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portal vein hypertension

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https://www.readbyqxmd.com/read/28319252/physiologic-reduction-of-hepatic-venous-blood-flow-by-the-valsalva-maneuver-decreases-liver-stiffness
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28288507/anticoagulation-in-cirrhosis-a-new-paradigm
#6
Filippo Leonardi, Nicola De Maria, Erica Villa
The liver plays a crucial role in coagulation cascade. Global hemostatic process is profoundly influenced by the presence of liver disease and its complications. Patients with cirrhosis have impaired synthesis of most of the factors involved in coagulation and fibrinolysis process due to a reduced liver function and altered platelet count secondary to portal hypertension. Altered routine tests and thrombocytopenia were considered in the past as associated with increased risk of bleeding. These concepts explain both the routine use of plasma and/or platelets transfusion in patients with liver cirrhosis, especially before invasive procedures, and why these patients were considered "auto-anticoagulated"...
March 14, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28286795/systemic-mastocytosis-complicated-by-non-cirrhotic-portal-hypertension-and-variceal-bleeding
#7
Thomas R McCarty, Adelina Hung, Arpan Mohanty, John I Allen
Systemic mastocytosis is a myeloproliferative disorder characterized by extracutaneous involvement of at least one organ. Although rare, infiltration of inflammatory mast cells within the portal vein may lead to obstruction of the sinusoids resulting in non-cirrhotic portal hypertension. We present a patient with known history of systemic mastocytosis with bone marrow involvement presenting with new-onset esophageal variceal bleeding. Although systemic mastocytosis is uncommon, the subsequent development of hepatic involvement and non-cirrhotic portal hypertension are discussed...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28283401/portal-vein-embolization-in-the-setting-of-staged-hepatectomy-with-preservation-of-segment-iv-%C3%A2-i-only-for-bilobar-colorectal-liver-metastases-safety-efficacy-and-clinical-outcomes
#8
Christophe Cassinotto, Anthony Dohan, Benoît Gallix, Eve Simoneau, Louis-Martin Boucher, Peter Metrakos, Tatiana Cabrera, Carlos Torres, Karl Muchantef, David A Valenti
PURPOSE: To assess frequency of adverse events, efficacy, and clinical outcomes of percutaneous portal vein embolization (PVE) in patients with bilobar colorectal liver metastases undergoing staged hepatectomy with preservation of segment IV ± I only. MATERIALS AND METHODS: Retrospective analysis was performed of 40 consecutive patients who underwent right PVE after successful left lobectomy between 2005 and 2013. Rates of adverse events, future liver remnant (FLR) > 30% compared with baseline liver volume, clinical success (completion of staged hepatectomy with clearance of liver metastases), and overall survival were analyzed...
March 7, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28282272/role-of-serum-soluble-cd163-in-the-diagnosis-risk-of-bleeding-and-prognosis-of-gastro-esophageal-varices-in-cirrhotic-patients
#9
Rabab Fouad, Iman Hamza, Marwa Khairy, Marwa Elsharkawy, Amal A Helmy
Research is continuous for noninvasive tools for the prediction of portal hypertension than upper gastrointestinal endoscopy. Serum sCD163 correlates with hepatic venous pressure gradient, aiding in the prediction of portal hypertension. We aimed at investigating the role of sCD163 in the prediction of the presence and size of varices as well as a stratification tool for surveillance or prophylaxis by assessment of prognosis and risk of bleeding. Two hundred forty-three cirrhotic patients were divided into 3 groups: group I: no varices, group II: small-sized varices, and group III: medium-sized and large-sized varices...
March 2017: Journal of Interferon & Cytokine Research
https://www.readbyqxmd.com/read/28280650/polycystic-liver-disease-and-sarcoidosis-unusual-coexisting-etiologies-of-portal-hypertension
#10
Waseem Amjad, Sophia Jagroop, Rukma Parthvi
Both polycystic liver disease (PLD) and sarcoidosis can involve liver. Most of the time, liver disease in both conditions is asymptomatic, but they can rarely cause portal hypertension. Our aim is to report a case of a 51-year-old female with a history of adult dominant polycystic kidney disease (ADPKD) and sarcoidosis who presented with multiple episodes of hematemesis. An endoscopy showed grade 3 esophageal varices. A computed tomography (CT) scan of the abdomen showed ascites with polycystic liver, nodular contour, and calcified granuloma...
