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portal vein hypertension

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https://www.readbyqxmd.com/read/28430610/treatment-of-hepatocellular-carcinoma-with-portal-vein-tumor-thrombus-advances-and-challenges
#1
REVIEW
Jin-Fang Jiang, Yong-Cong Lao, Bao-Hong Yuan, Jun Yin, Xin Liu, Long Chen, Jian-Hong Zhong
Portal vein tumor thrombus is a frequent, challenging complication in hepatocellular carcinoma. Hepatocellular carcinoma patients with portal vein tumor thrombus may show worse liver function, less treatment tolerance and worse prognosis than patients without portal vein tumor thrombus, and they may be at higher risk of comorbidity related to portal hypertension. Western and some Asian guidelines stratify hepatocellular carcinoma with portal vein tumor thrombus together with metastatic hepatocellular carcinoma and therefore recommend only palliative treatment with sorafenib or other systemic agents...
February 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28429043/transsplenic-endovascular-recanalization-and-stenting-of-a-completely-occluded-portal-vein-with-jejunal-variceal-embolization-in-a-pediatric-liver-transplant-recipient
#2
Jeffrey Forris Beecham Chick, Alexandria Jo, Narasimham Dasika, Wael E Saad, Ravi Nara Srinivasa
Portal vein thrombosis occurs in 1.4% of pediatric liver transplant candidates and 3.7% of liver transplant recipients. While portal vein recanalization without and with portal vein stenting has been described in adult transplant candidates and recipients, it has never been described in the pediatric transplant population. This report presents a pediatric liver transplant recipient with portal hypertension secondary to portal vein thrombosis successfully managed with transsplenic access and subsequent portal vein recanalization and stenting...
April 20, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28407511/clinical-and-cross-sectional-imaging-features-of-spontaneous-pancreatic-pseudocyst-portal-vein-fistula
#3
Francesco Alessandrino, Corinne Strickland, Amirkasra Mojtahed, Steven C Eberhardt, Koenraad J Mortele
PURPOSE: To evaluate clinical and imaging features of pancreatic pseudocyst-portal vein fistula (PPVF). METHODS: Patients with evidence of PPVF on CT/MRI were included. Clinical presentation, outcomes, imaging appearance of the portal vein were recorded. RESULTS: 75% of patients developed portal hypertension, 62% cavernous transformation of the portal vein and 25% portal biliopathy. PPVF presented on CT as fluid-attenuated portal vein, and on MRI as T2-weighted hyperintense fluid-filled portal vein...
April 1, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28402911/hassab-s-operation-for-joubert-syndrome-with-congenital-hepatic-fibrosis-a-case-report
#4
Koji Miyazawa, Yasuyuki Hara, Kenji Shimizu, Wataru Nakanishi, Kazuaki Tokodai, Chikashi Nakanishi, Shigehito Miyagi, Naoki Kawagishi, Noriaki Ohuchi
INTRODUCTION: Joubert syndrome is characterized by psychomotor developmental delay, hypotonia, oculomotor abnormalities, occasional retinal dystrophy and cystic kidneys, and frequent and often, striking breathing abnormalities, especially in the neonatal period, with panting tachypnea followed by apnea. We report a case of Joubert syndrome with hepatic fibrosis, portal hypertension, and pancytopenia treated by Hassab's operation. PRESENTATION OF CASE: Our patient was a 27-year-old woman with a history of tachypnea, muscle hypotonia, and psychomotor retardation shortly after birth and a diagnosis of Joubert syndrome at 2 years of age...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28396581/coil-embolization-of-spontaneous-splenic-arteriovenous-fistula-for-treatment-of-portal-hypertension
#5
H Edward Garrett, Lamar Mack
BACKGROUND Splenic arteriovenous fistula (AVF) is a rare cause of portal hypertension which may manifest with abdominal pain, diarrhea, ascites, and/or hematemesis. Fistula formation may be traumatic or spontaneous. Eighty-six percent of spontaneous splenic AVFs occur in women, and 55% are associated with a preexisting splenic artery aneurysm. CASE REPORT A 64-year-old Caucasian female with unremarkable past medical history presented with new onset of left lower quadrant abdominal pain and persistent diarrhea...
