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portal vein hypertension

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https://www.readbyqxmd.com/read/27896916/dihydroartemisinin-counteracts-fibrotic-portal-hypertension-via-farnesoid-x-receptor-dependent-inhibition-of-hepatic-stellate-cell-contraction
#1
Wenxuan Xu, Chunfeng Lu, Feng Zhang, Jiangjuan Shao, Shunyu Yao, Shizhong Zheng
Portal hypertension is a frequent pathological symptom occurring especially in hepatic fibrosis and cirrhosis. Current paradigms indicate that inhibition of hepatic stellate cell (HSC) activation and contraction is anticipated to be an attractive therapeutic strategy, because activated HSC dominantly facilitates an increase in intrahepatic vein pressure through secreting extracellular matrix and contracting. Our previous in vitro study indicated that dihydroartemisinin (DHA) inhibited contractility of cultured HSC by activating intracellular farnesoid X receptor (FXR)...
November 7, 2016: FEBS Journal
https://www.readbyqxmd.com/read/27896406/evaluation-of-rex-shunt-on-cavernous-transformation-of-the-portal-vein-in-children
#2
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...
November 28, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27895860/hydatid-liver-cyst-causing-portal-vein-thrombosis-and-cavernous-transformation-a-case-report-and-literature-review
#3
Serdar Kirmizi, Cuneyt Kayaalp, Sezai Yilmaz
A 33-year-old male with abdominal distention after meals was admitted to the hospital. He had a history of surgery for hydatid liver cyst. The cyst was located at the liver hilum and there were portal venous thrombosis and cavernous transformation. It had been treated with partial cystectomy, omentoplasty and albendazole. Two years later at the admission to our center, his laboratory tests were in normal ranges. Abdominal imaging methods revealed splenomegaly, portal vein thrombosis, cavernous transformation and the previously operated hydatid liver cyst...
2016: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/27895519/portal-hypertension-an-uncommon-clinical-manifestation-of-takayasu-arteritis-in-a-9-year-old-child
#4
Cristina N Herrera, Javier E Tomala-Haz
Takayasu arteritis (TA) is the third most common childhood vasculitis and its clinical manifestations depend on the arteries involved. We report a case of a 9-year-old boy with multiple aneurysms in carotid and iliac arteries, subclavian and coronary arteries, and abdominal aorta. At the age of 7 years, he presented with recurrent fever and hepatosplenomegaly. An angio-computed tomography scan showed aneurysms in the left subclavian artery, abdominal aorta, and both proximal iliac arteries. He was diagnosed with TA and was treated with corticosteroids, aspirin, and enalapril...
2016: Open Access Rheumatology: Research and Reviews
https://www.readbyqxmd.com/read/27880998/recurrent-acute-portal-vein-thrombosis-in-liver-cirrhosis-treated-by-rivaroxaban
#5
Hyeyoung Yang, Seo Ree Kim, Myeong Jun Song
Cirrhosis can occur with the development of portal vein thrombosis (PVT). PVT may aggravate portal hypertension, and it can lead to hepatic decompensation. The international guideline recommends for anticoagulation treatment to be maintained for at least 3 months in all patients with acute PVT. Low-molecular-weight-heparin and changing to warfarin is the usual anticoagulation treatment. However, warfarin therapy is problematic due to a narrow therapeutic window and the requirement for frequent dose adjustment, which has prompted the development of novel oral anticoagulants for overcoming these problems...
November 25, 2016: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/27855353/challenging-the-limits-in-pancreatic-surgery-a-case-report
#6
Johannes Lemke, Stefan A Schmidt, Marko Kornmann, Karl-Heinz Orend, Doris Henne-Bruns
INTRODUCTION: Today, pancreatic surgery can be performed with low mortality and tolerable morbidity in specialized centers. Nevertheless, due to its anatomical localization and proximity to important vascular structures, surgical resection of the pancreas remains challenging in many cases. PRESENTATION OF CASE: Here, we present the case of a young woman who presented in our department with abdominal pain and a tumor mass located at the pancreatic head. She had undergone explorative laparotomy elsewhere before, in which the pancreatic tumor mass was reported to be unresectable due to infiltration of the mesenteric root...
