2,588 results match your criteria: "Portal Vein Obstruction"

Gallbladder rupture, though rare, is a serious complication often arising from choledocholithiasis and subsequent interventions such as endoscopic retrograde cholangiopancreatography (ERCP). In this case, the patient presented with acute choledocholithiasis and underwent ERCP with sphincterotomy and stone extraction, followed by placement of a fully covered metal stent in the common bile duct (CBD). While the use of covered stents is appropriate, it is important to note that these stents can obstruct the cystic duct orifice in patients with a gallbladder.

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Proximal splenorenal shunt is the most commonly performed shunt in patients with extrahepatic portal venous obstruction (EHPVO). Sometimes, due to various anatomical and intraoperative factors, other rarely used shunts may be required. We present the case of a 27-year-old male who was diagnosed with EHPVO with complicated portal cavernomatous cholangiopathy.

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Concomitant, Acquired Cavo-Azygos Shunt and Spleno-Gastroepiploic Bypass After Multiple Venous Obstruction in a Dog.

Vet Med Sci

January 2025

Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan, Jeollabuk-do, Republic of Korea.

A 13-year-old intact female Shih Tzu presented with anorexia, panting and pain of unknown origin. Physical examination was normal except for a systolic murmur (grade 3/6). Abdominal radiographs revealed an ill-defined area of increased opacity in the mid-abdomen.

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The effectiveness of alternative vessel grafts for meso-rex bypass in the treatment of extrahepatic portal vein obstruction in children.

Pediatr Surg Int

December 2024

Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Purpose: This study aims to evaluate the effectiveness of alternative autologous vessel grafts in creating a Meso-Rex bypass (MRB) compared to the distal splenorenal shunt (DSRS) in resolving symptoms of portal hypertension in children.

Methods: All children with EHPVO evaluated for surgery at Siriraj Hospital from January 2011 to December 2023 were reviewed. Alternative autologous vessel grafts were used in all cases where MRB was feasible.

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Technical Note on Modified Direct Intrahepatic Portocaval Shunt Targeting Different Vessels for Portal Vein Obstruction in Cirrhosis.

Cardiovasc Intervent Radiol

December 2024

Department of Gastroenterology and Hepatology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan, 430071, Hubei Province, China.

Purpose: This study aimed to explore a modified direct intrahepatic portocaval shunt (DIPS) technique as an alternative approach for patients with portal vein occlusion (PVO) and cirrhosis who were not candidates for traditional transjugular intrahepatic portosystemic shunt (TIPS) due to anatomical challenges.

Technique: Three patients with esophageal or gastric fundus variceal hemorrhage complicated by severe PVO were treated using innovative DIPS approaches. Preoperative contrast-enhanced computed tomography was employed to assess anatomical feasibility.

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Clinical benefits of partial splenic embolization for cancer patients.

Hepatol Res

November 2024

Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.

Article Synopsis
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Article Synopsis
  • - Postpartum venous thromboembolism (VTE) is a serious complication that can occur after childbirth, driven by factors like increased blood clotting, reduced mobility, and injury to blood vessels, leading to high risks for new mothers.
  • - A case study details a 37-year-old woman with a history of recurrent clots and pregnancy issues that ultimately resulted in severe chronic venous obstruction despite various treatments, necessitating advanced procedures like stent implantation.
  • - The patient's medical journey involved multiple challenges, including spontaneous abortions, a pulmonary embolism linked to contraceptive use, and serious complications during and after her last pregnancy, highlighting the importance of careful monitoring and effective prevention strategies for postpartum VTE.
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[Re-Establishment of Vascular Access After Superior Vena Cava Occlusion in Hemodialysis Patients].

Sichuan Da Xue Xue Bao Yi Xue Ban

September 2024

/ ( 610041) Department of Nephrology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China.

