scholarly journals Isolated Splenic Vein Thrombosis: 8-Year-Old Boy with Massive Upper Gastrointestinal Bleeding and Hypersplenism

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Mohammad Ali Kiani ◽  
Arash Forouzan ◽  
Kambiz Masoumi ◽  
Behnaz Mazdaee ◽  
Mohammad Bahadoram ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Esophageal Varices ◽  
Upper Gastrointestinal Bleeding ◽  
Splenic Vein ◽  
Recurrent Bleeding ◽  
Vein Thrombosis ◽  
One Year ◽  
The One ◽  
Upper Gastrointestinal

We present an 8-year-old boy who was referred to our center with the complaint of upper gastrointestinal bleeding and was diagnosed with hypersplenism and progressive esophageal varices. Performing a computerized tomography (CT) scan, we discovered a suspicious finding in the venography phase in favor of thrombosis in the splenic vein. Once complementary examinations were done and due to recurrent bleeding and band ligation failure, the patient underwent splenectomy. And during the one-year follow-up obvious improvement of the esophageal varices was observed in endoscopy.

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.

Isolated, Idiopathic Splenic Vein Thrombosis, Presenting with Massive Lower GI Bleeding.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4131-4131
Author(s):  
Aref Agheli ◽  
Alka Arora ◽  
Maged Khalil ◽  
Seema Naik ◽  
Theresa Dumlao ◽  
...  
Keyword(s):  
Case Report ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Splenic Vein ◽  
Lower Gastrointestinal Bleeding ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis ◽  
History Of ◽  
Venous Phase ◽  
Upper Gastrointestinal

Abstract Isolated, also called idiopathic, splenic vein thrombosis (SVT) is a very rare clinical condition, which usually results in left-sided portal hypertension and isolated fundal varices. This syndrome is a rare cause of mostly upper, gastrointestinal bleeding. There are only a few hundreds of cases reported in the literature. Colonic varices are even much rarer, 0.07% post mortem autopsies, and 0.2% in a prospective large endoscopic trials. Pancreatic disorders, including malignancies are the most common underlying causes for SVT. Congenital aneurysm of the splenic vein is one of the theoretical explanations of the Isolated, Idiopathic SVT. Case report: A 53 year old Caucasian female with history of hypertension, and no history of smoking or alcohol abuse, presented with chronic lower gastrointestinal bleeding. Upper endoscopy and flexible colonoscopy revealed perigastric varices without any source of acute bleeding. A bleeding scan demonstrated marked splenomegaly and source of bleeding from left colon. Mesenteric angiogram during venous phase showed splenic vein thrombosis and extensive perigastric varices. In addition, a single large left colonic varix from the lower pole of the spleen was identified as the source of bleeding. The patient was treated with splenic artery embolization with coils, followed by splenectomy, without any major complication. Coagulation studies 8 weeks after the procedure did not show any hypercoagulable state. Conclusion: The Isolated, Idiopathic SVT, itself is a very rare syndrome. Our center has reported four cases of SVT, secondary to medical conditions, such as; pancreatic malignancy, MRSA sepsis, and multi-organ failure. Upper gastrointestinal bleeding has been more frequently reported than lower bleeding. Interestingly, in our case report, a single colonic varix secondary to SVT was proved to be the cause of chronic lower gastrointestinal bleeding. SVT should be suspected in any patient with a triad of gastric varices, splenomegaly, and normal liver function tests, who presents with gastrointestinal bleeding secondary to left sided or so called “sinistral” portal hypertension. Mesenteric angiography with venous phase is the gold standard for the diagnosis of SVT, as endoscopic studies may not be diagnostic of this syndrome. Splenectomy is the only and definitive procedure of choice in the patients with isolated SVT, followed by post splenectomy vaccination.

scholarly journals Rupture of esophageal varices due to portal hypertension

2010 ◽  
Vol 50 (5) ◽  
pp. 316
Author(s):  
Yusri Dianne Jurnalis ◽  
Yorva Sayoeti ◽  
Marlinda Marlinda
Keyword(s):  
Portal Hypertension ◽  
Esophageal Varices ◽  
Variceal Bleeding ◽  
Variceal Hemorrhage ◽  
Common Cause ◽  
Initial Episode ◽  
One Year ◽  
The One ◽  
Upper Gastrointestinal ◽  
Emergent Case

Variceal bleeding is the most common cause of serious upper gastrointestinal (UGI) bleeding in children. Most variceal bleeding is esophageal.1 Hemorrhages from esophageal varices due to portal hypertension are a major cause of morbidity and mortality. There is a 30% mortality rate following an initial episode of variceal hematemesis. Mortality increases to 70% with recurrent variceal hemorrhage. Moreover, the one year survival rate after variceal hemorrhage is often poor (32 to 80%).2-4 We report a case of esophageal varices rupture caused by portal hypertension, an emergent case in the Pediatric Gastrohepatology division.

