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Sample records for mesenteric veins

  1. Mesenteric vein thrombosis: CT identification

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    Rosen, A.; Korobkin, M.; Silverman, P.M.; Dunnick, N.R.; Kelvin, F.M.

    1984-07-01

    Superior mesenteric vein thrombosis was identified on computed tomographic scans in six patients. In each case, contrast-enhanced scans showed a high-density superior mesenteric vein wall surrounding a central filling defect. Four fo the six patients had isolated superior mesenteric vein thrombosis. A fifth patient had associated portal vein and splenic vein thrombosis, and the sixth patient had associated portal vein and inferior vena cava thrombosis. One of the six patients had acute ischemic bowel disease. The other five patients did not have acute ischemic bowel symptoms associated with their venous occlusion. This study defines the computed tomographic appearance of mesenteric vein thrombosis.

  2. Mesenteric vein thrombosis: CT identification

    International Nuclear Information System (INIS)

    Rosen, A.; Korobkin, M.; Silverman, P.M.; Dunnick, N.R.; Kelvin, F.M.

    1984-01-01

    Superior mesenteric vein thrombosis was identified on computed tomographic scans in six patients. In each case, contrast-enhanced scans showed a high-density superior mesenteric vein wall surrounding a central filling defect. Four fo the six patients had isolated superior mesenteric vein thrombosis. A fifth patient had associated portal vein and splenic vein thrombosis, and the sixth patient had associated portal vein and inferior vena cava thrombosis. One of the six patients had acute ischemic bowel disease. The other five patients did not have acute ischemic bowel symptoms associated with their venous occlusion. This study defines the computed tomographic appearance of mesenteric vein thrombosis

  3. Isolated inferior mesenteric portal hypertension with giant inferior mesenteric vein and anomalous inferior mesenteric vein insertion

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    G Raghavendra Prasad

    2013-01-01

    Full Text Available Extrahepatic portal hypertension is not an uncommon disease in childhood, but isolated inferior mesenteric portal varices and lower gastrointestinal (GI bleed have not been reported till date. A 4-year-old girl presented with lower GI bleed. Surgical exploration revealed extrahepatic portal vein obstruction with giant inferior mesenteric vein and colonic varices. Inferior mesenteric vein was joining the superior mesenteric vein. The child was treated successfully with inferior mesenteric - inferior vena caval anastomosis. The child was relieved of GI bleed during the follow-up.

  4. Mesenteric vein thrombosis following laparoscopic appendectomy

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    Jamie Harris; Brian Blackwood; Srikumar Pillai; Bill Chiu

    2014-01-01

    Mesenteric vein thrombosis is an uncommon complication following laparoscopic surgery. A review of the literature has shown that there is a higher incidence of thrombosis following laparoscopic bariatric procedures, including the gastric sleeve procedure and roux-en-y gastric bypass surgery. Additionally, pylephlebitis, thrombosis of portal or mesenteric veins, has been described following perforated appendicitis. However no report has described mesenteric vein thrombosis following laparoscop...

  5. Mesenteric vein thrombosis following laparoscopic appendectomy

    Directory of Open Access Journals (Sweden)

    Jamie Harris

    2014-11-01

    Full Text Available Mesenteric vein thrombosis is an uncommon complication following laparoscopic surgery. A review of the literature has shown that there is a higher incidence of thrombosis following laparoscopic bariatric procedures, including the gastric sleeve procedure and roux-en-y gastric bypass surgery. Additionally, pylephlebitis, thrombosis of portal or mesenteric veins, has been described following perforated appendicitis. However no report has described mesenteric vein thrombosis following laparoscopy for nonperforated appendicitis in the pediatric population. The cause of this thrombosis is hypothesized to be secondary to venous stasis secondary to insufflation during laparoscopy.

  6. Superior mesenteric vein thrombosis: a case report

    International Nuclear Information System (INIS)

    Costa Praxedes, Marcia da; Malheiros, Noemia Reis; Machado, Dianne Melo; Carvalho, Ana Alice Vidal de; Marchiori, Edson; Universidade Federal, Rio de Janeiro, RJ; Santos, Alair Augusto S.M.

    1995-01-01

    A case of superior mesenteric mesenteric vein thrombosis diagnosed by computed tomography in 29 year-old man with abdominal pain, without any predisposing pathologic disorders is reported. This patient had a chronic evolution, had not resulting in mesenteric infarction. He was treated conservatively with anticoagulant therapy and recanalization of the involved vessels was demonstrated by another computed tomography. The patient is asymptomatic now. (author). 8 refs., 3 figs

  7. [Management of mesenteric ischemia and mesenteric vein thrombosis].

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    Hoffmann, M; Keck, T

    2014-07-01

    Acute mesenteric ischemia is secondary to acute embolic disease or thrombosis of the superior mesenteric artery. Further pathologies that manifest themselves with the same clinical presentation are thrombosis of the superior mesenteric vein and non-occlusive disease. The patients are admitted to the emergency room with an acute abdomen. Most patients are more than 70 years old. Known risk factors for mesenteric ischemia are cardiac diseases as atrial fibrillation, aneurysms of the aorta and the visceral arteries, occlusive arterial diseases, tumorigenic compression of the vessel and several diseases that result in a reduction of the flow and intravascular volume in the superior mesenteric artery. The golden standard in the diagnosis of acute mesenteric ischemia is CT-angiography of the abdominal vessels with 3 D reconstruction. The therapy is different and dependent from the underlying pathology. A statistically significantly elevated mortality of more than 95% is associated with a delay of surgical or interventional therapy of more than 12 hours after the initial symptoms and non-occlusive mesenteric ischemia. Because of the advanced age of the patients and the co-morbidities a non-surgical interventional re-canalisation of the superior mesenteric vessels is recommended. A laparotomy is necessary in all patients with peritonitis and/or bowel necrosis or perforation. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Acute mesenteric vein thrombosis: factors associated with evolution to chronic mesenteric vein thrombosis.

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    Vietti Violi, Naïk; Fournier, Nicolas; Duran, Rafael; Schmidt, Sabine; Bize, Pierre; Guiu, Boris; Denys, Alban

    2014-07-01

    Acute mesenteric venous thrombosis signs at MDCT are well described, but the literature lacks studies assessing their evolution. We aimed to describe the radiologic evolution of isolated acute mesenteric venous thrombosis and associated prognostic factors. Patients with isolated acute mesenteric venous thrombosis with follow-up for a minimum of 1 month with MDCT were selected. Images at the acute phase and on follow-up were reviewed in consensus reading. For acute mesenteric venous thrombosis, we searched for low-attenuated intraluminal filling defect. For chronic mesenteric venous thrombosis, we searched for vessel stenosis or occlusion associated with collateral mesenteric veins. Treatment, thrombosis risk factor, symptoms, location, and length and diameter of mesenteric venous thrombosis were reported and correlated with evolution over time. Twenty patients (nine women and 11 men; mean age, 52 years) were selected. Four patients recovered without radiologic sequelae, and 16 developed chronic mesenteric venous thrombosis signs. Anticoagulation did not influence recovery (p = 1). Patients with recovery compared with patients with chronic mesenteric venous thrombosis showed more frequent central lesions (p = 0.03). At diagnosis, the thrombosed segment was shorter and larger in the complete radiologic recovery group compared with the chronic mesenteric venous thrombosis signs group: mean length (± SD) 6.25 ± 3.21 cm and 12.81 ± 5.96 cm, respectively (p = 0.01); mean transverse diameter 1.82 ± 0.42 cm and 1.12 ± 0.34 cm, respectively (p = 0.01). Mesenteric fat infiltration at diagnosis was more frequent in the chronic mesenteric venous thrombosis signs group than in the complete recovery group (p = 0.03). Most cases of acute mesenteric venous thrombosis evolve toward the chronic form with vein stenosis or occlusion and development of collateral veins. Location, length of mesenteric venous thrombosis, transverse diameter of the vein, and mesenteric fat

  9. Superior mesenteric vein thrombosis complicating appendicular masses

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    Echitibi, Salma S.; Bashir, Masoud O.; Ahmad, Misba U.

    2003-01-01

    Mesenteric vein thrombosis (MVT) is rare. Its diagnosis is usually difficult and delayed. We report two patients who developed MVT as a complication of an appendicular mass. One of them had appendectomy and developed fever 10 days postoperatively. The other was treated conservatively. An abdominal computerized tomography(CT) scan with intravenous contrast was helpful in diagnosing superior MVT in both patients, which were not suspected. Intravenous contrast should be used when performing CT of an appendicular mass. Special interest should be directed at studying the superior mesenteric vein. Early diagnosis of our patients helped to start early medical treatment with anticoagulation. (author)

  10. Portal vein and mesenteric vein gas: CT features

    International Nuclear Information System (INIS)

    Schmutz, G.; Fournier, L.; Le Pennec, V.; Provost, N.; Hue, S.; Phi, I.N.

    2001-01-01

    Portal vein and mesenteric vein gas are unusual conditions with a complex and nuclear pathogenesis. Mesenteric ischemia frequently causes such pathological conditions but a variety of other causes are known: inflammatory bowel disease, bowel distension, traumatic and iatrogenic injury, intra-abdominal sepsis, and idiopathic conditions. This pathologic entity is favored by intestinal wall alterations, bowel distension and sepsis. The prognosis is frequently fatal, especially when associated with extended bowel necrosis although in the majority of the cases, outcome is favorable without surgery. (author)

  11. A superior mesenteric vein thrombosis associated with in vitro fertilization.

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    Dorais, Jessie; Jones, Kirtly; Hammoud, Ahmad; Gibson, Mark; Johnstone, Erica; Peterson, C Matthew

    2011-02-01

    To describe a case of superior mesenteric vein thrombosis associated with IVF. Case report. University teaching hospital. A 33-year-old female developed progressive abdominal pain several days after ET in her first IVF cycle. A computed tomography scan 12 days after ET showed a superior mesenteric vein thrombosis. Therapeutic anticoagulation. Resolution of the superior mesenteric vein thrombosis with therapeutic anticoagulation. Early diagnosis and treatment of a superior mesenteric vein thrombosis associated with IVF led to a favorable outcome. Endocrine alterations consequent to controlled ovarian hyperstimulation for IVF place patients at risk for thromboembolic events. Thromboembolic events may occur during an IVF cycle in the absence of overt ovarian hyperstimulation, an inherited thrombophilia, or pregnancy. Early diagnosis and treatment of superior mesenteric vein thrombosis can lead to a favorable outcome. Treatment guidelines for superior mesenteric vein thrombosis in setting of IVF are discussed. Published by Elsevier Inc.

  12. Simultaneous thrombosis of superior mesenteric artery and superior mesenteric vein following chemotherapy: MDCT findings.

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    Olgun, Deniz Cebi; Bakan, Selim; Samanci, Cesur; Tutar, Onur; Demiryas, Suleyman; Korkmazer, Bora; Kantarci, Fatih

    2014-02-01

    A case of acute mesenteric ischemia due to thrombosis of superior mesenteric artery and vein in a 44-year-old woman following chemotherapy for invasive laryngeal carcinoma was diagnosed on a multi-detector CT scan. Although the link between malignancy and thromboembolism is widely recognized in patients with cancer, chemotherapy further elevates the risk of thrombosis. Acute mesenteric ischemia associated or not associated with chemotherapy rarely occurs in patients with cancer. Moreover, co-occurrence of superior mesenteric artery and superior mesenteric vein thrombosis is reported for the first time.

  13. The management of mesenteric vein thrombosis: a single institution's experience.

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    Yanar, Fatih; Ağcaoğlu, Orhan; Gök, Ali Fuat Kaan; Sarıcı, Inanç Samil; Ozçınar, Beyza; Aksakal, Nihat; Aksoy, Murat; Ozkurt, Enver; Kurtoğlu, Mehmet

    2013-05-01

    Mesenteric vein thrombosis occurs rarely and is responsible for approximately 5-15% of all cases of acute mesenteric ischemia. The aim of this report was to discuss the management of mesenteric vein thrombosis based on our experience with 34 patients. In the present study, 34 patients who were admitted to our emergency surgery department between January 2007 and January 2010 with a diagnosis of acute mesenteric vein thrombosis were assessed retrospectively. Patients with peritoneal signs first underwent diagnostic laparoscopy to rule out perforation or bowel gangrene. We performed a second-look laparoscopy within 72 hours of the first operation. All patients were administered 100 mg/kg of the anticoagulant enoxaparin twice daily. In the 6th and 12th months of follow up, CT angiography was performed to evaluate recanalization of the veins. CT angiography revealed superior mesenteric vein thrombosis in 25 (73%) patients, portal vein thrombosis in 24 (70%) patients, and splenic vein thrombosis in 12 (35%) patients. Eleven patients with peritoneal signs underwent diagnostic laparoscopy; eight of the patients underwent small bowel resection, anastomosis, and trocar insertion. During second-look laparoscopy, small bowel ischemia was found in two patients and re-resection was performed. Early diagnosis with CT angiography, surgical and non-surgical blood flow restoration, proper anticoagulation, and supportive intensive care are the cornerstones of successful treatment of mesenteric vein thrombosis.

  14. MDCT of inferior mesenteric vein: normal anatomy and pathology

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    Akpinar, E.; Turkbey, B. [Department of Radiology, Hacettepe University School of Medicine, Ankara (Turkey); Karcaaltincaba, M. [Department of Radiology, Hacettepe University School of Medicine, Ankara (Turkey)], E-mail: musturayk@yahoo.com; Karaosmanoglu, D.; Akata, D. [Department of Radiology, Hacettepe University School of Medicine, Ankara (Turkey)

    2008-07-15

    Multidetector computed tomography (MDCT) is a useful technique for imaging the inferior mesenteric vein. The aim of the present review was to discuss the normal anatomy and the pathologies of the inferior mesenteric vein, including partial or total thrombosis secondary to inflammation (pyophlebitis) and malignancy, occlusion, dilatation and reversed flow, which are rarely encountered. Optimal reconstruction techniques are also discussed. The pathologies of the inferior mesenteric vein can be clearly demonstrated using MDCT using curved-planar reformatted multiplanar reconstruction (MPR) and minimum intensity projection (MIP) images.

  15. MDCT of inferior mesenteric vein: normal anatomy and pathology

    International Nuclear Information System (INIS)

    Akpinar, E.; Turkbey, B.; Karcaaltincaba, M.; Karaosmanoglu, D.; Akata, D.

    2008-01-01

    Multidetector computed tomography (MDCT) is a useful technique for imaging the inferior mesenteric vein. The aim of the present review was to discuss the normal anatomy and the pathologies of the inferior mesenteric vein, including partial or total thrombosis secondary to inflammation (pyophlebitis) and malignancy, occlusion, dilatation and reversed flow, which are rarely encountered. Optimal reconstruction techniques are also discussed. The pathologies of the inferior mesenteric vein can be clearly demonstrated using MDCT using curved-planar reformatted multiplanar reconstruction (MPR) and minimum intensity projection (MIP) images

  16. A new technique for complete portal vein and superior mesenteric vein thrombosis in a liver transplant recipient.

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    Song, Sanghyun; Kwon, Choon Hyuck David; Shin, Milljae; Kim, Tae-Seok; Lee, Sanghoon; Moon, Hyung Hwan; Park, Jae Berm; Kim, Sung Joo; Joh, Jae-Won; Lee, Suk-Koo

    2014-02-01

    We describe a deceased-donor liver transplant recipient with grade 3 complete portal vein and superior mesenteric vein thromboses, which was successfully managed with an extensive thrombectomy through the venotomy site of superior mesenteric vein. In this case report, we suggest our method as an option for grade 3 portal vein thromboses, and discuss other options available for recipients with portal vein thromboses.

  17. Right portal vein embolization by laparoscopic catheterization of the inferior mesenteric vein

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    Marcus Vinicius Martins Cury

    2013-12-01

    Full Text Available Right portal vein embolization is often performed to prevent liver insufficiency after major hepatic resection. The procedure usually involves direct puncture of the portal vein, which requires hepatic hilum manipulation, and may be associated with liver injury, pneumothorax, and hemoperitoneum. This report describes a technique of laparoscopic insertion of a sheath into the inferior mesenteric vein followed by right portal vein embolization.

  18. Acute superior mesenteric vein thrombosis associated with abdominal trauma

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    Lim, Kyoung Hoon; Jang, Jihoon; Yoon, Hye Young; Park, Jinyoung

    2017-01-01

    Abstract Rationale: Acute mesenteric vein thrombosis (MVT) is defined as new-onset thrombosis of the mesenteric vein without evidence of collateralization, finally resulting in extensive intestinal infarction. MVT may be idiopathic or be caused by conditions responsible for thrombophilia and acquired risk factors. To date, there have been few reports of MVT after trauma. Herein we describe our experiences treating three patients with MVT. Patient concerns: Case 1 was a 44-year-old man with transverse colon mesenteric hematoma after blunt abdominal trauma. Case 2 was a 55-year-old man with jejunal transection after a traffic accident. Case 3 was a 26-year-old man presented with multiple abdominal stab bowel injury. Diagnoses: A 1-week follow-up abdominal computed tomography scan showed superior mesenteric vein thrombosis in all of three patients. Interventions: All patients were treated with anticoagulant for 3 or 6 months. Outcomes: MVTs were completely resolved without any complications. Lessons: If early diagnosis and treatment could be available, anticoagulation alone might be adequate for the treatment of SMVT associated with trauma. Early anticoagulation in patients with acute SMVT may avoid the grave prognosis observed in patients with arterial thrombosis. PMID:29382004

  19. A Rare Complication of Acute Appendicitis: Superior Mesenteric Vein Thrombosis

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    Hendra Koncoro

    2016-12-01

    Full Text Available Superior mesenteric vein (SMV thrombosis caused by acute appendicitis is quite rare nowadays. These conditions occurs secondary to infection in the region drained by the portal venous system. In this case, we report a successfully treated case of SMV thrombosis and liver abscess associated with appendicitis with antibiotics and anticoagulant.Early diagnosis and prompt treatment are basic to a favorable clinical course.

  20. Portal vein and mesenteric vein gas: CT features; Aeroportie ety aeromesenterie: donnees TDM

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    Schmutz, G.; Fournier, L.; Le Pennec, V.; Provost, N.; Hue, S.; Phi, I.N. [Centre Hospitalier Universitaire, 14 - Caen (France)

    2001-04-01

    Portal vein and mesenteric vein gas are unusual conditions with a complex and nuclear pathogenesis. Mesenteric ischemia frequently causes such pathological conditions but a variety of other causes are known: inflammatory bowel disease, bowel distension, traumatic and iatrogenic injury, intra-abdominal sepsis, and idiopathic conditions. This pathologic entity is favored by intestinal wall alterations, bowel distension and sepsis. The prognosis is frequently fatal, especially when associated with extended bowel necrosis although in the majority of the cases, outcome is favorable without surgery. (author)

  1. [Spontaneous dissolution of isolated superior mesenteric vein thrombosis in acute pancreatitis].

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    Na, Byung Soo; John, Byung Min; Kim, Ki Bum; Lee, Je Soo; Jo, Hyun Woo; Seock, Chang Hyeon; Kim, Dong Hui; Lee, Ki Sung

    2011-01-01

    Acute pancreatitis can result in many vascular complications in both artery and vein. Venous complication usually occurs as a form of splenic or portal vein thrombosis, and also can simultaneously occur in superior mesenteric vein as well. Rarely, isolated superior mesenteric vein thrombosis occurs as a venous complication. Although it is uncommon, mesenteric vein thrombosis is an important clinical entity because of the possibility of mesenteric ischemia and infarction of small bowel. The treatments of mesenteric venous thrombosis include anticoagulation therapy, transcatheter therapy and surgical intervention. We report a case of 45-year- old man who had acute pancreatitis with isolated superior mesenteric vein thrombosis, which was spontaneously dissolved with the resolution of underlying inflammation without anticoagulation or surgical intervention.

  2. Clinical Management of Acute Portal/Mesenteric Vein Thrombosis

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    Lang, Sven A.; Loss, Martin; Wohlgemuth, Walter A.; Schlitt, Hans J.

    2014-01-01

    Background Acute thrombosis of the portal vein (PV) and/or the mesenteric vein (MV) is a rare but potentially life-threatening disease. A multitude of risk factors for acute portal vein thrombosis (PVT)/mesenteric vein thrombosis (MVT) have been identified, including liver cirrhosis, malignancy, coagulation disorders, intra-abdominal infection/inflammation, and postoperative condition. Methods This article analyses the treatment options for acute PVT/MVT. Results Initially, the clinical management should identify patients with an intra-abdominal focus requiring immediate surgical intervention (e.g. bowel ischaemia). Subsequently, emphasis is placed on the recanalization of the PV/MV or at least the prevention of thrombus extension to avoid long-term complications of portal hypertension. Several therapeutic options are currently available, including anticoagulation therapy, local/systemic thrombolysis, interventional or surgical thrombectomy, and a combination of these procedures. Due to the lack of prospective randomized studies, a comparison between these therapeutic approaches regarding the efficacy of PV/MV recanalization is difficult, if not impossible. Conclusion In patients with acute PVT/MVT, an individualized treatment based on the clinical presentation, the underlying disease, the extent of the thrombosis, and the patients' comorbidities is mandatory. Therefore, these patients should be considered for an interdisciplinary therapy in specialized centres with the option to utilise all therapeutic approaches currently available. PMID:26285602

  3. Inferior mesenteric vein thrombosis in Crohn`s disease: CT diagnosis

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    Coralnick, J.R.; Budin, J.A.; Sedarat, A. [Hackensack Medical Center, NJ (United States)

    1996-01-01

    Mesenteric vein thrombosis has been described in association with such risk factors as coagulation disorders, postoperative dehydration, sepsis, and trauma. CT and ultrasound have greatly facilitated early diagnosis, and the features of superior mesenteric and portal vein thrombosis are well recognized. We present a case of inferior mesenteric vein thrombosis in a patient with Crohn`s disease. To our knowledge, this entity has not been reported in the radiologic literature. 7 refs., 2 figs.

  4. Acute Appendicitis Complicating into Portal and Superior Mesenteric Vein Thrombosis.

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    Yousaf, Adnan; Ahmed, Mushtaq; Aurangzeb, Mahmud

    2016-06-01

    This case report describes a young man who presented with 9-day history of sudden-onset epigastric and right-sided lower abdominal pain. He was tachycardiac with temperature of 102°F. Tenderness was present in the peri-umbilical area and right iliac fossa. Investigations revealed a raised total leucocyte count (predominantly neutrophilic). Triphasic CTscan abdomen found thrombosis of right portal vein and its hepatic tributaries alongwith superior mesenteric vein (SMV) and its tributaries. Co-existent fluid in right hemipelvis abutting the cecum and appendiceal tip was suggestive of acute appendicitis. He was resuscitated with fluids and analgesics and started on intravenous metronidazole and ceftriaxone. Anticoagulation with subcutaneous heparin was commenced and eventually switched over to warfarin. Appendicectomy was not performed as the patient responded to conservative treatment. Appendicitis is associated with multiple complications but secondary venous thrombosis has rarely been reported with it.

  5. Septic thrombophlebitis of the inferior mesenteric vein and associated mesenteric abscess complicating sigmoid diverticulitis: A case report

    International Nuclear Information System (INIS)

    Cha, Seong Jae; Lee, Hae Kyung; Yi, Beom Ha; Lee, Min Hee; Hong, Hyun Sook

    2013-01-01

    Thrombophlebitis occurs secondarily to inflammatory conditions of adjacent organs, and radiologic finding is essential for diagnosis. However, because of the rarity on clinical cases that involve the inferior mesenteric vein, many radiologists are unfamiliar with its location and appearance. We experience a case of septic thrombophlebitis with abscess complication sigmoid diverticulitis. CT scans reveals a low density thrombus and air in the inferior mesenteric vein, combining with perivascular fat infiltration, and focal wall defects with abscess formation. After surgical treatment, the abscess was not visible in the follow-up CT scans. Septic thrombophlebitis of the inferior mesenteric vein, although being a rare disease, should be diagnosed on CT according to the given unique location, the appearance of inflamed vein and the adjacent descending mesocolon.

  6. Septic thrombophlebitis of the inferior mesenteric vein and associated mesenteric abscess complicating sigmoid diverticulitis: A case report

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    Cha, Seong Jae; Lee, Hae Kyung; Yi, Beom Ha; Lee, Min Hee; Hong, Hyun Sook [Dept. of Radiology, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of)

    2013-07-15

    Thrombophlebitis occurs secondarily to inflammatory conditions of adjacent organs, and radiologic finding is essential for diagnosis. However, because of the rarity on clinical cases that involve the inferior mesenteric vein, many radiologists are unfamiliar with its location and appearance. We experience a case of septic thrombophlebitis with abscess complication sigmoid diverticulitis. CT scans reveals a low density thrombus and air in the inferior mesenteric vein, combining with perivascular fat infiltration, and focal wall defects with abscess formation. After surgical treatment, the abscess was not visible in the follow-up CT scans. Septic thrombophlebitis of the inferior mesenteric vein, although being a rare disease, should be diagnosed on CT according to the given unique location, the appearance of inflamed vein and the adjacent descending mesocolon.

  7. Mesenteric vein thrombosis after percutaneous transhepatic portal vein catheterisation for the localisation of an insulinoma

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    Luska, G.; Langer, H.E.; Le Blanc, S.

    1984-07-01

    The authors report on a fatal mesenteric vein thrombosis following an uncomplicated percutaneous transhepatic portal vein catheterisation for the localisation of an insulinoma. Several hours after the procedure the patient developed an acute abdomen. An emergency laparotomy revealed a haemorrhagic infarct of the ileum. The resected specimen showed an acute phlebitis with fresh thrombus. The cause of the phlebothrombosis was thought to be intimal damage from high osmolar contrast medium. There was no evidence of damage due to the catheder, either on the phlebogram or pathologically. 1 fig.

  8. Mesenteric vein thrombosis after percitaneous transhepatic portal vein catheterisation for the localisation of an insulinoma

    International Nuclear Information System (INIS)

    Luska, G.; Langer, H.E.; Le Blanc, S.; Medizinische Hochschule Hannover

    1984-01-01

    The authors report on a fatal mesenteric vein thrombosis following an uncomplicated percutaneous transhepatic portal vein catheterisation for the localisation of an insulinoma. Several hours after the procedure the patient developed an acute abdomen. An emergency laparotomy revealed a haemorrhagic infarct of the ileum. The resected specimen showed an acute phlebitis with fresh thrombus. The cause of the phlebothrombosis was thought to be intimal damage from high osmolar contrast medium. There was no evidence of damage due to the catheder, either on the phlebogram or pathologically. (orig.) [de

  9. Superior Mesenteric Vein Thrombosis Secondary to Oral Contraceptive Use

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    Heather Stewart

    2012-01-01

    Full Text Available Superior mesenteric vein thrombosis (SMVT is a rare yet frequently fatal cause of intestinal ischemia. Despite its severe consequences, SMVT often presents with nonspecific symptoms such as nausea, vomiting, and abdominal pain. It can occur with or without gastrointestinal bleeding, and symptoms may be present for hours to weeks. Physical exam can vary from a benign to an acute abdomen. The are no specific diagnostic laboratory studies for the presence of MVT, and it can be an incidental finding of computed tomography or ultrasound. Patients at risk for MVT include those with a history of a hypercoagulable state or secondary cases such as sepsis, gastrointestinal malignancy, liver disease, pancreatic pathology, abdominal surgery and medications. The authors present a case of a patient presenting with acute abdominal pain and ultimately a SMVT secondary to oral contraceptives by exclusion.

