scholarly journals Abernethy Malformation Type II in a 70-Year-Old Patient with Angina Pectoris

2021 ◽  
Vol 48 (4) ◽  
pp. 23-27
Author(s):  
V. Gandileva ◽  
P. Makaveeva ◽  
D. Tabakova ◽  
T. Valerieva ◽  
I. Simova ◽  
...  
Keyword(s):  
Hepatopulmonary Syndrome ◽  
Iliac Vein ◽  
Systemic Circulation ◽  
Abernethy Malformation ◽  
Exertional Dyspnea ◽  
Radiologic Findings ◽  
Portosystemic Shunts ◽  
Cardiology Department ◽  
Aberrant Vessels

Abstract Congenital extrahepatic portosystemic shunts (ECPSS) are rare developmental anomalies in which a variable portion of the portal blood bypasses the liver and is shunted in the systemic circulation via one or more aberrant vessels. We present a clinical case of a 70-year-old man, who was referred to the Cardiology Department because of exertional dyspnea, fatigue, and feeling of heaviness and pressure behind the sternum. MDCT of the aorta was performed and an aberrant vessel was discovered with communication with the left iliac vein on one side and superior mesenteric and splenic veins on the other. The portal vein was hypoplastic. The radiologic findings were suggestive of malformation of Abernethy. The ECPSS can be classified into 2 main groups (with complete and partial shunting). The patients have different clinical presentation. Some of them are completely asymptomatic while in others the shunt can manifest even before birth as fetal growth retardation or in the early neonatal period with neonatal cholestasis and galactosemia. Common complications are hepatic encephalopathy and hepatopulmonary syndrome and there is a wide variety of concomitant abnormalities. The imaging modalities play a crucial role in the diagnosis, classification, follow-up and the proper choice of therapeutic management in patients with ECPSS.

Laparoscopic Portosystemic Shunt Attenuation in Two Dogs

2006 ◽  
Vol 42 (2) ◽  
pp. 160-164 ◽  
Author(s):  
Jonathan M. Miller ◽  
J. David Fowler
Keyword(s):  
Postoperative Morbidity ◽  
Portosystemic Shunt ◽  
Visual Examination ◽  
Biochemical Evidence ◽  
Aberrant Vessels

Laparoscopic portosystemic shunt attenuation was successfully performed in two dogs. Aberrant vessels were noted on visual examination of the abdominal vasculature. Cellophane bands were placed around the vessel laparoscopically for attenuation. The dogs had minimal postoperative morbidity, and there was biochemical evidence of adequate shunt ligation at follow-up examination.

scholarly journals Histopathology of livers in patients with congenital portosystemic shunts (Abernethy malformation): a case series of 22 patients

2018 ◽  
Vol 474 (1) ◽  
pp. 47-57 ◽  
Author(s):  
Claudio De Vito ◽  
Athanasios Tyraskis ◽  
Mark Davenport ◽  
Richard Thompson ◽  
Nigel Heaton ◽  
...  
Keyword(s):  
Case Series ◽  
Abernethy Malformation ◽  
Portosystemic Shunts

Percutaneous device closure of abernethy malformation-A treatable cause of hepatopulmonary syndrome

2013 ◽  
Vol 83 (6) ◽  
pp. 968-970 ◽  
Author(s):  
Subramanian Venkateshwaran ◽  
Kavassery Mahadevan Krishnamoorthy ◽  
Sivasubramonian Sivasankaran
Keyword(s):  
Hepatopulmonary Syndrome ◽  
Device Closure ◽  
Abernethy Malformation ◽  
Percutaneous Device ◽  
Percutaneous Device Closure

scholarly journals Case Report: The Cox-Maze IV Procedure in the Mirror: The Use of Three-Dimensional Printing for Pre-operative Planning in a Patient With Situs Inversus Dextrocardia

2021 ◽  
Vol 8 ◽  
Author(s):  
Long Song ◽  
Chengming Fan ◽  
Hao Zhang ◽  
Hongduan Liu ◽  
Chukwuemeka Daniel Iroegbu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Situs Inversus ◽  
Three Dimensional ◽  
Holter Monitoring ◽  
Uneventful Recovery ◽  
Exertional Dyspnea ◽  
Three Dimensional Printing ◽  
Operative Planning ◽  
Dimensional Printing

The safety and efficacy of the Cox-Maze IV procedure (CMP-IV) for situs inversus dextrocardia patients with atrial fibrillation is yet to be determined. Herein, we present the case of a 39-year-old male patient admitted to our cardiac center following progressive exertional dyspnea. The patient was diagnosed with situs inversus dextrocardia, severe mitral regurgitation, and paroxysmal atrial fibrillation. A three-dimensional (3D) heart model printing device embedded with designated ablation lines was used for pre-operative planning. Mitral valvuloplasty, CMP-IV, and tricuspid annuloplasty were performed. The patient had an uneventful recovery and was in sinus rhythm during a 12-month follow-up period using a 24-h Holter monitoring device. The case herein is one of the first to report on adopting the CMP-IV procedure for situs inversus dextrocardia patients with complex valvuloplasty operation. In addition, the 3D printing technique enabled us to practice the Cox-maze IV procedure, given the patient's unique cardiac anatomy.

scholarly journals A case report: Type II Abernethy malformation complicated with congenital polydactyly and enlargement of all cardiac chambers.