January 25, 2017: Curēus
https://www.readbyqxmd.com/read/28258459/significance-of-simultaneous-splenic-artery-resection-in-left-sided-portal-hypertension-after-pancreaticoduodenectomy-with-combined-portal-vein-resection
#11
Kazuyuki Gyoten, Shugo Mizuno, Motonori Nagata, Toru Ogura, Masanobu Usui, Shuji Isaji
BACKGROUND: In pancreaticoduodenectomy (PD) with resection of portal vein (PV)/superior mesenteric vein (SMV) confluence, the splenic vein (SV) division may cause left-sided portal hypertension (LPH). METHODS: The 88 pancreatic ductal adenocarcinoma patients who underwent PD with PV/SMV resection after chemoradiotherapy were classified into three groups: both SV and splenic artery (SA) were preserved in Group A (n = 16), SV was divided and SA was preserved in Group B (n = 58), and both SV and SA were divided in Group C (n = 14)...
March 3, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28253218/association-between-mri-derived-hepatic-fat-fraction-and-blood-pressure-in-participants-without-history-of-cardiovascular-disease
#12
Roberto Lorbeer, Christian Bayerl, Sigrid Auweter, Susanne Rospleszcz, Wolfgang Lieb, Christa Meisinger, Margit Heier, Annette Peters, Fabian Bamberg, Holger Hetterich
OBJECTIVES: We assessed whether liver fat content, as determined by MRI, correlates with blood pressure (BP), a major vascular risk factor, in individuals from the general population without history of stroke and coronary or peripheral artery disease. METHODS: Cross-sectional data from 384 participants (161 women; aged 39-73 years) of a MRI substudy of the KORA FF4 survey were used. Hepatic fat fraction (HFF) was measured in the left and right lobe of the liver using single voxel multiecho H-spectroscopy and at the level of the portal vein using a multiecho Dixon-sequence...
April 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28247771/poems-syndrome-and-idiopathic-portal-hypertension-a-possible-association
#13
Sara Campos, Cláudia Agostinho, Maria Augusta Cipriano
A 48-year old female patient was admitted to the emergency department with upper gastrointestinal bleeding. Endoscopy showed large esophageal varices that were treated with band ligation. She had been treated with cyclophosphamide, melphalan, lenalidomide and corticosteroids for POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy or edema, M protein, skin changes). She had no other risk factors for chronic liver disease. Laboratory and radiological examinations could not confirm the etiology of portal hypertension...
March 1, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28238775/assessing-the-brain-through-the-eye-new-ways-to-explore-hepatic-encephalopathy
#14
Natalia Arias, Marta Méndez, Ignacio Alcalde, Almudena Íñigo-Portugués, Jesús Merayo-Lloves, Jaime Arias, Jorge L Arias
BACKGROUND & AIMS: Minimal hepatic encephalopathy (mHE) has been shown to affect daily functioning, quality of life, driving and overall mortality. However, little is known about treating or diagnosing early impairments in mHE. We studied one of its precipitating factors, portal hypertension which is driving the inflammatory process behind mHE. The purpose was to describe an indirect diagnostic method able to detect the pathology at early stages based on the study of the vascularization and mast cells conjunctival hyperplasia as secondary inflammatory response associated to portal hypertension...
February 24, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/28223261/use-of-transabdominal-ultrasound-guided-transjugular-portal-vein-puncture-on-radiation-dose-in-transjugular-intrahepatic-portosystemic-shunt-formation
#15
Aniket N Tavare, Andrew Wigham, Anastasia Hadjivassilou, Abdulrahman Alvi, Anthie Papadopoulou, Antony Goode, Nick Woodward, David Patch, Dominic Yu, Neil Davies
PURPOSE: Transjugular intrahepatic portosystemic shunt (TIPS) creation is used to treat portal hypertension complications. Often the most challenging and time-consuming step in the procedure is the portal vein (PV) puncture. TIPS procedures are associated with prolonged fluoroscopy time and high patient radiation exposures. We measured the impact of transabdominal ultrasound guidance for PV puncture on duration of fluoroscopy time and dose. METHODS: We retrospectively analyzed the radiation dose for all TIPS performed over a four-year period with transabdominal ultrasound guidance for PV puncture (n=212, with 210 performed successfully and data available for 206); fluoroscopy time, dose area product (DAP) and skin dose were recorded...
