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Splenic VeinArteriovenous FistulaPortal VeinArteriovenous Shunt, SurgicalFistulaCentral Nervous System Vascular MalformationsHypertension, PortalVeinsPortal SystemMesenteric VeinsHypertensionEsophageal and Gastric VaricesSplenic ArteryIntestinal FistulaDura MaterEmbolization, TherapeuticCranial SinusesCutaneous FistulaBronchial FistulaSplenic DiseasesVascular FistulaCerebral VeinsHypertension, PulmonaryBrachiocephalic VeinsRenal DialysisRectal FistulaHypersplenismGastric FistulaUrinary FistulaCavernous SinusEsophageal FistulaFemoral VeinRenal VeinsBiliary FistulaJugular VeinsVascular PatencyGastrointestinal HemorrhageAngiographyIliac VeinSaphenous VeinTomography, X-Ray ComputedPancreatic FistulaVenous ThrombosisRectovaginal FistulaSplenectomyPolyvinylsTreatment OutcomePortasystemic Shunt, SurgicalVesicovaginal FistulaRespiratory Tract FistulaMeningeal ArteriesCerebral AngiographyVaginal FistulaSplenic RuptureSplenorenal Shunt, SurgicalCatheters, IndwellingCranial Fossa, AnteriorTracheoesophageal FistulaConstriction, PathologicPulmonary VeinsPortal PressureCarotid-Cavernous Sinus FistulaArteriovenous MalformationsWounds, StabIntracranial Arteriovenous MalformationsSplenomegalySplenic NeoplasmsHypertension, RenalBlood PressureRadial ArteryVaricose VeinsAxillary VeinUrinary Bladder FistulaPancreatectomyUpper ExtremityRetrospective StudiesSubclavian VeinGraft Occlusion, VascularArterio-Arterial FistulaSuperior Sagittal SinusKidney Failure, ChronicVenous PressurePolytetrafluoroethyleneLiver CirrhosisMagnetic Resonance AngiographyAntihypertensive AgentsHypertension, RenovascularPhlebographyPulmonary ArteryBlood Vessel ProsthesisVascular DiseasesWounds, GunshotAneurysmTransverse SinusesVena Cava, InferiorFemoral ArteryPopliteal VeinVertebral ArteryTime FactorsSpinal Cord Diseases

DEEP VEIN THROMArterio-venous fistulaeThrombosisGreater than 5 mmHgDistalArteryCirrhosisInferiorThrombusEsophageal varicesAscitesTortuousArterialLiverARTERIESSplenectomyComplicationsCongenitalCaput medusaeSuperficialVascularDrainsEndoscopySurgeryVenous phaseDrainCollateralBlood flowAbdominalGradientSuperiorImagingLeftInjuryIncrease portal

DEEP VEIN THROM2

• A condition caused by one or more episodes of DEEP VEIN THROMBOSIS, usually the blood clots are lodged in the legs. (lookformedical.com)
• The most common presentation of venous thrombosis is deep vein thrombosis of the lower extremity with or without pulmonary embolism. (medlink.com)

Arterio-venous fistulae1

• Therapeutic phlebotomy may be indicated for hemochromatosis, polycythemia vera, porphyria cutanea tarda, and polycythemia secondary to arterio-venous fistulae, cyanotic congenital heart disease or cor pulmonale. (aetna.com)

Thrombosis5

• Other causes include: Prehepatic causes Portal vein thrombosis Splenic vein thrombosis Arteriovenous fistula (increased portal blood flow) Splenomegaly and/or hypersplenism (increased portal blood flow) Hepatic causes Cirrhosis of any cause. (wikipedia.org)
• C-4: Splenic vein thrombosis of the same patient is marked by arrows. (medscape.com)
• If a patient with venous thrombosis has a right-to-left shunt such as a patent foramen ovale or pulmonary arteriovenous malformation, an embolus may dislodge from the thrombus and pass through this shunt to cause an arterial ischemic stroke, termed a "paradoxical embolus. (medlink.com)
• Splenic vein thrombosis is a rare condition which causes esophageal varices without a raised portal pressure. (en-academic.com)
• Splenectomy can cure the variceal bleeding due to splenic vein thrombosis. (en-academic.com)

Greater than 5 mmHg2

• Portal hypertension is defined as a hepatic venous pressure gradient greater than 5 mmHg. (wikipedia.org)
• [ 2 ] A gradient greater than 5 mmHg is considered portal hypertension . (en-academic.com)