November 14, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27853493/implantability-complications-and-follow-up-after-transjugular-intrahepatic-portosystemic-stent-shunt-creation-with-the-6f-self-expanding-sinus-superflex-visual-stent
#7
Daniel Spira, Jakub Wiskirchen, Ulrich Lauer, Dominik Ketelsen, Konstantin Nikolaou, Benjamin Wiesinger
BACKGROUND: The transjugular intrahepatic portosystemic stent-shunt (TIPSS) builds a shortcut between the portal vein and a liver vein, and represents a sophisticated alternative to open surgery in the management of portal hypertension or its complications. OBJECTIVES: To describe clinical experiences with a low-profile nitinol stent system in TIPSS creation, and to assess primary and long-term success. PATIENTS AND METHODS: Twenty-six patients (5 females, 21 males; mean age 54...
July 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
https://www.readbyqxmd.com/read/27843428/a-rare-case-of-gastric-variceal-hemorrhage-secondary-to-infiltrative-b-cell-lymphoma
#8
Adrienne Lenhart, Juan Fernandez-Castillo, Keith Mullins, Reena Salgia
Portal hypertension commonly arises in the setting of advanced liver cirrhosis and is the consequence of increased resistance within the portal vasculature. Less commonly, left-sided noncirrhotic portal hypertension can develop in a patient secondary to isolated obstruction of the splenic vein. We present a rare case of left-sided portal hypertension and isolated gastric varices in a patient with large B-cell lymphoma, who was treated with splenic artery embolization. The patient is a 73-year-old male with no previous history of liver disease, who presented with coffee ground emesis and melena...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27805917/caval-subtraction-2d-phase-contrast-mri-to-measure-total-liver-and-hepatic-arterial-blood-flow-proof-of-principle-correlation-with-portal-hypertension-severity-and-validation-in-patients-with-chronic-liver-disease
#9
Manil D Chouhan, Rajeshwar P Mookerjee, Alan Bainbridge, Shonit Punwani, Helen Jones, Nathan Davies, Simon Walker-Samuel, David Patch, Rajiv Jalan, Steve Halligan, Mark F Lythgoe, Stuart A Taylor
OBJECTIVES: Caval subtraction phase-contrast magnetic resonance imaging (PCMRI) noninvasive measurements of total liver blood flow (TLBF) and hepatic arterial (HA) flow have been validated in animal models and translated into normal volunteers, but not patients. This study aims to demonstrate its use in patients with liver cirrhosis, evaluate measurement consistency, correlate measurements with portal hypertension severity, and invasively validate TLBF measurements. MATERIALS AND METHODS: Local research ethics committee approval was obtained...
October 31, 2016: Investigative Radiology
https://www.readbyqxmd.com/read/27789550/obscure-upper-gastrointestinal-haemorrhage-haemosuccus-pancreaticus
#10
Prateush Singh, Asim Khan, Manuel Jasper, Javaid Subhani
A Caucasian man aged 28 years with a history of pancreatitis presented with fatigue, intermittent melaena and severe anaemia. Symptomatic treatment for anaemia was coupled with thorough investigation to localise the source of gastrointestinal haemorrhage. Two oesophagogastroduodenoscopies and colonoscopies failed to identify a cause. CT abdomen revealed splenomegaly secondary to splenic vein thrombosis with evidence of portal hypertension and small collateral vessels. A CT mesenteric angiogram revealed a splenic artery pseudoaneurysm as the likely source of bleeding...
