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Portal venous thrombosis

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https://www.readbyqxmd.com/read/28932502/ultrasound-guided-direct-intrahepatic-portosystemic-shunt-in-patients-with-budd-chiari-syndrome-short-and-long-term-results
#1
Adam Hatzidakis, Nikolaos Galanakis, Elias Kehagias, Dimitrios Samonakis, Mairi Koulentaki, Erminia Matrella, Dimitrios Tsetis
BACKGROUND AND AIMS: Budd-Chiari syndrome (BCS) is treated with anticoagulation therapy, transjugular intrahepatic portosystemic shunt (TIPS), angioplasty, and liver transplantation. TIPS is not always technically feasible, due to the complete hepatic venous thrombosis. Direct intrahepatic portosystemic shunt (DIPS) is an alternative method for decompression of portal hypertension. This is a retrospective, single-center study aiming to evaluate the outcome of ultrasound (US)-guided DIPS in patients with BCS...
June 2017: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28929091/thrombosis-of-the-abdominal-veins-in-childhood
#2
REVIEW
Riten Kumar, Bryce A Kerlin
Abdominal venous thrombosis is a rare form of venous thromboembolic disease in children. While mortality rates are low, a significant proportion of affected children may suffer long-term morbidity. Additionally, given the infrequency of these thrombi, there is lack of stringent research data and evidence-based treatment guidelines. Nonetheless, pediatric hematologists and other subspecialists are likely to encounter these problems in practice. This review is therefore intended to provide a useful guide on the clinical diagnosis and management of children with these rare forms of venous thromboembolic disease...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28883536/techniques-and-long-term-effects-of-transjugular-intrahepatic-portosystemic-shunt-on-liver-cirrhosis-related-thrombotic-total-occlusion-of-main-portal-vein
#3
Lei Wang, Fuliang He, Zhendong Yue, Hongwei Zhao, Zhenhua Fan, Mengfei Zhao, Bin Qiu, Jiannan Yao, Qiushi Lin, Xiaoqun Dong, Fuquan Liu
Portal vein hypertension (PVH) in liver cirrhosis complicated with portal venous thrombosis (PVT) has been mainly treated with transjugular intrahepatic portosystemic shunt (TIPS). The clinical effects of TIPS have been confirmed, however, no large-scale studies have been focused on technical analyses and a long-term follow-up, especially on thrombotic total occlusion of main portal vein (MPV). To demonstrate critical techniques and clinical outcome of TIPS on liver cirrhosis-related thrombotic total occlusion of MPV, 98 patients diagnosed with liver cirrhosis related thrombotic total occlusion of MPV and treated with TIPS from January 2000 to January 2010 were retrospectively analyzed...
September 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28828527/pancreaticoduodenectomy-with-venous-resection-and-reconstruction-current-surgical-techniques-and-associated-postoperative-imaging-findings
#4
Ammar A Javed, Karen Bleich, Fabio Bagante, Jin He, Matthew J Weiss, Christopher L Wolfgang, Elliot K Fishman
PURPOSE: Introduction of effective neoadjuvant therapy for pancreas cancer has resulted in complex and aggressive operations involving vasculature resection. This results in complicated postoperative CT appearance of vasculature, which in addition to high rate of recurrence makes interpretation of imaging difficult. The aim of this study was to identify patterns of postoperative appearance of portal vein-superior mesenteric vein complex (PV-SMV). METHODS: A retrospective study was conducted on patients undergoing pancreaticoduodenectomy with PV-SMV resection and reconstruction (PVR) between 2004 and 2014...
August 21, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28818214/treatment-outcomes-and-risk-factors-for-bowel-infarction-in-patients-with-acute-superior-mesenteric-venous-thrombosis
#5
Hyung-Kee Kim, Deokbi Hwang, Sujin Park, Jong-Min Lee, Seung Huh
OBJECTIVE: The prognosis of acute superior mesenteric venous thrombosis (SMVT) remains obscure. We aimed to investigate the treatment outcomes and possible risk factors for bowel infarction in these patients. METHODS: We retrospectively included 66 patients with acute SMVT between January 2002 and June 2016. Each patient underwent contrast-enhanced computed tomography as part of the initial diagnosis. The standard protocol for management included a nonsurgical approach with early anticoagulation and selective exploration...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28808782/thromboembolic-events-following-splenectomy-risk-factors-prevention-management-and-outcomes
#6
Amihai Rottenstreich, Geffen Kleinstern, Galia Spectre, Nael Da'as, Esther Ziv, Yosef Kalish
BACKGROUND: Thromboembolic events following splenectomy are not uncommon. However, the role of thromboprophylaxis and risk factors for thrombosis, as well as the clinical course and outcomes, are not well characterized. METHODS: A retrospective review of individuals who underwent splenectomy between January 2006 and December 2015 in two university hospitals. RESULTS: Overall, 297 patients underwent splenectomy [open splenectomy (n = 199), laparoscopic splenectomy (n = 98)]...