2019 ◽  
Author(s):  
Cheng Zhu ◽  
Min Wang ◽  
Qian Hao
Keyword(s):  
Congenital Malformations ◽  
Portacaval Anastomosis ◽  
Test Results ◽  
Abernethy Malformation ◽  
Form And Function ◽  
Laboratory Test Results ◽  
Number Of Patients ◽  
Patient Reported ◽  
And Function

Abstract Background: Abernethy malformation is a kind of congenital malformation of portal vein system caused by abnormal portacaval anastomosis. It can be in combination with other congenital malformations. The major therapy of Abernethy malformation is surgery. There has been a limited number of patients since the first patient reported, leading to a limited view towards this kind of disease until now.Results: In August 2018 we treated a patient diagnosed with typeII Abernethy malformation complicated with both congenital polydactyly and enlargement of all cardiac chambers, which is extremely rare and can be a supplementary to the existing cases. Besides, the low white blood cell and platelet, the arrested megakaryocytic maturation and the positive platelet autoantibody in serum may result in misdiagnosis as immune thrombocytopenia, so we analyze the differential points between these two diseases. We treated this patient with silybin orally and advised him to make follow-up visits because of his mild liver function disorder, normal cardiac function and no other malformations or complications complicated. At the latest follow-up, we knew the condition of the patient was generally satisfactory, whether in terms of laboratory test results or his daily life experience.Conclusions: Because of some changes of spleen in form and function secondary to Abernethy malformation, in some cases, this disease has similarities with a part of blood diseases, which we should take into consideration for differential diagnosis, especially when other congenital malformations are found in combination at the same time. This case also suggests that simply conservative treatment with regular follow-up visits can be suitable for certain patients.

scholarly journals PHARMACOINVASIVE VERSUS THROMBOLYSIS IN STEMI COHORT – OUTCOMES FROM A TERTIARY CARE CENTRE OF NORTH INDIA

2020 ◽  
pp. 1-3
Author(s):  
Richa Sharma ◽  
Ajeet Jain ◽  
Praveen Singh ◽  
Bhushan Shah
Keyword(s):  
Myocardial Ischemia ◽  
Tertiary Care ◽  
Myocardial Necrosis ◽  
North India ◽  
Registry Study ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Promising Strategy ◽  
Cardiology Department

STEMI is an event where transmural myocardial ischemia induces myocardial necrosis. PI strategy is a promising strategy in the management of STEMI. It is prospective registry study conducted in Cardiology Department, KGMU between January-June 2016 to know 30 day outcome of thrombolysis alone or thrombolysis followed by PCI in north India.At 30 day follow up, patients undergoing PI strategy,complained less of angina and dyspnea compared to thrombolysis arm.

scholarly journals Cyclophosphamide Versus Rituximab in Progressive Forms of Multiple Sclerosis

2020 ◽  
Author(s):  
Masoud Etemadifar ◽  
Shadi Ghourchian ◽  
Nazanin Mahinparvar ◽  
Mehri Salari ◽  
Fatemeh Etemadifar ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Progressive Multiple Sclerosis ◽  
The Other ◽  
Medical Sciences ◽  
Mri Findings ◽  
Disability Score ◽  
Radiologic Findings ◽  
Spss Software ◽  
And Gender

This study aimed to compare the efficacy of rituximab versus Cyclophosphamide on active secondary progressive multiple sclerosis (SPMS). The randomized clinical trial was performed from 2015 to 2017 in multiple sclerosis (MS) clinics affiliated to Isfahan MS society (IMSS). Patients were randomized to two groups, and one of them received Rituximab that was repeated every six months in case of medical indication. The other one received a monthly pulse of methylprednisolone plus cyclophosphamide (Endoxan, Baxter, UK) until two years. Expanded disabilities status scale (EDSS), clinical, and MRI findings were assessed every six months. Statistical analysis was performed using SPSS software. 39 patients in the Rituximab group and 30 in the Cyclophosphamide group with similar age and gender distribution were entered for analysis. At baseline, the mean number of attacks in the Rituximab group was significantly more than the Cyclophosphamide group (P=0.0001). After 6, 12, and 18 months of treatment, the rate of attacks was similar between groups although it increased significantly in the Rituximab group (P=0.030) after 24 months of treatment. EDSS was increased in the Rituximab group more than the other group at the end of the study. Both drugs were well-tolerated by patients. The EDSS was increased in the Rituximab group but the disability score did not worsen in the Cyclophosphamide group. Both therapies were associated with a reduction in disease attacks and improvement in radiologic findings in a two-year period of follow-up. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(8):484-491.