October 27, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27784438/-research-advances-in-diagnosis-and-treatment-of-post-transjugular-intrahepatic-portosystemic-shunt-hepatic-encephalopathy
#11
J F Yang, B Q Zhang
Transjugular intrahepatic portosystemic shunt (TIPS) has become an important minimally invasive interventional technique for the treatment of complications of cirrhotic portal hypertension, and currently, it is often used in cirrhotic patients with esophagogastric variceal bleeding (EVB), intractable ascites, hepatic hydrothorax, and Budd-Chiari syndrome. On one hand, TIPS can effectively reduce portal vein pressure and the risk of EVB and intractable ascites; on the other hand, it may reduce the blood flow in liver perfusion, aggravate liver impairment, and cause porto-systemic encephalopathy...
July 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/27776486/bleeding-downhill-esophageal-varices-associated-with-benign-superior-vena-cava-obstruction-case-report-and-literature-review
#12
Michael Loudin, Sharon Anderson, Barry Schlansky
BACKGROUND: Proximal or 'downhill' esophageal varices are a rare cause of upper gastrointestinal hemorrhage. Unlike the much more common distal esophageal varices, which are most commonly a result of portal hypertension, downhill esophageal varices result from vascular obstruction of the superior vena cava (SVC). While SVC obstruction is most commonly secondary to malignant causes, our review of the literature suggests that benign causes of SVC obstruction are the most common cause actual bleeding from downhill varices...
October 24, 2016: BMC Gastroenterology
https://www.readbyqxmd.com/read/27762481/jejunal-varices-diagnosed-by-capsule-endoscopy-in-patients-with-post-liver-transplant-portal-hypertension
#13
Lee M Bass, Stanley Kim, Riccardo Superina, Saeed Mohammad
Portal hypertension secondary to portal vein obstruction following liver transplant occurs in 5%-10% of children. Jejunal varices are uncommon in this group. We present a case series of children with significant GI blood loss, negative upper endoscopy, and jejunal varices detected by CE. Case series of patients who had CE for chronic GI blood loss following liver transplantation. Three patients who had their initial transplants at a median age of 7 months were identified at our institution presenting at a median age of 8 years (range 7-16 years) with a median Hgb of 2...
October 20, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27761177/case-report-gallbladder-varices-in-a-patient-with-portal-vein-thrombosis-secondary-to-hepatocellular-carcinoma
#14
Jeffrey Gnerre, Yankai Sun, Andrzej Jedynak, Anthony Gilet
Gallbladder varices are a rare form of collateralization that develop in patients with portal hypertension. We present here a case of gallbladder varices accurately diagnosed by contrast enhanced CT imaging of the abdomen and confirmed by Color Doppler Sonography. A 76-year-old patient with hepatocellular carcinoma developed portal vein thrombosis due to tumor extension during the course of treatment and was incidentally discovered to have gallbladder varices. While most commonly asymptomatic, gallbladder varices are associated with increased risk of massive bleeding, either spontaneously or during cholecystectomy...
May 2016: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/27754409/diet-quality-the-greeks-had-it-right
#15
John J B Anderson, David C Nieman
The Mediterranean diet is upheld in the 2015-2020 Dietary Guidelines as an example of an eating pattern that promotes good health, a healthy body weight, and disease prevention throughout the lifespan. The Mediterranean eating pattern is based on a variety of unprocessed plant foods including fruits, vegetables, whole grains, legumes, nuts, and seeds that are high in polyphenols. The majority of polyphenols arrive in the colon where bacteria degrade them into smaller phenolics that can be translocated via the portal vein to the liver...
