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Pancreatitis and thrombosis

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https://www.readbyqxmd.com/read/28634524/a-rare-case-of-pylephlebitis-after-colonic-polypectomy
#1
Salik Nazir, Asad Jehangir, Anam Siddiqui, Niranjan Tachamo, Saroj Lohani, Eugene York
Pylephlebitis or infective suppurative thrombosis of the portal mesenteric venous system is an uncommon condition that can potentially be deadly if not recognized and treated early. Although most commonly associated with pancreatitis and diverticulitis, any intra-abdominal or pelvic infection occurring in the region drained by the portal venous system can cause this rare entity. We report a case of a 75-year-old woman who developed post polypectomy pylephlebitis following colonoscopy, a condition rarely reported in the literature...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28631148/early-postoperative-imaging-after-non-bariatric-gastric-resection-a-primer-for-radiologists
#2
REVIEW
Massimo Tonolini, Elena Bracchi
Surgical resection represents the mainstay treatment and only potentially curative option for gastric carcinoma, and is increasingly performed laparoscopically. Furthermore, other tumours and selected cases of non-malignant disorders of the stomach may require partial or total gastrectomy. Often performed in elderly patients, gastric resection remains a challenging procedure, with significant morbidity (14-43% complication rate) and non-negligible postoperative mortality (approximately 3%). This paper provides an overview of contemporary surgical techniques for non-bariatric gastric resection, reviews and illustrates the expected postoperative imaging appearances, common and unusual complications after partial and total gastrectomy...
June 19, 2017: Insights Into Imaging
https://www.readbyqxmd.com/read/28615140/imaging-features-of-myeloproliferative-neoplasms
#3
REVIEW
I G Murphy, E L Mitchell, L Raso-Barnett, A L Godfrey, E M Godfrey
Myeloproliferative neoplasms (MPNs) are a heterogeneous group of haematological disorders including polycythaemia vera (PV), essential thrombocythaemia (ET), primary myelofibrosis (PMF), and chronic myeloid leukaemia (CML). These disorders show large overlap in genetic and clinical presentations, and can have many different imaging manifestations. Unusual thromboses, embolic events throughout the systemic or pulmonary vasculature, or osseous findings can often be clues to the underlying disease. There is limited literature about the imaging features of these disorders, and this may result in under-diagnosis...
June 11, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28585779/the-impact-of-initial-cancer-stage-on-the-incidence-of-venous-thromboembolism-the-scandinavian-thrombosis-and-cancer-stac-cohort
#4
I L Gade, S K Braekkan, I A Naess, J-B Hansenx, S C Cannegieter, K Overvad, H Jensvoll, J Hammerstrøm, K Blix, A Tjønneland, S R Kristensen, M T Severinsen
BACKGROUND: Absolute measures of the impact of cancer stage on the incidence of venous thromboembolism (VTE) in distinct cancer types have not been investigated in a large population based cohort study. OBJECTIVES: To investigate differences in incidence rates of objectively confirmed VTE according to development of cancer in a large population based cohort study. Cancer type and stage at the time of diagnosis was taken into account. PATIENTS AND METHODS: The Scandinavian Thrombosis and Cancer cohort includes data regarding cancer types, stages and objectively confirmed VTE diagnoses among 144,952 participants followed from 1993 through 2012...
June 6, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28578318/recurrent-brain-ischaemia-and-deep-vein-thrombosis-the-clot-thickens
#5
David Turner, Marie Scully, Sheldon Stone, David J Werring
A 65-year-old man presented with two transient ischaemic attacks, and was then found to have a deep vein thrombosis. He later had recurrent ischaemic strokes. After thorough investigation, the only cause we identified was a previously undiagnosed metastatic pancreatic cancer. We describe the assessment of this presentation and discuss the causes and management of cancer-related stroke.
