Unlabelled: Hepatic cirrhosis is the leading cause of portal hypertension and is usually associated with the development ofsplacnic varices. Variceal intraabdominal rupture is a rare cause of hemoperitoneum. A case of spontaneous mesenteric vein rupture is reported.
Clinical Case: 43-year-old man with hepatic cirrhosis (Child-Pugh C stage) and previous bleeding of esophageal varices, admitted to hospital because of orthostatic hypotension episodes (positive tilt test) and abdominal distention. Laboratory: anemia, low platelet count and abnormal coagulation tests. CT scan showed abdominal fluid. Exploratory laparotomy was performed and 3 liters of blood were found into the abdominal cavity. The mesenteric vein had a ruptured variceal dilatation with intermitent jet bleeding. No organ abnormalities were found. Repair of the dilated vein was performed. The patient evolved well and was dismissed from hospital ten days after admittance.
Objective: To present a case in which a rare cause of intraabdominal bleeding, usually associated with high mortality rate, is follawed by a good clinical evolution.
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Heliyon
January 2025
Department of General Surgery, Fribourg Cantonal Hospital, 1700, Fribourg, Switzerland.
Background: Current management of patients with borderline resectable pancreatic adenocarcinoma (BR-PDAC) depends on the degree of involvement of the major arterial and venous structures. The aim of this study was to evaluate 3D segmentation and printing to predict tumor size and vascular involvement of BR-PDAC to improve pre-operative planning of vascular resection and better select patients for neoadjuvant therapy.
Methods: We retrospectively evaluated 16 patients with BR-PDAC near vascular structures who underwent pancreatoduodenectomy (PD) with or without vascular resection between 2015 and 2021.
Front Surg
January 2025
Department of Abdominal Transplant and Hepatopancreatobiliary Surgery, Nationwide Children's Hospital, Columbus, OH, United States.
Background: Prepancreatic postduodenal portal vein (PPPV) is a rare anatomic variant where the portal vein (PV) runs anterior to the pancreas and posterior to the duodenum. Only 20 cases of PPPV, all in adults, have been reported in literature. We report the first case of PPPV in a pediatric patient discovered intraoperatively during total pancreatectomy with islet autotransplantation (TPIAT) and the third known case in which the PPPV could be isolated intraoperatively.
View Article and Find Full Text PDFCureus
December 2024
Internal Medicine Department, Hospital Beatriz Ângelo, ULS Loures Odivelas, Loures, PRT.
Plasminogen activator inhibitor-1 (PAI-1) is central to fibrinolysis regulation, and genetic variants such as the 4G/4G genotype predispose individuals to hypercoagulability. This case highlights a 46-year-old female patient presenting with acute mesenteric venous thrombosis, where genetic evaluation revealed homozygosity for the PAI-1 4G/4G polymorphism. Management with unfractionated heparin followed by a transition to direct oral anticoagulants led to clinical resolution.
View Article and Find Full Text PDFFront Med (Lausanne)
January 2025
Department of General Surgery, Shanghai Fengxian District Central Hospital, Shanghai, China.
Introduction: In colostomy-related complications, variceal hemorrhage particularly induced by cirrhosis and portal hypertension is seldom encountered. The onset of peristome variceal hemorrhage necessitates swift and effective intervention to prevent potentially life-threatening outcomes such as hemorrhagic shock and recurrent stoma bleeding.
Case Presentation: This report details a case of repeated varicose vein hemorrhage around the stoma in a patient with liver cirrhosis.
Heliyon
January 2025
Department of Colorectal and Stomach Cancer Surgery-1, Jilin Cancer Hospital, Changchun, Jilin Province, China.
A 55-year-old woman with non-small cell lung carcinoma complained of epigastric pain, bloating, anorexia and postprandial nausea and vomiting over a five-year period. An upper gastrointestinal pan-glucosamine contrast examination revealed a distinctive large, hook-shaped, ptotic gastric lumen with normal motility. The contrast agent demonstrated an abnormal round-trip flow anterior to the spine at the duodenal level, with pooling and gradual passage through this region in strands after prolonged retention.
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