scholarly journals Portomesenteric Vein Thrombosis after Bariatric Surgery: An Online Survey

2021 ◽  
Vol 10 (17) ◽  
pp. 4024
Author(s):  
Francesco Maria Carrano ◽  
Sylvia Weiner ◽  
Moustafa Elshafei ◽  
Saleem Ahmed ◽  
Toghrul Talishinskiy ◽  
...  
Keyword(s):  
Metabolic Disorders ◽  
Online Survey ◽  
Splenic Vein ◽  
Treatment Modalities ◽  
Portal System ◽  
Vein Thrombosis ◽  
Predominant Symptom ◽  
Portomesenteric Vein Thrombosis ◽  
Time Gap ◽  
Structured Questionnaire

Portomesenteric vein thrombosis (PMVT) is a rare post-operative complication of bariatric procedures, occurring in between 0.3% and 1% of cases. A structured questionnaire consisting of 27 items was available online to members of the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) to investigate the occurrence of PMVT. A total of 89 bariatric surgeons from 61 countries participated. Twenty-six (29.21%) reported at least one case of PMVT (46.15% males; 53.84% females). The surgery most associated with PMVT occurrence was sleeve gastrectomy (84.6%), followed by Roux-en-Y gastric bypass (RYGB) (7.69%), and laparoscopic adjustable gastric banding (LAGB) (7.69%). The time gap between surgery and PMVT was 19.28 ± 8.72 days. The predominant symptom was abdominal pain in 96.15% of patients, followed by fever in 26.9%. Complete occlusion of the portal vein was reported in 34.6% of cases, with involvement of the portal system in 69%, extension to the superior mesenteric district in 23%, and extension to the splenic vein in two patients (7.7%). Our survey, which is the largest regarding PMVT to date, revealed a diffuse lack of standardization in the choice, duration, and dosing of prophylaxis regimens as well as treatment modalities, reflecting the literature gap on the topic.

scholarly journals Splenic Artery Embolisation for the Emergency Treatment of Sinistral Portal Hypertension: A Systematic Review

2021 ◽  
Vol 5 (02) ◽  
pp. 079-085
Author(s):  
Harriet Grout-Smith ◽  
Ozbil Dumenci ◽  
N. Paul Tait ◽  
Ali Alsafi
Keyword(s):  
Systematic Review ◽  
Portal Hypertension ◽  
Variceal Bleeding ◽  
Splenic Artery ◽  
Splenic Vein ◽  
Treatment Modalities ◽  
Portal System ◽  
Technical Success Rate ◽  
Randomized Controlled Studies ◽  
Sinistral Portal Hypertension

Abstract Objectives Sinistral portal hypertension (SPH) is caused by increased pressure on the left portal system secondary to splenic vein stenosis or occlusion and may lead to gastric varices. The definitive management of SPH is splenectomy, but this is associated with significant mortality and morbidity in the acute setting. In this systematic review, we investigated the efficacy and safety of splenic artery embolisation (SAE) in managing refractory variceal bleeding in patients with SPH. Methods A comprehensive literature search was conducted using MEDLINE and Embase databases. A qualitative analysis was chosen due to heterogeneity of the studies. Results Our search yielded 339 articles, 278 of which were unique. After initial screening, 16 articles relevant to our search remained for full text review. Of these, 7 were included in the systematic review. All 7 papers were observational, 6 were retrospective. Between them they described 29 SAE procedures to control variceal bleeding. The technical success rate was 100% and there were no cases of rebleeding during follow up. The most common complication was post-embolisation syndrome. Four major complications occurred, two resulting in death. These deaths were the only 30-day mortalities recorded and were in patients with extensive comorbidities. Conclusions Although there is a distinct lack of randomized controlled studies comparing SAE to other treatment modalities, it appears to be safe and effective in treating hemorrhage secondary to SPH.

scholarly journals Etiology of Portal Hypertension in Children-An Experience in a Tertiary Centre of Bangladesh

2016 ◽  
Vol 39 (1) ◽  
pp. 14-17
Author(s):  
Salahuddin Mahmud ◽  
Syed Shafi Ahmed ◽  
Jahida Gulshan ◽  
Farhana Tasneem
Keyword(s):  
Portal Hypertension ◽  
Venous Pressure ◽  
Tertiary Care ◽  
Splenic Vein ◽  
Portal System ◽  
Biliary Cirrhosis ◽  
Vein Thrombosis ◽  
Hepatic Diseases ◽  
Chronic Hepatitis B Virus ◽  
Hypertension In Children

