Introduction: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has been successfully applied to increase the future liver remnant before a right trisectionectomy. Tumor infiltration to the right portal vein is a challenge situation. Material and methods: A patient with advanced gallbladder carcinoma underwent exploration. Intraoperative finding showed tumor infiltration of the right portal vein and the duodenum. In-situ split of the left lateral liver lobe combined with postoperative right portal vein embolization completed the concept of ALPPS.. Results: Successful right trisectionectomy in combination with whipple operation without tumor residual could be achieved 8 days later, while the liver remnant increased from 491 ml to 911 ml. Neither post-hepatectomy liver failure nor postoperative anastomotic leak has been observed. 3 month follow up has not shown any sign of tumor recurrence. Conclusion: In-situ split combined with postoperative right portal vein ...
Determination of portal vein tumor thrombus blood supply using in vivo cellular magnetic resonance imaging in a rabbit model Xiuming Zhang,1 Bei Wu,1 Zhen Guo,1 Yang Gao,1 Wei Xi,1 Hui Yu,1 Guodong Feng,1 Jingyuan Zhang,2 Wenrong Shen*,1 Jun Chen11Department of Radiology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research and Cancer Hospital of Nanjing Medical University (NMU), Nanjing 210009, Peoples Republic of China; 2Department of Pathology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University (NMU), Nanjing 210009, Peoples Republic of China*These authors contributed equally to this work Objective: This study aimed to investigate the anatomic configuration of the blood vessels that contribute to portal vein tumor thrombus (PVTT), a common complication of hepatocellular carcinoma, in VX2 rabbits.Materials and methods: Peripheral blood mononuclear cells (MNCs) were isolated and labeled using superparamagnetic iron
Surgical brain injury (SBI) defines complications induced by intracranial surgery, such as cerebral edema and other secondary injuries. In our study, intrathymic and hepatic portal vein injection of allogeneic myelin basic protein (MBP) or autogeneic brain cell suspensions were administered to a standard SBI model. Serum pro-inflammatory IL-2, anti-inflammatory IL-4 concentrations and the CD4(+)T/CD8(+)T ratio were measured at 1, 3, 7, 14 and 21 d after surgery to verify the establishment of immune tolerance. Furthermore, we confirmed neuroprotective effects by evaluating neurological scores at 1, 3, 7, 14 and 21 d after SBI. Anti-Fas ligand (FasL) immunohistochemistry and TUNEL assays of brain sections were tested at 21 d after surgery. Intrathymic injections of MBP or autogeneic brain cell suspensions functioned by both suppressing secondary inflammatory reactions and improving prognoses, whereas hepatic portal vein injections of autogeneic brain cell suspensions exerted a better effect than ...
Portal vein thrombosis (PVT) is classified into acute and chronic types. Acute portal vein thrombosis presents within 60 days with symptoms like abdominal pain or distention, diarrhea, nausea, vomiting, anorexia and fever with absence of portal carvernoma and portal hypertension. Chronic PVT is mostly asymptomatic and associated with portal cavernoma and/or complications of portal hypertension. PVT is also classified into complete and partial types, and each is subclassified based on the presence or absence of portal cavernoma. Patients with complete PVT have higher frequency of cavernous transformation than those with partial PVT. The common causes of PVT include cirrhosis, neoplasm, myeloproliferative disorders, inflammatory disorders like pancreatitis and thrombophilias. PVT is a relatively common complication of liver cirrhosis. With the stoppage of the portal venous blood flow, there is a compensatory mechanism of venous rescue due to rapid development of collaterals to bypass the ...
