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extrahepatic portal venous obstruction

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https://www.readbyqxmd.com/read/29546610/surgical-treatment-for-rebleeding-caused-by-bypass-failure-after-rex-shunt-re-rex-shunt-or-warren-shunt
#1
Jin-Shan Zhang, Long Li, Wei Cheng
PURPOSE: Although Rex shunt is an effective treatment for extrahepatic portal venous obstruction (EHPVO), 4-20% children develop rebleeding postoperatively. This study was used to evaluate the surgical treatment of rebleeding after Rex shunt in our center. METHOD: From June 2008 to Jan 2017, 12 of 122 children with EHPVO underwent a second operation due to graft stenosis and occlusion after Rex shunt in our center. The abdominal ultrasound and computed tomography (CT) showed the occlusion of bypass vein in nine children, stenosis of bypass vein in two children, and the patency of bypass vein in one child with dysplasia of intrahepatic portal vein...
March 15, 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29464506/idiopathic-portal-hypertension-and-extrahepatic-portal-venous-obstruction
#2
REVIEW
Rajeev Khanna, Shiv Kumar Sarin
BACKGROUND: Idiopathic portal hypertension (IPH) and extrahepatic portal venous obstruction (EHPVO) are non-cirrhotic vascular causes of portal hypertension (PHT). Variceal bleed and splenomegaly are the commonest presentations. AIM: The present review is intended to provide the existing literature on etiopathogenesis, clinical profile, diagnosis, natural history and management of IPH and EHPVO. RESULTS: IPH and EHPVO are both characterized by normal hepatic venous pressure gradient, moderate to massive splenomegaly with preserved liver synthetic functions...
February 20, 2018: Hepatology International
https://www.readbyqxmd.com/read/29433861/metabolic-profile-of-children-with-extrahepatic-portal-vein-obstruction-undergoing-meso-rex-bypass
#3
Timothy B Lautz, Simon Eaton, Lisa Keys, Joy Ito, Mario Polo, Jonathan C K Wells, Agostino Pierro, Riccardo A Superina
BACKGROUND: Extrahepatic portal vein obstruction (EHPVO) in children is often associated with growth restriction, which improves after the restoration of portal venous flow with a meso-Rex bypass, but the physiologic mechanism is unknown. The purpose of this study was to investigate the mechanism of growth delay in children with EHPVO by detailing the metabolic and nutritional profile before and after meso-Rex bypass. METHODS: Twenty consecutive children with EHPVO were prospectively studied before and 1 year after meso-Rex bypass...
March 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29373442/stroop-test-validation-to-screen-for-minimal-hepatic-encephalopathy-in-pediatric-extrahepatic-portal-venous-obstruction
#4
Meera Vyshni Suresh, Barath Jagadisan, Preeti Kandasamy, Gandhipuram Periyasamy Senthilkumar
OBJECTIVES: Minimal hepatic encephalopathy (MHE) has been reported in children with extrahepatic portal vein obstruction (EHPVO). MHE assessment is restricted to research situations as neuropsychiatric tests are time-intensive. Computerized Stroop Test (CST) has been used in cirrhotic adults for MHE screening. The study aims to assess MHE frequency in young Indian children with EHPVO and validate CST for MHE screening in pediatric EHPVO. METHODS: Thirty-seven children with EHPVO between 7 and 12 years of age and 37 age- and sex-matched controls were enrolled...
May 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29260002/profile-of-extrahepatic-portal-venous-obstruction-among-children-in-central-india
#5
Mayank Jain, Jenisha Jain, Gauri Rao Passi, Kamna Jain, Shikhar Jain
Introduction: There is a paucity of data regarding the clinical profile of children with extrahepatic portal venous obstruction (EHPVO) from Central India. Material and methods: Retrospective analysis of 30 children with EHPVO treated between 2002 and 2012. Results: The median age of presentation was 12.5 years (range 5-14 years) and median duration of symptoms was 3.2 years (range 0.3-10 years). Home delivery was noted in 30 cases (100%), umbilical sepsis in 8 (27%) and history of cow dung application over the umbilical cord in 2 cases (6...
December 2017: Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29198895/portal-to-right-portal-vein-bypass-for-extrahepatic-portal-vein-obstruction
#6
Li Long, Zhang Jinshan, Chen Zhen, Li Qi, Dong Ning, Diao Mei, Cheng Wei
OBJECTIVE: Rex shunt (mesenteric-to-left portal vein bypass) is considered a more physiologically rational treatment for EHPVO than other portosystemic systemic shunts in children. However, about 13.6% of children with EHPVO do not have usable left portal veins and up to 28.1%. Rex operations in children are not successful. Hence, a Rex shunt in these children was impossible. This study reports a novel approach by portal-to-right portal vein bypass for treatment of children with failed Rex shunts...
