeding for first episode of bleeding from GV between August 2010 and August 2015 were analyzed...
June 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28612224/extrahepatic-portal-venous-obstruction-what-should-be-the-mainstay-of-treatment
#14
REVIEW
Richa Lal, Moinak Sen Sarma, Manish K Gupta
The two cornerstones of management for Extrahepatic portal vein obstruction (EHPVO) are endotherapy and surgery [Porto-systemic shunts (PSS)/Mesorex bypass (MRB)]. Endotherapy is the mainstay of treatment for acute variceal bleed control and has also been used extensively for secondary prophylaxis till variceal eradication is achieved. However, long-term follow-up beyond endoscopic eradication of esophageal varices (EEEV) indicates that there are numerous delayed bleed and non bleed sequelae of EHPVO, which merit surgery as a definitive procedure to decompress the hypertensive portal venous system...
September 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28348467/2d-shear-wave-elastography-of-liver-in-patients-with-primary-extrahepatic-portal-vein-obstruction
#15
Kumble S Madhusudhan, Raju Sharma, Ragini Kilambi, Sudhin Shylendran, Shalimar, Peush Sahni, Arun K Gupta
AIMS: To evaluate liver stiffness (LS) in patients of primary extrahepatic portal vein obstruction (EHPVO) using 2D shear wave elastography (SWE) and compare it with healthy volunteers. METHODS: Fifty patients (mean age: 22.4 years) of EHPVO and 25 healthy volunteers were included in the study. Liver function tests and viral markers were done in both groups and endoscopy in EHPVO group, followed by ultrasonography and SWE of liver. Liver elastography was done with patients/volunteers in supine position through right intercostal space...
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28018098/therapeutic-approaches-for-portal-biliopathy-a-systematic-review
#16
REVIEW
Irene Franceschet, Alberto Zanetto, Alberto Ferrarese, Patrizia Burra, Marco Senzolo
Portal biliopathy (PB) is defined as the presence of biliary abnormalities in patients with non-cirrhotic/non-neoplastic extrahepatic portal vein obstruction (EHPVO) and portal cavernoma (PC). The pathogenesis of PB is due to ab extrinseco compression of bile ducts by PC and/or to ischemic damage secondary to an altered biliary vascularization in EHPVO and PC. Although asymptomatic biliary abnormalities can be frequently seen by magnetic resonance cholangiopancreatography in patients with PC (77%-100%), only a part of these (5%-38%) are symptomatic...
December 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27878780/a-pilot-study-using-lactulose-in-management-of-minimal-hepatic-encephalopathy-in-children-with-extrahepatic-portal-vein-obstruction
#17
COMPARATIVE STUDY
Hanaa Mostafa El-Karaksy, Omneya Afifi, Azza Bakry, Ann Abdel Kader, Noha Saber
BACKGROUND: Minimal hepatic encephalopathy (MHE) is not associated with overt neuropsychiatric symptoms but rather with subtle changes in psychometric and/or neurophysiologic tests. We aimed to diagnose MHE in children with extrahepatic portal vein obstruction (EHPVO) and to evaluate the effect of lactulose on MHE. METHODS: A prospective study was carried out on 30 patients with EHPVO (21 males; mean age 10±2.5 years). The study was carried out in the Pediatric Hepatology Unit, Cairo University Pediatric Hospital, Cairo, Egypt, between 2011 and 2013...
February 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/27867876/prevalence-and-pattern-of-growth-abnormalities-in-children-with-extrahepatic-portal-vein-obstruction-response-to-shunt-surgery
#18
Toufeeq Ahmad Mir, Raiz Ahmad Misgar, Bashir Ahmad Laway, Omar Javed Shah, Zafar Amin Shah, Showkat Ali Zargar
OBJECTIVE: Growth retardation is common in children with extrahepatic portal vein obstruction (EHPVO) and growth hormone (GH) resistance may play a dominant role. The aim of this study was to ascertain growth parameters and growth-related hormones in children with EHPVO, comparing with controls and to study the response of shunt surgery on growth parameters. MATERIALS AND METHODS: The auxological and growth-related hormone profile (GH; insulin-like growth factor binding protein-3 [IGFBP-3] and IGF-1) of thirty children with EHPVO were compared with controls...
November 2016: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27847891/clinical-presentation-of-extrahepatic-portal-vein-obstruction-10-year-experience-at-a-tertiary-care-hospital-in-pakistan
#19
Farina M Hanif, Ghous Bux Soomro, Sara Nazir Akhund, Nasir Hassan Luck, Syed Mudassir Laeeq, Zaigham Abbas, Syed Mujahid Hassan, Muhammed Mubarak
OBJECTIVE: To evaluate the clinical presentation, possible etiological factors, management and outcome of patients in our hospital with extrahepatic portal vein obstruction (EHPVO). MATERIALS AND METHODS: This study included patients with EHPVO followed up in our department during last 10 years. Patients of cirrhosis with EHPVO were excluded. Patients' clinical presentation, etiology of EHPVO, management and outcome results were analyzed. RESULTS: Of 30 patients, 19 (67...
April 2015: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/27841011/portal-cavernoma-cholangiopathy-diagnosis-imaging-and-intervention
#20
REVIEW
Lauren N Moomjian, Sarah G Winks
The term portal cavernoma cholangiopathy refers to the biliary tract abnormalities that accompany extrahepatic portal vein obstruction (EHPVO) and subsequent cavernous transformation of the portal vein. EHPVO is a primary vascular disorder of the portal vein in children and adults manifested by longstanding thrombosis of the main portal vein. Nearly all patients with EHPVO have manifestations of portal cavernoma cholangiopathy, such as extrinsic indentation on the bile duct and mild bile duct narrowing, but the majority are asymptomatic...
January 2017: Abdominal Radiology
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