Article
Medicine, General & Internal
Ivan Yankov, Rayna Shentova-Eneva, Hristo Mumdzhiev, Penka Petleshkova, Maya Krasteva, Dimitar Chatalbashev, Penka Stefanova, Evgeniy Moshekov, Teodora Gogova
Summary: This study describes the clinical manifestations and risk factors for extrahepatic portal vein thrombosis (EHPVT) in pediatric patients. EHPVT is commonly presented with upper gastrointestinal bleeding and splenomegaly. The most common systemic risk factor is inherited prothrombotic disorder, while the most common local risk factor is umbilical vein catheterization. All participants had esophageal varices, most of which were grade >= 2. Propranolol and shunt surgery were commonly used for treatment.
MEDICAL PRINCIPLES AND PRACTICE
(2022)
Article
Medicine, General & Internal
Alina Grama, Alexandru Pirvan, Claudia Sirbe, Lucia Burac, Horia Stefanescu, Otilia Fufezan, Madalina Adriana Bordea, Tudor Lucian Pop
Summary: EHPVT in children is often associated with umbilical vein catheterization and neonatal bacterial infections, with clinical manifestations including upper gastrointestinal bleeding and splenomegaly. Treatment involves endoscopy, medication, and surgery, with a favorable outcome in the majority of cases.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Radiology, Nuclear Medicine & Medical Imaging
Huiying Wu, Ning Zhou, Lianwei Lu, Xiwen Chen, Tao Liu, Binbin Zhang, Hongsheng Liu, Zhe Wen
Summary: Among the four types of Rex recesses on CT angiography, types 1-3 allow for the performance of MRB surgery, while type 4 requires further evaluation. CT imaging was shown to have good sensitivity and diagnostic accuracy in determining the feasibility of MRB in children with EHPVO.
INSIGHTS INTO IMAGING
(2021)
Review
Gastroenterology & Hepatology
Shannon Zielsdorf, Lalita Narayanan, Sophia Kantymyr, Arianna Barbetta, Yong Kwon, Kambiz Etesami, Yuri Genyk, Juliet Emamaullee
Summary: Both MRS and PSS provide acceptable long-term patency rates for pediatric patients with EHPVO, but MRS is associated with higher post-shunt thrombosis and often requires further operative intervention. This study suggests that PSS may offer advantages for pediatric patients with EHPVO.
Article
Gastroenterology & Hepatology
Martin Brichard, Samuele Iesari, Jan Lerut, Raymond Reding, Pierre Goffette, Laurent Coubeau
Summary: Extrahepatic portal vein obstruction (EHPVO) leads to severe portal hypertension (PHT) and severely compromised quality of life. The meso-Rex bypass (MRB) procedure can restore hepatic portal flow and is considered as the last resort for adult EHPVO patients. Although successful in most cases, MRB is associated with significant morbidity and mortality.
HEPATOBILIARY & PANCREATIC DISEASES INTERNATIONAL
(2022)
Article
Medicine, General & Internal
H. S. Kiran, Rohan Karkra, V. N. Laghima, C. R. Venkatesh
Summary: This article reports a case of Extrahepatic portal vein obstruction (EHPVO) secondary to combined protein C and S deficiency and highlights the clinical presentation, diagnostic challenges, and management strategies. Early recognition and appropriate treatment can prevent life-threatening complications such as variceal bleeding and portal hypertension. This case emphasizes the importance of considering inherited thrombophilias in patients presenting with portal vein thrombosis, especially in the absence of traditional risk factors.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2023)
Article
Hematology
Yongjie Zhou, Zhiquan Zhuang, Tianzhu Yu, Wen Zhang, Jingqin Ma, Jiaze Yu, Zhiping Yan, Jianjun Luo
Summary: This study aimed to explore the effectiveness of warfarin anticoagulation treatment in cirrhotic patients with cavernous transformation of the portal vein (CTPV) and extrahepatic portal vein obstruction (EHPVO). The clinical characteristics of eligible patients were retrospectively analyzed, and they were divided into the anticoagulation group and control group. Results showed that the anticoagulation group had lower rates of portal vein progression and hepatic decompensation compared to the control group, but there was no significant improvement in thrombosis recanalization.
THROMBOSIS JOURNAL
(2023)
Article
Surgery
Alexander Y. Yang, Brianna L. Slatnick, Jonathan Durgin, Paul Truche, Heung Bae Kim, Alex G. Cuenca
Summary: This study reviewed the experience of performing fSRS procedures in children with EHPVT at a single institution. The results demonstrated significant improvement in the portosystemic gradient after fSRS, with no reported cases of variceal bleeding or shunt thrombosis.