April 11, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28381381/transjugular-intrahepatic-portosystemic-shunt-versus-open-splenectomy-and-esophagogastric-devascularization-for-portal-hypertension-with-recurrent-variceal-bleeding
#6
An-Ping Su, Zhao-Da Zhang, Bo-Le Tian, Jing-Qiang Zhu
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) and open splenectomy and esophagogastric devascularization (OSED) are widely used to treat patients with portal hypertension and recurrent variceal bleeding (PHRVB). This study aimed to compare the effectiveness between TIPS and OSED for the treatment of PHRVB. METHODS: The data were retrospectively retrieved from 479 cirrhotic patients (Child-Pugh A or B class) with PHRVB, who had undergone TIPS (TIPS group) or OSED (OSED group) between January 1, 2010 and October 31, 2014...
April 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28369056/pulmonary-shunts-in-severe-hepatosplenic-schistosomiasis-diagnosis-by-contrast-echocardiography-and-their-relationship-with-abdominal-ultrasound-findings
#7
Liana Gonçalves-Macedo, Ana Lucia Coutinho Domingues, Edmundo Pessoa Lopes, Carlos Feitosa Luna, Vitor Gomes Mota, Mônica Moraes de Chaves Becker, Brivaldo Markman-Filho
BACKGROUND: Schistosomiasis is endemic to several parts of the world. Among the species that affect humans, Schistosoma mansoni is one of the most common causes of illness. In regions where schistosomiasis mansoni is endemic, reinfection is responsible for the emergence of hepatosplenic schistosomiasis (HSS) with portal hypertension in about 10% of infected individuals. Regardless of its etiology, portal hypertension may bring about the formation of arteriovenous fistulas and pulmonary vascular dilation, thus constituting a pulmonary shunt and its presence has been associated with the occurrence of neurological complications...
April 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28367084/interrelationship-between-insulin-resistance-and-portal-haemodynamic-abnormality-in-cirrhosis
#8
Hitoshi Maruyama, Kazufumi Kobayashi, Soichiro Kiyono, Osamu Yokosuka
Background: There are only limited data regarding the effect of impaired portal circulation on the glucose metabolism. The study prospectively examined the interrelationship between insulin resistance (IR) and portal haemodynamic abnormality in cirrhosis. Methods: There were 53 cirrhosis patients (61.6 ± 13.0 years) all presenting gastroesophageal varices. Portal haemodynamics by both hepatic venous catheterisation and Doppler ultrasound were examined with respect to the homeostasis model assessment (HOMA)-IR and HOMA2-IR...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28364812/coagulopathy-before-and-after-liver-transplantation-from-the-hepatic-to-the-systemic-circulatory-systems
#9
REVIEW
Jonathan G Stine, Patrick G Northup
The hemostatic environment in patients with cirrhosis is a delicate balance between prohemostatic and antihemostatic factors. There is a lack of effective laboratory measures of the hemostatic system in patients with cirrhosis. Many are predisposed to pulmonary embolus, deep vein thrombosis, and portal vein thrombosis in the pretransplantation setting. This pretransplantation hypercoagulable milieu seems to extend for at least several months post-transplantation. Patients with nonalcoholic fatty liver disease, inherited thrombophilia, portal hypertension in the absence of cirrhosis, and hepatocellular carcinoma often require individualized approach to anticoagulation...
May 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28361122/risk-factors-for-intractable-ascites-after-adult-to-adult-living-donor-liver-transplantation-using-left-lobe
#10
Shinichi Matsudaira, Yoichi Ishizaki, Jiro Yoshimoto, Noriko Fujiwara, Seiji Kawasaki
BACKGROUND: Intractable ascites is one of the causes of graft loss after adult-to-adult living donor liver transplantation (LDLT) using a small graft. Identification of factors associated with increasing posttransplant ascites has important implications for prevention and treatment. METHODS: All 59 consecutive adult patients who underwent left lobe LDLT without portal inflow modulation between October 2002 and February 2016 were prospectively enrolled. Factors associated with the average daily amount of ascites for 2 weeks after LDLT were assessed...
