Mesenteric venous thrombosis is an uncommon but often fatal form of intestinal ischaemia. The authors present two cases of severe small intestinal ischaemia due to superior mesenteric vein thrombosis, the first associated with oral contraceptive use and a congenital methylene-tetrahydrofolate reductase defect and the second associated with atypical intestinal mycobacterial disease and acquired immunodeficiency syndrome. The authors review the relevant literature using the Medline search facility and comment on the changing aspects of MVT syndrome with regard to aetiological factors, diagnostic approach and surgical or pharmacological therapy.
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Ann Gastroenterol Surg
January 2025
Division of Frontier Surgery, The Institute of Medical Science The University of Tokyo Bunkyō Japan.
In right-sided colon cancer surgery, lymph node dissection around the superior mesenteric artery is necessary but technically challenging. Here we introduce the concept of "outermost layer-oriented robotic surgery" to improve the safety, efficacy, and reproducibility of superior mesenteric artery nodal dissection. In this procedure, the thin, loose connective tissue layer between the autonomic nerve sheath of the superior mesenteric artery and adipose tissue bearing lymph nodes, termed "the outermost layer of the autonomic nerve," is dissected.
View Article and Find Full Text PDFHPB (Oxford)
December 2024
Health Services Research Unit, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK; Department of Surgery, Dr Gray's Hospital, Elgin, IV30 1SN, UK; HPB Surgery Unit, East Lancashire Teaching Hospitals, England, BB2 3HH, UK; Integrated Centre of HPB Care, Elite Hospital, Alexandria, Egypt.
Background: Splanchnic vein thrombosis (SpVT) occurs in 17%-23 % of acute pancreatitis cases. Serious sequelae include hepatic and bowel ischaemia. However, management with therapeutic anticoagulation remains controversial due to potential bleeding risk.
View Article and Find Full Text PDFSci Rep
December 2024
Department of general surgery (intestinal surgery), The Sixth Affiliated Hospital, Sun Yat-Sen University, 26 Yuancun Erheng Rd, Guangzhou, 510655, Guangdong, People's Republic of China.
In hepatic flexure and transverse colon cancer surgeries, mobilizing the right mesocolon and precisely dissecting the gastrocolic trunk of Henle (GTH) are crucial. Previous classifications of GTH tributaries do not guide radical right hemicolectomy due to post-procedural anatomical acquisition. This study analyzed vessel associations, including the middle colic vein (MCV) converging site, right colic artery (RCA) presence, and other GTH tributaries, using ultra-thin CT for reconstruction.
View Article and Find Full Text PDFVasc Specialist Int
December 2024
Division of Vascular Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Major vessel invasion, particularly involving the portal and superior mesenteric veins, poses significant challenges during the radical resection of hepatobiliary and pancreatic cancers. Oncovascular surgery is essential for curative outcomes, and often requires portomesenteric vein reconstruction. Techniques, such as lateral venorrhaphy, patch repair, end-to-end anastomosis, and interposition grafting, have been employed.
View Article and Find Full Text PDFJ Vasc Surg Venous Lymphat Disord
December 2024
Division of Vascular Surgery, UPMC, Pittsburgh, Pennsylvania; Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address:
Background: Portal venous system aneurysms (PVA) are increasingly diagnosed on cross-sectional computed tomography (CT) imaging. However, the natural history of these aneurysms is poorly understood and reports are limited to small case series.
Methods: Terms relevant to PVA were searched in radiology reports (2010-2022) with PVA presence confirmed by manual review.
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