Chronic pancreatitis: about some complications and features of their pathogenesis and course

The review article provides up-to-date information on the complications of pancreatitis that are important for the tactics and strategy of patient management both at the inpatient and outpatient stages of observation. The purpose of the review was to emphasize the importance of complications for the course and life of patients with chronic pancreatitis. The authors draw the attention of internists to the course of such complications as pseudocysts, cysts, fistulas, thrombohemorrhagic, cholestatic syndromes, compression syndrome of adjacent organs, pancreatic encephalopathy (acute and chronic). The symptomatology of complications of chronic pancreatitis is discussed in detail, which is very important for differential diagnosis with the corresponding diseases. Such complications include the formation of erosive and ulcerative lesions, varicose veins of the esophagus and bleeding from varicose veins of the esophagus and stomach, portal hypertension syndrome with pancreatic ascites and chronic pancreatic encephalopathy, idiopathic non-cirrhotic portal hypertension, pancreatic cancer. The authors emphasize the need to analyze the corresponding symptoms, indicating the possibility of complications, negative consequences with each recurrence or exacerbation of chronic pancreatitis, since it concerns the prognosis and life of the patient.

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Pelvic congestion syndrome and left renal compression syndrome - clinical features and therapeutic approaches

VASA ◽

10.1024/0301-1526/a000538 ◽

2016 ◽

Vol 45 (4) ◽

pp. 275-282 ◽

Cited By ~ 8

Author(s):

Christina Jeanneret ◽

Konstantin Beier ◽

Alexander von Weymarn ◽

Jürg Traber

Keyword(s):

Varicose Veins ◽

Left Renal Vein ◽

Standing Position ◽

Ovarian Vein ◽

Pelvic Congestion Syndrome ◽

Compression Syndrome ◽

Abstract Knowledge ◽

Increased Risk ◽

Definition Of ◽

Pelvic Congestion

Abstract. Knowledge of the anatomy of the pelvic, gonadal and renal veins is important to understand pelvic congestion syndrome (PCS) and left renal vein compression syndrome (LRCS), which is also known as the nutcracker syndrome. LRCS is related to PCS and to the presence of vulvar, vaginal and pudendal varicose veins. The diagnosis of the two syndromes is difficult, and usually achieved with CT- or phlebography. The gold standard is the intravenous pressure measurement using conventional phlebography. The definition of PCS is described as pelvic pain, aggravated in the standing position and lasting for more than 6 months. Pain in the left flank and microhaematuria is seen in patients with LRCS. Women with multiple pregnancies are at increased risk of developing varicose vein recurrences with pelvic drainage and ovarian vein reflux after crossectomy and stripping of the great saphenous vein. The therapeutic options are: conservative treatment (medroxyprogesteron) or interventional (coiling of the ovarian vein) or operative treatment (clipping of the ovarian vein). Controlled prospective trials are needed to find the best treatment.

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Miscellaneous/Marginal/Evolving Indications (Other Abdominopelvic Tumors, Portal Hypertension-Related Varicose Veins, Osteoarticular Pathologies)

Embolization ◽

10.1007/978-1-4471-5182-1_24 ◽

2013 ◽

pp. 423-443

Author(s):

Louis Boyer ◽

Agaïcha Alfidja Lankoande ◽

Mickaël Fontarensky ◽

Pascal Chabrot

Keyword(s):

Portal Hypertension ◽

Varicose Veins

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Difficulties of differential diagnosis of portal hypertension: case report

Medical Council ◽

10.21518/2079-701x-2021-5-92-101 ◽

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.

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PROBLEMS OF INTERCULTURAL COMMUNICATION IN MODERN GERMANY (REVIEW ARTICLE ON THE PUBLICATIONS OF OLGA RöSCH)

Yazykoznaniye ◽

10.31249/ling/2021.03.01 ◽

2021 ◽

pp. 5-21

Author(s):

N. Troshina ◽

Keyword(s):

Higher Education ◽

Intercultural Communication ◽

National Culture ◽

English Language ◽

Review Article ◽

Negative Consequences ◽

Modern Germany

The article deals with the current social and cultural problems in modern Germany that are related to the wide wave of immigration and the need for changes in official communication caused by immigration. The article analyzes the language situation in the field of German higher education and science, due to the strengthening of the position of the English language, which has negative consequences for the German national culture.

