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https://www.readbyqxmd.com/read/29055931/congenital-shunts-of-the-portal-venous-system-case-series-of-uncommon-shunts
#1
Liliana Santos, Susana Nobre, Nadia Laezza, Catarina Cunha, Isabel Gonçalves, Maria F Lopes
BACKGROUND AND AIMS: Congenital shunts of the portal venous system are rare entities that can present in children with clinical heterogeneity. To evaluate the clinical course of children with uncommon shunts presenting to our institution and examine the available literature on this topic. Medical records of children with rare forms of congenital shunts were retrospectively reviewed for demographics, symptoms, management, and outcome between 2003 and 2016. RESULTS: Three female patients with congenital shunts, including a congenital mesenterico-portal Rex shunt (n = 1) and congenital portosystemic shunts (CPSS) (n = 2), were referred for surgical evaluation between ages 4 and 9...
October 16, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/29037349/the-optimal-procedure-of-modified-rex-shunt-for-the-treatment-of-extrahepatic-portal-hypertension-in-children
#2
Jin-Shan Zhang, Long Li, Wei Cheng
OBJECTIVE: Since 2008, the modified Rex shunt has been used for the treatment of extrahepatic portal venous obstruction (EHPVO) in our center, and satisfactory results were initially achieved. However, the postoperative recurrence rate gradually increased. We therefore performed a retrospective study to evaluate the outcome and identify the optimal procedure. METHODS: Between October 2008 and March 2016, 79 children with EHPVO underwent the Rex shunt in our hospital: 48 underwent the gastroportal shunt (GP), 26 underwent the portal cavernoma-Rex shunt with interposition of grafted portal vessel (PP), and 5 underwent a spleen-preserving splenoportal bypass (SP)...
November 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28643575/combined-rex-bypass-shunt-with-pericardial-devascularization-alleviated-prehepatic-portal-hypertension-caused-by-cavernomatous-transformation-of-portal-vein
#3
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...
September 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28640110/case-report-of-a-modified-meso-rex-bypass-as-a-treatment-technique-for-late-onset-portal-vein-cavernous-transformation-with-portal-hypertension-after-adult-deceased-donor-liver-transplantation
#4
Dongdong Han, Rui Tang, Liang Wang, Ang Li, Xin Huang, Shan Shen, Jiahong Dong
RATIONALE: Portal vein thrombosis is a complication after liver transplantation and cavernous transformation of the portal vein (CTPV) is a result of portal vein thrombosis, with symptoms of portal hypertension revealed by an enhanced CT scan. Meso-Rex bypass is an artificial shunt connecting the left portal vein to the superior mesenteric vein and is mainly used for idiopathic cavernomas. This technique is also used for post-transplant portal vein thrombosis in pediatric patients thereby bypassing obstructed sites of the extrahepatic portal vein...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28585786/-results-of-the-mesoportal-bypass-rex-shunt-in-the-treatment-of-idiopathic-extrahepatic-portal-vein-obstruction-in-children
#5
E Domínguez Amillo, C De la Torre Ramos, A Andrés Moreno, J L Encinas Hernández, F Hernández Oliveros, M López Santamaría
BACKGROUND: Extrahepatic portal vein obstruction (EPVO) is the principal cause of portal hypertension in children. The objective of this study was to analyze the capacity of the surgical technique that creates a mesoportal shunt to treat changes caused by EPVO. METHODS: Retrospective review of patients with idiopathic EPVO who underwent a mesoportal shunt and analysis of the changes in the number of leucocytes, platelets, prothrombin time and spleen size one year after the surgery...
January 25, 2017: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28583542/splenectomy-for-severe-intestinal-bleeding-caused-by-portal-hypertensive-enteropathy-after-pediatric-living-donor-liver-transplantation-a-report-of-three-cases
#6
K Tokodai, N Kawagishi, S Miyagi, C Nakanishi, Y Hara, W Nakanishi, T Kamei, N Ohuchi
BACKGROUND: The incidence of portal vein thrombosis after pediatric living-donor liver transplantation (LDLT) is reported to be higher than that after deceased-donor or adult liver transplantation. Portal vein thrombosis can cause portal hypertension and related complications, including portal hypertensive gastropathy or portal hypertensive enteropathy (PHE). PHE, in particular, can lead to severe intestinal bleeding, which is extremely difficult to treat. However, the pathogenesis of and appropriate treatment for PHE are not clearly defined, especially after pediatric LDLT...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28579293/withdrawn-the-optimal-procedure-of-modified-rex-shunt-for-the-treatment-of-extrahepatic-portal-hypertension-in-children
#7
Jin-Shan Zhang, Long Li, Wei Cheng
No abstract text is available yet for this article.
May 31, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28331438/clinical-images-interventional-management-of-pediatric-rex-shunt-stenosis
#8
Corey Area, David Kirsch, Lena Gowharji
No abstract text is available yet for this article.