Although transarterial chemoembolization (TACE) has been used extensively for advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT), no consensus has been reached and an evidence base for practice is lacking. This meta-analysis evaluated the efficacy and safety of TACE for treatment of HCC with PVTT. Ovid Medline, EMBASE, Web of Knowledge, and Cochrane library databases were searched up to August 2012 for controlled trials assessing TACE in patients with PVTT. Data concerning the study design, characteristics of trials, and outcomes were extracted. Hazard ratio (HR) and 95% confidence interval (CI) were calculated using random effects models. Eight controlled trials involving 1601 HCC patients were included. TACE significantly improved the 6-month (HR, 0.41; 95% CI: 0.32-0.53; z, 6.28; p = 0.000) and 1-year (HR, 0.44; 95% CI: 0.34-0.57; z, 6.22; p = 0.000) overall survival of patients with PVTT compared with conservative treatment. Subgroup analyses showed that TACE was
Portal vein thrombosis: Find the most comprehensive real-world symptom and treatment data on portal vein thrombosis at PatientsLikeMe. 34 patients with portal vein thrombosis experience fatigue, depressed mood, pain, anxious mood, and insomnia and use Ketamine, Rivaroxaban, Tramadol, and Warfarin to treat their portal vein thrombosis and its symptoms.
We report the case of a 37-year-old man with necrotizing pancreatitis associated with inflammatory extrahepatic portal vein stenosis and progressive ascites. Four months after the acute onset, when no signs of infection were present, portal decompression was performed to treat refractory ascites. Transjugulartranshepatic venoplasty failed to dilate the stenosis in the extrahepatic portion of the portal vein sufficiently. Therefore a Wallstent was implanted, resulting in almost normal diameter of the vessel. In follow-up imaging studies the stent and the portal vein were still patent 12 months after the intervention and total resolution of the ascites was observed. ...
For pediatric living donor liver transplantation, portal vein complications cause significant morbidity and graft failure. Routine intra‐operative Doppler ultrasound is performed after graft reperfusion to evaluate the flow of portal vein. This retrospective study reviewed 65 children who had undergone living donor liver transplantation. Seven patients were detected with suboptimal portal vein flow velocity following vascular reconstruction and abdominal closure. They underwent immediate on‐table interventions to improve the portal vein flow. Both surgical and endovascular modalities were employed, namely, graft re‐positioning, collateral shunt ligation, thrombectomy, revision of anastomosis, inferior mesenteric vein cannulation, and endovascular stenting. The ultrasonographic follow‐up assessment for all seven patients demonstrated patent portal vein and satisfactory flow. We reviewed our experience on the different modalities and proposed an approach for our future intra‐operative ...
Portal vein tumor thrombosis (PVTT) in hepatocellular carcinoma (HCC) is a sign of advanced stage disease, which is associated with poor prognosis. Liver resection (LR) may provide better prognosis in selected patients. In the present study, we aimed to assess information from HCC patients with PVTT who died within 3 months or 2 years after LR in order to identify preoperative factors correlated to short-term or long-term survival, by which inappropriate selection of patients for LR might be avoided in the future. A retrospective cohort study consisting of 487 consecutive cases of HCC patients with PVTT was performed from 2008 to 2010 at Eastern Hepatobiliary Surgery Hospital. Medical records, including laboratory values, imaging results and treatment information, were obtained from participants. Study endpoints were survival at 3 months and 2 years post-hepatectomy. Logistic regression analysis was utilized to determine the significant pre-operative factors influencing short-term or long-term survival.
Portal vein tumor thrombosis (PVTT) in hepatocellular carcinoma (HCC) is a sign of advanced stage disease, which is associated with poor prognosis. Liver resection (LR) may provide better prognosis in selected patients. In the present study, we aimed to assess information from HCC patients with PVTT who died within 3 months or 2 years after LR in order to identify preoperative factors correlated to short-term or long-term survival, by which inappropriate selection of patients for LR might be avoided in the future. A retrospective cohort study consisting of 487 consecutive cases of HCC patients with PVTT was performed from 2008 to 2010 at Eastern Hepatobiliary Surgery Hospital. Medical records, including laboratory values, imaging results and treatment information, were obtained from participants. Study endpoints were survival at 3 months and 2 years post-hepatectomy. Logistic regression analysis was utilized to determine the significant pre-operative factors influencing short-term or long-term survival.
