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Portal venous thrombosis

Marc Heincelman, Nithin Karakala, Don C Rockey
Acute lymphoblastic leukemia (ALL) in adults is a relatively rare malignancy. The typical presentation includes signs and symptoms associated with bone marrow failure, including fevers, infections, fatigue, and excessive bruising. In this article, we report an unusual systemic presentation of ALL in a previously healthy 18-year-old man. He initially presented with several-day history of nausea and vomiting, 10-pound weight loss, and right upper quadrant abdominal pain with evidence of acute hepatocellular liver injury (elevations in aspartate aminotransferase/alanine aminotransferase) and elevation in serum creatinine...
July 2016: Journal of Investigative Medicine High Impact Case Reports
Fuat H Saner, Carmen Kirchner
BACKGROUND: Patients with end-stage liver disease (ESLD) are assumed to be at high risk of bleeding when undergoing any kind of invasive intervention (any kind of operation, including transplantation or minimally invasive interventions). Both bleeding and thrombosis are associated with a poor outcome. METHODS: A selective literature research was conducted with the following key words: 'cirrhosis', 'coagulation', 'bleeding', 'INR' (international normalized ratio), 'aPTT' (activated partial thromboplastin time), and 'thrombocytopenia'...
August 2016: Visc Med
Mauricio Millan, Luis A Caicedo, Jorge I Villegas, Oscar Serrano, Liliana Caicedo, Mauricio Duque, Laura S Thomas, Gabriel J Echeverri
INTRODUCTION: One of the frequent complications suffered by patients with chronic renal failure is the lack of vascular access due to venous thrombosis. This means that the transplant surgeon must have a detailed knowledge of the intra-abdominal venous system, and other alternative surgeries, at the time of performing the renal graft implant, in order to ensure a good venous drainage. PRESENTATION OF THE CASE: This article provides a case report regarding a patient with no vascular access and with surgical difficulties at the time of the kidney transplant, in whom a renal-portal venous drainage was performed with very good outcome...
September 30, 2016: International Journal of Surgery Case Reports
Wentao Gao, Xinglong Dai, Cuncai Dai, Kuirong Jiang, Junli Wu, Qiang Li, Feng Guo, Jianmin Chen, Jishu Wei, Zipeng Lu, Min Tu, Yi Miao
INTRODUCTION: Few studies have compared patency rates of the different methods of venous reconstruction (VR) during a pancreatectomy. This study aimed to evaluate the patency rates and the clinical impact of various reconstruction methods. METHODS: For the meta-analysis, databases were systematically searched to identify studies reporting the outcomes of patients who underwent PVR/SMVR. For the retrospective study, clinical data were retrospectively analyzed from patients who underwent a pancreatectomy and VR between Feb...
September 20, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Isabel Macías
Portal hypertension is a clinical syndrome defined as a portal venous pressure that exceeds 10mmHg. Cirrhosis is the most common cause of portal hypertension and thrombosis of the splenoportal axis not associated with liver cirrhosis is the second cause of portal hypertension in the Western world. The primary myeloproliferative disorders are the main cause of portal venous thrombosis and somatic mutation of Janus Kinase 2 gene (JAK2 V617F) can be found in approximately 90% of polycythemia vera, 50% of essential thrombocyrosis and 50% primary myelofibrosis...
August 13, 2016: International Journal of Surgery Case Reports
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
Francesco Violi, Gino Roberto Corazza, Stephen Hugh Caldwell, Francesco Perticone, Angelo Gatta, Mario Angelico, Alessio Farcomeni, Michela Masotti, Laura Napoleone, Annarita Vestri, Valeria Raparelli, Stefania Basili
No abstract text is available yet for this article.
September 23, 2016: Internal and Emergency Medicine
Guoyong Chen, Sidong Wei, Zhongwu Zou, Jianjun Sun, Gaofeng Tang, Jianbin Chen, Shaotang Zhou
BACKGROUND: Liver transplantation (LT) accompanied by jejunectomy to treat patients with acute or chronic hepatic cirrhosis with thrombosis in the portal system is extremely rare. CASE PRESENTATION: A 47-year-old man presented with hematemesis and melena, and a diagnosis of decompensated cirrhosis, chronic portal vein thrombosis (PVT) and secondary gastro-esophageal variceal hemorrhage was made. Coagulants were administered, but portal vein thrombi occurred rapidly, and gastrointestinal bleeding recurred shortly thereafter...
2016: BMC Surgery
Minjung Shim, Tae Young Yang, Nam Gil Cho, Ara Woo, Eunju Kim, Keunhoi Park, Joo Ho Lee, Yun Bin Lee, Seong Gyu Hwang, Kyu Sung Rim, Hana Park
Portal vein thrombosis (PVT) is a form of venous thrombosis that usually presents in chronic form without any sequalae in patients with hepatocellular carcinoma (HCC) or liver cirrhosis. Accurate differential diagnosis of bland PVT from neoplastic PVT is an important step for planning treatment options, but the acute form can be challenging. Here we present a case of acute hepatic infarction caused by acute bland PVT combined with pylephlebitis, which was misdiagnosed as infiltrative hepatic malignancy with neoplastic PVT owing to the perplexing imaging results and elevated tumor markers...
September 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Sheila N Blumberg, Thomas S Maldonado
OBJECTIVE: This review explores the current literature on the natural history, diagnosis, and management of mesenteric venous thrombosis (MVT) in the modern era. METHODS: A review of the contemporary literature from 1997 to 2016 on MVT and its pathogenesis, diagnosis, and treatment was performed. RESULTS: MVT is an insidious and lethal disease associated with acute mesenteric ischemia. The prevalence of MVT has increased sharply during the past two decades commensurate with an increase in radiographic imaging for abdominal complaints...
