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Splenic thrombosis

Giulio Illuminati, Francesco G Calio', Giulia Pizzardi, Chiara Amatucci, Federica Masci, Piergaspare Palumbo
INTRODUCTION: Intra and perioperative anticoagulation in patients with heparin induced thrombocytopenia (HIT), candidates for peripheral vascular surgery remains a challenge, as the best alternative to heparin has not yet been established. We evaluated the off-label use of fondaparinux in four patients with HIT, undergoing peripheral vascular surgery procedures. PRESENTATION OF CASES: Four patients of whom 3 men of a mean age of 66 years, with proven heparin induced thrombocytopenia (HIT) underwent two axillo-femoral bypasses, one femoro-popliteal bypass and one resection of a splenic artery aneurysm under fondaparinux...
October 8, 2016: International Journal of Surgery Case Reports
Adam Joseph Rudinsky, Valerie Jill Parker, Julien Guillaumin
A 6-year-old Labrador retriever dog was presented for acute abdominal pain. A tentative diagnosis of mesenteric thrombosis was established antemortem. The dog was treated with supportive care and anti-coagulation but was ultimately euthanized due to disease-related complications. Necropsy examination confirmed an acute mesenteric thrombus along with widespread thromboembolic disease. Potential causes were protein-losing nephropathy, hepatopathy, and/or corticosteroid administration.
October 2016: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
Vojko Flis, Stojan Potrc, Nina Kobilica, Arpad Ivanecz
BACKGROUND: Recent reports have shown that patients with vascular tumour invasion who undergo concurrent vascular resection can achieve long-term survival rates equivalent to those without vascular involvement requiring pancreaticoduodenectomy alone. There is no consensus about which patients benefit from the portal-superior mesenteric vein resection and there is no consensus about the best surgical technique of vessel reconstruction (resection with or without graft reconstruction). As published series are small the aim of this study was to evaluate our experience in pancreatectomies with en bloc vascular resection and reconstruction of vessels...
September 1, 2016: Radiology and Oncology
A Bouvier, M Gout, S Audia, C Chalumeau, P Rat, O Deballon
BACKGROUND: Portal and/or splenic vein thrombosis (PSVT) is common after splenectomy. It can be a life-threatening complication, with a risk of bowel ischemia and portal hypertension. An early diagnosis allows an effective medical treatment and prevents life-threatening complications. There is no consensus regarding the benefit of systematic screening of patients after splenectomy for PSVT. We started in January 2012 a routine screening of PSVT after elective splenectomy. The aim of this study was to assess this policy...
September 14, 2016: La Revue de Médecine Interne
Jaime Ruiz-Tovar, Pablo Priego
The portal vein is formed by the confluence of the splenic and superior mesenteric veins, which drain the spleen and small intestine respectively. Occlusion of the portal vein by thrombus typically occurs in patients with cirrhosis and/or prothrombotic disorders. However, portal vein thrombosis (PVT) can also happen after determined surgeries. Moreover, PVT can have serious consequences depending on the location and extent of the thrombosis, including hepatic ischemia, intestinal ischemia, portal hypertension… In this chapter, we will review the incidence, management and prophylaxis of PVT after splenectomy, pancreas transplantation, pancreatic surgery and in the setting of acute and chronic pancreatitis...
September 17, 2016: Advances in Experimental Medicine and Biology
Jason T Salsamendi, Francisco J Gortes, Michelle Shnayder, Mehul H Doshi, Ji Fan, Govindarajan Narayanan
Portal vein thrombosis (PVT) is a potential complication of cirrhosis and can worsen outcomes after liver transplant (LT). Portal vein reconstruction-transjugular intrahepatic portosystemic shunt (PVR-TIPS) can restore flow through the portal vein (PV) and facilitate LT by avoiding complex vascular conduits. We present a case of transsplenic PVR-TIPS in the setting of complete PVT and splenic vein (SV) thrombosis. The patient had a 3-year history of PVT complicated by abdominal pain, ascites, and paraesophageal varices...
September 2016: Radiology case reports
Muhammad W Saif, Kristin Kaley, Lynne Lamb
Pancreatic cancer is known for vague symptoms that lead to a delay in diagnosis, and hence most cases are found at an advanced stage. Many complications can happen secondary to pancreatic cancer including diabetes, malabsorption, and deep venous thrombosis. Sinistral (segmental or left-sided) portal hypertension (SPH) refers to portal hypertension confined to the left-sided segment of the portal venous system namely the splenic side, and the most common etiology is splenic vein thrombosis (SVT). We present here a case of a 66-year-old male with advanced pancreatic cancer who died due to bleeding secondary to SVT...
