scholarly journals A rare and curable cause of cyanosis – Congenital portosystemic shunts

2021 ◽  
Vol 10 (1) ◽  
pp. 42
Author(s):  
BalasubramaniyanAmirtha Ganesh ◽  
Arumugam Aashish ◽  
Selvaraj Karthikeyan ◽  
Srinivasan Giridharan
Keyword(s):  
Portosystemic Shunts

scholarly journals Transsplenic portal vein recanalization and direct intrahepatic portosystemic shunt placement to optimize liver transplantation

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Osman Ahmed ◽  
Abhijit L. Salaskar ◽  
Steven Zangan ◽  
Anjana Pillai ◽  
Talia Baker
Keyword(s):  
Liver Transplantation ◽  
Portal Vein ◽  
Splenic Vein ◽  
Portosystemic Shunt ◽  
Refractory Ascites ◽  
Hepatic Veins ◽  
Sonographic Guidance ◽  
Portosystemic Shunts ◽  
Intrahepatic Portosystemic Shunt ◽  
End To End

Abstract Background Percutaneous trans-splenic portal vein recanalization (PVR) has been reported for facilitation of transjugular intrahepatic portosystemic shunts (TIPS), however has not been applied to patients undergoing direct intrahepatic portosystemic shunt (DIPS). We report the utilization of trans-splenic-PVR with DIPS creation in a patient with chronic portal and hepatic vein occlusions undergoing liver transplantation evaluation. Case presentation A 48-year-old male with decompensated alcoholic cirrhosis complicated by refractory ascites, hepatic encephalopathy, and variceal bleeding underwent CT that demonstrated chronic occlusion of the hepatic veins (HV), extrahepatic portal vein (PV), and superior mesenteric vein (SMV). Due to failed attempts at TIPS at outside institutions, interventional radiology was consulted for portal vein recanalization (PVR) with TIPS to treat the portal hypertension and ascites and also facilitate an end-to-end PV anastomosis at transplantation. After an initial hepatic venogram confirmed chronic HV occlusion, a DIPS with trans-splenic PVR was planned. The splenic vein was accessed under sonographic guidance using a micropuncture set and subsequently upsized to a 6 French sheath over a stiff guidewire. A splenic venogram via this access confirmed occlusion of the PV with drainage of the splenic vein (SV) through gastric varices. The thrombosed PV was then recanalized and angioplastied to restore PV flow via the transsplenic approach. A transjugular liver access kit with a modified 21-gauge needle was advanced into the IVC through the internal jugular vein (IJV) sheath and directed towards the target snare in PV. The needle was used to subsequently puncture the PV through the caudate lobe and facilitate placement of a wire into the SV. The initial portosystemic gradient (PSG) was 20 mmHg. The IJV sheath was advanced through the hepatic parenchymal tract into the main-PV and a stent-graft was placed across the main PV and into the IVC. A portal venogram demonstrated brisk blood flow through the DIPS, resolution of varices and a PSG of 8 mmHg. One month after the procedure, the patient had a significant reduction in ascites and MELD-NA score. Patient is currently listed and awaiting transplantation. Conclusions In the setting of chronically occluded portal and hepatic veins, trans-splenic PVR DIPS may serve as an effective bridge to liver transplantation by facilitating an end to end portal vein anastomosis.

Splanchnic Surface Oximetry during Experimental Portal Hypertension and Surgical Manipulation of Portosystemic Shunts in Dogs

1991 ◽  
Vol 20 (3) ◽  
pp. 164-168 ◽  
Author(s):  
STEVEN L. PETERSON ◽  
CLARE R. GREGORY ◽  
JACK R. SNYDER ◽  
PAMELA G. WHITING ◽  
DENNIS STRACK ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Portosystemic Shunts ◽  
Surgical Manipulation

USE OF 99MTCO TRANS-SPLENIC PORTAL SCINTIGRAPHY FOR DIAGNOSIS OF PORTOSYSTEMIC SHUNTS IN 28 DOGS

2005 ◽  
Vol 46 (2) ◽  
pp. 153-161 ◽  
Author(s):  
Federica Morandi ◽  
Robert C. Cole ◽  
Karen M. Tobias ◽  
Clifford R. Berry ◽  
James Avenell ◽  
...  
Keyword(s):  
Portosystemic Shunts

Inadvertent catheterization of the hepatic artery during placement of transjugular intrahepatic portosystemic shunts.

Radiology ◽  
1994 ◽  
Vol 193 (1) ◽  
pp. 273-276 ◽  
Author(s):  
R K Kerlan ◽  
J M LaBerge ◽  
R L Gordon ◽  
E J Ring
Keyword(s):  
Hepatic Artery ◽  
Portosystemic Shunts

Mass screening of Irish wolfhound puppies for portosystemic shunts by the dynamic bile acid test

1999 ◽  
Vol 144 (25) ◽  
pp. 693-696 ◽  
Author(s):  
M. G. Kerr ◽  
T. van Doorn
Keyword(s):  
Bile Acid ◽  
Mass Screening ◽  
Portosystemic Shunts ◽  
Acid Test

No Foul Play for Transjugular Intrahepatic Portosystemic Shunts in Liver Transplant for Hepatocellular Carcinoma

2021 ◽  
Author(s):  
Kali Zhou ◽  
Courtney L. Hanlon ◽  
Selena Zhou ◽  
Jennifer L. Dodge ◽  
Yong K. Kwon ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplant ◽  
Portosystemic Shunts

Ultrasound detection of unusual spontaneous portosystemic shunts associated with uncomplicated portal hypertension.

1985 ◽  
Vol 4 (6) ◽  
pp. 297-305 ◽  
Author(s):  
G Di Candio ◽  
A Campatelli ◽  
F Mosca ◽  
V Santi ◽  
P Casanova ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Portosystemic Shunts
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