  10. Superior mesenteric vein thrombosis: a case report; Trombose da veia mesenterica superior: relato de um caso

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    Costa Praxedes, Marcia da; Malheiros, Noemia Reis; Machado, Dianne Melo; Carvalho, Ana Alice Vidal de [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia; Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia]|[Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina; Santos, Alair Augusto S.M. [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Inst. Biomedico

    1995-09-01

    A case of superior mesenteric mesenteric vein thrombosis diagnosed by computed tomography in 29 year-old man with abdominal pain, without any predisposing pathologic disorders is reported. This patient had a chronic evolution, had not resulting in mesenteric infarction. He was treated conservatively with anticoagulant therapy and recanalization of the involved vessels was demonstrated by another computed tomography. The patient is asymptomatic now. (author). 8 refs., 3 figs.

  11. JAK2 V617F mutation, mesenteric vein thrombosis, and myeloproliferative disorders.

    Science.gov (United States)

    Owens, Christopher D

    2010-07-01

    Mesenteric vein thrombosis is a rare disorder that is often the first manifestation of a systemic condition such as a hypercoagulable state or cancer. In particular, myeloproliferative disorders can present as mesenteric vein thrombosis even in the setting of relatively normal peripheral blood counts. A recent novel mutation in the Janus activated kinase 2 gene involving a gain-of-function substitute of valine to phenylalanine at position 617 (JAK2 V617F) has been discovered to be prevalent in patients with mesenteric vein thrombosis and myeloproliferative disorders. This article reports a patient who presented with mesenteric vein thrombosis and relatively normal peripheral blood counts. He was diagnosed with essential thrombocythemia after he tested positive for the JAK2 V617F mutation. Copyright (c) 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  12. Progression of Thrombus in Portal Vein, Superior Mesenteric Vein, and Splenic Vein Even on Anticoagulation in a Patient with Ascending Colonic Malignancy with Liver Metastasis: Portal Vein Thrombosis versus Portal Vein Tumor Thrombosis.

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    Sule, Ashish; Borja, Annamarie; Chin, Tay Jam

    2016-12-01

    Portal vein thrombosis (PVT) in a setting of liver metastasis is not easy to treat as it may be portal vein tumor thrombus (PVTT). A 77-year-old male patient was diagnosed as ascending colon carcinoma, underwent right hemicolectomy in 1991 with a recurrence in July 2009. In August 2009, he underwent computed tomography (CT) scan of the abdomen which showed evidence of superior mesenteric vein thrombosis with no liver metastasis. He was started with anticoagulation and decision was to treat long term. He was admitted with mesenteric artery ischemic symptoms in February 2012 on anticoagulation. CT scan abdomen and pelvis in February 2012 showed tumor thrombus involving the superior mesenteric vein, portal vein, and splenic vein with hepatic metastasis. His tumor marker chorioembryonic antigen was 34 µg/L. He was continued on anticoagulation. A repeat CT scan abdomen after 2 years (in January 2014) showed, increase in size of hepatic metastasis, extensive thrombus involving the superior mesenteric vein, portal vein, and splenic vein with collaterals. Mesentery was congested due to extensive superior mesenteric vein thrombus. He finally succumbed in June 2014. It is very important to differentiate PVT from PVTT as the prognosis is different. PVTT progresses despite of long-term anticoagulation with poor prognosis.

  13. Thrombosis of a Superior Mesenteric Vein Aneurysm: Transarterial Thrombolysis and Transhepatic Aspiration Thrombectomy

    International Nuclear Information System (INIS)

    Hechelhammer, L.; Crook, D.W.; Widmer, U.; Wildermuth, S.; Pfammatter, T.

    2004-01-01

    We report the case of a 31-year-old woman presenting with abdominal pain due to acute thrombosis of a superior and inferior mesenteric vein aneurysm, which was treated by a combination of arterial thrombolysis and transhepatic thrombus aspiration. At the last follow-up CT, 21 months following this procedure, there was no evidence of rethrombosis, and the patient continues to do well under oral anticoagulation. The literature regarding these uncommon mesenteric vein aneurysms without portal vein involvement, as well as their treatment options, is reviewed

  14. Treatment of postoperative main portal vein and superior mesenteric vein thrombosis with balloon angioplasty and/or stent placement.

    Science.gov (United States)

    Cao, Guangshao; Ko, Gi-Young; Sung, Kyu-Bo; Yoon, Hyun-Ki; Gwon, Dong Il; Kim, Jin-Hyoung

    2013-06-01

    Thrombolysis and mechanical thrombectomy have been used to treat postoperative main portal vein and superior mesenteric vein thrombosis. To evaluate the safety and efficacy of balloon angioplasty and/or stent placement without thrombolysis or thrombectomy for treating such thromboses. Fourteen patients with postoperative main portal vein or superior mesenteric vein thrombosis underwent percutaneous transhepatic balloon angioplasty and/or stent placement without thrombolysis or thrombectomy. The rates of technical and clinical success, major complications, and recurrence were evaluated retrospectively. Initial technical success was achieved in 13 of the 14 patients (93%). After the procedures, these 13 patients showed brisk portal inflow, without a significant amount of residual thrombus in the stented lumen or embolism. One patient was considered to be a technical failure despite showing a brisk portal inflow because 50% stenosis and partial residual thrombus remained in the stented lumen. Initial clinical success was achieved in 13 patients. One patient with technical success died of acute respiratory distress syndrome 8 days after the procedure, whereas one patient with technical failure achieved clinical success. One patient experienced acute rethrombosis 8 days after the procedure. During the median follow-up period of 16.3 months, rethrombosis occurred in six patients (43%), including one patient with acute rethrombosis. Balloon angioplasty and/or stent placement without thrombolysis or thrombectomy may be a safe and effective treatment modality for postoperative main portal vein and superior mesenteric vein thrombosis. © 2013 The Foundation Acta Radiologica.

  15. Mesenteric vein thrombosis caused by secondary polycythaemia from AndroGel.

    Science.gov (United States)

    Katz, Heather; Popov, Eugene; Bray, Natasha; Berman, Barry

    2014-10-21

    Mesenteric vein thrombosis is a rare but potentially lethal cause of abdominal pain. It is usually caused by prothrombotic states that can either be hereditary or acquired. Testosterone supplementation causes an acquired prothrombotic state by promoting erythropoeisis thus causing a secondary polycythaemia. We report a case of a 59-year-old man with a history of chronic obstructive pulmonary disease (COPD) stage III, who presented with abdominal pain. Evaluation revealed an elevated haemoglobin and haematocrit, a superior mesenteric vein thrombosis on CT and a negative Janus kinase 2 mutation. The patient is currently being treated with 6 months of anticoagulation with rivaroxiban. Although a well-known side effect of testosterone is thrombosis, the present case is used to document in the literature the first case of mesenteric vein thrombosis due to secondary polycythaemia from Androgel in the setting of COPD. 2014 BMJ Publishing Group Ltd.

  16. Paroxysmal Nocturnal Haemoglobinuria Type III Presenting as Portal and Mesenteric Vein Thrombosis in a Young Girl.

    Science.gov (United States)

    Sarwar, Shahzad; Chaudhry, Monazza; Ali, Natasha

    2016-11-01

    Paroxysmal nocturnal haemoglobinuria (PNH) is a rare, acquired, life-threatening haematological disorder. It is characterised by complement induced haemolytic anaemia, thrombosis and impaired bone marrow function. Thrombosis most commonly occurs in the hepatic, portal, superior mesenteric and cerebral veins. A22-year female, previously diagnosed with severe aplastic anaemia treated with anti-lymphocyte globulin (ALG) and cyclosporine, had become transfusion independent for more than 10 years. She presented with abdominal pain and vomiting, initially diagnosed with portal and superior mesenteric vein thrombosis. Immunophenotyping by flow cytometry revealed a diagnosis of paroxysmal nocturnal haemoglobinuria type III. She was treated with vitmamin K anatagonist and platelet transfusion.

  17. [A case of adenosquamous carcinoma of the sigmoid colon with inferior mesenteric vein thrombosis].

    Science.gov (United States)

    Otsuka, Ryota; Maruyama, Takashi; Tanaka, Hajime; Matsuzaki, Hiroshi; Natsume, Toshiyuki; Miyazaki, Akinari; Sato, Yayoi; Sazuka, Tetsutaro; Yamamoto, Yuji; Yoshioka, Takafumi; Kanada, Yoko; Yanagihara, Akitoshi; Yokoyama, Masaya; Kobayashi, Hiroshi; Shimizu, Shinichiro

    2014-11-01

    A 63-year-old man who had been admitted to another institute with sepsis and renal failure was referred to our hospital after computed tomography (CT) findings showed thickening of the walls in the sigmoid colon and a defect in contrast enhancement in the portal and inferior mesenteric veins. Emergency sigmoid colon resection with D2 lymphadenectomy was performed after detection of perforation due to sigmoid colon cancer. The histopathological diagnosis was adenosquamous carcinoma, pSS, int, INF b, ly1, v0, pN2, pStage IIIband inferior mesenteric vein thrombosis. He was discharged on day 12, and we administered anticoagulant warfarin therapy.

  18. Trauma to the Superior Mesenteric Artery and Superior Mesenteric Vein: A Narrative Review of Rare but Lethal Injuries.

    Science.gov (United States)

    Phillips, B; Reiter, S; Murray, E P; McDonald, D; Turco, L; Cornell, D L; Asensio, J A

    2018-03-01

    Mesenteric vessels, including the superior mesenteric artery (SMA) and vein (SMV), provide and drain the rich blood supply of the midgut and hindgut. SMA and SMV injuries are rare and often lethal. Clinical management of these injuries is not well established, but treatment options include operative, non-operative, and endovascular strategies. A narrative review of the literature was conducted using MEDLINE Complete-EBSCO. Relevant studies, specifically those focusing on diagnosis and management of SMA and SMV injuries, were selected. Only original reports and collected series were selected to prevent duplication of cases. A search of the literature for mesenteric arterial injuries yielded 87 studies. Vessel-specific breakdown of the studies yielded 40 with SMA injuries and 41 with SMV injuries. These searches were winnowed to 26 individual studies, which were included in this collective review. Limitations of this study are similar to all narrative literature reviews: the dependence on previously published research and availability of references as outlined in our methodology. Although historically rare, mesenteric vessel injuries are seen with increasing incidence and continue to present a challenge to trauma surgeons due to their daunting mortality rates. Currently, universal treatment guidelines do not exist, but the various options for their management have been extensively reviewed in the literature.

  19. Nephrotic syndrome complicated with portal, splenic, and superior mesenteric vein thrombosis

    Directory of Open Access Journals (Sweden)

    Bong Soo Park

    2014-09-01

    Full Text Available Thromboembolism is a major complication of nephrotic syndrome. Renal vein thrombosis and deep vein thrombosis are relatively common, especially in membranous nephropathy. However, the incidence of portal vein and superior mesenteric vein (SMV thrombosis in patients with nephrotic syndrome is very rare. To date, several cases of portal vein thrombosis treated by anticoagulation therapy, not by thrombolytic therapy, have been reported as a complication of nephrotic syndrome. Here, we report a case of portal, splenic, and SMV thrombosis in a patient with a relapsed steroid dependent minimal change disease who was treated successfully with anticoagulation and thrombolytic therapy using urokinase. Radiologic findings and his clinical conditions gradually improved. Six months later, a complete remission of the nephrotic syndrome was observed and the follow-up computed tomography scan showed the disappearance of all portal vein, splenic vein, and SMV thrombi.

  20. CT diagnosis of acute mesenteric vein thrombosis with bowel infarction

    International Nuclear Information System (INIS)

    Sommer, A.; Jaschke, W.; Georgi, M.

    1994-01-01

    Imaging methods provide an important diagnostic basis to clarify mesenteric ischemia. Angiography is the definitive method of investigation in such cases. Other noninvasive methods such as ultrasonography, computed tomography, and magnetic resonance imaging must still prove their importance. We describe three cases of unspezific abdominal pain where the CT shows a mesenteric venous thrombosis with an infarcted bowel. The venous infarcted bowel is clearly demonstrated by CT when other signs for MTV such as ascites, bowel wall thickening, bowel dilatation, and pneumatosis intestinalis are present. CT seems to be a good procedure in order to identify unspecific abdominal pain as being caused by a vascular insufficiency. (orig.) [de

  1. Mesenteric vein thrombosis associated with Klinefelters syndrome--a case report.

    Science.gov (United States)

    Murray, F E

    1988-01-01

    A case of mesenteric vein thrombosis presenting as gastrointestinal hemorrhage in a patient with Klinefelter's syndrome is reported, an association not previously described. The diagnosis was made preoperatively and was confirmed by angiography. The patient underwent a small bowel resection and made an uneventful recovery. A possible association between Klinefelter's syndrome and a hypercoagulable state, previously suggested elsewhere, is emphasized.

  2. Mesenteric vein thrombosis associated with primary cytomegalovirus infection : a case report

    NARCIS (Netherlands)

    Lijfering, Willem M.; Sprenger, Herman G.; van Son, Willem J.; van der Meer, Jan

    In the past few years several studies have supported an interplay between cytomegalovirus infections and a prothrombotic state. We describe a case of primary cytomegalovirus infection in an immunocompetent adult that was complicated with mesenteric vein thrombosis. Transient protein C deficiency,

  3. Detection of superior mesenteric vein thrombosis by real time and Doppler sonography

    International Nuclear Information System (INIS)

    Mildenberger, P.; Schild, H.; Jenny, E.

    1988-01-01

    Superior mesenteric vein thrombosis after splenectomy is very rare. In the case described of a patient presenting with acute abdominal pain the diagnosis was made primarily by real-time and Doppler ultrasonography. This reduced the time elapsing before it was recognized that angiography and subsequent thrombectomy were indicated. (orig.) [de

  4. Interventional treatment for symptomatic acute-subacute portal and superior mesenteric vein thrombosis.

    Science.gov (United States)

    Liu, Feng-Yong; Wang, Mao-Qiang; Fan, Qing-Sheng; Duan, Feng; Wang, Zhi-Jun; Song, Peng

    2009-10-28

    To summarize our methods and experience with interventional treatment for symptomatic acute-subacute portal vein and superior mesenteric vein thrombosis (PV-SMV) thrombosis. Forty-six patients (30 males, 16 females, aged 17-68 years) with symptomatic acute-subacute portal and superior mesenteric vein thrombosis were accurately diagnosed with Doppler ultrasound scans, computed tomography and magnetic resonance imaging. They were treated with interventional therapy, including direct thrombolysis (26 cases through a transjugular intrahepatic portosystemic shunt; 6 through percutaneous transhepatic portal vein cannulation) and indirect thrombolysis (10 through the femoral artery to superior mesenteric artery catheterization; 4 through the radial artery to superior mesenteric artery catheterization). The blood reperfusion of PV-SMV was achieved completely or partially in 34 patients 3-13 d after thrombolysis. In 11 patients there was no PV-SMV blood reperfusion but the number of collateral vessels increased significantly. Symptoms in these 45 patients were improved dramatically without severe operational complications. In 1 patient, the thrombi did not respond to the interventional treatment and resulted in intestinal necrosis, which required surgical treatment. In 3 patients with interventional treatment, thrombi re-formed 1, 3 and 4 mo after treatment. In these 3 patients, indirect PV-SMV thrombolysis was performed again and was successful. Interventional treatment, including direct or indirect PV-SMV thrombolysis, is a safe and effective method for patients with symptomatic acute-subacute PV-SMV thrombosis.

  5. Thrombosis of the mesenteric vein and occlusion of the mesenteric artery

    International Nuclear Information System (INIS)

    Boettger, T.; Jenny, E.; Junginger, T.; Weber, W.

    1989-01-01

    The differentiation between an arterial and a venous occlusion of a mesenteric vessel is difficult. The diagnosis of an occlusion of a mesenteric vessel in general is made preoperatively in every fourth patient only. Typical findings are abdominal pains of unknown origin and a distinct discrepancy between the stated complaints, the poor general condition of the patient and the relatively non-contributory examination findings. A known history of cardiac diseases or an arterial occlusive disease is typically found in the event of an occlusion of the mesenteric artery. Patients with a venous thrombosis present with a frequent incidence of thrombophlebitis, coagulation disorders, abdominal inflammations and traumata, or of a tumour. A reliable preoperative diagnosis in terms of differentiation is only possible by angiography. This is always indicated unless on account of the abdominal findings the indication for laparotomy is given anyway. (orig.) [de

  6. Thrombosis of the mesenteric vein and occlusion of the mesenteric artery. A contribution to clinical differentiation

    Energy Technology Data Exchange (ETDEWEB)

    Boettger, T.; Jenny, E.; Junginger, T.; Weber, W.

    1989-01-20

    The differentiation between an arterial and a venous occlusion of a mesenteric vessel is difficult. The diagnosis of an occlusion of a mesenteric vessel in general is made preoperatively in every fourth patient only. Typical findings are abdominal pains of unknown origin and a distinct discrepancy between the stated complaints, the poor general condition of the patient and the relatively non-contributory examination findings. A known history of cardiac diseases or an arterial occlusive disease is typically found in the event of an occlusion of the mesenteric artery. Patients with a venous thrombosis present with a frequent incidence of thrombophlebitis, coagulation disorders, abdominal inflammations and traumata, or of a tumour. A reliable preoperative diagnosis in terms of differentiation is only possible by angiography. This is always indicated unless on account of the abdominal findings the indication for laparotomy is given anyway.

  7. Clinical and radiographic presentation of superior mesenteric vein thrombosis in Crohn's disease: a single center experience.

    Science.gov (United States)

    Kopylov, Uri; Amitai, Marianne M; Lubetsky, Aharon; Eliakim, Rami; Chowers, Yehuda; Ben-Horin, Shomron

    2012-06-01

    Mesenteric vein thrombosis (MVT) is a rare and frequently underdiagnosed complication of Crohn's disease (CD). This study describes the clinical and radiological characteristics of CD /patients with superior mesenteric vein thrombosis (MVT) diagnosed by CT/MRI. The database of Crohn's disease patients treated in Sheba Medical Center between 2005-2010 was searched for MVT diagnosis. Imaging studies of identified patients were retrieved and reviewed by an experienced abdominal radiologist. MVT was defined by superior mesenteric vein obliteration and/or thrombus in the vessel lumen on abdominal imaging. The clinical and radiologic data of these patients were collected from the medical records. MVT was demonstrated in 6/460 CD patients. Five patients had stricturing disease, and one patient had a combined fistulizing and stricturing disease phenotype. All patients had small bowel disease, but 3/6 also had colonic involvement. No patient had a prior thromboembolic history or demonstrable hypercoagulability. One patient had an acute SMV thrombus demonstrable on CT scanning, the remaining patients showed an obliteration of superior mesenteric vein. Two patients received anticoagulation upon diagnosis of thrombosis. No subsequent thromboembolic events were recorded. The incidence of mesenteric vein thrombosis is likely to be underestimated in patients with Crohn's disease. Both CT and MRI imaging demonstrate the extent of enteric disease and coincident SMV thrombosis. In our cohort, thrombosis was associated with stricturing disease of the small bowel. The clinical impact of SMV thrombosis and whether anticoagulation is mandatory for all of these patients remains to be determined. Copyright © 2011 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

  8. Antiphospholipid syndrome presenting as acute mesenteric venous thrombosis involving a variant inferior mesenteric vein and successful treatment with rivaroxaban.

    Science.gov (United States)

    Singh, Kevin; Khan, Gulam

    2018-03-26

    Acute mesenteric venous thrombosis (MVT) is the rarest cause of acute mesenteric ischaemia, so thrombosis of a variant inferior mesenteric vein (IMV) is especially uncommon in the setting of antiphospholipid syndrome (APS). Here, we present such a case of seronegative APS initially manifesting as an anomalous IMV thrombosis in a 76-year-old woman. Although guidelines support anticoagulation with vitamin K antagonists in these patients, we anticoagulated with rivaroxaban (a direct oral anticoagulant (DOAC)) due to patient preference, which resulted in complete clinical and endoscopic resolution. IMV thrombosis is a rare form of MVT, only two case reports describe successful anticoagulation with DOACs in the setting of MVT and none report APS as an underlying aetiology. Therefore, this case provides the opportunity to review the pathophysiology of MVT, APS and their medical management including current trends in anticoagulation. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Superior Mesenteric Vein Occlusion Causing Severe Gastrointestinal Haemorrhage in Two Paediatric Cases

    Directory of Open Access Journals (Sweden)

    Anna L. Fox

    2012-01-01

    Full Text Available Reports about superior mesenteric vein thrombosis in childhood are very rare and have not been associated with gastrointestinal bleeding. We describe two cases of severe bleeding from the upper and lower gastrointestinal tract in children who had undergone complex abdominal surgery at considerable time before. The first child had a tracheoesophageal fistula, corrected by division, gastrostomy insertion, and repair of duodenal rupture. The child presented with severe bleeding from the gastrostomy site and was diagnosed with a thrombosis of the proximal superior mesenteric vein. The second child had a gastroschisis and duodenal atresia, and required duodenoplasty, gastrostomy insertion, hemicolectomy, and adhesiolysis. The child presented with intermittent severe lower gastrointestinal bleeding, resulting from collateral vessels at location of the surgical connections. He was diagnosed with a thrombosis of the superior mesenteric vein. In both children, the extensive previous surgery and anastomosis were considered the cause of the mesenteric thrombosis. CT angiography confirmed the diagnosis in both cases, in addition to characteristic findings on endoscopy. Paediatricians should suspect this condition in children with severe gastrointestinal bleeding, particularly in children with previous, complex abdominal surgery.

  10. Acute superior mesenteric vein thrombosis associated with abdominal trauma: A rare case report and literature review.

    Science.gov (United States)

    Lim, Kyoung Hoon; Jang, Jihoon; Yoon, Hye Young; Park, Jinyoung

    2017-11-01

    Acute mesenteric vein thrombosis (MVT) is defined as new-onset thrombosis of the mesenteric vein without evidence of collateralization, finally resulting in extensive intestinal infarction. MVT may be idiopathic or be caused by conditions responsible for thrombophilia and acquired risk factors. To date, there have been few reports of MVT after trauma. Herein we describe our experiences treating three patients with MVT. Case 1 was a 44-year-old man with transverse colon mesenteric hematoma after blunt abdominal trauma. Case 2 was a 55-year-old man with jejunal transection after a traffic accident. Case 3 was a 26-year-old man presented with multiple abdominal stab bowel injury. A 1-week follow-up abdominal computed tomography scan showed superior mesenteric vein thrombosis in all of three patients. All patients were treated with anticoagulant for 3 or 6 months. MVTs were completely resolved without any complications. If early diagnosis and treatment could be available, anticoagulation alone might be adequate for the treatment of SMVT associated with trauma. Early anticoagulation in patients with acute SMVT may avoid the grave prognosis observed in patients with arterial thrombosis. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  11. MRI of portal vein and superior mesenteric venous thrombosis with intestinal ischemia

    International Nuclear Information System (INIS)

    Mo Youfa; Zhang Xuelin; Zhang Lijuan; Li Xiangliang; Hu Basheng

    2007-01-01

    Objective: To discuss the diagnostic value of MRI for portal vein (PV) and superior mesenteric venous (SMV) thrombosis. Methods: Twelve patients with portal vein and superior mesenteric venous thrombosis proved by operation and pathology were examined with T 1 WI, T 2 WI, T 2 -weighted fat suppression imaging, MR angiography (MRA) and Gd-DTPA enhanced dynamic MRI. Results: Signals in PV and SMV were detected on T 1 WI and T 2 WI in 12 cases; 3 acute thrombus presented hypo- or isointense on T 1 WI and hyperintense on T 2 WI. Hyperintense on T 1 WI and T 2 WI were showed in 8 subacute thrombus; 1 chronic thrombus presented heterogenous intense on T 1 WI and hypointense on T 2 WI. No enhancement within PV and SMV was found on Gd-DTPA enhanced images. Bowel dilatation was found in 10 cases, bowel hemorrhage in 6, bowel wall thickening in 12, intestinal pneumatosis in 3, ascites in 12, cavernous transformation of the portal vein in 3, hepatic perfusion disorder in 6. Conclusion: MRI is an important and sensitive imaging method for the diagnosis and location of portal vein and superior mesenteric venous thrombosis with intestinal ischemia. (authors)

  12. Multidetector CT venography and contrast-enhanced MR venography of the inferior mesenteric vein in paediatric extrahepatic portal vein obstruction

    International Nuclear Information System (INIS)

    Chennur, Vikash SrinivasaiahSetty; Sharma, Raju; Gamanagatti, Shivanand; Gupta, Arun Kumar; Bhatnagar, Veereshwar; Vishnubhatla, Sreenivas

    2011-01-01

    Extrahepatic portal vein obstruction (EHPVO) is a common cause of paediatric portal hypertension and the only permanent treatment is shunt surgery. The inferior mesenteric vein (IMV) is a portal venous channel that can be used for the shunt when the splenic vein/superior mesenteric vein is thrombosed or when a lienorenal shunt is not possible. To compare MDCT venography (MDCTV) and contrast-enhanced MR venography (CEMRV) for visualisation of the IMV in children with EHPVO. This was a prospective study of 26 children (4-12 years, median 10 years) who underwent MDCTV and CEMRV. The IMV visualisation was graded using 4- and 2-point scales and the difference in visualisation was assessed by calculating the exact significance probability (P). The IMV was visualised in all children on MDCTV and 25/26 children on CEMRV (96%). The images were diagnostic in 23/26 children (88%) on MDCTV and in 18/26 (69%) children on CEMRV (P = 0.063). MDCTV and CEMRV are comparable for IMV visualisation with a tendency toward MDCTV being superior. (orig.)

