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https://www.readbyqxmd.com/read/28643575/combined-rex-bypass-shunt-with-pericardial-devascularization-alleviated-prehepatic-portal-hypertension-caused-by-cavernomatous-transformation-of-portal-vein
#1
Ruo-Yi Wang, Jun-Feng Wang, Qian Liu, Nan Ma, Wei-Xiu Chen, Jin-Liang Li
OBJECTIVE: To evaluate the effects of combined Rex-bypass shunt and pericardial devascularization on prehepatic portal hypertension secondary to cavernomatous transformation of portal vein (CTPV). METHODS: Forty-two patients aged from 3 years to 49 years (divided into 3 groups), 26 cases male and 16 female, with prehepatic vascular hepertention were treated with Rex-bypass shunt combined with pericardial devascularization. In each patient, preoperative assessment included ultrasound and computed tomographic angiography of the portal vein and blood analysis...
June 23, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28639036/customization-of-laparoscopic-gastric-devascularization-and-splenectomy-for-gastric-varices-based-on-ct-vascular-anatomy
#2
Hirofumi Kawanaka, Tomohiko Akahoshi, Yoshihiro Nagao, Nao Kinjo, Daisuke Yoshida, Yoshihiro Matsumoto, Norifumi Harimoto, Shinji Itoh, Tomoharu Yoshizumi, Yoshihiko Maehara
BACKGROUND: Laparoscopic gastric devascularization(Lap GDS) and splenectomy (SPL) for gastric varices is technically challenging because of highly developed collateral vessels and bleeding tendency. We investigated the feasibility of customization of Lap GDS and SPL based on CT vascular anatomy. METHODS: We analyzed 61 cirrhotic patients with gastric varices who underwent Lap GDS and SPL between 2006 and 2014. Lap GDS was customized according to the afferent feeding veins (left gastric vein (LGV) and/or posterior gastric vein (PGV)/short gastric vein (SGV)) and efferent drainage veins (gastrorenal shunt and/or gastrophrenic shunt, or numerous retroperitoneal veins) based on CT imaging...
June 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28637548/pancreatic-pseudocyst-induced-gastric-varices-a-rare-case-of-extrahepatic-portal-hypertension
#3
Neal Cooper, Jason D Sciarretta, Ayolola Onayemi, John Davis
No abstract text is available yet for this article.
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28632135/evaluation-of-the-branched-chain-amino-acid-to-tyrosine-ratio-prior-to-treatment-as-a-prognostic-predictor-in-patients-with-liver-cirrhosis
#4
Toru Ishikawa, Michitaka Imai, Masayoshi Ko, Hiroki Sato, Yujiro Nozawa, Tomoe Sano, Akito Iwanaga, Keiichi Seki, Terasu Honma, Toshiaki Yoshida
This study evaluated whether the branched-chain amino acid-to-tyrosine ratio (BTR) is a prognostic predictive factor in patients with liver cirrhosis by determining the relationship of the BTR with event-free survival in a retrospective, observational cohort study. The medical records of patients with liver cirrhosis who visited our institution from February 2000 to May 2012 were examined. Events due to liver cirrhosis were defined as death, worsening of esophageal and/or gastric varices, hepatocellular carcinoma, and liver failure...
June 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/28629642/splenic-vein-reconstruction-is-unnecessary-in-pancreatoduodenectomy-combined-with-resection-of-the-superior-mesenteric-vein-portal-vein-confluence-according-to-short-term-outcomes
#5
Haruyoshi Tanaka, Akimasa Nakao, Kenji Oshima, Kiyotsugu Iede, Yukiko Oshima, Hironobu Kobayashi, Yasunori Kimura
BACKGROUND: Superior mesenteric vein-portal vein confluence resection combined with pancreatoduodenectomy (SMPVrPD) is occasionally required for resection of pancreatic head tumors. It remains unclear whether such situations require splenic vein (SV) reconstruction for decompression of left-sided portal hypertension (LSPH). METHODS: The data from 93 of 104 patients who underwent pancreatoduodenectomy (PD) for pancreatic head malignancies were reviewed. Surgical outcomes in three groups-standard PD (control group), PD combined with vascular resection and SV preservation (SVp group), and SMPVrPD with SV resection (SVr group)-were compared...
