scholarly journals Primary portal vein hypoplasia with portal hypertension in a young dog

2017 ◽  
Vol 65 (4) ◽  
pp. 257
Author(s):  
D. KASABALIS (Δ. ΚΑΣΑΜΠΑΛΗΣ) ◽  
D. ALATZAS (Δ. ΑΛΑΤΖΑΣ) ◽  
D. ALATZA (Δ. ΑΛΑΤΖΑ) ◽  
T. A. PETANIDES (Θ. ΠΕΤΑΝΙΔΗΣ) ◽  
G. ALATZAS (Γ. ΑΛΑΤΖΑΣ) ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Exploratory Laparotomy ◽  
Abdominal Ultrasonography ◽  
Liver Histopathology ◽  
Low Protein ◽  
Portosystemic Collateral ◽  
History Of ◽  
Collateral Vessels

A 5-month old Caucasian dog was presented with a 20-day history of abdominal distention along with inappetance, depression and vomiting of 24-hour duration. Physical examination findings included depression, ascites, mild inspiratory dyspnea and dehydration. Clinicopathological evaluation revealed hyperammonemia, hypoalbuminemia, hyperbilirubinemia, hypoglycemia and hyponatremia. Μicrohepatia and free abdominal fluid was detected with abdominal ultrasonography. During exploratory laparotomy, multiple acquired portosystemic collateral vessels were found, indicative of portal hypertension, along with a small liver of normal color and texture. Liver histopathology included features consistent with liver hypoperfusion. These findings supported the diagnosis of primary portal vein hypoplasia with portal hypertension. The animal recovered uneventfully postoperatively and was discharged with diuretics, hepatoprotectants and a low-protein diet and remains healthy two years after diagnosis. This case underscores that a favorable prognosis may be anticipated in cases of primary portal vein hypoplasia with portal hypertension, thus, justifying the long-term conservative management instead of considering euthanasia.

An Unusual Case of Portal Hypertension Secondary to Primary Hypoplasia of the Portal Vein

2017 ◽  
Vol 53 (6) ◽  
pp. 331-337
Author(s):  
Lauren Harris ◽  
Miryam Reems ◽  
Sharon Dial
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Clinical Manifestations ◽  
Normal Liver ◽  
Normal Serum ◽  
Serum Bile Acid ◽  
Liver Histopathology ◽  
Portosystemic Shunts ◽  
Portosystemic Collateral ◽  
Portal Hypoperfusion

ABSTRACT Primary hypoplasia of the portal vein with secondary portal hypertension and acquired portosystemic collateral circulation is infrequently reported in the veterinary literature. Diagnosis of this condition requires documentation of abnormal hepatocellular function, the lack of intrahepatic or extrahepatic macroscopic congenital portosystemic shunts, and liver histopathology demonstrating portal hypoperfusion in the absence of hepatic inflammation or nodular regeneration. Due to a perceived poor prognosis, many patients with this condition are euthanized; however, those that are spared can be medically managed, in some cases for years. This case report describes the diagnosis and management of a patient with primary hypoplasia of the portal vein and secondary portal hypertension that presented with the severe but typical clinical manifestations of ascites and hepatic encephalopathy, normal liver enzyme concentrations, and normal serum bile acid concentrations.

scholarly journals Causes and Management of Non-cirrhotic Portal Hypertension​

2020 ◽  
Vol 22 (12) ◽  
Author(s):  
Stefania Gioia ◽  
Silvia Nardelli ◽  
Lorenzo Ridola ◽  
Oliviero Riggio
Keyword(s):  
Liver Transplantation ◽  
Portal Hypertension ◽  
Natural History ◽  
Portal Vein ◽  
Liver Failure ◽  
Western World ◽  
Vein Thrombosis ◽  
Prevention Of Thrombosis ◽  
Portal Cavernoma ◽  
History Of

Abstract Purpose of the Review Non-cirrhotic portal hypertension (NCPH) includes a heterogeneous group of conditions. The aim of this paper is to make an overview on the denominations, diagnostical features and management of porto-sinusoidal vascular disease (PSVD) and chronic portal vein thrombosis (PVT) being the main causes of NCPH in the Western world. Recent Findings The management of NCPH consists in the treatment of associated diseases and of portal hypertension (PH). PH due to PSVD or PVT is managed similarly to PH due to cirrhosis. TIPS placement and liver transplantation are considerable options in patients with refractory variceal bleeding/ascites and with progressive liver failure. Anticoagulation is a cornerstone both in the treatment of thrombosis in PSVD and in the prevention of thrombosis recurrence in patients with portal cavernoma. Summary Physicians should be aware of the existence of PSVD and chronic PVT and actively search them in particular settings. To now, the management of portal hypertension-related complications in NCPH is the same of those of cirrhosis. Large cooperative studies on the natural history of NCPH are necessary to better define its management.