Distal5

• This 52-year-old man presented with pain in the left upper quadrant and was found to have a 3.2-cm aneurysm of the distal splenic artery. (medscape.com)
• Two widely used embolization approaches are proximal and distal splenic artery embolization. (springeropen.com)
• In this article we review relevant literature on splenic embolization indication, and technique, comparing and contrasting proximal and distal embolization. (springeropen.com)
• Distal splenic artery embolization is preferred in cases of focal vascular injury (e.g. vessel truncation, pseudoaneurysm, focal extravasation) (Bessoud and Denys 2004 ). (springeropen.com)
• Distal embolization is often precluded given the predominantly multifocal injury pattern of blunt splenic injury (Scatliff et al. (springeropen.com)

Artery12

• Compression of the left common ILIAC VEIN by the right common ILIAC ARTERY against the underlying fifth LUMBAR VERTEBRA is the typical underlying malformation. (lookformedical.com)
• The clinical manifestations reflect the arteries involved and most commonly include hypertension caused by renal-artery stenosis (RAS) or strokes from carotid artery disease. (medscape.com)
• Histology of the resected splenic artery revealed intimal fibroplasia. (medscape.com)
• In this case, the lesions involve the main right renal artery and the right accessory renal artery in a 37-year-old man with difficult-to-control hypertension. (medscape.com)
• those stable patients with moderate to severe splenic injuries (grade III-V) benefit from endovascular splenic artery embolization. (springeropen.com)
• Proximal splenic artery embolization decreases the perfusion pressure in the spleen but allows for viability of the spleen to be maintained via collateral pathways. (springeropen.com)
• Finally, we review potential complications of splenic artery embolization. (springeropen.com)
• when splenic preservation is done without adjunctive splenic artery embolization, failure (defined as the need for subsequent splenectomy) is seen in approximately 40% of high grade injuries compared to 2% when embolization has been performed (Banerjee et al. (springeropen.com)
• Endovascular splenic artery embolization can be performed distally or proximally depending on the injury pattern. (springeropen.com)
• 1975 ). In cases of multifocal injury or when no focal angiographic abnormality is identified, but CT has demonstrated injury, proximal splenic artery embolization (PSAE) is performed (Imbrogno and Ray 2012 ). (springeropen.com)
• 2009 ). PSAE may also be performed outside the setting of trauma such as in cases of splenic artery aneurysm/pseudoaneurysm and in post liver transplant splenic artery steal syndrome (Loffroy et al. (springeropen.com)
• Conventional flush aortogram in a 47-year-old woman with difficult-to-control hypertension shows the characteristic string-of-beads sign of the right renal artery due to medial fibroplasia. (medscape.com)

Cirrhosis4

• The most common cause of portal hypertension is cirrhosis. (medscape.com)
• It is usually caused by an increase in resistance in the portal-hepatic vascular bed due to obstruction to flow, which in the vast majority of patients is related to cirrhosis. (gastrotraining.com)
• However, a variety of disorders can cause portal hypertension in the absence of cirrhosis, a condition referred to as "noncirrhotic portal hypertension. (gastrotraining.com)
• In situations where portal pressures increase, such as with cirrhosis , there is dilation of veins in the anastomosis , leading to esophageal varices. (en-academic.com)

Inferior2

• A vein on either side of the body which is formed by the union of the external and internal iliac veins and passes upward to join with its fellow of the opposite side to form the inferior vena cava. (lookformedical.com)
• Normal portal pressure is approximately 9 mmHg compared to an inferior vena cava pressure of 2-6 mmHg. (en-academic.com)

Thrombus2

• Transjugular portography demonstrates extensive portal vein thrombus in the whole-liver allograft of a 40-year-old woman whose clinical condition rapidly deteriorated on postoperative day 39. (medscape.com)
• The formation or presence of a blood clot (THROMBUS) within a vein. (lookformedical.com)

Esophageal varices3

• The image below depicts esophageal varices, which are responsible for the main complication of portal hypertension, massive upper gastrointestinal (GI) hemorrhage. (medscape.com)
• In medicine ( gastroenterology ), esophageal varices (or oesophageal varices ) are extremely dilated sub-mucosal veins in the lower esophagus . (en-academic.com)
• These veins have no part in the development of esophageal varices. (en-academic.com)

Ascites2

• citation needed] Signs and symptoms of portal hypertension include: Ascites (free fluid in the peritoneal cavity), Abdominal pain or tenderness (when bacteria infect the ascites, as in spontaneous bacterial peritonitis). (wikipedia.org)
• Volume resuscitation can also worsen ascites and increase portal pressure. (en-academic.com)

Tortuous1

• Enlarged and tortuous VEINS. (lookformedical.com)

Arterial1

• PSAE works by decreasing the systolic arterial pressure in the spleen, promoting hemostasis and healing within the splenic parenchyma. (springeropen.com)