June 16, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28612224/extrahepatic-portal-venous-obstruction-what-should-be-the-mainstay-of-treatment
#6
Richa Lal, Moinak Sen Sarma, Manish K Gupta
The two cornerstones of management for Extrahepatic portal vein obstruction (EHPVO) are endotherapy and surgery [Porto-systemic shunts (PSS)/Mesorex bypass (MRB)]. Endotherapy is the mainstay of treatment for acute variceal bleed control and has also been used extensively for secondary prophylaxis till variceal eradication is achieved. However, long-term follow-up beyond endoscopic eradication of esophageal varices (EEEV) indicates that there are numerous delayed bleed and non bleed sequelae of EHPVO, which merit surgery as a definitive procedure to decompress the hypertensive portal venous system...
June 14, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28553915/-oesophageal-vascular-ectasia-in-a-patient-with-anaemia
#7
Vera Crone, Lasse Bremholm
This case report describes the findings of oesophageal vascular ectasia (OVE) in a patient with known gastric antral vascular ectasia, who presented with anaemia. OVE is a very rare endoscopic finding and therefore a diagnostic challenge. An 85-year-old male was admitted due to anaemia. He went through a gastroscopic examination where severe OVE changes were seen, along with newfound oesophageal varices. There was no need for treating the OVE, but the findings coupled with the knowledge of the varices led to the diagnosis of portal thrombosis...
May 22, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28533996/gastric-varices-in-absence-of-splenic-vein-thrombosis-a-rare-entity-of-idiopathic-non-cirrhotic-portal-hypertension
#8
Vivek Choksi, Binna Chokshi, Andrew Chu, Deepa Mandale, Daniel L Wolfson, Steven Kaplan, Hamid Feiz
Idiopathic non-cirrhotic portal hypertension (INCPH) is portal hypertension (PHT) without cirrhosis and other identifiable causes. Esophageal and gastric varices are seen in INCPH which are mostly asymptomatic. We present a rare case of symptomatic isolated gastric varices (IGV) in the setting of INCPH. We report a case of a 60-year-old man who presented with an acute onset of hematemesis and no identifiable history. Upon further evaluation, he was found to have non-bleeding dilated gastric varices on esophagogastroduodenoscopy (EGD) and PHT without cirrhosis...
April 19, 2017: Curēus
https://www.readbyqxmd.com/read/28530783/a-rare-case-of-obscure-gastrointestinal-bleeding-small-bowel-varices-flowing-into-the-inferior-epigastric-vein
#9
Akira Hoshiai, Junya Tsurukiri, Yasuhiro Sumi
Ectopic varices include all varices except esophageal or gastric varices and comprise large portosystemic venous collaterals that occur anywhere in the abdomen. Ectopic varices are relatively rare; however, approximately 5% are related to gastrointestinal bleeding. Ectopic varices usually occur in the rectum, duodenum, or colon, and portal hypertension is the most common cause. Hemodynamic profiles of ectopic varices remain unknown, and extensive bleeding from these structures occurs because diagnosis and treatment are difficult...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28523485/report-of-mesocaval-shunt-in-the-management-of-variceal-hemorrhage-following-gastric-bypass-surgery
#10
Anurag Shrimal, Ranjan Sudan, Gaurav Chaubal, Ahmad Zaaroura, Kitza Williams, Kadiyala Ravindra
Gastrointestinal bleeding following Roux-en- Y gastric bypass (RYGB) is rare. We report an unusual cause of upper gastrointestinal bleeding following RYGB that was complicated by porto- splenic vein thrombosis. A 35- year- old woman was successfully treated by mesocaval surgical shunt for recurrent variceal hemorrhage in the excluded stomach following RYGB.
