scholarly journals Pregnancy in a Woman with Latent Myeloproliferative Neoplasm Induced Chronic Portal Vein Thrombosis, Portal Cavernoma, and Gastric Varices

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Andréanne Durivage ◽  
Geneviève Le Templier ◽  
Annabelle Cumyn ◽  
Nadine Sauvé
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Myeloproliferative Neoplasms ◽  
Myeloproliferative Neoplasm ◽  
Vascular Complications ◽  
Breech Presentation ◽  
Gastric Varices ◽  
Vein Thrombosis ◽  
Increased Risk

Extra-hepatic portal vein thrombosis (EHPVO) represents the obstruction of the portal vein outside the liver and is not related to chronic liver disease or neoplasia. In chronic EHPVO, collateral veins and portal hypertension develop, resulting in splenomegaly and variceal formation. Myeloproliferative neoplasms (MPN) are the most frequent acquired etiology of EHPVO. These conditions put pregnant women at increased risk of vascular complications, including venous thrombosis, occlusion of the placental circulation, and variceal bleeding. In this report, we present a 36-year-old pregnant woman with chronic, anticoagulated EHPVO secondary to latent MPN who developed severe intrauterine growth restriction and had cesarean section at 32+1 weeks for increased umbilical doppler resistance and breech presentation. The article will emphasize outcome and management of pregnancies complicated by chronic EHPVO, portal hypertension, and MPN.

scholarly journals The Role of Portal Vein Thrombosis in the Clinical Course of Inflammatory Bowel Diseases: Report on Three Cases and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Emanuele Sinagra ◽  
Emma Aragona ◽  
Claudia Romano ◽  
Simonetta Maisano ◽  
Ambrogio Orlando ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Inflammatory Bowel Diseases ◽  
Vascular Complications ◽  
Hepatic Abscess ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Thromboembolism Events

Inflammatory bowel diseases are associated with an increased risk of vascular complications. The most important are arterial and venous thromboembolisms, which are considered as specific extraintestinal manifestations of inflammatory bowel diseases. Among venous thromboembolism events, portal vein thrombosis has been described in inflammatory bowel diseases. We report three cases of portal vein thrombosis occurring in patients with active inflammatory bowel disease. In two of them, hepatic abscess was present. Furthermore, we performed a systematic review based on the clinical literature published on this topic.

scholarly journals MesoTIPS: Combined Approach for the Treatment of Portal Hypertension Secondary to Portal Vein Thrombosis – A Brief Report

2017 ◽  
Vol 01 (01) ◽  
pp. 20-26
Author(s):  
Abbas Chamsuddin ◽  
Lama Nazzal ◽  
Thomas Heffron ◽  
Osama Gaber ◽  
Raja Achou ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Portosystemic Shunt ◽  
Vein Thrombosis ◽  
Intrahepatic Portosystemic Shunt ◽  
The Right ◽  
Minilaparotomy Approach ◽  
Mean Time

AbstractIntroduction: We describe a technique we call “Meso-transjugular intrahepatic portosystemic shunt (MTIPS)” for relief of portal hypertension secondary to portal vein thrombosis (PVT) using combined surgical and endovascular technique. Materials and Methods: Nine adult patients with PVT underwent transjugular intrahepatic portosystemic shunt through a combined transjugular and mesenteric approach (MTIPS), in which a peripheral mesenteric vein was exposed through a minilaparotomy approach. The right hepatic vein was accessed through a transjugular approach. Mechanical thrombectomy, thrombolysis, and angioplasty were performed when feasible to clear PVT. Results: All patients had technically successful procedures. Patients were followed up for a mean time of 13.3 months (range: 8 days to 3 years). All patients are still alive and asymptomatic. Conclusion: We conclude that MTIPS is effective for the relief of portal hypertension secondary to PVT.