August 14, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28764227/portal-venous-thrombosis-disseminated-tuberculosis-in-rheumatoid-arthritis
#7
Vasanthi Natarajan, Kevin John, David Jose, Pradeep Kalaiselvan, Ashok Kumar Das
Vascular thrombosis is one of the complications of tuberculosis. Deep vein thrombosis and pulmonary thrombosis have been reported with pulmonary and extrapulmonary tuberculosis. Splenic involvement in abdominal tuberculosis is among the rarest manifestations. Disseminated tuberculosis is predominantly reported in rheumatoid arthritis following ingestion of biological agents. Here, we report a case of disseminated tuberculosis in a rheumatoid arthritis patient who was on steroids and methotrexate for a long period, presenting with multiple splenic lesion and portal vein thrombosis, which was not reported earlier...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28741138/trans-splenic-access-for-portal-venous-interventions-in-children-do-benefits-outweigh-risks
#8
Sheena Pimpalwar, Ponraj Chinnadurai, Alberto Hernandez, Kamlesh Kukreja, Shakeel Siddiqui, Henri Justino
BACKGROUND: The primary concern of trans-splenic access for portal interventions is the risk of life-threatening intraperitoneal bleeding. OBJECTIVE: To review the clinical indications and efficacy and evaluate the risk factors for intraperitoneal bleeding during trans-splenic portal interventions in children. MATERIALS AND METHODS: A retrospective review of consecutive patients who underwent trans-splenic portal interventions at a tertiary care pediatric institution between March 2011 and April 2017 was performed...
July 24, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28719059/pancreatic-allograft-thrombosis-suggestion-for-a-ct-grading-system-and-management-algorithm
#9
A Hakeem, J Chen, S Iype, M R Clatworthy, C J E Watson, E M Godfrey, S Upponi, K Saeb-Parsy
Pancreatic allograft thrombosis (PAT) remains the leading cause of nonimmunologic graft failure. Here, we propose a new computed tomography (CT) grading system of PAT to identify risk factors for allograft loss and outline a management algorithm by retrospective review of consecutive pancreatic transplantations between 2009 and 2014. Triple-phase CT scans were graded independently by 2 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/28718265/haemoglobinuria-and-portal-venous-thrombosis-in-a-young-male
#10
Zain Ul Abideen, Munnam Sohail Jafar, Nasir Hameed, Ahmad Malik
Paroxysmal nocturnal haemoglobinuria is a non-malignant stem cell disorder due to acquired somatic mutations in cell surface anchored proteins CD55 and CD59. Both have a compliment inhibitory role and their deficiency leads to intravascular haemolysis. This paper reports a challenging case of a 25 years old male who presented with generalized weakness, exertional dyspnoea and episodic early morning haematuria. Recently, he started developing progressive abdominal distention and dull generalized abdominal pain...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28707821/splenic-vein-thrombosis-following-pancreas-transplantation-identification-of-factors-that-support-conservative-management
#11
J W Harbell, T Morgan, V A Feldstein, G R Roll, A Posselt, S-M Kang, S Feng, R Hirose, C E Freise, P Stock
Prophylaxis for graft portal/splenic venous thrombosis following pancreas transplant varies between institutions. Similarly, treatment of venous thrombosis ranges from early re-exploration to conservative management with anticoagulation. We wished to determine the prevalence of graft splenic vein (SV) thrombosis, as well as the clinical significance of non-occlusive thrombus observed on routine imaging. Records of 112 pancreas transplant recipients over a 5-year period at a single center were reviewed. Venous thrombosis was defined as absence of flow or presence of thrombus identified in any part of the graft SV on ultrasound...
July 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28694570/extrahepatic-portal-vein-obstruction-in-children-role-of-preoperative-imaging
#12
Shashidhar Achar, Hemonta Kumar Dutta, Rudra Kanta Gogoi
AIM: Extrahepatic portal vein obstruction (EHPVO) is characterized by features of recent thrombosis or portal hypertension with portal cavernoma as a sequel of portal vein obstruction. Imaging of spleno-portal axis is the mainstay for the diagnosis of EHPVO. The aim of this study is to analyze the role of imaging in the preoperative assessment of the portal venous system in children with EHPVO. MATERIALS AND METHODS: A hospital-based cross-sectional study was conducted on twenty children with EHPVO aged between 1 and 18 years over a period of 1 year...
July 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28685257/budd-chiari-syndrome-hepatic-venous-outflow-tract-obstruction
#13
REVIEW
Dominique-Charles Valla
BACKGROUND: Budd-Chiari syndrome (BCS) is a rare disease characterized by hepatic venous outflow tract obstruction (HVOTO). METHODS: Recent literature has been analyzed for this narrative review. RESULTS: Primary BCS/HVOTO is a result of thrombosis. The same patient often has multiple risk factors for venous thrombosis and most have at least one. Presentation and etiology may differ between Western and certain Eastern countries. Myeloproliferative neoplasms are present in 40% of patients and are usually associated with the V617F-JAK2 mutation in myeloid cells, in particular peripheral blood granulocytes...