Background: Portal hypertension is defined by a pathological increase in portal venous pressure. Any condition that interfere with blood flow at any level within the portal system can lead to portal hypertension. For better management, it is important to determine the underlying cause.Objective: To evaluate the etiology of portal hypertension in children admitted in a tertiary care centre of Bangladesh.Materials & Methods: This cross sectional study was done in the Department of Pediatric Gastroenterology, Hepatology & Nutrition, Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh on 40 consecutive cases of portal hypertension enrolled from April 2014 to March 2015. Results: Age of the children was 2-12 years with mean age of 7.2±4.3 years and male:female ratio was 1.5:1. Out of 40 children, 32 (80%) developed portal hypertension due to pre-hepatic causes and 8 (20%) hepatic causes. In pre-hepatic causes of portal hypertension, out of 32 children, portal vein thrombosis was found in 20 (62.5%) cases, splenic vein thrombosis in 4 (12.5%) & 8 (25%) were idiopathic. On the other hand hepatic causes of portal hypertension, out of 8 children, cryptogenic was found in 4 (50%) cases, wilson’s disease, chronic hepatitis B virus infection, biliary cirrhosis & autoimmune hepatitis each was found in 1 (12.5%) case. In pre-hepatic cases first variceal bleed much earlier than hepatic cases (4.4±3.6 Vs 7.6±4.6 years).Conclusion: Extra-hepatic diseases were the most common etiology of portal hypertension in studied children. Portal venous thrombosis in extra-hepatic cases & cryptogenic liver disease in intra-hepatic cases were the most common causesBangladesh J Child Health 2015; VOL 39 (1) :14-17

Management of Vatarakta w.s.r. to Gout through Panchakarma

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Dr. Chandramohan Arya ◽  
Dr.Sanjay Gupta
Keyword(s):  
Metabolic Disorders ◽  
Molecular Level ◽  
Modern Science ◽  
Monosodium Urate ◽  
Monosodium Urate Crystals ◽  
Predominant Symptom ◽  
Essential Components ◽  
Unique Approach ◽  
Ayurvedic Treatment ◽  
Urate Crystals

Vatarakta is more distressing and common metabolic disorder prevalent in present era. It is Vatapradhana Tridoshaja Vatavyadhi where Rakta is main Dushya. Vata is a predominant Dosha in Vatarakta, when it is excessively aggravated with vitiated Rakta is called Vatarakta. Vatarakta is correlated with gout in modern science. Gout is an abnormality of purine metabolism causes hyperuricemia and deposition of monosodium urate crystals in joints. Pain is predominant symptom of gout, which disturbs day-today life of the patients. The Panchakarma is not only a important component of Ayurvedic treatment but it is also forms the fundamental basis of Ayurveda therapy. The different procedures like Swedana, Vamana, Virechana, Basti, Sirovirechana, Raktamokshana focus on the purification which detoxifies the human body, i.e. the correction of the metabolism at molecular level. These detoxification procedures are essential components of the management in various metabolic disorders. So Panchakarma is an unique approach in the management of Vatarakta.

Portomesenteric thrombosis after robotic sleeve gastrectomy

2020 ◽  
Vol 13 (12) ◽  
pp. e236202
Author(s):  
Omkaar Jaikaran ◽  
Derek Lim ◽  
Brian Binetti ◽  
Vadim Meytes
Keyword(s):  
Sleeve Gastrectomy ◽  
Portal Vein ◽  
Methylenetetrahydrofolate Reductase ◽  
Splenic Vein ◽  
Subsequent Development ◽  
Obese Women ◽  
Splenic Vein Thrombosis ◽  
Vein Thrombosis ◽  
Robotic Sleeve Gastrectomy ◽  
Compound Mutation

Portomesenteric thrombosis is an important but rarely reported complication following bariatric surgery. It has been suggested that the incidence of portal vein thrombosis is directly related to many risk factors inherent in the bariatric population as well as factors related to local and systemic effects of laparoscopic surgery. Possible aetiologies vary from systemic inherited hypercoagulable states to a direct inflammatory reaction of portosystemic vessels. Here we present a case report of a 47-year-old obese women who underwent a robotic sleeve gastrectomy with subsequent development of a main portal vein, complete right intrahepatic portal vein and splenic vein thrombosis ultimately found to have a compound mutation of the methylenetetrahydrofolate reductase C677T and A1298C alleles.

scholarly journals Awareness of parents towards Teething

1970 ◽  
Vol 11 (1) ◽  
pp. 40-43 ◽  
Author(s):  
K Bhavneet
Keyword(s):  
Health Care ◽  
Child Health ◽  
General Health ◽  
Deciduous Tooth ◽  
Treatment Modalities ◽  
Child Health Care ◽  
Statistical Software ◽  
Relationship Of ◽  
The Relationship ◽  
Structured Questionnaire

Objective: The relationship of the first deciduous tooth eruption and the general health of an infant has always been a subject of curiosity. The enigma of teething although historical, continues to pervade contemporary child health care due to many unexplained teething myths. The treatment modalities used in teething have been diverse. The objective of this study was to evaluate the awareness, beliefs and knowledge of parents towards teething symptoms. Materials and method: Hundred parents were randomly selected from two kindergarten schools and were interviewed according to a structured questionnaire. Collected data was analyzed by a statistical software known as SPSS. Results: Results revealed that though parents knew about teething but there was lack of awareness regarding diverse treatment modalities and the teething myths and realities. Conclusions: More educative programs should be initiated to make parents aware of teething myths and realities. DOI: http://dx.doi.org/10.3329/bjms.v11i1.9822 BJMS 2012; 11(1): 40-43

Sign in / Sign up

Export Citation Format

Share Document