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 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 Gastric Variceal Bleeding Secondary to Splenic Vein Thrombosis

2019 ◽  
Vol 9 (2) ◽  
pp. 34-36
Author(s):  
Benjamin W. Quick ◽  
Gilbert Kisang ◽  
William J. Salyers, Jr.
Keyword(s):  
Variceal Bleeding ◽  
Splenic Vein ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis

scholarly journals Gastric variceal bleeding due to pancreatitis-induced splenic vein thrombosis

2014 ◽  
Vol 2014 (mar24 1) ◽  
pp. bcr2013201359-bcr2013201359 ◽  
Author(s):  
A. Gotto ◽  
M. Lieberman ◽  
M. Pochapin
Keyword(s):  
Variceal Bleeding ◽  
Splenic Vein ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis
Sign in / Sign up

Export Citation Format

Share Document