Case report of a pancreatic pseudocyst ruptured into the splenic vein causing extrahepatic portal hypertension

1982 ◽  
Vol 12 (5) ◽  
pp. 387-390 ◽  
Author(s):  
Sadahiro Yamamoto ◽  
Kotohito Takeshige ◽  
Toshiyuki Aradawa ◽  
Hirofumi Kuroda ◽  
Saburo Kanda ◽  
...  
Keyword(s):  
Case Report ◽  
Portal Hypertension ◽  
Pancreatic Pseudocyst ◽  
Splenic Vein ◽  
Extrahepatic Portal Hypertension

Pancreatic Pseudocyst-Induced Gastric Varices: A Rare Case of Extrahepatic Portal Hypertension?

2017 ◽  
Vol 83 (6) ◽  
pp. 208-209
Author(s):  
Neal Cooper ◽  
Jason D. Sciarretta ◽  
Ayolola Onayemi ◽  
John Davis
Keyword(s):  
Portal Hypertension ◽  
Rare Case ◽  
Pancreatic Pseudocyst ◽  
Gastric Varices ◽  
Extrahepatic Portal Hypertension

Massive Gastrointestinal Bleeding Due to Isolated Jejunal Varices in a Patient With Extrahepatic Portal Hypertension: A Case Report

2016 ◽  
Vol 111 (8) ◽  
pp. 1209-1211 ◽  
Author(s):  
Emad Mansoor ◽  
Ajaypal Singh ◽  
Gregory Nizialek ◽  
Hazel Marie Veloso ◽  
Jeffry Katz ◽  
...  
Keyword(s):  
Case Report ◽  
Portal Hypertension ◽  
Gastrointestinal Bleeding ◽  
Jejunal Varices ◽  
Extrahepatic Portal Hypertension ◽  
Massive Gastrointestinal Bleeding

scholarly journals Splenic vein aneurysm in association with extrahepatic portal hypertension

2006 ◽  
Vol 26 (3) ◽  
pp. 237-238 ◽  
Author(s):  
Omar Javed Shah ◽  
Irfan Robbani
Keyword(s):  
Portal Hypertension ◽  
Splenic Vein ◽  
Extrahepatic Portal Hypertension

scholarly journals Splenic Vein Stenting for Recurrent Chylous Ascites in Sinistral Portal Hypertension: A Case Report

2021 ◽  
Author(s):  
Brian Covello ◽  
Jacob Miller ◽  
Roberto Fourzali
Keyword(s):  
Case Report ◽  
Portal Hypertension ◽  
Minimally Invasive ◽  
Gastrointestinal Bleeding ◽  
Splenic Vein ◽  
Chylous Ascites ◽  
Arterial Embolization ◽  
Viable Option ◽  
Current Case ◽  
Sinistral Portal Hypertension

Abstract Background: Sinistral portal hypertension results from obstruction or stenosis of the splenic vein and is characterized by normal portal vein pressures and liver function tests. Gastrointestinal bleeding is the most common presentation and indication for treatment. Although sinistral portal hypertension-related chylous ascites is rare, several cases have described successful treatment with portal venous, rather than splenic venous, recanalization. Splenectomy is effective in the treatment of sinistral portal hypertension-related bleeding, although recent studies have evaluated splenic vein stenting and splenic arterial embolization as minimally-invasive treatment alternatives. Splenic vein stenting may be a viable option for other presentations of sinistral portal hypertension. Case Presentation: A 59-year-old gentleman with a history of necrotizing gallstone pancreatitis was referred to interventional radiology for management of recurrent chylous ascites. Analysis of ascites demonstrated a triglyceride level of 1,294 mg/dL. Computed tomography revealed splenic and superior mesenteric venous stricture. The patient elected to undergo minimally invasive transhepatic portal venography, which confirmed the presence of splenic vein and superior mesenteric vein stenosis. Venography of the splenic vein showed reversal of portal venous flow, multiple collaterals, and a pressure gradient of 14 mmHg. Two 10 mm x 40 mm Cordis stents were placed, which decreased the pressure gradient to 7 mmHg, and resolved the portosystemic collaterals. At 6 months follow-up, the patient had no recurrent episodes of ascites. Conclusion: The current case highlights successful treatment of sinistral portal hypertension-related intractable chylous ascites treated with transhepatic splenic vein stenting. Splenic venous stent patency rates of 92.9% at twelve months have been reported. Rebleeding rates of 7.1% for splenic vein stenting, 16% for splenectomy, and 47.8% for splenic arterial embolization have been reported in the treatment of sinistral portal hypertension-related gastrointestinal bleeding. The literature regarding splenic vein stenting for sinistral portal hypertension-related ascites is less robust. Technical and clinical success in the current case suggests that splenic vein recanalization may be a safe and viable option in other sinistral portal hypertension-related symptomatology.Level of Evidence: Level 4, Case Report

scholarly journals Splenic vein stenting for recurrent chylous ascites in sinistral portal hypertension: a case report

