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Splenic thrombosis

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https://www.readbyqxmd.com/read/28210634/potential-of-a-pharmacogenetic-guided-algorithm-to-predict-optimal-warfarin-dosing-in-a-high-risk-hispanic-patient-role-of-a-novel-nqo1-2-polymorphism
#1
Dagmar F Hernandez-Suarez, Karla Claudio-Campos, Javier E Mirabal-Arroyo, Bianca A Torres-Hernández, Angel López-Candales, Kyle Melin, Jorge Duconge
Deep abdominal vein thrombosis is extremely rare among thrombotic events secondary to the use of contraceptives. A case to illustrate the clinical utility of ethno-specific pharmacogenetic testing in warfarin management of a Hispanic patient is reported. A 37-year-old Hispanic Puerto Rican, non-gravid female with past medical history of abnormal uterine bleeding on hormonal contraceptive therapy was evaluated for abdominal pain. Physical exam was remarkable for unspecific diffuse abdominal tenderness, and general initial laboratory results-including coagulation parameters-were unremarkable...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28194181/simultaneous-left-ventricular-and-deep-vein-thrombi-caused-by-protein-c-deficiency
#2
Harufumi Maki, Motohiro Nishiyama, Motoaki Shirakawa
Protein C deficiency is a risk of venous thrombosis because of poor fibrinolytic activity. It remains controversial whether protein C deficiency causes arterial thrombosis. A 21-year-old woman was referred with a chief complaint of right leg pain and numbness. Contrast-enhanced computed tomography revealed a low-density mass in the left ventricle (LV), splenic infarction, and peripheral arterial obstructions in her right leg. Thrombosis extending from the renal vein to the inferior vena cava was also detected...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28188676/hemoglobin-based-oxygen-carrier-rescues-double-transplant-patient-from-life-threatening-anemia
#3
M F Gomez, O Aljure, G Ciancio, M Lynn
This is a case of a 46-year-old male, Jehovah's Witness kidney-pancreas transplant recipient found to have early in the postoperative period, splenic vein thrombosis requiring heparin infusion. Two days later, he developed severe symptomatic anemia (Hb < 6 g/dL). Standard medical therapy for bloodless surgical patients with severe anemia was instituted. Nevertheless, the patient's hemoglobin concentration continued to decline to critical levels (2 g/dL). Transfusion of allogeneic blood products was not an option, prompting use of a hemoglobin-based oxygen carrier (HBOC)...
February 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28181172/discrepant-imaging-findings-of-portal-vein-thrombosis-with-dynamic-computed-tomography-and-computed-tomography-during-arterial-portography-in-hepatocellular-carcinoma-possible-cause-leading-to-inappropriate-treatment-selection
#4
Hidenori Toyoda, Takashi Kumada, Toshifumi Tada, Kazuyuki Mizuno, Natsuko Kobayashi, Yosuke Inukai, Akira Takeda, Yasuhiro Sone
We encountered a patient with hepatocellular carcinoma who had discrepant imaging findings on portal vein thrombosis with portal phase dynamic computed tomography (CT) and CT during arterial portography (CTAP). CTAP, via the superior mesenteric artery and via the splenic artery, both showed a portal perfusion defect in the right hepatic lobe, indicating portal vein thrombosis in the main trunk of the right portal vein. Portal phase dynamic CT clearly depicted portal perfusion of the same hepatic area. Transarterial chemoembolization was successfully performed, but it was associated with severe liver injury...
February 8, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28133818/distal-pancreatectomy-for-benign-and-low-grade-malignant-tumors-short-term-postoperative-outcomes-of-spleen-preservation-a-systematic-review-and-update-meta-analysis
#5
Fiorella Pendola, Rahul Gadde, Caroline Ripat, Rishika Sharma, Omar Picado, Laila Lobo, Danny Sleeman, Alan S Livingstone, Nipun Merchant, Danny Yakoub
BACKGROUND: The value of spleen preservation with distal pancreatectomy (DP) for benign and low grade malignant tumors remains unclear. The aim of this study was to evaluate the short-term postoperative clinical outcomes in patients undergoing DP with splenectomy (DPS) or spleen preservation (SPDP). METHODS: Online database search was performed (2000 to present); key bibliographies were reviewed. Studies comparing patients undergoing DP with either DPS or SPDP, and assessing postoperative complications were included...