Portal vein embolization (PVE) is a preoperative procedure performed in interventional radiology to initiate hypertrophy of the anticipated future liver remnant a couple weeks prior to a major liver resection procedure. The procedure involves injecting the right or left portal vein with embolic material to occlude portal blood flow. By occluding the blood flow to areas of the liver that will be resected away, the blood is diverted to healthy parts of the liver and induces hyperplasia. This may allow for a more extensive resection or stage bilateral resections that would otherwise be contraindicated resulting in better oncological treatment outcomes. Indications for PVE depend on the ratio of future liver remnant (FLR) to total estimated liver volume (TELV) and liver condition. Although there is no consensus to the absolute minimum liver volume required for adequate post-resection liver function, a FLR/TELV ratio of at least 25% in recommended in patients with otherwise normal livers. The ...
Spanier and Frederiks describe the role of diagnosing hyperhomocysteinaemia in a patient with portal vein thrombosis. Their case not only illustrates the potential importance of hyperhomocysteinaemia but also the concurrence of multiple risk factors in portal vein thrombosis.1,2 Two inherited thrombotic risk factors (methylenetetrahydrofolate and prothrombin gene G20210A mutation) predisposed the patient to a thrombotic event which became clinically manifest after the recent start of progesterone.. There is clear evidence that hyperhomocysteinaemia is an independent risk factor for cardiovascular diseases. Hyperhomocysteinaemia can be diagnosed by genetic testing for the methylenetetrahydrofolate mutation and by measurement of increased plasma homocysteine levels, both fasting and after loading with methionine. The pathophysiological mechanism of homocysteine induced vascular disease is not well understood. It is even unclear whether homocysteine itself or a related metabolite or cofactor is ...
A B ST R A CT The effect of equal (1.1±0.1 g/kg body wt) amounts of glucose administered orally, or by peripheral intravenous or intraportal infusion on hepatic glucose uptake and fractional hepatic extraction of insulin and glucagon was studied in conscious dogs with chronically implanted Doppler flow probes on the portal vein and hepatic artery and catheters in the portal vein, hepatic vein, carotid artery, and superior mesenteric vein. Portal vein and hepatic vein plasma flow increased only after oral glucose administration. Arterial plasma glucose increased equally to 150-160 mg/100 ml after all three routes of glucose administration. Portal vein glucose was similar after oral (195±15 mg/100 ml) and intraportal glucose infusion (215±11 mg/100 ml) and significantly higher than after peripheral intravenous glucose. Hepatic glucose uptake after oral (68±4%) and intraportal glucose administration (65±7%) significantly exceeded that after peripheral intravenous glucose infusion (23±5%). The amount
TY - JOUR. T1 - Improved results of liver transplantation in patients with portal vein thrombosis. AU - Seu, Philip. AU - Shackleton, Christopher R.. AU - Shaked, Abraham. AU - Imagawa, David K.. AU - Olthoff, Kim M.. AU - Rudich, Steven R.. AU - Kinkhabwala, Milan. AU - Busuttil, Ronald W.. PY - 1996/8. Y1 - 1996/8. N2 - Objective: To analyze the impact of preexisting portal vein thrombosis (PVT) on the operative management and outcome of liver transplantation. Design: Retrospective review of 1423 patients who received transplants over 11 years. Setting: Tertiary referral center. Patients or Other Participants: Seventy patients who underwent liver transplantation who had preexisting PVT. Interventions: Portal vein thromboendovenectomy, vein grafting, or use of portal collateral veins for inflow during liver transplantation. Main Outcome Measures: Postoperative PVT, intraoperative transfusion, retransplantation rate, 30-day and 1-year actuarial survival tales. Results: Operative management ...
... is caused by a blood clot blocking or narrowing the vein that takes blood from the intestines to the spleen and liver. This situation can decrease or even stop blood flow to the liver. The portal vein is very important because about 75% of the livers blood supply comes through this vein. Portal vein thrombosis can cause serious liver damage due to lack of blood flow as well as an enlarged spleen and esophageal or gastric (stomach) varices (varicose veins in the esophagus or stomach caused by valves failing due to too much pressure in the veins or portal hypertension).. Symptoms may include fever, indigestion, and worsening abdominal pain. The spleen may be enlarged, causing pain. If the esophageal or gastric varices rupture or burst open, there will be a lot of bleeding which requires emergency treatment. If the person already has scarring of the liver (cirrhosis) due to liver disease, fluid may build up in the abdomen. However, not all affected individuals have ...
