Portal vein thrombosis in patients with hepatosplenic schistosomiasis who underwent oesophagogastric devascularization combined with splenectomy

2021 ◽  
Author(s):  
Guilherme G L Cançado ◽  
Mateus J Nardelli ◽  
Fernanda A Barbosa ◽  
Catherine F Silva ◽  
Fernanda M F Osório ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Surgical Approach ◽  
Odds Ratio ◽  
Independent Risk Factor ◽  
Hospital Admissions ◽  
Vein Thrombosis ◽  
Significant Difference ◽  
Β Blocker ◽  
Hepatosplenic Schistosomiasis

Abstract Background Portal vein thrombosis (PVT) has been described in nearly 50% of patients who underwent oesophagogastric devascularization combined with splenectomy (EGDS), but no previous study has compared its occurrence in surgical and non-surgical groups. This study aimed to investigate PVT in hepatosplenic schistosomiasis (HSS) and its association with EGDS and upper variceal bleeding (UVB). Methods Retrospectively, 104 HSS individuals were enrolled. Following EGDS, the occurrence of PVT, mesenteric vein thrombosis (MVT), hospital admissions and UVB were recorded. Results EGDS was performed in 27 (26%) patients. PVT and MVT were detected in 30 (33%) and 8 (9.8%) patients, respectively. Patients who underwent EGDS were at greater risk of PVT (63% vs 19.7%; odds ratio [OR] 6.12 [95% confidence interval {CI} 2.3 to 16.1], p<0.001) when compared with a non-surgical approach. There was no significant difference in UVB occurrence and β-blocker usage. PVT was associated with more hospital admissions (p=0.030) and higher alkaline phosphatase levels (p=0.008). UVB occurrence in patients with and without thrombosis was similar. In multivariate analysis, after adjustment, PVT was associated with the surgical approach (OR 4.56 [95% CI 1.55 to 13.38], p=0.006) and age at HSS diagnosis (OR 0.94 [95% CI 0.90 to 0.99], p=0.021). Conclusions EGDS was not associated with a decreased frequency of UVB when compared with the non-surgical approach but was an independent risk factor for PVT.

scholarly journals Determination of Platelets Parameters among People Vaccinated with Oxford-AstraZeneca Vaccine - COVID Vaccine at Khartoum State -Sudan

2021 ◽  
pp. 529-535
Author(s):  
Wafa Salah Eldein Ibrahim Mohamed ◽  
Elharam Ibrahim Abdallah ◽  
Alaa Eltayeb Omer ◽  
Lienda Bashier Eltayeb
Keyword(s):  
Statistical Analysis ◽  
Side Effects ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Muscle Pain ◽  
Healthcare Providers ◽  
Vein Thrombosis ◽  
Significant Difference ◽  
And Gender

Background: The global SARS-CoV-2 vaccination program has been hampered by the rare-and initially inexplicable emergence of vaccine-associated thrombosis, particularly venous territory strokes or other venous obstructions, including portal vein thrombosis, which has been dubbed Vaccine-Induced Thrombotic Thrombocytopenia (VITT). So, this study was conducted to determine platelets parameters among people vaccinated with the AstraZeneca vaccine at Khartoum state. Materials & Methods: A total of 50 AstraZeneca vaccinated participants (22 male and 26 female) were utilized as a case and 50 healthy non-vaccinated participants (21 male and 29 female) were used as control. The age of both groups ranged between (20-62) years with a mean of 34.6 ± 11.9. Platelets parameters were assayed for all patients using Sysmex KX-21. Results: The statistical analysis was performed by using SPSS. The results of the study showed that there was no significant difference in platelets count and platelets indices when compared according to vaccine intake and gender. Also, the most frequent symptoms among vaccinated people were: muscle pain at the site of puncture (56%), fatigue (54%), fever (34%), headache (22%), nausea (16%), and diarrhea (6%) respectively and developed no symptoms (30%). Conclusions: The study concludes that the side effects of the COVID-19 AstraZeneca vaccine in Khartoum state, Sudan was consistent with the manufacturers’ data.  Healthcare providers and recipients of vaccines can be more confident about the safety of Oxford-AstraZeneca COVID-19 vaccines.

