scholarly journals Posttraumatic Aneurysm of a Patent Umbilical Vein: Diagnosis and Specific Treatment

2017 ◽  
Vol 03 (03) ◽  
pp. e113-e116
Author(s):  
Matthias Grade ◽  
Siegfried Krishnabhakdi ◽  
Thomas Vestring ◽  
Micha Löbermann ◽  
Joachim Arnold
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Acute Abdominal Pain ◽  
Umbilical Vein ◽  
Specific Treatment ◽  
Rare Condition ◽  
Risk Of Rupture ◽  
Valuable Treatment ◽  
Intrahepatic Portosystemic Shunt ◽  
History Of

A patent umbilical vein is a rare condition in healthy volunteers, but can be detected in up to 11% of patients with liver cirrhosis as a consequence of portal hypertension.We report the case of a 52-year-old woman who was admitted to our department with acute abdominal pain after blunt trauma to her forehead and abdomen. She had a history of alcohol abuse with liver cirrhosis that had been classified as Child–Pugh stage C 5 years earlier. Signs of portosystemic shunting had been present at an earlier endoscopy, and esophageal varices were found.Clinical examination revealed typical signs of liver cirrhosis, and ultrasound examination showed an aneurysm of 6 cm of the umbilical vein, which had not been present at earlier examinations. After lowering portal hypertension by inserting a transjugular intrahepatic portosystemic shunt, an open surgical resection of the aneurysmal umbilical vein was performed without complications. The patient recovered well and was discharged from the hospital 10 days later.We hypothesize that the abdominal trauma prompted or aggravated umbilical vein aneurysm in this patient with liver cirrhosis and portal hypertension. Due to the risk of rupture, a surgery-based resection is a valuable treatment option.

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.

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.

scholarly journals Systemic and Splanchnic Lipopolysaccharide and Endothelin-1 Plasma Levels in Liver Cirrhosis before and after Transjugular Intrahepatic Portosystemic Shunt

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Jiaxiang Meng ◽  
Qing Wang ◽  
Kai Liu ◽  
Shuofei Yang ◽  
Xinxin Fan ◽  
...  
Keyword(s):  
Blood Flow ◽  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Bacterial Translocation ◽  
Portosystemic Shunt ◽  
Before And After ◽  
Intrahepatic Portosystemic Shunt ◽  
Cirrhotic Patients

Lipopolysaccharide (LPS) and endothelin- (ET-) 1 may aggravate portal hypertension by increasing intrahepatic resistance and splanchnic blood flow. In the portal vein, after TIPS shunting, LPS and ET-1 were significantly decreased. Our study suggests that TIPS can benefit cirrhotic patients not only in high hemodynamics related variceal bleeding but also in intestinal bacterial translocation associated complications such as endotoxemia.

scholarly journals A case presentation of patient from northern China with endomyocardial fibrosis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yonggang Yuan ◽  
Yingkai Li ◽  
Zesheng Xu
Keyword(s):  
Enzyme Inhibitor ◽  
Beta Blockers ◽  
Specific Treatment ◽  
Rare Condition ◽  
Northern China ◽  
Multiple Organ ◽  
Chinese Patient ◽  
Endomyocardial Fibrosis ◽  
Case Presentation ◽  
History Of

Abstract Background Endomyocardial fibrosis (EMF) is a rare condition and a major cause of death in tropical countries. The etiology of EMF remains elusive, and no specific treatment has been developed yet, therefore it carries poor prognosis. Case presentation An 81-year-old male Chinese patient with a history of long-standing exertional breathlessness, presented with worsening symptoms rapidly evolving to orthopnea. A proper specific treatment was prescribed to the patient in the following days, including diuretics, angiotensin-converting-enzyme inhibitor and beta blockers. The patient died of progressive multiple organ failure. Conclusion Echocardiography is technically limited due to the acoustic shadowing as a result of the calcification. Chest computed tomography is a more accurate diagnostic tool to examine the anatomic distribution and extent of endomyocardial calcification in this rare case.

scholarly journals Hepatic Hydrothorax without Any Evidence of Ascites

2011 ◽  
Vol 11 ◽  
pp. 587-591 ◽  
Author(s):  
Vikram Doraiswamy ◽  
Sandeep Riar ◽  
Pranabh Shrestha ◽  
Justin Pi ◽  
Mohammad Alsumrain ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Pleural Effusions ◽  
Hepatic Hydrothorax ◽  
Gastrointestinal Involvement ◽  
History Of

Hepatic hydrothorax usually presents in association with ascites, but there are rare cases when it does not. This case helps to support the differential of hepatic hydrothorax in patients who have a history of liver cirrhosis, portal hypertension, and recurrent pleural effusions without ascites. We hope to support the conclusion that a patient with recurrent pleural effusions, without ascites, does not exclude gastrointestinal involvement in its etiology.

scholarly journals EVALUATION OF THE METHODS OF IMAGING IN THE DIAGNOSIS OF LIVER CIRRHOSIS AND PORTAL HYPERTENSION

2016 ◽  
pp. 21-25
Author(s):  
A. N. Lyzikov ◽  
A. G. Skuratov ◽  
Yu. P. Shpakovsky
Keyword(s):  
Computed Tomography ◽  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Multislice Computed Tomography ◽  
3D Visualization ◽  
Umbilical Vein ◽  
Therapeutic Agents ◽  
Portal System ◽  
Combined Use