June 3, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28574850/whole-exome-sequencing-identified-genetic-risk-factors-for-asparaginase-related-complications-in-childhood-all-patients
#6
Rachid Abaji, Vincent Gagné, Chang Jiang Xu, Jean-François Spinella, Francesco Ceppi, Caroline Laverdière, Jean-Marie Leclerc, Stephen E Sallan, Donna Neuberg, Jeffery L Kutok, Lewis B Silverman, Daniel Sinnett, Maja Krajinovic
Allergy, pancreatitis and thrombosis are common side-effects of childhood acute lymphoblastic leukemia (ALL) treatment that are associated with the use of asparaginase (ASNase), a key component in most ALL treatment protocols. Starting with predicted functional germline variants obtained through whole-exome sequencing (WES) data of the Quebec childhood ALL cohort we performed exome-wide association studies with ASNase-related toxicities. A subset of top-ranking variants was further confirmed by genotyping (N=302) followed by validation in an independent replication group (N=282); except for thrombosis which was not available for that dataset...
May 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/28567456/surgery-for-intractable-pain-in-a-patient-with-chronic-pancreatitis-complicated-with-biliary-obstruction-portal-vein-stenosis-and-mesenteric-venous-collaterals
#7
Cuneyt Kayaalp, Murat Sait Dogan, Veysel Ersan
Pancreatic head resection for chronic pancreatitis is a challenging procedure, in the presence of venous collaterals, cavernous transformation, extensive fibrosis or porto-mesenteric stenosis or thrombosis. We present a surgically treated patient for the intractable pain of chronic pancreatitis. Complications with biliary obstruction and portal vein stenosis/thrombosis resulted in cavernous transformation. A pancreaticoduodenectomy combined with portal vein resection was intended in a 51 year-old male, but the procedure was terminated due to the high risk associated with intraoperative bleeding...
May 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28468602/salvage-of-pancreas-transplant-after-successful-splenic-artery-thrombectomy
#8
Pierpaolo Di Cocco, Sham Dholakia, Nadey S Hakim
Primary nonfunction due to thrombosis after pancreas transplant is still the leading cause of nonimmunologic graft failure. Early identification of pancreatic graft arterial thrombus and prompt surgical intervention are effective for rescue of graft perfusion and its associated complications. Here, we report a case of successful surgical thrombectomy of the splenic artery, with particular emphasis on clinical presentation, diagnosis, and surgical technique.
May 4, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28457384/liver-retransplantation-for-hepatic-abscess-due-to-hepatic-artery-thrombosis-a-case-report
#9
G Zanus, M Romano, M Finotti, E Dalla Bona, D Sgarabotto, D Bassi, C Mescoli, P Angeli, P Burra, E Gringeri, A Vitale, F D'Amico, P Feltracco, U Cillo
INTRODUCTION: Hepatic artery thrombosis (HAT) is a well-recognized complication of liver transplantation (LT). HAT is an important risk factor for infectious, in particular hepatic abscess, which can cause graft loss and increasing morbidity and mortality. CASE REPORT: We present a case report of complicated LT in a 52-year-old Caucasian man with primary sclerosing cholangitis. In 2007 the patient was included on the waiting list in Padua for LT. In 2012 the patient underwent percutaneous transhepatic biliary drainage for bile duct stricture, complicated with acute pancreatitis...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28440015/hypertriglyceridemia-during-asparaginase-treatment-in-children-with-acute-lymphoblastic-leukemia-correlates-with-antithrombin-activity-in-adolescents
#10
Lisa Persson, Arja Harila-Saari, Ida Hed Myrberg, Mats Heyman, Anna Nilsson, Susanna Ranta
BACKGROUND: Asparaginase (ASP) is a cornerstone in the treatment of acute lymphoblastic leukemia (ALL). It is also known for its ability to cause side effects, such as allergy and pancreatitis, as well as lipid and coagulation disturbances. The most important laboratory abnormalities are hypertriglyceridemia (HTG) and low antithrombin (AT). HTG is usually considered to be transient and benign in children with ALL, whereas low AT activity predisposes to thrombosis. Studies on the incidence and significance of HTG in children with ALL are scarce, and their findings have not always been congruent...
