scholarly journals Treatment of gastric body variceal bleeding caused by splenic vein thrombosis using color Doppler endoscopic ultrasonography

2021 ◽  
Author(s):  
Yoshihiro Furuichi ◽  
Masakazu Abe ◽  
Takao Itoi
Keyword(s):  
Endoscopic Ultrasonography ◽  
Variceal Bleeding ◽  
Color Doppler ◽  
Splenic Vein ◽  
Gastric Body ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis

scholarly journals Serum Lipoprotein (a) on Postoperative Day 3: A Strong Predictor of Portal and/or Splenic Vein Thrombosis in Cirrhotic Patients With Splenectomy

2020 ◽  
Vol 26 ◽  
pp. 107602962091202
Author(s):  
Zhiyong Shi ◽  
Mingxia Zhang ◽  
Xiushan Dong ◽  
Jun Xu
Keyword(s):  
Strong Predictor ◽  
Color Doppler ◽  
Splenic Vein ◽  
Area Under The Curve ◽  
Serum Lipoprotein ◽  
Splenic Vein Thrombosis ◽  
Lipoprotein A ◽  
Vein Thrombosis ◽  
Cirrhotic Patients ◽  
The Impact

Elevated lipoprotein (a) [Lp(a)] is related to the incidence of lower limb deep vein thrombosis and pulmonary embolism. Its role in portal and/or splenic vein thrombosis (PSVT) is not established. A total of 77 consecutive patients who underwent splenectomy for cirrhotic portal hypertension were prospectively studied between 2014 and 2017. The impact of Lp(a) on preoperative day 1 and postoperative days (PODs) 1, 3, 5, 7, and 14 was analyzed. Color Doppler ultrasound examination was performed for the diagnosis of PSVT. The median interval between surgery and postoperative PSVT was 6 days (range: 2-13 days). The levels of Lp(a) were highly increased in patients with PSVT and significant intergroup differences (vs non-PSVT) were found until day 3 and day 5 after operation, respectively. On POD 3, at a threshold of 309.06 mg/L, Lp(a) was a better predictor of PSVT (area under the curve [AUC] = 0.872) compared to the levels on PODs 1, 5, and 7 (AUC = 0.775, 0.796, and 0.791, respectively). The median Lp(a) values peaked at 382.5 mg/L on POD 5 for patients without PSVT. After POD 5, the Lp(a) decreased with values at 347.4 mg/L on POD 7 and 150.7 mg/L on POD 14. For the first time, Lp(a) was shown to be abnormal in patients with PSVT following splenectomy. Monitoring of serum Lp(a) levels on POD 3 might represent a valuable tool to predict early PSVT after splenectomy in cirrhotic patients.

scholarly journals Gastric Variceal Bleeding Secondary to Splenic Vein Thrombosis

2019 ◽  
Vol 9 (2) ◽  
pp. 34-36
Author(s):  
Benjamin W. Quick ◽  
Gilbert Kisang ◽  
William J. Salyers, Jr.
Keyword(s):  
Variceal Bleeding ◽  
Splenic Vein ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis

scholarly journals Gastric variceal bleeding due to pancreatitis-induced splenic vein thrombosis

2014 ◽  
Vol 2014 (mar24 1) ◽  
pp. bcr2013201359-bcr2013201359 ◽  
Author(s):  
A. Gotto ◽  
M. Lieberman ◽  
M. Pochapin
Keyword(s):  
Variceal Bleeding ◽  
Splenic Vein ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis

scholarly journals Periampullary Variceal Bleeding: An Atypical Complication of Portal Hypertension

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Zahava C. Farkas ◽  
Priyanka Chugh ◽  
Shalom Frager ◽  
Khwaja F. Haq ◽  
Muhammad Ali Khan ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Variceal Bleeding ◽  
Splenic Vein ◽  
Splenic Vein Thrombosis ◽  
Fatal Complication ◽  
Endoscopic Retrograde ◽  
Vein Thrombosis ◽  
Esophagogastric Varices

Variceal bleeding remains a fatal complication of portal hypertension. Periampullary varices are rare and, due to their location, are difficult to diagnose and treat. Similar to esophagogastric varices, they are the result of high portosystemic pressures secondary to intrahepatic causes such as cirrhosis and extrahepatic causes such as portal or splenic vein thrombosis. We report a case of a periampullary varix resulting in hemobilia during endoscopic retrograde cholangiopancreatography (ERCP).

