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Splenic vein thrombosis

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
A Bouvier, M Gout, S Audia, C Chalumeau, P Rat, O Deballon
BACKGROUND: Portal and/or splenic vein thrombosis (PSVT) is common after splenectomy. It can be a life-threatening complication, with a risk of bowel ischemia and portal hypertension. An early diagnosis allows an effective medical treatment and prevents life-threatening complications. There is no consensus regarding the benefit of systematic screening of patients after splenectomy for PSVT. We started in January 2012 a routine screening of PSVT after elective splenectomy. The aim of this study was to assess this policy...
September 14, 2016: La Revue de Médecine Interne
Jaime Ruiz-Tovar, Pablo Priego
The portal vein is formed by the confluence of the splenic and superior mesenteric veins, which drain the spleen and small intestine respectively. Occlusion of the portal vein by thrombus typically occurs in patients with cirrhosis and/or prothrombotic disorders. However, portal vein thrombosis (PVT) can also happen after determined surgeries. Moreover, PVT can have serious consequences depending on the location and extent of the thrombosis, including hepatic ischemia, intestinal ischemia, portal hypertension… In this chapter, we will review the incidence, management and prophylaxis of PVT after splenectomy, pancreas transplantation, pancreatic surgery and in the setting of acute and chronic pancreatitis...
September 17, 2016: Advances in Experimental Medicine and Biology
Jason T Salsamendi, Francisco J Gortes, Michelle Shnayder, Mehul H Doshi, Ji Fan, Govindarajan Narayanan
Portal vein thrombosis (PVT) is a potential complication of cirrhosis and can worsen outcomes after liver transplant (LT). Portal vein reconstruction-transjugular intrahepatic portosystemic shunt (PVR-TIPS) can restore flow through the portal vein (PV) and facilitate LT by avoiding complex vascular conduits. We present a case of transsplenic PVR-TIPS in the setting of complete PVT and splenic vein (SV) thrombosis. The patient had a 3-year history of PVT complicated by abdominal pain, ascites, and paraesophageal varices...
September 2016: Radiology case reports
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
Moinuddin Ahmed, Muhammad Usman Aziz, Muhammad Ayub Mansoor, Saleha Anwar
OBJECTIVE: To record the incidence of vascular complications in cases of acute pancreatitis. METHODS: This retrospective, cross-sectional study was performed at the Liaquat National Hospital, Karachi, from October 31, 2012 to October 31, 2014, and comprised computerised records and computerised tomography scan images related to cases of pancreatitis. RESULTS: Of the 210 patients included, 97(46.19%) were men and 113(53.81%) were women. A total of 24(11...
August 2016: JPMA. the Journal of the Pakistan Medical Association
Seiichiro Shishido, Takeshi Kawamura, Yuko Hamasaki, Yusuke Takahashi, Yoshihiro Itabashi, Masaki Muramatsu, Hiroyuki Satoh, Atsushi Aikawa
BACKGROUND: Children with a compromised inferior vena cava (IVC) were previously considered unsuitable for kidney transplantation because of the technical difficulties and the increased risk of graft thrombosis secondary to inadequate renal venous outflow. METHODS: We conducted a retrospective study of 11 transplants in 9 patients with end-stage renal disease and thrombosed IVCs who received adult kidney allografts between 2000 and 2015. The mean age at transplantation was 7...
June 2016: Transplantation Direct
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
Shoufei Jiao, Hongxing Chen, Youlong Wang, Jiye Zhu, Jingwang Tan, Jie Gao
Background. Both splenectomy (SP) and partial splenic embolization (PSE) are used to treat massive splenomegaly (MSM) secondary to hepatitis B-related liver cirrhosis (HB-LC). This retrospective case-control study was conducted to compare the effects of SP and PSE on these patients. Methods. From July 2004 to January 2012, patients with MSM secondary to HB-LC who underwent SP or PSE were 1 : 1 : 1 matched with similar nonsurgery patients, respectively. Intraoperative situation, hematological indices, liver function, HBV DNA level, HBeAg seroconversion rate, morbidity, and mortality at 6 months postoperatively were compared...
2016: Gastroenterology Research and Practice
James Maurice, Edgar Brodkin, Frances Arnold, Annalan Navaratnam, Heidi Paine, Sabrina Khawar, Ameet Dhar, David Patch, James O'Beirne, Raj Mookerjee, Massimo Pinzani, Emmanouil Tsochatzis, Rachel H Westbrook
BACKGROUND: The Baveno VI guidelines propose that cirrhotic patients with a liver stiffness measurement (LSM) <20kPa and a platelet count >150000/μL can avoid screening endoscopy as their combination is highly specific for excluding clinically significant varices. The aim of the study was to validate these criteria. METHODS: Transient elastography data was collected from two institutions from 2006-2015. Inclusion criteria were a LSM ⩾10kPa and an upper gastrointestinal endoscopy within 12 months, with a diagnosis of compensated chronic liver disease...
July 4, 2016: Journal of Hepatology
Qiao Zhou, Chirag Shah, Jean-Michel Arthus, Harlan Vingan, John Agola
We present the case of a 59-year-old man with atraumatic splenic rupture because of splenic vein thrombosis who was successfully treated with splenic artery embolization.
June 2016: Radiology case reports
Takana Yamakawa Hayashi, Izuru Matsuda, Kazuchika Hagiwara, Tomoko Takayanagi, Akifumi Hagiwara
We report a case of splenic infarction in a patient with sickle cell traits (SCT), focusing on the computed tomography (CT) findings. The patient was an African-American man in his twenties with no past medical history who experienced sudden left upper quadrant pain while climbing a mountain (over 3000 m above sea level). Dynamic contrast-enhanced CT revealed massive non-segmental splenic infarction accompanied with nodule-like preserved splenic tissue. The region of splenic infarction did not coincide with the arterial vascular territory and differed from the features of infarction caused by large arterial embolism...