Objective: to evaluate the prospects and role of the methods of imaging (ultrasound and CT) in the diagnosis of the pathogenic aspects of the development and correction of portal hypertension in liver cirrhosis. Material and methods. Patients with liver cirrhosis and portal hypertension, Doppler ultrasound, multislice computed tomography. Conclusion. The combined use of ultrasound and computed tomography facilitates tracing of the dynamics of the disclosure of portocaval anastomoses and predict the course of liver cirrhosis and portal hypertension. The application of the integrated ultrasound to determine the rate of blood flow volume in vessels of portal system and portocaval anastomosis will enable development of differential diagnostic criteria for the early diagnosis of portal hypertension. The detection of recanalized umbilical vein by means of 3D-visualization of its anatomy makes it possible to use it for delivering of therapeutic agents to the liver in its pathology.

scholarly journals Splenectomy May Decrease the Risk of Hepatocellular Carcinoma in Patients with Liver Cirrhosis: A Multi-institutional Cohort Study

2020 ◽  
Author(s):  
Xu-Feng Zhang ◽  
Yang Liu ◽  
Jian-Hui Li ◽  
Peng Lei ◽  
Xing-Yuan Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Cohort Study ◽  
Portal Hypertension ◽  
Multivariable Analysis ◽  
Matched Cohort ◽  
University Hospitals ◽  
Time Period ◽  
Tertiary Hospitals ◽  
History Of

Abstract BackgroundHypersplenism is a common consequence of liver cirrhosis and a risk factor of hepatocellular carcinoma (HCC) development. The objective of the current study was to identify whether splenectomy for treatment of hypersplenism has any impact on risk of HCC. ­­MethodsPatients who underwent splenectomy for hypersplenism secondary to liver cirrhosis and portal hypertension between 2008 and 2012 were included from seven University Hospitals in China, whereas patients receiving medication treatments for liver cirrhosis and portal hypertension (non-splenectomy) at this time period were also included as control. ResultsA total of 871 patients with liver cirrhosis and hypertension were included synchronously from 7 tertiary hospitals. Among them, 407 patients had a history of splenectomy for hypersplenism, whereas 464 patients who received medical treatment but not splenectomy (non-splenectomy group). The cumulative incidence of HCC development at 1, 3, 5 and 7 years were 1%, 6%, 11% and 16% in splenectomy group, and 2%, 10%, 17% and 24% in non-splenectomy group in the unadjusted cohort (Breslow test = 7.7, p=0.005). Consistently, in the matched cohort, the cumulative rates of HCC diagnosis at 1, 3, 5 and 7 years were 1%, 6%, 7% and 15% in splenectomy group, and 1%, 6%, 15% and 23% in non-splenectomy group (Breslow test = 4.9, p=0.028). On multivariable analysis, splenectomy was independently associated with decreased risk of HCC development (HR 0.55, 95% CI, 0.32-0.95, p=0.031). ConclusionSplenectomy for treatment of hypersplenism may decrease the risk of HCC development.

scholarly journals A CASE REPORT ON WILSON'S DISEASE INDUCED LIVER CIRRHOSIS

2017 ◽  
Vol 10 (4) ◽  
pp. 113
Author(s):  
Remya Reghu ◽  
Bini Vincent ◽  
Aloysius James ◽  
Syamaprasad Tv ◽  
Reshma Reji
Keyword(s):  
Liver Cirrhosis ◽  
Case Report ◽  
Portal Hypertension ◽  
Medical History ◽  
Copper Deposit ◽  
Copper Transport ◽  
Medical Professionals ◽  
Genetic Abnormality ◽  
History Of ◽  
Cellular Copper

ABSTRACTWilsons disease is an inherited autosomal genetic abnormality genetic abnormality which results in impairment in cellular copper transport. Overtime this may leads to liver cirrhosis. The main focus of this case is to shows the importance of taking medical history. Here we discuss a case of 35 year old male diagnosed with Wilsons disease induced Liver cirrhosis and portal hypertension. He was physically very weak. Since the same genetic abnormality was the reason for the death of his sibling which was not considered while taking the medical history of this patient, this led to a late diagnosis of 4 years while the patient's condition became worst. Here in we report a case that provides an insight to medical professionals about taking proper medical history of patients.Key Words : Wilsons Disease, Liver Cirrhosis, Copper Deposit

scholarly journals Gastrointestinal Bleeding Secondary to Portal Hypertensive Duodenopathy in a Patient with Decompensated Liver Cirrhosis

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Rohini Krishna ◽  
Samuel O. Igbinedion ◽  
Richie Diaz ◽  
Nazneen Hussain ◽  
Moheb Boktor
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Alcoholic Cirrhosis ◽  
The United States ◽  
Decompensated Liver Cirrhosis ◽  
Nonalcoholic Fatty Liver ◽  
Gastrointestinal Bleed ◽  
Hypertension Portal ◽  
Intrahepatic Portosystemic Shunt ◽  
Cirrhotic Patients

With alcoholic cirrhosis and nonalcoholic fatty liver disease continuously on the rise in the United States, there is also a corresponding rise in portal hypertension. Portal hypertensive duodenopathy (PHD) is a complication of portal hypertension not commonly seen in cirrhotic patients. We present a case of a 46-year-old man who presented with decompensated liver cirrhosis secondary to gastrointestinal bleed. The patient underwent esophagogastroduodenoscopy (EGD) with findings indicative of PHD. Patient subsequently underwent transjugular intrahepatic portosystemic shunt (TIPS) with resolution of gastrointestinal bleed. We highlight TIPS as a management strategy in patients with PHD for whom less invasive measures are not effective.

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