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Splenic vein thrombosis

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https://www.readbyqxmd.com/read/29306522/visceral-thromboses-in-pancreas-adenocarcinoma-systematic-review
#1
REVIEW
Angel Mier Hicks, Antonio DeRosa, Michael Raj, Richard Do, Kenneth H Yu, Maeve A Lowery, Anna Varghese, Eileen M O'Reilly
Within gastrointestinal malignancies, primary hepatocellular carcinoma and pancreatic ductal adenocarcinoma (PDAC) are frequently associated with visceral thromboses (VT). Thrombus formation in the portal (PVT), mesenteric (MVT), or splenic vein (SVT) system leads to portal hypertension and intestinal ischemia. VT in PDAC may convey a risk of increased distal thrombosis and poses therapeutic uncertainty regarding the role of anticoagulation. An increasing number of reports describe VT associated with PDAC. It is possible that early diagnosis of these events may help reduce morbidity and speculatively improve oncologic outcomes...
December 12, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/29234547/testicular-cancer-presenting-as-gastric-variceal-hemorrhage
#2
Carlos Eduardo Salazar-Mejía, David Hernández-Barajas, Edio Llerena-Hernández, José Luis González-Vela, María Inés Contreras-Salcido, Adriana González-Gutiérrez, Omar David Borjas-Almaguer, Luis Alberto Pérez-Arredondo, Blanca Otilia Wimer-Castillo
Testicular cancer is the most common solid malignancy affecting males between the ages of 15 and 35. The symptomatology caused by this tumor varies according to the site of metastasis. We present the case of a 26-year-old male who arrived to the emergency department with hematemesis. He had no previous medical history. On arrival, we noted enlargement of the left scrotal sac. There was also a mass in the left scrotum which provoked displacement of the penis and right testis. The serum alpha-fetoprotein level was 17,090 ng/mL, lactate dehydrogenase was 1480 U/L, and human chorionic gonadotropin was 287...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29217335/rivaroxaban-and-apixaban-for-initial-treatment-of-acute-venous-thromboembolism-of-atypical-location
#3
Dawid T Janczak, Malgorzata K Mimier, Robert D McBane, Patrick S Kamath, Benjamin S Simmons, Dalene M Bott-Kitslaar, Charles J Lenz, Emily R Vargas, David O Hodge, Waldemar E Wysokinski
OBJECTIVES: To assess the outcome of direct oral anticoagulants (DOACs), specifically Xa inhibitors: rivaroxaban and apixaban, for the treatment of venous thromboembolism (VTE) of atypical location (VTE-AL), portal, mesenteric, hepatic, splenic, gonadal, renal, and cerebral veins, prospectively collected data of Mayo Thrombophilia Clinic Registry were used. METHODS: Patients with acute VTE-AL treated with DOACs, enrolled between March 1, 2013, and February 1, 2017, were compared with patients with VTE of typical location (VTE-TL: deep vein thrombosis of extremities and/or pulmonary embolism) receiving DOACs and with patients with VTE-AL treated with enoxaparin...
December 4, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29211374/-splanchnic-vein-thrombosis
#4
Bobby Gouin, Helia Robert-Ebadi, Alessandro Casini, Yan Beauverd, Pierre Fontana, Marc Righini, Laure Elkrief
Splanchnic vein thromboses include thrombosis of the portal venous system (including the portal, mesenteric and splenic vein) and hepatic vein thrombosis (also called Budd-Chiari syndrome). They are rare manifestations of venous thromboembolism. These thromboses are frequently associated with local or systemic factors. The therapeutic approach is often complex due to heterogeneity of patients and limited available data in the literature. The cornerstone of treatment is anticoagulation. However, the bleeding risk, related to portal hypertension, should be accurately assessed to individualize the treatment...
December 6, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29202678/approach-to-thrombosis-at-unusual-sites-splanchnic-and-cerebral-vein-thrombosis
#5
REVIEW
Nicoletta Riva, Walter Ageno
Splanchnic vein thrombosis (SVT) and cerebral vein thrombosis (CVT) are two manifestations of unusual site venous thromboembolism (VTE). SVT includes thrombosis in the portal, mesenteric or splenic veins, and the Budd-Chiari syndrome. CVT encompasses thrombosis of the dural venous sinuses and thrombosis of the cerebral veins. Unusual site VTE often represents a diagnostic and therapeutic challenge because of the heterogeneity in clinical presentation, the limited evidence available in the literature on the acute and long-term prognosis of these diseases, and the lack of large randomized controlled trials evaluating different treatment options...