Article Synopsis
  • The study aimed to assess how effective percutaneous right atrial puncture and tunneled cuffed catheter insertion are for hemodialysis patients with superior vena cava occlusion (SVCO), and to explore options for patients with limited vascular access.
  • Methods involved enrolling SVCO patients and allowing them to choose between catheterization or establishing peripheral arteriovenous (AV) access, followed by specific procedures to restore vascular access based on imaging guidance.
  • Results showed that 45 patients participated, with 21 receiving catheters and 24 receiving AV access, and the researchers tracked demographic info, clinical outcomes, and complications related to each intervention.
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Article Synopsis
  • * Treatment options include pharmacotherapy, endoscopic techniques, transcatheter embolization, portal venous stenting, and surgical procedures.
  • * A definitive management strategy remains undetermined, primarily due to insufficient randomized controlled trials with large patient groups to guide effective treatment.
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We report the case of a 38-year-old woman with a history of extrahepatic portal vein obstruction (EHPVO) who became pregnant and developed portal vein thrombosis. She gave birth after intervention by gastroenterology and cardiology. She was referred to our department due to significant leg edema at eight weeks of gestation, and we noticed EHPVO, portal vein thrombosis, and left pulmonary arteriovenous fistula by contrast-enhanced CT.

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Background: The categorization of intrahepatic portal venous system (IHPS) patterns using wedged hepatic venous portography (WHVP) has proven to be an effective tool in the preoperative evaluation of Rex recessus and in identifying pediatric patients with extrahepatic portal vein obstruction (EHPVO) who are suitable for meso-Rex bypass (MRB). Despite this classification system being proposed a decade ago, its clinical application remains underutilized.

Methods: A single-center retrospective study of 182 children with EHPVO was conducted between October 2014 and July 2023 when MRB was attempted.

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Introduction: To diagnose sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD), transabdominal ultrasonography is usually used to detect hemodynamic changes, but we tried to detect the changes using four-dimensional computed tomography (4D-CT). A 42-year-old Japanese woman was diagnosed with late-onset SOS/VOD with transabdominal ultrasonography and was also assessed using 4D-CT. Method We analyzed the portal vein (PV) contrast effect every 1.

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Medium-to Long-term Outcomes of Rex Shunt in 105 Children With Extrahepatic Portal Vein Obstruction in China.

J Pediatr Surg

September 2024

Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, China. Electronic address:

Article Synopsis
  • The study aimed to evaluate the long-term effectiveness of Rex shunts in children with extrahepatic portal vein obstruction (EHPVO) by analyzing data from 105 patients over a median follow-up of 41 months.
  • Results showed a high shunt patency rate of 91.43%, with significant improvement in portal hypertension symptoms for those with patent shunts, although complications like thrombosis (8.57%) and anastomotic stenosis (14.26%) were noted.
  • Classical Rex shunts exhibited better outcomes compared to modified versions, showing higher patency rates and lower complication rates, indicating that the surgical method impacts the overall success of the procedure.
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  • Nonocclusive mesenteric ischemia (NOMI) involves intestinal ischemia from spasms in small blood vessels, which can become life-threatening if not diagnosed and treated quickly.
  • In this case, an 81-year-old man was diagnosed with NOMI after imaging showed signs of intestinal distress, leading to emergency surgery where ICG fluorescence was used to assess blood flow in the intestines.
  • The use of ICG fluorescence allowed for the precise removal of ischemic areas, improving outcomes and suggesting that more research on this technique could enhance future diagnostics and treatment of NOMI.
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Background And Aims: Portal vein thrombosis (PVT) is associated with increased mortality post-transplant, but treatment of the clot is not definitively associated with improvement in mortality. We aimed to assess the effect of anticoagulation (AC), transjugular intrahepatic portosystemic shunt (TIPS), or best supportive care only (SCO) as treatment options in patients with PVT and cirrhosis.

Methods: This was a retrospective controlled cohort study from a large urban health system.

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Analysis of Serum Bile Acid Profile Characteristics and Identification of New Biomarkers in Lean Metabolic Dysfunction-Associated Fatty Liver Disease Based on LC-MS/MS.

Clin Med Insights Endocrinol Diabetes

September 2024

Department of Clinical Laboratory, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.

