scholarly journals Bleed caused by varicose veins rupture in a rare site in portal hypertension. Differential diagnosis with causes of acute hypovolemic shock in emergency.

2011 ◽  
Vol 7 (3) ◽  
pp. 13
Author(s):  
Rosarino Procopio ◽  
Elio Scaramuzzino
Keyword(s):  
Differential Diagnosis ◽  
Portal Hypertension ◽  
Varicose Veins ◽  
Hypovolemic Shock ◽  
Rare Site

scholarly journals Difficulties of differential diagnosis of portal hypertension: case report

2021 ◽  
pp. 92-101
Author(s):  
T. V. Penkina ◽  
O. E. Berezutskaya ◽  
D. T. Dicheva ◽  
E. V. Partsvania-Vinogradova ◽  
V. S. Larina ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Clinical Case ◽  
Clinical Symptoms ◽  
Varicose Veins ◽  
Small Diameter ◽  
Magnetic Resonance Tomography ◽  
Vein Thrombosis

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. 

Miscellaneous/Marginal/Evolving Indications (Other Abdominopelvic Tumors, Portal Hypertension-Related Varicose Veins, Osteoarticular Pathologies)

Embolization ◽  
2013 ◽  
pp. 423-443
Author(s):  
Louis Boyer ◽  
Agaïcha Alfidja Lankoande ◽  
Mickaël Fontarensky ◽  
Pascal Chabrot
Keyword(s):  
Portal Hypertension ◽  
Varicose Veins

scholarly journals Fatal bleeding caused by a ruptured varicose vein

2020 ◽  
Vol 88 (1) ◽  
pp. 41-44
Author(s):  
Serenella Serinelli ◽  
Luigi Bonaccorso ◽  
Lorenzo Gitto
Keyword(s):  
Varicose Vein ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Hypovolemic Shock ◽  
Massive Bleeding ◽  
The Body ◽  
Medical Emergency ◽  
Medial Aspect ◽  
Fatal Bleeding ◽  
The Right

Chronic venous insufficiency is generally not lethal, but massive bleeding from ruptured varicose veins can be fatal. A 79-year-old woman was found dead in her apartment in Rome. Pools of blood and contact pattern bloodstains were observed around the body. She lived alone and suffered from vascular dementia. On the medial aspect of the right leg, a circular ulcer communicating with the lumen of a varicose vein was noted. Death was attributed to hypovolemic shock caused by bleeding from the rupture of the varicose vein. Our case confirms that varicose veins rupture is a potentially fatal medical emergency. Conditions such as dementia may lead to failure to understand the gravity of the bleeding and to seek help. Recognition of this issue is important especially when the care of people suffering from mental illness is involved.

Combined endoscopic intervention (ligation+sclerotherapy) compared with TIPS for prevention of bleeding from gastro-esophageal varices in patients with liver cirrhosis

2016 ◽  
Vol 5 (1) ◽  
pp. 124
Author(s):  
Utkirbek Matkuliev
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Varicose Veins ◽  
Portal System ◽  
Endoscopic Intervention ◽  
Portosystemic Shunts ◽  
System Pressure ◽  
Intrahepatic Portosystemic Shunt ◽  
History Of ◽  
The Mean

Background: Liver cirrhosis (LC) and portal hypertension (PH) is one of the most serious problems of modern surgical hepatology. The most common complication of liver cirrhosis is bleeding from varicose veins of esophagus and stomach. Today experts have several ways to prevent rebleeding from varices: pharmacotherapy, endoscopic intervention, transjugular intrahepatic portosystemic shunt (TIPS), a surgical portocaval bypass. Purpose of this study was to compare effectiveness of transjugular intrahepatic portosystemic shunts (TIPS) and combined endoscopic therapy the management of bleeding in cirrhotic patients.Methods: We observed 96 consecutive patients with portal hypertension who were treated in 2nd clinic of Tashkent Medical Academy (2014-2015). Bleeding was in history of 17 (17.7%) patients. The duration of the bleeding averaged 9.7±4.3 hours. Ascites was observed in 54.5 % of patients. Patients were divided two major groups. First group included 72 patients who was performed endoscopic intervention. Second group consisted of 24 patients who underwent TIPS in emergency cases.Results: Seventy-two patients were assigned to variceal ligation and Sclerotherapy, other 24 patients to TIPS. In the ligation combined Sclerotherapy group, a second treatment was performed 8–10 days after the initial endoscopy. Deterioration of portal gastropathy was observed in 9 (9.4%) cases after EL and 24 (25.0%) after ES (p <0.05). The mean portal system pressure prior to TIPS placement was 53.67±4.21 mm Hg, which decreased to 25.10±4.06 mmHg after the first shunt tract was established (P <0.001). The mean portal system pressure prior to the second TIPS was 43.68±3.98 mm Hg and decreased to 25.14±4.67 mm Hg after the procedures (P <0.001).Conclusions: TIPS can become dysfunctional if stenosis develops in the shunt or the hepatic vein above the shunt. Screening allows detection of stenosis before portal hypertensive–related complications recur. Revision of stenotic shunts can be easily accomplished in most cases. Techniques for screening and revision will be discussed. This is one of the most effective methods to control patients with liver cirrhosis.