October 14, 2016: Nutrients
https://www.readbyqxmd.com/read/27746739/calcineurin-nfat-activation-dependence-of-leptin-synthesis-and-vascular-growth-in-response-to-mechanical-stretch
#16
Nadia Soudani, Crystal M Ghantous, Zein Farhat, Wassim N Shebaby, Kazem Zibara, Asad Zeidan
Background and Aims: Hypertension and obesity are important risk factors of cardiovascular disease. They are both associated with high leptin levels and have been shown to promote vascular hypertrophy, through the RhoA/ROCK and ERK1/2 phosphorylation. Calcineurin/NFAT activation also induces vascular hypertrophy by upregulating various genes. This study aimed to decipher whether a crosstalk exists between the RhoA/ROCK pathway, Ca(2+)/calcineurin/NFAT pathway, and ERK1/2 phosphorylation in the process of mechanical stretch-induced vascular smooth muscle cell (VSMC) hypertrophy and leptin synthesis...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27740529/%C3%A2-hepatoportal-sclerosis-related-to-the-use-of-herbals-and-nutritional-supplements-causality-or-coincidence
#17
Fernanda Ferreira Rios, Luiz Antônio Rodrigues de Freitas, Liana Codes, Genario Oliveira Santos Junior, Maria Isabel Schinoni, Raymundo Paraná
:  Introduction and aim. Non-cirrhotic idiopathic portal hypertension (NCIPH), also known as hepatoportal sclerosis (HPS) is a disease of uncertain etiology. However, various pathophysiological mechanisms has been postulated, including chronic or recurrent infections and exposure to drugs or toxins. In this context, it appears to be of multifactorial etiology or resulting from a portal vascular endothelium aggression. It is important to consider whether the use of dietary supplements and herbs can trigger or contribute to the occurance of HPS...
November 2016: Annals of Hepatology
https://www.readbyqxmd.com/read/27706547/-percutaneous-paraumbilical-embolization-of-bleeding-rectal-varices-due-to-portal-hypertension
#18
T Stuber, B Schmitz, H J Brambs
Introduction: Portal hypertension may lead to severe esophageal or rectal variceal bleeding. Case report: We present a case of a 67-year-old patient presenting with recurrent rectal variceal bleeding who was non-responsive to endoscopic treatment. We are reporting on an interventional therapeutic approach found in interdisciplinary consensus. Discussion: Endoscopy, surgery or TIPS (transjugular intrahepatic portosystemic shunt) can be performed in patients with gastrointestinal bleeding due to portal hypertension in liver cirrhosis...
October 5, 2016: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27706456/evaluation-of-primary-prophylaxis-with-propranolol-and-elastic-band-ligation-in-variceal-bleeding-in-cirrhotic-children-and-adolescents
#19
Júlio Rocha Pimenta, Alexandre Rodrigues Ferreira, Paulo Fernando Souto Bittencourt, Camilo Brandão de Resende, Eleonora Druve Tavares Fagundes, Isabela Maria Lopes da Silva
Background: The efficacy of nonselective β-blocker and endoscopic procedures, such as endoscopic variceal ligation, as primary prophylaxis of variceal hemorrhage in cirrhotic adults was demonstrated by numerous controlled trials, but in pediatric population, few are the number of studies. Objective: The objective of this study is to evaluate the primary prophylaxis with β-blocker in cirrhotic children and adolescents with portal hypertension. Methods: This is a cohort study encompassing 26 cirrhotic patients...
October 2016: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/27697318/surgical-strategy-according-to-the-anatomical-types-of-congenital-portosystemic-shunts-in-children
#20
Toshiharu Matsuura, Yoshiaki Takahashi, Yusuke Yanagi, Koichiro Yoshimaru, Kenichiro Yamamura, Eiji Morihana, Hazumu Nagata, Kiyoshi Uike, Hidetoshi Takada, Tomoaki Taguchi
BACKGROUND: Congenital portosystemic shunts (CPSS) with intrahepatic portal vein (IHPV) hypoplasia or absence cause encephalopathy or pulmonary hypertension (PH). Acute shunt closure may result in postoperative portal hypertension. The aim of this study was to propose a surgical strategy according to the anatomical types of CPSS and IHPV. METHODS: Twenty-three CPSS patients were diagnosed from1990 to 2015. All patients were evaluated by computed tomography, angiography, and PV pressure monitoring under a shunt occlusion test...
September 21, 2016: Journal of Pediatric Surgery
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