The meso-Rex bypass is a physiological and anatomical bypass procedure for relief of extrahepatic portal vein obstruction and restoration of mesenteric venous return to the liver. Most patients who are candidates for the bypass are children or young adults with portal hypertension and hypersplenism secondary to cavernous transformation of the portal vein. Most frequently, the bypass utilizes an autologous venous graft to connect the intrahepatic left portal vein to the infrapancreatic superior mesenteric vein (SMV) re-establishing first-pass portal perfusion. We describe the preoperative imaging of the 92 bypass candidates, the surgical anatomy as reflected in postoperative imaging, and the imaging of bypass complications at our institution.Preoperative imaging with US, CT and MR is directed to demonstrate patency and size of the left portal vein and SMV, to define the extent of cavernous transformation and splanchnic collaterals, and to assess for any associated abdominal vascular or solid organ abnormalities. Postoperative imaging is aimed at diagnosing meso-Rex bypass stenosis or occlusion and the interventional management of these complications.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00247-011-2283-0 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Hemodynamic comparisons of different shunt positions and geometrical model simplification strategies in the simulation of transjugular intrahepatic portosystemic shunt (TIPS).
Sci Rep
December 2024
School of Gongli Hospital Medical Technology, University of Shanghai for Science and Technology, No. 516 Jungong Road, Yangpu District, Shanghai, 200093, China.
Transjugular intrahepatic portosystemic shunt (TIPS) is a widely used surgery for portal hypertensive patients, whose potential postoperative complications are closely related to the hemodynamic condition of the portal venous system. The selection of shunt position in the surgery may affect the postoperative hemodynamics; however, it is difficult for clinical studies to investigate the influence. Therefore, this study aims to employ the computational model simulating TIPS to compare the hemodynamic differences resulting from different shunt positions, and also to investigate the influences of different geometrical model simplification strategies used in the TIPS simulation.
View Article and Find Full Text PDFLife-Threatening Esophageal Variceal Hemorrhage in a 7-Year-Old Boy with Massive Portal Vein Enlargement Due to Congenital Arterioportal Fistula.
Am J Case Rep
December 2024
I Department of Radiology and Diagnostic Imaging, Norbert Barlicki Memorial Teaching Hospital No. 1, Medical University of Łódź, Łódź, Poland.
BACKGROUND Arterioportal fistulas (APFs) are abnormal connections between the arterial and portal venous systems, leading to portal hypertension (PH) and symptoms such as gastrointestinal bleeding, splenomegaly, and hepatic pain. Symptoms typically appear by the age of 2 years in about 75% of cases. CASE REPORT A 7-year-old boy with an asymptomatic APF developed life-threatening complications following a Clostridium difficile infection.
View Article and Find Full Text PDFComputational exploration of injection strategies for improving medicine distribution in the liver.
Comput Biol Med
December 2024
Faculty of Chemical & Petroleum Engineering, University of Tabriz, Tabriz, Iran. Electronic address:
Background And Objectives: The liver, a vital metabolic organ, is always susceptible to various diseases that ultimately lead to fibrosis, cirrhosis, acute liver failure, chronic liver failure, and even cancer. Optimal and specific medicine delivery in various diseases, hepatectomy, shunt placement, and other surgical interventions to reduce liver damage, transplantation, optimal preservation, and revival of the donated organ all rely on a complete understanding of perfusion and mass transfer in the liver. This study aims to simulate the computational fluid dynamics of perfusion and the temporal-spatial distribution of a medicine in a healthy liver to evaluate the hemodynamic characteristics of flow and medicine transport with the purpose of more effective liver treatment.
View Article and Find Full Text PDFDifferentiating Benign from Malignant Causes of Splenomegaly: Is Acoustic Radiation Force Impulse Elastography Helpful?
Diseases
November 2024
Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, University Hospital Giessen and Marburg, Philipp University of Marburg, Baldingerstraße, 35037 Marburg, Germany.
Purpose: To evaluate the ability of acoustic radiation force impulse (ARFI) elastography in differentiating benign from malignant etiologies of splenomegaly based on differences in splenic stiffness.
Materials And Methods: Between September 2020 and November 2022, we evaluated 40 patients with splenomegaly-defined by a splenic long axis greater than 13 cm and/or a short axis greater than 6 cm, without visible focal or infiltrative mass lesions-using abdominal ultrasound at our university hospital. Each patient also underwent a standardized ARFI elastographic assessment of the enlarged spleen, with data collected prospectively.
Preduodenal portal vein (PDPV) is a rare congenital vascular malformation, which was first described by Knight in 1921 as an anomalous vein that lies in front of the duodenum, common bile duct, and hepatic artery instead of beneath them. This abnormal position may result in congenital duodenal obstruction and puts it in danger during operations around this region. PDPV is typically associated with other congenital anomalies, mainly intraabdominal and cardiac ones.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!