Pancreatic Pseudocyst-Induced Gastric Varices: A Rare Case of Extrahepatic Portal Hypertension?

2017 ◽  
Vol 83 (6) ◽  
pp. 208-209
Author(s):  
Neal Cooper ◽  
Jason D. Sciarretta ◽  
Ayolola Onayemi ◽  
John Davis
Keyword(s):  
Portal Hypertension ◽  
Rare Case ◽  
Pancreatic Pseudocyst ◽  
Gastric Varices ◽  
Extrahepatic Portal Hypertension

Case report of a pancreatic pseudocyst ruptured into the splenic vein causing extrahepatic portal hypertension

1982 ◽  
Vol 12 (5) ◽  
pp. 387-390 ◽  
Author(s):  
Sadahiro Yamamoto ◽  
Kotohito Takeshige ◽  
Toshiyuki Aradawa ◽  
Hirofumi Kuroda ◽  
Saburo Kanda ◽  
...  
Keyword(s):  
Case Report ◽  
Portal Hypertension ◽  
Pancreatic Pseudocyst ◽  
Splenic Vein ◽  
Extrahepatic Portal Hypertension

scholarly journals Splenic artery aneurysms and extrahepatic portal hypertension during pregnancy

2021 ◽  
Vol 26 (4) ◽  
pp. 120-125
Author(s):  
A. E. Markarov ◽  
G. V. Manukyan ◽  
R. A. Musin ◽  
E. A. Kitsenko ◽  
S. V. Apresyan ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Pregnant Woman ◽  
Splenic Artery ◽  
Clinical Case ◽  
Surgical Intervention ◽  
Vena Cava ◽  
Gastric Varices ◽  
Extrahepatic Portal Hypertension ◽  
Cavernous Transformation

Clinical case demonstrates successful treatment of a pregnant woman, who had multiple giant splenic artery aneurysms with a high risk of spontaneous rupture. Pregnancy proceeded along with hereditary thrombophilia, thrombosis and cavernous transformation of the vena cava, extrahepatic portal hypertension, esophageal and gastric varices II–III. The surgical and obstetric tactics, surgical intervention, appropriate salvage and multidisciplinary pregnancy follow-up ensured a successful Cesarean delivery at 38 weeks, saving the life of the child and mother.

scholarly journals 2675 A Rare Case of Bleeding Isolated Gastric Varices in the Setting of Non-Cirrhotic Portal Hypertension

2019 ◽  
Vol 114 (1) ◽  
pp. S1475-S1477
Author(s):  
Hector H. Gonzalez ◽  
Levonti Ohanisian ◽  
Michael Bank ◽  
Simran Sidhu
Keyword(s):  
Portal Hypertension ◽  
Rare Case ◽  
Gastric Varices ◽  
Isolated Gastric Varices

scholarly journals SELECTIVE DEVASCULARIZATION OF THE GASTRIC FUNDUS IN PATIENTS WITH CHRONIC PANCREATITIS AND HEPATIC PORTAL HYPERTENSION. Case Series Preliminary Report

2021 ◽  
Vol 5 (1) ◽  
pp. 71-78
Author(s):  
E. V. Mahiliavets ◽  
◽  
P. V. Harelik ◽  
Keyword(s):  
Chronic Pancreatitis ◽  
Portal Hypertension ◽  
Pancreatic Pseudocyst ◽  
Case Series ◽  
Gastric Varices ◽  
Gastric Fundus ◽  
Gastroesophageal Varices ◽  
Hepatic Portal ◽  
Variant Anatomy

Background. Making treatment / prevention decisions in bleeding from gastroesophageal varices in patients with subhepatic portal hypertension remains challenging and thus requires further research. Objective. To perform a preliminary analysis of the outcomes of selective devascularization of the gastric fundus in patients with chronic pancreatitis and subhepatic portal hypertension. Material and methods. Selective devascularization of the gastric fundus was performed in five patients (3 men and 2 women) aged 23 to 54 with chronic recurrent pancreatitis and subhepatic portal hypertension. In 2 patients, Roux-en-Y cystojejunostomy for pancreatic pseudocyst was performed as the main treatment, and in 3 patients - Frey's surgery. Selective devascularization of the gastric fundus was adjuvant to a draining surgery or a resection-draining one. Results. All patients underwent surgery successfully. The duration of the operation (Me [min; max]) was 205 [190; 255] min. The time spent in the Department of anesthesiology, resuscitation and intensive care comprised 1 [1; 2] days. Postoperative follow-up of these patients over the period of 17 - 58 months detected no recurrence of bleeding from gastric varices. Endoscopy performed a year after revealed a decrease in the size of esophageal varices in all patients. Conclusions. The proposed technique of selective devascularization of the gastric fundus is substantiated by numerous studies of the variant anatomy of venous outflow from the spleen in extrahepatic portal hypertension. This technique is regarded as adjuvant to a draining surgery or a resection-draining one in patients with chronic pancreatitis and subhepatic portal hypertension performed to prevent bleeding from gastric fundus varices. There should be noted the reproducibility of this surgical intervention, its effectiveness and safety. Further research on the efficiency of the technique using randomized controlled trials is required.