September 2016: Abdominal Radiology
Andrew C Storm, Christopher C Thompson
AIM: To determine the feasibility and safety of transgastric direct endoscopic necrosectomy (DEN) in patients with walled-off necrosis (WON) and gastric varices. METHODS: A single center retrospective study of consecutive DEN for WON was performed from 2012 to 2015. All DEN cases with gastric fundal varices noted on endoscopy, computed tomography (CT) or magnetic resonance imaging (MRI) during the admission for DEN were collected for analysis. In all cases, external urethral sphincter (EUS) with doppler was used to exclude the presence of intervening gastric varices or other vascular structures prior to 19 gauge fine-needle aspiration (FNA) needle access into the cavity...
May 25, 2016: World Journal of Gastrointestinal Endoscopy
Linda Pasta, Francesca Pasta, Mario D'Amico
BACKGROUND: There are no univocal opinions on the role of genetic thrombophilia on splanchnic vein thrombosis (SVT). We defined genetic thrombophilia the presence of one of these thrombophilic genetic factors (THRGFs): PAI-1 4G-4G, MTHFR 677TT, V Leiden 506Q, and prothrombin 20210A. OBJECTIVES: To evaluate the frequencies of these THRGFs in SVT patients, we analyzed individual data of 482 Caucasian patients, recruited from 2000 to 2014 in three prospective studies...
March 2016: Journal of Clinical and Experimental Hepatology
A Vorobev, A Makatsaria
INTRODUCTION: Thrombosis of rare localizations: hepatic vein thrombosis, splenic, mesenteric, ovarian veins, brain, portal vein are life-threatening disorders, which often goes unrecognized. The most frequently atypical localizations develop thrombosis in patients with inherited defects of hemostasis - genetic thrombophilia. Rare localizations of thrombosis often accompanied acquired abnormalities of hemostasis, which include antiphospholipid syndrome, hypercoagulation in oncology. AIM: The detection of thrombosis rare localizations required screening for genetic forms of thrombophilia and antiphospholipid syndrome and timely appointment of anticoagulant therapy...
April 2016: Thrombosis Research
Brittany McIntyre, Melanie Marsh, Jeffrey Walden
This report details a 58-year-old gentleman who presented to his outpatient primary care physician's clinic several times over four weeks for ongoing epigastric pain radiating into his left flank, dry heaving, and constipation. He was presumed to have gastritis at each visit and prescribed escalating doses of proton pump inhibitors. Due to the unrelenting pain, he eventually was admitted to the hospital and diagnosed with splenic vein thrombosis after computed tomography imaging of the abdomen. Our literature search revealed that pancreatic pathology is overwhelmingly the contributing factor to splenic vein thrombosis...
June 2016: Postgraduate Medicine
Kichang Han, Heung Kyu Ko, Jiaywei Tsauo, Dong Jae Shim, Yook Kim, Gi-Young Ko, Duck Jong Han, Sung Shin, Young Hoon Kim
PURPOSE: To investigate the safety and efficacy of mechanical thrombectomy used as a tool for graft rescue in patients with pancreas graft venous thrombosis (PGVT). MATERIALS AND METHODS: Graft venous thrombosis was discovered in 36 (33%) of 110 patients who underwent pancreas transplantation. Percutaneous aspiration thrombectomy was performed in seven patients (mean age, 31 y; range, 15-36 y) who had complete or severe thrombosis of the splenic vein or superior mesenteric vein seen on postoperative computed tomography...
June 2016: Journal of Vascular and Interventional Radiology: JVIR
Li-jun Liu, Wei Yu, Yong-jun Kuang
OBJECTIVE: To evaluate the effects of the perfusion of low molecular dextran via the splenic artery in portal azygous devascularization for portal hypertension in the prevention from portal vein thrombosis. METHODS: A total of 92 patients with portal hypertension were randomly divided into a control group (46 cases) that received the extensive devascularization around the cardia, and a trial group (46 cases) that received the above-mentioned operation and the perfusion of low molecular dextran via the splenic artery...
December 2015: Zhongguo Xue Xi Chong Bing Fang Zhi za Zhi, Chinese Journal of Schistosomiasis Control
Ricard Corcelles, Mena Boules, Dvir Froylich, Christopher Ryan Daigle, Amani Hag, Phillip R Schauer, Tomasz Rogula
BACKGROUND: Further minimization of abdominal wall trauma during laparoscopic bariatric surgery is a topic of great interest. Reducing the number of trocars may provide superior cosmetic results with less pain and shorter length of stay (LOS). However, it remains unclear if this approach compromises safety or effectiveness of weight loss. The aim of this study is to report initial safety and feasibility results using a three-port minimally invasive sleeve gastrectomy technique. MATERIALS AND METHODS: A retrospective review of patients who underwent laparoscopic three-port sleeve gastrectomy (3PSG) at our institution was conducted...
May 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
A N Tavare, A J Wigham, A Goode
Transjugular intrahepatic porto-systemic shunt (TIPSS) is increasingly used to treat chronic portal vein thrombosis. However shunt thrombosis is a recognised early complication, particularly in those with thrombophilia. We outline a case of non-cirrhotic portal hypertension secondary to chronic portal vein occlusion where TIPSS was successfully performed but rapidly complicated by shunt thrombosis with extension into the portal and splenic veins. Mechanical thrombectomy and low dose systemic pharmacological thrombolysis were of limited benefit...
March 2016: Acta Gastro-enterologica Belgica
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