AMERICAN JOURNAL OF SURGERY
(2022)
Article
Gastroenterology & Hepatology
Florent Artru, Naik Vietti-Violi, Christine Sempoux, Joana Vieira Barbosa, Fabio Becce, Nelly Sah, Astrid Marot, Pierre Deltenre, Eleni Moschouri, Montserrat Fraga, Arnaud Hocquelet, Rafael Duran, Darius Moradpour, Pierre-Emmanuel Rautou, Alban Denys
Summary: This retrospective study aimed to evaluate the long-term outcomes of patients with chronic non-cirrhotic extrahepatic portal vein obstruction (CNC-EHPVO) who underwent portal vein recanalisation (PVR) without transjugular intrahepatic portosystemic shunt (TIPS) insertion. The study found that PVR without TIPS was feasible and safe, and associated with improved muscle mass and decreased spleen volume in patients with technical success.
Article
Surgery
Shugo Mizuno, Hiroyuki Kato, Hiroki Yamaue, Tsutomu Fujii, Sohei Satoi, Akio Saiura, Yoshiaki Murakami, Masayuki Sho, Masakazu Yamamoto, Shuji Isaji
Summary: The study revealed that dividing the splenic vein during pancreaticoduodenectomy increases the incidence of variceal formation and bleeding, as well as causing thrombocytopenia in patients. These findings suggest the importance of careful consideration of splenic vein management during surgery.
Article
Surgery
Jitendra Mistry, Sandeep Rao, Deepali Mistry
Summary: This study focused on 20 patients with extrahepatic portal vein obstruction and portal biliopathy who underwent single-stage surgical intervention, with 3 patients being older, having atrophied left lobe of the liver, and dilated segment III duct approachable at liver surface. The combination of procedures did not increase major morbidity or mortality, but it took longer than expected to resolve jaundice.
INDIAN JOURNAL OF SURGERY
(2021)
Article
Gastroenterology & Hepatology
Juliana C. C. Barreto, Natascha S. Sandy, Gabriel Hessel, Roberta de Alcantara, Adriana Maria A. De Tommaso, Roberto M. Yamada, Maria Angela Bellomo-Brandao
Summary: This study described long-term changes in blood tests and ultrasound findings in pediatric patients with EHPVO who have not undergone MRB surgery. Results showed a significant increase in leukopenia, thrombocytopenia, and left lobe atrophy over time, with correlations found between umbilical catheterization history and various findings. The study suggests further exploration of left lobe atrophy as a marker of portal hypertension, particularly in patients with a history of umbilical catheterization.
JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION
(2021)
Editorial Material
Surgery
Jitendra Mistry, Deepali Mistry, Prashant Buch, Suresh Zinzuvadia
Summary: Portal biliopathy, commonly seen in cases of extrahepatic portal vein obstruction, can be treated with portosystemic shunt surgery and bilioenteric anastomosis. In cases where shunt surgery is not feasible, Roux-enY hepaticojejunostomy with segment 3 duct can be considered.
INDIAN JOURNAL OF SURGERY
(2022)
Article
Surgery
Xiaofen Xu, Yaopeng Zhang, Wei Zheng, Yingchun Wang, Wei Yao, Ke Li, Xiue Yan, Hong Chang, Yonghui Huang
Summary: This study compared the patency of enteral extended biliary stents with lengths of 26 cm (EEBS-26 cm) and 30 cm (EEBS-30 cm) to conventional plastic biliary stent (CPBS). The results showed that EEBS-26 cm had longer stent patency and lower stent occlusion rates compared to CPBS and EEBS-30 cm. Therefore, EEBS-26 cm is safe and effective for alleviating unresectable extrahepatic malignant biliary obstruction.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2022)
Review
Health Care Sciences & Services
Chan Hyuk Park, Se Woo Park, Jang Han Jung, Eun Suk Jung, Jung Hee Kim, Da Hae Park
Summary: The study found that both uncovered and covered self-expandable metal stents (SEMSs) had lower risk of recurrent biliary obstruction compared to plastic stents. Among patients using SEMSs, tumor ingrowth was common in the uncovered group, while stent migration, tumor overgrowth, and occlusion by sludge were common in the covered group; however, the overall risk of recurrent biliary obstruction did not differ between these groups.
JOURNAL OF PERSONALIZED MEDICINE
(2021)
Article
Gastroenterology & Hepatology
Rajesh Rajalingam, Amit Javed, Dharmanjay Sharma, Puja Sakhuja, Shivendra Singh, Hirdaya H. Nag, Anil K. Agarwal
HEPATOBILIARY & PANCREATIC DISEASES INTERNATIONAL
(2012)
Article
Surgery
Mukesh Khedar, Dharamanjai Kumar Sharma, Vijay Ola
Summary: The study identified RDW as a marker of inflammatory pathology and a predictor of postoperative complications and mortality. High RDW levels were significantly correlated with underlying inflammatory pathology, development of postoperative complications, and 30-day mortality, suggesting RDW could be a useful indicator for risk stratification and decision-making in surgical patients.
FORMOSAN JOURNAL OF SURGERY
(2021)