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 Duplex sonography study in schistosomiasis portal hypertension: characterization of patients with and without a history of variceal bleeding

2008 ◽  
Vol 45 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Severino Marcos Borba de Arruda ◽  
Victorino Spinelli Toscano Barreto ◽  
Fernando José do Amaral
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Variceal Bleeding ◽  
Collateral Circulation ◽  
Past History ◽  
Duplex Sonography ◽  
Group I ◽  
History Of ◽  
Group Ii ◽  
Upper Gastrointestinal

BACKGROUND: Presinusoidal portal hypertension with frequent episodes of upper gastrointestinal variceal bleeding are hallmarks of hepatosplenic Manson’s schistosomiasis; a clinical form that affects about 5% of Brazilians who are infected by Schistosoma mansoni. AIMS: To evaluate duplex sonography findings in patients with hepatosplenic Manson’s schistosomiasis with and without upper gastrointestinal variceal hemorrhage. METHODS: A cross-sectional study was performed whereby 27 consecutive patients with hepatosplenic Manson’s schistosomiasis were divided into two groups: group I (six men and six women; mean age 48.7 years) with a past history of bleeding and group II (four men and eight women; mean age 44.7 years) without a past history of upper gastrointestinal bleeding, underwent duplex sonography examination. All patients underwent the same upper gastrointestinal endoscopy and laboratory examinations. Those with signs of mixed chronic liver disease or portal vein thrombosis (three cases) were excluded. RESULTS: Group I showed significantly higher mean portal vein flow velocity than group II (26.36 cm/s vs 17.15 cm/sec). Although, as a whole it was not significant in all forms of collateral vessels (83% vs 100%), there was a significantly higher frequency of splenorenal collateral circulation type in group II compared with group I (17% vs 67%). The congestion index of the portal vein was significantly lower in group I than in group II (0.057 cm vs 0.073 cm/sec). CONCLUSION: Our duplex sonography findings in hepatosplenic Manson’s schistosomiasis support the idea that schistosomotic portal hypertension is strongly influenced by overflow status, and that collateral circulation seems to play an important role in hemodynamic behavior.

Prevalence, classification and natural history of gastric varices: A long-term follow-up study in 568 portal hypertension patients

Hepatology ◽  
1992 ◽  
Vol 16 (6) ◽  
pp. 1343-1349 ◽  
Author(s):  
Shiv K. Sarin ◽  
Deepak Lahoti ◽  
Sanjay P. Saxena ◽  
Nandguri S. Murthy ◽  
Uday K. Makwana
Keyword(s):  
Portal Hypertension ◽  
Natural History ◽  
Gastric Varices ◽  
Follow Up Study ◽  
Long Term Follow Up ◽  
History Of

scholarly journals Hepatic Arterioportal Fistula: A Curable Cause of Portal Hypertension in Infancy

HPB Surgery ◽  
1997 ◽  
Vol 10 (5) ◽  
pp. 311-314 ◽  
Author(s):  
J. S. Billing ◽  
N. V. Jamieson
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Main Portal Vein ◽  
Colour Doppler ◽  
Left Hepatic Artery ◽  
Arterioportal Fistula ◽  
Left Portal Vein ◽  
Left Hemihepatectomy

Hepatic arterioportal fistulae are a rare cause of portal hypertension. The case is reported of a twoyear old girl with a congenital arterioportal fistula, who presented with splenomegaly and ascites. Colour doppler ultrasound showed a large shunt between the left hepatic artery and a branch of the left portal vein, producing a reversal of flow in the main portal vein. She was treated by a formal left hemihepatectomy, which has been successful in eliminating the fistula and its consequent portal hypertension in the long term. The literature regarding arterioportal fistulae and their treatment is reviewed.

scholarly journals Risk Factors Regarding Portal Vein Thrombosis in Chronic Liver Disease

2020 ◽  
Vol 25 (4) ◽  
pp. 38-41
Author(s):  
Liliana Vecerzan ◽  
Romeo Gabriel Mihăilă
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Hepatic Cirrhosis ◽  
Vascular Diseases ◽  
High Rate ◽  
Imaging Method ◽  
Vein Thrombosis ◽  
Common Causes ◽  
Portosystemic Collateral ◽  
Collateral Vessels

Abstract The portal vein thrombosis (PVT) is one of the most frequent vascular diseases of the liver, with a high rate of morbidity and mortality. The most common causes of the PVT are hepatic cirrhosis, hepatobiliary neoplasms, inflammatory and infectious abdominal diseases, and myeloproliferative syndromes.(1,2) The natural progress of the PVT has as a result portal hypertension which leads to splenomegaly and the formation of portosystemic collateral vessels, as well as gastroesophageal, duodenal and jejunal varices. Ultrasonography, especially Doppler ultrasound, is the most widely used imaging method to asses, supervise and diagnose PVT in patients with hepatopathies. The purpose of acute PVT treatment is to re-permeabilize the obstructed vessels; the endoscopic ligature of the varices in the eventuality of their rupture is safe and extremely efficient in chronic PVT. To conclude, PVT is the most common hepatic vascular disorder, and its prevalence has increased particularly among the patients with chronic hepatopathies.(3)

scholarly journals Successful Treatment of Hepatoportal Arteriovenous Fistula by Transcatheter Embolization with Steel Coils

