Congenital Hepatoportal Arteriovenous Fistula Leading to Segmental Portal Hypertension and Splenic Vein Thrombosis

2007 ◽  
Vol 45 (2) ◽  
pp. 265-267 ◽  
Author(s):  
Mandeep Kumar Garg ◽  
Anupam Lal ◽  
Rajiv J Bapuraj
Keyword(s):  
Portal Hypertension ◽  
Arteriovenous Fistula ◽  
Splenic Vein ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis

scholarly journals A73 PHARYNGEAL VARICES AS A COMPLICATION OF PORTAL HYPERTENSION: A CASE SERIES

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 86-88
Author(s):  
J Ghaith ◽  
P James ◽  
F Wong
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Esophageal Varices ◽  
Splenic Vein ◽  
Case Series ◽  
Brachiocephalic Vein ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis ◽  
Ectopic Varices ◽  
Collateral Vessels

Abstract Background One of the complications of portal hypertension, with or without the presence of cirrhosis, is the development of varices along the length of the gastrointestinal tract. The commonest sites are along the esophagus or in the stomach. Ectopic varices in the small and large bowels can also be observed, but ectopic varices in the pharynx are extremely uncommon. Aims To present a case series and review the literature regarding pharyngeal varcies. Methods - Results Three elderly female patients presented for esophagogastric varices surveillance gastroscopy were diagnosed with pharyngeal varices. One patient has hepatitis C cirrhosis, while the other two non-cirrhotic patients have myeloproliferative neoplasm (MPN). None of the patients had thromboses of the portal vein or its tributaries. All three patient have concomitant esophageal varices, but only one required band ligation of her esophageal varices. All patients are asymptotic except for mild dysphagia. No patient has bled from their pharyngeal varices to date. Two patients have had prophylactic treatment of their portal hypertension with non-selective beta blocker (NSBB), while the third one has not received NSBB prophylaxis because of her age. Conclusions Pharyngeal varices are extremely rare. To date, there are three case reports in the literature, however, we have been able to identify three cases in our practice. The previous two cases reported possible left-sided portal hypertension with splenic vein thrombosis, leading to the development of collateral vessels including a gastrocaval shunt, which by some contiguous route connects to the brachiocephalic vein; and a third case was a complication of neck dissection surgery. In our case series, none of our patients had splenic vein thrombosis. However, none of them has had a careful CT angiogram to delineate the portal vein tributaries and the collateral vessels, which may further help to define their pathogenesis. It is unclear whether NSBB would be effective as primary prophylaxis against their bleeding, The plan is to continue to monitor these patients to learn about the natural history of these pharyngeal varices. Funding Agencies None

scholarly journals Isolated Splenic Vein Thrombosis: An Unusual Cause and Review of the Literature

2004 ◽  
Vol 18 (3) ◽  
pp. 173-174 ◽  
Author(s):  
Seyfettin Köklü ◽  
Aydın Köksal ◽  
Ömer Yolcu ◽  
Gürsel Bayram ◽  
Zişan Sakaoğulları ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Gastrointestinal Bleeding ◽  
Present Article ◽  
Splenic Vein ◽  
Review Of The Literature ◽  
Splenic Vein Thrombosis ◽  
Pancreatic Diseases ◽  
Vein Thrombosis ◽  
One Year

Isolated obstruction (mainly due to thrombosis) of the splenic vein usually results in left-sided portal hypertension and isolated fundal varice formation. This syndrome is a rare cause of gastrointestinal bleeding. Pancreatic diseases are among the most common etiologies of splenic vein obstruction. Renal disorders are rarely reported as a cause of splenic vein thrombosis. In the present article, a case of a 26-year-old woman with a perirenal abscess presenting with gastrointestinal bleeding as a complication of an isolated splenic vein thrombosis is described. The thrombosis could not be visualized with ultrasonography and angiography because of its extremely proximal localization. Fundal varices disappeared following splenectomy and nephrectomy. Follow-up at one year revealed the patient to be well both clinically and endoscopically.

scholarly journals Periampullary Variceal Bleeding: An Atypical Complication of Portal Hypertension

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Zahava C. Farkas ◽  
Priyanka Chugh ◽  
Shalom Frager ◽  
Khwaja F. Haq ◽  
Muhammad Ali Khan ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Variceal Bleeding ◽  
Splenic Vein ◽  
Splenic Vein Thrombosis ◽  
Fatal Complication ◽  
Endoscopic Retrograde ◽  
Vein Thrombosis ◽  
Esophagogastric Varices

