Splenic thrombosis

Guo-Qing Ouyang, Yong-Bin Li, Yun-Qiang Cai, He Cai, Bing Peng
Objective: To present our institutional experience in laparoscopic spleen-preserving distal pancreatectomy (Lap-SPDP) using Kimura technique with or without early occlusion of the root of the splenic artery. In addition, to explore the safety and feasibility of this occlusion technique, especially its advantages in intraoperative hemorrhage control and spleen preservation. Methods: From February 2011 to May 2019, 54 consecutive patients who were diagnosed as benign or low-grade malignant space-occupying lesions at the body and the tail of pancreas underwent Lap-SPDP using Kimura technique in our institution...
March 2020: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
Dimitrios Schizas, Ioannis Katsaros, Elli Karatza, Stylianos Kykalos, Eleftherios Spartalis, Gerasimos Tsourouflis, Dimitrios Dimitroulis, Nikolaos Nikiteas
Background: Concomitant laparoscopic splenectomy and cholecystectomy (CLSC) is performed for concurrent pathologies of the spleen and gallbladder. This systematic review aimed to evaluate the available evidence on its indications, operative technique, and outcomes. Materials and Methods: The PubMed and Cochrane bibliographical databases were searched from the beginning of time (last search: December 6, 2019) for studies reporting on CLSC. The National Heart, Lung, and Blood Institute (NHLBI) quality assessment tool was utilized for the evaluation of eligible articles...
March 23, 2020: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Mehdi Faraji, Taylor S Harmon, Arya N Bagherpour, Lynsey M Maciolek
Due to lower clinical significance, the management of Dieulafoy and Dieulafoy-like lesions is less commonly reported than the management of their impending venous equivalent, variceal bleeding. Though Dieulafoy and Dieulafoy-like lesions are often benign, they can become life-threatening in certain clinical scenarios, especially with substantial changes in hemodynamic blood flow, which results in hemorrhage. Post-procedural hemodynamic blood flow should be carefully monitored in patients who receive procedures that drastically alter hemodynamic flow pressures...
January 21, 2020: Curēus
Lei Zhang, Zhan-Guo Zhang, Xin Long, Fei-Long Liu, Wan-Guang Zhang
Background: Splenomegaly/hypersplenism is one of the most common complications of portal hypertension. Splenic artery embolization (SAE) has been increasingly used for treatment of splenomegaly/hypersplenism. However, few studies focused on the severe complications after embolization. In this paper, we reported 16 cases of severe complications after SAE for portal hypertension. Methods: From February 2011 to January 2019, 16 cirrhotic patients were diagnosed with severe complications after embolization...
2020: Risk Management and Healthcare Policy
Parmeshwar Ramesh Junare, Suhas Udgirkar, Sujit Nair, Prasanta Debnath, Shubham Jain, Ammar Modi, Pravin Rathi, Siddhesh Rane, Qais Contractor
Background: Splanchnic venous system thrombosis is a well recognized local vascular complication of acute pancreatitis (AP). It may involve thrombosis of splenic vein (SplV), portal vein (PV) and superior mesenteric vein (SMV), either separately or in combinations, and often detected incidentally, indeed some cases present with upper gastrointestinal bleed, bowel ischemia and hepatic decompensation. Incidence is variable depending on study subjects and diagnostic modalities. Pathogenesis is multifactorial centered on local and systemic inflammation...
February 2020: Gastroenterology Research
Francesco Colombo, Pierluigi D'Amore, Michele Crespi, Gianluca Sampietro, Diego Foschi
Background: Wandering spleen (WS) is a rare clinical entity resulting from the absence or maldevelopment of the ligaments normally involved in the attachment of the spleen in its normal position. WS can be a cause of acute abdomen leading to different complications ranging from torsion of the vascular pedicle to spleen infarction. Often, in absence of symptoms, it is an occasional finding during radiological exams and surgery represents the gold standard in the management of this unusual condition...
February 2020: Annals of Medicine and Surgery
Hiroaki Hiraiwa, Takahiro Okumura, Akinori Sawamura, Toru Kondo, Shingo Kazama, Yuki Kimura, Naoki Shibata, Yoshihito Arao, Hideo Oishi, Hiroo Kato, Tasuku Kuwayama, Shogo Yamaguchi, Kenji Furusawa, Ryota Morimoto, Toyoaki Murohara
The spleen has been recognized as an important organ that holds a reserve of 20% to 30% of the total blood volume. Spleen contraction and splenic volume reduction occur in patients with hypovolemic shock. However, the change in the spleen volume and the association between spleen size and hemodynamic parameters remain unclear in patients with advanced heart failure (HF) who need left ventricular assist device (LVAD) support. This study was performed to investigate the change in spleen size and the relationship between spleen size and hemodynamic parameters before and after LVAD implantation in patients with advanced HF...