May 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28515596/balloon-occluded-retrograde-transvenous-obliteration-for-bleeding-gastric-varices-eyes-see-what-the-mind-knows
#11
Pushpinder S Khera, Lee Myungsu, Choi Joonsung
Approximately one in six patients with portal hypertension who develop varices at sites of portosystemic venous collaterals has gastric varices due to hepatofugal flow into the gastric veins. Bleeding from gastric varices, though less common, has a higher mortality and morbidity compared to bleeding esophageal varices, which are easier to manage endoscopically. The efferent channel for gastric varices is mostly the gastrorenal shunt (GRS) which opens into the left renal vein. Balloon-occluded transvenous obliteration (BRTO) involves accessing the GRS with an aim to temporarily occlude its outflow using a balloon catheter and at the same time injecting sclerosant mixture within the varix so as to cause its thrombosis and thereby obliteration...
January 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28503308/portal-hypertension-as-the-initial-manifestation-of-poems-syndrome-a-case-report
#12
Lina Wu, Yue Li, Fang Yao, Chongmei Lu, Jian Li, Weixun Zhou, Jiaming Qian
BACKGROUND: Portal hypertension has a broad differential diagnosis. POEMS syndrome is an uncommon cause of it. POEMS syndrome is a rare disease involving multiple organs. In differential diagnosis of portal hypertension, POEMS syndrome should be considered especially when other symptoms such as numbness, organomegaly, endocrine alteration and skin changes also present, as it is highlighted by our case. CASE PRESENTATION: We report a 46-year-old Chinese male, a teacher, presenting with portal hypertension...
2017: BMC Hematology
https://www.readbyqxmd.com/read/28501975/changes-in-liver-perfusion-and-function-before-and-after-percutaneous-occlusion-of-spontaneous-portosystemic-shunt
#13
Yasukazu Kako, Koichiro Yamakado, Wataru Jomoto, Toshiya Nasada, Koichiro Asada, Haruyuki Takaki, Kaoru Kobayashi, Takashi Daimon, Shozo Hirota
PURPOSE: To evaluate changes in liver perfusion after occlusion of spontaneous portosystemic shunt and to analyze mechanisms of liver profile improvement. MATERIALS AND METHODS: Liver function changes and portal venous and hepatic arterial blood flow were evaluated using perfusion CT before and after shunt occlusion in 23 patients who underwent percutaneous occlusion of spontaneous portosystemic shunt because of gastric varices (n = 15) or hepatic encephalopathy (n = 8)...
May 13, 2017: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/28494001/partial-spleen-embolization-reduces-the-risk-of-portal-hypertension-induced-upper-gastrointestinal-bleeding-in-patients-not-eligible-for-tips-implantation
#14
Matthias Buechter, Alisan Kahraman, Paul Manka, Guido Gerken, Alexander Dechêne, Ali Canbay, Axel Wetter, Lale Umutlu, Jens M Theysohn
INTRODUCTION: Upper gastrointestinal bleeding (UGIB) is a severe and life-threatening complication among patients with portal hypertension (PH). Covered transjugular intrahepatic portosystemic shunt (TIPS) is the treatment of choice for patients with refractory or recurrent UGIB despite pharmacological and endoscopic therapy. In some patients, TIPS implantation is not possible due to co-morbidity or vascular disorders. Spleen embolization (SE) may be a promising alternative in this setting...
2017: PloS One
https://www.readbyqxmd.com/read/28491877/nodular-regenerative-hyperplasia-a-case-of-rare-prognosis
#15
Mindy Lee, Manhal Izzy, Ashwin Akki, Kathryn Tanaka, Harmit Kalia
Introduction: Nodular regenerative hyperplasia (NRH) is a known etiology of noncirrhotic portal hypertension. Cases of biopsy-proven NRH in human immunodeficiency virus (HIV)-positive patients have been described. While these patients often have normal synthetic liver function, several reports described disease progression to liver failure. Case: We here present a 26-year-old woman with history of congenital HIV on antiretroviral therapy complicated by Pneumocystis carinii pneumonia at age 14. CD4 counts have been >300 with undetectable viral load...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28483304/short-term-safety-and-efficacy-of-balloon-occluded-retrograde-transvenous-obliteration-using-ethanolamine-oleate-results-of-a-prospective-multicenter-single-arm-trial
#16
Masao Kobayakawa, Shigehiro Kokubu, Shozo Hirota, Jun Koizumi, Norifumi Nishida, Taku Yasumoto, Satoshi Mochida, Hisashi Hidaka, Noriko Tanaka, Tsuyoshi Tajima
PURPOSE: To evaluate 90-day outcomes after balloon-occluded retrograde transvenous obliteration (BRTO) with ethanolamine oleate (EO) in patients with gastric varices (GVs). MATERIALS AND METHODS: An 8-site prospective single-arm clinical trial was conducted. Patients who had endoscopically confirmed GVs with a gastrorenal shunt were eligible for the study. Overnight BRTO was performed, and efficacy was evaluated by endoscopy and contrast-enhanced computed tomography (CT)...
