scholarly journals A basic understanding of congenital extrahepatic portosystemic shunt: incidence, mechanism, complications, diagnosis, and treatment

2020 ◽  
Vol 9 (2) ◽  
pp. 64-70 ◽  
Author(s):  
Haowen Tang ◽  
Peipei Song ◽  
Zhiqiang Wang ◽  
Bing Han ◽  
Xiangfei Meng ◽  
...  
Keyword(s):  
Portosystemic Shunt ◽  
Diagnosis And Treatment ◽  
Basic Understanding ◽  
Congenital Extrahepatic Portosystemic Shunt

Long‐term outcome of liver transplantation for congenital extrahepatic portosystemic shunt

2021 ◽  
Author(s):  
Valérie McLin ◽  
Maurice Beghetti ◽  
Lorenzo D’Antiga ◽  
Stéphanie Franchi‐Abella ◽  
Keyword(s):  
Liver Transplantation ◽  
Portosystemic Shunt ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Congenital Extrahepatic Portosystemic Shunt

scholarly journals Clinical and laboratory outcome after surgical treatment of single congenital extrahepatic portosystemic shunt using ameroid constrictor in 25 dogs

2020 ◽  
Vol 89 (4) ◽  
pp. 357-365
Author(s):  
Andrea Nečasová ◽  
Jana Lorenzová ◽  
Ladislav Stehlík ◽  
Pavel Proks ◽  
Zita Filipejová ◽  
...  
Keyword(s):  
Bile Acid ◽  
Surgical Treatment ◽  
Clinical Outcome ◽  
Acid Concentration ◽  
Ammonia Concentration ◽  
Portosystemic Shunt ◽  
Stimulation Test ◽  
Bile Acid Concentration ◽  
Congenital Extrahepatic Portosystemic Shunt

The objective of the study was to evaluate the clinical and laboratory outcome after the surgical treatment of a single congenital extrahepatic portosystemic shunt using an ameroid constrictor. Patient medical records were reviewed in retrospect. Data on the signalment, clinical signs, preoperative bile acid stimulation test and ammonia concentration were recorded. The surgical treatment success rate was evaluated by mortality in the perioperative and short-term postoperative period and by the long-term clinical outcome. Bile acid stimulation test and ammonia concentration were also analysed 2–3 days, 4–6 weeks, and 6–8 weeks postoperatively. No patient died in the selected periods. The long-term clinical outcome was excellent in 15 out of 20 patients, good in 3 out of 20 patients and poor in 2 out of 20 patients. Preprandial bile acid concentration was elevated in 96.00%, postprandial bile acid concentration in 100.00% and ammonia concentration in 80.95% of patients preoperatively. A significant decrease was found in postprandial bile acid and ammonia 2–3 days postoperatively and in preprandial bile acid 4–6 weeks postoperatively. A significant decrease in liver function parameters in days post operation indicates a rapid restoration of hepatic function. The surgical treatment of a single extrahepatic portosystemic shunt using an ameroid constrictor is a successful method of treatment for this type of portosystemic shunt, with as much as 75.00% of the patients having an excellent long-term clinical outcome.

scholarly journals Comparison of Surgical Ligation and Endovascular Embolization in the Management of Type II Congenital Extrahepatic Portosystemic Shunt: A Retrospective Clinical Study

2021 ◽  
Author(s):  
Jin-long Zhang ◽  
Wei Dong Duan ◽  
Zhu Ting Fang ◽  
Mao Qiang Wang ◽  
Li Cui ◽  
...  
Keyword(s):  
Endovascular Embolization ◽  
Portosystemic Shunt ◽  
Type Ii ◽  
Intraoperative Blood Loss ◽  
Procedure Time ◽  
Surgical Ligation ◽  
Post Procedure ◽  
Congenital Extrahepatic Portosystemic Shunt ◽  
Interventional Group ◽  
Surgical Group

Abstract Background: Surgical ligation and endovascular embolization have been recommended for type II congenital extrahepatic portosystemic shunt (CEPS); however, no consensus has been reached. This study was designed to compare the safety and efficacy of surgical ligation and endovascular embolization for the treatment of type II CEPS. Methods: In this retrospective study, 23 consecutive patients diagnosed with type II CEPS between March 2011 and April 2019 were divided into either a surgical group (n=13; 41.5±19.9years) or the interventional group (n =10; 44.9±19.7years). The surgical group underwent laparoscopic surgical ligation of the shunt alone or ligation of the shunt and splenic artery and/or vein. The interventional group underwent endovascular embolization using microcoils, detachable coils and vascular plug. Results: All 23 patients received a one-step shunt closure, and their clinical symptoms were significantly improved within 3 months post-procedure and without recurrence during follow-up. The serum ammonia levels in both groups decreased after the procedure and dropped to normal level at 6 to 12 months post-procedure. Compared with baseline, the portal vein diameter in interventional group increased significantly at 3-, 6-, 12-, and 36-month post-occlusion (P=0.01 for all). The procedure time was shorter in interventional group (127.0±43.2minutes) than surgical group (219.8±56.7minutes; P <0.001). The intraoperative blood loss in interventional group (32.0±62.5mL) was less than that in surgical group (238.5±396.9mL; P=0.001).Conclusion: Both surgical ligation and endovascular embolization are effective in the treatment of type II CEPS. Endovascular embolization has the advantages of shorter procedure time, and less intraoperative blood loss. The ligation of the portosystemic shunt and splenic artery and vein is feasible with apparent safety, and it could avoid a second surgical treatment.