February 3, 2020: Artificial Organs
Shahana Gupta, Biju Pottakkat, Surendra Kumar Verma, Raja Kalayarasan, Sandip Chandrasekar A, Ajith Ananthakrishna Pillai
BACKGROUND: Portal hypertension (PH) is associated with changes in vascular structure and function of the portosplenomesenteric system (PSMS). This is referred to as portal hypertensive vasculopathy. Pathological abnormalities of PSMS has been described in the literature for cirrhotic patients. Raised portal pressure and hyperdynamic circulation are thought to be the underlying cause of this vasculopathy. In view of this, it is expected that pathological changes in splenic and portal vein similar to those reported in cirrhotic patients with PH may also be present in patients with non-cirrhotic PH (NCPH)...
January 27, 2020: World Journal of Gastrointestinal Surgery
Lei Zhang, Zheng Chen, Xingqiang Lai, Junjie Ma, Jiali Fang, Yuhe Guo, Guanghui Li, Lu Xu, Wei Yin, Yunyi Xiong, Luhao Liu, Rongxin Chen, Li Li
Background: To preliminarily explore the clinical effect of the homolateral simultaneous pancreas and kidney (SPK) transplantation in China. Methods: SPK using the surgical technique was performed in 88 patients from September 2016 to July 2019 in the Department of Transplantation of the Second Affiliated Hospital of Guangzhou Medical University. Patients were followed up for 2 to 36 months to summarize the efficacy and complications. Results: Up to now, 83 patients have achieved good clinical efficacy with no major surgical complications, but 3 patients died of severe infection and 2 have graft loss...
November 2019: Annals of Translational Medicine
Muhammad Hamza, Huma Sabir Khan, Amna Arshad, Muhammad Ahmed, Muhammad Hanif
An arterial thrombus affecting the descending aorta, celiac artery, and superior mesenteric artery at the same time, resulting in mesenteric ischemia and splenic infarction, is a very rare phenomenon. We report a case of a 35-year-old, unmarried female, gravida 0 para 0, who presented with abdominal pain, vomiting, and constipation for two days. Computed tomography (CT) scan showed thrombi in the descending aorta to the celiac axis and superior mesenteric artery with splenic infarction, bowel ischemia, hepatic portal venous air, and uterine fibroid...
November 14, 2019: Curēus
Antonio J Martín-Jiménez, Oliva Mera-Gallardo, Daniel García-Gil
-An 83-year-old woman with a history of hypertension, diabetes and paroxysmal atrial fibrillation anticoagulated with acenocoumarol was brought to the emergency department due to dyspnoea. At admission, the patient reported a 1-week history of malaise, shortness of breath and non-productive cough. She denied fever but reported pain on the left flank. On examination, auscultation showed arrhythmic tones and crackles in the left lower lung field. Laboratory findings showed leucocytosis of 15.32×103 /μL, and the C reactive protein was 177 mg/L...
January 2020: Emergency Medicine Journal: EMJ
Whitney E Phipps, Armelle M de Laforcade, Bruce A Barton, John Berg
OBJECTIVE: To determine the frequency and severity of thrombocytosis and thromboelastographic evidence of hypercoagulability during the first 2 weeks after splenectomy in dogs with splenic masses and to investigate relationships between platelet counts and thromboelastography values. ANIMALS: 34 dogs undergoing splenectomy for splenic masses. PROCEDURES: Blood samples for platelet counts and thromboelastography were obtained at induction of anesthesia (day 0) prior to splenectomy and on days 2, 7, and 14...
January 1, 2020: Journal of the American Veterinary Medical Association
Harish Patel, Peter Bhandari, Kishore Kumar, Jasbir Makker, Chaitanya Chandrala
Essential thrombocytosis is associated with gastrointestinal (GI) vascular thrombosis. Sinistral portal hypertension (left-sided portal hypertension) due to splenic vein thrombosis can lead to isolated gastric varices and should be suspected in a patient with obscure GI bleeding with normal liver function. This case reviews the challenges presented in diagnosing isolated gastric varices due to splenic vein thrombosis through radiologic or endoscopic studies. Unrevealing radiologic or endoscopic studies does not rule out splenic vein thrombosis, which should be suspected in a patient with essential thrombocytosis and obscure GI bleeding...
