scholarly journals An Unusual Case of Gastrointestinal Bleeding from Isolated Gallbladder Varices in a Patient with Pancreatic Cancer Complicated by Portal Biliopathy

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Mahir Gachabayov ◽  
Kubach Kubachev ◽  
Elbrus Abdullaev ◽  
Nonna Zarkua ◽  
Abakar Abdullaev ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Gastrointestinal Bleeding ◽  
Unusual Case ◽  
Umbilical Vein ◽  
Extrahepatic Portal Vein Obstruction ◽  
Intrahepatic Bile Ducts ◽  
Portal Vein Obstruction ◽  
History Of ◽  
Noncirrhotic Portal Fibrosis ◽  
Portal Biliopathy

Portal biliopathy is the complex of abnormalities of extrahepatic and intrahepatic bile ducts, cystic duct, and gallbladder, arising as a result of extrahepatic portal vein obstruction and noncirrhotic portal fibrosis, which can be caused by coagulopathies, tumors, inflammation, postoperative complications, dehydration, and neonatal umbilical vein catheterization. We report a case of a 55-year-old male patient with the history of pancreatic cancer and cholecystoenteric anastomosis presenting with gastrointestinal bleeding from gallbladder varices via the anastomosis.

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 An unusual case of acute lower gastrointestinal bleeding due to fungal infection

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052096782
Author(s):  
Jianchun Xiao ◽  
Ruopeng Zhang ◽  
Wanqi Chen ◽  
Beizhan Niu
Keyword(s):  
Gastrointestinal Bleeding ◽  
Fungal Infection ◽  
Lupus Erythematosus ◽  
Unusual Case ◽  
Exploratory Laparotomy ◽  
Lower Gastrointestinal Bleeding ◽  
Pathological Examination ◽  
Disorder Of Consciousness ◽  
Glucocorticoid Treatment ◽  
History Of

A 63-year-old woman was admitted to our hospital with herpes zoster viral infection and intermittent disorder of consciousness. On day 13 of hospitalization for glucocorticoid treatment, the patient experienced seven episodes of hematochezia. She had a 2-year history of systemic lupus erythematosus and had undergone splenectomy at 40 years of age. Computed tomography and electronic endoscopy revealed bleeding and contrast agent leakage into the splenic flexure of the colon. The patient underwent an emergency exploratory laparotomy and left hemicolectomy for suspected active hemorrhaging into the digestive tract. Pathological examination revealed that the bleeding had been caused by a fungal infection. No further hemorrhaging occurred after the surgery, suggesting that intestinal fungal infection might be a potential differential diagnosis for gastrointestinal bleeding in compromised hosts.

Recanalized umbilical vein conduit for meso-Rex bypass in extrahepatic portal vein obstruction

Surgery ◽  
2009 ◽  
Vol 145 (4) ◽  
pp. 406-410 ◽  
Author(s):  
Marcelo E. Facciuto ◽  
Manuel I. Rodriguez-Davalos ◽  
Manoj K. Singh ◽  
Juan P. Rocca ◽  
Caroline Rochon ◽  
...  
Keyword(s):  
Portal Vein ◽  
Umbilical Vein ◽  
Extrahepatic Portal Vein Obstruction ◽  
Portal Vein Obstruction

Recanalized umbilical vein as a conduit for mesenterico/porto-Rex bypass for patients with extrahepatic portal vein obstruction

2010 ◽  
Vol 27 (3) ◽  
pp. 315-319 ◽  
Author(s):  
Masato Shinkai ◽  
Youkatsu Ohhama ◽  
Shohei Honda ◽  
Norihiko Kitagawa ◽  
Kyoko Mochizuki ◽  
...  
Keyword(s):  
Portal Vein ◽  
Umbilical Vein ◽  
Extrahepatic Portal Vein Obstruction ◽  
Portal Vein Obstruction

scholarly journals Clinical presentation of extrahepatic portal vein obstruction: 10-year experience at a tertiary care hospital in Pakistan

2015 ◽  
Vol 3 (2) ◽  
pp. 74-78 ◽  
Author(s):  
Farina M. Hanif ◽  
Ghous Bux Soomro ◽  
Sara Nazir Akhund ◽  
Nasir Hassan Luck ◽  
Syed Mudassir Laeeq ◽  
...  
Keyword(s):  
Portal Vein ◽  
Clinical Presentation ◽  
Activity Index ◽  
Tertiary Care ◽  
Shunt Operation ◽  
Factor V ◽  
Care Hospital ◽  
Extrahepatic Portal Vein Obstruction ◽  
Portal Vein Obstruction ◽  
Portal Biliopathy

