Does umbilical vein catheterisation in exchange transfusion lead to portal vein thrombosis

2000 ◽  
Vol 67 (4) ◽  
pp. 266-266
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Exchange Transfusion ◽  
Umbilical Vein ◽  
Vein Thrombosis

Does umbilical vein catheterization to exchange transfusion lead to portal vein thrombosis?

1998 ◽  
Vol 157 (6) ◽  
pp. 461-463 ◽  
Author(s):  
H. Guimarães ◽  
L. Castelo ◽  
J. Guimarães ◽  
A. Cardoso ◽  
C. d'Orey ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Exchange Transfusion ◽  
Umbilical Vein ◽  
Vein Thrombosis ◽  
Vein Catheterization

scholarly journals A226 INCIDENTAL FINDING OF A LARGE GASTRIC VARIX ASSOCIATED WITH NEONATAL UMBILICAL VEIN CANALIZATION

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 261-263
Author(s):  
L Tsang ◽  
J Abraldes ◽  
E Wiebe ◽  
G S Sandha ◽  
S van Zanten
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Umbilical Vein ◽  
Gastroesophageal Junction ◽  
Splenic Vein ◽  
Gastric Varix ◽  
Vein Thrombosis ◽  
Inferior Aspect ◽  
Upper Abdomen

Abstract Results A 41-year old Asian male, who immigrated to Canada many years ago, and who had previously been successfully treated for Helicobacter pylori infection underwent gastroscopy for investigation of dyspepsia. His gastroscopy was normal except for a large subepithelial abnormality that was noted close to the gastroesophageal junction. Routine gastric biopsies from the antrum and body were normal. Subsequent endoscopic ultrasound revealed flow through the anechoic tortuous lesion and confirmed it was a very large isolated gastric varix type 1. Abdominal CT scan revealed chronic occlusion of the portal vein, splenic vein, and the portal confluence with extensive collateralization in the upper abdomen. There was complete cavernous transformation of the portal vein. Of the numerous varices in the upper abdomen, a very large varix drained into the left renal vein and indented into the posterior wall of the fundus of the stomach which accounted for the endoscopic finding. Multiple mesenteric veins were identified that connected to varices adjacent to the inferior aspect of the pancreas and duodenum. Notably, there was no evidence of cirrhosis or chronic pancreatitis. Liver enzymes, albumin, and INR were normal. Further collateral history revealed that he was hospitalized as a neonate for pneumonia with catheterization of the umbilical vein, which is known to be associated with thrombosis of the portal vein. Conclusions Detection of congenital absence of the portal vein (CAPV) is recognized more often due to advances in diagnostic imaging. Radiologically, the absence of the portal vein in CAPV is distinguished from portal vein thrombosis by the lack of venous collaterals or sequalae of portal hypertension, such as ascites or splenomegaly. A more gradual thrombosis of the portal vein may permit collaterals to develop without acute changes and is not equivalent to portal vein aplasia or agenesis as intrahepatic bile ducts are normal. The gold standard for diagnosis of CAPV is histologic absence of the portal vein in the liver on catheter angiography. CAPV is associated with abnormal embryologic development of the portal vein and frequently presents with complications of portal hypertension or portosystemic encephalopathy or the sequalae of venous shunts, hepatic or cardiac abnormalities found on imaging. Our case is an incidentally discovered absence of the portal venous system due to chronic thrombosis with extensive collateralization and an enlarged gastric varix protruding into the proximal stomach. It is well documented that canalization of the umbilical vein in infancy is associated with portal vein thrombosis, with incidences up to 68%. This case highlights the importance of eliciting a childhood hospitalization history in cases of non-cirrhotic portal hypertension. Funding Agencies None

scholarly journals Hematemesis in an eight-year-old female as a presenting symptom of portal vein thrombosis following neonatal umbilical vein catheterization

2020 ◽  
Vol 61 (6) ◽  
pp. 663-664
Author(s):  
Anne Louise van Els ◽  
Joël Israëls ◽  
Marianne Alice van Houten ◽  
Timotheüs Gualtherus Jacob de Meij
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Umbilical Vein ◽  
Vein Thrombosis ◽  
Vein Catheterization

scholarly journals Successful Thrombectomy via a Surgically Reopened Umbilical Vein for Extended Portal Vein Thrombosis Caused by Portal Vein Embolization prior to Extended Liver Resection