Sheila, I am sorry to hear of your husbands condition. I had portal vein thrombosis following a resection for HCC, it was approximately 15cm in size. I was treated with Warafin (which is a blood thinner) to breakup the thrombosis and that worked just fine. I am a little confused as to why they cant treat the thrombosis. Do you have the information on the location of the HCC lesion and its size? I have survived 2 rounds with HCC in the last 5 years; I had hep-c (contracted during the Vietnam war) which I went through treatment for and now am undetectable, advanced stage of Cirrhosis, then HCC with 2 tumors first time treated with liver resection, then the Portal Vein Thrombosis, and then 1 tumor a 2nd time treated with a RFA procedure. I receive MRIs now every 6 months to help with early detection of another recurrence. I am 62 years of age. I would suggest seeking out a Comprehensive Cancer treatment center ( I go to the University of Michigan Hospital) and to obtain a 2nd opinion. Keep the ...
The portal vein and hepatic arteries form the livers dual blood supply. Approximately 75% of hepatic blood flow is derived from the portal vein, while the remainder is from the hepatic arteries.[2] Unlike most veins, the portal vein does not drain into the heart. Rather, it is part of a portal venous system that delivers venous blood into another capillary system, the hepatic sinusoids of the liver. In carrying venous blood from the gastrointestinal tract to the liver, the portal vein accomplishes two tasks: it supplies the liver with metabolic substrates and it ensures that substances ingested are first processed by the liver before reaching the systemic circulation. This accomplishes two things. First, possible toxins that may be ingested can be detoxified by the hepatocytes before they are released into the systemic circulation. Second, the liver is the first organ to absorb nutrients just taken in by the intestines. After draining into the liver sinusoids, blood from the liver is drained by ...
The prognosis of hepatocellular carcinoma with portal vein tumor thrombus remains extremely poor. This pilot study aimed to evaluate the technical feasibility, effectiveness and safety of transcatheter chemoembolization for tumors in the liver parenchyma plus intra-arterial ethanol embolization for portal vein tumor thrombus. A pilot study was carried out on 31 patients in the treatment group (transcatheter chemoembolization plus intra-arterial ethanol embolization) and 57 patients in the control group (transcatheter chemoembolization alone). Enhanced computed tomography/magnetic resonance images were repeated 4 weeks after the procedure to assess the response. Overall survival and complications were assessed until the patient died or was lost to follow-up. Median survival was 10.5 months in the treatment group (2.4 ± 1.7 courses) and 3.9 months in the control group (1.9 ± 1 courses) (P = 0.001). Patients in the treatment group had better overall survival (at 3, 6 and 12 months, respectively),
TY - JOUR. T1 - Portal vein ligation as an efficient method of increasing the future liver remnant volume in the surgical treatment of colorectal metastases. T2 - Invited critique. AU - Billingsley, Kevin. PY - 2008/10. Y1 - 2008/10. UR - http://www.scopus.com/inward/record.url?scp=54349094981&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=54349094981&partnerID=8YFLogxK. U2 - 10.1001/archsurg.143.10.982. DO - 10.1001/archsurg.143.10.982. M3 - Article. AN - SCOPUS:54349094981. VL - 143. SP - 982. JO - JAMA Surgery. JF - JAMA Surgery. SN - 2168-6254. IS - 10. ER - ...