2016: Curēus
Moinuddin Ahmed, Muhammad Usman Aziz, Muhammad Ayub Mansoor, Saleha Anwar
OBJECTIVE: To record the incidence of vascular complications in cases of acute pancreatitis. METHODS: This retrospective, cross-sectional study was performed at the Liaquat National Hospital, Karachi, from October 31, 2012 to October 31, 2014, and comprised computerised records and computerised tomography scan images related to cases of pancreatitis. RESULTS: Of the 210 patients included, 97(46.19%) were men and 113(53.81%) were women. A total of 24(11...
August 2016: JPMA. the Journal of the Pakistan Medical Association
Ziqing Yu, Bing Fan, Hongyi Wu, Xiangfei Wang, Chenguang Li, Rende Xu, Yangang Su, Junbo Ge
BACKGROUND: Systemic embolism, especially septic embolism, is a severe complication of infective endocarditis (IE). However, concurrent embolism to the brain, coronary arteries, and spleen is very rare. Because of the risk of hemorrhage or visceral rupture, anticoagulants are recommended only if an indication is present, e.g. prosthetic valve. Antiplatelet therapy in IE is controversial, but theoretically, this therapy has the potential to prevent and treat thrombosis and embolism in IE...
August 11, 2016: BMC Infectious Diseases
Kenichiro Uchida, Mitsuharu Hosono, Toshihiko Shibata, Daisuke Kaku, Tomonori Yamamoto, Takafumi Terada, Naoki Shinyama, Yasumitsu Mizobata
BACKGROUND: Mobile intra-aortic thrombus without atherosclerosis, aneurysm, or congenital coagulopathy is very rare, and there are few reports especially in young or middle-aged patients. Furthermore, there are presently no established guidelines or common strategies for the treatment of mobile intra-aortic thrombus. In this case report, we describe the first case of intra-aortic thrombus caused by secondary erythrocytosis and describe the recommended treatment strategy for intra-aortic thrombus...
2016: Journal of Medical Case Reports
E Warchol-Celinska, K Hanus, P Talarowska, E Florczak, K Jozwik-Plebanek, M Januszewicz, I Michalowska, A Prejbisz, W Wojcik, H Janaszek-Sitkowska, M Makowiecka-Ciesla, L Stryczynski, M Protasiewicz, L Swiatlowski, A Niemirska, M Litwitn, T Przewlocki, M Szczerbo-Trojanowska, A Tykarski, A Januszewicz
OBJECTIVE: To present preliminary evaluation of vascular bed involvement and vascular complications in patients with fibromuscular dysplasia (FMD) enrolled to ARCADIA-POL registry. DESIGN AND METHOD: The first 84 patients (59F[70.2%], 25M[29.8%], mean age: 42.5 ± 14.8 years, range:18-72) with confirmed FMD in any vascular bed were enrolled in 2015 in ARCADIA-POL registry (instituted on the basis of as Polish-French collaboration). A standardized FMD data form was used for data collection...
September 2016: Journal of Hypertension
Seiichiro Shishido, Takeshi Kawamura, Yuko Hamasaki, Yusuke Takahashi, Yoshihiro Itabashi, Masaki Muramatsu, Hiroyuki Satoh, Atsushi Aikawa
BACKGROUND: Children with a compromised inferior vena cava (IVC) were previously considered unsuitable for kidney transplantation because of the technical difficulties and the increased risk of graft thrombosis secondary to inadequate renal venous outflow. METHODS: We conducted a retrospective study of 11 transplants in 9 patients with end-stage renal disease and thrombosed IVCs who received adult kidney allografts between 2000 and 2015. The mean age at transplantation was 7...
June 2016: Transplantation Direct
Ahmet Can Topcu, Ufuk Ciloglu, Ahmet Bolukcu, Sabri Dagsali
Traumatic aortic rupture is rupture of all or part of the aortic wall, mostly resulting from blunt trauma to the chest. The most common site of rupture is the aortic isthmus. Traumatic rupture of the ascending aorta is rare. A 62-year-old man with a family history of ascending aortic aneurysm was referred to our hospital after a motor vehicle accident. He had symptoms of cardiogenic shock. A contrast-enhanced computed tomographic scan revealed rupture of the proximal ascending aorta and an ascending aortic aneurysm with a diameter of 55 mm at the level of the sinuses of Valsalva...