  13. Multidetector CT venography and contrast-enhanced MR venography of the inferior mesenteric vein in paediatric extrahepatic portal vein obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Chennur, Vikash SrinivasaiahSetty; Sharma, Raju; Gamanagatti, Shivanand; Gupta, Arun Kumar [All India Institute of Medical Sciences (AIIMS), Department of Radiology, New Delhi (India); Bhatnagar, Veereshwar [AIIMS, Department of Paediatric Surgery, New Delhi (India); Vishnubhatla, Sreenivas [AIIMS, Department of Biostatistics, New Delhi (India)

    2011-03-15

    Extrahepatic portal vein obstruction (EHPVO) is a common cause of paediatric portal hypertension and the only permanent treatment is shunt surgery. The inferior mesenteric vein (IMV) is a portal venous channel that can be used for the shunt when the splenic vein/superior mesenteric vein is thrombosed or when a lienorenal shunt is not possible. To compare MDCT venography (MDCTV) and contrast-enhanced MR venography (CEMRV) for visualisation of the IMV in children with EHPVO. This was a prospective study of 26 children (4-12 years, median 10 years) who underwent MDCTV and CEMRV. The IMV visualisation was graded using 4- and 2-point scales and the difference in visualisation was assessed by calculating the exact significance probability (P). The IMV was visualised in all children on MDCTV and 25/26 children on CEMRV (96%). The images were diagnostic in 23/26 children (88%) on MDCTV and in 18/26 (69%) children on CEMRV (P = 0.063). MDCTV and CEMRV are comparable for IMV visualisation with a tendency toward MDCTV being superior. (orig.)

  14. Small bowel stricture as a late sequela of superior mesenteric vein thrombosis.

    Science.gov (United States)

    Paraskeva, Panoraia; Akoh, Jacob A

    2015-01-01

    The increasing frequency of use of CT in patients with acute abdomen is likely to improve the diagnosis of rarely occurring conditions/causes such as superior mesenteric vein thrombosis (MVT). Despite its severe consequences, MVT often presents with nonspecific clinical features. AD, a 64-year-old man was an emergency admission with vague abdominal discomfort of two weeks duration, acute upper abdominal pain, loose stools, fresh rectal bleeding and vomiting. A contrast enhanced abdominal CT showed thrombosis of the proximal portal vein and the entire length of the superior mesenteric vein (SMV) with small bowel ischaemia extending from the terminal ileum to the mid jejunal loops. Tests for paroxysmal nocturnal haemoglobinuria and Janus kinase 2 mutation yielded negative results. AD was readmitted seven months later with small bowel obstruction requiring segmental small bowel resection with end-to-end anastomosis. Abdominal CT had shown complete resolution of MVT but a small bowel stricture. Thrombosis limited to mesenteric veins results in earlier and more frequent development of infarction compared to portal combined with mesenteric venous thrombosis. Most patients may be successfully treated with anti-coagulation therapy alone. However, surgery may be required to deal with intestinal infarction or late sequela of MVT. This case demonstrates that MVT can be reversed by effective anticoagulation. However, the price paid for a mild to moderate effect on the bowel may be significant stricture later on. Patients escaping early bowel resection due to massive MVT leading to bowel infarction may still require resection later due to stricture. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. Percutaneous Mesocaval Shunt Creation in a Patient with Chronic Portal and Superior Mesenteric Vein Thrombosis

    International Nuclear Information System (INIS)

    Bercu, Zachary L.; Sheth, Sachin B.; Noor, Amir; Lookstein, Robert A.; Fischman, Aaron M.; Nowakowski, F. Scott; Kim, Edward; Patel, Rahul S.

    2015-01-01

    The creation of a transjugular intrahepatic portosystemic shunt (TIPS) is a critical procedure for the treatment of recurrent variceal bleeding and refractory ascites in the setting of portal hypertension. Chronic portal vein thrombosis remains a relative contraindication to conventional TIPS and options are limited in this scenario. Presented is a novel technique for management of refractory ascites in a patient with hepatitis C cirrhosis and chronic portal and superior mesenteric vein thrombosis secondary to schistosomiasis and lupus anticoagulant utilizing fluoroscopically guided percutaneous mesocaval shunt creation

  16. Percutaneous Mesocaval Shunt Creation in a Patient with Chronic Portal and Superior Mesenteric Vein Thrombosis.

    Science.gov (United States)

    Bercu, Zachary L; Sheth, Sachin B; Noor, Amir; Lookstein, Robert A; Fischman, Aaron M; Nowakowski, F Scott; Kim, Edward; Patel, Rahul S

    2015-10-01

    The creation of a transjugular intrahepatic portosystemic shunt (TIPS) is a critical procedure for the treatment of recurrent variceal bleeding and refractory ascites in the setting of portal hypertension. Chronic portal vein thrombosis remains a relative contraindication to conventional TIPS and options are limited in this scenario. Presented is a novel technique for management of refractory ascites in a patient with hepatitis C cirrhosis and chronic portal and superior mesenteric vein thrombosis secondary to schistosomiasis and lupus anticoagulant utilizing fluoroscopically guided percutaneous mesocaval shunt creation.

  17. Percutaneous Mesocaval Shunt Creation in a Patient with Chronic Portal and Superior Mesenteric Vein Thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Bercu, Zachary L., E-mail: zachary.bercu@mountsinai.org; Sheth, Sachin B., E-mail: sachinsheth@gmail.com [Icahn School of Medicine at Mount Sinai, Division of Interventional Radiology (United States); Noor, Amir, E-mail: amir.noor@gmail.com [The George Washington University School of Medicine and Health Sciences (United States); Lookstein, Robert A., E-mail: robert.lookstein@mountsinai.org; Fischman, Aaron M., E-mail: aaron.fischman@mountsinai.org; Nowakowski, F. Scott, E-mail: scott.nowakowski@mountsinai.org; Kim, Edward, E-mail: edward.kim@mountsinai.org; Patel, Rahul S., E-mail: rahul.patel@mountsinai.org [Icahn School of Medicine at Mount Sinai, Division of Interventional Radiology (United States)

    2015-10-15

    The creation of a transjugular intrahepatic portosystemic shunt (TIPS) is a critical procedure for the treatment of recurrent variceal bleeding and refractory ascites in the setting of portal hypertension. Chronic portal vein thrombosis remains a relative contraindication to conventional TIPS and options are limited in this scenario. Presented is a novel technique for management of refractory ascites in a patient with hepatitis C cirrhosis and chronic portal and superior mesenteric vein thrombosis secondary to schistosomiasis and lupus anticoagulant utilizing fluoroscopically guided percutaneous mesocaval shunt creation.

  18. Portal, superior mesenteric and splenic vein thrombosis secondary to hyperhomocysteinemia with pernicious anemia: a case report.

    Science.gov (United States)

    Venkatesh, Prashanth; Shaikh, Nissar; Malmstrom, Mohammad F; Kumar, Vajjala R; Nour, Bakr

    2014-08-25

    Acute portomesenteric vein thrombosis is an uncommon but serious condition with potential sequelae, such as small-bowel gangrene and end-stage hepatic failure. It is known to be caused by various pro-thrombotic states, including hyperhomocysteinemia. We describe what is, to the best of our knowledge, the first reported case of concomitant thrombosis of portal, superior mesenteric and splenic veins due to hyperhomocysteinemia secondary to pernicious anemia and no other risk factors. A 60-year-old Indian man presented with epigastric pain, diarrhea and vomiting. An abdominal imaging scan showed that he had concomitant pernicious anemia and concomitant portal, superior mesenteric and splenic vein thrombosis. A work-up for the patient's hypercoagulable state revealed hyperhomocysteinemia, an undetectable vitamin B12 level and pernicious anemia with no other thrombophilic state. He developed infarction with perforation of the small bowel and subsequent septic shock with multi-organ dysfunction syndrome, and he ultimately died due to progressive hepatic failure. This report demonstrates that pernicious anemia, on its own, can lead to hyperhomocysteinemia significant enough to lead to lethal multiple splanchnic vein thrombosis. Our case also underscores the need to (1) consider portomesenteric thrombosis in the differential diagnosis of epigastric abdominal pain, (2) perform a complete thrombotic work-up to elucidate metabolic abnormalities that could be contributing to a pro-thrombotic state and (3) initiate aggressive measures, including early consideration of multi-visceral transplantation, in order to avoid decompensation and a significant adverse outcome.

  19. A case report of minimal change nephrotic syndrome complicated with portal, splenic and superior mesenteric vein thrombosis.

    Science.gov (United States)

    Wang, Jun; Fan, QiuLing; Chen, Ying; Dong, Xuezhu; Zhang, YuXia; Feng, JiangMin; Ma, JianFei; Wang, LiNing

    2012-06-01

    Venous thrombosis is common in nephrotic syndrome, but portal vein thrombosis has a relatively low incidence in patients with nephrotic syndrome. We describe here a case of an 18-year old male student with newly diagnosed nephrotic syndrome that was complicated with portal, splenic and superior mesenteric vein thrombosis. In the presence of newly diagnosed nephrotic syndrome of minimal change disease, thrombus formation can occur and should be noted, particularly when it occurs, in rare sites. The recognition in nephrotic syndrome complicated with portal, splenic and superior mesenteric vein thrombosis should be emphasized.

  20. Ligation of superior mesenteric vein and portal to splenic vein anastomosis after superior mesenteric-portal vein confluence resection during pancreaticoduodenectomy – Case report

    Directory of Open Access Journals (Sweden)

    Jianlin Tang

    2014-12-01

    Conclusion: The lessons we learned are (1 Before SMPV confluence resection, internal jugular vein graft should be ready for reconstruction. (2 Synthetic graft is an alternative for internal jugular vein graft. (3 Direct portal vein to SMV anastomosis can be achieved by mobilizing liver. (4 It is possible that venous collaterals secondary to SMV tumor obstruction may have allowed this patient's post-operative survival.

  1. Superior mesenteric vein thrombosis as a complication of cecal diverticulitis: A case report

    Directory of Open Access Journals (Sweden)

    Soniya Pinto

    2016-01-01

    Full Text Available Pylephlebitis is an uncommon complication of uncontrolled intra-abdominal infection that is associated with high morbidity and mortality. We present our experience with a unique case of cecal diverticulitis and septic thrombophlebitis of the superior mesenteric vein that was promptly diagnosed with high-resolution imaging and blood cultures. Antibiotic and anticoagulation therapy was instituted on confirming the diagnosis with magnetic resonance imaging (MRI to control the infection and prevent propagation of the thrombus. Our case report raises awareness about a rare and potentially fatal condition and provides appropriate imaging supplementation to aid in timely diagnosis.

  2. Super-mesenteric-vein-expia-thrombosis, the clinical sequelae can be quite atrocious.

    Science.gov (United States)

    Lole Harris, Benjamin Howell; Walsh, Jason Leo; Nazir, Sarfraz A

    2016-11-01

    Superior mesenteric vein (SMV) thrombosis is a rare, potentially life-threatening complication of intra-abdominal infection. Here we present a case of massive SMV thrombosis secondary to appendicitis in a 13-year-old boy. He presented with vague abdominal pain and associated symptoms, persistently elevated serum inflammatory markers and a pyrexia of unknown origin. Sonography proved inconclusive, and a definitive diagnosis was made by abdominal contrast-enhanced computed tomography. He was treated with antibiotics and anticoagulation before interval elective laparoscopic appendectomy. The non-specific nature of the presenting symptoms makes SMV thrombosis an important differential to consider when dealing with such patients.

  3. An Autopsy Case of Acute Massive Hematochezia Caused by Superior Mesenteric Vein Thrombosis: A First Report in Forensic Medicine.

    Science.gov (United States)

    Watanabe, Mayumi; Unuma, Kana; Makino, Yohsuke; Noritake, Kanako; Yamada, Atsushi; Iwase, Hirotaro; Uemura, Koichi

    2016-01-01

    Superior mesenteric vein thrombosis (SMVT) is an uncommon cause of intestinal ischemia and massive gastrointestinal bleeding. This report describes a man with alcoholic liver cirrhosis, who died of massive hematochezia due to SMVT. A medicolegal autopsy disclosed a thrombus at the superior mesenteric vein and hemorrhagic infarction of the bowel wall, an area also within the territory of the superior mesenteric vein. Liver cirrhosis, an enlarged spleen, and esophageal varices without rupture were also observed, but ulcers and variceal bleeding were not. Other organs showed no significant findings. His blood alcohol level was 0.14% w/v. Thus, this man died from severe hematochezia associated with SMVT due to liver cirrhosis and alcohol dehydration, which can lead to coagulopathy and rapid progress of thrombus formation. This is the first report on an alternate cause for massive gastrointestinal hemorrhage with a cirrhotic patient in a forensic autopsy. © 2015 American Academy of Forensic Sciences.

  4. Diagnostic imagings and embolotherapy for the superior mesenteric vein-inferior vena cava shunt

    International Nuclear Information System (INIS)

    Morita, Yutaka; Yamada, Masataka; Miyata, Mutsuhiko; Kubo, Kohzo.

    1994-01-01

    Diagnostic imaging and embolization therapy for the uncommon portal and mesenteric vein-inferior vena cave shunt (PV·SMV-IVC shunt) are reported. As the frequency of clinical symptoms such as hematemesis, melena and confusion caused by gastrointestinal varices, or hepatoencephalopathy was about 40%, it was important for this disease entity to be diagnosed with noninvasive diagnostic images. The careful examination of the area around the right renal vein was able to overcome the low diagnostic rate of 20-40% obtained with US and CT images. In cases of simple PV·SMV-IVC shut without gastrointestinal varices, embolization therapy using steel coils and done by the intravenous approach is easy and noninvasive. On the other hand, in cases of complex PV-SMV-IVC shunt with gastrointestinal varices, dual balloon occluded embolization therapy using a liquid sclerosing agent and done by the intravenous and portal approaches is preferable. (author)

  5. Mesenteric vein thrombosis following impregnation via in vitro fertilization-embryo transfer.

    Science.gov (United States)

    Hirata, Masaaki; Yano, Hiroko; Taji, Tomoe; Shirakata, Yoshiharu

    2017-10-27

    Pregnancy is an acquired hypercoagulable state. Most patients with thrombosis that develops during pregnancy present with deep vein leg thrombosis and/or pulmonary embolism, whereas the development of mesenteric vein thrombosis (MVT) in pregnant patients is rare. We report a case of MVT in a 34-year-old woman who had achieved pregnancy via in vitro fertilization-embryo transfer (IVF-ET). At 7 wk of gestation, the patient was referred to us due to abdominal pain accompanied by vomiting and hematochezia, and she was diagnosed with superior MVT. Following resection of the gangrenous portion of the small intestine, anticoagulation therapy with unfractionated heparin and thrombolysis therapy via a catheter placed in the superior mesenteric artery were performed, and the patient underwent an artificial abortion. Oral estrogen had been administered for hormone replacement as part of the IVF-ET procedure, and additional precipitating factors related to thrombosis were not found. Pregnancy itself, in addition to the administered estrogen, may have caused MVT in this case. We believe that MVT should be included in the differential diagnosis of a pregnant patient who presents with an acute abdomen.

  6. Vascular reactivity of mesenteric arteries and veins to endothelin-1 in a murine model of high blood pressure.

    Science.gov (United States)

    Pérez-Rivera, Alex A; Fink, Gregory D; Galligan, James J

    2005-06-01

    We characterized vascular reactivity to endothelin-1 (ET-1) in mesenteric vessels from DOCA-salt hypertensive and SHAM control mice and assessed the effect that endothelial-derived vasodilators have on ET-1-induced vasoconstriction. Changes in the diameter of unpressurized small mesenteric arteries and veins (100- to 300-microm outside diameter) were measured in vitro using computer-assisted video microscopy. Veins were more sensitive than arteries to the contractile effects of ET-1. There was a decrease in arterial maximal responses (E(max)) compared to veins, this effect was larger in DOCA-salt arteries. The selective ET(B) receptor agonist, sarafotoxin 6c (S6c), contracted DOCA-salt and SHAM veins but did not contract arteries. The ET(B) receptor antagonist, BQ-788 (100 nM), but not the ET(A) receptor antagonist, BQ-610 (100 nM), blocked S6c responses. BQ-610 partially inhibited responses to ET-1 in mesenteric veins from DOCA-salt and SHAM mice while BQ-788 did not affect responses to ET-1. Co-administration of both antagonists inhibited responses to ET-1 to a greater extent than BQ-610 alone suggesting a possible functional interaction between ET(A) and ET(B) receptors. Responses to ET-1 in mesenteric arteries were completely inhibited by BQ-610 while BQ-788 did not affect arterial responses. Nitric oxide synthase inhibition potentiated ET-1 responses in veins from SHAM but not DOCA-salt mice. There was a prominent role for ET-mediated nitric oxide release in DOCA-salt but not SHAM arteries. In summary, these studies showed a differential regulation of ET-1 contractile mechanisms between murine mesenteric arteries and veins.

  7. Use of inferior mesenteric vein as an interposition graft for distal renal shunt – A case report

    Directory of Open Access Journals (Sweden)

    Fábio César Miranda Torricelli

    2007-03-01

    Full Text Available Upper digestive bleeding due to rupture of esophageal varices is asevere complication of portal hypertension in cirrhotic patients. Whenit is associated with portal vein thrombosis, transjugular intrahepaticportosystemic shunt or endoscopic procedures are difficult and lesseffective. In this situation, splenorenal shunt is a good alternative.The aim was to discuss a distal splenorenal shunt with autologousinferior mesenteric vein graft. We report a case of a male patient, 52years old, suffering from alcoholic hepatic cirrhosis and portal veinthrombosis. He had nine episodes of upper digestive bleeding, in spiteof endoscopic treatment. His hepatic function remained good and distalsplenorenal shunt was chosen as the best therapeutic option. Theinferior mesenteric vein was used as an interposition graft for distalrenal shunt due to unexpected events during splenic vein dissection.Postoperative recovery went uneventfully.

  8. How to reduce the superior mesenteric vein bleeding risk during laparoscopic right hemicolectomy.

    Science.gov (United States)

    Garcia-Granero, Alvaro; Sánchez-Guillén, Luis; Frasson, Matteo; Sancho Muriel, Jorge; Alvarez Sarrado, Eduardo; Fletcher-Sanfeliu, Delfina; Flor Lorente, Blas; Pamies, Jose; Corral Rubio, Javier; Valverde Navarro, Alfonso A; Martinez Soriano, Francisco; Garcia-Granero, Eduardo

    2018-02-01

    The superior right colic vein (SRCV) has been proposed as the main cause of superior mesenteric vein bleeding by avulsion during laparoscopic right hemicolectomy. Our objective is to identify the main vessel causing transverse mesocolic tension during the extraction of the surgical specimen or extracorporeal anastomosis and to perform an anatomical description of the SRCV. In this cadaveric study, we performed a simulation of right hemicolectomy and anatomical description of the surgical area of the gastrocolic trunk of Henle (SAGCTH), the gastrocolic trunk of Henle (GCTH), and SRCV. The length of the exteriorization of the anastomotic transverse colon (ATC) was measured before and after sectioning the vascular vessel causing the exteriorization tension. Five fresh cadavers and 12 formalin were dissected. In 100% of the specimens, the SRCV was present and drained in 95% into the GCTH and in 5% directly into the superior mesenteric vein (SMV). In 100% of the specimens, the SRCV caused the tension when extracting the ATC. The mean length of exteriorization of the ATC before and after SRCV section was 7.2 and 10.4 cm in formalin cadavers, meaning a 44% of increment in the length of exteriorization. In fresh cadavers, the mean length of exteriorization increased to 2.7 cm, meaning a 28% of the initial length of exteriorization. The SRCV is the main cause of tension in the extraction of the surgical specimen after right hemicolectomy. Its high tie increases the length of the ATC exteriorization, in about 3 cm, and could reduce the risk of SMV bleeding during laparoscopic right hemicolectomy and facilitate an extracorporeal anastomosis free of tension.

  9. Clinical analysis of patients with autoimmune disease complicated by mesenteric vein thrombosis: a retrospective study in a hospital.

    Science.gov (United States)

    Luo, Wen; Li, Mingwei; Luo, Jing; He, Yueming

    2012-05-01

    To analyze the clinical characteristics of patients with mesenteric venous thrombosis related to autoimmune disease (AID). Retrospective study of 5 AID patients with mesenteric vein thrombosis in a single hospital. All 5 patients were female with an average age of 57.6 years. At the clinical visit all patients had clinical manifestations with signs of mesenteric blood vessel involvement and a significant increase of inflammatory markers. Surgical exploration identified peritonitis in all 5 cases - 2 cases of intestinal stenosis with mucosal ulcers and 3 cases of intestinal necrosis complicated by perforation. All 5 patients underwent partial bowel resection. Pathological examination confirmed chronic inflammation and vasculitis of intestinal connective tissue, combined with the formation of mesenteric vein thrombosis. Mesenteric vein thrombosis is a serious complication of AID. AID patients with digestive tract symptoms should be screened by abdominal imaging. In addition to early hormonal therapy and immunosuppressant treatment of the primary disease, surgical treatment should be performed as soon as possible if the disease progresses.

  10. Detection of superior mesenteric vein thrombosis by real time and Doppler sonography. [comparison with CT and radiographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Mildenberger, P.; Schild, H.; Jenny, E.

    1988-08-01

    Superior mesenteric vein thrombosis after splenectomy is very rare. In the case described of a patient presenting with acute abdominal pain the diagnosis was made primarily by real-time and Doppler ultrasonography. This reduced the time elapsing before it was recognized that angiography and subsequent thrombectomy were indicated.

  11. Simultaneous thrombosis of the mesenteric artery and vein as a novel clinical manifestation of intravascular large B-cell lymphoma.

    Science.gov (United States)

    Arima, Hiroshi; Inoue, Daichi; Tabata, Sumie; Matsushita, Akiko; Imai, Yukihiro; Ishikawa, Takayuki; Takahashi, Takayuki

    2014-01-01

    A 79-year-old man with a 2-month history of fever and weight loss was admitted to our hospital because of an acute abdomen. Abdominal CT scans showed marked sectional thickening and edema of the small intestine. On laparotomy, a 16-cm section of the small intestine was ischemic and necrotic; therefore, segmentectomy of the intestine was performed. A thrombus was noted at the stump of the mesenteric artery branch. Histopathological analysis of the resected intestine revealed fibrin thrombi in both mesenteric arteries and veins. Furthermore, a cluster of large, abnormal lymphoid cells bordering the intima of most branches of the mesenteric veins and small vessels was observed. Immunohistochemical analysis revealed that these abnormal cells were positive for CD20, leading to a diagnosis of intravascular large B-cell lymphoma (IVLBCL). The patient was successfully treated with standard R-CHOP chemotherapy; however, the lymphoma recurred in the central nervous system 18 months after the initial diagnosis, and the patient died. Simultaneous thrombosis of the mesenteric artery and vein is unusual as a clinical manifestation of IVLBCL. However, IVLBCL should be taken into consideration when ischemic disorders of unknown cause, accompanied by fever of unknown origin, are encountered. © 2014 S. Karger AG, Basel.

  12. Transjugular Intrahepatic Portosystemic Shunt, Mechanical Aspiration Thrombectomy, and Direct Thrombolysis in the Treatment of Acute Portal and Superior Mesenteric Vein Thrombosis

    International Nuclear Information System (INIS)

    Ferro, Carlo; Rossi, Umberto G.; Bovio, Giulio; Dahamane, M'Hamed; Centanaro, Monica

    2007-01-01

    A patient was admitted because of severe abdominal pain, anorexia, and intestinal bleeding. Contrast-enhanced multidetector computed tomography demonstrated acute portal and superior mesenteric vein thrombosis (PSMVT). The patient was treated percutaneously with transjugular intrahepatic portosystemic shunt (TIPS), mechanical aspiration thrombectomy, and direct thrombolysis, and 1 week after the procedure, complete patency of the portal and superior mesenteric veins was demonstrated. TIPS, mechanical aspiration thrombectomy, and direct thrombolysis together are promising endovascular techniques for the treatment of symptomatic acute PSMVT

  13. Huge Varicose Inferior Mesenteric Vein: an Unanticipated {sup 99m}Tc-labeled Red Blood Cell Scintigraphy Finding

    Energy Technology Data Exchange (ETDEWEB)

    Hoseinzadeh, Samaneh; Shafiei, Babak; Salehian, Mohamadtaghi; Neshandar Asli, Isa; Ghodoosi, Iraj [Shaheed Beheshti Medical University, Tehran (Iran, Islamic Republic of)

    2010-09-15

    Ectopic varices (EcV) are enlarged portosystemic venous collaterals, which usually develop secondary to portal hypertension (PHT). Mesocaval collateral vessels are unusual pathways to decompress the portal system. Here we report the case of a huge varicose inferior mesenteric vein (IMV) that drained into peri rectal collateral veins, demonstrated by {sup 99m}Tc-labeled red blood cell (RBC) scintigraphy performed for lower gastrointestinal (GI) bleeding in a 14-year-old girl. This case illustrates the crucial role of {sup 99m}Tc-labeled RBC scintigraphy for the diagnosis of rare ectopic lower GI varices.

  14. Type 2 diabetes mellitus as a risk factor for intestinal resection in patients with superior mesenteric vein thrombosis.

    Science.gov (United States)

    Elkrief, Laure; Corcos, Olivier; Bruno, Onorina; Larroque, Beatrice; Rautou, Pierre-Emmanuel; Zekrini, Kamal; Bretagnol, Frédéric; Joly, Francisca; Francoz, Claire; Bondjemah, Vanessa; Cazals-Hatem, Dominique; Boudaoud, Larbi; De Raucourt, Emmanuelle; Panis, Yves; Goria, Odile; Hillaire, Sophie; Valla, Dominique; Plessier, Aurélie

    2014-10-01

    The most serious complication of acute mesenteric vein thrombosis (MVT) is acute intestinal ischaemia requiring intestinal resection or causing death. Risk factors for this complication are unknown. To identify risk factors for severe intestinal ischaemia leading to intestinal resection in patients with acute MVT. We retrospectively analysed consecutive patients seen between 2002 and 2012 with acute MVT in 2 specialized units. Patients with cirrhosis were excluded. We compared patients who required intestinal resection to patients who did not. Among 57 patients, a local risk factor was identified in 14 (24%) patients, oral contraceptive use in 16 (29%), and at least one or more other systemic prothrombotic condition in 25 (44%). Five (9%) patients had diabetes mellitus (DM), 33 (58%) had overweight or obesity, 9 (18%) had hypertriglyceridemia and 10 (19%) had arterial hypertension. Eleven patients (19%) underwent intestinal resection. DM was significantly associated with intestinal resection (P = 0.02) while local factors or prothrombotic conditions were not. Computed tomography (CT) scans performed at diagnosis found that occlusion of second order radicles of the superior mesenteric vein was more frequently observed in patients who underwent intestinal resection (P = 0.009). In acute MVT, patients with underlying DM have an increased risk of requiring intestinal resection. Neither local factors nor systemic prothrombotic conditions are associated with intestinal resection. When CT scan shows the preservation of second order radicles of the superior mesenteric vein, the risk of severe resection is low. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Transradial Approach for Transcatheter Selective Superior Mesenteric Artery Urokinase Infusion Therapy in Patients with Acute Extensive Portal and Superior Mesenteric Vein Thrombosis

    International Nuclear Information System (INIS)

    Wang Maoqiang; Guo Liping; Lin Hanying; Liu Fengyong; Duan Feng; Wang Zhijun

    2010-01-01

    The purpose of this investigation was to assess the feasibility and effectiveness of transradial approach for transcatheter superior mesenteric artery (SMA) urokinase infusion therapy in patients with acute extensive portal and superior mesenteric venous thrombosis. During a period of 7 years, 16 patients with acute extensive thrombosis of the portal (PV) and superior mesenteric veins (SMV) were treated by transcatheter selective SMA urokinase infusion therapy by way of the radial artery. The mean age of the patients was 39.5 years. Through the radial sheath, a 5F Cobra catheter was inserted into the SMA, and continuous infusion of urokinase was performed for 5-11 days (7.1 ± 2.5 days). Adequate anticoagulation was given during treatment, throughout hospitalization, and after discharge. Technical success was achieved in all 16 patients. Substantial clinical improvement was seen in these 16 patients after the procedure. Minor complications at the radial puncture site were observed in 5 patients, but trans-SMA infusion therapy was not interrupted. Follow-up computed tomography scan before discharge demonstrated nearly complete disappearance of PV-SMV thrombosis in 9 patients and partial recanalization of PV-SMV thrombosis in 7 patients. The 16 patients were discharged 9-19 days (12 ± 6.0 days) after admission. Mean duration of follow-up after hospital discharge was 44 ± 18.5 months, and no recurrent episodes of PV-SMV thrombosis developed during that time period. Transradial approach for transcatheter selective SMA urokinase infusion therapy in addition to anticoagulation is a safe and effective therapy for the management of patients with acute extensive PV-SMV thrombosis.