scholarly journals Graft and patient survival in portal vein thrombosis in living donor liver transplantation

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M Ramadan ◽  
N M Hytham ◽  
K K Mamdouh ◽  
A M Fathy
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Lower Survival Rate ◽  
Donor Liver Transplantation ◽  
Vein Thrombosis ◽  
Life Saving ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Stay Hospital

Abstract Background and Rational To date, only few studies have evaluated the benefits of anticoagulation in individuals with cirrhosis. An obvious goal of anticoagulation is PV recanalization: when cirrhotic individuals with PVT are treated with anticoagulation, complete recanalization has been described in 33–45% while partial PV recanalization is observed in 15–35% of cases. LDLT has emerged as the alternative life-saving treatment to DDLT. Over the past 2 decades, the number of LDLTs has steadily increased in many transplant centers, especially in Asia. The separation between occlusive and non-occlusive thrombosis is very important; in patients with partial PVT, post-transplant mortality outcomes are no different from non-PVT patients but it is significantly increased in patients with complete PVT. Patients and Methods This randomized prospective study will include 79 patients who will undergo LDLT in Ain Shams Specialized and Egypt Air hospitals, there are two groups of patients according to presence of portal vein thrombosis or not group A 39 patients of non PVT and group B 40 patient of PVT including different grades of PVT according Yerdel classification. Results In this study, there is no significant difference between groups regard age but Males were significantly associated with group B. In this study, there is no significant difference between groups regard CHILD and MELD scores and this findings. In our study there is no significantly difference between groups A and B regarding ICU stay, hospital stay and cell saver. In this study, comparisons of the PVT patients and controls showed no statistical significant differences regard HA thrombosis, post operative pulmonary embolism and biliary leak but PV rethrombosis is significantly associated with PVT patients, mortality sig associated with PVT patients. Conclusion The outcomes of patients with PVT who underwent LDLT are inferior to those without PVT. Patients with PVT has lower survival rate, higher postoperative PV rethrombosis.

scholarly journals Portal vein thrombosis post-splenectomy in thalassemia major patients

2019 ◽  
Vol 10 (4) ◽  
pp. 3356-3368
Author(s):  
Kussay M. Abbas Zwain ◽  
Samer M. Mohamed Al-Hakkak ◽  
Alaa A. Al-Wadees ◽  
Zainab Mahdi Majeed
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Female Gender ◽  
Thalassemia Major ◽  
Spleen Weight ◽  
P Value ◽  
Vein Thrombosis ◽  
Significant Difference ◽  
The Mean ◽  
Wbc Count

β-thalassemia major is a chronic, inherited hematological disease that leads to chronic anemia in the affected children. One of the options of treatment in such patients was splenectomy; however, it is not without risk of many complications; one of them is the thrombotic events. A prospective study of 55 patients with β-thalassemia inscribes in this study. 14 patients (25.5%) had a normal thrombocyte count and 41 patients (74.5%) have an abnormally high thrombocytes count which was significantly associated with PVT (P. Value <0.001), Regarding the WBC count, it extended between 4000 to more than 30,000, in both genders with non-statistically significant differences between both genders, (P>0.05). Regarding the serum ferritin, the mean level was 2908.5 ± 1024.3 ng/ml. In males, the mean S. Ferritin was relatively higher than that of females, 3167.6 ± 1841.3 mg/dl, and 2573.8 ± 1150.6 ng/ml. The weight of the spleen was up to 1500 grams in 25 (80.6%) of males and 20 (83.3 %) of females while it was more than 1500 grams in the remaining and females and males, without a significant difference statistically in the spleen weight of, (P>0.05). The most frequent presenting symptom was abdominal pain. It was founded in 46 patients (83.6%), followed by fever in 76.4%, diarrhea in 58.2%, and Nausea and vomiting in 31 (56.4%). 3 patients out of the 55 (5.5%) developed portal vein thrombosis in their follow up period. Post splenectomy PVT in thalassemia the patient is relatively frequent (5.5%) complication that require a high degree of doubt for diagnosis early, especially in patients with postoperative pain of the abdomen within 2 months after surgery, Female gender, Large spleen and postoperative increase number of platelets are risk factors for PVT so one can initiate surveillance by Doppler ultrasound postoperatively and start antiplatelet prophylactic therapy immediately for such patients. 