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Brian Covello ◽  
Jacob Miller ◽  
Roberto Fourzali
Keyword(s):  
Case Report ◽  
Portal Hypertension ◽  
Minimally Invasive ◽  
Gastrointestinal Bleeding ◽  
Splenic Vein ◽  
Chylous Ascites ◽  
Arterial Embolization ◽  
Viable Option ◽  
Current Case ◽  
Sinistral Portal Hypertension

Abstract Background Sinistral portal hypertension results from obstruction or stenosis of the splenic vein and is characterized by normal portal vein pressures and liver function tests. Gastrointestinal bleeding is the most common presentation and indication for treatment. Although sinistral portal hypertension-related chylous ascites is rare, several cases have described successful treatment with portal venous, rather than splenic venous, recanalization. Splenectomy is effective in the treatment of sinistral portal hypertension-related bleeding, although recent studies have evaluated splenic vein stenting and splenic arterial embolization as minimally-invasive treatment alternatives. Splenic vein stenting may be a viable option for other presentations of sinistral portal hypertension. Case presentation A 59-year-old gentleman with a history of necrotizing gallstone pancreatitis was referred to interventional radiology for management of recurrent chylous ascites. Analysis of ascites demonstrated a triglyceride level of 1294 mg/dL. Computed tomography revealed splenic and superior mesenteric venous stricture. The patient elected to undergo minimally invasive transhepatic portal venography, which confirmed the presence of splenic vein and superior mesenteric vein stenosis. Venography of the splenic vein showed reversal of portal venous flow, multiple collaterals, and a pressure gradient of 14 mmHg. Two 10 mm × 40 mm Cordis stents were placed, which decreased the pressure gradient to 7 mmHg and resolved the portosystemic collaterals. At 6 months follow-up, the patient had no recurrent episodes of ascites. Conclusion The current case highlights the successful treatment of sinistral portal hypertension-related intractable chylous ascites treated with transhepatic splenic vein stenting. Splenic venous stent patency rates of 92.9% at 12 months have been reported. Rebleeding rates of 7.1% for splenic vein stenting, 16% for splenectomy, and 47.8% for splenic arterial embolization have been reported in the treatment of sinistral portal hypertension-related gastrointestinal bleeding. The literature regarding splenic vein stenting for sinistral portal hypertension-related ascites is less robust. Technical and clinical success in the current case suggests that splenic vein recanalization may be a safe and viable option in other sinistral portal hypertension-related symptomatology. Level of Evidence: Level 4, Case Report.

scholarly journals Left-sided portal hypertension caused by idiopathic splenic vein stenosis improved by splenectomy: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Hikaru Hayashi ◽  
Akira Shimizu ◽  
Hiroaki Motoyama ◽  
Koji Kubota ◽  
Tsuyoshi Notake ◽  
...  
Keyword(s):  
Case Report ◽  
Portal Hypertension ◽  
Splenic Vein ◽  
Vein Stenosis

An unusual presentation of epigastric pain due to thrombophlebitis of a recanalised umbilical vein – case report

2019 ◽  
Vol 98 (8) ◽  
pp. 326-327 ◽  
Keyword(s):  
Liver Cirrhosis ◽  
Abdominal Pain ◽  
Case Report ◽  
Portal Hypertension ◽  
Liver Disease ◽  
Epigastric Pain ◽  
Umbilical Vein ◽  
History Of ◽  
Clinically Significant ◽  
Inflammatory Changes

Introduction: The umbilical vein can become recanalised due to portal hypertension in patients with liver cirrhosis but the condition is rarely clinically significant. Although bleeding from this enlarged vein is a known complication, the finding of thrombophlebitis has not been previously described. Case report: We report the case of a 62-year-old male with a history of liver cirrhosis due to alcoholic liver disease presenting to hospital with epigastric pain. A CT scan of the patient’s abdomen revealed a thrombus with surrounding inflammatory changes in a recanalised umbilical vein. The patient was managed conservatively and was discharged home the following day. Conclusion: Thrombophlebitis of a recanalised umbilical vein is a rare cause of abdominal pain in patients with liver cirrhosis.

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