Objective: Hepatocellular carcinoma with portal vein thrombosis is considered a relative contraindication for transarterial chemoembolization (TACE). The aim of our study was to evaluate the prognostic factors and management in patients with hepatocellular carcinoma with portal vein thrombosis (PVT). Methods: Between February 2011 and February 2015, 140 patients presented to our specialized multidisciplinary HCC clinic. All were assessed by imaging at regular intervals for tumor response and the data compared with baseline laboratory and imaging characteristics obtained before treatment. Results: At the end of the follow up in February 2015, 78 (55.7%) of the 140 patients had died, 33.1% in the 1st year and 20.7% in the 2nd year. The overall median survival was 10 months from the date of diagnosis. Clinical progression was noted in 45 (32.1%). Univariate analysis revealed that, the Child-Pugh score, the performance states (Eastern Cooperative Oncology Group ECOG 0-1) and the presence of ascites
Portal vein thrombosis (PVT), a blockage in the hepatic portal vein, is a serious medical condition. It can be caused by liver damage, dehydration, a clotting disorder, or one of several other related medical conditions. For most patients, treatment is very successful, and may include medication or a shunt to bypass the blockage, returning normal blood flow to the liver. Because the most common symptom is vomiting blood, it is essential to get emergency medical treatment for this condition immediately.
TY - JOUR. T1 - Sonographic diagnosis of aneurysm of the right portal vein.. AU - Fanney, D.. AU - Castillo, M.. AU - Montalvo, B.. AU - Casillas, J.. PY - 1987/10. Y1 - 1987/10. UR - http://www.scopus.com/inward/record.url?scp=0023432118&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=0023432118&partnerID=8YFLogxK. U2 - 10.7863/jum.1987.6.10.605. DO - 10.7863/jum.1987.6.10.605. M3 - Article. C2 - 3316693. AN - SCOPUS:0023432118. VL - 6. SP - 605. EP - 607. JO - Journal of Ultrasound in Medicine. JF - Journal of Ultrasound in Medicine. SN - 0278-4297. IS - 10. ER - ...
CT Abdomen with contrast. A: Computed tomography (CT) during hepatic artery phase reveals contrast in aorta and right anterior portal vein (arrow). B: Maximum intensity projection also during hepatic artery phase shows hepatic artery (arrowhead) and right portal vein branches (arrow). (Source: Gallego C, Velasco M, Marcuello P, Tejedor D, De Campo L, Friera A. Congenital and acquired anomalies of the portal venous system. RadioGraphics 2002;22:141-159, with permission from the Radiological Society ...
is taken care by these plates and plays a vital role in formation of the lobules in liver. Within each lobule a central vein pass by. The peripheral edge of each lobule comprises of a branch of hepatic portal vein and hepatic artery. This results in a wide space between each and every hepatic plate. The GI tract serves the function of absorption and the process is hosted by the portal ...
The portal venous system is located between two capillary beds: the splanchnic capillaries and the hepatic sinusoids. Sinusoids are the specialized liver capillaries and they receive blood both from the portal vein and the hepatic artery. The branches of the portal vein and hepatic artery form the portal triad along with the interlobular bile ducts in the portal tracts. The blood flows in the sinusoid from the portal tract to the central hepatic venule. The endothelial cells that line the sinusoids are fenestrated and are devoid of a basement membrane. The sinusoids therefore have a unique structure with high permeability that allows direct contact between plasma and hepatocyte surface through the space of Disse. The sinusoidal blood drains into the tributaries of the hepatic veins through the terminal hepatic venules, and subsequently into the inferior vena cava and right atrium. Portal venous system is a low pressure system. The difference between the hepatic vein and portal vein pressure is ...
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Sigma-Aldrich offers abstracts and full-text articles by [Jeong Won Lee, Sang Hyun Hwang, Do Young Kim, Kwang-Hyub Han, Mijin Yun].
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In cirrhosis, portal vein thrombosis (PVT) could be a cause or a consequence of the progression of liver disease. We analyzed data from a prospective trial of ultrasound screening for hepatocellular carcinoma in order to identify risk factors for and the impact of PVT in patients with cirrhosis. In all, 1,243 adults with cirrhosis without PVT were enrolled from 43 liver units in France and Belgium between June 2000 and March 2006. The mean follow-up was 47 months. Doppler ultrasonography was used to check the portal vein. Progression of liver disease was defined by the development of: ascites, hepatic encephalopathy, variceal bleeding, prothrombin ,45%, serum bilirubin ,45 μmol/L, albumin ,28 g/L, and/or creatinine ,115 μmol/L. G20210A prothrombin and factor V gene mutations were assessed in sera stored at three large centers. The 5-year cumulative incidence of PVT was 10.7%. PVT was mostly partial and varied over time. The development of PVT was independently associated with baseline ...
