Aberrant Left Gastric Vein Directly Draining into Left Portal Venous System

A 66-year-old man with early gastric cancer and liver cirrhosis was diagnosed by preoperative angiography as having an aberrant left gastric vein communicating directly with the left lateral portal vein system. This communication was confirmed during operation for the gastric cancer. Our report is the first of an aberrant left gastric vein showing direct communication with the left portal vein system.

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No Association of Homocysteine, Anticardiolipin Antibody, and Anti-β2 Glycoprotein I Antibody With Portal Venous System Thrombosis in Liver Cirrhosis

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/10760296211010969 ◽

2021 ◽

Vol 27 ◽

pp. 107602962110109

Author(s):

Le Wang ◽

Xiaozhong Guo ◽

Xiangbo Xu ◽

Shixue Xu ◽

Juqiang Han ◽

...

Keyword(s):

Liver Cirrhosis ◽

Portal Vein ◽

Anticardiolipin Antibody ◽

Venous System ◽

Common Complication ◽

Portal Venous System ◽

Main Portal Vein ◽

Glycoprotein I ◽

Cirrhotic Patients ◽

Clinically Significant

Portal venous system thrombosis (PVST), a common complication of liver cirrhosis, is closely associated with thrombophilia. To explore the association of homocysteine (Hcy), anticardiolipin antibody (aCL), and anti-β2 glycoprotein I antibody (aβ2GPI), which are possible thrombophilic factors, with PVST in liver cirrhosis. Overall, 654 non-malignant patients (219 with and 435 without liver cirrhosis) admitted between January 2016 and June 2020 were retrospectively evaluated. Presence of PVST, degree of main portal vein (MPV) thrombosis, and clinically significant PVST were identified. Hcy level, hyperhomocysteinemia (HHcy), aCL positivity, and aβ2GPI positivity were compared according to the presence of liver cirrhosis and PVST. Positive aβ2GPI was significantly more frequent in patients with liver cirrhosis than those without, but Hcy level and proportions of HHcy and positive aCL were not significantly different between them. PVST could be evaluated in 136 cirrhotic patients. Hcy level [10.57 μmol/L (2.71-56.82) versus 9.97 μmol/L (2.05-53.44); P = 0.796] and proportions of HHcy [4/44 (9.1%) versus 13/81 (16.0%); P = 0.413] and positive aCL [1/23 (4.3%) versus 10/52 (19.2%); P = 0.185] and aβ2GPI [9/23 (39.1%) versus 21/52 (40.4%); P = 0.919] were not significantly different between cirrhotic patients with and without PVST. There was still no significant association of Hcy level, HHcy, aCL, or aβ2GPI with PVST based on Child-Pugh classification, MPV thrombosis >50%, and clinically significant PVST. Hcy, aCL, and aβ2GPI may not be associated with PVST in liver cirrhosis, suggesting that routine screening for Hcy, aCL, and aβ2GPI should be unnecessary in such patients.

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Detection of the Left Portal Vein during Laparoscopic Gastrectomy for Early Gastric Cancer

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) ◽

10.3919/jjsa.75.427 ◽

2014 ◽

Vol 75 (2) ◽

pp. 427-431

Author(s):

Ken YUU ◽

Yoshiaki IWASAKI ◽

Kazuhito YAJIMA ◽

Ryouki OOHINATA ◽

Keiichi TAKAHASHI

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Portal Vein ◽

Laparoscopic Gastrectomy ◽

Left Portal Vein

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The ABCD of portal vein thrombosis: a systematic approach

Radiologia Brasileira ◽

10.1590/0100-3984.2019.0109 ◽

2020 ◽

Vol 53 (6) ◽

pp. 424-429

Author(s):

Alexandre Makoto Minoda ◽

Raissa Brito Fernandes Cadete ◽

Sara Reis Teixeira ◽

Valdair Francisco Muglia ◽

Jorge Elias Junior ◽

...

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Systematic Approach ◽

Careful Analysis ◽

Venous System ◽

Portal Venous System ◽

Vein Thrombosis ◽

Case Files ◽

Collateral Vessels ◽

And Diffusion

Abstract Portal vein thrombosis refers to complete or partial obstruction of the portal venous system, in the intrahepatic or extrahepatic venous tract or even in the splenic or superior mesenteric veins. This common and potentially fatal condition can develop in various clinical contexts, especially those of liver cirrhosis, hepatocellular carcinoma, and other solid tumors. Certain characteristics, such as the time since the onset of the thrombus (acute or chronic), its biology (hematic or tumoral), the presence of collateral vessels, and the magnetic resonance imaging aspects, are important components of a thorough, careful analysis, as well as informing decisions regarding the appropriate therapeutic strategy. Here, we present a brief review of the anatomy of the portal venous system and a systematic approach to analyzing the condition, using a mnemonic (ABCD, for age, biology, collaterals, and diffusion). We discuss the various imaging methods and illustrate our discussion with images selected from the case files archived at our facility.

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Spontaneous portosystemic shunts in liver cirrhosis: new approaches to an old problem

Therapeutic Advances in Gastroenterology ◽

10.1177/1756284820961287 ◽

2020 ◽

Vol 13 ◽

pp. 175628482096128 ◽

Cited By ~ 1

Author(s):

Judit Vidal-González ◽

Sergi Quiroga ◽

Macarena Simón-Talero ◽

Joan Genescà

Keyword(s):

Liver Cirrhosis ◽

Hepatic Encephalopathy ◽

Portosystemic Shunt ◽

Venous System ◽

Variceal Hemorrhage ◽

Portal Venous System ◽

Portal Flow ◽

Portosystemic Shunts ◽

Intrahepatic Portosystemic Shunt

Portal hypertension is the main consequence of liver cirrhosis, leading to severe complications such as variceal hemorrhage, ascites or hepatic encephalopathy. As an attempt to decompress the portal venous system, portal flow is derived into the systemic venous system through spontaneous portosystemic shunts (SPSSs), bypassing the liver. In this review, we aim to provide an overview of the published reports in relation to the prevalence and physiopathology behind the appearance of SPSS in liver cirrhosis, as well as the complications derived from its formation and its management. The role of SPSS embolization is specifically discussed, as SPSSs have been assessed as a therapeutic target, mainly for patients with recurrent/persistent hepatic encephalopathy and preserved liver function. Furthermore, different aspects of the role of SPSS in liver transplantation, as well as in candidates for transjugular intrahepatic portosystemic shunt are reviewed. In these settings, SPSS occlusion has been proposed to minimize possible deleterious effects, but results are so far inconclusive.

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