Liver4

• Portal hypertension is abnormally increased portal venous pressure - blood pressure in the portal vein and its branches, that drain from most of the intestine to the liver. (wikipedia.org)
• The causes for portal hypertension are classified as originating in the portal venous system before it reaches the liver (prehepatic causes), within the liver (intrahepatic) or between the liver and the heart (post-hepatic). (wikipedia.org)
• When the portal circulation is obstructed, whether it is within or outside the liver, a remarkable collateral circulation develops to carry portal blood into the systemic circulation veins. (gastrotraining.com)
• At gradients greater than 10 mmHg, blood flow though the hepatic portal system is redirected from the liver into areas with lower venous pressures. (en-academic.com)

ARTERIES1

• Neoplasms located in the vasculature system, such as ARTERIES and VEINS. (lookformedical.com)

Splenectomy1

• Therefore, in the setting of splenic trauma, splenectomy is avoided when possible. (springeropen.com)

Complications1

• When it becomes severe enough to cause symptoms or complications, treatment may be given to decrease portal hypertension itself or to manage its complications. (wikipedia.org)

Congenital1

• A congenital disorder that is characterized by a triad of capillary malformations (HEMANGIOMA), venous malformations (ARTERIOVENOUS FISTULA), and soft tissue or bony hypertrophy of the limb. (lookformedical.com)

Caput medusae1

• Increased spleen size (splenomegaly), which may lead to lower platelet counts (thrombocytopenia) Anorectal varices Swollen veins on the anterior abdominal wall (sometimes referred to as caput medusae) In addition, a widened (dilated) portal vein as seen on a CT scan or MRI may raise the suspicion about portal hypertension. (wikipedia.org)

Superficial3

• Skin breakdown or ulceration caused by VARICOSE VEINS in which there is too much hydrostatic pressure in the superficial venous system of the leg. (lookformedical.com)
• The remaining blood from the esophagus is drained into the superficial veins lining the esophageal mucosa, which drain into the coronary vein ( left gastric vein ), which in turn drains directly into the portal vein . (en-academic.com)
• These superficial veins (normally only approximately 1mm in diameter) become distended up to 1-2 cm in diameter in association with portal hypertension. (en-academic.com)

Vascular1

• A compression of ILIAC VEIN that results in a decreased flow in the vein and in the left LOWER EXTREMITY due to a vascular malformation. (lookformedical.com)

Drains2

• The vein which drains the foot and leg. (lookformedical.com)
• The majority of blood from the esophagus is drained via the esophageal veins , which carry deoxygenated blood from the esophagus to the azygos vein , which in turn drains directly into the superior vena cava . (en-academic.com)

Endoscopy1

• In cases of refractory bleeding, balloon tamponade with Sengstaken-Blakemore tube may be necessary, usually as a bridge to further endoscopy or treatment of the underlying cause of bleeding (usually portal hypertension). (en-academic.com)

Surgery1

• American Association for the Surgery of Trauma (AAST) splenic laceration grade is based on CT angiography findings (Moore et al. (springeropen.com)

Venous phase2

• The abdomen is typically scanned in a portal venous phase (Dreizin and Munera 2012 ). (springeropen.com)
• On CT, it appears as a well-defined or ill-defined mass showing heterogenous enhancement usually in the portal venous phase and it may infiltrate the adjacent organs. (sajr.org.za)

Drain1

• Veins in the neck which drain the brain, face, and neck into the brachiocephalic or subclavian veins. (lookformedical.com)

Collateral1

• Collaterals usually imply PH although occasionally if the collateral circulation is very extensive portal pressure may fall. (gastrotraining.com)

Blood flow2

• Increased endogenous vasodilators in turn promote more blood flow in the portal veins. (wikipedia.org)
• Venous hypertension leads to increased pressure in the capillary bed, transudation of fluid and proteins into the interstitial space, altering blood flow and supply of nutrients to the skin and subcutaneous tissues, and eventual ulceration. (lookformedical.com)

Abdominal1

• Normal uncorrected portal pressure is 5-10mm Hg and is influenced by the intra-abdominal pressure and central venous filling pressure. (gastrotraining.com)

Gradient1

• If the portal pressure rises above 12 mmHg, this gradient rises to 7-10 mmHg. (en-academic.com)

Superior1

• A short thick vein formed by union of the superior mesenteric vein and the splenic vein. (lookformedical.com)

Imaging1

• Ultrasonography (US) is the first-line imaging technique for the diagnosis and follow-up of portal hypertension because it is non-invasive, low-cost and can be performed on-site. (wikipedia.org)

Left1

• The veins that return the oxygenated blood from the lungs to the left atrium of the heart. (lookformedical.com)

Injury1

• Splenorrhaphy can be used for splenic preservation involves suturing splenic defects and/or applying hemostatic agents to the areas of splenic injury. (springeropen.com)

Increase portal1

• Nitric oxide inhibition has been shown in some studies to increase portal hypertension and hepatic response to norepinephrine. (wikipedia.org)