scholarly journals Evaluation of endoscopic secondary prophylaxis in children and adolescents with esophageal varices

2017 ◽  
Vol 54 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Júlio Rocha PIMENTA ◽  
Alexandre Rodrigues FERREIRA ◽  
Eleonora Druve Tavares FAGUNDES ◽  
Paulo Fernando Souto BITTENCOURT ◽  
Alice Mendes MOURA ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Gastrointestinal Bleeding ◽  
Children And Adolescents ◽  
Esophageal Varices ◽  
Upper Gastrointestinal Bleeding ◽  
Secondary Prophylaxis ◽  
Gastric Fundus ◽  
Portal Hypertensive Gastropathy ◽  
Band Ligation ◽  
Upper Gastrointestinal

ABSTRACT BACKGROUND Bleeding of esophageal varices is the main cause of morbidity and mortality in children and adults with portal hypertension and there are few studies involving secondary prophylaxis in children and adolescents. OBJECTIVE To evaluate the efficacy of endoscopic secondary prophylaxis in prevention of upper gastrointestinal bleeding in children and adolescents with esophageal varices. METHODS This is a prospective analysis of 85 patients less than 18 years of age with or without cirrhosis, with portal hypertension. Participants underwent endoscopic secondary prophylaxis with sclerotherapy or band ligation. Eradication of varices, incidence of rebleeding, number of endoscopic sessions required for eradication, incidence of developing gastric fundus varices and portal hypertensive gastropathy were evaluated. RESULTS Band ligation was performed in 34 (40%) patients and sclerotherapy in 51 (60%) patients. Esophageal varices were eradicated in 81.2%, after a median of four endoscopic sessions. Varices relapsed in 38 (55.1%) patients. Thirty-six (42.3%) patients experienced rebleeding, and it was more prevalent in the group that received sclerotherapy. Gastric varices and portal hypertensive gastropathy developed in 38.7% and 57.9% of patients, respectively. Patients undergoing band ligation showed lower rebleeding rates (26.5% vs 52.9%) and fewer sessions required for eradication of esophageal varices (3.5 vs 5). CONCLUSION Secondary prophylaxis was effective in eradicating esophageal varices and controlling new upper gastrointestinal bleeding episodes due to the rupture of esophageal varices. Band ligation seems that resulted in lower rebleeding rates and fewer sessions required to eradicate varices than did sclerotherapy.

scholarly journals Effectiveness of TC-325 (Hemospray) for treatment of diffuse or refractory upper gastrointestinal bleeding – a single center experience

2017 ◽  
Vol 05 (11) ◽  
pp. E1159-E1164 ◽  
Author(s):  
Oscar Cahyadi ◽  
Markus Bauder ◽  
Benjamin Meier ◽  
Karel Caca ◽  
Arthur Schmidt
Keyword(s):  
Gastrointestinal Bleeding ◽  
Salvage Therapy ◽  
Upper Gastrointestinal Bleeding ◽  
Clinical Success ◽  
Treatment Algorithm ◽  
Endoscopic Hemostasis ◽  
Ulcer Bleeding ◽  
Recurrent Bleeding ◽  
Technical Success ◽  
Upper Gastrointestinal

Abstract Background and study aims TC-325 (Hemospray, Cook Medical) is a powder agent for endoscopic hemostasis in patients with upper gastrointestinal bleeding (UGIB). Although most publications are based on case-reports and retrospective studies, data on efficacy are promising. Here we report our experience with TC-325 for diffuse or refractory UGIB. Patients and methods Data on patients receiving TC-325 for endoscopic hemostasis from November 2013 to February 2017 at our center were analyzed retrospectively. Primary endpoints were technical success (successful immediate hemostasis) and clinical success (effective hemostasis and no recurrent bleeding). Secondary endpoints were recurrent bleeding within 3 and 7 days, hospital mortality and TC-325 associated complications. TC-325 was used for bleeding not amenable to standard endoscopic treatment (e. g. diffuse bleeding) or as salvage therapy after failure of conventional methods Results Fifty-two patients received TC-325 treatment. Most of the patients were treated for peptic ulcer bleeding (18/52 patients, 34.6 %) and post-interventional bleeding (13/52 patients, 25 %). Hemospray was used in 23/52 (44.2 %) patients as monotherapy and in 29/52 (55.8 %) patients as a salvage therapy. Application of the powder on the bleeding source was successful in all patients with no therapy-related adverse events (AEs). Immediate hemostasis was achieved in 51/52 (98.1 %) patients. Recurrent bleeding within 3 and 7 days was observed in 22/51 and 25/51 patients respectively (43.1 % and 49 %). The overall clinical success was 56.9 % on day 3 and 51 % on day 7. Total mortality was 15.4 % (8 patients), bleeding associated mortality was 3.8 % (2 patients). There were no therapy-related AEs. Conclusions TC-325 showed a high technical success rate as monotherapy for bleeding sources not amenable to standard methods or as an “add-on” therapy after unsuccessful hemostasis. However, rebleeding was frequent in this cohort and further studies are warranted to exactly define a treatment algorithm for TC-325 use.