December 2017: Vascular Medicine
https://www.readbyqxmd.com/read/29190873/-segmental-portal-hypertension-with-splenic-vein-thrombosis-caused-by-pancreatitis
#6
Luis Franco-Avilés, Federico I Hernández-Rocha, Ulises Mercado, Cristian G Malvido-Torres
BACKGROUND: Splenic vein thrombosis is a complication of pancreatic carcinoma, pancreatitis or pancreatic pseudocyst. It may lead to segmental portal hypertension and bleeding from gastric varices. CLINICAL CASE: A 31 year-old man was diagnosed with pancreatitis of two weeks of evolution and was referred to our hospital in 2013. He had a history of alcohol consumption. Physical examination showed no stigmata of liver cirrhosis. Laboratory analyses revealed hemoglobin 9...
November 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/29158925/splenic-infarct-and-pulmonary-embolism-as-a-rare-manifestation-of-cytomegalovirus-infection
#7
Prashanth Rawla, Anantha R Vellipuram, Sathyajit S Bandaru, Jeffrey Pradeep Raj
Cytomegalovirus (CMV) is a type of herpes infection that has a characteristic feature of maintaining lifelong latency within the host cell. CMV manifestations can cover a broad spectrum from fever to as severe as pancytopenia, hepatitis, retinitis, meningoencephalitis, Guillain-Barre syndrome, pneumonia, and thrombosis. Multiple case reports of thrombosis associated with CMV have been reported. Deep vein thrombosis or pulmonary embolism is more common in immunocompetent patients while splenic infarct is more common in immunocompromised patients...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/29151701/clinical-outcomes-of-transcatheter-selective-superior-mesenteric-artery-urokinase-infusion-therapy-vs-transjugular-intrahepatic-portosystemic-shunt-in-patients-with-cirrhosis-and-acute-portal-vein-thrombosis
#8
Ting-Ting Jiang, Xiao-Ping Luo, Jian-Ming Sun, Jian Gao
AIM: To compare the outcomes of transcatheter superior mesenteric artery (SMA) urokinase infusion and transjugular intrahepatic portosystemic shunt (TIPS) for acute portal vein thrombosis (PVT) in cirrhosis. METHODS: From January 2013 to December 2014, patients with liver cirrhosis and acute symptomatic PVT who met the inclusion criteria were randomly assigned to either an SMA group or a TIPS group. The two groups accepted transcatheter selective SMA urokinase infusion therapy and TIPS, respectively...
November 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29118687/renoportal-anastomosis-in-left-lateral-lobe-living-donor-liver-transplantation-a-pediatric-case
#9
Hiroyuki Ogasawara, Chikashi Nakanishi, Shigehito Miyagi, Kazuaki Tokodai, Yasuyuki Hara, Wataru Nakanishi, Koji Miyazawa, Kenji Shimizu, Hiroyuki Kumata, Hitoshi Goto, Masafumi Goto, Michiaki Unno, Takashi Kamei
In adult liver transplantation, renoportal anastomosis (RPA) has been introduced as a useful technique for patients with grade 4 portal vein thrombosis and a splenorenal shunt. Here, we report a pediatric case in which RPA allowed a left lateral lobe living donor liver transplantation (LDLT) despite portal vein thrombosis and a large splenorenal shunt. At 36 days old, the patient underwent a Kasai operation for biliary atresia. At 17 months old, she underwent LDLT because of repetitive cholangitis. Pretransplant examinations revealed a large splenorenal shunt and portal vein thrombosis...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29111221/portomesentric-and-splenic-vein-thrombosis-pmsvt-after-bariatric-surgery-a-systematic-review-of-110-patients
#10
Saeed Shoar, Alan A Saber, Rebecca Rubenstein, Saeed Safari, Stacy A Brethauer, Hassan Al-Thani, Armand P Asarian, Ali Aminian
BACKGROUND: Portomesenteric and splenic vein thrombosis (PMSVT) is a rare but potentially serious complication after bariatric surgery. No study has systematically analyzed its incidence and risk factors. OBJECTIVES: To pool the data regarding PMSVT after bariatric surgery and determine its incidence and risk factors. METHODS: A meta-analysis and systematic review was conducted to retrieve studies on PMSVT after bariatric surgery. RESULTS: A total of 41 eligible studies including 110 patients with postbariatric PMSVT were enrolled; the estimated incidence rate based on 13 studies was ...
January 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28971378/endoscopic-ultrasound-guided-transmural-drainage-of-walled-off-pancreatic-necrosis-in-patients-with-portal-hypertension-and-intra-abdominal-collaterals
#11
Surinder S Rana, Ravi Sharma, Sobur Uddin Ahmed, Rajesh Gupta
BACKGROUND: Acute necrotizing pancreatitis (ANP) is complicated with segmental portal hypertension (PHT) and formation of venous collaterals. Presence of collaterals in vicinity of endoscopic transmural tract can lead to potentially catastrophic situation. Here, we report safety and outcome of EUS-guided transmural drainage of walled-off pancreatic necrosis (WOPN) in patients with PHT and intra-abdominal collaterals. METHODS: Retrospective analysis of collected database of patients (n=18; age 40...
