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Pancreatitis and thrombosis

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https://www.readbyqxmd.com/read/28719059/pancreatic-allograft-thrombosis-suggestion-for-a-ct-grading-system-and-management-algorithm
#1
Abdul Hakeem, John Chen, Satheesh Iype, Menna Clatworthy, Christopher Watson, Edmund M Godfrey, Sara Upponi, Kourosh Saeb-Parsy
Pancreatic allograft thrombosis (PAT) remains the leading cause of non-immunological graft failure. Herein we propose a new CT grading system of PAT to identify risk factors for allograft loss and outline a management algorithm by retrospective review of consecutive pancreatic transplants between 2009-2014. Triple-phase CT scans were graded independently by two radiologists as; Grade 0 - no thrombosis, Grade 1 - peripheral thrombosis, Grade 2 - intermediate non-occlusive thrombosis and Grade 3 - central occlusive thrombosis...
July 18, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28696022/outcomes-in-pancreas-transplantation-with-exocrine-drainage-through-a-duodenoduodenostomy-versus-duodenojejunostomy
#2
J P Lindahl, R Horneland, E Nordheim, A Hartmann, E M Aandahl, K Grzyb, H Haugaa, G Kjøsen, A Åsberg, T Jenssen
Until recently, pancreas transplantation has mostly been performed with exocrine drainage via duodenojejunostomy (DJ). Since 2012, DJ was substituted with duodenoduodenostomy (DD) in our hospital, allowing endoscopic access for biopsies. This study assessed safety profiles with DD versus DJ procedures, and clinical outcomes with the DD technique in pancreas transplantation. DD patients (n=117; 62 simultaneous pancreas and kidney [SPKDD ] and 55 pancreas transplantation alone [PTADD ] with median follow-up 2...
July 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28688877/splenic-and-pancreatic-abscesses-associated-with-in-situ-thrombosis-of-splenic-artery
#3
Yu Lun, Jiang Han, Shijie Xin, Jian Zhang
Splenic infarction is rare and occurs when the splenic artery or its branches become occluded, either by an embolus or by in situ thrombosis. In situ thrombosis of splenic artery leading to splenic and pancreatic abscess formation after infarction is rare. We here present a case of a 65-year old man who was found to have acute complete splenic and distal pancreatic infarction and abscess formation attributable to in situ thrombosis of splenic artery.
July 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28688516/pancreas-transplantation-advantages-of-a-retroperitoneal-graft-position
#4
Joana Ferrer, Víctor Molina, Ramón Rull, Miguel Ángel López-Boado, Santiago Sánchez, Rocío García, Ma José Ricart, Pedro Ventura-Aguiar, Ángeles García-Criado, Enric Esmatjes, Josep Fuster, Juan Carlos Garcia-Valdecasas
INTRODUCTION: In the 50 years since the first pancreas transplant performed at the University of Minnesota, the surgical techniques employed have undergone many modifications. Techniques such as retroperitoneal graft placement have further improved the ability to reproduce the physiology of the «native» pancreas. We herein present our experience of a modified technique for pancreatic transplant, with the organ placed into a fully retroperitoneal position with systemic venous and enteric drainage of the graft by duodeno-duodenostomy...
July 5, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28682910/nonfunctional-pancreatic-neuroendocrine-tumor-masked-as-anemia-a-case-report
#5
Baojin Xu, Yue Wang, Xiaoyan Li, Jie Lin
After a series of clinical relevant examinations. The patient was dignosed as pancreatic tomor in the pancreatic tail accompanied with the symptom of anenmia and dizziness.Until now surgery is the best treatment strategy for pancreatic tumors.So we take a joint multiple organ removal surgery.Before surgery, the main concerns of patient is whether the operation can relieve the anemia-related symptoms and improve the quality of life.The patient was dignosed as nonfunctional pancreatic neuroendocrine tumor.A joint multiple organ removal surgery including pancreaticbody and tail, spleen, part of the stomach wall, left adrenal gland,and portal splenic vein thrombosis and lymphadenectomy were performed on this patient...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28677005/tumor-thrombosis-a-peculiar-finding-associated-with-pancreatic-neuroendocrine-neoplasms-a-pictorial-essay
#6
REVIEW
Riccardo De Robertis, Salvatore Paiella, Nicolò Cardobi, Luca Landoni, Paolo Tinazzi Martini, Silvia Ortolani, Giulia De Marchi, Stefano Gobbo, Alessandro Giardino, Giovanni Butturini, Giampaolo Tortora, Claudio Bassi, Mirko D'Onofrio
While abutment, encasement or vessel occlusion are identified in most patients with a pancreatic tumor, tumor thrombosis is an uncommon finding. In particular, there are no description in the literature of tumor thrombosis associated with ductal adenocarcinoma, the most common pancreatic tumor. On the other hand, surgical series reveal that tumor thrombosis is associated with about 5% of pancreatic neuroendocrine neoplasms (PanNENs), and literature data suggest that this finding is frequently underreported on pre-operative imaging examinations...
July 4, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28634524/a-rare-case-of-pylephlebitis-after-colonic-polypectomy
#7
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
#8
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...
August 2017: Insights Into Imaging
https://www.readbyqxmd.com/read/28615140/imaging-features-of-myeloproliferative-neoplasms
#9
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
#10
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
#11
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
#12
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...
July 4, 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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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