PATIENTS. Ninety-two patients underwent extended right-sided hepatic resection for hepatobiliary malignancy during a 45-month period (January 2000 to September 2003). Among them, 15 (16%) underwent portal vein embolisation via a percutaneous ipsilateral approach (n=9) or through the ileocolic vein with a mini-laparotomy (n=6). The remaining 77 (84%) patients underwent hepatic resection without portal vein embolisation ...
In 5 Japanese Black steers (2-2.4 years old) that originated from 5 different feedlots, the livers were found at slaughter to have multiple nodular or cordlike lesions (5 steers) and an extensive fibrotic area (1 steer). Microscopic changes included extensive fibroplasia in the portal tracts and chronic proliferative endophlebitis-like lesions confined to the portal vein branches. Fibroplasia was much more prominent in the macroscopic fibrotic lesion of 1 steer. Portal vein branches presented irregular variciform dilation of the vascular lumen and fibroplastic changes in the subendothelial areas that showed occasional hemorrhage and were simultaneously infiltrated with large numbers of mast cells and moderate to large numbers of eosinophils ...
オレイン酸モノエタノールアミンおよび二酸化炭素のフォームを用いた肝切除術前経皮経肝門脈塞栓術の臨床的検 ...
Video articles in JoVE about liver failure acute include Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure, Rat Model of the Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) Procedure, Development of an Ethanol-induced Fibrotic Liver Model in Zebrafish to Study Progenitor Cell-mediated Hepatocyte Regeneration, Generation of a Humanized Mouse Liver Using Human Hepatic Stem Cells, Bile Duct Ligation in Mice: Induction of Inflammatory Liver Injury and Fibrosis by Obstructive Cholestasis, The CYP2D6 Animal Model: How to Induce Autoimmune Hepatitis in Mice, Two-photon Intravital Imaging of Leukocytes During the Immune Response in Lipopolysaccharide-treated Mouse Liver, A Standardized Method for the Analysis of Liver Sinusoidal Endothelial Cells and Their Fenestrations by Scanning Electron Microscopy, Constitutive and Inducible Systems for Genetic In Vivo Modification of Mouse Hepatocytes
RADIOLOGY: VASCULAR: Case# 20: SMV & PV THROMBOSIS, BOWEL EDEMA, ITP. 54 yo female with ITP and hepatitis who presents with severe abdominal pain, nausea and vomiting. There is thrombosis of the right and left portal veins, main portal vein, splenic vein and superior mesenteric vein. Thrombus extends into a segmental branch of the SMV (seen on the last image). In the portion of bowel drained by the thrombosed SMV, the bowel wall is thickened. Diffuse strandy inflammatory changes are also apparent in the region of ileum and ascending colon indicating mesenteric congestion. SMV thrombosis can be an acute or chronic process. In acute SMV thrombosis, the SMV may become enlarged and have a high attenuation value (equal to or higher than soft tissue). Chronic SMV thrombosis is characterized by mild enlargement of the vein with central low denstiy surrounded by higher density wall. Associated findings may include increased attenuatiuon of the mesenteric fat due to mesenteric edema and bowel wall ...
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Portal vein aneurysms are extremely rare, less than 200 cases have been reported until late 2015. They are defined as a portal vein diameter exceeding 19 mm for cirrhotic patients and 15 mm in normal livers. Most patients are asymptomatic, but complications may occur.We report a case of a 68-year-old female admitted for etiological assessment of a portal hypertension revealed by an upper gastro intestinal bleeding, who was incidentally diagnosed with a portal vein aneurysm.