April 25, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28421699/hepatic-infarction-from-portal-vein-thrombosis-a-fatal-consequence-of-acute-pancreatitis
#11
Somak Das, Sudeepta Kumar Swain, Anand Ramamurthy
Acute pancreatitis is potentially fatal and in its severe form is often associated with pancreatic necrosis and higher mortality. The inflammatory response causes peripancreatic and pancreatic necrosis, and in severe cases results in multiple organ damage through vascular insult either in form of arterial spasm, arterial thrombosis or splanchnic thrombosis [1].
April 19, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28413438/a-case-report-of-brief-psychotic-disorder-with-catalepsy-associated-with-sequential-life-threatening-events-in-a-patient-with-advanced-cancer
#12
Mayumi Ishida, Satoshi Kawada, Hideki Onishi
BACKGROUND: Cancer is commonly perceived as life-threatening and universally stressful; however, brief psychotic disorder, which occurs in response to extremely stressful events, has not been reported. CASE PRESENTATION: A 63-year-old woman, who was diagnosed as having pancreatic cancer with liver metastasis, became unresponsive with very little reaction to verbal contact after sequential life-threatening events, such as thrombosis of both pulmonary arteries and stenosis of the third portion of the duodenum, due to disease progression over 3 weeks beginning with oncological emergency hospital admission...
2017: BioPsychoSocial Medicine
https://www.readbyqxmd.com/read/28407511/clinical-and-cross-sectional-imaging-features-of-spontaneous-pancreatic-pseudocyst-portal-vein-fistula
#13
Francesco Alessandrino, Corinne Strickland, Amirkasra Mojtahed, Steven C Eberhardt, Koenraad J Mortele
PURPOSE: To evaluate clinical and imaging features of pancreatic pseudocyst-portal vein fistula (PPVF). METHODS: Patients with evidence of PPVF on CT/MRI were included. Clinical presentation, outcomes, imaging appearance of the portal vein were recorded. RESULTS: 75% of patients developed portal hypertension, 62% cavernous transformation of the portal vein and 25% portal biliopathy. PPVF presented on CT as fluid-attenuated portal vein, and on MRI as T2-weighted hyperintense fluid-filled portal vein...
July 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28368336/serum-concentrations-of-angiopoietin-2-and-soluble-fms-like-tyrosine-kinase-1-sflt-1-are-associated-with-coagulopathy-among-patients-with-acute-pancreatitis
#14
Paulina Dumnicka, Beata Kuśnierz-Cabala, Mateusz Sporek, Małgorzata Mazur-Laskowska, Krzysztof Gil, Marek Kuźniewski, Piotr Ceranowicz, Zygmunt Warzecha, Artur Dembiński, Joanna Bonior, Ryszard Drożdż
In severe acute pancreatitis (SAP), systemic inflammation leads to endothelial dysfunction and activation of coagulation. Thrombotic disorders in acute pancreatitis (AP) include disseminated intravascular coagulation (DIC). Recently, angiopoietin-2 and soluble fms-like tyrosine kinase 1 (sFlt-1) were proposed as markers of endothelial dysfunction in acute states. Our aim was to assess the frequency of coagulation abnormalities in the early phase of AP and evaluate the relationships between serum angiopoietin-2 and sFlt-1 and severity of coagulopathy...