Development of Portal Vein Thrombosis Complicating Idiopathic Portal Hypertension

1985 ◽  
Vol 88 (4) ◽  
pp. 1034-1040 ◽  
Author(s):  
Kunihiko Ohnishi ◽  
Masayuki Saito ◽  
Hidetaka Terabayashi ◽  
Fumio Nomura ◽  
Kunio Okuda
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Idiopathic Portal Hypertension ◽  
Vein Thrombosis

Covered TIPS versus endoscopic band ligation plus propranolol for the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis: a randomised controlled trial

Gut ◽  
2017 ◽  
Vol 67 (12) ◽  
pp. 2156-2168 ◽  
Author(s):  
Yong Lv ◽  
Xingshun Qi ◽  
Chuangye He ◽  
Zhengyu Wang ◽  
Zhanxin Yin ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Adverse Events ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Decompensated Cirrhosis ◽  
Covered Stents ◽  
Band Ligation ◽  
Vein Thrombosis ◽  
Cirrhotic Patients ◽  
Endoscopic Band Ligation

ObjectiveLimited data are available on the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis (PVT). This study aimed to compare transjugular intrahepatic portosystemic shunt (TIPS) with covered stents versus endoscopic band ligation (EBL) plus propranolol for the prevention of variceal rebleeding among patients with cirrhosis and PVT.DesignConsecutive cirrhotic patients (94% Child-Pugh class A or B) with PVT who had variceal bleeding in the past 6 weeks were randomly assigned to TIPS group (n=24) or EBL plus propranolol group (EBL+drug, n=25), respectively. Primary endpoint was variceal rebleeding. Secondary endpoints included survival, overt hepatic encephalopathy (OHE), portal vein recanalisation and rethrombosis, other complications of portal hypertension and adverse events.ResultsDuring a median follow-up of 30 months in both groups, variceal rebleeding was significantly less frequent in the TIPS group (15% vs 45% at 1 year and 25% vs 50% at 2 years, respectively; HR=0.28, 95% CI 0.10 to 0.76, p=0.008), with a significantly higher portal vein recanalisation rate (95% vs 70%; p=0.03) and a relatively lower rethrombosis rate (5% vs 33%; p=0.06) compared with the EBL+drug group. There were no statistically significant differences in survival (67% vs 84%; p=0.152), OHE (25% vs 16%; p=0.440), other complications of portal hypertension and adverse events between groups.ConclusionCovered TIPS placement in patients with PVT and moderately decompensated cirrhosis was more effective than EBL combined with propranolol for the prevention of rebleeding, with a higher probability of PVT resolution without increasing the risk of OHE and adverse effects, but this benefit did not translate into improved survival.Trial registration numberClinicalTrials.gov: NCT01326949.

scholarly journals Difficulties of differential diagnosis of portal hypertension: case report

2021 ◽  
pp. 92-101
Author(s):  
T. V. Penkina ◽  
O. E. Berezutskaya ◽  
D. T. Dicheva ◽  
E. V. Partsvania-Vinogradova ◽  
V. S. Larina ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Clinical Case ◽  
Clinical Symptoms ◽  
Varicose Veins ◽  
Small Diameter ◽  
Magnetic Resonance Tomography ◽  
Vein Thrombosis

In the article we analysed the difficulties of differential diagnosis of portal hypertension, considers a clinical case that illustrates the presented theoretical material. In the presented clinical observation, the patient’s disease was manifested by bleeding from the varicose veins of the esophagus. In most cases, portal hypertension syndrome in practicing clinicians is associated with liver cirrhosis, however, it is necessary to remember about the possibility of developing subhepatic portal hypertension, in particular as a result of the formation of portal vein thrombosis. If there are signs of portal hypertension, it is necessary to specify the level of obstruction to blood flow, that is, the form of portal hypertension (subhepatic, hepatic, suprahepatic). Often, portal vein thrombosis can be formed due to undiagnosed blood diseases that occur without any clinical symptoms. The provided clinical example demonstrates a case of portal hypertension in the outcome of a chronic form of myeloproliferative syndrome. Portal cavernoma is quite rare and it is formed due to multiple small-diameter venous structures that gradually replace the occluded vessel with a system of collaterals proximal and distal to the portal vein thrombosis site. In the formation of the diagnosis the main are radiation research methods, but the conclusions should be considered only in conjunction with the clinical evidence. The clinical case is interesting because a large cavernoma of the portal vein in a patient with subhepatic portal hypertension was regarded as a «solid formation» according to magnetic resonance tomography. According to the literature data, cavernous transformation has an external similarity to the tumor process, which expands the range of differential diagnosis and requires the exclusion of oncological formations. 