Case report: Portal-systemic encephalopathy due to a congenital extrahepatic portosystemic shunt

1996 ◽  
Vol 11 (7) ◽  
pp. 626-629 ◽  
Author(s):  
MASATO KIRIYAMA ◽  
SHIGEKI TAKASHIMA ◽  
HIROYUKI SAHARA ◽  
YOSHIYUKI KUROSAKA ◽  
MASAHIRO MATSUSHITA ◽  
...  
Keyword(s):  
Case Report ◽  
Portosystemic Shunt ◽  
Portal Systemic Encephalopathy ◽  
Congenital Extrahepatic Portosystemic Shunt

Chronic kidney disease-mineral bone disorder

2019 ◽  
Vol 80 (12) ◽  
pp. C180-C183
Author(s):  
Thomas Cronin ◽  
Mohammed Abdelmahamoud ◽  
Derek Falls ◽  
Katherine Punshon ◽  
Jamie Willows ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diagnosis And Treatment ◽  
Advanced Chronic Kidney Disease ◽  
Mineral Bone Disorder ◽  
Basic Understanding ◽  
Bone Disorder ◽  
Outpatient Settings

Chronic kidney disease-mineral bone disorder is typically seen in patients with advanced chronic kidney disease. It is managed primarily by renal physicians, but non-renal physicians are also likely to encounter patients undergoing treatment for this condition in both inpatient and outpatient settings so a basic understanding of the principles may be helpful. This article covers the fundamentals of the pathophysiology, diagnosis and treatment of chronic kidney disease-mineral bone disorder.

scholarly journals Pulmonary arteriovenous malformations in a patient with single ventricle and polysplenia syndrome

2019 ◽  
Vol 12 (7) ◽  
pp. e229491
Author(s):  
Shinichiro Sakaki ◽  
Taiyu Hayashi ◽  
Hiroshi Ono
Keyword(s):  
Arteriovenous Malformations ◽  
Single Ventricle ◽  
Vena Cava ◽  
Portosystemic Shunt ◽  
Pulmonary Arteriovenous Malformations ◽  
Polysplenia Syndrome ◽  
Abdominal Angiography ◽  
Venous Filling ◽  
Congenital Extrahepatic Portosystemic Shunt ◽  
Kawashima Operation

A 5-month-old girl with single ventricle, interrupted inferior vena cava and polysplenia syndrome palliated with bilateral Blalock-Taussig shunts developed severe cyanosis despite apparently increased pulmonary blood flow. Angiography revealed diffuse pulmonary arteriolar capillary dilatation and early pulmonary venous filling, suggesting the presence of pulmonary arteriovenous malformations. Abdominal angiography at 6 months demonstrated a large extrahepatic portosystemic shunt, which was percutaneously closed with a vascular plug. Kawashima operation was performed 2 weeks after portosystemic shunt closure. Although cyanosis improved temporarily, the patient suffered from deteriorating cyanosis at 9 months of age and underwent Fontan completion. Thereafter, her oxygen saturation gradually improved to 95% over the course of 3 weeks. Both the congenital extrahepatic portosystemic shunt and Kawashima operation contributed to the development of pulmonary arteriovenous malformations.

scholarly journals Association of increased erythrocyte osmotic resistance with haematological and histopathological findings in dogs with a congenital extrahepatic portosystemic shunt

2013 ◽  
Vol 82 (4) ◽  
pp. 393-398
Author(s):  
Kristína Řeháková ◽  
Ivana Uhríková ◽  
Leona Raušerová-Lexmaulová ◽  
Jana Lorenzová ◽  
Ladislav Stehlík ◽  
...  
Keyword(s):  
Osmotic Fragility ◽  
Portosystemic Shunt ◽  
Osmotic Resistance ◽  
Test Results ◽  
Cell Deformability ◽  
Histological Changes ◽  
Congenital Portosystemic Shunt ◽  
Congenital Extrahepatic Portosystemic Shunt ◽  
Healthy Dogs ◽  
Complete Blood Counts

The aim of the study was to investigate changes in erythrocyte osmotic resistance in relation to haematological and histological changes in dogs with a congenital portosystemic shunt. Osmotic fragility tests with complete blood counts and liver histological examinations were performed in 12 dogs with single extrahepatic portosystemic shunt confirmed by surgical exploration. Laboratory results were compared with those from 30 healthy dogs. Dogs with portosystemic shunt had a significantly increased erythrocyte osmotic resistance (P < 0.01) with 5%, 50% and 90% haemolysis corresponding to 0.45%, 0.35% and 0.30% NaCl solution, respectively. Statistical analyses revealed no correlation between haematological indicators and the osmotic fragility test results. Increased osmotic resistance was significantly associated with hepatic lipogranulomas. Based on these results, dogs with a congenital portosystemic shunt have a significantly increased erythrocyte osmotic resistance suggesting impaired red blood cell deformability. Osmotic resistance test that until now was not studied in canine hepatopathies seems to be independent of routinely performed haematological tests.

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