November 4, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29037349/the-optimal-procedure-of-modified-rex-shunt-for-the-treatment-of-extrahepatic-portal-hypertension-in-children
#7
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/28694570/extrahepatic-portal-vein-obstruction-in-children-role-of-preoperative-imaging
#8
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/28663672/gastric-varices-in-cirrhosis-vs-extrahepatic-portal-venous-obstruction-and-response-to-endoscopic-n-butyl-2-cyanoacrylate-injection
#9
Barjesh C Sharma, Shivakumar Varakanahalli, Jatinder P Singh, Siddharth Srivastava
BACKGROUND: Gastric varices (GV) are found in patients with portal hypertension. Incidence of bleeding from GV is relatively low, but is severe, and associated with higher mortality. AIMS AND OBJECTIVES: To compare the types of GV in cirrhosis vs. extrahepatic portal venous obstruction (EHPVO) and the results of endoscopic N-butyl-2-cyanoacrylate (NBC, glue) injection. METHODS: Four hundred and fifty-four patients undergone glue injection of GV for primary prophylaxis or control of bleeding for first episode of bleeding from GV between August 2010 and August 2015 were analyzed...
June 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28612224/extrahepatic-portal-venous-obstruction-what-should-be-the-mainstay-of-treatment
#10
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...
September 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28579293/withdrawn-the-optimal-procedure-of-modified-rex-shunt-for-the-treatment-of-extrahepatic-portal-hypertension-in-children
#11
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/28154908/mild-asymptomatic-intrahepatic-biliary-dilation-after-cholecystectomy-a-common-incidental-variant
#12
Christopher J Atkinson, Christopher J Lisanti, Ryan B Schwope, Daniel Ramsey, Timothy Dinh, Allyson Cochet, Michael J Reiter
OBJECTIVE: The purpose of this study is to evaluate the prevalence of intra- and extrahepatic ductal dilatation in asymptomatic individuals after cholecystectomy. METHODS AND MATERIALS: This IRB-approved retrospective cohort study evaluated the prevalence of intra- and extrahepatic biliary dilation in 77 consecutive post cholecystectomy patients who had CT obtained in the portal venous phase. These were then compared to age and sex matched control patients. Two radiologists in consensus blinded to surgical history evaluated the intrahepatic ducts qualitatively for dilatation...
May 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/27829605/jejunal-varices-after-choledochojejunostomy-treated-with-laparotomic-transcatheter-variceal-embolization
#13
Nobuo Waguri, Rie Azumi, Kazuhito Sugimura, Yoshihisa Arao, Shunzo Ikarashi, Norihiro Sakai, Masahiro Ogawa, Akihiko Osaki, Munehiro Sato, Tsuneo Aiba, Osamu Yoneyama, Koichi Furukawa, Kentarou Igarashi
Portal hypertension induces collateral shunt formation between the portal and systemic circulation, decompressing the elevated portal pressure. Ectopic varices outside of the gastroesophageal region, such as jejunal varices, are rare conditions. This report describes the successful embolization of ruptured jejunal varices resulting from an extrahepatic portal obstruction. A 62-year-old man was admitted to our hospital with recurrent massive gastrointestinal bleeding. Fourteen months earlier, he had undergone a choledochojejunostomy and pancreatic cystojejunostomy for bile duct stenosis with an enlarged pancreatic pseudocyst due to severe chronic pancreatitis...
2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/27757413/endoscopic-management-of-bleeding-gastric-varices-with-n-butyl-2-cyanoacrylate-glue-injection-in-children-with-non-cirrhotic-portal-hypertension
#14
Ujjal Poddar, Vibhor Borkar, Surender Kumar Yachha, Anshu Srivastava
Background and study aims: In view of the paucity of literature, we carried out this audit to evaluate the safety and efficacy of N- butyl, 2-cynoacrylate glue injection therapy in secondary prophylaxis of gastric varices in children. Patients and methods: Consecutive children (≤ 18 years) with non-cirrhotic portal hypertension who presented with bleeding from gastric varices and who had undergone cyanoacrylate glue injection therapy were included. They were evaluated for safety, efficacy and complications...
October 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27633031/low-frequency-of-v617f-mutation-in-jak2-gene-in-indian-patients-with-hepatic-venous-outflow-obstruction-and-extrahepatic-portal-venous-obstruction
#15
Praveer Rai, Pankaj Kumar, Swapnil Mishra, Rakesh Aggarwal
BACKGROUND: Hepatic venous outflow tract obstruction (HVOTO) and extrahepatic portal venous obstruction (EHPVO) are important causes of portal hypertension and related complications in India. Both these conditions result from splanchnic venous thrombosis. In recent years, a V617F somatic mutation in Janus kinase 2 (JAK2) gene which is highly specific for myeloproliferative disorders has been detected in 40 % to 50 % and 30 % to 35 % of Western patients with HVOTO and EHPVO, respectively...