  16. [Transradial approach for transcatheter selective superior mesenteric artery urokinase infusion therapy in patients with acute extensive portal and superior mesenteric vein thrombosis].

    Science.gov (United States)

    Wang, Yan; Wang, Mao-qiang; Liu, Feng-yong; Wang, Zhi-jun; Duan, Feng; Song, Peng

    2012-06-05

    To evaluate the feasibility and efficacy of urokinase infusion therapy via a transradial approach for transcatheter superior mesenteric artery (SMA) in patients with acute extensive portal and superior mesenteric venous thrombosis. During a period of 8 years, 47 patients with acute extensive thrombosis of portal vein (PV) and superior mesenteric veins (SMV) received urokinase infusion therapy by transcatheter selective SMA via radial artery. Their mean age was 44 ± 13 years (range: 19 - 65). Through radial sheath, a 5F catheter was placed into SMA and subsequently the infusion of urokinase was given for 5 - 11 days (mean: 7.1 ± 2.5). Adequate anticoagulation was initiated during treatment, throughout hospitalization and post-discharge. Follow-up contrast-enhanced computed tomography (CT) was performed in each patient every 3 days and before the removal of infusion catheter. Termination of urokinase infusion therapy was decided on the basis of clinical and radiographic findings. Technical success was achieved in all patients. Two patients had worsening abdominal pain, developed the signs of peritonitis at 24 hours after interventional treatment and underwent eventual laparotomy with the resection of necrotic bowel. Substantial clinical improvement was observed in 45 (95.7%) of them after the procedure. Minor complications at the radial puncture site were observed in 7 patients (14.9%) and infusion therapy continued. Follow-up CT scans at pre-discharge demonstrated a nearly complete disappearance of PV-SMV thrombosis in 29 patients (64.4%) and partial recanalization of PV-SMV thrombosis in 16 patients (35.6%). They were discharged at 9 - 20 days (mean: 12 ± 6) post-admission. The mean post-discharge duration of follow-up was 48 ± 20 months. Recurrent episodes of PV and SMV thrombosis were observed in 2 (4.4%) patients at 6 months and 5 years respectively post-discharge and they were treated successfully with urokinase infusion. The transcatheter SMA urokinase

  17. Portal vein thrombosis secondary to embolization of superior mesenteric arteriovenous fistula.

    Science.gov (United States)

    Zhao, Yuliang; Li, Zhengyan; Zhang, Ling; Wei, Bo; Zeng, Xiaoxi; Fu, Ping

    2014-02-01

    Superior mesenteric arteriovenous fistula is a rare vascular disorder. Endovascular embolization has been widely used to treat this disease. Patients receiving successful fistula embolization generally have good prognoses. We present a man with iatrogenic superior mesenteric arteriovenous fistula who received endovascular embolization. Portal thrombus was detected on postoperative day 2, and the patient eventually died of multiple organ failure on postoperative day 13 despite having received antithrombotic and antiplatelet therapy. We identified portal thrombosis as a serious complication of transcatheter superior mesenteric arteriovenous fistula embolization. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. SUPERIOR MESENTERIC VEIN THROMBOSIS AND CYTOMEGALOVIRUS: A DIAGNOSTIC DILEMMA. A CASE REPORT AND REVIEW OF THE LITERATURE.

    Directory of Open Access Journals (Sweden)

    Vincenzo Davide Palumbo

    2014-04-01

    Full Text Available Superior mesenteric vein thrombosis (SMVT is a rare condition, usually caused by infections, intra-abdominal inflammatory diseases, portal hypertension, hypercoagulable states, or contraceptive therapy. Due to its vague symptomatology, SMVT is often diagnosed only after an abdominal contrast-enhanced computed tomography (CT scan. In this article, we present a case of SMVT in a patient with a history of contraceptive drug use and a recent cytomegalovirus infection. A 36-year-old female was admitted to our department with the clinical symptoms of an acute appendicitis. The patient was a smoker and had been using hormonal contraceptives for over a year. Surgery was deemed the best course of action. Before the operation, blood tests showed a mild lymphocytosis and altered liver enzyme levels, while coagulation values were normal. A contrast-enhanced CT scan revealed a complete superior mesenteric vein thrombosis without signs of bowel ischemia. Anticoagulants were immediately administered. A thrombophilia panel did not highlight any noteworthy elements. Cytomegalovirus (CMV tests resulted positive. Since CMV is a rare, but potentially significant cause or precipitating factor for thrombosis in immunocompetent hosts, all patients with an unexplained fever and seemingly spontaneous thrombosis should be screened for CMV infection.

  19. Thrombosis of the superior mesenteric vein in association with hormonal contraceptive use. A case report and review of the literature.

    Science.gov (United States)

    Gubitosi, Adelmo; Docimo, Giovanni; Avenia, Nicola; Ruggiero, Roberto; Esposito, Franceso; Esposito, Emanuela; Foroni, Fabrizio; Agresti, Massimo

    2011-01-01

    There are a number of reports in the literature which describe the association of venous thrombosis with oral contraceptives. Venous thrombosis is a rare form of mesenteric ischemia which may be lethal if not diagnosed and treated quickly. Although the non specificity of clinical signs do not always permit an early diagnosis. The patient, aged 52, with a case history characterized by alteration of the alvus with occasional emission of blood, and abdominal pain. She referred with metrorrhagia of about one year, and was being treated with Ethynylestradiol/Gestodene. A CAT scan with contrast showed the signs of thrombosis in the superior mesenteric vein. The patient underwent surgical laparotomy. On opening the peritoneum we found a large tumefaction formed of conglobate iliac loops together with intense inflammation. A resection of the tumefaction was performed "en bloc". Pharmacological contraception remains in various cases as the only identified risk factor and there are reports which also censure a relationship of greater risk with increased hormonal doses and even reports of mesenteric venous thrombosis in patients taking triphasic drugs. Thus, we may state with near certainty, that a relationship between pharmacological contraceptives and mesenteric venous thrombosis exists and is probably more than a simple risk factor in contrast to that which exists for tobacco smoking and obesity. Before the prescription of contraceptive therapy the examination of risk factors is necessary, compiled preferably by hematochemical screening to exclude haematological and/or coagulative pathologies, and not deriding the use of non-pharmalogical methods of contraception when possible. Considering the technological advancement of instrumentation (CAT scan, angiogram), even a diagnosis aimed at a suspected clinical history; starting from less invasive screening by ultrasonographic Doppler, might induce to a rapid intervention and thereby avoid sacrificing too much intestinal tissue

  20. Acute Superior Mesenteric Venous Thrombosis: Transcatheter Thrombolysis and Aspiration Thrombectomy Therapy by Combined Route of Superior Mesenteric Vein and Artery in Eight Patients

    International Nuclear Information System (INIS)

    Yang, Shuofei; Liu, Baochen; Ding, Weiwei; He, Changsheng; Wu, Xingjiang; Li, Jieshou

    2015-01-01

    PurposeTo assess the feasibility, effectiveness, and safety of catheter-directed thrombolysis and aspiration thrombectomy therapy by combined route of superior mesenteric vein and artery (SMV+SMA) for acute superior mesenteric venous thrombosis (ASMVT).MethodsThis retrospective study reviewed eight ASMVT patients with transcatheter direct thrombolysis and aspiration thrombectomy therapy via SMV and indirect thrombolysis via SMA during a period of 14 months. The demographics, etiology, risk factors, therapeutic effect, complications, mortality, and follow-up of the study population were assessed. Anatomic and imaging classification of location and extent of thrombus at diagnosis and degree of thrombus lysis were described.ResultsTechnical success was achieved with substantial improvement in symptoms and thrombus resolution after thrombolytic therapy in all patients. The local urokinase infusion by SMA and SMV was performed for 5–7 (6.13 ± 0.83) and 7–15 (12 ± 2.51) days. Anticoagulation was performed catheter-directed and then orally throughout hospitalization and after discharge. Four patients required delayed localized bowel resection after thrombolytic therapy with no death. Thrombolytic therapy was not interrupted despite minor bleeding at the puncture site in two patients and sepsis in another two postoperatively. Nearly complete removal of thrombus was demonstrated by contrast-enhanced CT scan and portography before discharge. Patients were discharged in 10–27 (19.25 ± 4.89) days after admission. No recurrence developed during the follow-up of 10–13 (12.13 ± 0.99) months.ConclusionsCatheter-directed thrombolytic and aspiration therapy via SMV+SMA is beneficial for ASMVT in avoiding patient death, efficient resolving thrombus, rapid improving symptoms, reversing extensive intestinal ischemia, averting bowel resection, or localizing infarcted bowel segment and preventing short bowel syndrome

  1. Acute superior mesenteric venous thrombosis: transcatheter thrombolysis and aspiration thrombectomy therapy by combined route of superior mesenteric vein and artery in eight patients.

    Science.gov (United States)

    Yang, Shuofei; Liu, Baochen; Ding, Weiwei; He, Changsheng; Wu, Xingjiang; Li, Jieshou

    2015-02-01

    To assess the feasibility, effectiveness, and safety of catheter-directed thrombolysis and aspiration thrombectomy therapy by combined route of superior mesenteric vein and artery (SMV+SMA) for acute superior mesenteric venous thrombosis (ASMVT). This retrospective study reviewed eight ASMVT patients with transcatheter direct thrombolysis and aspiration thrombectomy therapy via SMV and indirect thrombolysis via SMA during a period of 14 months. The demographics, etiology, risk factors, therapeutic effect, complications, mortality, and follow-up of the study population were assessed. Anatomic and imaging classification of location and extent of thrombus at diagnosis and degree of thrombus lysis were described. Technical success was achieved with substantial improvement in symptoms and thrombus resolution after thrombolytic therapy in all patients. The local urokinase infusion by SMA and SMV was performed for 5-7 (6.13 ± 0.83) and 7-15 (12 ± 2.51) days. Anticoagulation was performed catheter-directed and then orally throughout hospitalization and after discharge. Four patients required delayed localized bowel resection after thrombolytic therapy with no death. Thrombolytic therapy was not interrupted despite minor bleeding at the puncture site in two patients and sepsis in another two postoperatively. Nearly complete removal of thrombus was demonstrated by contrast-enhanced CT scan and portography before discharge. Patients were discharged in 10-27 (19.25 ± 4.89) days after admission. No recurrence developed during the follow-up of 10-13 (12.13 ± 0.99) months. Catheter-directed thrombolytic and aspiration therapy via SMV+SMA is beneficial for ASMVT in avoiding patient death, efficient resolving thrombus, rapid improving symptoms, reversing extensive intestinal ischemia, averting bowel resection, or localizing infarcted bowel segment and preventing short bowel syndrome.

  2. Acute Superior Mesenteric Venous Thrombosis: Transcatheter Thrombolysis and Aspiration Thrombectomy Therapy by Combined Route of Superior Mesenteric Vein and Artery in Eight Patients

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Shuofei, E-mail: yangshuofei@gmail.com; Liu, Baochen, E-mail: 306446264@qq.com; Ding, Weiwei, E-mail: dingwei-nju@hotmail.com; He, Changsheng, E-mail: hechsh@163.com; Wu, Xingjiang, E-mail: wuxingjiang@sohu.com; Li, Jieshou, E-mail: lijieshou2013@sohu.com [Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University (China)

    2015-02-15

    PurposeTo assess the feasibility, effectiveness, and safety of catheter-directed thrombolysis and aspiration thrombectomy therapy by combined route of superior mesenteric vein and artery (SMV+SMA) for acute superior mesenteric venous thrombosis (ASMVT).MethodsThis retrospective study reviewed eight ASMVT patients with transcatheter direct thrombolysis and aspiration thrombectomy therapy via SMV and indirect thrombolysis via SMA during a period of 14 months. The demographics, etiology, risk factors, therapeutic effect, complications, mortality, and follow-up of the study population were assessed. Anatomic and imaging classification of location and extent of thrombus at diagnosis and degree of thrombus lysis were described.ResultsTechnical success was achieved with substantial improvement in symptoms and thrombus resolution after thrombolytic therapy in all patients. The local urokinase infusion by SMA and SMV was performed for 5–7 (6.13 ± 0.83) and 7–15 (12 ± 2.51) days. Anticoagulation was performed catheter-directed and then orally throughout hospitalization and after discharge. Four patients required delayed localized bowel resection after thrombolytic therapy with no death. Thrombolytic therapy was not interrupted despite minor bleeding at the puncture site in two patients and sepsis in another two postoperatively. Nearly complete removal of thrombus was demonstrated by contrast-enhanced CT scan and portography before discharge. Patients were discharged in 10–27 (19.25 ± 4.89) days after admission. No recurrence developed during the follow-up of 10–13 (12.13 ± 0.99) months.ConclusionsCatheter-directed thrombolytic and aspiration therapy via SMV+SMA is beneficial for ASMVT in avoiding patient death, efficient resolving thrombus, rapid improving symptoms, reversing extensive intestinal ischemia, averting bowel resection, or localizing infarcted bowel segment and preventing short bowel syndrome.

  3. Successful medical management of acute mesenteric ischemia due to superior mesenteric and portal vein thrombosis in a 27-year-old man with protein S deficiency: a case report.

    Science.gov (United States)

    Osti, N P; Sah, D N; Bhandari, R S

    2017-11-09

    Acute mesenteric ischemia poses a diagnostic challenge due to nonspecific clinical clues and lack of awareness owing to its rarity. Ischemia due to mesenteric venous thrombosis has a good prognosis compared to arterial cause and can be managed conservatively with early diagnosis. The portomesenteric venous system is an unusual site of thrombosis in patients with protein S deficiency, and its thrombosis is an uncommon cause of acute mesenteric ischemia. We present a case of a 27-year-old Mongolian man who presented with acute abdominal pain increasing in severity, and refractory to repeated attempts at treatment with a misdiagnosis of acute peptic ulcer disease. Contrast-enhanced computed tomography of his abdomen detected complete occlusion of the superior mesenteric vein, an extension of acute thrombus into the portal vein, and ischemic mid-jejunal loops. Early diagnosis and immediate anticoagulation with continuous intravenous infusion of unfractionated heparin prevented subsequent consequences. On further workup, our patient was diagnosed with isolated protein S deficiency. We started lifelong thromboprophylaxis with warfarin to prevent recurrence and our patient was asymptomatic on the latest follow-up 5 months after discharge. Despite accurate detection of acute mesenteric ischemia by contrast-enhanced computed tomography, high index of suspicion is indispensable for its early diagnosis. Early diagnosis and immediate anticoagulation will prevent subsequent complications and need for surgical intervention. Young patients without known risk factors presenting with venous thrombosis in atypical sites should be investigated for prothrombotic diseases.

  4. Involvement of cyclic AMP-mediated pathway in neural release of noradrenaline in canine isolated mesenteric artery and vein.

    Science.gov (United States)

    Mutafova-Yambolieva, Violeta N; Smyth, Lisa; Bobalova, Janette

    2003-01-01

    Our major hypothesis is that cyclic adenosine-3',5'-monophosphate (cAMP)-mediated modulation of neurotransmitter release plays different roles at low and high activity of the sympathetic nervous system. We further hypothesize that cAMP-mediated neuromodulation might underlie disparate neurovascular control in mesenteric arteries and veins. Electrical field stimulation (EFS)-evoked overflow of noradrenaline (NA) was evaluated in the absence or presence of activators and inhibitors of cAMP-dependent pathway at low (4 Hz) and high (16 Hz) frequencies of stimulation of endothelium-denuded secondary and tertiary branches of the canine isolated inferior mesenteric arteries and veins. The content of NA in samples of the superfusates collected before and during nerve stimulation was assayed by high-performance liquid chromatography (HPLC) technique in conjunction with electrochemical detection. Student's t-test and ANOVA analyses were applied for statistical analysis. Activation of cAMP-dependent pathway with either isoproterenol (ISO, 10 microM), forskolin (1 microM), dibutyryl cAMP (100 microM) or combined site-specific activators of cAMP-dependent protein kinase (PKA) [i.e. N(6)-phenyl-adenosine-3',5'-cyclic monophosphate, 8-(6-aminohexyl) aminoadenosine-3',5'-cyclic monophosphate, and the Sp-isomer of 5,6-dichloro-1-D-ribofuranosylbenzimidazole-3',5'-cyclic monophosphorothioate, each 100 microM] caused an enhancement of the EFS-evoked overflow of endogenous NA at 16 Hz of stimulation but was without an effect at 4 Hz of stimulation both in artery and vein. The EFS (16 Hz)-evoked overflow of NA in vein was also increased in the presence of inhibitors of phosphodiesterase (PDE) III and PDE IV (i.e. milrinone, 0.4 microM, and roilpram, 30 microM), whereas these inhibitors did not affect the overflow of NA in the artery. The facilitating effect of activators of cAMP-dependent pathway on the EFS-evoked release of NA at 16 Hz appears to be more pronounced in the vein than in

  5. Studies on blood supply of liver metastasis with DSA, CT and portal vein perfusion CT during superior mesenteric arterial portography

    International Nuclear Information System (INIS)

    Li Zhigang; Shi Gaofeng; Huang Jingxiang; Li Shunzong; Liang Guoqing; Wang Hongguang; Han Pengyin; Wang Qi; Gu Tieshu

    2008-01-01

    Objective: To probe the blood supply of liver metastasis by celiac artery, proper hepatic artery DSA, portal vein perfusion CT during superior mesenteric arterial portography (PCTAP). Methods: One hundred patients with liver metastases were examined prospectively by plain CT scan, multiphase enhanced CT scan, celiac arteriography and proper hepatic arteriography. Of them, 56 patients were examined by PCTAP. All primary lesions were confirmed by operation and (or) pathology examination. In order to investigate the blood supply of metastasis lesions, the software of Photoshop was used to obtain the time-attenuation curves (TDC) of tumor center, tumor edge, portal vein and normal liver parenchyma adjacent to the tumor to calculate liver perfusion for DSA image analysis, while a deconvolution model from CT perfusion software was designed for the dual blood supply. Results: DSA findings: TDC of proper hepatic arteriography showed: the mean peak concentration (K value) in tumor centers was (67 ± 12)%, and it was (76 ± 15)% for peritumor tissue, (51 ± 10)% in normal liver parenchyma. TDC of celiac arteriogaphy showed that the contrast concentration of tumor centers and tumor edge increased fast in early stage, then maintained a slight upward plateau, in the meanwhile, the contrast concentration of normal liver parenchyma kept increasing slowly. PCTAP findings: tumors exhibited no enhancement during 30 s continued scans. Conclusion: The blood supply of liver metastasis mainly comes from hepatic artery, but barely from portal vein. (authors)

  6. Intestinal malrotation in patients with situs anomaly: Implication of the relative positions of the superior mesenteric artery and vein

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    Choi, Kyu Sung [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Choi, Young Hun, E-mail: iater@snu.ac.kr [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Department of Radiology, Seoul National University College of Medicine (Korea, Republic of); Cheon, Jung-Eun; Kim, Woo Sun; Kim, In One [Department of Radiology, Seoul National University Hospital (Korea, Republic of); Department of Radiology, Seoul National University College of Medicine (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of)

    2016-10-15

    Purpose: To assess the usefulness of the relative position of the superior mesenteric artery (SMA) and superior mesenteric vein (SMV) in diagnosing intestinal malrotation in situs anomaly. Materials and methods: From January 2004 to April 2015, 33 patients with situs anomalies were enrolled in this study who underwent abdominal USG, CT or MRI as well as upper gastrointestinal series (UGIS) or surgery: situs inversus (n = 16), left isomerism (n = 10), and right isomerism (n = 7); age 21.2 ± 23.2 years (mean ± standard deviation), range 0–72 years. The intestinal malrotation was confirmed with UGIS and/or operation in 16 patients. Relative positions of the SMV to the SMA were classified into four groups by reviewing abdominal USG, CT, or MRI: right sided, left sided, ventral sided, and dorsal sided. The incidence of malrotation was analyzed for each group. Results: In 16 patients with situs inversus, there was reversed SMA-SMV relationship: left sided (n = 11) or ventral sided (n = 5). One situs inversus patient with ventral sided SMV had intestinal malrotation (6.25%). 17 patients with situs ambiguus showed various SMA-SMV relationships (ventral sided, n = 7; left sided, n = 5; right sided, n = 4; dorsal sided, n = 1). Among them, 15 patients (88.2%) had intestinal malrotation. Two patients with normal rotation had either right sided or dorsal sided SMV. Conclusion: Situs ambiguus was commonly associated with intestinal malrotation with a variable SMA-SMV relationship. Reversal of the mesenteric vascular relationship was observed in situs inversus with normal rotation, not excluding the possibility of intestinal malrotation.

  7. Septic thrombophlebitis of the superior mesenteric vein and multiple liver abscesses in a patient with Crohn's disease at onset

    Directory of Open Access Journals (Sweden)

    Grueso Jose

    2007-06-01

    Full Text Available Abstract Background Portal-mesenteric vein thrombosis, pylephlebitis and liver abscesses are rare complications of inflammatory bowel disease (IBD. The purpose of this case report is to relate an unusual presentation of CD in order to show how conservative treatment could be an appropriate option as a bridge to the surgery, in patients with septic thrombophlebitis and multiple liver abscesses with CD. Case presentation We report a case of a 25-year-old man with Crohn's disease (CD who developed a superior mesenteric venous thrombosis, multiple liver abscesses and pylephlebitis, diagnosed through abdominal ultrasound and an abdominal computed tomography (CT scan. The patient was successfully treated with conservative treatment consisting of intravenous antibiotics, subcutaneous anticoagulation and percutaneous catheter drainage of liver abscesses. Conclusion We reported an unnusual case of pylephlebitis in CD. Until now this association has not been reported in adult patients at onset. We hypothesise that the infection developed as a result of mucosal disease and predisposed by corticoid therapy. Adequated management was discussed.

  8. Pancreatectomy with Mesenteric and Portal Vein Resection for Borderline Resectable Pancreatic Cancer: Multicenter Study of 406 Patients.

    Science.gov (United States)

    Ramacciato, Giovanni; Nigri, Giuseppe; Petrucciani, Niccolò; Pinna, Antonio Daniele; Ravaioli, Matteo; Jovine, Elio; Minni, Francesco; Grazi, Gian Luca; Chirletti, Piero; Tisone, Giuseppe; Napoli, Niccolò; Boggi, Ugo

    2016-06-01

    The role of pancreatectomy with en bloc venous resection and the prognostic impact of pathological venous invasion are still debated. The authors analyzed perioperative, survival results, and prognostic factors of pancreatectomy with en bloc portal (PV) or superior mesenteric vein (SMV) resection for borderline resectable pancreatic carcinoma, focusing on predictive factors of histological venous invasion and its prognostic role. A multicenter database of 406 patients submitted to pancreatectomy with en bloc SMV and/or PV resection for pancreatic adenocarcinoma was analyzed retrospectively. Univariate and multivariate analysis of factors related to histological venous invasion were performed using logistic regression model. Prognostic factors were analyzed with log-rank test and multivariate proportional hazard regression analysis. Complications occurred in 51.9 % of patients and postoperative death in 7.1 %. Histological invasion of the resected vein was confirmed in 56.7 % of specimens. Five-year survival was 24.4 % with median survival of 24 months. Vein invasion at preoperative computed tomography (CT), N status, number of metastatic lymph nodes, preoperative serum albumin were related to pathological venous invasion at univariate analysis, and vein invasion at CT was independently related to venous invasion at multivariate analysis. Use of preoperative biliary drain was significantly associated with postoperative complications. Multivariate proportional hazard regression analysis demonstrated a significant correlation between overall survival and histological venous invasion and administration of adjuvant therapy. This study identifies predictive factors of pathological venous invasion and prognostic factors for overall survival, including pathological venous invasion, which may help with patients' selection for different treatment protocols.

  9. [Thrombosis of the portal, upper mesenteric, and splenic veins in a patient with thrombophilia (a clinical case report)].

    Science.gov (United States)

    Shklyaev, A E; Malakhova, I G; Bessonov, A G; Utkin, I Yu

    Currently there are several dozens of hereditarily associated thrombophilias and acquired states known to condition the development of a thrombus. Thrombosis of visceral veins appears to be a considerably less often encountered event than thrombosis in the system of visceral arteries. Presented herein in the article is a clinical case report concerning subacute thrombosis of the portal, upper mesenteric and splenic veins, having developed on the background of mutations of 7 genes of the system of haemostasis in a young adult patient. Timely comprehensive examination with determining polymorphism of the haemostasis system genes made it possible to verify the aetiology of the disease in the patient, while multispiral computed tomography contributed favourably to specifying the extension of thrombosis. Due to the developed segmental necrosis of the small intestine the patient was subjected to resection of the necrotised portion of the small intestine followed by establishing an entero-enteric anastomosis. In the postoperative period adequate anticoagulant therapy was adjusted in order to prevent relapse of thrombogenesis.

  10. Incidence of deep vein thrombosis and thrombosis of the portal-mesenteric axis after laparoscopic sleeve gastrectomy.