August 2016: Annals of Thoracic Surgery
Amihai Rottenstreich, Ram Elazary, Yosef Kalish
BACKGROUND: Thrombotic events involving the portal-splenic-mesenteric venous system (PSMVT) are rare but potentially lethal after bariatric surgery. OBJECTIVES: To investigate the incidence, clinical presentation, management, and outcome of thrombotic events after bariatric surgery. SETTING: Two university hospitals. METHODS: A retrospective review of individuals who underwent bariatric surgery between January 2006 and December 2015...
May 12, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Shoufei Jiao, Hongxing Chen, Youlong Wang, Jiye Zhu, Jingwang Tan, Jie Gao
Background. Both splenectomy (SP) and partial splenic embolization (PSE) are used to treat massive splenomegaly (MSM) secondary to hepatitis B-related liver cirrhosis (HB-LC). This retrospective case-control study was conducted to compare the effects of SP and PSE on these patients. Methods. From July 2004 to January 2012, patients with MSM secondary to HB-LC who underwent SP or PSE were 1 : 1 : 1 matched with similar nonsurgery patients, respectively. Intraoperative situation, hematological indices, liver function, HBV DNA level, HBeAg seroconversion rate, morbidity, and mortality at 6 months postoperatively were compared...
2016: Gastroenterology Research and Practice
James Maurice, Edgar Brodkin, Frances Arnold, Annalan Navaratnam, Heidi Paine, Sabrina Khawar, Ameet Dhar, David Patch, James O'Beirne, Raj Mookerjee, Massimo Pinzani, Emmanouil Tsochatzis, Rachel H Westbrook
BACKGROUND: The Baveno VI guidelines propose that cirrhotic patients with a liver stiffness measurement (LSM) <20kPa and a platelet count >150000/μL can avoid screening endoscopy as their combination is highly specific for excluding clinically significant varices. The aim of the study was to validate these criteria. METHODS: Transient elastography data was collected from two institutions from 2006-2015. Inclusion criteria were a LSM ⩾10kPa and an upper gastrointestinal endoscopy within 12 months, with a diagnosis of compensated chronic liver disease...
July 4, 2016: Journal of Hepatology
Osman Koç, Kadir Acar, Orhan Özbek, İbrahim Güler, Kadir Sarıtaş, Tuba Bera Erdem, Yalçın Solak, Hatice Toy, Ahmet Küçükapan, Seda Özbek, Abduzhappar Gaipov, İbrahim C Haznedaroğlu
PURPOSE: Splenic artery embolization is a minimally invasive therapeutic procedure utilized in a number of disorders. Ankaferd blood stopper (ABS) is a novel hemostatic agent with a new mechanism of action independent of clotting factors. We aimed to investigate the safety and efficiency of ABS for splenic artery embolization in a sheep model. METHODS: Seven adult female sheep were included in the study. Selective celiac angiography was performed using a 5F diagnostic catheter and then a 2...
July 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
Qiao Zhou, Chirag Shah, Jean-Michel Arthus, Harlan Vingan, John Agola
We present the case of a 59-year-old man with atraumatic splenic rupture because of splenic vein thrombosis who was successfully treated with splenic artery embolization.
June 2016: Radiology case reports
Takana Yamakawa Hayashi, Izuru Matsuda, Kazuchika Hagiwara, Tomoko Takayanagi, Akifumi Hagiwara
We report a case of splenic infarction in a patient with sickle cell traits (SCT), focusing on the computed tomography (CT) findings. The patient was an African-American man in his twenties with no past medical history who experienced sudden left upper quadrant pain while climbing a mountain (over 3000 m above sea level). Dynamic contrast-enhanced CT revealed massive non-segmental splenic infarction accompanied with nodule-like preserved splenic tissue. The region of splenic infarction did not coincide with the arterial vascular territory and differed from the features of infarction caused by large arterial embolism...
September 2016: Abdominal Radiology
Andrew C Storm, Christopher C Thompson
AIM: To determine the feasibility and safety of transgastric direct endoscopic necrosectomy (DEN) in patients with walled-off necrosis (WON) and gastric varices. METHODS: A single center retrospective study of consecutive DEN for WON was performed from 2012 to 2015. All DEN cases with gastric fundal varices noted on endoscopy, computed tomography (CT) or magnetic resonance imaging (MRI) during the admission for DEN were collected for analysis. In all cases, external urethral sphincter (EUS) with doppler was used to exclude the presence of intervening gastric varices or other vascular structures prior to 19 gauge fine-needle aspiration (FNA) needle access into the cavity...
May 25, 2016: World Journal of Gastrointestinal Endoscopy
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