Abstract Objective: To evaluate the clinical presentation, possible etiological factors, management and outcome of patients in our hospital with extrahepatic portal vein obstruction (EHPVO). Materials and Methods: This study included patients with EHPVO followed up in our department during last 10 years. Patients of cirrhosis with EHPVO were excluded. Patients’ clinical presentation, etiology of EHPVO, management and outcome results were analyzed. Results: Of 30 patients, 19 (67.9%) were males. Median age was 12 years. Of 14 patients who underwent liver biopsy 9 had histological activity index stage of 1/6. History of omphalitis and pulmonary tuberculosis was present in one case each. Of 22 patients with the available thrombophilia profile, nine patients had a deficiency of protein C, five patients had a deficiency of protein S, one each had reduced level S of anti-thrombin III and factor V mutation. The predominant presenting symptom was hematemesis (15 patients, 53.6%). Seven patients (25%) had splenomegaly. Three patients (10.7%) had no esophageal varices on endoscopy. Three patients underwent splenectomy due to severe pancytopenia. Endoscopic retrograde cholangipancreatography was performed in four patients (14.3%) due to portal biliopathy. Common bile duct stenting was performed in all four patients. Of them, one patient underwent splenorenal shunt operation for indication of hemobilia. One patient died at the age of 40 years, due to cholangitis and sepsis. Conclusions: Results from this study show that the anticoagulant deficiency is a common cause of EHPVO in our setup. Hematemesis is a common presenting symptom. Some of these patients have symptomatic portal biliopathy.

Long-Term Results after Diversion Surgery in Extrahepatic Portal Vein Obstruction

2018 ◽  
Vol 29 (01) ◽  
pp. 023-027 ◽  
Author(s):  
Ana Alvarez ◽  
Mariela Dore ◽  
Javier Jimenez Gomez ◽  
Alba Sánchez Galán ◽  
Alejandra Vilanova-Sánchez ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Portal Vein ◽  
Statistical Significance ◽  
Long Term Results ◽  
Spleen Size ◽  
Extrahepatic Portal Vein Obstruction ◽  
Prothrombin Activity ◽  
Portal Vein Obstruction ◽  
Bleeding Episodes

Aim Extrahepatic portal vein obstruction (EHPVO) is a frequent cause of noncirrhotic portal hypertension in children. The aim of this study is to analyze long-term results after diversion surgery. Patients and Methods Retrospective review of EHPVO patients who underwent diversion surgery analyzing number of platelets, leukocytes, prothrombin activity, splenomegaly, and gastrointestinal bleeding 10 years after surgery. Results Thirty-three patients were evaluated, mostly males (64%) and presenting with gastrointestinal bleeding (46%). Mesoportal shunt (Rex) was performed in 19 patients, mesocaval in 7, distal splenorenal in 7, and proximal splenorenal in 3. While comparing mesoportal shunt to the other portosystemic shunts, an increase in platelets was found with every technique, but it was clearly higher in mesoportal shunt. The highest increase was 6 months after surgery (p = 0.0015) as well as prothrombin activity (p = 0.0003). Leukocytes level also increased without statistical significance. Spleen size (cm) and spleen size Z score (SSAZ) decreased significantly 6 months after mesoportal shunt (p = 0.0168). Before surgery, over 94% patients suffered gastrointestinal bleeding, which reduced significantly afterward with bleeding episodes in only four (12%) of them. Conclusion Diversion surgery in EHPVO, especially mesoportal shunt of Rex, improves hepatic function (prothrombin activity), reduces hypersplenism (platelets, leukocytes, and spleen size), and decreases gastrointestinal bleeding episodes.

PORTAL HYPERTENSION—A COMPLICATION OF UMBILICAL VEIN CATHETERIZATION

PEDIATRICS ◽  
1963 ◽  
Vol 31 (2) ◽  
pp. 297-302
Author(s):  
Frank A. Oski ◽  
Donald M. Allen ◽  
Louis K. Diamond
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Exchange Transfusion ◽  
Umbilical Vein ◽  
Extrahepatic Portal Vein Obstruction ◽  
Portal Vein Obstruction ◽  
Vein Catheterization

The histories of four children with apparent extrahepatic portal vein obstruction and portal hypertension presumably secondary to umbilical vein catheterization are presented. Recommendations for the avoidance of this complication of exchange transfusion are made.

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