October 2, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28960455/nontraditional-sites-for-vascular-anastomoses-to-enable-kidney-transplantation-in-patients-with-major-systemic-venous-thromboses
#12
Bonnie E Lonze, Nabil N Dagher, Nada Alachkar, Annette M Jackson, Robert A Montgomery
Successful renal transplantation requires low-pressure venous drainage to permit adequate outflow from the allograft. We report here a series of three patients in whom the inferior vena cava as well as bilateral iliac veins were thrombosed, making it necessary to explore less traditional vessels for venous drainage of the renal allograft. We utilized the splanchnic vasculature in two cases and the native left renal vein in another. The resulting atypical intra-abdominal locations of these allografts also presented difficulties for arterial anastomoses and for urinary drainage...
December 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28919051/incidence-and-predictors-of-portal-and-splenic-vein-thrombosis-after-pure-laparoscopic-splenectomy
#13
Nicola de'Angelis, Solafah Abdalla, Vincenzo Lizzi, Francesco Esposito, Pietro Genova, Lydia Roy, Frédéric Galacteros, Alain Luciani, Francesco Brunetti
BACKGROUND: Optimal modalities for diagnosis, treatment, and surveillance of portal or splenic vein thrombosis have not yet been defined. The present retrospective study aimed to investigate the role of computed tomography performed systematically before and after laparoscopic splenectomy to assess the incidence of portal or splenic vein thrombosis, predictors, and outcomes. METHODS: Computed tomography scans were obtained from 170 patients undergoing elective laparoscopic splenectomy between 2005 and 2015...
December 2017: Surgery
https://www.readbyqxmd.com/read/28880010/chronic-pancreatitis
#14
REVIEW
Jorg Kleeff, David C Whitcomb, Tooru Shimosegawa, Irene Esposito, Markus M Lerch, Thomas Gress, Julia Mayerle, Asbjørn Mohr Drewes, Vinciane Rebours, Fatih Akisik, J Enrique Domínguez Muñoz, John P Neoptolemos
Chronic pancreatitis is defined as a pathological fibro-inflammatory syndrome of the pancreas in individuals with genetic, environmental and/or other risk factors who develop persistent pathological responses to parenchymal injury or stress. Potential causes can include toxic factors (such as alcohol or smoking), metabolic abnormalities, idiopathic mechanisms, genetics, autoimmune responses and obstructive mechanisms. The pathophysiology of chronic pancreatitis is fairly complex and includes acinar cell injury, acinar stress responses, duct dysfunction, persistent or altered inflammation, and/or neuro-immune crosstalk, but these mechanisms are not completely understood...
September 7, 2017: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/28808782/thromboembolic-events-following-splenectomy-risk-factors-prevention-management-and-outcomes
#15
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/28799827/laparoscopic-splenectomy-for-massive-splenomegaly-does-size-matter
#16
Levan Tsamalaidze, John A Stauffer, Samantha L Permenter, Horacio J Asbun
BACKGROUND: Laparoscopic splenectomy (LS) has become the most common approach for elective splenectomy, but use of LS for patients with massive splenomegaly (MS) remains controversial. By the 2008 European guidelines, LS for MS (spleen size >20 cm) is generally not recommended. METHODS: We performed a retrospective analysis of 229 consecutive patients undergoing LS, hand-assist (HALS), and open splenectomy (OS) at our institution from January 1, 1995 to December 2016...
October 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28764227/portal-venous-thrombosis-disseminated-tuberculosis-in-rheumatoid-arthritis
#17
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
#18
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/28740966/portal-vein-thrombosis-as-a-rare-cause-of-abdominal-pain-when-to-consider
#19
Cengiz Tavusbay, Erdinç Kamer, Turan Acar, İbrahim Kokulu, Haldun Kar, Özlem Gür
Extrahepatic portal vein thrombosis (PVT) is a rare condition that is characterized by the presence of thrombus within any segment of the portal vein, including the right and left intrahepatic branches. It may also extend to the splenic or superior mesenteric veins. Portal vein thrombosis may be related to cirrhosis or liver malignancy as well as to local inflammatory conditions in the abdomen and genetic or acquired thrombophilic diseases. Currently, PVT is being increasingly diagnosed due to advances in modern imaging techniques...
2017: Turkish Journal of Surgery
https://www.readbyqxmd.com/read/28707821/splenic-vein-thrombosis-following-pancreas-transplantation-identification-of-factors-that-support-conservative-management
#20
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...
November 2017: American Journal of Transplantation
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