February 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28133273/-a-case-of-advanced-gastric-cancer-successfully-treated-with-curative-conversion-surgery-after-chemotherapy-with-s-1-plus-oxaliplatin
#6
Toru Ishiguro, Minoru Fukuchi, Toshiro Ogura, Yu Muta, Erito Mochiki, Hideyuki Ishida
This report describes a patient with unresectable advanced gastric cancer who was successfully treated with potentially curative conversion surgery after chemotherapy with S-1 plus oxaliplatin(SOX). An 82-year-old man was diagnosed with type 5 gastric cancer(por1, HER2-negative)with multiple granular mucosal necroses that had metastasized throughout his body. Computed tomography revealed multiple lymph node metastases, tumor thrombosis in the splenic and portal veins, and peritoneal dissemination. After 9 courses of first-line chemotherapy with SOX, there was no tumor thrombosis in the splenic and portal veins or peritoneal dissemination, and the primary tumor and lymph node metastases were markedly reduced in size, indicative of a partial response(PR)...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133173/-remission-of-advanced-gastric-cancer-with-concurrent-portal-vein-tumor-thrombosis-via-chemotherapy-a-case-report
#7
Seiko Miura, Nobuhiko Ueda, Hideto Fujita, Shinichi Kinami, Takeo Kosaka, Hiroshi Funaki, Noriaki Sakata, Ryuhei Nishino, Wataru Koda
The following is a case report of moderately differentiated tubular adenocarcinoma of the stomach with widespread thrombosis of the portal vein, for which chemotherapy proved effective. A 75-year-old man presented to the clinic with a new onset ofmalaise. The patient had anemia, elevation ofliver and biliary enzymes, and significantly elevated CA19-9 levels at 43,581 U/mL and CEA levels at 2,560 ng/mL. An upper endoscopy revealed a mass lesion extending from the fundus to the pylorus as well as to the duodenum along the smaller curvature of the stomach...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28129955/-primary-infection-with-cytomegalovirus-an-infectious-cause-of-splenic-infarction
#8
H Kassem, K Khamadi, C Farrugia, N Ho Hio Hen, T El Gharbi, L Turner
INTRODUCTION: Cytomegalovirus-associated thrombosis has been extensively reported in the medical literature, mainly in immune-compromised patients. However, the association with splenic infarcts has rarely been reported. CASE REPORT: We report a 32-year-old Caucasian and immunocompetent woman who presented with a splenic infarction during a primary infection with CMV. The differential diagnostic ruled out embolic, hematologic, gastrointestinal and coagulation disorders...
January 24, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28123975/utility-of-cone-beam-computed-tomography-in-the-assessment-of-the-porto-spleno-mesenteric-venous-system
#9
REVIEW
Karunakaravel Karuppasamy
The common diagnostic tools available to evaluate the porto-spleno-mesenteric venous (PSMV) system provide either good hemodynamic information with limited morphological details [e.g., ultrasonography (US)] or excellent tomographic display of the anatomy with limited information about flow patterns [e.g., multidetector computed tomography (MDCT) and magnetic resonance imaging]. Although catheter-directed selective digital subtraction angiography (DSA) can provide excellent information about flow at a high temporal resolution and can generate images at a high spatial resolution, this technique is often limited by a lack of cross-sectional detail...
