Laparoscopy in Diagnosis and Differential Diagnosis of Portal Hypertension

2015 ◽  
pp. 90-92
Author(s):  
H. Brailski
2021 ◽  
pp. 92-101
Author(s):  
T. V. Penkina ◽  
O. E. Berezutskaya ◽  
D. T. Dicheva ◽  
E. V. Partsvania-Vinogradova ◽  
V. S. Larina ◽  
...  

In the article we analysed the difficulties of differential diagnosis of portal hypertension, considers a clinical case that illustrates the presented theoretical material. In the presented clinical observation, the patient’s disease was manifested by bleeding from the varicose veins of the esophagus. In most cases, portal hypertension syndrome in practicing clinicians is associated with liver cirrhosis, however, it is necessary to remember about the possibility of developing subhepatic portal hypertension, in particular as a result of the formation of portal vein thrombosis. If there are signs of portal hypertension, it is necessary to specify the level of obstruction to blood flow, that is, the form of portal hypertension (subhepatic, hepatic, suprahepatic). Often, portal vein thrombosis can be formed due to undiagnosed blood diseases that occur without any clinical symptoms. The provided clinical example demonstrates a case of portal hypertension in the outcome of a chronic form of myeloproliferative syndrome. Portal cavernoma is quite rare and it is formed due to multiple small-diameter venous structures that gradually replace the occluded vessel with a system of collaterals proximal and distal to the portal vein thrombosis site. In the formation of the diagnosis the main are radiation research methods, but the conclusions should be considered only in conjunction with the clinical evidence. The clinical case is interesting because a large cavernoma of the portal vein in a patient with subhepatic portal hypertension was regarded as a «solid formation» according to magnetic resonance tomography. According to the literature data, cavernous transformation has an external similarity to the tumor process, which expands the range of differential diagnosis and requires the exclusion of oncological formations. 


1992 ◽  
Vol 33 (5) ◽  
pp. 457-458 ◽  
Author(s):  
E. Ben-Chetrit ◽  
J. Bar-Ziv

A 46-year-old male with cirrhosis and portal hypertension complained of lower pelvic pain. CT of the rectum raised a strong suspicion of a rectal tumor. However, rectal examination, anoscopy, direct rectoscopy, and, unfortunately, post-mortem dissection, failed to confirm its existence. Nevertheless, large flat hemorrhoids were evident. Review of the patient's chart disclosed the presence of large thrombosed hemorrhoids detected by rectal examination prior to the CT examination. It is suggested that rectal hemorrhoids be included in the differential diagnosis of rectal tumor shown by CT in patients with portal hypertension.


Author(s):  
Fiona Jenkinson ◽  
Michael J Murphy

Background: Modified Light's criteria are widely used to categorize pleural fluids as either exudates or transudates. Similarly, the serum-ascites albumin gradient (SAAG) is used in the differential diagnosis of ascites, particularly with reference to the prediction of portal hypertension. Fluid and serum samples are required for both of these to be applied. The effect of the time interval between fluid and serum samples on the interpretation of results has not been studied. Methods: We examined the effect of sample timing on (a) the application of modified Light's criteria, and (b) the categorization of SAAG as wide (≥11 g/L) or narrow (<11 g/L). Specifically, we compared the use of a 'routine' serum sample, i.e. one that was not formally paired by the requesting clinician with the fluid sample, with serum samples collected within 2 h of the fluid sample. Results: Of 77 pleural fluids included for analysis, 45/47 were categorized as exudates, and 32/30 as transudates, using near-simultaneous/routine serum samples respectively. Discrepant categorization was observed in two cases ( P=0.74). Of 109 ascitic fluids, SAAG was ≥11 g/L in 100/95 cases, and <11 g/L in 9/14, using near-simultaneous/routine serum samples respectively. Discrepant categorization was observed in five cases ( P=0.27). Conclusions: With reference to categorizing pleural and ascitic fluids as described above under (a) and (b), in most cases the use of routine serum samples does not alter the fluid categorization compared with the use of serum samples collected within 2 h.


Author(s):  
Bruce Mackay

The broadest application of transmission electron microscopy (EM) in diagnostic medicine is the identification of tumors that cannot be classified by routine light microscopy. EM is useful in the evaluation of approximately 10% of human neoplasms, but the extent of its contribution varies considerably. It may provide a specific diagnosis that can not be reached by other means, but in contrast, the information obtained from ultrastructural study of some 10% of tumors does not significantly add to that available from light microscopy. Most cases fall somewhere between these two extremes: EM may correct a light microscopic diagnosis, or serve to narrow a differential diagnosis by excluding some of the possibilities considered by light microscopy. It is particularly important to correlate the EM findings with data from light microscopy, clinical examination, and other diagnostic procedures.


2011 ◽  
Vol 21 (2) ◽  
pp. 59-62
Author(s):  
Joseph Donaher ◽  
Christina Deery ◽  
Sarah Vogel

Healthcare professionals require a thorough understanding of stuttering since they frequently play an important role in the identification and differential diagnosis of stuttering for preschool children. This paper introduces The Preschool Stuttering Screen for Healthcare Professionals (PSSHP) which highlights risk factors identified in the literature as being associated with persistent stuttering. By integrating the results of the checklist with a child’s developmental profile, healthcare professionals can make better-informed, evidence-based decisions for their patients.


Sign in / Sign up

Export Citation Format

Share Document