1994 ◽  
Vol 8 (5) ◽  
pp. 313-316
Author(s):  
Taralyn D Picton ◽  
Lindsay Machan ◽  
Jennifer Davis ◽  
Hugh J Freeman ◽  
Urs P Steinbrecher
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Arteriovenous Fistula ◽  
Hepatic Artery ◽  
Successful Treatment ◽  
Variceal Bleeding ◽  
Transcatheter Embolization ◽  
Liver Trauma ◽  
Steel Coils ◽  
History Of

Portal hypertension is most commonly caused by increased intrahepatic resistance as a result of cirrhosis, but can also occur as a result of abnormally high portal bloodflow. This article describes a patient with a history of remote liver trauma in whom portal hypertension and variceal bleeding were shown to be due to an arteriovenous fistula between the hepatic artery and portal vein. Transcatheter embolization with Gianturco coils resulted in obliteration of the fistula and normalization of portal pressures.

Effect of Long-Term Octreotide and Isosorbide Dinitrate on Haemodynamics in Rats with Portal Vein Stenosis

1998 ◽  
Vol 94 (6) ◽  
pp. 645-650 ◽  
Author(s):  
Han-Chieh Lin ◽  
Yi-Tsau Huang ◽  
Yuh-Ren Cheng ◽  
Ming-Chih Hou ◽  
Fa-Yauh Lee ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Isosorbide Dinitrate ◽  
Portal Pressure ◽  
Vehicle Group ◽  
Hyperdynamic Circulation ◽  
Portal Vein Stenosis ◽  
Term Administration ◽  
Vein Stenosis

1. Both octreotide and isosorbide dinitrate have been shown to have portal hypotensive effects in animals with portal hypertension. Moreover, in both animals and humans with portal hypertension, the reduction of portal pressure was enhanced when nitrovasodilators were combined with propranolol or vasopressin. The present study was undertaken to evaluate the effect of long-term administration of octreotide and isosorbide dinitrate on haemodynamics in rats with portal vein stenosis. 2. Portal hypertension was induced by portal vein stenosis. Portal hypertensive rats were allocated into one of four groups (eight rats in each group): vehicle group, octreotide group (100 μg/kg via subcutaneous injection every 12 h), isosorbide dinitrate group (5 mg/kg via gastric gavage every 12 h) and combined treatment group. Drug was given for eight consecutive days, starting 1 day before surgery. Haemodynamic values were measured using a radioactive microsphere technique. 3. Long-term octreotide treatment decreased portal pressure and improved the hyperdynamic circulation. In contrast, long-term administration of isosorbide dinitrate reduced portal pressure but did not ameliorate vasodilatation. A combination of octreotide and isosorbide dinitrate improved the hyperdynamic circulation with a reduction of portal pressure. In addition, the mean value of portal pressure after combination treatment was significantly lower than in rats receiving octreotide alone. 4. These results showed that, in rats with portal hypertension, long-term combined administration of octreotide and isosorbide dinitrate improved the hyperdynamic circulation together with a more profound reduction of portal pressure than rats receiving octreotide alone.

scholarly journals Porta hepatis abscess and portal vein thrombosis following ingestion of a fishbone

2019 ◽  
Vol 12 (4) ◽  
pp. e227271 ◽  
Author(s):  
Brittany Greene ◽  
Daniel Jones ◽  
Josée Sarrazin ◽  
Natalie G Coburn
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Gastric Perforation ◽  
Exploratory Laparotomy ◽  
Porta Hepatis ◽  
Surgical Exploration ◽  
Vein Thrombosis ◽  
History Of ◽  
Serial Ct ◽  
Upper Abdomen

A man in his late 50s presented to the emergency room with a 1-month history of severe abdominal pain and an endoscopic fishbone retrieval from his rectum. Serial CT scans revealed a fishbone located in the patient’s upper abdomen, which had migrated through the stomach wall, into the periportal space, causing a contained gastric perforation, development of a porta hepatis abscess and secondary portal vein thrombosis. Furthermore, the sharp tip of the fishbone lay 5 mm from the patient’s hepatic artery. He was transferred to a hepatobiliary centre where he underwent urgent exploratory laparotomy, with surgical exploration of the porta, drainage of the abscess and retrieval of the fishbone. Postoperatively, he received further treatment with antibiotics and anticoagulation and recovered without further sequelae.

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