December 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28058472/partial-splenectomy-is-superior-to-total-splenectomy-for-selected-patients-with-hemangiomas-or-cysts
#10
Lei Wang, Jianwei Xu, Feng Li, Hanxiang Zhan, Han Liu, Wei Chen, Sanyuan Hu
BACKGROUND: The superiority of partial splenectomy (PS) as a treatment for benign tumors has not well been confirmed. This study aimed to identify the short- and long-term outcomes of PS, to compare laparoscopic and laparotomic PS, and to demonstrate whether the effects of PS are superior to that of total splenectomy (TS). METHODS: Patients with either a hemangioma or cyst who underwent PS or TS from 2009 to 2015 at Qilu Hospital of Shandong University were included...
January 5, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28035311/primary-splenic-lymphoma-current-diagnostic-trends
#11
EDITORIAL
Sachin B Ingle, Chitra R Hinge Ingle
The primary splenic lymphoma is extremely uncommon, can present with grave complications like hypersplenism and splenic rupture. In view of vague clinical presentation, it is difficult to arrive at the diagnosis. In such circumstances, histopathological diagnosis is very important. A precise diagnosis can only be made on histopathology and confirmed on immunohistochemistry.Emergency splenectomy is preferred as an effective therapeutic and diagnostic tool in cases with giant splenomegaly. Core biopsy is usually not advised due to a high risk of post-core biopsy complications in view of its high vascularity and fragility...
December 16, 2016: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28031667/progression-of-thrombus-in-portal-vein-superior-mesenteric-vein-and-splenic-vein-even-on-anticoagulation-in-a-patient-with-ascending-colonic-malignancy-with-liver-metastasis-portal-vein-thrombosis-versus-portal-vein-tumor-thrombosis
#12
Ashish Sule, Annamarie Borja, Tay Jam Chin
Portal vein thrombosis (PVT) in a setting of liver metastasis is not easy to treat as it may be portal vein tumor thrombus (PVTT). A 77-year-old male patient was diagnosed as ascending colon carcinoma, underwent right hemicolectomy in 1991 with a recurrence in July 2009. In August 2009, he underwent computed tomography (CT) scan of the abdomen which showed evidence of superior mesenteric vein thrombosis with no liver metastasis. He was started with anticoagulation and decision was to treat long term. He was admitted with mesenteric artery ischemic symptoms in February 2012 on anticoagulation...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27935897/-thrombosis-of-the-portal-upper-mesenteric-and-splenic-veins-in-a-patient-with-thrombophilia-a-clinical-case-report
#13
A E Shklyaev, I G Malakhova, A G Bessonov, I Yu Utkin
Currently there are several dozens of hereditarily associated thrombophilias and acquired states known to condition the development of a thrombus. Thrombosis of visceral veins appears to be a considerably less often encountered event than thrombosis in the system of visceral arteries. Presented herein in the article is a clinical case report concerning subacute thrombosis of the portal, upper mesenteric and splenic veins, having developed on the background of mutations of 7 genes of the system of haemostasis in a young adult patient...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27932170/living-donor-liver-transplantation-in-a-patient-with-extensive-portomesenteric-venous-thrombosis-case-report
#14
S Choi, K K Kim, W S Lee, J M Kang, Y H Park
Extensive portomesenteric venous thrombus preventing restoration of adequate portal venous flow used to be considered a contraindication to liver transplantation. The subject was a 49-year-old male with hepatitis B cirrhosis and extensive thrombosis of portal, splenic, and superior mesenteric veins, and two large collateral vessels; one dilated and tortuous inferior to the pancreaticoduodenal vein and relevant to splanchnic venous return and the other a dilated coronary vein relevant to splenic venous return...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932132/collateral-development-in-thrombosis-of-the-hepatic-artery-after-transplantation
#15
C M García Bernardo, B Argüelles García, P Redondo Buil, A Miyar de León, L González Dieguez, V Cadahía Rodrigo, I González-Pinto Arrillaga, L Vázquez Velasco