scholarly journals Non Cirrhotic Portal Vein Thrombosis: Diagnostic and Therapeutic Challenge

2021 ◽  
Vol 22 (1) ◽  
pp. 79-83
Author(s):  
Syifa Mustika ◽  
Pratista Adi Krisna
Keyword(s):  
Gastrointestinal Bleeding ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Upper Gastrointestinal Bleeding ◽  
Recurrent Thrombosis ◽  
Common Cause ◽  
Vein Thrombosis ◽  
Physical Laboratory ◽  
Prevention And Treatment ◽  
Upper Gastrointestinal

Portal vein thrombosis (PVT), the second most common cause of portal hypertension, can be found in cirrhosis and non-cirrhosis patients. Various factors can cause non-cirrhosis PVT, such as biliary infection. Upper gastrointestinal bleeding without sign of liver failure, must be considered as non-cirrhosis PVT manifestation. Combining physical, laboratory, endoscopic and radiological examination is needed to establish the diagnosis of PVT. The principle of PVT management consists of 3 keypoints. They are prevention and treatment of gastrointestinal bleeding, prevention of recurrent thrombosis and portal cholangiopathy therapy. Many aspect should be considered regarding the administration of anticoagulants in PVT patients, especially chronic PVT with cavernomas.

scholarly journals Histoacryl glue injection without lipiodol dilution and post sclerotherapy bleeding; prevalence among patients with upper GIT bleed.

2020 ◽  
Vol 27 (06) ◽  
pp. 1182-1186
Author(s):  
Muhammad Ayub ◽  
Sagheer Hussain ◽  
Salman Ahmed
Keyword(s):  
Liver Cirrhosis ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Gastric Varices ◽  
Recurrent Bleeding ◽  
Endoscopic Sclerotherapy ◽  
Ulcer Disease ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Glue Injection ◽  
Upper Gastrointestinal

Objectives: To determine role of histoacryl injection in preventing upper acute upper gastrointestinal bleeding. Study Design: Prospective Study. Setting: Gastroenterology ward of DHQ Teaching Hospital Gujranwala. Period: One year from 1st September 2017 to 31st August 2018. Material & Methods: Patients presented to the study hospital having upper gastrointestinal bleeding of acute onset due to gastric varices bleeding were included in this study. All other cases having upper GIT bleeding due to other causes like peptic ulcer disease, Mallory weise syndrome, gastritis or esophageal varices were not included in this study. Both male and female patients were included irrespective of their age. Hemostasis in these cases was achieved by endoscopic sclerotherapy using histoacryl glue (N-butyl-2-cyanoacrylate) injection without lipoidal dilution. After first session of injection patients were called on follow up after 5 days and they were assessed for recurrent GIT bleeding and treatment failure. All data was documented on a predesigned performa. Frequencies and percentage were calculated and results were expressed in tabular form and graphs. Results: Total 80 cases were studied including 56% male and 44% female cases. Endoscopic sclerotherapy using histoacryl injection proved successful in 87.5% cases and recurrent bleeding occurred in 12.5% cases. Minimum age of patients was 25 years and maximum age 70 years with mean age of 45 years. Total 450 cases presented in study institution with Upper GIT bleeding during study period and causes among them were liver cirrhosis in 92% cases, peptic ulcer disease in 4% cases, Malloryweise Syndrome in 2.5% and gastritis in 1.5% cases. In our study group cause of gastric varices was liver cirrhosis due to viral hepatitis in 73% cases and alcoholic hepatitis in 27% cases. After single session of endoscopic histoacryl glue injection to 80 cases, no bleeding occurred after 5 days in 71(88.7%) cases, recurrent bleeding occurred within 5 days in 9(11.2%) cases.  Two cases died due to massive recurrent bleeding and mortality rate was 2.5%. Conclusion: Endoscopic sclerotherapy using Histoacryl injection is very successful treatment for acute upper gastrointestinal bleeding with very low recurrence rate of bleeding and low mortality rate.

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