October 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Thomas S Maldonado, Sheila N Blumberg, Sharvil U Sheth, Gabriel Perreault, Mikel Sadek, Todd Berland, Mark A Adelman, Caron B Rockman
BACKGROUND: Mesenteric venous thrombosis (MVT) is a relatively uncommon but potentially lethal condition associated with bowel ischemia and infarction. The natural history and long-term outcomes are poorly understood and under-reported. METHODS: A single-institution retrospective review of noncirrhotic patients diagnosed with MVT from 1999 to 2015 was performed using International Classification of Diseases, Ninth Revision and radiology codes. Patients were excluded if no radiographic imaging was available for review...
October 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Praveer Rai, Pankaj Kumar, Swapnil Mishra, Rakesh Aggarwal
BACKGROUND: Hepatic venous outflow tract obstruction (HVOTO) and extrahepatic portal venous obstruction (EHPVO) are important causes of portal hypertension and related complications in India. Both these conditions result from splanchnic venous thrombosis. In recent years, a V617F somatic mutation in Janus kinase 2 (JAK2) gene which is highly specific for myeloproliferative disorders has been detected in 40 % to 50 % and 30 % to 35 % of Western patients with HVOTO and EHPVO, respectively...
September 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
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
Nalini Bansal, Chhagan Bihari
Protein C deficiency is a well recognized risk factor for development of venous thromboembolism but has never been reported to be associated with development of liver cirrhosis .We report a case of a 26 years old female who presented with multiple thrombosis involving superior mesenteric vein ,main portal vein and multiple cerebral veins. Liver biopsy done was reported as cirrhosis possibly due to Wilson's disease. However no improvement was seen with D penicillamine and patient's condition detiorated. Further, work up of patient revealed absence of Protein C levels in the plasma...
July 2016: Indian Journal of Pathology & Microbiology
Ujjwal Gorsi, Pankaj Gupta, Naveen Kalra, Mandeep Kang, Rajinder Singh, Rajesh Gupta, Vikas Gupta, Niranjan Khandelwal
OBJECTIVE: To evaluate the role of multidetector computed tomography (CT) and CT angiography (CTA) in post cholecystectomy complications. METHODS: A retrospective analysis of data from December 2012 to August 2014 was performed. Eight hundred sixty consecutive patients with history of cholecystectomy (laparoscopic or open) were evaluated. After exclusion of 645 patients with normal imaging, analysis for post cholecystectomy complications was performed in 215 patients...
October 2015: Tropical Gastroenterology: Official Journal of the Digestive Diseases Foundation
Rodrigo Canellas, Farhad Mehrkhani, Manuel Patino, Avinash Kambadakone, Dushyant Sahani
OBJECTIVE: The purpose of this study was to investigate the role of CT texture analysis and thrombus density (measured in Hounsfield units) in distinguishing between neoplastic and bland portal vein thrombosis (PVT) on portal venous phase CT. MATERIALS AND METHODS: In this retrospective study, 117 contrast-enhanced CT studies of 109 patients were included for characterization of PVT. Assessment of PVT was performed by estimation of CT textural features using CT texture analysis software and measurement of attenuation values...
August 4, 2016: AJR. American Journal of Roentgenology
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
Xingshun Qi, Guohong Han, Chun Ye, Yongguo Zhang, Junna Dai, Ying Peng, Han Deng, Jing Li, Feifei Hou, Zheng Ning, Jiancheng Zhao, Xintong Zhang, Ran Wang, Xiaozhong Guo
BACKGROUND Portal venous system thrombosis (PVST) is a life-threatening complication of liver cirrhosis. We conducted a retrospective study to comprehensively analyze the prevalence and risk factors of PVST in liver cirrhosis. MATERIAL AND METHODS All cirrhotic patients without malignancy admitted between June 2012 and December 2013 were eligible if they underwent contrast-enhanced CT or MRI scans. Independent predictors of PVST in liver cirrhosis were calculated in multivariate analyses. Subgroup analyses were performed according to the severity of PVST (any PVST, main portal vein [MPV] thrombosis >50%, and clinically significant PVST) and splenectomy...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
E Tas, S Atlanoglu, K T Onbasi, B Tas, A O Harmanci
Hypotension, hypoxia or hypotension and hypoxia together may proceed to ischaemic hepatitis; hypotension is often as a result of cardiovascular diseases. Ischaemic hepatitis not due to cirrhotic process or malignancy but due to acute thrombosis of the portal venous system is rare. In this article, we present a case of acute ischaemic hepatitis due to an acute thrombus developing after a ketoacidosis coma which was thought to have triggered this event. Other reasons which could be have triggered this event, such as a thrombophilia and cirrhosis or malignancy, were excluded...
December 16, 2015: West Indian Medical Journal
Mustapha A El Lakis, Agostino Pozzi, Jad Chamieh, Bassem Safadi
BACKGROUND: Portomesenteric vein thrombosis following laparoscopic bariatric surgical procedures is a serious and potentially lethal complication. It is quite rare, and its clinical presentation, management, and sequelae remain poorly understood. METHODS: We searched PubMed, Medline, Google Scholar, Ovid, and Cochrane databases for articles reporting case series and systematic reviews in the English language on patients who underwent laparoscopic bariatric surgery and had a subsequent portal or mesenteric vein thrombosis...
July 7, 2016: Surgical Endoscopy
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