Gastrointestinal bleeding in the tropics: Look for the hookworm

2016 ◽  
Vol 47 (1) ◽  
pp. 48-51
Author(s):  
Vishal Sharma ◽  
Deepak Gunjan ◽  
Puneet Chhabra ◽  
Ravi Sharma ◽  
Surinder Singh Rana ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Iron Deficiency ◽  
Gastrointestinal Bleeding ◽  
Iron Deficiency Anaemia ◽  
Hypovolemic Shock ◽  
Endoscopic Diagnosis ◽  
Deficiency Anaemia ◽  
Tropical Countries ◽  
Endemic Areas ◽  
The Tropics

Hookworms are recognised as a cause of iron-deficiency anaemia in endemic areas. They are, however, often not considered in the differential diagnosis of overt gastrointestinal bleeding. We report the endoscopic diagnosis of hookworms as the cause of gastrointestinal bleeding in three patients, two of whom had frank haemorrhage with one presenting in hypovolemic shock. Hookworm infestation is an important treatable cause of gastrointestinal bleeding in tropical countries.

scholarly journals Portosystemic shunting procedures for complicated portal hypertension: modern opportunities of mini-invasive technique

2021 ◽  
Vol 26 (3) ◽  
pp. 34-45
Author(s):  
Yu. V. Khoronko ◽  
E. V. Kosovtsev ◽  
M. A. Kozyrevskiy ◽  
E. Yu. Khoronko ◽  
N. A. Krivorotov ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Varicose Veins ◽  
Sharp Decrease ◽  
Portosystemic Shunt ◽  
Long Term Results ◽  
Invasive Technique ◽  
Recurrent Bleeding ◽  
Clinical Group ◽  
Shunt Thrombosis ◽  
Group I

Aim. To improve the results of treatment for patients with complicated portal hypertension of cirrhotic genesis using the transjugular intahepatic portosystemic shunt with endovascular obliteration of the inflow pathways to the esophageal-gastric varicose veins.Material and methods. Transjugular intahepatic portosystemic shunt was performed in 172 patients with gastroesophageal variceal bleeding. The patients were divided into 3 clinical groups. The shunting procedure was applied to 62 patients. Another 110 patients underwent transjugular intahepatic portosystemic shunt and selective obliteration of the esophageal-gastric vein inflow pathways. The short-term and long-term results (up to 140 months), the incidence of thrombosis, recurrent bleeding and mortality, as well as their relationship with the established risk factors for complications were traced.Results. All patients achieved an effective reduction in the portosystemic pressure gradient and a reduction in the manifestations of portal hypertension. Recurrence of bleeding caused by shunt thrombosis occurred in 23 (13.3%) patients. In clinical group I (n = 62), this complication was noted in 9 (14.5%) patients, in II (n = 54) – 11 (20.4%) cases, in III (n = 56) – only in 3 (5.4%) cases. Bleeding-free survival decreased from 1.0 to 0.82 in 83.9 months, then plateaued. A sharp decrease in the Kaplan–Meier curve from 1.0 to 0.88 was observed within 24.5 months after the intervention. The largest number of deaths was in group I (30.6%), the smallest in group III (7.1%).Conclusion. Transjugular intahepatic portosystemic shunt supplemented by obliteration the inflows of the esophagealgastric varicose veins provides complete eradication of varicose veins, helps to reduce the frequency of recurrent bleeding and death.

Sign in / Sign up

Export Citation Format

Share Document