Letter to Editor: Congenital extrahepatic portosystemic shunts (Abernethy malformation): A new variant

Hepatology ◽  
2020 ◽  
Author(s):  
Vijay Waman Dhakre ◽  
Preet Shah ◽  
Aabha nagral ◽  
Sanjay Nagral
Keyword(s):  
Abernethy Malformation ◽  
Portosystemic Shunts ◽  
New Variant

scholarly journals Work-related adverse respiratory health outcomes at a machine manufacturing facility with a cluster of bronchiolitis, alveolar ductitis and emphysema (BADE)

2020 ◽  
Vol 77 (6) ◽  
pp. 386-392 ◽  
Author(s):  
Kristin J Cummings ◽  
Marcia L Stanton ◽  
Kathleen Kreiss ◽  
Randy J Boylstein ◽  
Ju-Hyeong Park ◽  
...  
Keyword(s):  
Lung Function ◽  
Health Outcomes ◽  
Respiratory Health ◽  
Forced Expiratory Volume ◽  
Medical Surveillance ◽  
Exertional Dyspnea ◽  
Manufacturing Facility ◽  
Work Related ◽  
Endotoxin Exposure

ObjectivesFour machine manufacturing facility workers had a novel occupational lung disease of uncertain aetiology characterised by lymphocytic bronchiolitis, alveolar ductitis and emphysema (BADE). We aimed to evaluate current workers’ respiratory health in relation to job category and relative exposure to endotoxin, which is aerosolised from in-use metalworking fluid.MethodsWe offered a questionnaire and spirometry at baseline and 3.5 year follow-up. Endotoxin exposures were quantified for 16 production and non-production job groups. Forced expiratory volume in one second (FEV1) decline ≥10% was considered excessive. We examined SMRs compared with US adults, adjusted prevalence ratios (aPRs) for health outcomes by endotoxin exposure tertiles and predictors of excessive FEV1 decline.ResultsAmong 388 (89%) baseline participants, SMRs were elevated for wheeze (2.5 (95% CI 2.1 to 3.0)), but not obstruction (0.5 (95% CI 0.3 to 1.1)). Mean endotoxin exposures (range: 0.09–28.4 EU/m3) were highest for machine shop jobs. Higher exposure was associated with exertional dyspnea (aPR=2.8 (95% CI 1.4 to 5.7)), but not lung function. Of 250 (64%) follow-up participants, 11 (4%) had excessive FEV1 decline (range: 403–2074 mL); 10 worked in production. Wheeze (aPR=3.6 (95% CI 1.1 to 12.1)) and medium (1.3–7.5 EU/m3) endotoxin exposure (aPR=10.5 (95% CI 1.3 to 83.1)) at baseline were associated with excessive decline. One production worker with excessive decline had BADE on subsequent lung biopsy.ConclusionsLung function loss and BADE were associated with production work. Relationships with relative endotoxin exposure indicate work-related adverse respiratory health outcomes beyond the sentinel disease cluster, including an incident BADE case. Until causative factors and effective preventive strategies for BADE are determined, exposure minimisation and medical surveillance of affected workforces are recommended.

Iliac Venous Obstruction: Surgical Reconstruction

2000 ◽  
Vol 15 (3-4) ◽  
pp. 144-148
Author(s):  
F. Mercier ◽  
F. Cormier ◽  
J. M. Fichelle ◽  
F. Duarte ◽  
J. M. Cormier
Keyword(s):  
Iliac Artery ◽  
Lower Limb ◽  
Iliac Vein ◽  
Lower Limbs ◽  
Surgical Reconstruction ◽  
Invasive Technique ◽  
Venous Obstruction ◽  
Long Term Outcome ◽  
First Choice

Aim: To review the investigation and treatment of iliac vein obstruction. Method: A review of current literature in the field of management of iliac venous obstruction has been conducted. Synthesis: Iliac venous obstruction results in chronic or acute symptoms in the lower limb presenting as pain, swelling, oedema and discomfort of the lower limb. Intrinsic or extrinsic obstruction of the iliac veins may be the cause. Cockett syndrome is the classic aetiology for chronic intermittent or fixed left inferior limb venous obstruction. Other causes include tumours, vascular grafts or lymph node compression and retroperitoneal fibrosis. Duplex ultrasound imaging is now the first-choice investigation. CT scanning is useful where external vein compression is suspected. Phlebography is used when an endovascular procedure is to be done. The surgical treatment of Cockett syndrome described by Cormier is transposition of the common right iliac artery in the left internal iliac artery. This is being replaced by endovascular balloon venoplasty completed by stenting of the left iliac vein. We reviewed the experience of surgical correction of Cockett syndrome with Cormier's technique in 70 patients operated on between 1976 and 1990; 55 patients had a follow-up of 12-177 months. Anatomical and functional results were perfect for all patients except when endoluminal synechiae or iliac venous thrombosis were associated with postural compression. In this case a 50% success rate was achieved. The endovascular revolution offers a less invasive technique for treatment of chronic iliac venous obstruction. Follow-up is short at present in the few publications found in the literature. Conclusions: Iliac vein obstruction results in symptoms of swelling in the lower limbs. These may be managed conservatively. Where there is an indication for venous reconstruction, investigation by duplex ultrasonography is the first step. Endovascular procedures including stenting offer significant benefit. The long-term outcome of these interventions has yet to be established.

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