March 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28353569/case-report-and-systematic-literature-review-of-a-novel-etiology-of-sinistral-portal-hypertension-presenting-with-ugi-bleeding-left-gastric-artery-pseudoaneurysm-compressing-the-splenic-vein-treated-by-embolization-of-the-pseudoaneurysm
#11
REVIEW
Seifeldin Hakim, Jared Bortman, Molly Orosey, Mitchell S Cappell
INTRODUCTION: A novel case is reported of upper gastrointestinal (UGI) bleeding from sinistral portal hypertension, caused by a left gastric artery (LGA) pseudoaneurysm (PA) compressing the splenic vein (SV) that was successfully treated with PA embolization. CASE REPORT: A 41-year-old man with previous medical history of recurrent, alcoholic pancreatitis presented with several episodes of hematemesis and abdominal pain for 48 hours. Physical examination revealed a soft abdomen, with no abdominal bruit, no pulsatile abdominal mass, and no stigmata of chronic liver disease...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28350741/short-article-noninvasive-assessment-of-portal-hypertension-and-detection-of-esophageal-varices-in-cirrhosis-state-of-the-art
#12
Ana C de Oliveira
Portal hypertension (PHT) is a major consequence of any chronic liver disease and it is the main cause of complications in patients with cirrhosis. Measurement of hepatic vein pressure gradient is considered the gold standard for PHT assessment, together with its diagnosis and prognosis relevance. Even though hepatic vein pressure gradient measurement is a safe procedure, it is still considered an invasive technique and not widely available. There is thus a need for noninvasive methods that can predict the progression of PHT as well as the presence and the risk of complications related to esophageal varices...
May 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28348478/portal-hypertension-imaging-of-portosystemic-collateral-pathways-and-associated-image-guided-therapy
#13
REVIEW
Murad Feroz Bandali, Anirudh Mirakhur, Edward Wolfgang Lee, Mollie Clarke Ferris, David James Sadler, Robin Ritchie Gray, Jason Kam Wong
Portal hypertension is a common clinical syndrome, defined by a pathologic increase in the portal venous pressure. Increased resistance to portal blood flow, the primary factor in the pathophysiology of portal hypertension, is in part due to morphological changes occurring in chronic liver diseases. This results in rerouting of blood flow away from the liver through collateral pathways to low-pressure systemic veins. Through a variety of computed tomographic, sonographic, magnetic resonance imaging and angiographic examples, this article discusses the appearances and prevalence of both common and less common portosystemic collateral channels in the thorax and abdomen...
March 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28348475/giant-intrahepatic-portal-vein-aneurysm-leave-it-or-treat-it
#14
Amit Shrivastava, Jagdeesh S Rampal, D Nageshwar Reddy
Portal vein aneurysm (PVA) is a rare vascular dilatation of the portal vein. It is a rare vascular anomaly representing less than 3% of all visceral aneurysms and is not well understood. Usually, PVA are incidental findings, are asymptomatic, and clinical symptoms are proportionally related to size. Patients present with nonspecific epigastric pain or gastrointestinal bleeding with underlying portal hypertension. PVA may be associated with various complications such as biliary tract compression, portal vein thrombosis/rupture, duodenal compression, gastrointestinal bleeding, and inferior vena cava obstruction...
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28346001/assessment-of-contrast-enhanced-ultrasonography-of-the-hepatic-vein-for-detection-of-hemodynamic-changes-associated-with-experimentally-induced-portal-hypertension-in-dogs
#15
Keitaro Morishita, Akira Hiramoto, Asuka Michishita, Satoshi Takagi, Yuki Hoshino, Takaharu Itami, Sue Yee Lim, Tatsuyuki Osuga, Sayuri Nakamura, Kenji Ochiai, Kensuke Nakamura, Hiroshi Ohta, Masahiro Yamasaki, Mitsuyoshi Takiguchi
OBJECTIVE To assess the use of contrast-enhanced ultrasonography (CEUS) of the hepatic vein for the detection of hemodynamic changes associated with experimentally induced portal hypertension in dogs. ANIMALS 6 healthy Beagles. PROCEDURES A prospective study was conducted. A catheter was surgically placed in the portal vein of each dog. Hypertension was induced by intraportal injection of microspheres (10 to 15 mg/kg) at 5-day intervals via the catheter. Microsphere injections were continued until multiple acquired portosystemic shunts were created...
