Life-threatening hemorrhage rarely occurs from the portal vein following blunt hepatic trauma. Traditionally, severe portal bleeding in this setting has been controlled by surgical techniques such as packing, ligation, and venorrhaphy. The presence of portal hypertension could potentially increase the amount of hemorrhage in the setting of blunt portal vein trauma making it more difficult to control. This case series describes the use of indirect carbon dioxide portography to identify portal hemorrhage. Furthermore, these cases illustrate attempted endovascular treatment utilizing a transjugular intrahepatic portosystemic shunt in one scenario and transmesocaval shunt coiling of a jejunal varix in the other.
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http://dx.doi.org/10.4329/wjr.v5.i10.381 | DOI Listing |
JMIR Form Res
December 2024
Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, MI, United States.
Background: Remote blood pressure (BP) monitoring (RBPM) or BP telemonitoring is beneficial in hypertension management. People with hypertension involved in telemonitoring of BP often have better BP control than those in usual care. However, most reports on RBPM are from intervention studies.
View Article and Find Full Text PDFAnn Vasc Dis
December 2024
Division of Cardiovascular Surgery, Hachinohe City Hospital, Hachinohe, Aomori, Japan.
A superior mesenteric arteriovenous fistula (SMAVF) following gastrointestinal surgery represents a rare vascular complication. Enhanced computed tomography with 3-dimensional reconstruction proves to be the most efficacious modality for detecting this uncommon entity. Superior mesenteric angiography becomes imperative to accurately delineate the location and extent of mesenteric vessel involvement, which is essential for devising an optimal treatment strategy.
View Article and Find Full Text PDFCureus
November 2024
Division of Interventional Radiology, Columbia University Irving Medical Center, New York, USA.
Aim This study aims to evaluate the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) check and revision procedures performed in a freestanding interventional radiology (IR) outpatient facility. Methodology A total of 40 patients (male 31:female 9, median age 60 years old) underwent a TIPS check and/or revision at a freestanding IR outpatient facility between 2009 and 2017. Procedures were performed using a mobile C-arm unit under intravenous (IV) moderate sedation, with the patient discharged home on the same day.
View Article and Find Full Text PDFJ Dig Dis
December 2024
Department of Gastroenterology and Hepatology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
Objectives: This study aimed to evaluate the performance of virtual portal pressure gradient (vPPG) and its associated hemodynamic parameters of 3-dimensional (3D) model in patients with cirrhosis.
Methods: Seventy cirrhotic patients who underwent both hepatic venous pressure gradient (HVPG) measurement and vPPG calculation were prospectively collected. The ideal-state model (ISM; n = 44) was defined by sinusoidal PH without hepatic vein shunt or portal vein thrombosis, whereas those not conforming to the criteria were classified as non-ISM (n = 26).
Hepatology
December 2024
Chair, Department of Medicine, University of Arizona, Phoenix, Arizona.
Portopulmonary hypertension (POPH), a form of pulmonary artery hypertension, occurs because of portal hypertension. Pulmonary hemodynamics and right heart function are key entities that are considered when diagnosing and treating POPH. Medical management, combined with liver transplantation, offers a unique opportunity of POPH "cure," however transplant risk can be significant as it relates to the severity of POPH.
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