2020 ◽  
Vol 14 (2) ◽  
pp. 320-328
Author(s):  
Wouter J.M. Derksen ◽  
Iris E.M. de Jong ◽  
Carlijn I. Buis ◽  
Koen M.E.M. Reyntjens ◽  
G. Matthijs Kater ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Portal Vein Embolization ◽  
Liver Surgery ◽  
Umbilical Vein ◽  
Future Liver Remnant ◽  
Main Stem ◽  
Liver Remnant ◽  
Vein Thrombosis ◽  
The Future

Selective portal vein embolization (PVE) before extended liver surgery is an accepted method to stimulate growth of the future liver remnant. Portal vein thrombosis (PVT) of the main stem and the non-targeted branches to the future liver remnant is a rare but major complication of PVE, requiring immediate revascularization. Without revascularization, curative liver surgery is not possible, resulting in a potentially life-threatening situation. We here present a new surgical technique to revascularize the portal vein after PVT by combining a surgical thrombectomy with catheter-based thrombolysis via the surgically reopened umbilical vein. This technique was successfully applied in a patient who developed thrombosis of the portal vein main stem, as well as the left portal vein and its branches to the left lateral segments after selective right-sided PVE in preparation for an extended right hemihepatectomy. The advantage of this technique is the avoidance of an exploration of hepatoduodenal ligament and a venotomy of the portal vein. The minimal surgical trauma facilitates additional intravascular thrombolytic therapy as well as the future right extended hemihepatectomy. We recommend this technique in patients with extensive PVT in which percutaneous less invasive therapies have been proven unsuccessful.

scholarly journals Point of Care Perioperative Coagulation Management in Liver Transplantation and Complete Portal Vein Thrombosis

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Cristiano Piangatelli ◽  
Lucia Faloia ◽  
Claudia Cristiani ◽  
Ilaria Valentini ◽  
Marco Vivarelli
Keyword(s):  
Liver Transplantation ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Umbilical Vein ◽  
Point Of Care ◽  
Ischemia Reperfusion ◽  
Color Doppler ◽  
Coagulation Management ◽  
Human Fibrinogen ◽  
Vein Thrombosis

Liver transplantation (LT) is a serious hemostatic challenge in patients with portal vein thrombosis (PVT). Advances in monitoring systems have improved surgery in this setting. We report the successful application of a point-of-care (POC) rotational viscoelastic thromboelastometry-guided (TEM) testing system (ROTEM) which allowed management of coagulation during LT in a 64-year-old cirrhotic patient with a model for end-stage liver disease (MELD) score of 16. Perioperatively, the patient showed complete PVT, hepatomegaly, splenomegaly, recanalization of the umbilical vein, and portosystemic shunt. Macroscopic liver and spleen adherences with collateral circulation were evident. Coagulation factors and fibrinolysis were assessed preoperatively and at graft reperfusion to evaluate the need of hemostatic therapy. Based on ROTEM findings, the patient received 16 g of human fibrinogen concentrate, half preoperatively (with prothrombin complex concentrate 2000 IU, tranexamic acid 1 g, and platelets 2 IU), and two doses of 4 g before and after graft reperfusion; we achieved normalization of all monitored parameters. No ischemia-reperfusion syndrome was present. Postoperatively portal vein flux at Color-Doppler ultrasonography was normal. After a 3-day ICU stay, the patient was moved to the Department of Surgery and discharged on day 14. The postoperative course was uneventful and did not require any further haemostatic therapy.

Selective Fibrinolysis for Acute Portal Vein Thrombosis in Infants

PEDIATRICS ◽  
1979 ◽  
Vol 63 (3) ◽  
pp. 504-504
Author(s):  
Charles T. Dotter
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Mesenteric Artery ◽  
Umbilical Vein ◽  
Vein Thrombosis ◽  
Cavernous Transformation ◽  
Portosystemic Shunting ◽  
Complete Lysis ◽  
Primary Problem ◽  
Vein Catheterization

Acute portal vein thrombosis secondary to omphalitis or umbilical vein catheterization usually leads, years later, to death from the hemorrhagic consequences of portal hypertension. While the delayed manifestation, sometimes inaccurately referred to as "cavernous transformation of the portal vein," is therapeutically approached by surgical portosystemic shunting, results are dismal. A feasible, untried, therapeutic attack on the primary problem is now available in selective fibrinolysis of the acute portal vein thrombus. Streptokinase (or urokinase), given by catheter either into the superior mesenteric artery or via transhepatic portal vein catheterization directly into the fresh thrombus, could be expected to result in complete lysis within a matter of hours.

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