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Disseminated intravascular coagulation and cirrhotic coagulopathy: overlap and differences. The current state of knowledge. Communication from the SSC of the ISTH.
J Thromb Haemost
December 2024
Surgical Research Laboratory and Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Patients with disseminated intravascular coagulation (DIC) have decreasing plasma levels of coagulation factors and platelet counts with increased levels of D-dimer. Standard laboratory tests are used clinically to diagnose DIC and quantify the severity of the disease. In patients with cirrhosis, liver-derived plasma coagulation factor levels are reduced due to decreased hepatic synthesis, further exacerbated by extravascular redistribution of these proteins, causing prolongation of routine diagnostic coagulation tests.
View Article and Find Full Text PDFPartial Splenectomy Versus Total Splenectomy in Sickle Cell Disease: A Systematic Review and Meta-Analysis.
J Pediatr Surg
November 2024
Medical Research Group of Egypt, Negida Academy, Arlington, MA, USA; Faculty of Medicine, Al-Azhar University, 11651 Cairo, Egypt.
Background: Sickle cell disease (SCD) patients encounter various complications, such as acute splenic sequestration crisis and hypersplenism that may require splenectomy. This systematic review and meta-analysis aims to clarify differences between total splenectomy (TS) or partial splenectomy (PS) in terms of hematological and postoperative outcomes.
Methods: We identified studies involving SCD patients who underwent PS or TS, whether open or laparoscopic, and whose hematological and operative outcomes were evaluated, through searching PubMed, Web of Science, Scopus, Embase and Cochrane databases from inception until June 2024.
Recurrent TIPS dysfunction and variceal bleeding: A combined, staged, use of large-bore aspiration thrombectomy and partial splenic artery embolization-A case report.
Radiol Case Rep
January 2025
Faculty of Diagnostic Radiology, University of Calgary, Calgary, Alberta, Canada.
A 51-year-old man, with a history of cirrhotic portal hypertension and recurrent transjugular intrahepatic portosystemic shunt (TIPS) stenoses, presented with an acute gastro-esophageal variceal hemorrhage in the setting of an acute and massive thrombotic TIPS shunt occlusion. The clinical presentation was complicated by patient's severe, chronic thrombocytopenia which had precluded empiric anticoagulation previously for recurrent TIPS dysfunction. Following endoscopic treatment of the variceal bleeding, the CAT 12 Indigo aspiration system (Penumbra) was used to remove a large burden of thrombus from the TIPS, allowing successful re-stenting and restoration of blood flow through the TIPS.
View Article and Find Full Text PDFOrgan-preserving embolization of a giant splenic hemangioma in an adult.
CVIR Endovasc
November 2024
Interventional Unit of Radiology, Agios Savas Anticancer Hospital, Alexandras Avenue 171, Athens, 11522, Greece.
Article Synopsis
- Splenic hemangioma is a rare benign tumor that can cause life-threatening issues if it ruptures; safe management is crucial due to the spleen's importance in immunity and blood filtration.
- A 51-year-old patient with a large spleen hemangioma was treated successfully with embolization, preserving the spleen and avoiding complications.
- The case report highlights the procedure's safety, symptom relief without surgery, and lower complication rates compared to traditional surgical methods, with a notable 2-year follow-up showing significant size reduction of the hemangioma.
Uncommon Presentation of Hypersplenism in Adult Sickle Cell Disease Patients: A Rare Case Report.
Am J Case Rep
September 2024
Department of Surgery, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
Article Synopsis
- Hypersplenism is a condition where blood cells are destroyed rapidly, characterized by splenomegaly, cytopenias, and increased bone marrow activity, and can be secondary to diseases like sickle cell disease, specifically hemoglobin sickle C disease (HbSC).
- A 41-year-old woman with HbSC presented with complications from splenomegaly and anemia due to hypersplenism, leading to her undergoing a splenectomy after preoperative splenic artery embolization.
- Hypersplenism can lead to severe complications like splenic sequestration crises, affecting adults rarely but is associated with significant spleen enlargement, as demonstrated by the patient’s spleen measuring 21.1 cm, necessitating effective
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