February 22, 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28217250/advanced-non-alcoholic-steatohepatitis-cirrhosis-a-high-risk-population-for-pre-liver-transplant-portal-vein-thrombosis
#16
Jonathan G Stine, Curtis K Argo, Shawn J Pelletier, Daniel G Maluf, Stephen H Caldwell, Patrick G Northup
AIM: To examine if liver transplant recipients with high-risk non-alcoholic steatohepatitis (NASH) are at increased risk for pre-transplant portal venous thrombosis. METHODS: Data on all liver transplants in the United States from February 2002 through September 2014 were analyzed. Recipients were sorted into three distinct groups: High-risk (age > 60, body mass index > 30 kg/m(2), hypertension and diabetes), low-risk and non-NASH cirrhosis. Multivariable logistic regression models were constructed...
January 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28177946/transient-elastography-evaluation-of-hepatic-and-spleen-stiffness-in-patients-with-hepatosplenic-schistosomiasis
#17
Zulane S T Veiga, Cristiane A Villela-Nogueira, Flávia F Fernandes, Marta G Cavalcanti, Fátima A Figueiredo, João L Pereira, Gustavo H Pereira, Henrique S Moraes Coelho, José M Peralta, Carlos E Marques, Renata M Perez, Homero S Fogaça
BACKGROUND: Hepatosplenic schistosomiasis (HES) has not been evaluated by transient elastography so far and its correlation with ultrasound variables remains to be defined. AIMS: The aim of this study was to describe the parameters of liver and spleen stiffness in HES assessed by transient elastography in comparison with cirrhotics and controls evaluating its correlation with ultrasonographic data. PATIENTS AND METHODS: HES, hepatitis C virus-cirrhotic, and control patients were included in this sectional study...
February 7, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28150309/portal-systemic-shunt-between-the-hepatic-portal-vein-and-right-renal-vein-in-a-patient-with-multifocal-hepatocellular-carcinoma-case-report
#18
Mateja Sabol Pušić, Ivan Budimir, Zdravko Dorosulić, Branko Ostrički, Marko Nikolić, Gordana Lovrenčić Prpić, Katherina B Sreter
Portal hypertension is a clinical syndrome characterized by the development of collateral circulation and portosystemic shunts, as well as ascites and hepatic encephalopathy. We present the case of a large portosystemic shunt between the hepatic portal vein and aneurysmal right renal vein in a cirrhotic 64-year-old man with thrombosis of the portal vein and hepatocellular carcinoma. This is a very rare clinical manifestation which, to our knowledge, has been described only once previously in the literature...
February 2, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28143477/portal-vein-stent-placement-for-the-treatment-of-postoperative-portal-vein-stenosis-long-term-success-and-factor-associated-with-stent-failure
#19
Atsushi Kato, Hiroaki Shimizu, Masayuki Ohtsuka, Hideyuki Yoshitomi, Katsunori Furukawa, Masaru Miyazaki
BACKGROUND: Portal vein stenosis develops due to different causes including postoperative inflammation and oncological processes. However, limited effective therapy is available for portal vein stenosis. The objectives of this study were to evaluate the efficacy of a portal vein stent for portal vein stenosis after hepatobiliary pancreatic surgery and to determine the factors associated with stent patency. METHODS: From December 2003 to December 2015, portal vein stents were implanted in 29 patients who had portal vein stenosis after hepatobiliary pancreatic surgery...
February 1, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28105103/inhibition-of-p-glycoprotein-multidrug-resistance-associated-protein-2-and-cytochrome-p450-3a4-improves-the-oral-absorption-of-octreotide-in-rats-with-portal-hypertension
#20
Xiao-Yu Sun, Zhi-Jun Duan, Zhen Liu, Shun-Xiong Tang, Yang Li, Shou-Cheng He, Qiu-Ming Wang, Qing-Yong Chang
The aim of the present study was to increase the intestinal transport of octreotide (OCT) by targeting the first-pass impact to identify a potential method for decreasing portal vein pressure (PVP) using oral OCT. Thus, the bioavailability of intestinally absorbed OCT was evaluated in normal rats and rats with portal hypertension (PH) that had been administered P-glycoprotein/multidrug resistance-associated protein 2/cytochrome P450 3A4 (P-gp/MRP2/CYP3A4) inhibitors. The mRNA and protein expression levels of P-gp, MRP2 and CYP3A4 were evaluated in normal and PH rats with or without OCT and the inhibitors using RT-PCR, western blot and immunohistochemical analyses...
December 2016: Experimental and Therapeutic Medicine
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