Portal vein thrombosis associated with protein C deficiency and elevated Factor VIII in hepatosplenic schistosomiasis

2016 ◽  
Vol 27 (2) ◽  
pp. 210-212
Author(s):  
Luiz Arthur Calheiros Leite ◽  
Rita de Cássia dos Santos Ferreira ◽  
Betânia Lucena Domingues Hatzlhofer ◽  
Maria Conceição Barros Correia ◽  
Ângela Pontes Bandeira ◽  
...  
Keyword(s):  
Portal Vein ◽  
Factor Viii ◽  
Portal Vein Thrombosis ◽  
Protein C ◽  
Protein C Deficiency ◽  
Vein Thrombosis ◽  
Hepatosplenic Schistosomiasis

scholarly journals Interventional recanalization therapy in patients with non-cirrhotic, non-malignant portal vein thrombosis: comparison between transjugular versus transhepatic access

2022 ◽  
Author(s):  
Nabeel Mansour ◽  
Osman Öcal ◽  
Mirjam Gerwing ◽  
Michael Köhler ◽  
Sinan Deniz ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Significant Risk ◽  
Bleeding Complications ◽  
Percutaneous Technique ◽  
Complication Rates ◽  
Technical Success ◽  
Technical Success Rate ◽  
Vein Thrombosis ◽  
Significant Difference

Abstract Purpose To compare the safety and outcome of transjugular versus percutaneous technique in recanalization of non-cirrhotic, non-malignant portal vein thrombosis. Methods We present a retrospective bicentric analysis of 21 patients with non-cirrhotic, non-malignant PVT, who were treated between 2016 and 2021 by interventional recanalization via different access routes (percutaneous [PT] vs. transjugular in transhepatic portosystemic shunt [TIPS] technique). Complication rates with a focus on periprocedural bleeding and patency as well as outcome were compared. Results Of the 21 patients treated (median age 48 years, range of 19–78), seven (33%) patients had an underlying prothrombotic condition. While 14 (57%) patients were treated for acute PVT, seven (43%) patients had progressive thrombosis with known chronic PVT. Nine patients underwent initial recanalization via PT access and twelve via TIPS technique. There was no significant difference in complete technical success rate according to initial access route (55.5% in PT group vs. 83.3% in TIPS group, p = 0.331). However, creation of an actual TIPS was associated with higher technical success in restoring portal venous flow (86.6% vs. 33.3%, p = 0.030). 13 (61.9%) patients received thrombolysis. Nine (42.8%) patients experienced hemorrhagic complications. In a multivariate analysis, thrombolysis (p = 0.049) and PT access as the first procedure (p = 0.045) were significant risk factors for bleeding. Conclusion Invasive recanalization of the portal vein in patients with PVT and absence of cirrhosis and malignancy offers a good therapeutic option with high recanalization and patency rates. Bleeding complications result predominantly from a percutaneous access and high amounts of thrombolytics used; therefore, recanalization via TIPS technique should be favored.

Portal vein thrombosis and liver transplantation: Implications for waiting list period, surgical approach, early and late follow-up

2014 ◽  
Vol 28 (2) ◽  
pp. 92-101 ◽  
Author(s):  
Francesca Romana Ponziani ◽  
Maria Assunta Zocco ◽  
Marco Senzolo ◽  
Maurizio Pompili ◽  
Antonio Gasbarrini ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Surgical Approach ◽  
Waiting List ◽  
Vein Thrombosis

scholarly journals Assessment the Effect of Prophylaxis Therapy on Splenic and Portal Vein Thrombosis after Open Splenectomy: A Controlled Randomized Clinical Trial