2017: Ochsner Journal
https://www.readbyqxmd.com/read/27896406/evaluation-of-rex-shunt-on-cavernous-transformation-of-the-portal-vein-in-children
#9
Ruo-Yi Wang, Jun-Feng Wang, Xiao-Gang Sun, Qian Liu, Jia-Long Xu, Qi-Gang Lv, Wei-Xiu Chen, Jin-Liang Li
BACKGROUND: Children with cavernous transformation of the portal vein (CTPV) develop severe complications from prehepatic portal hypertension, such as recurrent variceal bleeding and thrombocytopenia. In this study, we reported the results of 30 children with symptomatic CTPV that were treated by a Rex shunt. The effectiveness of this surgical approach was evaluated. METHODS: A retrospective review was performed of 30 children aged between 3 and 18 years with CTPV, who underwent a Rex shunt between 2008 and 2015...
April 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/27118711/a-new-procedure-for-the-treatment-of-extrahepatic-portal-hypertension-in-children-portal-cavernoma-rex-shunt-with-interposition-of-grafted-portal-vessel
#10
Jin-Shan Zhang, Long Li, Wei Cheng
No abstract text is available yet for this article.
June 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/26475346/variant-meso-rex-bypass-with-transposition-of-abdominal-autogenous-vein-for-the-management-of-idiopathic-extrahepatic-portal-vein-obstruction-a-retrospective-observational-study
#11
Tae-Yong Ha, Kyung-Mo Kim, Gi-Young Ko, Seak Hee Oh, Tae-Won Kwon, Yong-Pil Cho, Sung-Gyu Lee
BACKGROUND: The aim of this study was to evaluate whether variant meso-Rex bypass with transposition of abdominal autogenous vein can be used as an alternative treatment modality for selected patients with symptomatic extrahepatic portal vein obstruction. METHODS: This was a retrospective review of six consecutive patients who received this alternative procedure for the treatment of symptomatic portal hypertension secondary to idiopathic extrahepatic portal vein obstruction...
2015: BMC Surgery
https://www.readbyqxmd.com/read/26378482/portal-cavernoma-in-the-era-of-mesoportal-shunt-rex-and-liver-transplant-in-children
#12
Gloria Chocarro, Paloma Triana Junco, Eva Dominguez, María Virginia Amesty, Vanesa Nuñez Cerezo, Francisco Hernandez, Javier Murcia, Juan Antonio Tovar, Manuel Lopez Santamaria
OBJECTIVE: The mesoportal shunt (MPS) and liver transplantation (LT) have changed the scenario of extrahepatic portal vein obstruction (EHPVO) since the MPS, the only "curative" technique, can now be offered in asymptomatic patients and also thrombotic complications of LT have increased the incidence of EHPVO. MATERIAL AND METHODS: A retrospective study of patients undergoing surgery for EHPVO was conducted between 1990 and 2015. An analysis was done for the shunt permeability and clinical evolution over time...
February 2016: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/25783357/spleen-preserving-proximal-splenic-left-intrahepatic-portal-shunt-for-the-treatment-of-extrahepatic-portal-hypertension-in-children
#13
Jin-Shan Zhang, Long Li, Wen-Ying Hou, Shu-Li Liu, Mei Diao, Jun Zhang, Qi Li, Mao Ye, An-Xiao Ming, Ning Dong, Wei Cheng
PURPOSE: The Rex shunt has been employed successfully to treat patients with extrahepatic portal hypertension. In the conventional Rex shunt, the internal jugular vein is used as a venous graft. Inevitably, such a procedure requires neck exploration and sacrifice of the internal jugular vein. The authors describe a novel adaptation of spleen-preserving spleno-Rex bypass, successfully carried out in children with extrahepatic portal hypertension. METHODS: The mean age of the four patients (1 boy, 3 girls) was 46 months at the time of operation...
June 2015: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/25403486/meso-rex-bypass-to-manage-prehepatic-portal-hypertension-after-the-failure-of-an-intrahepatic-portosystemic-stent-shunting
#14
Fabrizio di Francesco, Lidia Monti, Chiara Grimaldi, Cristina Lo Zupone, Arianna Bertocchini, Jean de Ville de Goyet
A cavernomatous transformation of the extrahepatic portion of the portal vein is a common cause of chronic portal hypertension in children. A few attempts at radiological interventions have been reported, but have rarely been successful. In this report, a surgical Meso-Rex bypass was performed to treat complicated prehepatic portal hypertension, after the insertion of an intrahepatic stent for portosystemic shunting had failed. The review of this case nicely illustrates how differently effective are these two shunting procedures-in terms of restoring hepatopetal flow, managing portal hypertension, and establishing-or not-portosystemic connections...