    Science.gov (United States)

    Alsina, Ena; Ruiz-Tovar, Jaime; Alpera, Maria Remedios; Ruiz-García, Jose Gregorio; Lopez-Perez, Manuel Enrique; Ramon-Sanchez, Jose Francisco; Ardoy, Francisco

    2014-09-01

    Venous thromboembolism is the most common postoperative medical complication after bariatric surgery. Mortality associated with thromboembolic processes can reach up to 50%-75%. The aim of this study was to determine the incidence of deep vein thrombosis (DVT) and portal-splenic-mesenteric vein thrombosis (PSMVT) in our population undergoing laparoscopic sleeve gastrectomy (LSG) as the bariatric technique, with an anti-thromboembolic dosage scheme of 0.5 mg/kg/day 12 hours preoperatively and maintained during 30 days postoperatively. A prospective observational study was performed, including 100 consecutive patients undergoing LSG between October 2007 and September 2013. To determine the incidence of DVT and PSMVT, all patients undergo contrast-enhanced abdominal computed tomography (CT) and Doppler ultrasonography (US) of both lower limbs on the third postoperative month, whether they were asymptomatic or symptomatic. Contrast-enhanced CT showed 1 case of PSMVT (1%). Two patients presented DVT in the right leg (2%). All the cases were asymptomatic. The incidence of PSMVT and DVT after LSG with a prophylactic low-molecular-weight heparin dose of 0.5 mg/kg/day and maintained during 30 days postoperatively is 1% and 2%, respectively. According to these results, a postoperative screening with Doppler US and/or contrast-enhanced CT seems to be unnecessary.

  11. Comparison of Systemic Thrombolysis Versus Indirect Thrombolysis via the Superior Mesenteric Artery in Patients with Acute Portal Vein Thrombosis.

    Science.gov (United States)

    Liu, Kun; Li, Wen-Dong; Du, Xiao-Long; Li, Cheng-Long; Li, Xiao-Qiang

    2017-02-01

    The aim of this study was to evaluate the safety and efficacy of indirect thrombolysis via the superior mesenteric artery (SMA) in patients with acute portal vein thrombosis. Over 10 years, we studied the safety and efficacy of indirect thrombolysis via the SMA in 34 patients with acute portal vein thrombosis. Eighteen patients were categorized as the systemic thrombolysis (ST) group and 16 as the catheter thrombolysis (CT) group. The ST group was administered low-molecular-weight heparin, and patients in the CT group received catheter thrombolysis. Clinical data, such as comorbidities, laboratory test results, therapeutic methods, and prognosis, were recorded. All the patients underwent a routine clinical follow-up that was performed by inpatient examinations or outpatient visits at a mean follow-up time of 34 months. The thrombus score was significantly higher in the ST group (3.67 ± 1.19) than in the CT group (2.38 ± 0.62) after 2 weeks of treatment (P thrombosis compared with systemic thrombolysis. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Clinical presentation and outcome of mesenteric vein thrombosis: a single-center experience.

    Science.gov (United States)

    Al-Thani, Hassan; El-Mabrok, Jamela; El-Menyar, Ayman; Al-Sulaiti, Marym; Tabeb, Abdel Hakem; Hajaji, Khairi; Elgohary, Hesham; Asim, Mohammad; Latifi, Rifat

    2015-03-01

    Mesenteric venous thrombosis (MVT) is an uncommon event. We retrospectively analyzed data for patients who were admitted with MVT between June 2005 and May 2012 in Qatar. The study included 35 patients with a mean age of 45 ± 11 years. The risk of MVT was significantly high among males who smoked and females of Arab ethnicity. The main manifestations of MVT were abdominal distension and vomiting. The major etiological factors included deficiency in protein C and S, homocysteinemia, and prior abdominal surgery. Computed tomography (CT) findings were helpful in 80% of the patients. Bowel resection with primary anastomosis was performed in 25 (71%) patients. The overall mortality rate was 17%. High index of suspicion, detection of risk factors, CT imaging, and timely intervention are essential for better prognosis. © The Author(s) 2014.

  13. Presynaptic alpha2-adrenoceptor-mediated modulation of adenosine 5' triphosphate and noradrenaline corelease: differences in canine mesenteric artery and vein.

    Science.gov (United States)

    Bobalova, J; Mutafova-Yambolieva, V N

    2001-02-01

    1. The modulatory effects of agonists and antagonists of prejunctional alpha2-adrenoceptors on the electrical field stimulation (EFS, 0.3 ms, 12 V)-induced release of endogenous noradrenaline (NA) and the cotransmitter adenosine 5' triphosphate (ATP) were measured in endothelium-denuded segments of canine inferior mesenteric artery and compared with effects in mesenteric vein. The overflow of NA and ATP was evoked by long-duration (2 min) EFS at low frequency (4 Hz) and high frequency (16 Hz) of stimulation and was analysed using HPLC techniques with electrochemical detection and fluorescence detection, respectively. 2. The EFS-evoked overflow of both NA and ATP was significantly reduced by tetrodotoxin (1 microM) and guanethidine (10 microM) in the artery and vein. Desipramine (10 microM), a blocker of neuronal uptake of NA, increased the EFS (4 and 16 Hz)-evoked overflow of NA in both artery and vein. EFS-evoked overflow of NA in vein exceeded the NA overflow in artery at both 4 and 16 Hz in control preparations as well as in the presence of desipramine. However, the EFS-evoked overflow of ATP was equal in the artery and vein. 3. Stimulation of alpha2-adrenoceptors with clonidine (0.1 microM) and oxymethazoline (0.3 microM) reduced the EFS evoked overflow of NA in both artery and vein at 4 Hz, whereas the NA overflow at 16 Hz remained unchanged in both blood vessels. The overflow of ATP as well as of ADP (and hence ATP:ADP ratio) was unaffected by the alpha2-adrenoceptor agonists in the artery and vein. 4. In artery, blockade of alpha2-adrenoceptors with yohimbine at a concentration of 0.1 microM caused no effect on the NA overflow neither at 4 Hz nor at 16 Hz of EFS. Yohimbine at a concentration of 1 microM increased the overflow of NA at 4 Hz but not 16 Hz of EFS. In vein, however, yohimbine (0.1 and 1 microM) increased NA overflow at both 4 and 16 Hz of stimulation. Idazoxan (1 microM) increased the NA overflow in artery only at 4 Hz, whereas in vein idazoxan

  14. Emergency Pancreatico-Duodenectomy with Superior Mesenteric and Portal Vein Resection and Reconstruction Using a Gore-Tex Vascular Graft.

    Science.gov (United States)

    Eftimie, Mihai Adrian; Lungu, Vasile; Tudoroiu, Marian; Vatachki, Genady; Batca, Severina; David, Leonard

    2017-01-01

    Emergency pancreatico-duodenectomy(EPD) is a very rare procedure and few reports are present in medical literature. It is an uncommon approach, usually used for emergency surgical treatment of abdominal trauma that involves the head of the pancreas or the duodenum, but it is also a surgical tool for the treatment of ruptured aneurysms, bleeding pseudocysts, duodenal perforations, uncontrollable hemorrhage from ulcers and tumors, severe infectious complications of acute pancreatitis or endoscopic retrograde cholangiopancreatography related complications (1,2). It is rarely used as the first line of treatment in case of acute bleeding from arterial pseudoaneurysm of the cephalad region of the pancreas. We present the case of a bleeding pseudoaneurysm of the cefalic region of the pancreas in a young patient with previously undiagnosed chronic pancreatitis and with suspicion of a malignant process located in the head of the pancreas. We performed a pancreatico-duodenectomy with resection of superior mesenteric and portal vein with reconstruction using Gore-Tex vascular graft due to probable venous abutment. Postoperative course was without any major complications, only minor grad-I pancreatic fistula was present. We determine that EPD is a useful tool in the treatment of such cases. It can be used as a first line of treatment or secondary to endovascular stenting or embolization. Celsius.

  15. Small bowel varices secondary to chronic superior mesenteric vein thrombosis in a patient with heterozygous Factor V Leiden mutation: a case report.

    Science.gov (United States)

    Garcia, Maria C; Ahlenstiel, Golo; Mahajan, Hema; van der Poorten, David

    2015-10-01

    Bleeding ectopic small bowel varices pose a clinical dilemma for the physician, given their diagnostic obscurity and the lack of evidence-based medicine to guide therapy. They often occur in the context of portal hypertension, secondary to either liver disease or extrahepatic causes. Rarely is their presence associated with chronic superior mesenteric vein thrombosis and hereditary coagulopathies. A 74-year-old white woman, with a heterozygous Factor V Leiden mutation and no underlying liver disease or portal hypertension, presented over the course of 13 months for recurrent episodes of melena and per rectal bleeding. An initial endoscopy showed a clean-based chronic gastric ulcer, while colonoscopies showed multiple, non-bleeding angioectasias which were treated with argon plasma coagulation. Subsequent video capsule endoscopy and double balloon enteroscopy revealed red wale marks overlying engorged submucosal veins in her distal ileum, consistent with ectopic varices. A chronic superior mesenteric vein thrombus, found via computed tomography venogram, was the cause of the ileal varices. She underwent curative surgical resection of the affected bowel, with no re-bleeding episodes 17 months post-surgery, despite needing lifelong anticoagulation for recurrent venous thromboembolisms. Clinicians should consider ectopic varices in patients who present with obscure gastrointestinal bleeding, even in the absence of portal hypertension or liver disease. In those with a known thrombophilia, patients should be screened for splanchnic thrombosis, which may precipitate ectopic varices.

  16. Clinical outcomes of transcatheter selective superior mesenteric artery urokinase infusion therapy vs transjugular intrahepatic portosystemic shunt in patients with cirrhosis and acute portal vein thrombosis.

    Science.gov (United States)

    Jiang, Ting-Ting; Luo, Xiao-Ping; Sun, Jian-Ming; Gao, Jian

    2017-11-07

    To compare the outcomes of transcatheter superior mesenteric artery (SMA) urokinase infusion and transjugular intrahepatic portosystemic shunt (TIPS) for acute portal vein thrombosis (PVT) in cirrhosis. From January 2013 to December 2014, patients with liver cirrhosis and acute symptomatic PVT who met the inclusion criteria were randomly assigned to either an SMA group or a TIPS group. The two groups accepted transcatheter selective SMA urokinase infusion therapy and TIPS, respectively. The total follow-up time was 24 mo. The primary outcome measure was the change in portal vein patency status which was evaluated by angio-computed tomography or Doppler ultrasound. Secondary outcomes were rebleeding and hepatic encephalopathy. A total of 40 patients were enrolled, with 20 assigned to the SMA group and 20 to the TIPS group. The symptoms of all patients in the two groups improved within 48 h. PVT was improved in 17 (85%) patients in the SMA group and 14 (70%) patients in the TIPS group. The main portal vein (MPV) thrombosis was significantly reduced in both groups ( P mesenteric vein (SMV) thrombosis and splenic vein (SV) thrombosis were significantly reduced ( P = 0.048 and P = 0.02), which did not occur in the TIPS group. At 6-, 12-, and 24-mo follow-up, in the SMA group and the TIPS group, the cumulative rates free of the first episode of rebleeding were 80%, 65%, and 45% vs 90%, 80%, and 60%, respectively ( P = 0.320); the cumulative rates free of the first episode of hepatic encephalopathy were 85%, 80%, and 65% vs 50%, 40%, and 35%, respectively ( P = 0.022). Transcatheter selective SMA urokinase infusion and TIPS are safe and effective for acute symptomatic PVT in cirrhosis.

  17. [Submucosal bacterial abscesses of the ascending colon and liver associated with portal and superior mesenteric vein thrombosis due to Enterococcus faecalis infection: a case report].

    Science.gov (United States)

    Norimura, Daisuke; Takeshima, Fuminao; Satou, Yoshiaki; Nakagoe, Tohru; Ohnita, Ken; Isomoto, Hajime; Nakao, Kazuhiko

    2014-06-01

    A 72-year-old woman with diabetes mellitus was admitted with fever and general fatigue. Blood biochemistry showed elevated hepatic and biliary enzyme levels, abdominal computed tomography showed multiple liver abscesses with portal and superior mesenteric vein thrombosis, and total colonoscopy revealed a submucosal bacterial abscess in the ascending colon. The abscesses were determined to be associated with Enterococcus faecalis infection. The patient was treated conservatively with antibiotics (meropenem) and anticoagulants (warfarin), which led to a gradual amelioration of symptoms and resolution of thrombosis.

  18. CT diagnosis of acute mesenteric vein thrombosis with bowel infarction. CT-Diagnostik der akuten Mesenterialvenenthrombose mit Darminfarzierung

    Energy Technology Data Exchange (ETDEWEB)

    Sommer, A. (Inst. fuer Klinische Radiologie, Klinikum Mannheim, Univ. Heidelberg (Germany)); Jaschke, W. (Inst. fuer Klinische Radiologie, Klinikum Mannheim, Univ. Heidelberg (Germany)); Georgi, M. (Inst. fuer Klinische Radiologie, Klinikum Mannheim, Univ. Heidelberg (Germany))

    1994-11-01

    Imaging methods provide an important diagnostic basis to clarify mesenteric ischemia. Angiography is the definitive method of investigation in such cases. Other noninvasive methods such as ultrasonography, computed tomography, and magnetic resonance imaging must still prove their importance. We describe three cases of unspezific abdominal pain where the CT shows a mesenteric venous thrombosis with an infarcted bowel. The venous infarcted bowel is clearly demonstrated by CT when other signs for MTV such as ascites, bowel wall thickening, bowel dilatation, and pneumatosis intestinalis are present. CT seems to be a good procedure in order to identify unspecific abdominal pain as being caused by a vascular insufficiency. (orig.)

  19. Small-bowel necrosis complicating a cytomegalovirus-induced superior mesenteric vein thrombosis in an immunocompetent patient: a case report

    Science.gov (United States)

    2012-01-01

    Introduction Superior mesenteric venous thrombosis as a result of acute cytomegalovirus infection is rare, with only a few cases reported in the literature. Case presentation We present the case of a 40-year-old Caucasian man who was admitted to our hospital with a 5-day history of fever. His serological test and pp65 antigen detection of cytomegalovirus were positive, suggesting acute infection. On the sixth day after his admission, the patient complained of acute, progressive abdominal pain. Abdominal computed tomography revealed acute superior mesenteric venous thrombosis. An emergency laparotomy showed diffuse edema and ischemic lesions of the small bowel and its associated mesentery with a 50-cm-long segmental infarction of the proximal jejunum. An extensive enterectomy of about 100 cm of jejunum that included the necrotic segment was performed, followed by an end-to-end anastomosis. Anti-coagulation therapy was administered pre-operatively in the form of small-fractionated heparin and continued postoperatively. The patient had an uneventful recovery and was discharged on the 11th postoperative day. Conclusion Acute cytomegalovirus infection can contribute to the occurrence of mesenteric venous thrombosis in immunocompetent patients. It is important for physicians and internists to be aware of the possible thrombotic complications of cytomegalovirus infection. A high level of clinical suspicion is essential to successfully treat a potentially lethal condition such as superior mesenteric venous thrombosis. PMID:22531275

  20. Mesenteric vein thrombosis in a patient heterozygous for factor V Leiden and G20210A prothrombin genotypes.

    Science.gov (United States)

    Karmacharya, Paras; Aryal, Madan Raj; Donato, Anthony

    2013-11-21

    Mesenteric venous thrombosis (MVT) is a rare but life threatening form of bowel ischemia. It is implicated in 6%-9% of all cases of acute mesenteric ischemia. The proportion of patients with primary (or idiopathic) MVT varies from 0% to 49%, with a decrease in frequency secondary to more recent availability of newer investigations for hypercoagulability. The presence of factor V Leiden (FVL) and prothrombin G20210A mutations (PGM) have been well documented in these cases. However, there have been scarce case reports describing MVT in heterozygotes of both these mutations occurring simultaneously and its implications on long term management. Our case describes acute MVT in a previously asymptomatic young patient with no prior history of venous thromboembolism. The patient was found to be heterozygous for FVL and PGM and treated with lifelong anticoagulation with warfarin (goal international normalized ratio: 2-3) and avoidance of hormonal contraceptives.

  1. t-PA power-pulse spray with rheolytic mechanical thrombectomy using cross-sectional image-guided portal vein access for single setting treatment of subacute superior mesenteric vein thrombosis

    Directory of Open Access Journals (Sweden)

    Mubin I Syed

    2018-01-01

    Full Text Available Background: Isolated superior mesenteric vein (SMV thrombosis is a rare but potentially fatal condition if untreated. Current treatments include transjugular or transhepatic approaches for rheolytic mechanical thrombectomy and subsequent infusions of thrombolytics. Tissue plasminogen activator (t-PA power-pulse spray can provide benefit in a single setting without thrombolytic infusions. Computed tomography (CT guidance for portal vein access is underutilized in this setting. Materials and Methods: Case 1 discusses acute SMV thrombosis treated with rheolytic mechanical thrombectomy alone using ultrasound guidance for portal vein access. Case 2 discusses subacute SMV thrombosis treated with the addition of t-PA power-pulse spray to the rheolytic mechanical thrombectomy, using CT guidance for portal vein access. Results: With rheolytic mechanical thrombectomy alone, the patient in Case 1 had significant improvement in abdominal pain. Follow-up CT demonstrated no residual SMV thrombosis and the patient continued to do well in long-term follow-up. With the addition of t-PA power-pulse spray to rheolytic mechanical thrombectomy, the patient in Case 2 with subacute SMV thrombosis dramatically improved postprocedure with resolution of abdominal pain. Follow-up imaging demonstrated patency to the SMV and partial resolution of thrombus. The patient continued to do well at 2-year follow-up. Conclusions: Adding t-PA power-pulse spray to rheolytic mechanical thrombectomy can provide benefit in a single setting versus mechanical thrombectomy alone and prevent the need for subsequent infusions of thrombolytic therapy. CT guidance is a useful alternative of localization for portal vein access via the transhepatic route that is nonoperator-dependent and helpful in the case of obese patients.

  2. Compression of the superior mesenteric vein - a sign of acute internal herniation in patients with antecolic laparoscopic Roux-en-Y gastric bypass

    International Nuclear Information System (INIS)

    Maier, Jens; Herrasti Gallego, Amaya; Floyd, Andrea K.

    2017-01-01

    To investigate whether compression of the superior mesenteric vein (SMV) on computed tomography (CT) can serve as a valid sign of internal herniation (IH) in patients with antecolic laparoscopic Roux-en-Y gastric bypass (LRYGBP). With institutional review board approval, we performed a retrospective analysis of 41 patients with antecolic LRYGBP referred for acute CT of the abdomen with suspicion of IH or another cause of acute abdomen. CT scans were randomly reviewed for signs of IH by two radiologists in a blinded manner, and the findings were correlated with the results of the patients' bariatric workup. Sensitivity, specificity, and inter-observer agreement were calculated for each sign. Five patients were classified as having intermittent IH and were excluded. Eighteen patients were found to have IH at laparoscopy and served as the study group; 18 patients served as the control group. SMV compression had the best sensitivity (67 % for both reviewers) and inter-observer agreement (kappa = 0.82) of all investigated signs. The swirl sign showed a lower sensitivity (39 and 50 % respectively) and kappa (0.37). SMV compression is a reliable sign of IH in patients with antecolic LRYGBP. circle CT can help detect internal herniation after laparoscopic Roux-en-Y gastric bypass. (orig.)

  3. Compression of the superior mesenteric vein - a sign of acute internal herniation in patients with antecolic laparoscopic Roux-en-Y gastric bypass

    Energy Technology Data Exchange (ETDEWEB)

    Maier, Jens; Herrasti Gallego, Amaya [Koege Sygehus, Department of Radiology, Koege (Denmark); Floyd, Andrea K. [Holbaek Sygehus, Department of Abdominal Surgery, Holbaek (Denmark)

    2017-04-15

    To investigate whether compression of the superior mesenteric vein (SMV) on computed tomography (CT) can serve as a valid sign of internal herniation (IH) in patients with antecolic laparoscopic Roux-en-Y gastric bypass (LRYGBP). With institutional review board approval, we performed a retrospective analysis of 41 patients with antecolic LRYGBP referred for acute CT of the abdomen with suspicion of IH or another cause of acute abdomen. CT scans were randomly reviewed for signs of IH by two radiologists in a blinded manner, and the findings were correlated with the results of the patients' bariatric workup. Sensitivity, specificity, and inter-observer agreement were calculated for each sign. Five patients were classified as having intermittent IH and were excluded. Eighteen patients were found to have IH at laparoscopy and served as the study group; 18 patients served as the control group. SMV compression had the best sensitivity (67 % for both reviewers) and inter-observer agreement (kappa = 0.82) of all investigated signs. The swirl sign showed a lower sensitivity (39 and 50 % respectively) and kappa (0.37). SMV compression is a reliable sign of IH in patients with antecolic LRYGBP. circle CT can help detect internal herniation after laparoscopic Roux-en-Y gastric bypass. (orig.)

  4. Long-term survival following total pancreatectomy and superior mesenteric-portal vein resection for pancreatic ductal adenocarcinoma: A case report.

    Science.gov (United States)

    Tong, Han-Xing; Zhang, Lei; Rong, Ye-Fei; Wang, Dan-Song; Kuang, Tian Tao; Xu, Xue-Feng; Lou, Wen-Hui; Jin, DA-Yong

    2015-01-01

    Pancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer with few therapeutic options. At present, surgical resection remains the only potential curative treatment for PDAC. However, only 15-20% of patients with PDAC are eligible for lesion resection. Total pancreatectomy (TP) and superior mesenteric-portal vein resection (SMPVR) may increase the rate of resection of PDCA, but the effect of this approach on improving long-term patient outcomes remains controversial. The present study investigated a case of PDAC in the pancreatic neck of a male patient. The patient underwent a TP, combined with SMPVR, for a margin-negative resection. Following an uneventful post-operative recovery, the patient received adjuvant chemoradiotherapy. The patient is currently alive at six years post-surgery, with a high quality of life. Given the clinical outcome of this patient, TP combined with SMPVR may provide PDAC patients with an opportunity for long-term survival. Therefore, patients with PDAC that is believed to be unresectable based on pre-operative assessment, may benefit from TP and SMPVR.

  5. [Widespread mesenteric venous thrombosis and cirrhosis diagnosed with autopsy].

    Science.gov (United States)

    Kömür, İlhami; Özdemirel, Rifat Özgür; Başpınar, Bünyamin; Şam, Bülent; Anık Karayel, Ferah

    2015-09-01

    Mesenteric venous thrombosis is a rare disorder with a high mortality rate. Since patients remain asymptomatic, diagnosis of the disease is difficult. Diagnosis can be mainly made with either laparotomy or autopsy. Many factors are considered in the etiology of mesenteric venous thrombosis. Liver cirrhosis and chronic pyelonephritis, which we detected in the autopsy and histologic examination of our case, are considered as two of the factors. In our study, it was aimed to present a case with near-total intestinal necrosis caused by portal vein thrombosis which spread to the lineal vein, pancreatic vein and to the branches of superior mesenteric veins.

  6. Long-term Follow-up of Partial Thrombosis of the Superior Mesenteric Vein in a Cirrhotic Patient with Hepatocellular Carcinoma

    Directory of Open Access Journals (Sweden)

    Men-Shun Hsieh

    2003-05-01

    Full Text Available Superior mesenteric venous thrombosis (SMVT is an uncommon but potentially life-threatening disorder. We describe a cirrhotic patient with hepatocellular carcinoma who had partial SMVT for at least 28 months. Our experience may help in the management of such patients. The partial SMVT was not treated at the time of discovery because there was no evidence of bowel infarction. Moreover, the patient had a tendency to bleed severely and was in a poor condition. SMVT was followed using regular ultrasonography and the pattern of SMVT did not change significantly during the follow-up period. A symptom that may have been related to SMVT was abdominal colic pain after meals, which was sometimes followed by diarrhea and/or nausea and vomiting. There was no evidence of bowel ischemia or infarction during follow-up. Abdominal discomfort can be successfully treated using anticholinergic drugs with or without analgesia.

  7. Portal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Ronny Cohen

    2015-01-01

    Full Text Available Portal vein thrombosis (PVT is the blockage or narrowing of the portal vein by a thrombus. It is relatively rare and has been linked with the presence of an underlying liver disease or prothrombotic disorders. We present a case of a young male who presented with vague abdominal symptoms for approximately one week. Imaging revealed the presence of multiple nonocclusive thrombi involving the right portal vein, the splenic vein, and the left renal vein, as well as complete occlusion of the left portal vein and the superior mesenteric vein. We discuss pathogenesis, clinical presentation, and management of both acute and chronic thrombosis. The presence of PVT should be considered as a clue for prothrombotic disorders, liver disease, and other local and general factors that must be carefully investigated. It is hoped that this case report will help increase awareness of the complexity associated with portal vein thrombosis among the medical community.

  8. [Mesenteric panniculitis].

    Science.gov (United States)

    Kienzle, H F; Karim, R; Recepoglu, A; Bähr, R; Dopper, T; Stolte, M

    1995-12-01

    We report three cases of mesenteric panniculitis in which the disease took different courses. The first case clinically mimicked an acute diverticulitis and consequently laparotomy was performed. During this operation a large space-occupying tumour was found in the lower abdomen. After resecting this tumour mass of uncertain classification (benign or malignant) a preternatural anus of sigmoid colon was formed. Histological exploration revealed mesenteric panniculitis. Six months later we restored continuity of large bowel by end-to-end anastomosis. No residues of the preexisting panniculitic alterations were seen. The second case concerned a female patient who again complained of discomfort after surgical treatment of colon carcinoma. We measured an elevated erythrocyte sedimentation rate and suspected a relapse of the malignant disease. Notwithstanding radiological and endoscopic diagnostics, the origin and classification of an intra-abdominal tumour could not be determined preoperatively. Laparoscopically we took a biopsy of the local mass, but a definite diagnosis was not found. Postoperatively undulant fever occurred, uninfluenced by cortisone treatment. Finally the patient died because of unstoppable hemorrhage under coagulopathy. Mesenteric panniculitis was identified as causative disease by autopsy.

  9. Functional testing in the diagnosis of chronic mesenteric ischemia

    NARCIS (Netherlands)

    van Noord, Desiree; Kolkman, Jeroen J.

    Chronic mesenteric ischemia (CMI) results from insufficient oxygen delivery or utilization to meet metabolic demand. Two main mechanisms may lead to mesenteric ischemia: occlusion in the arteries or veins of the gastrointestinal tract, or reduced blood flow from shock states or increased

  10. Endoscopic ultrasound (EUS diagnosis of blunt pancreatic trauma associated to the superior mesenteric vein thrombosis Diagnóstico de trauma pancreático associado à trombose da veia mesentérica feito através da ultrassonografia endoscópica

    Directory of Open Access Journals (Sweden)

    Everson L. A. Artifon

    2010-03-01

    Full Text Available BACKGROUND: Blunt pancreatic injuries occur when a high-energy crushing force is applied to the upper abdomen. In adults, the majority of blunt pancreatic injuries result from motor vehicle accidents. CASE REPORT: Male with 32 years old had a high-energy crushing history in witch he was pressured by the chest on the front car area. His life signs demonstrated to be regular. Ct scan demonstrated body pancreatic edema. All routine laboratorial exams were normal, EUS revealed pancreatic lesion grade II without involvement of the pancreatic duct and an impressive superior mesenteric vein thrombosis. He was sustained by means of anti- coagulation for about two months and after that time the multislice CT scan showed a mesenteric vein recanalization and a normal pancreatic parenchyma. The patient had an uneventfull follow-up. CONCLUSION: Patients presenting possible pancreatic trauma associated to superior mesenteric vein thrombosis, EUS must be used firstly.INTRODUÇÃO: Traumas pancreáticos fechados ocorrem em acidentes que promovem força intensa no abdome superior, principalmente em acidentes automobilísticos. RELATO DO CASO: Homem de 32 anos foi jogado contra a área frontal de seu automóvel. Seus sinais vitais eram normais. CT mostrou edema pancreático. EUS mostrou lesão pancreática grau II sem envolvimento do ducto pancreático, mas com impressionante trombose da veia mesentérica superior. Ele foi mantido com anticoagulants por dois meses e após este period novo scan mostrou recanalização e pâncreas normal. Teve seguimento favorável. CONCLUSÃO: Paciente apresentando edema pancreático associado a possível trombose de veia mesentérica superior deve ser submetido à EUS para monitorização e acompanhamento.