September 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/27358683/imaging-and-radiological-interventions-in-extra-hepatic-portal-vein-obstruction
#16
REVIEW
Sudheer S Pargewar, Saloni N Desai, S Rajesh, Vaibhav P Singh, Ankur Arora, Amar Mukund
Extrahepatic portal vein obstruction (EHPVO) is a primary vascular condition characterized by chronic long standing blockage and cavernous transformation of portal vein with or without additional involvement of intrahepatic branches, splenic or superior mesenteric vein. Patients generally present in childhood with multiple episodes of variceal bleed and EHPVO is the predominant cause of paediatric portal hypertension (PHT) in developing countries. It is a pre-hepatic type of PHT in which liver functions and morphology are preserved till late...
June 28, 2016: World Journal of Radiology
https://www.readbyqxmd.com/read/27317208/budd-chiari-syndrome-an-update-on-imaging-features
#17
Sid Ahmed Faraoun, Mohamed El Amine Boudjella, Nabil Debzi, Naima Benidir, Nawel Afredj, Youcef Guerrache, Kamel Bentabak, Philippe Soyer, Salah Eddine Bendib
Budd-Chiari syndrome (BCS) is a rare cause of portal hypertension and liver failure. This condition is characterized by an impaired hepatic venous drainage. The diagnosis of BCS is based on imaging, which helps initiate treatment. Imaging findings can be categorized into direct and indirect signs. Direct signs are the hallmarks of BCS and consist of visualization of obstructive lesions of the hepatic veins or the upper portion of the inferior vena cava. Indirect signs, which are secondary to venous obstruction, correspond to intra- and extrahepatic collateral circulation, perfusion abnormalities, dysmorphy and signs of portal hypertension...
July 2016: Clinical Imaging
https://www.readbyqxmd.com/read/27044769/portal-biliopathy-treated-with-endoscopic-biliary-stenting
#18
Sung Jin Jeon, Jae Ki Min, So Young Kwon, Jun Hyun Kim, Sun Young Moon, Kang Hoon Lee, Jeong Han Kim, Won Hyeok Choe, Young Koog Cheon, Tae Hyung Kim, Hee Sun Park
Portal biliopathy is defined as abnormalities in the extra- and intrahepatic ducts and gallbladder of patients with portal hypertension. This condition is associated with extrahepatic venous obstruction and dilatation of the venous plexus of the common bile duct, resulting in mural irregularities and compression of the biliary tree. Most patients with portal biliopathy remain asymptomatic, but approximately 10% of them advance to symptomatic abdominal pain, jaundice, and fever. Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography are currently used as diagnostic tools because they are noninvasive and can be used to assess the regularity, length, and degree of bile duct narrowing...
March 2016: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/26943433/epiploic-gonadal-vein-as-a-new-bypass-route-for-extrahepatic-portal-venous-obstruction-report-of-a-case
#19
Tatsuaki Sumiyoshi, Yasuo Shima, Takehiro Okabayashi, Yuji Negoro, Akihito Kozuki, Jun Iwata, Yuichi Saisaka, Teppei Tokumaru, Toshio Nakamura, Sojiro Morita
A 61-year-old man was referred to our hospital to treat extrahepatic portal venous obstruction. Endoscopic injection sclerotherapy (EIS) was performed for the esophageal varices; however, the patient returned with massive hematemesis from gastric varices 6 months after treatment. Although the varices were treated with EIS, gastric devascularization and splenectomy concomitant with shunt surgery were required to treat uncontrollable, frequent diarrhea and abdominal distension. Because the splenic vein, left gastric vein, left portal vein, and inferior vena cava were inadequate for anastomosis, an epiploic gonadal vein bypass was performed...
December 2015: Surgical Case Reports
https://www.readbyqxmd.com/read/26288604/etiology-and-complications-of-portal-vein-thrombosis
#20
REVIEW
Jonel Trebicka, Christian P Strassburg
BACKGROUND: Portal venous occlusion represents a disorder with considerable clinical relevance. The underlying causes of portal vein thrombosis (PVT) are frequently multifactorial and include malignancies, progressive chronic liver diseases, processes localized to the epigastrium and hepatobiliary system, and acquired as well as inherited thrombophilia. The three main categorical groups are malignant thrombosis, cirrhotic PVT, and non-malignant, non-cirrhotic PVT. METHODS: Review of the literature...
December 2014: Viszeralmedizin
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