OBJECTIVES: The authors sought to identify strictures or hepatic artery obstruction with posterior collateral transformation in our series of liver transplantation, treatment, and evolution. The thrombosis or severe hepatic artery stenosis sometimes presents a compensation mechanism, the collateral transformation of the artery. MATERIAL AND METHODS: From April 2002 to December 2011 we collected 18 cases of collateral transformation. We analyzed data regarding the transplantation, diagnosis, treatment, clinical evolution, liver function, and Doppler-ultrasound...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27900976/multiple-visceral-venous-thromboses-associated-with-oral-contraceptive-use
#16
Kamel El-Reshaid, Shaikha Al-Bader, Hatem Sallam
Peripheral venous thromboembolism (VTE) is a known complication of oral contraceptive drugs (OCs), yet its association with visceral VTE is rarely reported. We describe a 21-year-old female patient who presented with sudden left loin pain. Plain computed tomography (CT) urography did not show kidney lesion but was suspicious of left renal vein thrombosis. Contrast study confirmed the diagnosis and also disclosed thrombosis of the splenic and left ovarian veins. The patient did not have a family history or laboratory evidence of hypercoagulable disorder...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27891150/splenic-artery-embolization-for-the-treatment-of-gastric-variceal-bleeding-secondary-to-splenic-vein-thrombosis-complicated-by-necrotizing-pancreatitis-report-of-a-case
#17
Hee Joon Kim, Eun Kyu Park, Young Hoe Hur, Yang Seok Koh, Chol Kyoon Cho
Splenic vein thrombosis is a relatively common finding in pancreatitis. Gastric variceal bleeding is a life-threatening complication of splenic vein thrombosis, resulting from increased blood flow to short gastric vein. Traditionally, splenectomy is considered the treatment of choice. However, surgery in necrotizing pancreatitis is dangerous, because of severe inflammation, adhesion, and bleeding tendency. In the Warshaw operation, gastric variceal bleeding is rare, even though splenic vein is resected. Because the splenic artery is also resected, blood flow to short gastric vein is not increased problematically...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27843428/a-rare-case-of-gastric-variceal-hemorrhage-secondary-to-infiltrative-b-cell-lymphoma
#18
Adrienne Lenhart, Juan Fernandez-Castillo, Keith Mullins, Reena Salgia
Portal hypertension commonly arises in the setting of advanced liver cirrhosis and is the consequence of increased resistance within the portal vasculature. Less commonly, left-sided noncirrhotic portal hypertension can develop in a patient secondary to isolated obstruction of the splenic vein. We present a rare case of left-sided portal hypertension and isolated gastric varices in a patient with large B-cell lymphoma, who was treated with splenic artery embolization. The patient is a 73-year-old male with no previous history of liver disease, who presented with coffee ground emesis and melena...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27836795/ultrasound%C3%A2-for%C3%A2-patients%C3%A2-in-a-high-hiv-tb-prevalence-setting-a%C3%A2-needs-assessment-and-review-of-focused-applications-for-sub-saharan-africa
#19
REVIEW
Tom Heller, Eric A Mtemang'ombe, Michaëla A M Huson, Charlotte C Heuvelings, Sabine Bélard, Saskia Janssen, Sam Phiri, Martin P Grobusch
Ultrasound is increasingly used in point-of-care applications and has great potential to support the diagnosis of infectious diseases, especially in resource-limited settings. We performed a cross-sectional study including 100 Malawian patients with a clinical indication for ultrasound and reviewed the literature on point-of-care ultrasound (POCUS) in Sub-Saharan Africa to establish its applicability, most frequent indications, findings, and implications for treatment, and therefore relevance in POCUS curricula, with a main focus on infectious diseases...
November 8, 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/27818226/primary-care-of-the-blunt-splenic-injured-adult
#20
REVIEW
Brian K Yorkgitis
The spleen is the most commonly injured abdominal organ in blunt trauma. Immediate treatment is aimed at assessing for bleeding and abating it when it is severe. Methods for the management of blunt splenic injury-associated bleeding include observation, splenectomy, and splenic salvage procedures through splenorrhaphy or embolization. After blunt splenic injury, complications commonly occur, including bleeding, infection, thrombosis, and pneumonia. If a patient undergoes splenectomy, infections can be severe...
November 4, 2016: American Journal of Medicine
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