November 4, 2019: Curēus
H X You, J L Zhao, Q Wang, X P Tian, M T Li, X F Zeng
Objective: Portal vein thrombosis (PVT) is a rare and severe clinical manifestation of antiphospholipid syndrome (APS), as well as a predictor of poor prognosis. This study was conducted to explore the clinical features and risk factors of PVT in APS patients. Methods: A total of 123 APS patients diagnosed from 2012 to 2019 were retrospectively enrolled. The diagnosis of PVT was made according to the 2009 American College of Liver Diseases (AASLD) criteria. Clinical and laboratory data were collected. A multivariate (MV) logistic regression model was constructed using a stepwise forward selection procedure among those candidate univariables with P values<0...
December 1, 2019: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Vassilis G Giannakoulis, Vasiliki Ntella, Andreas Kiriakopoulos, Maria Kostrova, Evangelos Menenakos
Superior mesenteric venous thrombosis (SMVT) following laparoscopic sleeve gastrectomy (LSG) is a rare, potentially life-threatening complication, which presents either isolated, or as a part of portal/mesenteric/splenic vein thrombosis. Distinction between them possibly confers an important clinical and prognostic value. Antithrombin III (ATIII) deficiency causes an hypercoagulable state which predisposes to SMVT. We report the clinical presentation and treatment of two patients among 1211 LSGs (incidence = 0...
November 2019: Journal of Surgical Case Reports
A Pachet, C Dumestre-Perard, M Moine, R Marlu, A Rubio, C Bost-Bru
We report the first paediatric case of splenic infarction following acute Mycoplasma pneumoniae infection with induction of anti-prothrombin (aPT) antibodies. A 12-year-old boy was admitted to the paediatric emergency department for a left pleuropneumonia and a splenic infarction. aPT antibodies were transitorily detected. The patient recovered fully after antibiotic therapy and a 3-month course of anticoagulation treatment. Antiphospholipid (aPL) antibodies induced by acute infections have already been reported but cases of clinically relevant thrombosis remain rare...
November 15, 2019: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Sławomir Kozieł, Katarzyna Pawlak, Łukasz Błaszczyk, Mateusz Jagielski, Anna Wiechowska-Kozłowska
BACKGROUND AND AIMS: Gastric varices (GVs) occur in 20% of patients with portal hypertension. GVs are associated with a 65% risk of bleeding over the course of 2 years and have a mortality rate of up to 20%. The standard treatment for GVs is obliteration with cyanoacrylate (CYA). This study presents our experience with combined therapy (vascular coils and CYA) under endoscopic ultrasound (EUS) guidance. METHODS: 16 patients (9 male and 7 female) were included into our study...
October 25, 2019: Journal of Clinical Medicine
Joe L Pantoja, Kevin Chang, Peter A Pellionisz, Karen Woo, Steven M Farley
BACKGROUND: Venous resection during pancreaticoduodenectomy for the excision of pancreatic cancer allows for a more complete resection with negative margins, which increases survival. When the resected vein is greater than 3cm, reconstruction with an interposition graft is recommended. However, consensus regarding the optimal venous conduit has not been reached. The objective of this study is to compare outcomes between the paneled saphenous vein graft (SVG) and internal jugular vein graft (IJVG) in portomesenteric venous reconstructions after pancreaticoduodenectomy...
November 8, 2019: Annals of Vascular Surgery
Emanuele Valeriani, Nicoletta Riva, Marcello Di Nisio, Walter Ageno
Splanchnic vein thrombosis (SVT) including portal, mesenteric, splenic vein thrombosis and the Budd-Chiari syndrome, is a manifestation of unusual site venous thromboembolism. SVT presents with a lower incidence than deep vein thrombosis of the lower limbs and pulmonary embolism, with portal vein thrombosis and Budd-Chiari syndrome being respectively the most and the least common presentations of SVT. SVT is classified as provoked if secondary to a local or systemic risk factor, or unprovoked if the causative trigger cannot be identified...
2019: Vascular Health and Risk Management
Jiacheng Liu, Chen Zhou, Qin Shi, Jinqiang Ma, Tianhe Ye, Chuansheng Zheng, Gansheng Feng, Bin Xiong
OBJECTIVES: To explore the candidates, efficacy and safety of interventional therapies in the treatment of portal vein occlusion (PVO). METHODS: In our study, 13 patients diagnosed with PVO were included. Of all 13 patients, two received percutaneous portal vein recanalization (PVR), 10 received PVR and transjugular intrahepatic portosystemic shunt (PVR-TIPS), and one underwent intrahepatic portal branch-large collateral vessel shunt. RESULTS: Interventional approaches were completed in all patients, and the technical success rate was 100%...
October 24, 2019: European Journal of Gastroenterology & Hepatology
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