April 2, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28355969/incidence-of-asparaginase-related-hepatotoxicity-pancreatitis-and-thrombotic-events-in-adults-with-acute-lymphoblastic-leukemia-treated-with-a-pediatric-inspired-regimen
#15
Trevor N Christ, Wendy Stock, Randall W Knoebel
Asparaginase is a critical component of acute lymphoblastic leukemia (ALL) treatment in children; however, its use in adults is often avoided as a result of toxicities including hepatotoxicity, thrombosis, and pancreatitis which have been reported more commonly in adults than in children. In this retrospective analysis, short-acting L-asparaginase (L-ASP) and long-acting polyethylene glycol (PEG)-asparaginase (PEG-ASP) were compared for grade 3-4 toxicities and characterized by patient and drug-related factors to identify strategies for toxicity avoidance in adults with ALL...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28353569/case-report-and-systematic-literature-review-of-a-novel-etiology-of-sinistral-portal-hypertension-presenting-with-ugi-bleeding-left-gastric-artery-pseudoaneurysm-compressing-the-splenic-vein-treated-by-embolization-of-the-pseudoaneurysm
#16
REVIEW
Seifeldin Hakim, Jared Bortman, Molly Orosey, Mitchell S Cappell
INTRODUCTION: A novel case is reported of upper gastrointestinal (UGI) bleeding from sinistral portal hypertension, caused by a left gastric artery (LGA) pseudoaneurysm (PA) compressing the splenic vein (SV) that was successfully treated with PA embolization. CASE REPORT: A 41-year-old man with previous medical history of recurrent, alcoholic pancreatitis presented with several episodes of hematemesis and abdominal pain for 48 hours. Physical examination revealed a soft abdomen, with no abdominal bruit, no pulsatile abdominal mass, and no stigmata of chronic liver disease...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28350292/rescue-arterial-revascularization-using-cryopreserved-iliac-artery-allograft-in-liver-transplant-patients
#17
Kayvan Mohkam, Benjamin Darnis, Agnès Rode, Nathalie Hetsch, Gregorio Balbo, Jean-Paul Bourgeot, Salim Mezoughi, Hassan Demian, Christian Ducerf, Jean-Yves Mabrut
OBJECTIVES: Management of hepatic arterial complications after liver transplant remains challenging. The aim of our study was to assess the efficacy of rescue arterial revascularization using cryopreserved iliac artery allografts in this setting. MATERIALS AND METHODS: Medical records of patients with liver transplants who underwent rescue arterial revascularization using cryopreserved iliac artery allografts at a single institution were reviewed. RESULTS: From 1992 to 2015, 7 patients underwent rescue arterial revascularization using cryopreserved iliac artery allografts for hepatic artery pseudoaneurysm (3 patients), thrombosis (2 patients), aneurysm (1 patient), or stenosis (1 patient)...
March 28, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28348475/giant-intrahepatic-portal-vein-aneurysm-leave-it-or-treat-it
#18
Amit Shrivastava, Jagdeesh S Rampal, D Nageshwar Reddy
Portal vein aneurysm (PVA) is a rare vascular dilatation of the portal vein. It is a rare vascular anomaly representing less than 3% of all visceral aneurysms and is not well understood. Usually, PVA are incidental findings, are asymptomatic, and clinical symptoms are proportionally related to size. Patients present with nonspecific epigastric pain or gastrointestinal bleeding with underlying portal hypertension. PVA may be associated with various complications such as biliary tract compression, portal vein thrombosis/rupture, duodenal compression, gastrointestinal bleeding, and inferior vena cava obstruction...
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28341510/endovascular-stenting-of-portal-vein-for-graft-rescue-after-a-pancreas-transplant-venous-graft-thrombosis-a-case-report
#19
Ossama M Reslan, Jordan M Kirsch, Hitesh Kaul, Stalin Campos, Radi Zaki, Paul S Brady, Kamran Khanmoradi
Venous thrombosis of pancreas transplant allografts often leads to graft loss. It is an worrisome complication and difficult to treat, forming the most common nonimmunological cause of graft loss. Multiple risk factors have been implicated in the development of venous thrombosis of pancreas transplant. Color Doppler ultrasonography enables early diagnosis of venous thrombosis, thus increasing the possibility of graft-rescue treatments. Endovascular management of pancreatic transplant vascular complications is scant and in the form of case reports...
March 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28331334/safety-efficacy-and-clinical-utility-of-asparaginase-in-the-treatment-of-adult-patients-with-acute-lymphoblastic-leukemia
#20
REVIEW
Jamie Koprivnikar, James McCloskey, Stefan Faderl
Adults with acute lymphoblastic leukemia (ALL) are known to have inferior outcomes compared to the pediatric population. Although the reasons for this are likely manyfold, the agents utilized and the increased intensity of pediatric treatments compared to adult treatments are likely significant contributing factors. Asparaginase, an enzyme that converts asparagine to aspartic acid, forms the backbone of almost all pediatric regimens and works by depleting extracellular asparagine, which ALL cells are unable to synthesize...
2017: OncoTargets and Therapy
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