July 6, 2017: Hepatology International
https://www.readbyqxmd.com/read/28673473/clinical-manifestations-and-imaging-tools-in-the-diagnosis-of-splanchnic-and-cerebral-vein-thromboses
#14
Nicoletta Riva, Walter Ageno
Splanchnic vein thrombosis (SVT) and cerebral vein thrombosis (CVT) are uncommon manifestation of venous thromboembolism (VTE), occurring less frequently than deep vein thrombosis of the lower extremities and pulmonary embolism. SVT encompasses portal vein thrombosis, mesenteric vein thrombosis, splenic vein thrombosis and the Budd-Chiari syndrome. It is therefore a heterogeneous disease, with differences in clinical manifestations according to the site of thrombosis. CVT includes thrombosis of the cortical or deep cerebral veins and thrombosis of the major dural venous sinuses...
June 27, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28650573/factors-associated-with-thromboembolic-events-following-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy
#15
Amihai Rottenstreich, Yosef Kalish, Geffen Kleinstern, Almog Ben Yaacov, Joseph Dux, Aviram Nissan
BACKGROUND AND OBJECTIVES: We investigated the risk factors, incidence, and role of thromboprophylaxis in the development of thrombosis following cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). METHODS: We reviewed data of patients with CRS/HIPEC in three hospitals. RESULTS: Overall, 192 patients underwent CRS/HIPEC during 2007-2016. Mechanical (thigh-length pneumatic compression stockings) and pharmacologic thromboprophylaxis (40 mg enoxaparin daily, starting 12 h before surgery until discharge) was provided for all patients; and 116 (60...
June 26, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28634524/a-rare-case-of-pylephlebitis-after-colonic-polypectomy
#16
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/28597681/mesenteric-portal-axis-thrombosis-and-deep-venous-thrombosis-in-a-patient-with-inferior-vena-cava-agenesis
#17
Laia Lluis Pons, Nadia Chahri Vizcarro, Silvia Llaverias Borrell, Carlos Miquel Abbad
Splenoportal axis thrombosis not associated with cirrhosis or neoplasms has a prevalence lower than 5 per 10,000 people. An etiologic factor responsible for portal thrombosis is finally identified in most cases, usually systemic thrombogenic factors or predisposing local factors. However, despite a detailed study of all etiologic factors, up to 30% of cases are eventually considered as idiopathic in origin. We report the case of a 41-year-old patient who presented with abdominal pain and lower extremity edema...
June 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28594784/retrospective-study-to-compare-selective-decongestive-devascularization-and-gastrosplenic-shunt-versus-splenectomy-with-pericardial-devascularization-for-the-treatment-of-patients-with-esophagogastric-varices-due-to-cirrhotic-portal-hypertension
#18
Haili Bao, Qikuan He, Ninggao Dai, Ruifan Ye, Qiyu Zhang
BACKGROUND For patients with esophagogastric varices secondary to portal hypertension due to liver cirrhosis, portosystemic shunts and devascularization have become the most commonly used treatment methods. We have developed a novel surgical approach for the treatment of patients with cirrhotic portal hypertension, selective decongestive devascularization, and shunt of the gastrosplenic region (SDDS-GSR). This aim of this study was to compare the efficacy and safety of SDDS-GSR with splenectomy with pericardial devascularization (SPD)...
June 8, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28593007/case-report-acute-portal-vein-thrombosis-associated-with-acute-cytomegalovirus-infection-in-an-immunocompetent-adult
#19
Fania Puccia, Vania Lombardo, Lydia Giannitrapani, Anna Licata, Giovanni Mazzola, Maurizio Soresi
Cytomegalovirus (CMV) infection is usually asymptomatic and self-limiting in healthy individuals, but significant complications can develop in immunosuppressed patients. Venous or arterial thromboembolic phenomena are uncommon yet very serious complications of CMV infection. Most published reports describe immunosuppressed patients, but thrombotic events in CMV-infected immunocompetent individuals may also occur. We describe the case of an immunocompetent young man with acute CMV hepatitis that was complicated with portal vein thrombosis (PVT)...
June 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28583558/successful-treatment-of-a-patient-with-diffuse-portosplenomesenteric-thrombosis-using-a-pericholedochal-varix-for-portal-flow-reconstruction-during-deceased-donor-liver-transplantation-a-case-report
#20
Y-D Yu, D-S Kim, J-H Han, Y-I Yoon
Portal vein thrombosis remains a challenging issue in liver transplantation. When thrombectomy is not feasible due to diffuse portosplenomesenteric thrombosis, other modalities are adapted such as the use of a jump graft or portal tributaries or even multivisceral transplantation. For patients with diffuse thrombosis of the splanchnic venous system, a large pericholedochal varix can be a useful vessel for providing splanchnic blood flow to the graft and for relieving portal hypertension. We report our experience of successfully treating a patient with diffuse portosplenomesenteric thrombosis using a pericholedochal varix for portal flow reconstruction during deceased donor liver transplantation and eventually preventing unnecessary multivisceral transplantation...
June 2017: Transplantation Proceedings
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