2016 ◽  
Vol 9 (5) ◽  
pp. 189
Author(s):  
Amin Bahraini ◽  
Majid Asnaashari ◽  
Amir Ahmad Salmasi ◽  
Mohamad Momen Gharibvand
Keyword(s):  
Clinical Trial ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Intervention Group ◽  
Control Group ◽  
Open Splenectomy ◽  
Vein Thrombosis ◽  
Significant Difference ◽  
Prophylaxis Therapy ◽  
And Control

<p>Splenic and portal vein thrombosis (SPVT) is considered as a serious complication of splenectomy with potential life-threatening. Chemoprophylaxis may help to curb the incidence of SPVT after splenectomy. This clinical trial study was conducted to determine the incidence rate of SPVT after splenectomy and investigate the effect of chemoprophylaxis to reduce its incidence. Sixty six patients undergoing open splenectomy were included in this single-blind clinical randomized controlled trial (RCT). Patients were randomly assigned in two groups of intervention and control using block randomization to either d receive 40 mg of enoxaparin subcutaneously once a day for 5 days and then 100mg aspirin for one month or no postoperative drug. After one month, all patients over a week underwent Doppler ultrasonography of the splenic, portal and superior mesenteric veins for thrombosis. The mean age of patients was similar between intervention and control groups (28.3±14.5 and 25.6±14.9, respectively) (P value=0.9).Furthermore, two groups were matched regarding distribution of gender. None of patients in intervention group developed portal vein thrombosis, while of 23 patients in control group, 2 (8.69%) subjects were diagnosed with portal vein thrombosis. The two groups had no statistically significant difference in the rate of portal vein thrombosis (P=0.18). Based on the results of our study, prophylaxis therapy had no effects in preventing portal vein thrombosis developed in patients undergoing open splenectomy for any reason.</p>

Liver stiffness is able to differentiate hepatosplenic Schistosomiasis mansoni from liver cirrhosis and spleen stiffness may be a predictor of variceal bleeding in hepatosplenic schistosomiasis

2021 ◽  
Author(s):  
Catherine F Silva ◽  
Mateus J Nardelli ◽  
Fernanda A Barbosa ◽  
Humberto O Galizzi ◽  
Tereza C M F Cal ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Variceal Bleeding ◽  
Transient Elastography ◽  
Characteristic Curve ◽  
Liver Stiffness ◽  
Vein Thrombosis ◽  
Spleen Stiffness ◽  
Hepatosplenic Schistosomiasis

Abstract Background Ultrasonography is limited for differentiating portal hypertension due to liver cirrhosis from that secondary to hepatosplenic schistosomiasis (HSS). We aimed to investigate the role of transient elastography (TE) in differentiating HSS mansoni from cirrhosis and the factors associated with liver and spleen stiffness (LS and SS) in HSS. Method A cross-sectional study was conducted including patients with HSS mansoni (n=29) and liver cirrhosis due to non-alcoholic steatohepatitis (n=23). All patients underwent TE and those with HSS were assessed by the Niamey protocol. Results HSS subjects presented lower median LS (9.6 vs 21.3 Kpa, p&lt;0.001) and liver controlled attenuation parameter (229 vs 274 dB/m, p=0.010) than cirrhosis subjects, in addition to higher SS (73.5 vs 42.2 Kpa, p=0.002). The area under the receiver operating characteristic curve for detecting cirrhosis by LS was 0.947 (95% CI 0.89 to 1.00, p&lt;0.001), with an optimal cut-off of 11.75 Kpa. In HSS subjects, higher SS was associated with the presence of the following: diabetes mellitus (p=0.036), metabolic syndrome (p=0.043), esophageal varices (p=0.001), portal vein thrombosis (p=0.047) and previous variceal bleeding (p=0.011). In HSS patients without portal vein thrombosis, variceal bleeding was associated with higher SS (p=0.018). Niamey categories were not associated with LS (p=0.676) or SS (p=0.504). Conclusion TE can play a role in differentiating HSS from cirrhosis, especially by LS. SS may be further investigated for predicting complications in HSS.

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