The clinical presentation and outcome of 15 neonates with porto-systemic (PS) shunt detected by mass screening (Paigen method) for galactosemia are reviewed. Routine screening for galactosemia initially recognized fourteen patients, but one patient was discovered by the presentation of multiple skin hemangiomas and subsequent re-screening for galactosemia. The majority of patients were excluded by enzyme assay for hereditary galactosemias and diagnosed by ultrasonography and /or angiogram as having PS shunts in the neonatal period. Galactose is effectively extracted from portal blood by liver and PS shunts result in hypergalactosemia. The neonates with PS shunts were separated into 3 types. Two patients had congenital absence of portal vein (CAPV) with PS shunt by ductus venosus Arantii. Four had extrahepatic porto-left renal venous (PRV) shunt. Nine neonates presented with intrahepatic porto-hepatic venous (PV) shunts associated with or without multiple hepatic hemangiomas. At diagnosis, ...
The clinical presentation and outcome of 15 neonates with porto-systemic (PS) shunt detected by mass screening (Paigen method) for galactosemia are reviewed. Routine screening for galactosemia initially recognized fourteen patients, but one patient was discovered by the presentation of multiple skin hemangiomas and subsequent re-screening for galactosemia. The majority of patients were excluded by enzyme assay for hereditary galactosemias and diagnosed by ultrasonography and /or angiogram as having PS shunts in the neonatal period. Galactose is effectively extracted from portal blood by liver and PS shunts result in hypergalactosemia. The neonates with PS shunts were separated into 3 types. Two patients had congenital absence of portal vein (CAPV) with PS shunt by ductus venosus Arantii. Four had extrahepatic porto-left renal venous (PRV) shunt. Nine neonates presented with intrahepatic porto-hepatic venous (PV) shunts associated with or without multiple hepatic hemangiomas. At diagnosis, ...
In vascular smooth muscles, angiotensin II (AII) has been reported to activate phospholipase C (PLC) and phosphatidylinositol 3-kinase (PI3K). We investigated the time-dependent effects of AII on both phosphatidylinositol 3,4,5-trisphosphate (PtdInsP3) and inositol phosphates (InsPs) accumulation in permeabilized microsomes from rat portal vein smooth muscle in comparison with those of noradrenaline (NA). AII stimulated an early production of PtdInsP3 (within 30 s) followed by a delayed production of InsPs (within 3-5 min), in contrast to NA which activated only a fast production of InsPs. The use of pharmacological inhibitors and antibodies raised against the PI3K and PLC isoforms expressed in portal vein smooth muscle showed that AII specifically activated PI3Kgamma and that this isoform was involved in the AII-induced stimulation of InsPs accumulation. NA-induced InsPs accumulation depended on PLCbeta1 activation whereas AII-induced InsPs accumulation depended on PLCgamma1 activation. AII-induced
Integrity of the portal vein is a condition for normal function of the reproductive tract in female rats. Section of the portal vein (PVS) always abolished periodic sexual function. In a series of 23 animals, 6 developed continuous estrus and other signs of the presence of excessive amounts of estrogenic hormones; yet the ovaries of these rats were small. In 6 other rats there was growth of the prostate and additional evidence of increased activity of androgenic hormones. Many rats failed to become pregnant and nearly all pregnant rats aborted. Except for a decrease in lipid content, the composition of the liver of PVS rats resembled that of intact mates in the criteria which were applied. The rapid passage of blood through the liver is necessary to conjugate the excessive amounts of steroids which the rat ovary normally produces and an intact portal vein is an essential unit in the mechanism necessary for their partial inactivation. ...