January 2015: Pediatric Surgery International
https://www.readbyqxmd.com/read/25384413/partial-splenectomy-and-use-of-splenic-vein-as-an-autograft-for-meso-rex-bypass-a-clinical-observational-study
#15
Zhang Wei, Shao Guang Rui, Zhang Yuan, Li Dian Guo, Liu Qian, Liu Shu Wei
BACKGROUND: Meso-Rex bypass (MRB) surgery is being increasingly used to treat chronic prehepatic portal hypertension secondary to extrahepatic portal vein thrombosis (EPVT) and cavernous transformation (EPVCT) in children. Rather than using the internal jugular vein (IJV, the traditional venous graft), we used an autogenous splenic vein segment graft for MRB. MATERIAL/METHODS: We examined 25 children with extrahepatic portal hypertension and a history of recurrent upper gastrointestinal (GI) variceal bleeding despite previous endoscopic sclerotherapy...
November 11, 2014: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/25092088/intrahepatic-portal-venous-systems-in-children-with-noncirrhotic-prehepatic-portal-hypertension-anatomy-and-clinical-relevance
#16
Arianna Bertocchini, Pierluigi Falappa, Chiara Grimaldi, Giuseppe Bolla, Lidia Monti, Jean de Ville de Goyet
BACKGROUND: Children with extrahepatic portal hypertension typically present with cavernomatous transformation of the portal vein and a poorly defined intrahepatic portal vein system on conventional imaging. With the Meso-Rex Bypass becoming the gold-standard intervention for a cure, a precise assessment of the intrahepatic portal vein system provides helpful data for deciding whether a Meso-Rex Bypass is feasible or not. METHODS: All children with extrahepatic portal hypertension were prospectively assessed by wedged hepatic venous portography...
August 2014: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/24761417/use-of-meso-rex-shunt-with-transposition-of-the-coronary-vein-for-the-management-of-extrahepatic-portal-vein-obstruction
#17
Yong-Pil Cho, Tae-Yong Ha, Gi-Young Ko, Kyung-Mo Kim, Sung-Gyu Lee
The meso-Rex shunt is used to safely and effectively treat patients with portal hypertension due to extrahepatic portal vein obstruction. In the standard meso-Rex shunt technique, the patient's own internal jugular vein is used as a vascular autograft. Inevitably, such a procedure requires neck exploration and sacrifice of the internal jugular vein. Here, we present a case of a 20-year-old man with idiopathic extrahepatic portal vein obstruction, who was treated with a new technique of transposition of the coronary vein, which is enlarged in most cases of portal hypertension, as an alternative to the standard meso-Rex shunt technique...
February 2014: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/24620643/rex-shunt-for-portal-vein-thrombosis-after-adult-living-donor-liver-transplantation
#18
Yuji Soejima, Ken Shirabe, Tomoharu Yoshizumi, Hideaki Uchiyama, Toru Ikegami, Yo-Ichi Yamashita, Tetsuo Ikeda, Hirofumi Kawanaka, Keishi Sugimachi, Koshi Mimori, Masayuki Watanabe, Masaru Morita, Eiji Oki, Hiroshi Saeki, Yoshihiko Maehara
Portal vein thrombosis (PVT) after liver transplantation is a relatively common but serious complication which could lead to portal hypertension or a direct graft loss. A "Rex" shunt created between the superior mesenteric vein (SMV) and the umbilical portion of the left portal vein can be a useful option to treat PVT after pediatric liver transplantation, however, its application to adult patients has not been reported so far because appropriate vein grafts are hardly available. Herein we present a case of PVT after left lobe living donor liver transplantation (LDLT) who underwent the procedure using the own inferior jugular vein and the gonadal vein as a shunt graft...
November 2013: Fukuoka Igaku Zasshi, Hukuoka Acta Medica
https://www.readbyqxmd.com/read/24341631/management-of-late-onset-portal-vein-complications-in-pediatric-living-donor-liver-transplantation
#19
Yong-Pil Cho, Kyung-Mo Kim, Tae-Yong Ha, Gi-Young Ko, Jae-Yeon Hwang, Hojong Park, Young Soo Chung, Taein Yoon, Shin Hwang, Heungman Jun, Tae-Won Kwon, Sung-Gyu Lee
The purpose of this study was to evaluate retrospectively the results of PTA for late-onset PV complications after pediatric LDLT and to assess whether a meso-Rex shunt is a viable option for treating restenosis of the PV after PTA in selected cases. Seventy-five children who underwent adult-to-child LDLT were included in this study, and there were six late-onset PV complications (8.0%). The initial therapeutic approach was PTA, with or without stent: PTA with balloon dilation for three children, PTA with stent placement for one child, and failure to cannulate the occluded PV for two children...
February 2014: Pediatric Transplantation
https://www.readbyqxmd.com/read/24326080/meso-rex-bypass-a-procedure-to-cure-prehepatic-portal-hypertension-the-insight-and-the-inside
#20
REVIEW
Fabrizio di Francesco, Chiara Grimaldi, Jean de Ville de Goyet
No abstract text is available yet for this article.
February 2014: Journal of the American College of Surgeons
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