scholarly journals A comparative study of multi-detector CT portography versus endoscopy in evaluation of gastro-esophageal varices in portal hypertension patients

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Hany El-Assaly ◽  
Lamiaa I. A. Metwally ◽  
Heba Azzam ◽  
Mohamed Ibrahim Seif-Elnasr
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Esophageal Varices ◽  
Imaging Modality ◽  
Splenic Vein ◽  
Gastric Varices ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
Upper Gi Endoscopy ◽  
Vein Diameter

Abstract Background Portal hypertension is a major complication resulting from obstruction of portal blood flow, like cirrhosis or portal vein thrombosis, that leads to portal hypertension. MDCT angiography has become an important tool for investigation of the liver as well as potentially challenging varices by detailing the course of these tortuous vessels. This information is decisive for liver transplantation as well as for common procedures in which an unexpected varix can cause significant bleeding. Results This study included an assessment of 60 cases of portal hypertension (28 males and 32 females), their age ranged from 42 to 69 years (mean age = 57.2 ± 6.63). All patients were diagnosed with portal hypertension, underwent upper GI endoscopy followed by a triphasic CT scan with CT angiographic assessment for the screening of gastro-esophageal varices. CT is highly sensitive as compared to upper GI endoscopy (sensitivity 93%) in detecting esophageal varices. Gastric varices detected by CT in 22 patients (37%) compared to 14 patients (23%) detected by endoscopy. While paraesophageal varices were detected in 63% of patients and retro-gastric varices in 80% of patients that were not visualized by endoscopy. Our study reported that the commonest type of collaterals were the splenic collaterals, and we also found there is a significant correlation between the portal vein diameter and the number of collaterals as well as between the portal vein diameter and splenic vein diameter. Conclusions Multi-slice CT serves as an important non-invasive imaging modality in the diagnosis of collaterals in cases of portal hypertension. CT portography can replace endoscopy in the detection of high-risk varices. It also proved that there is a correlation between portal vein diameter, splenic vein diameter, and number of collaterals.

Su1707 PROTEUS SYNDROME: A RARE CASE OF NON-CIRRHOTIC PORTAL HYPERTENSION MANIFESTING AS REFRACTORY ASCITES

2020 ◽  
Vol 158 (6) ◽  
pp. S-1389-S-1390
Author(s):  
Sharon Joseph ◽  
Ranjit S. Makar ◽  
Daisy S. Lankarani ◽  
Zeid Kayali
Keyword(s):  
Portal Hypertension ◽  
Rare Case ◽  
Refractory Ascites ◽  
Proteus Syndrome

scholarly journals Endoscopic follow-up of cyanoacrylate obliteration of gastric varices

2009 ◽  
Vol 46 (1) ◽  
pp. 81-84 ◽  
Author(s):  
Fernanda Prata Martins ◽  
Erika Pereira de Macedo ◽  
Gustavo Andrade de Paulo ◽  
Frank Shigueo Nakao ◽  
José Celso Ardengh ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Portal Hypertension ◽  
Gastric Varices ◽  
Study Endpoint ◽  
Mild Abdominal Pain ◽  
Threatening Condition ◽  
Life Threatening ◽  
Related Mortality ◽  
Overall Mortality

Bleeding from gastric varices is a life-threatening condition. We report our experience with cyanoacrylate injection. Twenty three patients with portal hypertension and gastric varices underwent intra-variceal injection of a cyanoacrylate/lipiodol solution (1:1). Study endpoint was variceal obliteration. Mean follow-up was 25.3 months. Variceal obliteration was achieved in 87% of patients. Recurrence occurred in one patient (4.3%) and rebleeding in another case (4.3%). Mild abdominal pain was described in 13% of patients. Overall mortality was 21.7% and rebleeding related mortality rate was 4.3%. Our results confirm that cyanoacrylate injection is effective and safe to eradicate gastric varices.

scholarly journals Endoscopic Management of Portal Hypertension

2012 ◽  
Vol 2012 ◽  
pp. 1-12 ◽  
Author(s):  
Said A. Al-Busafi ◽  
Peter Ghali ◽  
Philip Wong ◽  
Marc Deschenes
Keyword(s):  
Portal Hypertension ◽  
Endoscopic Ultrasound ◽  
Capsule Endoscopy ◽  
Interventional Therapy ◽  
Gastric Varices ◽  
Active Management ◽  
Endoscopic Management ◽  
Diagnostic Modality ◽  
Gastroesophageal Varices ◽  
Life Threatening

Cirrhosis is the leading cause of portal hypertension worldwide, with the development of bleeding gastroesophageal varices being one of the most life-threatening consequences. Endoscopy plays an indispensible role in the diagnosis, staging, and prophylactic or active management of varices. With the expected future refinements in endoscopic technology, capsule endoscopy may one day replace traditional gastroscopy as a diagnostic modality, whereas endoscopic ultrasound may more precisely guide interventional therapy for gastric varices.

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