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Review article: update on the role of transjugular intrahepatic portosystemic stent-shunt (TIPSS) in the management of complications of portal hypertension

Alimentary Pharmacology & Therapeutics ◽

10.1046/j.1365-2036.1997.156331000.x ◽

1997 ◽

Vol 11 (2) ◽

pp. 261-272 ◽

Cited By ~ 11

Author(s):

A. J. STANLEY ◽

D. N. REDHEAD ◽

P. C. HAYES

Keyword(s):

Portal Hypertension ◽

Review Article ◽

Management Of Complications

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Extrahepatic Portal Hypertension Caused by Chronic Pancreatitis

Annals of Internal Medicine ◽

10.7326/0003-4819-75-6-903 ◽

1971 ◽

Vol 75 (6) ◽

pp. 903 ◽

Cited By ~ 47

Author(s):

GEORGE F. LONGSTRETH

Keyword(s):

Chronic Pancreatitis ◽

Portal Hypertension ◽

Extrahepatic Portal Hypertension

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Combined endoscopic intervention (ligation+sclerotherapy) compared with TIPS for prevention of bleeding from gastro-esophageal varices in patients with liver cirrhosis

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20164534 ◽

2016 ◽

Vol 5 (1) ◽

pp. 124

Author(s):

Utkirbek Matkuliev

Keyword(s):

Liver Cirrhosis ◽

Portal Hypertension ◽

Varicose Veins ◽

Portal System ◽

Endoscopic Intervention ◽

Portosystemic Shunts ◽

System Pressure ◽

Intrahepatic Portosystemic Shunt ◽

History Of ◽

The Mean

Background: Liver cirrhosis (LC) and portal hypertension (PH) is one of the most serious problems of modern surgical hepatology. The most common complication of liver cirrhosis is bleeding from varicose veins of esophagus and stomach. Today experts have several ways to prevent rebleeding from varices: pharmacotherapy, endoscopic intervention, transjugular intrahepatic portosystemic shunt (TIPS), a surgical portocaval bypass. Purpose of this study was to compare effectiveness of transjugular intrahepatic portosystemic shunts (TIPS) and combined endoscopic therapy the management of bleeding in cirrhotic patients.Methods: We observed 96 consecutive patients with portal hypertension who were treated in 2nd clinic of Tashkent Medical Academy (2014-2015). Bleeding was in history of 17 (17.7%) patients. The duration of the bleeding averaged 9.7±4.3 hours. Ascites was observed in 54.5 % of patients. Patients were divided two major groups. First group included 72 patients who was performed endoscopic intervention. Second group consisted of 24 patients who underwent TIPS in emergency cases.Results: Seventy-two patients were assigned to variceal ligation and Sclerotherapy, other 24 patients to TIPS. In the ligation combined Sclerotherapy group, a second treatment was performed 8–10 days after the initial endoscopy. Deterioration of portal gastropathy was observed in 9 (9.4%) cases after EL and 24 (25.0%) after ES (p <0.05). The mean portal system pressure prior to TIPS placement was 53.67±4.21 mm Hg, which decreased to 25.10±4.06 mmHg after the first shunt tract was established (P <0.001). The mean portal system pressure prior to the second TIPS was 43.68±3.98 mm Hg and decreased to 25.14±4.67 mm Hg after the procedures (P <0.001).Conclusions: TIPS can become dysfunctional if stenosis develops in the shunt or the hepatic vein above the shunt. Screening allows detection of stenosis before portal hypertensive–related complications recur. Revision of stenotic shunts can be easily accomplished in most cases. Techniques for screening and revision will be discussed. This is one of the most effective methods to control patients with liver cirrhosis.

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