May 5, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28482406/-a-prognostic-analysis-of-cirrhotic-esophageal-variceal-bleeding-treated-with-standardized-endoscopic-therapy
#17
Y P Dai, Q Gao
Objective: To analyze the clinical effect of standardized endoscopic esophageal variceal ligation alone or in combination with tissue adhesive injection for gastric varices (GV) after the first cirrhotic esophageal variceal bleeding. Methods: A total of 97 patients who underwent a successful endoscopic therapy in our hospital due to the first cirrhotic esophageal variceal bleeding were enrolled, and according to the subsequent therapeutic regimen, they were divided into control group (48 patients) and treatment group (49 patients)...
March 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28471827/management-of-different-types-of-gastric-varices-with-band-ligation-a-3-year-experience
#18
Waseem M Seleem, Amr S Hanafy
BACKGROUND AND AIM: Gastric varices (GVs) occur with an incidence of 20% in patients with portal hypertension. The aim of this study was to evaluate the efficacy of endoscopic band ligation (BL) as an option in the management of small-to-moderate nonbleeding GVs in cirrhotic patients. PATIENTS AND METHODS: A total of 50 patients (GOV2; n=6, IGV1; n=34, IGV2; n=10) with nonbleeding small-to-moderate-sized GVs without local risk signs of bleeding, such as large size, red-colored elevated areas or red wales, and systemic factors of bleeding risk such as an international normalized ratio of at least 2 and a platelet count of 80 000/µl or less were subjected to endoscopic BL...
May 3, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28458309/isolated-gastric-varices-refractory-to-balloon-occluded-retrograde-transvenous-obliteration-brto-successfully-treated-by-shunt-occluded-endoscopic-injection-sclerotherapy-so-eis-a-case-report-and-review-of-the-literature
#19
Takeshi Hatanaka, Satoru Kakizaki, Yuhei Suzuki, Takashi Ueno, Yasushi Shimada, Daichi Takizawa, Kenji Katakai, Ken Sato, Motoyasu Kusano, Masanobu Yamada
Balloon-occluded retrograde transvenous obliteration (BRTO) is widely used to treat isolated gastric varices (IGVs) in Japan. However, BRTO is difficult to perform for IGVs with many small collateral veins, and no secondary treatment has been established. We herein report a rare case of IGVs refractory to BRTO successfully treated by shunt-occluded endoscopic injection sclerotherapy (SO-EIS), which is a combination therapy of major shunt occlusion by a balloon catheter and endoscopic injection sclerotherapy...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28445299/endoscopic-ultrasonography-predicts-early-esophageal-variceal-bleeding-in-liver-cirrhosis-a-case-report
#20
Changjun Men, Guoliang Zhang
RATIONALE: Bleeding esophageal and gastric varices constitute a serious complication in liver cirrhosis. Previous studies have shown that endoscopic ultrasonography (EUS) can be used to predict early esophageal variceal bleeding in liver cirrhosis. PATIENT CONCERNS: We report a case of a 46-year-old man with hepatitis B liver cirrhosis (CTP score, 5; Child-Pugh class, A) who was admitted to our hospital due to a decreased appetite lasting 1 week. DIAGNOSIS: He was initially diagnosed with decompensated hepatitis B cirrhosis; an abdominal computed tomography (CT) scan indicated a diagnosis of liver cirrhosis and portal hypertension (PHT)...
April 2017: Medicine (Baltimore)
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