  11. Mesenteric angina through superior mesenteric venous thrombosis

    OpenAIRE

    Mohan, Divya; Aijaz, Faisal; Krijgsman, Brandon

    2010-01-01

    We present the case of a 67-year-old male with mesenteric venous thrombosis resulting in mesenteric angina, where early diagnosis made a favourable outcome possible through prompt anticoagulation and bowel rest. Mesenteric venous thrombosis is a relatively rare but important cause of bowel ischaemia, as a delay in diagnosis is associated with high morbidity and mortality. Early diagnosis through computed tomography scanning and subsequent treatment resulted in resolution of the thrombus with ...

  12. Retrograde superior mesenteric artery stenting for acute mesenteric arterial thrombosis.

    Science.gov (United States)

    Do, Natalie; Wisniewski, Paul; Sarmiento, Jose; Vo, Trung; Aka, Paul K; Hsu, Jeffrey H; Tayyarah, Majid

    2010-08-01

    Retrograde superior mesenteric artery stenting (ROMS) represents a significant development in the treatment of acute mesenteric ischemia. Compared to traditional surgical mesenteric bypass, ROMS is a less invasive technique that avoids many complications associated with emergent mesenteric bypass. This case report illustrates that retrograde superior mesenteric artery (SMA) stenting is an option for the treatment of acute mesenteric ischemia for patients in extremis.

  13. Mesenteric venous thrombosis

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001157.htm Mesenteric venous thrombosis To use the sharing features on this page, please enable JavaScript. Mesenteric venous thrombosis (MVT) is a blood clot in one or ...

  14. MDCT of acute conditions affecting the mesenteric vasculature

    International Nuclear Information System (INIS)

    Heller, M.T.; Shah, A.; Furlan, A.

    2014-01-01

    Acute conditions affecting the mesenteric vessels can cause abdominal pain and result in significant morbidity and mortality if not diagnosed and treated quickly. As bowel viability depends on patency of the mesenteric vessels, prompt diagnosis is essential. Helical multidetector computed tomography (MDCT) provides a rapid, widely available, non-invasive method to promptly evaluate the mesenteric arteries, veins, and abdominopelvic viscera. Given the value of MDCT in diagnosing vascular disease, it is important the radiologist understand technical and imaging findings of mesenteric vascular injury. Therefore, successful diagnosis hinges on familiarity with MDCT angiography and the extended capabilities of volume rendering and multiplanar reformation. In this review, we illustrate and describe key MDCT findings of congenital, inflammatory, traumatic, infectious, and thromboembolic conditions affecting the mesenteric vasculature in adult patients

  15. Successful Treatment of Acute on Chronic Mesenteric Ischaemia by Common Iliac to Inferior Mesenteric Artery Bypass

    Directory of Open Access Journals (Sweden)

    D. N. Coakley

    2015-01-01

    Full Text Available Chronic mesenteric ischaemia is a rare and potentially fatal condition most commonly due to atherosclerotic stenosis or occlusion of two or more mesenteric arteries. Multivessel revascularisation of both primary mesenteric vessels, the celiac artery and superior mesenteric artery (SMA, is the current mainstay of treatment; however, in a certain cohort of patients, revascularisation one or both vessels may not be possible. Arteries may be technically unreconstructable or the patient may be surgically unfit for the prolonged aortic cross clamping times required. Here we present a case involving a 72-year-old woman with acute on chronic mesenteric ischaemia. She was a high risk surgical patient with severe unreconstructable stenotic disease of the SMA and celiac arteries. She was successfully treated with single vessel revascularisation of the inferior mesenteric artery (IMA via a common iliac to IMA reversed vein bypass. At two-year follow-up, the graft remains patent and the patient continues to be symptom-free and is maintaining her weight.

  16. Mechanical thrombectomy-assisted thrombolysis for acute symptomatic portal and superior mesenteric venous thrombosis

    Science.gov (United States)

    Jun, Kang Woong; Kim, Mi Hyeong; Park, Keun Myoung; Chun, Ho Jong; Hong, Kee Chun; Jeon, Yong Sun; Cho, Soon Gu

    2014-01-01

    Acute portal vein and mesenteric vein thrombosis (PVMVT) can cause acute mesenteric ischemia and be fatal with mortality rate of 37%-76%. Therefore, early diagnosis and prompt venous revascularization are warranted in patients with acute symptomatic PVMVT. Due to advances in catheter-directed treatment, endovascular treatment has been used for revascularization of affected vessels in PVMVT. We report two cases of symptomatic PVMVT treated successfully by transhepatic percutaneous mechanical thrombectomy-assisted thrombolysis. PMID:24949327

  17. Acute mesenteric ischemia: a vascular emergency.

    Science.gov (United States)

    Klar, Ernst; Rahmanian, Parwis B; Bücker, Arno; Hauenstein, Karlheinz; Jauch, Karl-Walter; Luther, Bernd

    2012-04-01

    Acute mesenteric ischemia is still fatal in 50% to 70% of cases. This consensus paper was written with the participation of physicians from all of the involved specialties for the purpose of improving outcomes. Mesenteric ischemia must be recognized as a vascular emergency requiring rapid and efficient clinical evaluation and treatment. We reviewed pertinent literature that was retrieved by a PubMed search on the terms "mesenteric ischemia" AND "arterial" OR "venous" OR "clinical presentation" OR "diagnosis" OR "therapy" OR "surgery" OR " interventional radiology." Our review also took account of the existing guidelines of the American College of Cardiology/American Heart Association. Intensive discussions among the participating physicians, representing all of the specialties involved in the management of mesenteric ischemia, led to the creation of this interdisciplinary paper. Biphasic contrast-enhanced computerized tomography is the diagnostic tool of choice for the detection of arterial or venous occlusion. If non-occlusive mesenteric ischemia is suspected, angiography should be performed, with the option of intraarterial pharmacotherapy to induce local vasodilation. Endovascular techniques have become increasingly important in the treatment of arterial occlusion. Embolic central mesenteric artery occlusion requires surgical treatment; surgery is also needed in case of peritonitis. Portal-vein thrombosis can be treated by local thrombolysis through a transhepatically placed catheter. This should be done within 3 to 4 weeks of the event to prevent later complications of portal hypertension. Rapid diagnosis (within 4 to 6 hours of symptom onset) and interdisciplinary cooperation in the provision of treatment are required if the poor outcome of this condition is to be improved.

  18. Mesenteric cysts and mesenteric venous thrombosis leading to intestinal necrosis in pregnancy managed with laparotomy: a case report and review of the literature.

    Science.gov (United States)

    Giannos, Aris; Stavrou, Sofoklis; Goumalatsos, Nikolaos; Fragkoulidis, George; Chra, Eleni; Argiropoulos, Dimitrios; Loutradis, Dimitrios; Drakakis, Peter

    2017-07-07

    Mesenteric cyst is a rare clinical entity especially in pregnancy; therefore, few cases have been reported in the literature. The standard method of their treatment is surgical excision either with laparotomy or laparoscopy. In addition, mesenteric vein thrombosis is a rare and life-threatening condition in pregnancy and needs immediate treatment because it can lead to intestinal necrotic ischemia. This is the first report of the coexistence of mesenteric cysts and mesenteric vein thrombosis during gestation. A 27-year-old Greek woman, gravida 2 para 1, presented at 10 weeks' gestation to the Emergency Unit of our hospital complaining of diffuse abdominal pain which deteriorated the last 3 days, which was localized in her right iliac fossa, along with vomiting. She had undergone open laparotomy and right salpingo-oophorectomy at the age of 23 due to an ovarian cyst. Besides this, her personal and family medical history was unremarkable. She had never received oral contraceptives or any hormone therapy. On arrival, a clinical examination revealed tenderness on palpation of her right iliac fossa, without rebound tenderness or muscle guarding. Within 10 hours of hospitalization, her symptoms deteriorated further with rebound tenderness during the examination, tachycardia, and a drop of 12 units in her hematocrit value. An emergency laparotomy was performed. Two mesenteric cysts and a 60 cm necrotic part of her intestine were revealed intraoperatively. In the postoperative period, she complained of acute abdominal pain, tachycardia, and dyspnea. Computed tomography imaging revealed mesenteric vein thrombosis and pulmonary thromboembolism. She was treated with low molecular weight heparin and she was discharged on the 11th postoperative day. To the best of our knowledge, this is the first report in the literature of a simultaneous mesenteric cyst and mesenteric vein thrombosis in pregnancy. It is known that pregnancy is a state of hypercoagulation and clinicians

  19. Mesenteric Air Embolism Following Enteroscopic Small Bowel Tattooing Procedure

    Directory of Open Access Journals (Sweden)

    Natalie Chen

    2012-01-01

    Full Text Available Double balloon enteroscopy (DBE is a revolutionary procedure in which the entire small bowel can be visualized endoscopically. DBE has the advantage of both diagnostic and therapeutic capabilities in the setting of small bowel neoplasms and vascular malformations. We present a unique case of a 76-year-old female who underwent small bowel DBE tattoo marking of a distal small bowel tumor complicated by development of severe abdominal pain postprocedure secondary to bowel air embolism into the mesenteric veins. Mesenteric air can be seen after other endoscopic procedures such as biopsy, mucosal clip placement and polypectomy, or following a colonoscopy. Mesenteric air embolism following small bowel tattooing procedure has not been previously reported in the literature. Mesenteric air when present may be attributed to mesenteric ischemia and can subject the patient to unnecessary surgical intervention if misdiagnosed. Thus, this report holds significance for the radiologist as computed tomography (CT findings of mesenteric air embolism must be evaluated in the context of appropriate clinical history before treatment decisions are made.

  20. Mesenteric Infarction: Clinical Outcomes After Restoration of Bowel Continuity.

    Science.gov (United States)

    Adaba, Franklin; Rajendran, Arun; Patel, Amit; Cheung, Yee-Kee; Grant, Katherine; Vaizey, Carolynne J; Gabe, Simon M; Warusavitarne, Janindra; Nightingale, Jeremy M D

    2015-12-01

    Patients who have a bowel resection for mesenteric infarction may require parenteral nutrition (PN). This study primarily aimed to determine the aetiological factors for a mesenteric infarction and the effects of restoring bowel continuity on the long-term PN requirements. A retrospective review of data on patients treated for mesenteric infarction from 2000 to 2010. A total of 113 patients (61 women, median age 54 years) were identified. Seventy-four (65%) had a superior mesenteric artery thromboembolism, 25 (22%) had a superior mesenteric vein thrombosis, and 4 (3%) had superior mesenteric artery stricture or spasm. Patients younger than 60 years most commonly had a clotting abnormality (n = 23/46, 50%), whereas older patients had a cardiological risk factor (n = 11/17, 65%). All patients with a jejunostomy required long-term PN. Fifty-seven (49%) patients had restoration of bowel continuity (colon brought into circuit). After this, PN was stopped within 1 year in 20 (35%), within 2 years in 29 (50%) patients and within 5 years in 44 (77%) patients (P = 0.001). A thrombotic tendency is the main etiological factor in most patients younger than 60 years. An anastomosis of the remaining jejunum to the colon can allow PN to be stopped.

  1. Portal vein thrombosis in patients with cirrhosis

    DEFF Research Database (Denmark)

    von Köckritz, Leona; De Gottardi, Andrea; Trebicka, Jonel

    2017-01-01

    Portal vein thrombosis (PVT) is frequent in patients with liver cirrhosis and possible severe complications such as mesenteric ischemia are rare, but can be life-threatening. However, different aspects of clinical relevance, diagnosis and management of PVT are still areas of uncertainty...

  2. Portal, Splenic and Mesenteric Thrombosis in Hypereosinophilic Syndrome: A Case Report

    International Nuclear Information System (INIS)

    Hwang, Su Yeon; Jang, Kyung Mi; Kim, Min Jeong; Lee, Kwan Seop; Koh, Sung Hye; Jeon, Eui Yong; Lee, Hyun; Choi, Ju Hyun; Yie, Mi Yeon

    2009-01-01

    Idiopathic hypereosinophilic syndrome is a spectrum of diseases characterized by prominent peripheral eosinophilic leukocytosis without an identifiable cause. Several reports have described hepatic involvement as depicted on sonography and CT imaging in patients with hypereosinophilic syndrome. However, thrombosis of the portal, splenic and mesenteric veins in hypereosinophilic syndrome has been rarely reported. We present here a case of portal, splenic and mesenteric thrombosis in a 33-year-old man with hypereosinophilic syndrome

  3. Portal, Splenic and Mesenteric Thrombosis in Hypereosinophilic Syndrome: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Su Yeon; Jang, Kyung Mi; Kim, Min Jeong; Lee, Kwan Seop; Koh, Sung Hye; Jeon, Eui Yong; Lee, Hyun; Choi, Ju Hyun; Yie, Mi Yeon [Hallym University, Chuncheon (Korea, Republic of)

    2009-07-15

    Idiopathic hypereosinophilic syndrome is a spectrum of diseases characterized by prominent peripheral eosinophilic leukocytosis without an identifiable cause. Several reports have described hepatic involvement as depicted on sonography and CT imaging in patients with hypereosinophilic syndrome. However, thrombosis of the portal, splenic and mesenteric veins in hypereosinophilic syndrome has been rarely reported. We present here a case of portal, splenic and mesenteric thrombosis in a 33-year-old man with hypereosinophilic syndrome.

  4. Abdominal Aortic Dissection with Acute Mesenteric Ischemia in a Patient with Marfan Syndrome

    Directory of Open Access Journals (Sweden)

    Chii-Shyan Lay

    2006-07-01

    Full Text Available Marfan syndrome is an autosomal dominant inherited disorder of connective tissue, with various complications manifested primarily in the cardiovascular system. It potentially leads to aortic dissection and rupture, these being the major causes of death. We report a patient who complained of acute abdominal pain, which presented as acute mesenteric ischemia combined with abdominal aortic dissection. Echocardiography showed enlargement of the aortic root and mitral valve prolapse. Abdominal computed tomography scan revealed acute mesenteric ischemia due to abdominal aortic dissection. Finally, the patient underwent surgery of aortic root replacement and had a successful outcome. Therefore, we suggest that for optimal risk assessment and monitoring of patients with Marfan syndrome, both aortic stiffness and the diameter of the superior mesenteric vein compared with that of the superior mesenteric artery are useful screening methods to detect acute mesenteric ischemia secondary to abdominal aortic dissection. Early diagnosis and early treatment can decrease the high mortality rate of patients with Marfan syndrome.

  5. Compression syndrome of the left renal vein

    Energy Technology Data Exchange (ETDEWEB)

    Justich, E.

    1982-04-01

    Severe compression of the left renal vein produces a pressure gradient between it and the inferior vena cava and results in changes in haemodynamics. The cause of the narrowing is usually the aorta, less commonly the superior mesenteric artery. Compression of the left renal vein may be responsible for a number of abnormalities such as primary varicoceles, primary varices of the ovarian, renal, pelvic and ureteric veins on the left, the more frequent occurrence of unilateral renal vein thrombosis on the left and the development of renovascular hypertension. One hundred and twenty-three selective phlebograms of the left renal vein and CT examinations of this structure in a further 87 patients acting as a control group were carried out. The significance of compression of the left renal vein as an aetiological factor in the development of the above mentioned abnormalities is discussed.

  6. Managing mesenteric vasculitis.

    Science.gov (United States)

    Angle, John Fritz; Nida, Berhanemeskel A; Matsumoto, Alan H

    2015-03-01

    Mesenteric vasculitis is a rare diagnosis, but it comprises a group of disorders that may have devastating manifestations. It is often difficult to diagnose using clinical symptoms and biomarkers. Vascular imaging often provides the best opportunity for the noninvasive diagnosis of vasculitis and obviates the need for performing a biopsy. The medical management of vasculitis involves controlling the inflammatory process with the use of steroids or other immunosuppressants, but medical therapy does not consistently provide regression of the vascular changes (ie, aneurysms or vascular occlusions) seen at the time of the initial diagnosis. Operative management remains the mainstay of therapy for focal occlusive or aneurysms, but the treatment options for multifocal disease remain challenging. Endovascular treatment is increasingly being used as a first line of treatment for symptomatic vasculitis. Interventionalists should be familiar with the indications and outcomes associated with the various therapeutic options for mesenteric vasculitis-associated occlusive disease and aneurysms. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Fat containing chylous mesenteric lymphangiomatosis

    International Nuclear Information System (INIS)

    Kim, Soon Yong; Lim, Jae Hoon; Ko, Young Tae; Lee, Sun Wha; Oh, Soo Myung

    1984-01-01

    We have experienced an unusual case of mesenteric lymphangiomatosis in a 6-month-old male infant. Computed tomography (CT) disclosed fatty abdominal masses with attenuation coefficient being -5∼-28 Hounsfield units (HU). Laparotomy disclosed innumerable small and large chyle containing masses in the mesentery as well as mesenteric root. Pathologically these were confirmed to be cavernous and cystic lymphangiomatosis. One must bear in mind the possibility of lymphangioma in case of fat containing mesenteric mass on CT

  8. Portal vein gas in emergency surgery

    Directory of Open Access Journals (Sweden)

    Mahmood Hind

    2008-07-01

    Full Text Available Abstract Background Portal vein gas is an ominous radiological sign, which indicates a serious gastrointestinal problem in the majority of patients. Many causes have been identified and the most important was bowel ischemia and mesenteric vascular accident. The presentation of patients is varied and the diagnosis of the underlying problem depends mainly on the radiological findings and clinical signs. The aim of this article is to show the clinical importance of portal vein gas and its management in emergency surgery. Methods A computerised search was made of the Medline for publications discussing portal vein gas through March 2008. Sixty articles were identified and selected for this review because of their relevance. These articles cover a period from 1975–2008. Results Two hundreds and seventy-five patients with gas in the portal venous system were reported. The commonest cause for portal vein gas was bowel ischemia and mesenteric vascular pathology (61.44%. This was followed by inflammation of the gastrointestinal tract (16.26%, obstruction and dilatation (9.03%, sepsis (6.6%, iatrogenic injury and trauma (3.01% and cancer (1.8%. Idiopathic portal vein gas was also reported (1.8%. Conclusion Portal vein gas is a diagnostic sign, which indicates a serious intra-abdominal pathology requiring emergency surgery in the majority of patients. Portal vein gas due to simple and benign cause can be treated conservatively. Correlation between clinical and diagnostic findings is important to set the management plan.

  9. Acute mesenteric ischemia: angiographic spectrum

    International Nuclear Information System (INIS)

    Clark, R.A.; Gallant, T.E.

    1984-01-01

    Fifty-six patients, selected by clinical criteria, underwent angiography for suspected acute mesenteric ischemia. Twenty-nine patients subsequently did not have mesenteric ischemia and had negative arteriograms. Twenty-seven patients had mesenteric ischemia: arterial thrombosis (three), arterial embolus (seven), venous thrombosis (five), vasculitis with thrombosis (one), and nonocclusive ischemia (11). Of these 27 patients, 12 (44%) received intraarterial vasodilator infusions. Overall, 13 (48%) of the 27 patients survived their hospitalization, including five (45%) of 11 with nonocclusive ischemia. This experience confirms that nonocclusive ischemia is the most common form of the disorder diagnosed by angiography. Most patients with mesenteric ischemia are candidates for intraarterial vasodilator therapy. Early angiography in patients with suspected acute mesenteric ischemia permits early diagnosis and differentiation between occlusive and nonocclusive types. Interventional infusion therapy may improve survival

  10. Acute mesenteric ischemia: angiographic spectrum

    Energy Technology Data Exchange (ETDEWEB)

    Clark, R.A.; Gallant, T.E.

    1984-03-01

    Fifty-six patients, selected by clinical criteria, underwent angiography for suspected acute mesenteric ischemia. Twenty-nine patients subsequently did not have mesenteric ischemia and had negative arteriograms. Twenty-seven patients had mesenteric ischemia: arterial thrombosis (three), arterial embolus (seven), venous thrombosis (five), vasculitis with thrombosis (one), and nonocclusive ischemia (11). Of these 27 patients, 12 (44%) received intraarterial vasodilator infusions. Overall, 13 (48%) of the 27 patients survived their hospitalization, including five (45%) of 11 with nonocclusive ischemia. This experience confirms that nonocclusive ischemia is the most common form of the disorder diagnosed by angiography. Most patients with mesenteric ischemia are candidates for intraarterial vasodilator therapy. Early angiography in patients with suspected acute mesenteric ischemia permits early diagnosis and differentiation between occlusive and nonocclusive types. Interventional infusion therapy may improve survival.

  11. Scintiangiographic diagnosis of acute mesenteric venous thrombosis

    International Nuclear Information System (INIS)

    Smith, R.W.; Selby, J.B.

    1979-01-01

    Scintiangiographic findings of prolonged mesenteric activity in a case of acute mesenteric thrombosis is described and 105 cases with abdominal scintiangiography are reviewed. Usual peak mesenteric blush occurred 5 to 15 sec after initial visualization of the aorta. Normal clearance of this activity was 15 to 30 sec. Future cases should confirm the importance of this observation in early diagnosis of mesenteric venous thrombosis

  12. Massive mesenteric and portal venous thrombosis secondary to hormone replacement therapy.

    Science.gov (United States)

    Watt, D G; Shapter, O; Mittapalli, D; Murray, W G

    2013-11-01

    Hormone replacement therapy increases risk of deep venous thrombosis (DVT) mainly in the extremities and lungs. There are reports of mesenteric ischemia secondary to oral contraceptive pills but no reports on hormone replacement therapy and mesenteric thrombosis. The authors present a case of a 44-year-old obese (BMI 32) woman, on long-term hormone replacement therapy, presented with thrombosis of portal, splenic and superior mesenteric veins. She underwent surgical resection of ischemic bowel and planned re-look laparotomies with further resections and jejuno-ileal anastomosis at final laparotomy. Thorough haematological investigations were normal. The authors conclude that hormone replacement therapy in obese patients with no other risk factors can cause a catastrophic mesenteric thrombosis. Aggressive surgical resection with re-look laparotomies and further resections can be lifesaving.

  13. Multidetector Computed Tomography Evaluation of Mesenteric Venous Thrombosis Following Laparoscopic Bariatric Surgery.

    Science.gov (United States)

    Dane, Bari; Clark, Jaclyn; Megibow, Alec

    2017-01-01

    The purpose of this study is to review multidetector computed tomography (CT) imaging findings of mesenteric venous thrombosis occurring following bariatric surgery. To our knowledge, this complication has not been described in the radiologic literature. Multidetector CT examinations of 6 patients known to have developed mesenteric venous thrombosis after laparoscopic bariatric surgery were reviewed. The thrombus was characterized, and associated imaging findings including presence of mesenteric edema, small bowel edema, and thrombotic complications were described. Four patients underwent laparoscopic sleeve gastrectomy approximately 12 days before CT diagnosis of mesenteric thrombosis and 2 patients had a laparoscopic Roux-en-Y gastric bypass approximately 11 years before imaging diagnosis of mesenteric thrombosis.The thrombus occupied the entire length of the superior mesenteric vein in all cases. Extension into jejunal branches was present in 4 cases. The thrombus was completely occlusive in 4 of 6 patients. Mesenteric venous thrombosis is an increasingly recognized complication of laparoscopic bariatric surgery. Awareness demands that postbariatric surgery patients with acute abdominal pain be studied with intravenous contrast material.

  14. Vasculitis of the mesenteric circulation.

    Science.gov (United States)

    Koster, Matthew J; Warrington, Kenneth J

    2017-02-01

    Vasculitis of the mesenteric circulation is an uncommon but life-threatening manifestation of systemic vasculitis. Initial symptoms are frequently non-specific and therefore patients often present to primary care physicians and gastroenterologists with abdominal pain or gastrointestinal bleeding. Given the severity of the conditions associated with mesenteric vasculitis, it is imperative to appropriately diagnose and initiate treatment of suspected cases. This review will focus on diseases commonly associated with vasculitis of the mesenteric vessels. Imaging characteristics and clinical features assisting in diagnosis as well as initial approaches to treatment are emphasized. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. PORTAL VEIN THROMBOSIS-ULTRASOUND IMAGING

    Directory of Open Access Journals (Sweden)

    Trajkovska Meri

    2016-07-01

    Full Text Available Portal venous system, apart from the main portal vein, includes its tributaries: superior and inferior mesenteric vein, as well as splenic vein, so the term portal venous thrombosis encompasses a broad spectrum of pathological conditions. Usually, one or more causative factors can be recognized, either local endothelial/ flow disturbances, or systemic inherited /acquired conditions. Portal vein thrombosis can be associated with benign or malignant disorders. Weather we are speaking about acute or chronic thrombosis, the clinical presentation is different. Acute thrombosis can be presented in a wide range, from mild abdominal discomfort to a state of intestinal ischemia and life-threatening infarction. Chronic thrombosis is usually recognized when variceal bleeding or other symptoms of portal hypertension express. Fast and accurate diagnosis sometimes is a life-saving procedure, especially in acute vascular alterations. Recently, due to the improvement of imaging procedures the number of patients with diagnosed portal vein thrombosis is increasingly growing. With a negative predictive value of 98% color Doppler ultrasound is considered as imaging modality of choice in detecting portal vein thrombosis. Based on large studies it is presumed that overall risk of getting portal vein thrombosis during lifetime is 1% in general population, but much bigger 5%-15% in cirrhotic patients. Existence of specific ultrasound criteria, if fulfilled, has ensured that diagnosis of portal vein thrombosis is fast and non-invasive. Procedure is convenient for the patient and healthcare providers, and above all, allows prompt treatment preventing further deterioration.

  16. [Mesenteric cysts in children].