Variceal bleeding remains a fatal complication of portal hypertension. Periampullary varices are rare and, due to their location, are difficult to diagnose and treat. Similar to esophagogastric varices, they are the result of high portosystemic pressures secondary to intrahepatic causes such as cirrhosis and extrahepatic causes such as portal or splenic vein thrombosis. We report a case of a periampullary varix resulting in hemobilia during endoscopic retrograde cholangiopancreatography (ERCP).

scholarly journals P-BN09 Management of isolated splenic vein thrombosis: Risks and benefits of Anticoagulation

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Amar M Eltweri ◽  
Mohammed Basamh ◽  
Ying Yang Ting ◽  
Mark Harris ◽  
Giuseppe Garcea ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Ct Scan ◽  
Portal Vein Thrombosis ◽  
Variceal Bleeding ◽  
Splenic Vein ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis ◽  
Anticoagulation Treatment ◽  
Therapeutic Anticoagulation

Abstract Background Isolated splenic vein thrombosis (iSVT) is a common complication of pancreatic disease. Whilst patients remain asymptomatic, there is a risk of sinistral portal hypertension and subsequent bleeding from gastric varices if recanalization does not occur. There is a wide variation of iSVT treatment, even within single centres. We report outcomes of iSVT from tertiary referral hepatobiliary and pancreatic (HPB) units including the impact of anticoagulation on recanalization rates and subsequent variceal bleeding risk.   Methods A retrospective cohort study including all patients diagnosed with iSVT on CT scan abdomen and pelvis between 2011 and 2019 from two institutions. Patients with both SVT and portal vein thrombosis at diagnosis, and isolated splenic vein thrombosis secondary to malignancy were excluded. The outcomes of anticoagulation, recanalization rates, risk of bleeding, and progression to portal vein thrombosis were examined. Results Ninety-eight patients with iSVT were included; of which thirty-nine patients received anticoagulation (40%). The most common cause of iSVT was acute pancreatitis n = 88 (90%). The recanalization rate in the anticoagulation group was 46% vs 15% in patients receiving no anticoagulation (p = 0.0008, OR = 4.7, 95% CI 1.775 to 11.72). Upper abdominal vascular collaterals (demonstrated on CT scan angiography) were significantly less among patients who received anticoagulation treatment (p = 0.03, OR = 0.4, 95% CI 0.1736 to 0.9288). The overall rate of upper GI variceal related bleeding was 3% (n = 3/98) and it was independent of anticoagulation treatment. Two of the patients received therapeutic anticoagulation. Conclusions The current data support that therapeutic anticoagulation is associated with a statistically significant increase in recanalization rates of the splenic vein; with a subsequent reduction in radiological left-sided portal hypertension. However, all patients had a very low risk of variceal bleeding regardless of anticoagulation. The findings from this retrospective study should merit further investigation in large-scale randomized clinical trials.

scholarly journals Successful Treatment of Bleeding Gastric Varices with Splenectomy in a Patient with Splenic, Portal, and Mesenteric Thromboses

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Lior Menasherian-Yaccobe ◽  
Nathan T. Jaqua ◽  
Patrick Kenny
Keyword(s):  
Portal Hypertension ◽  
Successful Treatment ◽  
Splenic Vein ◽  
Gastric Varices ◽  
Variceal Hemorrhage ◽  
Splenic Vein Thrombosis ◽  
Packed Red Blood Cells ◽  
Vein Thrombosis ◽  
Shunt Procedure ◽  
Gastric Variceal Hemorrhage

A 59-year-old female with a history of multiple splanchnic and portal thromboses treated with warfarin underwent an esophagogastroduodenoscopy for cancer screening, and a polypoid mass was biopsied. One week later, she was admitted with upper gastrointestinal hemorrhage. Her therapeutic coagulopathy was reversed with fresh frozen plasma, and she was transfused with packed red blood cells. An esophagogastroduodenoscopy demonstrated an erosion of a gastric varix without evidence of recent bleeding. Conservative measures failed, and she continued to bleed during her stay. She was not considered a candidate for a shunt procedure; therefore, a splenectomy was performed. Postoperative esophagogastroduodenoscopy demonstrated near complete resolution of gastric varices. One year after discharge on warfarin, there has been no recurrence of hemorrhage. Gastric varices often arise from either portal hypertension or splenic vein thrombosis. Treatment of gastric variceal hemorrhage can be challenging. Transjugular intrahepatic portosystemic shunt is often effective for emergency control in varices secondary to portal hypertension. Splenectomy is the treatment for varices that arise from splenic vein thrombosis. However, treatment of gastric variceal hemorrhage in the context of multiple splanchnic and portal vein thromboses is more complicated. We report splenectomy as a successful treatment of gastric varices in a patient with multiple extrahepatic thromboses.

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