April 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/28319252/physiologic-reduction-of-hepatic-venous-blood-flow-by-the-valsalva-maneuver-decreases-liver-stiffness
#16
Selcan Ipek-Ugay, Heiko Tzschätzsch, Jürgen Braun, Thomas Fischer, Ingolf Sack
OBJECTIVES: Liver stiffness increases after intake of food or water, suggesting that hepatic venous blood flow affects the results of elastographic measurements. This study investigated the correlation between in vivo liver stiffness and hepatic blood flow using the Valsalva maneuver for reducing intrahepatic venous blood flow. METHODS: Intrahepatic changes in venous blood flow were assessed by sonography based on the pulsed wave Doppler velocity, vessel diameter assessment, and blood flow volume measurements in the portal vein and right hepatic vein...
March 20, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28316323/a-rare-cause-of-upper-gastrointestinal-hemorrhage-chronic-thrombosis-of-the-splenic-artery
#17
Sevtap Arslan, Mehmet Ruhi Onur, Erhan Akpınar
Upper gastrointestinal bleeding (UGIB) represents one of the most serious conditions of the gastrointestinal tract with a mortality rate of 10%. The main cause of UGIB is peptic ulcer, accounting for 28%-59% of cases. A rare cause of UGIB is submucosal arterial collaterals, which develop after splenic artery thrombosis. UGIB secondary to gastric submucosal collateral arteries should be considered in patients with endoscopic appearance of varicose veins in the absence of portal hypertension. Computed tomography angiography (CTA) is the only fast and noninvasive definitive imaging technique for such patients...
March 17, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28302230/distal-duodenal-varices-first-presentation-of-upper-gastrointestinal-bleeding
#18
Inam -Ul- Haq, Amir Ali Shah, S Chandramohan
Varices are abnormal dilated veins which result from increased pressure in the portal circulation. Although the oesophagus and stomach are the most common sites for varices to develop, they may also occur as ectopic varices in the duodenum, rectum, and retroperitoneal areas. Isolated duodenal varices involving distal duodenum, particularly the fourth part of the duodenum, are extremely rare. However, such ectopic varices are associated with an increased risk of bleeding and mortality. Not only are they a diagnostic challenge, particularly if they present as a first manifestation of portal hypertension, they are also very difficult to treat due to their location...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28298943/hepatic-vein-transit-time-of-second-generation-ultrasound-contrast-agent-new-tool-in-the-assessment-of-portal-hypertension
#19
Siciliani Luisa, Giovanna Vitale, Anna Rita Sorbo, Pompili Maurizio, Rapaccini Gian Lodovico
PURPOSE: It has been demonstrated that Doppler waveform of the hepatic vein (normally triphasic) is transformed into a biphasic or monophasic waveform in cirrhotic patients. The compressive mechanism of liver tissue has been considered up till now the cause of this change. Moreover, cirrhotics show, after USCA injection, a much earlier HVTT due to intrahepatic shunts. Our aim was to prospectively evaluate the correlation between Doppler pattern of hepatic vein and HVTT of a second-generation USCA; we also correlated HVTT with the most common indexes of portal hypertension...
March 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28295621/hepatic-and-plasma-endothelin-1-in-dogs-with-chronic-hepatitis
#20
Y Sakamoto, M Sakai, T Watari
BACKGROUND: Endothelin (ET)-1 is a 21-amino-acid peptide with potent vasoactive properties, which increases intrahepatic resistance in patients with chronic hepatitis (CH) or cirrhosis. ET-1 concentrations have not been investigated in dogs with CH. HYPOTHESIS/OBJECTIVES: This study compared hepatic and plasma ET-1 levels in healthy dogs and in dogs with CH, and examined the relationship between the plasma ET-1 level and portal vein pressure in dogs with CH. ANIMALS: Fourteen healthy dogs and twenty dogs with CH were used in this study...
March 14, 2017: Journal of Veterinary Internal Medicine
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