    Science.gov (United States)

    Fernández Ibieta, M; Rojas Ticona, J; Martinez Castaño, I; Reyes Rios, P; Villamil, V; Giron Vallejo, O; Mendez Aguirre, N; Sanchez Morote, J; Aranda Garcia, M J; Guirao Piñera, M J; Zambudio Carmona, G; Ruiz Pruneda, R; Ruiz Jiménez, J I

    2015-01-01

    Mesenteric cysts (MC) are benign cystic tumors that grow within mesentery or omentum tissue. We have reviewed the cases of MC reported and operated on in our centre. Retrospective review of clinical records of MC cases during the period 2002-2012 RESULTS: A total of 7 patients were found. Mean age was 5.3 years (range 3-11). Abdominal ultrasound was the diagnostic tool in all cases, except for one, which was diagnosed during laparotomy. All presented abdominal pain, 5 (71.4%) vomiting, 4 (57%) gross abdominal distension, 3 (42.8%) fever, and none presented complete abdominal obstruction, although 2 patients (28.6%) had slight sub-occlusion symptoms. All MC were pedicled or sesil, except for our last case, which extended into the retroperitoneum. All specimens were reported as Limphatic Malformation. None recurred. MC in children are mostly Lymphatic Malformations of mesentery or omentum origin, and clinical presentation varies from chronic abdominal pain to sudden-onset peritonitis or volvulus. About 50-60% require intestinal resection and anastomosis. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  17. Varicose veins

    Science.gov (United States)

    ... varicose veins, and taking birth control pills or hormone replacement can increase your risk) Being born with defective valves Obesity Pregnancy History of blood clots in your legs Standing or ...

  18. Computed tomographic evaluation of the portal vein in the hepatomas

    International Nuclear Information System (INIS)

    Lee, Kee Hyung; Lee, Seung Chul; Bae, Man Gil; Seo, Heung Suk; Kim, Soon Yong; Lee, Min Ho; Kee, Choon Suhk; Park, Kyung Nam

    1986-01-01

    Computed tomography and pornographic findings of 63 patients with hepatoma, undergone hepatic angiography and superior mesenteric pornography for evaluation of tumor and thrombosis of portal vein and determination of indication of transcatheter arterial embolization for palliative treatment of hepatoma from April, 85 to June, 86 in Hanyang university hospital, were reviewed. The results were as follows: 1. In 36 cases, portal vein thrombosis was detected during photography. Nineteen of 37 cases which revealed localized hepatoma in the right lobe of the liver showed portal vein thrombosis; 9 of 11 cases of the left lobe; 8 of 14 cases which were involved in entire liver revealed thrombosis. One case localized in the caudate lobe showed no evidence of invasion to portal vein. 2. Twenty-four of 34 cases with diffuse infiltrative hepatoma revealed portal vein thrombosis and the incidence of portal vein thrombosis in this type were higher than in the cases of the nodular type. 3. The portal vein thrombosis appeared as filling defects of low density in the lumen of the portal veins in CT and they did not reveal contrast enhancement. 4. CT revealed well the evidence of obstructions in the cases of portal vein thrombosis and the findings were well-corresponded to the findings of the superior mesenteric photography. 5. Five of the cases of the portal vein thrombosis were missed in the CT and the causes were considered as due to partial volume effect of enhanced portal vein with partial occlusion or arterioportal shunts. 6. Six of 13 cases with occlusion of main portal vein showed cavernous transformation and they were noted as multiple small enhanced vascularities around the porta hepatis in the CT. According to the results, we conclude that CT is a useful modality to detect the changes of the portal veins in the patients of the hepatoma.

  19. Computed tomographic evaluation of the portal vein in the hepatomas

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kee Hyung; Lee, Seung Chul; Bae, Man Gil; Seo, Heung Suk; Kim, Soon Yong; Lee, Min Ho; Kee, Choon Suhk; Park, Kyung Nam [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    1986-10-15

    Computed tomography and pornographic findings of 63 patients with hepatoma, undergone hepatic angiography and superior mesenteric pornography for evaluation of tumor and thrombosis of portal vein and determination of indication of transcatheter arterial embolization for palliative treatment of hepatoma from April, 85 to June, 86 in Hanyang university hospital, were reviewed. The results were as follows: 1. In 36 cases, portal vein thrombosis was detected during photography. Nineteen of 37 cases which revealed localized hepatoma in the right lobe of the liver showed portal vein thrombosis; 9 of 11 cases of the left lobe; 8 of 14 cases which were involved in entire liver revealed thrombosis. One case localized in the caudate lobe showed no evidence of invasion to portal vein. 2. Twenty-four of 34 cases with diffuse infiltrative hepatoma revealed portal vein thrombosis and the incidence of portal vein thrombosis in this type were higher than in the cases of the nodular type. 3. The portal vein thrombosis appeared as filling defects of low density in the lumen of the portal veins in CT and they did not reveal contrast enhancement. 4. CT revealed well the evidence of obstructions in the cases of portal vein thrombosis and the findings were well-corresponded to the findings of the superior mesenteric photography. 5. Five of the cases of the portal vein thrombosis were missed in the CT and the causes were considered as due to partial volume effect of enhanced portal vein with partial occlusion or arterioportal shunts. 6. Six of 13 cases with occlusion of main portal vein showed cavernous transformation and they were noted as multiple small enhanced vascularities around the porta hepatis in the CT. According to the results, we conclude that CT is a useful modality to detect the changes of the portal veins in the patients of the hepatoma.

  20. Transjugular Intrahepatic Portosystemic Shunt After Previous Recanalization of a Chronically Thrombosed Portal Vein via a Transmesenteric Approach

    International Nuclear Information System (INIS)

    Matsui, Osamu; Yoshikawa, Jun; Kadoya, Masumi; Gabata, Tosifumi; Takashima, Tsutomu; Urabe, Takeshi; Unoura, Masasi; Kobayashi, Kenichi

    1996-01-01

    We report a cirrhotic patient with complete occlusion of the portal vein with marked cavernous transformation due to chronic thrombosis in whom a transjugular intrahepatic portosystemic shunt (TIPS) was successfully created after direct minilaparotomy mesenteric vein catheterization, lysis and aspiration of the thrombus, and stenting in the portal vein. The methods used, we believe, provide a new technique for performing TIPS in chronically thrombosed portal veins in which previously no effective surgical therapeutic options were available

  1. The compression syndrome of the left renal vein

    International Nuclear Information System (INIS)

    Justich, E.

    1982-01-01

    Severe compression of the left renal vein produces a pressure gradient between it and the inferior vena cava and results in changes in haemodynamics. The cause of the narrowing is usually the aorta, less commonly the superior mesenteric artery. Compression of the left renal vein may be responsible for a number of abnormalities such as primary varicoceles, primary varices of the ovarian, renal, pelvic and ureteric veins on the left, the more frequent occurrence of unilateral renal vein thrombosis on the left and the development of renovascular hypertension. One hundred and twenty-three selective phlebograms of the left renal vein and CT examinations of this structure in a further 87 patients acting as a control group were carried out. The significance of compression of the left renal vein as an aetiological factor in the development of the above mentioned abnormalities is discussed. (orig.) [de

  2. Mesenteric panniculitis: computed tomography aspects

    International Nuclear Information System (INIS)

    Moreira, Luiza Beatriz Melo; Alves, Jose Ricardo Duarte; Marchiori, Edson; Pinheiro, Ricardo Andrade; Melo, Alessandro Severo Alves de; Noro, Fabio

    2001-01-01

    Mesenteric panniculitis is an inflammatory process that represents the second stage of a rare progressive disease involving the adipose tissue of the mesentery. Imaging methods used in the diagnosis of mesenteric panniculitis include barium studies, ultrasonography, computed tomography and magnetic resonance imaging. Computed tomography is important for both, diagnosis and evaluation of the extension of the disease and treatment monitoring. Computed tomography findings may vary according to the stage of the disease and the amount of inflammatory material or fibrosis. There is also good correlation between the computed tomography and anatomical pathology findings. The authors studied 10 patients with mesenteric panniculitis submitted to computed tomography. Magnetic resonance imaging was also performed in one patient. In all patients, computed tomography revealed a heterogeneous mass in the mesentery with density of fat, interspersed with areas of soft tissue density and dilated vessels. (author)

  3. Superior mesenteric venous injuries: to ligate or to repair remains the question.

    Science.gov (United States)

    Asensio, Juan A; Petrone, Patrizio; Garcia-Nuñez, Luis; Healy, Matthew; Martin, Matthew; Kuncir, Eric

    2007-03-01

    Superior mesenteric vein injuries are rare and incur high mortality. Given their low incidence, little data exist delineating indications for when to institute primary repair versus ligation. The purposes of this study are to review our institutional experience, to determine the additive effect on mortality of associated vascular injuries, to correlate mortality with the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) for abdominal vascular injury and to examine and define the indications and outcomes for primary repair versus ligation. Retrospective 156 months study (January 1992 through December 2004) in a large Level I urban trauma center of all patients admitted with superior mesenteric vein injuries. Patients were stratified, according to surgical technique employed to deal with their injuries, into those undergoing primary repair versus ligation to determine outcomes and define the surgical indications of these methods. The main outcome measure was overall survival. Cases of survival were stratified according to surgical method: primary repair versus ligation. There were 51 patients with a mean Injury Severity Score of 25 +/- 12. Mechanism of injury was penetrating for 38 (76%), blunt for 13 (24%), and patients undergoing emergency department thoracotomy for 4 (8%). Surgical management was ligation for 30 (59%), primary repair for 16 (31%), and 5 (10%) patients were exsanguinated before repair. The overall survival rate was 24/50 (47%). The survival rate excluding patients undergoing emergency department thoracotomy was 51%. The survival rate excluding patients that sustained greater than 3 to 4 associated vessels injured was 65%. The survival rates of patients with superior mesenteric vein and superior mesenteric artery was 55% and superior mesenteric vein and portal vein (PV) was 40%. The survival rate of patients with isolated superior mesenteric vein injuries was 55%. Mortality stratified to AAST-OIS grade III, 44%; grade IV

  4. Mesenteric vascular occlusion: Comparison of ancillary CT findings between arterial and venous occlusions and independent CT findings suggesting life-threatening events

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Yon Cheong; Wu, Cheng Hsien; Wang, Li Jen; Chen, Huan Wu; Lin, Being Chuan; Huang, Chen Chih [Chang Gung Memorial Hospital, Chang Gung University, Taoyuan (China)

    2013-01-15

    To compare the ancillary CT findings between superior mesenteric artery thromboembolism (SMAT) and superior mesenteric vein thrombosis (SMVT), and to determine the independent CT findings of life-threatening mesenteric occlusion. Our study was approved by the institution review board. We included 43 patients (21 SMAT and 22 SMVT between 1999 and 2008) of their median age of 60.0 years, and retrospectively analyzed their CT scans. Medical records were reviewed for demographics, management, surgical pathology diagnosis, and outcome. We compared CT findings between SMAT and SMVT groups. Multivariate analysis was conducted to determine the independent CT findings of life-threatening mesenteric occlusion. Of 43 patients, 24 had life-threatening mesenteric occlusion. Death related to mesenteric occlusion was 32.6%. A thick bowel wall (p < 0.001), mesenteric edema (p < 0.001), and ascites (p = 0.009) were more frequently associated with SMVT, whereas diminished bowel enhancement (p = 0.003) and paralytic ileus (p = 0.039) were more frequent in SMAT. Diminished bowel enhancement (OR = 20; p = 0.007) and paralytic ileus (OR = 16; p = 0.033) were independent findings suggesting life-threatening mesenteric occlusion. The ancillary CT findings occur with different frequencies in SMAT and SMVT. However, the independent findings indicating life-threatening mesenteric occlusion are diminished bowel wall enhancement and paralytic ileus.

  5. Mesenteric vascular occlusion: Comparison of ancillary CT findings between arterial and venous occlusions and independent CT findings suggesting life-threatening events

    International Nuclear Information System (INIS)

    Wong, Yon Cheong; Wu, Cheng Hsien; Wang, Li Jen; Chen, Huan Wu; Lin, Being Chuan; Huang, Chen Chih

    2013-01-01

    To compare the ancillary CT findings between superior mesenteric artery thromboembolism (SMAT) and superior mesenteric vein thrombosis (SMVT), and to determine the independent CT findings of life-threatening mesenteric occlusion. Our study was approved by the institution review board. We included 43 patients (21 SMAT and 22 SMVT between 1999 and 2008) of their median age of 60.0 years, and retrospectively analyzed their CT scans. Medical records were reviewed for demographics, management, surgical pathology diagnosis, and outcome. We compared CT findings between SMAT and SMVT groups. Multivariate analysis was conducted to determine the independent CT findings of life-threatening mesenteric occlusion. Of 43 patients, 24 had life-threatening mesenteric occlusion. Death related to mesenteric occlusion was 32.6%. A thick bowel wall (p < 0.001), mesenteric edema (p < 0.001), and ascites (p = 0.009) were more frequently associated with SMVT, whereas diminished bowel enhancement (p = 0.003) and paralytic ileus (p = 0.039) were more frequent in SMAT. Diminished bowel enhancement (OR = 20; p = 0.007) and paralytic ileus (OR = 16; p = 0.033) were independent findings suggesting life-threatening mesenteric occlusion. The ancillary CT findings occur with different frequencies in SMAT and SMVT. However, the independent findings indicating life-threatening mesenteric occlusion are diminished bowel wall enhancement and paralytic ileus.

  6. Deep Vein Thrombosis

    Science.gov (United States)

    Deep vein thrombosis, or DVT, is a blood clot that forms in a vein deep in the body. Most deep vein ... the condition is called thrombophlebitis. A deep vein thrombosis can break loose and cause a serious problem ...

  7. Varicose vein stripping

    Science.gov (United States)

    ... stripping; Venous reflux - vein stripping; Venous ulcer - veins Patient Instructions Surgical wound care - open Varicose veins - what to ask your doctor Images Circulatory system References American Family Physician. Management of varicose veins. www.aafp.org/afp/2008/ ...

  8. Risk factors of mesenteric venous thrombosis and current situation of diagnosis and treatment in China

    International Nuclear Information System (INIS)

    Zhuang Zhiwei; Zhu Huanxing; Xu Changsheng

    2010-01-01

    Objective: To investigate risk factors of mesenteric venous thrombosis and current situation of diagnosis and treatment in China. Methods: One hundred and seven case of mesenteric venous thrombosis reported in literature were analyzed. The literature from 2003 to 2007 were retrieved from Chinese Scientific and Technical Periodical Database and Wanfangdata. Results: One hundred and seven papers included 978 MVT patients, male: female = 1. 9:1, the average age was 47. 9. The most common risk factors were portal hypertension (28. 9% ), splenectomy (18. 8%) and thrombophlebitis (11. 5%) in 833 cases with integrated medical history. Final diagnosis was established by medical imageology (40. 0%) and exploratory laparotomy (60. 0%). The achievement ratio of thrombolysis therapy was 83. 9% (73 /87) by peripheral vein and 90. 0% (63 /70) by superior mesenteric artery. 34. 7% patients took warfarin orally after discharge. Conclusions: Portal hypertension, splenectomy and thrombophlebitis may be the most common risk factor for MVT; through peripheral vein or superior mesenteric artery urokinase thrombolytic therapy is an effective means of treatment of early MVT; MVT diagnostic awareness and anticoagulant therapy after surgery awareness of the importance is to be strengthened. (authors)

  9. Paralytic Ileus due to Superior Mesenteric Venous Thrombosis after Transarterial Injection for Hepatocellular Carcinoma.

    Science.gov (United States)

    Nakajima, Yuki; Takahashi, Atsushi; Kanno, Yukiko; Gunji, Naohiko; Imaizumi, Hiromichi; Hayashi, Manabu; Okai, Ken; Abe, Kazumichi; Watanabe, Hiroshi; Ohira, Hiromasa

    2016-01-01

    A 69-year-old man was admitted to hospital with abdominal pain. In the four years prior to his presentation, he had undergone repeated transarterial chemoembolizations and injections for hepatocellular carcinoma. He underwent his 8th transcatheter arterial therapy one month prior to admission. Abdominal X-rays and contrast-enhanced computed tomography showed large amounts of small intestinal gas and venous thrombosis from the portal vein to the superior mesenteric vein, respectively. The thrombosis was reduced after anticoagulation therapy (heparin, antithrombin III, danaparoid sodium and warfarin). This is the first case report of paralytic ileus due to superior mesenteric venous thrombosis after transcatheter arterial therapy for hepatocellular carcinoma with an arterioportal shunt.

  10. Oral contraceptive and acute intestinal ischemia with mesenteric venous thrombosis: a case report

    Directory of Open Access Journals (Sweden)

    Béliard A

    2017-01-01

    Full Text Available Aude Béliard,1 Lucie Verreth,2 Pascale Grandjean2 1Department of Obstetrics and Gynaecology, Centre Hospitalier du Bois de l’Abbaye (CHBA, Liege, Belgium; 2Department of Obstetrics and Gynaecology, Centre Hospitalier Régional (CHR Mons Hainaut, Mons, Belgium Background: Venous thrombosis is a serious complication of combined contraceptive usage. However, mesenteric venous thrombosis and intestinal necrosis are infrequently seen in women using oral contraceptives, and in such cases diagnosis is often delayed.Case presentation: We report the case of a 38-year-old obese female patient who presented with acute abdominal pain. A bowel infection was first diagnosed and treated with antibiotics. Contrast-enhanced tomography of the abdomen revealed diffuse ischemia of the small ­intestine with superior mesenteric thrombosis. Laparotomy with segmental resection of both small and large bowel was performed. No predisposing factor of mesenteric venous thrombosis was demonstrated except association of the combined contraceptive with obesity.Conclusion: This report highlights the need for clinicians to suspect venous mesenteric thrombosis in women of reproductive age with acute abdominal pain and poor physical ­findings. Detailed personal history including prescriptions should help to quickly and accurately ­determine the problem. Keywords: hormonal contraceptive, deep venous thrombosis, superior mesenteric vein, obesity, bowel infection

  11. Multiple detector-row CT angiography of the renal and mesenteric vessels

    Energy Technology Data Exchange (ETDEWEB)

    Fleischmann, Dominik. E-mail: dominik.fleischmann@univie.ac.at

    2003-03-01

    Computed tomography angiography (CTA) of the abdomen with multiple detector-row computed tomography (MD-CT) is an effective technique for minimally invasive imaging of the renal arteries and the visceral vasculature. This article reviews the clinical and technical aspects of MD-CT angiography in terms of image acquisition and reconstruction parameters, contrast medium application, and three-dimensional visualization with special attention to renal and mesenteric vascular imaging. Because of its high sensitivity to detect renal artery stenosis on the one hand, and because a normal renal CTA virtually excludes the presence of a significant renal artery stenosis on the other hand, renal CTA plays a useful role in the management of patients with suspected renovascular hypertension. Mesenteric CTA is a useful tool for visualizing normal vascular anatomy and its variants--particularly in the setting of organ transplantation. Vascular pathology, e.g. atherosclerotic disease (abdominal angina), or aneurysms of the visceral arteries are reliably assessed with CTA. Mesenteric CTA is an invaluable adjunct to abdominal CT in the setting of abdominal emergencies, because of its ability to detect the causes of acute intestinal ischemia (superior mesenteric artery embolism or thrombosis, superior mesenteric vein thrombosis). Accurate timing of the CTA acquisition and the subsequent parenchymal phase acquisition relative to the contrast medium transit time is critical to obtain excellent image quality in double-pass abdominal CT acquisitions.

  12. Multiple detector-row CT angiography of the renal and mesenteric vessels

    International Nuclear Information System (INIS)

    Fleischmann, Dominik.

    2003-01-01

    Computed tomography angiography (CTA) of the abdomen with multiple detector-row computed tomography (MD-CT) is an effective technique for minimally invasive imaging of the renal arteries and the visceral vasculature. This article reviews the clinical and technical aspects of MD-CT angiography in terms of image acquisition and reconstruction parameters, contrast medium application, and three-dimensional visualization with special attention to renal and mesenteric vascular imaging. Because of its high sensitivity to detect renal artery stenosis on the one hand, and because a normal renal CTA virtually excludes the presence of a significant renal artery stenosis on the other hand, renal CTA plays a useful role in the management of patients with suspected renovascular hypertension. Mesenteric CTA is a useful tool for visualizing normal vascular anatomy and its variants--particularly in the setting of organ transplantation. Vascular pathology, e.g. atherosclerotic disease (abdominal angina), or aneurysms of the visceral arteries are reliably assessed with CTA. Mesenteric CTA is an invaluable adjunct to abdominal CT in the setting of abdominal emergencies, because of its ability to detect the causes of acute intestinal ischemia (superior mesenteric artery embolism or thrombosis, superior mesenteric vein thrombosis). Accurate timing of the CTA acquisition and the subsequent parenchymal phase acquisition relative to the contrast medium transit time is critical to obtain excellent image quality in double-pass abdominal CT acquisitions

  13. Chylous mesenteric cyst: A diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Doreen L.P. Lee

    2016-07-01

    Full Text Available A mesenteric cyst is defined as a cyst that is located in the mesentery of the gastrointestinal tract and may extend from the base of the mesentery into the retroperitoneum. A case report of a patient with mesenteric cyst is presented. In addition, a systematic review was performed of English language literature on chylous mesenteric cysts in adult humans. Of the 18 articles included in the review, there were 19 cases of chylous mesenteric cysts reported. Male to female ratio was 1.4:1 with a median age of 46 years. A preoperative diagnosis of mesenteric cyst was made in four patients based on computed tomography. All patients underwent surgery and there were no reports of recurrence on follow up. Chylous mesenteric cyst is a rare entity that needs to be recognized whenever a preliminary diagnosis of intra-abdominal cystic mass is made.

  14. Analysis of mesenteric thickening on computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Takano, Hideyuki; Sekiya, Tohru; Miyakawa, Kunihisa; Ozaki, Masatoki; Katsuyama, Naofumi; Nakano, Masao (University of the Ryukyu, Okinawa (Japan). School of Medicine)

    1990-12-01

    Computed tomography (CT) provides noninvasive information in the evaluation of abnormalities of the gastrointestinal tract by direct imaging of the bowel wall and adjacent mesentery. Several prior studies have discussed the variable CT appearances of mesenteric abnormalities, such as lymphoma, metastasis, inflammatory disease and edema. Although mesenteric thickening was mentioned in these studies, no study has provided a detailed analysis of the CT appearance of the thickened mesentery. Two characteristic types of mesenteric thickening were identified in 47 patients. Type I is 'intramesenteric thickening', which was noted in 25 patients with vascular obstruction, inflammatory disease and edema. Type II is 'mesenteric surface thickening', which was noted in 22 patients with peritonitis carcinomatosa, peritoneal mesothelioma, tuberculous peritonitis and pseudomyxoma peritoneai. An understanding of these two types of mesenteric diseases is important in the identification of mesenteric pathology. (author).

  15. Analysis of mesenteric thickening on computed tomography

    International Nuclear Information System (INIS)

    Takano, Hideyuki; Sekiya, Tohru; Miyakawa, Kunihisa; Ozaki, Masatoki; Katsuyama, Naofumi; Nakano, Masao

    1990-01-01

    Computed tomography (CT) provides noninvasive information in the evaluation of abnormalities of the gastrointestinal tract by direct imaging of the bowel wall and adjacent mesentery. Several prior studies have discussed the variable CT appearances of mesenteric abnormalities, such as lymphoma, metastasis, inflammatory disease and edema. Although mesenteric thickening was mentioned in these studies, no study has provided a detailed analysis of the CT appearance of the thickened mesentery. Two characteristic types of mesenteric thickening were identified in 47 patients. Type I is 'intramesenteric thickening', which was noted in 25 patients with vascular obstruction, inflammatory disease and edema. Type II is 'mesenteric surface thickening', which was noted in 22 patients with peritonitis carcinomatosa, peritoneal mesothelioma, tuberculous peritonitis and pseudomyxoma peritoneai. An understanding of these two types of mesenteric diseases is important in the identification of mesenteric pathology. (author)

  16. Reperfusion hemorrhage following superior mesenteric artery stenting.

    LENUS (Irish Health Repository)

    Moore, Michael

    2012-02-03

    Percutaneous transluminal angioplasty and stent placement is now an established treatment option for chronic mesenteric ischemia and is associated with low mortality and morbidity rates. We present a case of reperfusion hemorrhage complicating endovascular repair of superior mesenteric artery stenosis. Although a recognized complication following repair of carotid stenosis, hemorrhage has not previously been reported following mesenteric endovascular reperfusion. We describe both spontaneous cessation of bleeding and treatment with coil embolization.

  17. CT diagnosis in acute mesenteric infarction

    International Nuclear Information System (INIS)

    Jiang Hao; Zhang Bei; Zhang Hua; Zhu Dacheng; Zhu Xiaolei; Yang Weijie; Ding Xiaolong; Wu Lizhong

    2005-01-01

    Objective: To determine the diagnostic value of CT in acute mesenteric infarction (AMI). Methods: Ten patients with mesenteric infarction (6 male, 4 female, average age 67.2 years old) were analysed from April 2003 to September 2004, whose symptoms include abdominal pain, melena, nausea and vomiting, etc. Nine cases were confirmed by surgery and pathology except one diedimmediately after CT scan. They included superior mesenteric arterial (SMA) thrombosis (n=4), superior mesenteric venous (SMV) thrombosis (n=5) and inferior mesenteric venous (IMV) thrombosis (n=1). Except one routine CT scan, all the other cases were performed by contrast-enhanced CT examination. Results: The direct sign of acute mesenteric infarction in CT images was filling defect in mesentery vessels (n=8). The indirect signs included dilatation of bowl loops (n=4), bowel wall thickening (n=6), the paper-thin wall sign (n=4), mesenteric stranding (n=5), mesenteric haziness (n=3), pneumatosis of bowel wall (n=2), portal veno gas (n=1) and ascites (n=3). Conclusion: Computed tomography is sensitive to acute mesenteric infarction and is valuable in diagnosis. (authors)

  18. Interventional therapy of mesenteric venous thrombosis

    International Nuclear Information System (INIS)

    Li Xuan; Ouyang Qiang; Xiao Xiangsheng

    2006-01-01

    Objective: To evaluate the clinical effect of interventional therapy in treating intestinal ischemia of mesenteric venous thrombosis. Methods: Twelve cases (male 7 cases, female 5 cases; ranging from 33 to 86 years of age) of mesenteric venous thrombosis (MVT) were treated with percutaneous transhepatic mesenteric venous thrombectomy and thrombolysis associated with papaverin perfusion via superior mesenteric artery. Results: Seven of the 12 cases recovered; 3 cases were undertaken laparotomy; 2 died within 30 days respectively. No severe complications occurred in all of the 12 cases. Conclusions: Interventional therapy of MVT is a safe and effective method with reduction of the mortality. (authors)

  19. Right hemicolectomy for mesenteric phlebosclerosis potentially caused by long-term use of herbal medicine: A case report and literature review.