The thrombosis of the portal vein represents an important milestone in the natural history of patients with cirrhosis, often increasing morbidity before and mortality after liver transplantation. Obtainment of recanalization through anticoagulation is therefore paramount, and in the present study, an analysis was performed regarding factors that may have an impact on efficacy of anticoagulation with low molecular weight heparin in cirrhotic patients with this complication. Anticoagulation with low molecular weight heparin was demonstrated to be a valid strategy for achieving portal vein recanalization, with a response rate of 65.2%, including complete recanalization in 24 of the 46 treated patients, after a mean of 4.5 months (±3.1 months) of anticoagulation. Whereas the hemostatic status of patients did not correlate with the response to anticoagulation, the interval between thrombus onset and start of therapy was the only predictive factor of therapeutic efficacy. Specifically, thrombus age ...
cavernous transformation. A network of collateral vessels may form around a thrombosed main portal vein at the porta, especially if the thrombosis is due to extrahepatic causes (for example pancreatitis) rather than diseased liver. The appearance of cavernous transformation of the PV is quite striking (Fig. A 1) and colour Doppler is particularly useful in its diagnosis. Make sure, before diagnosing PV thrombosis, that the vein axis is less than 60° to the transducer and that the Doppler sensitivity is set to pick up lowvelocity flow. Ultrasound is known to have a falsepositive rate for PV thrombosis but this is often due to inadequate technique or insensitive equipment. False-negative results, indicating that flow is present in a vein which is actually thrombosed, are due to the detection of flow within a collateral vessel at the porta, which can be mistaken for the main ...
Visceral vessel processes are primarily or secondarily included in a multitude of clinical abdominal symptoms, with which the specialist in internal medicine is confronted. The spectrum ranges from more sharply outlined manifestations, such as chronic ischemic bowel disease up to dysfunctional disturbances of blood pressure regulation, such as high-grade renal artery stenosis. Sometimes diseases with prognostic implications, such as arterial aneurysms, are revealed as incidental findings. As a rule the B‑mode and duplex ultrasound can often be complemented by computed tomography (CT) and magnetic resonance imaging (MRI), as in aneurysms or portal vein thrombosis or the indications for subsequent digital subtraction angiography (DSA) and catheter-based therapy can be directly obtained from duplex and Doppler ultrasound ...
The volume flow rate of blood in the portal vein was measured using a duplex ultrasound system. The many errors inherent in the duplex method were assessed with particular reference to the portal vein and appropriate correction factors were obtained by in vitro calibration. The effect of posture on flow was investigated by examining 45 healthy volunteers in three different positions; standing, supine and tilted head down at 20 degrees from the horizontal. The mean volume blood flow in the supine position was 864 (188)ml/min (mean 1SD). When standing, the mean volume blood flow was significantly reduced by 26% to 662 (169)ml/min. There was, however, no significant difference between flow when supine and when tilted head down at 20 degrees from the horizontal.. ...
Outcomes of patients with portal vein thrombosis undergoing live donor liver transplantation.: Patients with PVT who underwent LDLT had a worse prognosis than t
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Portal Absorption of Feed Oligo-peptides in Chickens - Chickens;Oligo-peptide;Intestinal Absorption;Duodenal Infusion;Portal Amino Acid;
TY - JOUR. T1 - Current concepts in portal vein thrombosis. T2 - etiology, clinical presentation and management. AU - Alzubaidi, Sadeer. AU - Patel, Indravadan. AU - Saini, Aman. AU - Knuttinen, Grace. AU - Naidu, Sailendra. AU - Kriegshuaser, Scott. AU - Albadawi, Hassan. AU - Oklu, Rahmi. PY - 2019/1/1. Y1 - 2019/1/1. N2 - Objective: The aim of this article is to focus on etiology, risk factors, clinical presentation and classification systems of acute and chronic PVT as well as focusing on current diagnostic and therapeutic options for the management of acute and chronic PVT. Results: PVT represents a serious clinical concern in cirrhotic patients and in those with specific local or systemic risk factors. The rate and extent of thrombus formation can significantly impact patient presentation and the resulting clinical outcomes. The presentation of acute PVT can range from abdominal pain to intestinal ischemia/infarction and even death, while chronic PVT can remain clinically silent. A number ...
Portal vein thrombosis (PVT) is a blood clot that causes irregular blood flow to the liver. Learn about the symptoms and treatment of this condition.
... - ABC Homeopathy Forum. Natrum Sulphuricum, Salamander are mentioned. 7 replies to 2010-05-09.