scholarly journals P-BN09 Management of isolated splenic vein thrombosis: Risks and benefits of Anticoagulation

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Amar M Eltweri ◽  
Mohammed Basamh ◽  
Ying Yang Ting ◽  
Mark Harris ◽  
Giuseppe Garcea ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Ct Scan ◽  
Portal Vein Thrombosis ◽  
Variceal Bleeding ◽  
Splenic Vein ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis ◽  
Anticoagulation Treatment ◽  
Therapeutic Anticoagulation

Abstract Background Isolated splenic vein thrombosis (iSVT) is a common complication of pancreatic disease. Whilst patients remain asymptomatic, there is a risk of sinistral portal hypertension and subsequent bleeding from gastric varices if recanalization does not occur. There is a wide variation of iSVT treatment, even within single centres. We report outcomes of iSVT from tertiary referral hepatobiliary and pancreatic (HPB) units including the impact of anticoagulation on recanalization rates and subsequent variceal bleeding risk.   Methods A retrospective cohort study including all patients diagnosed with iSVT on CT scan abdomen and pelvis between 2011 and 2019 from two institutions. Patients with both SVT and portal vein thrombosis at diagnosis, and isolated splenic vein thrombosis secondary to malignancy were excluded. The outcomes of anticoagulation, recanalization rates, risk of bleeding, and progression to portal vein thrombosis were examined. Results Ninety-eight patients with iSVT were included; of which thirty-nine patients received anticoagulation (40%). The most common cause of iSVT was acute pancreatitis n = 88 (90%). The recanalization rate in the anticoagulation group was 46% vs 15% in patients receiving no anticoagulation (p = 0.0008, OR = 4.7, 95% CI 1.775 to 11.72). Upper abdominal vascular collaterals (demonstrated on CT scan angiography) were significantly less among patients who received anticoagulation treatment (p = 0.03, OR = 0.4, 95% CI 0.1736 to 0.9288). The overall rate of upper GI variceal related bleeding was 3% (n = 3/98) and it was independent of anticoagulation treatment. Two of the patients received therapeutic anticoagulation. Conclusions The current data support that therapeutic anticoagulation is associated with a statistically significant increase in recanalization rates of the splenic vein; with a subsequent reduction in radiological left-sided portal hypertension. However, all patients had a very low risk of variceal bleeding regardless of anticoagulation. The findings from this retrospective study should merit further investigation in large-scale randomized clinical trials.

scholarly journals Splenic Artery Embolization for the Treatment of Gastric Variceal Bleeding Secondary to Splenic Vein Thrombosis Complicated by Necrotizing Pancreatitis: Report of a Case

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Hee Joon Kim ◽  
Eun Kyu Park ◽  
Young Hoe Hur ◽  
Yang Seok Koh ◽  
Chol Kyoon Cho
Keyword(s):  
Blood Flow ◽  
Variceal Bleeding ◽  
Splenic Artery ◽  
Necrotizing Pancreatitis ◽  
Splenic Vein ◽  
Common Finding ◽  
Splenic Vein Thrombosis ◽  
Artery Embolization ◽  
Splenic Artery Embolization ◽  
Vein Thrombosis

Splenic vein thrombosis is a relatively common finding in pancreatitis. Gastric variceal bleeding is a life-threatening complication of splenic vein thrombosis, resulting from increased blood flow to short gastric vein. Traditionally, splenectomy is considered the treatment of choice. However, surgery in necrotizing pancreatitis is dangerous, because of severe inflammation, adhesion, and bleeding tendency. In the Warshaw operation, gastric variceal bleeding is rare, even though splenic vein is resected. Because the splenic artery is also resected, blood flow to short gastric vein is not increased problematically. Herein, we report a case of gastric variceal bleeding secondary to splenic vein thrombosis complicated by necrotizing pancreatitis successfully treated with splenic artery embolization. Splenic artery embolization could be the best treatment option for gastric variceal bleeding when splenectomy is difficult such as in case associated with severe acute pancreatitis or associated with severe adhesion or in patients with high operation risk.

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