Journal Article10.1055/S-2002-23206
Extrahepatic portal vein obstruction.
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TL;DR: Variceal bleeding in EHPVO can be successfully managed by endoscopic obliteration of varices, which has low morbidity but requires repeated visits, or by portosystemic shunt surgery, which provides good control of bleeding, possibly helps growth retardation, hypersplenism, and protects against future development of portal biliopathy.
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Abstract: Extrahepatic portal vein obstruction (EHPVO) is an important cause of noncirrhotic portal hypertension, especially in Third World countries. The etiology and clinical presentation are different in children and adults. The portal vein is transformed into a cavernoma, resulting in portal hypertension and oesophagogastic varices. In addition, extensive collateral circulation develops, involving paracholecystic, paracholedochal and pancreaticoduodenal veins resulting in formation of ectopic varices, and portal biliopathy. Besides variceal bleeding, which is the commonest presentation, patients may have symptomatic portal biliopathy, hypersplenism, and growth retardation. Although the liver may appear normal, functional compromise develops in the long term. Variceal bleeding in EHPVO can be successfully managed by endoscopic obliteration of varices, which has low morbidity but requires repeated visits, or by portosystemic shunt surgery, which provides good control of bleeding, possibly helps growth retardation, hypersplenism, and protects against future development of portal biliopathy but is associated with surgical mortality and is sometimes not feasible due to nonavailability of a satisfactory vessel.
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Citations
Adams-Oliver syndrome and portal hypertension: fortuitous association or common mechanism?
Gisela Silva,Alexandre Braga,Banquart Leitão,Abel Mesquita,Aurélio Reis,Carlos Duarte,José Barbot,Ermelinda Santos Silva +7 more
TL;DR: It is hypothesized that there may be an early embryonic vascular abnormality (vascular disruption) that may explain these vascular phenomena in AOS who developed a progressive splenomegaly and hypersplenism and was admitted for acute gastrointestinal bleeding at the age of 9 months.
3
Management of a rare case of extra hepatic portal vein obstruction with temporomandibular joint ankylosis and review of literature.
Kailash ChKurdia,Ambuj Aggarwal,Cherring Tandup,Divya Dahiya,Subrata Podder,Arunanshu Behera +5 more
- 31 May 2021
TL;DR: In this paper, a 14 year young girl who had TMJ ankylosis due to ear infection and EHPVO with esophageal varices had multiple episodes of upper GI bleed with mild deficiency of protein C and S, successfully managed with proximal splenorenal shunt.
3
Portal Vein Thrombosis in non cirrhotic patients
Manon Spaander
- 17 Dec 2010
TL;DR: The etiology of EPVT is diverse and can be divided into local risk factors such as cirrhosis, hepatobiliary malignancies and pancreatitis, and systemic risk factorsSuch as inherited and acquired prothrombotic disorders, and in at least one third of the patients a combination of thrombotics is demonstrated.
3
Portal biliopathy; multidetector CT (MDCT) imaging features
TL;DR: Examination of patients with extra-hepatic portal vein obstruction and biliary dilatation shows MDCT is an excellent technique for the diagnosis of portal biliopathy reducing errors in diagnosis.
3
A patient with adult extrahepatic portal obstruction,of which distinction from intrahepatic cholangiocarcinoma was difficult
Takahiro Horie,Ichiro Shimizu,Michiyo Okazaki,Kensuke Fujiwara,Soichiro Fujiwara,Koji Yamamoto,Arata Iuchi,Akihito Tanagami,Mitsuyoshi Hirokawa,Susumu Ito +9 more
TL;DR: A 51-year-old Japanese male with chief complaints of slightly high fever and epigastralgia was hospitalized at the authors' facility, and the possibility of intrahepatic cholangiocarcinoma could not be excluded, extended left hepatectomy combined with caudate lobectomy was performed.
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TL;DR: It is concluded that portal or hepatic venous thrombosis should be regarded as an index for 1 or several prothrombotic disorders, whether or not local precipitating factors or oral contraceptive use are found.
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Incidence of portal vein thrombosis in liver cirrhosis: An angiographic study in 708 patients
Kunio Okuda,Kunihiko Ohnishi,Kunio Kimura,Shoichi Matsutani,Masatoshi Sumida,Nobuaki Goto,Hirotaka Musha,Motohide Takashi,Noriaki Suzuki,Takashi Shinagawa,Naondo Suzuki,Toshio Ohtsuki,Masahiro Arakawa,Toshiro Nakashima +13 more
TL;DR: In this article, the incidence of portal vein thrombosis was studied in 708 consecutive patients with unequivocal cirrhosis seen in the past 10 years in which either transhepatic portography or superior mesenteric arterial portography clearly delineated the major portal vein system.
391
Portal vein thrombosis: a review.
TL;DR: A comprehensive description of etiologic factors and clinical aspects of portal vein thrombosis is presented and a framework for the diagnostic work-up and management of patients with PVT is provided.
302
Cavernous transformation of the portal vein: patterns of intrahepatic and splanchnic collateral circulation detected with Doppler sonography.
TL;DR: After thrombosis of the portal vein, portoportal venous channels may form not only at the porta hepatis but also within the liver, suggesting that, despite extensive hemodynamic adaptations, portal hypertension ensues.
Portal obstruction in children. I. Clinical investigation and hemorrhage risk
Fernando Alvarez,Olivier Bernard,Francis Brunelle,P. Hadchouel,Michel Odièvre,Daniel Alagille +5 more
TL;DR: Angiography should be limited to children with a history of gastrointestinal tract bleeding for whom a surgical portosystemic shunt is being considered, and the presence of tense varices and congestion of esophageal mucosa clearly augmented the risk of bleeding.
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