scholarly journals A226 INCIDENTAL FINDING OF A LARGE GASTRIC VARIX ASSOCIATED WITH NEONATAL UMBILICAL VEIN CANALIZATION

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 261-263
Author(s):  
L Tsang ◽  
J Abraldes ◽  
E Wiebe ◽  
G S Sandha ◽  
S van Zanten
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Umbilical Vein ◽  
Gastroesophageal Junction ◽  
Splenic Vein ◽  
Gastric Varix ◽  
Vein Thrombosis ◽  
Inferior Aspect ◽  
Upper Abdomen

Abstract Results A 41-year old Asian male, who immigrated to Canada many years ago, and who had previously been successfully treated for Helicobacter pylori infection underwent gastroscopy for investigation of dyspepsia. His gastroscopy was normal except for a large subepithelial abnormality that was noted close to the gastroesophageal junction. Routine gastric biopsies from the antrum and body were normal. Subsequent endoscopic ultrasound revealed flow through the anechoic tortuous lesion and confirmed it was a very large isolated gastric varix type 1. Abdominal CT scan revealed chronic occlusion of the portal vein, splenic vein, and the portal confluence with extensive collateralization in the upper abdomen. There was complete cavernous transformation of the portal vein. Of the numerous varices in the upper abdomen, a very large varix drained into the left renal vein and indented into the posterior wall of the fundus of the stomach which accounted for the endoscopic finding. Multiple mesenteric veins were identified that connected to varices adjacent to the inferior aspect of the pancreas and duodenum. Notably, there was no evidence of cirrhosis or chronic pancreatitis. Liver enzymes, albumin, and INR were normal. Further collateral history revealed that he was hospitalized as a neonate for pneumonia with catheterization of the umbilical vein, which is known to be associated with thrombosis of the portal vein. Conclusions Detection of congenital absence of the portal vein (CAPV) is recognized more often due to advances in diagnostic imaging. Radiologically, the absence of the portal vein in CAPV is distinguished from portal vein thrombosis by the lack of venous collaterals or sequalae of portal hypertension, such as ascites or splenomegaly. A more gradual thrombosis of the portal vein may permit collaterals to develop without acute changes and is not equivalent to portal vein aplasia or agenesis as intrahepatic bile ducts are normal. The gold standard for diagnosis of CAPV is histologic absence of the portal vein in the liver on catheter angiography. CAPV is associated with abnormal embryologic development of the portal vein and frequently presents with complications of portal hypertension or portosystemic encephalopathy or the sequalae of venous shunts, hepatic or cardiac abnormalities found on imaging. Our case is an incidentally discovered absence of the portal venous system due to chronic thrombosis with extensive collateralization and an enlarged gastric varix protruding into the proximal stomach. It is well documented that canalization of the umbilical vein in infancy is associated with portal vein thrombosis, with incidences up to 68%. This case highlights the importance of eliciting a childhood hospitalization history in cases of non-cirrhotic portal hypertension. Funding Agencies None

Pyogenic Portal Vein Thrombosis as a Reservoir of Persistent Septicemia after Cyanoacrylate Injection for Bleeding Gastric Varices

Digestion ◽  
2008 ◽  
Vol 78 (2-3) ◽  
pp. 139-143 ◽  
Author(s):  
Chen-Jung Chang ◽  
Yih-Tsong Shiau ◽  
Te-Li Chen ◽  
Ming-Chih Hou ◽  
Chih-Hao Sun ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Gastric Varices ◽  
Vein Thrombosis
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