Article Synopsis
  • This study investigates the plasma bile acid (BA) levels in patients with lean metabolic dysfunction-associated fatty liver disease (MAFLD), a condition that hasn't been well understood in this demographic.
  • Researchers used advanced mass spectrometry techniques to analyze 65 types of BAs and found 17 that are expressed differently in lean MAFLD patients compared to healthy individuals.
  • The study identified six specific BAs that could serve as effective biomarkers for diagnosing lean MAFLD, demonstrating their potential value in clinical settings.
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Portal cavernoma cholangiopathy treated with living donor liver transplantation: a case report and review of the literature.

Clin J Gastroenterol

December 2024

Division of Gastroenterological, General and Transplant Surgery, Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, , Shimotsuke city, Tochigi, 329-0498, Japan.

Portal cavernoma cholangiopathy (PCC) is a complex condition associated with portal hypertension, particularly in patients with extrahepatic portal vein obstruction (EHPVO). Herein, we present a case of liver failure with PCC in a 55-year-old male successfully treated with living-donor liver transplantation (LDLT). The patient had a history of gastrointestinal bleeding and recurrence of cholangitis.

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Patients with esophageal cancer who have severe complications such as diabetes sometimes require two-stage surgery. Herein, we describe two cases of gastric emphysema that were treated at our facility after the patients had previously undergone minimally invasive esophagectomy as the first-stage surgical treatment of esophageal cancer. Case 1: A 72-year-old man with a history of diabetes mellitus (DM) was diagnosed with esophageal cancer and an esophageal obstruction and subsequently underwent percutaneous endoscopic gastrostomy (PEG) placement followed by neoadjuvant chemoradiotherapy.

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Background: Glyphosate is a widely used herbicide. Clinical presentations of glyphosate intoxication show variation, but hepatic portal venous gas(HPVG) caused by glyphosate poisoning is rarely reported. Herein, we report a rare case of ominous HPVG after ingesting glyphosate.

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Objectives: Portal hypertension resulting from non-cirrhotic extrahepatic portal vein obstruction (EHPVO) in children has been primarily managed with the Meso-Rex bypass, but only a few patients have a viable Rex recessus, required by surgery. This study reports a preliminary series of patients who underwent interventional radiology attempts at portal vein recanalization (PVR), with a focus on technical aspects and safety.

Methods: A retrospective review of consecutive patients with severe portal hypertension due to non-cirrhotic EHPVO at a single institution from 2022, who underwent percutaneous attempts at PVR, was performed.

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Purpose: Locally advanced pancreatic ductal adenocarcinoma (PDAC) with an unreconstructible superior mesenteric vein (SMV) invasion is one of the criteria of unresectability in the National Comprehensive Cancer Network guidelines. Advances in chemotherapy have improved downstaging and conversion surgery outcomes, thereby broadening surgical options for locally advanced PDAC. However, operations for PDAC with an unreconstructible SMV is less well-documented.

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[Budd-Chiari syndrome and JAK2 gene mutation].

Rinsho Ketsueki

September 2024

Division of Hematology, Department of Internal Medicine, Juntendo University.

Budd-Chiari syndrome (BCS) is a rare vascular disorder characterized by obstruction of hepatic venous outflow, culminating in elevated hepatic and portal venous pressure. BCS is associated with myeloproliferative neoplasms (MPN) in 40% of cases, which is significantly higher than the rate observed in other venous thrombotic conditions, and suggests that MPN may contribute to the etiology of BCS. In particular, the JAK2 V617F mutation has recently attracted substantial attention, given its profound association with thrombogenesis, mechanically implicated through endothelial damage, increased blood cell adhesion, and facilitation of neutrophil extracellular trap formation.

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Extrahepatic portal vein obstruction (EHPVO) is a rare disease with myeloproliferative neoplasm (MPN) as the most common cause. We report that hypersplenic hematologic changes in EHPVO might be eliminated by MPN. Through experience with splenectomy for variceal control with EHPVO, we suspected that spleen might mask MPN-induced thrombocytosis, and that MPN might have a significant influence on excessive thrombocytosis after splenectomy.

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