Natural History of Minimal Hepatic Encephalopathy in Patients With Extrahepatic Portal Vein Obstruction

2009 ◽  
Vol 104 (4) ◽  
pp. 885-890 ◽  
Author(s):  
Praveen Sharma ◽  
Barjesh Chander Sharma ◽  
Vinod Puri ◽  
Shiv Kumar Sarin
Keyword(s):  
Hepatic Encephalopathy ◽  
Natural History ◽  
Portal Vein ◽  
Minimal Hepatic Encephalopathy ◽  
Extrahepatic Portal Vein Obstruction ◽  
Portal Vein Obstruction ◽  
History Of

scholarly journals Value of preoperative computed tomography for meso-Rex bypass in children with extrahepatic portal vein obstruction

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Huiying Wu ◽  
Ning Zhou ◽  
Lianwei Lu ◽  
Xiwen Chen ◽  
Tao Liu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Portal Vein ◽  
Predictive Value ◽  
Extrahepatic Portal Vein Obstruction ◽  
Portal Vein Obstruction ◽  
Left Portal Vein ◽  
History Of ◽  
Associated Malformations ◽  
Sensitivity Specificity

Abstract Background Extrahepatic portal vein obstruction (EHPVO) is the most important cause of hematemesis in children. Intrahepatic left portal vein and superior mesenteric vein anastomosis, also known as meso-Rex bypass (MRB), is becoming the gold standard treatment for EHPVO. We analyzed the value of preoperative computed tomography (CT) in determining whether MRB is feasible in children with EHPVO. Results We retrieved data on 76 children with EHPVO (50 male, 26 female; median age, 5.9 years) who underwent MRB (n = 68) or the Warren procedure (n = 8) from 2013 to 2019 and retrospectively analyzed their clinical and CT characteristics. The Rex recess was categorized into four subtypes (types 1–4) depending on its diameter in CT images. Of all 76 children, 7.9% had a history of umbilical catheterization and 1.3% had leukemia. Sixteen patients (20 lesions) had associated malformations. A total of 72.4% of Rex recesses could be measured by CT, and their mean diameter was 3.5 ± 1.8 mm (range 0.6–10.5 mm). A type 1, 2, 3, and 4 Rex recess was present in 9.2%, 53.9%, 11.8%, and 25.0% of patients, respectively. MRB could be performed in patients with types 1, 2, and 3, but those with type 4 required further evaluation. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of CT were 100%, 83.8%, 42.1%, 100%, and 85.5%, respectively. Conclusions Among the four types of Rex recesses on CT angiography, types 1–3 allow for the performance of MRB.

scholarly journals Natural history of extra-hepatic portal vein obstruction (EHPVO) in western countries

2000 ◽  
Vol 118 (4) ◽  
pp. A967
Author(s):  
Massimo Primignani ◽  
Nicola De Bortoli ◽  
Marco Moia ◽  
Paolo Bucciarelli ◽  
Paolo Carnevale ◽  
...  
Keyword(s):  
Natural History ◽  
Portal Vein ◽  
Western Countries ◽  
Portal Vein Obstruction ◽  
History Of ◽  
Hepatic Portal Vein ◽  
Hepatic Portal
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