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extrahepatic portal venous obstruction

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https://www.readbyqxmd.com/read/28694570/extrahepatic-portal-vein-obstruction-in-children-role-of-preoperative-imaging
#1
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
#2
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
#3
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/28579293/withdrawn-the-optimal-procedure-of-modified-rex-shunt-for-the-treatment-of-extrahepatic-portal-hypertension-in-children
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/26155864/-a-case-of-idiopathic-portal-vein-obstruction-identified-by-severe-bleeding-after-a-routine-hemorrhoid-operation
#14
Naoto Nishigori, Fumikazu Koyama, Shinji Nakamura, Takeshi Ueda, Takashi Inoue, Keijirou Kawasaki, Takayuki Nakamoto, Rumiko Nishigori, Hisao Fujii, Yoshiyuki Nakajima
We report our experiences of a case of repeated bleeding after hemorrhoid ligation. A 53-year-old man underwent hemorrhoid ligation for internal hemorrhoids at another hospital. Postoperatively, he developed severe and repeated bleeding. Scanning revealed extrahepatic portal venous obstruction. The severe bleeding persisted after transfer to our institution, where we re-sutured the ligature and performed superior rectal artery embolism, leading to arrest of bleeding. The rectal varix arose due to portal hypertension, which resulted in the diagnosis of idiopathic extrahepatic portal vein obstruction...
July 2015: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/26111208/multimodality-imaging-of-primary-extrahepatic-portal-vein-obstruction-ehpvo-what-every-radiologist-should-know
#15
A Arora, S K Sarin
Portal vein thrombosis (PVT) is a frequent complication of liver cirrhosis, but it can also occur as a primary vascular disorder amid absent liver disease. Extrahepatic portal vein obstruction (EHPVO) refers to the obstruction of the extrahepatic portal vein with or without involvement of the intrahepatic portal vein branches, splenic and/or superior mesenteric vein. It is a distinct disorder that excludes PVT occurring in concurrence with liver cirrhosis or hepatocellular carcinoma. The term "EHPVO" implies chronicity and is principally reserved for a long-standing condition characterized by cavernous transformation of the portal vein...
August 2015: British Journal of Radiology
https://www.readbyqxmd.com/read/25759562/portal-vein-aneurysm-associated-with-budd-chiari-syndrome-treated-with-transjugular-intrahepatic-portosystemic-shunt-a-case-report
#16
Jiaywei Tsauo, Xiao Li
A 65-year-old woman with Budd-Chiari syndrome (BCS) presented with right upper quadrant pain. A computed tomography (CT) scan showed a saccular aneurysm located at the extrahepatic portal vein main branch measuring 3.2 cm in height and 2.5 cm × 2.4 cm in diameter. The aneurysm was thought to be associated with BCS as there was no preceding history of trauma and it had not been present on Doppler ultrasound examination performed 3 years previously. Because of increasing pain and concern for complications due to aneurysm size, the decision was made to relieve the hepatic venous outflow obstruction...
March 7, 2015: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/25755599/surgical-management-of-portal-cavernoma-cholangiopathy
#17
REVIEW
Vibha Varma, Arunanshu Behera, Leileshwar Kaman, Somnath Chattopadhyay, Samiran Nundy
The majority of patients with portal cavernoma cholangiopathy (PCC) are asymptomatic, however some (5-38%) present with obstructive jaundice, cholangitis, or even biliary pain due to bile duct stones which form as a result of stasis. Most patients with extrahepatic portal venous obstruction (EHPVO) present with variceal bleeding and hypersplenism and these are the usual indications for surgery. Those who present with PCC may also need decompression of their portosystemic system to reverse the biliary obstruction...
February 2014: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/25755593/portal-cavernoma-cholangiopathy-clinical-characteristics
#18
REVIEW
Ajay Duseja
Because of the presence of portal cavernoma, paracholedochal and pericholedochal varices, portal cavernoma cholangiopathy (PCC) has become an entity unique to patients with extrahepatic portal venous obstruction (EHPVO). Majority of patients with these abnormalities are asymptomatic and are incidentally detected to have the presence of biliary abnormalities on cholangiography. Minority of patients present with symptoms of chronic cholestasis with or without biliary pain or acute cholangitis related most often to the presence of biliary strictures or stones...
February 2014: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/25755591/portal-cavernoma-cholangiopathy-consensus-statement-of-a-working-party-of-the-indian-national-association-for-study-of-the-liver
#19
REVIEW
Radha K Dhiman, Vivek A Saraswat, Dominique C Valla, Yogesh Chawla, Arunanshu Behera, Vibha Varma, Swastik Agarwal, Ajay Duseja, Pankaj Puri, Naveen Kalra, Chittapuram S Rameshbabu, Vikram Bhatia, Malay Sharma, Manoj Kumar, Subhash Gupta, Sunil Taneja, Leileshwar Kaman, Showkat A Zargar, Samiran Nundy, Shivaram P Singh, Subrat K Acharya, Jang B Dilawari
Portal cavernoma cholangiopathy (PCC) is defined as abnormalities in the extrahepatic biliary system including the cystic duct and gallbladder with or without abnormalities in the 1st and 2nd generation biliary ducts in a patient with portal cavernoma. Presence of a portal cavernoma, typical cholangiographic changes on endoscopic or magnetic resonance cholangiography and the absence of other causes of these biliary changes like bile duct injury, primary sclerosing cholangitis, cholangiocarcinoma etc are mandatory to arrive a diagnosis...
February 2014: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/25755467/gastric-varices-in-cirrhosis-versus-extrahepatic-portal-venous-obstruction-and-response-to-endoscopic-n-butyl-2-cyanoacrylate-injection
#20
Barjesh C Sharma, Ameet K Banka, Ajit Rawat, Siddharth Srivastava
BACKGROUND: Gastric varices are found in patients with portal hypertension. Incidence of bleeding from gastric varices is relatively low, but tends to be more severe, and is associated with higher mortality than esophageal variceal bleeding. AIMS AND OBJECTIVES: To compare the prevalence and types of gastric varices in cirrhosis versus extrahepatic portal venous obstruction (EHPVO) and the results of endoscopic N-butyl-2-cyanoacrylate (NBC, glue) injection. METHODS: Eighty six patients presenting with bleeding from gastric varices between August 2010 and August 2011 were retrospectively analyzed...
March 2013: Journal of Clinical and Experimental Hepatology
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