    Science.gov (United States)

    Hoshino, Nobuaki; Hasegawa, Suguru; Hida, Koya; Kawada, Kenji; Sakai, Yoshiharu

    2016-01-01

    Mesenteric phlebosclerosis is a rare ischemic disease affecting the colon. Systemic disease and herbal medicine have been pointed out as possible causes, and the disease is characterized by calcifications involved the mesocolic veins. Patients who do not respond to conservative therapy require surgical treatment. In surgical intervention, an adequate extent of colonic resection is important. We present a case of an 87-year-old woman with mesenteric phlebosclerosis who had consumed herbal medicine for 40 years. She suffered from ileus caused by mesenteric phlebosclerosis, and the symptoms did not improve with conservative therapy. Right hemicolectomy was performed since the disease was localized in the right colon. Long-term use of herbal medicine was considered the potential cause of mesenteric phlebosclerosis. The postoperative course was mostly uneventful. The patient stopped using herbal medicine and had no signs of recurrence 2 years after surgery. The greatest concern in surgery for mesenteric phleboscrerosis is to detect the affected area, which should be removed. Characteristic findings in computed tomography and intraoperative findings can help to determine the optimal extent of colonic resection. Mesenteric phlebosclerosis caused by herbal medicines occurs as localized disease in the right colon compared with mesenteric phlebosclerosis caused by other pathogenesis. Limited colonic resection is usually indicated for mesenteric phlebosclerosis caused by herbal medicine. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. Balloon occlusion retrograde transvenous obliteration of gastric varices in two-cirrhotic patients with portal vein thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Borhei, Peyman; Kim, Seung Kwon; Zukerman, Darryl A [Interventional Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (United States)

    2014-02-15

    This report describes two non-cirrhotic patients with portal vein thrombosis who underwent successful balloon occlusion retrograde transvenous obliteration (BRTO) of gastric varices with a satisfactory response and no complications. One patient was a 35-year-old female with a history of Crohn's disease, status post-total abdominal colectomy, and portal vein and mesenteric vein thrombosis. The other patient was a 51-year-old female with necrotizing pancreatitis, portal vein thrombosis, and gastric varices. The BRTO procedure was a useful treatment for gastric varices in non-cirrhotic patients with portal vein thrombosis in the presence of a gastrorenal shunt.

  1. Balloon occlusion retrograde transvenous obliteration of gastric varices in two-cirrhotic patients with portal vein thrombosis

    International Nuclear Information System (INIS)

    Borhei, Peyman; Kim, Seung Kwon; Zukerman, Darryl A

    2014-01-01

    This report describes two non-cirrhotic patients with portal vein thrombosis who underwent successful balloon occlusion retrograde transvenous obliteration (BRTO) of gastric varices with a satisfactory response and no complications. One patient was a 35-year-old female with a history of Crohn's disease, status post-total abdominal colectomy, and portal vein and mesenteric vein thrombosis. The other patient was a 51-year-old female with necrotizing pancreatitis, portal vein thrombosis, and gastric varices. The BRTO procedure was a useful treatment for gastric varices in non-cirrhotic patients with portal vein thrombosis in the presence of a gastrorenal shunt.

  2. Prevalence and clinical importance of mesenteric venous thrombosis in the Swiss Inflammatory Bowel Disease Cohort.

    Science.gov (United States)

    Violi, N Vietti; Vietti Violi, Naïk; Schoepfer, Alain M; Fournier, Nicolas; Guiu, Boris; Bize, Pierre; Denys, Alban

    2014-07-01

    The purpose of this study was to evaluate the prevalence of mesenteric venous thrombosis (MVT) in the Swiss Inflammatory Bowel Disease Cohort Study and to correlate MVT with clinical outcome. Abdominal portal phase CT was used to examine patients with inflammatory bowel disease (IBD). Two experienced abdominal radiologists retrospectively analyzed the images, focusing on the superior and inferior mesenteric vein branches and looking for signs of acute or chronic thrombosis. The location of abnormalities was registered. The presence of MVT was correlated with IBD-related radiologic signs and complications. The cases of 160 patients with IBD (89 women, 71 men; Crohn disease [CD], 121 patients; ulcerative colitis [UC], 39 patients; median age at diagnosis, 27 years for patients with CD, 32 years for patients with UC) were analyzed. MVT was detected in 43 patients with IBD (26.8%). One of these patients had acute MVT; 38, chronic MVT; and four, both. The prevalence of MVT did not differ between CD (35/121 [28.9%]) and UC (8/39 [20.5%]) (p = 0.303). The location of thrombosis was different between CD and UC (CD, jejunal or ileal veins only [p = 0.005]; UC, rectocolic veins only [p = 0.001]). Almost all (41/43) cases of thrombosis were peripheral. MVT in CD patients was more frequently associated with bowel wall thickening (p = 0.013), mesenteric fat hypertrophy (p = 0.005), ascites (p = 0.002), and mesenteric lymph node enlargement (p = 0.036) and was associated with higher rate of bowel stenosis (p < 0.001) and more intestinal IBD-related surgery (p = 0.016) in the outcome. Statistical analyses for patients with UC were not relevant because of the limited population (n = 8). MVT is frequently found in patients with IBD. Among patients with CD, MVT is associated with bowel stenosis and CD-related intestinal surgery.

  3. Childhood giant omental and mesenteric lipoma

    Directory of Open Access Journals (Sweden)

    Hidayatullah Hamidi, MD

    2016-03-01

    Full Text Available Omental and mesenteric lipomas are very rare benign lesions of mature adipose tissue. They are well-defined, noninvasive, and encapsulated masses that can be discovered in asymptomatic patients or may cause variable nonspecific symptoms depending on their size and location. The omental and mesenteric lipoma has confusing features in ultrasound; however, computed tomography and magnetic resonance imaging can well characterize and demarcate these lesions. Though few cases of mesenteric and omental lipomas have been reported in the literature, but because of its large size and childhood presentation, the case we present, can be one of the largest childhood omental and mesenteric lipomas ever reported. A 6-year-old girl presented with slowly progressing abdominal distension and repeated dull abdominal pain for last 4 years. Abdominal and pelvic computed tomography examination revealed a huge mesenteric and omental lipoma that was resected surgically without any complications.

  4. CARCINOEMBRYONIC ANTIGEN LEVELS IN THE PERIPHERAL AND MESENTERIC VENOUS BLOOD OF PATIENTS WITH RECTAL CARCINOMA

    Directory of Open Access Journals (Sweden)

    Herminio Cabral de REZENDE JUNIOR

    2013-12-01

    Full Text Available Context The serum carcinoembryonic antigen (CEA is an important prognostic factor in colorectal cancer, however the rectum presents different routes of venous drainage, stating that the level of CEA in peripheral and mesenteric rectal tumors may be different, depending on the location of the tumor in the rectal segment. Objective The goal of this study was to evaluate the relationship between the peripheral and mesenteric venous levels of CEA and the association between these levels and the tumour location in the rectums of patients successfully operated on for rectal carcinoma. Methods Thirty-two patients who were surgically treated for rectal carcinoma were divided into patients with tumours located in the upper rectum (n = 11 or lower rectum (n = 21. The CEA values were assessed by electrochemiluminescence immunoassay. Serum and mesenteric CEA levels were associated with the tumour anatomopathological characteristics: location, histological type, cellular differentiation grade, depth of invasion into the rectal wall, angiolymphatic invasion, tumour, node, and metastasis staging; and the CEA index (≤1.0 or ≥1.0 ng /mL. Results Analysis of the serum CEA values using clinical and anatomopathological parameters revealed no significant association with tumour location, histological type, cellular differentiation grade, depth of invasion into the intestinal wall, and tumour, node, and metastasis staging. The mesenteric CEA levels were significantly associated with the tumour location (P = 0.01. The CEA values in the mesenteric venous blood and the presence of angiolymphatic invasion (P = 0.047 were significantly different. A significant relationship was found between the CEA index value and the rectal tumour location (P = 0.0001. Conclusions The CEA levels were higher in the mesenteric vein in tumours located in the upper rectum and in the presence of angiolymphatic invasion. CEA drainage from lower rectum adenocarcinomas preferentially occurs

  5. Non-Occlusive Mesenteric Ischemia

    International Nuclear Information System (INIS)

    Kraemer, S.C.; Universitaetsklinikum Ulm; Goerich, J.; Oertel, F.; Scheld, H.; Heindel, W.

    2003-01-01

    The so-called non-occlusive disease (NOD) or non-occlusive mesenteric ischemia (NOMI) is a severe and life-threatening pathology. Even under optimal circumstances and standardised diagnostic and therapeutic procedures maximum survival rates do not exceed 50%. The NOD is a pathology of the elder patient and its incidence rises with other comorbidities such as reduced cardiac output, diabetes and renal insufficiency. Induction of the disease with a severe vasoconstriction of the splanchnic vessels may be a simple cardiac decompensation, a frequent trigger however is a previous heart surgery with consecutive cardiac shock. Early diagnosis is difficult to conduct because of unspecific symptoms. Beside abdominal pain in awake patients, ileus or subileus is remaining the single acute symptom which could be also a consequence of a postoperative paralysis. Laboratory parameters such as leucocytosis and elevated lactat levels are often positive, but unspecific and the latter may be a delayed sign of progressive disease. The only sufficient method for diagnosis implicating a possible treatment option seems to be an immediate angiographic examination. Because of the disappointing results of a solitary surgical approach transarterial medication via catheter is indicated. Depending of the course of the disease only a combination of local mesenteric infusion of vasodilatory drugs and surgical resection of already necrotic bowel promises a successful therapeutic approach and better survival rates. (orig.) [de

  6. The use of intraperitoneal xenon for early diagnosis of acute mesenteric ischemia

    International Nuclear Information System (INIS)

    Gharagozloo, F.; Bulkley, G.B.; Zuidema, G.D.; O'Mara, C.S.; Alderson, P.O.

    1984-01-01

    We evaluated the technique of intraperitoneal use of xenon Xe 133, previously described for the diagnosis of early intestinal strangulation obstruction in rats and dogs, for the recognition of acute mesenteric vascular occlusion in these animals. 133 Xe was injected intraperitoneally into five groups of six rats: control, sham operation, superior mesenteric artery (SMA) ligation, superior mesenteric vein ligation, and portal vein ligation. Residual gamma-activity was monitored by external counting and camera imaging. At 30 minutes after injection, the activity was significantly higher in the rats from the three groups with vascular ligation than in the control and sham operation animals (P less than 0.001). gamma-Camera images reflected these findings, with positive images only in the rats that underwent vascular ligation. ''Blinded'' readings of the 30 sets of scans confirmed the diagnostic accuracy of the images. Results were essentially the same in a second series of experiments in eight control dogs and six dogs with balloon occlusion of the SMA. Concentrations of isotope in ischemic intestine ranged from 10(3) to 10(5) times the levels in adjacent normal bowel. These levels and the positive images appeared early, prior to the development of tissue necrosis. The intraperitoneal use of 133 Xe therefore continues to show promise for the recognition of patients with early intestinal ischemia

  7. The use of intraperitoneal xenon for early diagnosis of acute mesenteric ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Gharagozloo, F.; Bulkley, G.B.; Zuidema, G.D.; O' Mara, C.S.; Alderson, P.O.

    1984-04-01

    We evaluated the technique of intraperitoneal use of xenon Xe 133, previously described for the diagnosis of early intestinal strangulation obstruction in rats and dogs, for the recognition of acute mesenteric vascular occlusion in these animals. /sup 133/Xe was injected intraperitoneally into five groups of six rats: control, sham operation, superior mesenteric artery (SMA) ligation, superior mesenteric vein ligation, and portal vein ligation. Residual gamma-activity was monitored by external counting and camera imaging. At 30 minutes after injection, the activity was significantly higher in the rats from the three groups with vascular ligation than in the control and sham operation animals (P less than 0.001). gamma-Camera images reflected these findings, with positive images only in the rats that underwent vascular ligation. ''Blinded'' readings of the 30 sets of scans confirmed the diagnostic accuracy of the images. Results were essentially the same in a second series of experiments in eight control dogs and six dogs with balloon occlusion of the SMA. Concentrations of isotope in ischemic intestine ranged from 10(3) to 10(5) times the levels in adjacent normal bowel. These levels and the positive images appeared early, prior to the development of tissue necrosis. The intraperitoneal use of /sup 133/Xe therefore continues to show promise for the recognition of patients with early intestinal ischemia.

  8. Diagnosis and treatment of mesenteric volvulus in a red kangaroo (Macropus rufus).

    Science.gov (United States)

    Knafo, S Emmanuelle; Rosenblatt, Alana J; Morrisey, James K; Flanders, James A; Thompson, Margret S; Knapp-Hoch, Heather M

    2014-04-01

    An 8-year-old male red kangaroo (Macropus rufus) was evaluated with a 2-week history of vomiting and anorexia. Four days prior, the patient became refractory to medical management. The kangaroo was admitted for diagnostic testing and treatment including whole body CT, blood work, and emergency laparotomy. CT findings of a severely enlarged stomach, splenic displacement, and a whirl sign were indicative of mesenteric volvulus with gastric dilatation-volvulus (GDV). Contrast enhancement of abdominal viscera suggested intact arterial blood supply; however, compression of the caudal vena cava and portal vein indicated venous obstruction. Results of preoperative blood work suggested biliary stasis without evidence of inflammation. Additionally, a tooth root abscess was diagnosed on the basis of results of CT. Exploratory laparotomy confirmed the diagnosis of mesenteric volvulus and GDV. The volvuli were corrected by clockwise derotation, and a gastropexy was performed. Tissue samples were obtained from the spleen and liver for evaluation. The kangaroo recovered from surgery, and the abscessed tooth was extracted 6 days later. Eight days after initial evaluation, the kangaroo was discharged. In the present report, the CT whirl sign was used to diagnose volvulus of the abdominal viscera, which suggests that this diagnostic indicator has utility in veterinary patients. Mesenteric volvulus with GDV was successfully treated in a nondomestic species. The tooth root abscess, a common condition in macropods, may explain the historic episodes of anorexia reported by the owner and may have contributed to the development of mesenteric volvulus and GDV in this kangaroo.

  9. Portal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Hakan Demirci

    2016-01-01

    Full Text Available Portal vein thrombosis is an important cause of presinusoidal portal hypertension. Portal vein thrombosis commonly occurs in patient with cirrhosis, malignancy and prothrombotic states. Patients with acute portal vein thrombosis have immediate onset. Patients with chronic portal vein thrombosis have developed portal hypertension and cavernous portal transformation. Portal vein thrombosis is diagnosed with doppler ultrasound, computed tomography and magnetic resonance imaging. Therapy with low molecular weight heparin achieves recanalization in more than half of acute cases.

  10. Septic thrombosis of the portal vein due to peripancreatic ligamental abscess

    Energy Technology Data Exchange (ETDEWEB)

    Wakisaka, M.; Mori, H.; Kiyosue, H. [Dept. of Radiology, Oita Medical Univ. (Japan); Kamegawa, T. [Dept. of Surgery, Nankai Hospital (Japan); Uragami, S. [Dept. of Internal Medicine, Nankai Hospital, Saiki (Japan)

    1999-02-01

    Septic thrombus formation of both the main portal vein and its intrahepatic branches were observed on CT in a patient with peripancreatic abscess. The septic thrombosis of portal vein (STPV) extended from the level of porta hepatis into the intrahepatic branches, but the portal vein and superior mesenteric vein at the level of pancreatic head were preserved with no evidence of thrombosis angiographically. The gas-containing abscess near the head of the pancreas extended toward the hepatic hilum and surrounded the portal vein and its branches on CT. It was concluded that these thrombi of portal vein branches at porta hepatis and intrahepatic branches were caused by extensions of peripancreatic abscess via the hepatoduodenal ligament and ligamentum teres. Computed tomography was useful in depicting the ligamentous spread of peripancreatic abscess resulting in STPV. (orig.) (orig.) With 2 figs., 6 refs.

  11. Septic thrombosis of the portal vein due to peripancreatic ligamental abscess

    International Nuclear Information System (INIS)

    Wakisaka, M.; Mori, H.; Kiyosue, H.; Kamegawa, T.; Uragami, S.

    1999-01-01

    Septic thrombus formation of both the main portal vein and its intrahepatic branches were observed on CT in a patient with peripancreatic abscess. The septic thrombosis of portal vein (STPV) extended from the level of porta hepatis into the intrahepatic branches, but the portal vein and superior mesenteric vein at the level of pancreatic head were preserved with no evidence of thrombosis angiographically. The gas-containing abscess near the head of the pancreas extended toward the hepatic hilum and surrounded the portal vein and its branches on CT. It was concluded that these thrombi of portal vein branches at porta hepatis and intrahepatic branches were caused by extensions of peripancreatic abscess via the hepatoduodenal ligament and ligamentum teres. Computed tomography was useful in depicting the ligamentous spread of peripancreatic abscess resulting in STPV. (orig.) (orig.)

  12. Superior mesenteric artery syndrome causing growth retardation

    Directory of Open Access Journals (Sweden)

    Halil İbrahim Taşcı

    2013-03-01

    Full Text Available Superior mesenteric artery syndrome is a rare and lifethreateningclinical condition caused by the compressionof the third portion of the duodenum between the aortaand the superior mesenteric artery’s proximal part. Thiscompression may lead to chronic intermittent, acute totalor partial obstruction. Sudden weight-loss and the relateddecrease in the fat tissue are considered to be the etiologicalreason of acute stenosis. Weight-loss accompaniedby nausea, vomiting, anorexia, epigastric pain, andbloating are the leading complaints. Barium radiographs,computerized tomography, conventional angiography,tomographic and magnetic resonance angiography areused in the diagnosis. There are medical and surgical approachesto treatment. We hereby present the case ofa patient with superior mesenteric artery syndrome withdelayed diagnosis.Key words: superior mesenteric artery syndrome, nausea-vomiting, anorexia

  13. Torsion of a giant mesenteric lipoma

    Energy Technology Data Exchange (ETDEWEB)

    Wolko, Jonathan D.; Rosenfeld, David L.; Lazar, Michael J.; Underberg-Davis, Sharon J. [Department of Radiology, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, P.O. Box 19, New Brunswick, NJ 08903-0019 (United States)

    2003-01-01

    Mesenteric lipoma is a rare benign neoplastic condition that can grow to be very large and mimic other midgut fatty tumors. These benign tumors can cause various gastrointestinal symptoms such as obstruction and abdominal pain. We report the case of a 9-year-old boy who presented with a small bowel obstruction caused by torsion of a large mesenteric lipoma. This is an important but unusual tumor and should be considered in the differential of fatty lesions within the mesentery. (orig.)

  14. Mesenteric venous thrombosis: multidisciplinary therapeutic approach

    Directory of Open Access Journals (Sweden)

    Stefano Pieri

    2007-08-01

    Full Text Available Mesenteric venous thrombosis is a particular form of intestinal ischemia related to high mortality. The lack of a characteristic clinical picture often leads to a difficult diagnostic and therapeutic classification. We report the case of a young woman, using estrogenic and progestinic oral therapy, affected by a severe form of mesenteric thrombosis and complicated by segmental post ischemic stenosis of small intestine.

  15. Cholinergic innervation of human mesenteric lymphatic vessels.

    Science.gov (United States)

    D'Andrea, V; Bianchi, E; Taurone, S; Mignini, F; Cavallotti, C; Artico, M

    2013-11-01

    The cholinergic neurotransmission within the human mesenteric lymphatic vessels has been poorly studied. Therefore, our aim is to analyse the cholinergic nerve fibres of lymphatic vessels using the traditional enzymatic techniques of staining, plus the biochemical modifications of acetylcholinesterase (AChE) activity. Specimens obtained from human mesenteric lymphatic vessels were subjected to the following experimental procedures: 1) drawing, cutting and staining of tissues; 2) staining of total nerve fibres; 3) enzymatic staining of cholinergic nerve fibres; 4) homogenisation of tissues; 5) biochemical amount of proteins; 6) biochemical amount of AChE activity; 6) quantitative analysis of images; 7) statistical analysis of data. The mesenteric lymphatic vessels show many AChE positive nerve fibres around their wall with an almost plexiform distribution. The incubation time was performed at 1 h (partial activity) and 6 h (total activity). Moreover, biochemical dosage of the same enzymatic activity confirms the results obtained with morphological methods. The homogenates of the studied tissues contain strong AChE activity. In our study, the lymphatic vessels appeared to contain few cholinergic nerve fibres. Therefore, it is expected that perivascular nerve stimulation stimulates cholinergic nerves innervating the mesenteric arteries to release the neurotransmitter AChE, which activates muscarinic or nicotinic receptors to modulate adrenergic neurotransmission. These results strongly suggest, that perivascular cholinergic nerves have little or no effect on the adrenergic nerve function in mesenteric arteries. The cholinergic nerves innervating mesenteric arteries do not mediate direct vascular responses.

  16. Hepatic Veins and Inferior Vena Cava Thrombosis in a Child Treated by Transjugular Intrahepatic Portosystemic Shunt

    International Nuclear Information System (INIS)

    Carnevale, Francisco Cesar; Santos, Aline Cristine Barbosa; Tannuri, Uenis; Cerri, Giovanni Guido

    2010-01-01

    We report the case of a 9-year-old boy with portal hypertension, due to Budd-Chiari syndrome, and retrohepatic inferior vena cava thrombosis, submitted to a transjugular intrahepatic portosystemic shunt (TIPS) by connecting the suprahepatic segment of the inferior vena cava directly to the portal vein. After 3 months, the withdrawal of anticoagulants promoted the thrombosis of the TIPS. At TIPS revision, thrombosis of the TIPS and the main portal vein and clots at the splenic and the superior mesenteric veins were found. Successful angiography treatment was performed by thrombolysis and balloon angioplasty of a severe stenosis at the distal edge of the stent.

  17. Surgical Anatomy of the Superior Mesenteric Vessels Related to Colon and Pancreatic Surgery: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Negoi, Ionut; Beuran, Mircea; Hostiuc, Sorin; Negoi, Ruxandra Irina; Inoue, Yosuke

    2018-03-08

    The surgeon dissecting the base of the mesenterium, around the superior mesenteric vein (SMV) and artery, is facing a complex tridimensional vascular anatomy and should be aware of the anatomical variants in this area. The aim of this systematic review is to propose a standardized terminology of the superior mesenteric vessels, with impact in colon and pancreatic resections. We conducted a systematic search in PubMed/MEDLINE and Google Scholar databases up to March 2017. Forty-five studies, involving a total of 6090 specimens were included in the present meta-analysis. The pooled prevalence of the ileocolic, right colic and middle colic arteries was 99.8%, 60.1%, and 94.6%, respectively. The superior right colic vein and Henle trunk were present in 73.9%, and 89.7% of specimens, respectively. In conclusion, the infra-pancreatic anatomy of the superior mesenteric vessels is widely variable. We propose the term Henle trunk to be used for any venous confluence between gastric, pancreatic and colic veins, which drains between the inferior border of the pancreas and up to 20 mm downward on the right-anterior aspect of the SMV. The term gastrocolic trunk should not be synonymous, but a subgroup of the Henle trunk, together with to gastropancreatocolic, gastropancreatic, or colopancreatic trunk.

  18. Regional blood flow distribution and oxygen metabolism during mesenteric ischemia and congestion.

    Science.gov (United States)

    Cruz, Ruy J; Garrido, Alejandra G; Ribeiro, Cristiane M F; Harada, Tomoyuki; Rocha-e-Silva, Mauricio

    2010-06-01

    Acute mesenteric ischemia is a potentially fatal vascular emergency with mortality rates ranging between 60% and 80%. Several studies have extensively examined the hemodynamic and metabolic effects of superior mesenteric artery occlusion. On the other hand, the cardiocirculatory derangement and the tissue damage induced by intestinal outflow obstruction have not been investigated systematically. For these reasons we decided to assess the initial impact of venous mesenteric occlusion on intestinal blood flow distribution, and correlate these findings with other systemic and regional perfusion markers. Fourteen mongrel dogs were subjected to 45 min of superior mesenteric artery (SMAO) or vein occlusion (SMVO), and observed for 120 min after reperfusion. Systemic hemodynamics were evaluated using Swan-Ganz and arterial catheters. Regional blood flow (ultrasonic flow probes), intestinal O(2)-derived variables, and mesenteric-arterial and tonometric-arterial pCO(2) gradients (D(mv-a)pCO(2) and D(t-a)pCO(2)) were also calculated. SMVO was associated with hypotension and low cardiac output. A significant increase in the regional pCO(2) gradients was also observed in both groups during the ischemic period. After reperfusion, a progressive reduction in D(mv-a)pCO(2) occurred in the SMVO group; however, no improvement in D(t-a)pCO(2) was observed. The histopathologic injury scores were 2.7 +/- 0.5 and 4.8 +/- 0.2 for SMAO and SMVO, respectively. SMV occlusion promoted early and significant hemodynamic and metabolic derangement at systemic and regional levels. Additionally, systemic pCO(2) gradient is not a reliable parameter to evaluate the local intestinal oxygenation. Finally, the D(t-a)pCO(2) correlates with histologic changes during intestinal congestion or ischemia. However, minor histologic changes cannot be detected using this methodology. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  19. Percutaneous stenting of the superior mesenteric artery for the treatment of chronic mesenteric ischemia

    International Nuclear Information System (INIS)

    Gweon, Hye Mi; Suh, Sang Hyun; Won, Jong Yun; Lee, Do Yun; Kim, Sam Soo

    2008-01-01

    We wanted to evaluate the effectiveness of stent placement on the superior mesenteric artery as a treatment for chronic mesenteric ischemia. Seven patients (mean age: 55 years, age range: 43-66 years) with chronic mesenteric ischemia were enrolled between March 2000 and September 2003. All the patients underwent pre-procedure contrast enhanced computerized tomography to evaluate for occlusion or stenosis of the mesenteric arteries and they then underwent an angiographic procedure. A balloon-expandable metal stent was placed in the superior mesenteric artery, and this was combined with balloon angioplasty and thrombolysis. We evaluated the angiographic and procedural success after the procedures. Angiographic and procedural success was obtained in 100% of the patients and the clinical symptoms improved in 100% of the patients. The patency at 6-months and 1-year was 85% and 71%, respectively. The mean follow-up period was 12 months (range: 1-25 months). During the follow-up period, ischemic symptoms recurred in 2 patients, and restenosis in a stent was confirmed with angiography; one patient was successfully treated by stent placement in the celiac artery and the other patient died due to extensive mesenteric thrombosis. For the treatment of chronic mesenteric ischemia, percutaneous stent placement on the superior mesenteric artery showed a favorable result and it was an effective alternative to surgery for the high-risk patients

  20. Percutaneous stenting of the superior mesenteric artery for the treatment of chronic mesenteric ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Gweon, Hye Mi; Suh, Sang Hyun; Won, Jong Yun [Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Do Yun [Yonsei National College of Medicine, Seoul (Korea, Republic of); Kim, Sam Soo [Kangwon National University Hospital, Chuncheon (Korea, Republic of)

    2008-06-15

    We wanted to evaluate the effectiveness of stent placement on the superior mesenteric artery as a treatment for chronic mesenteric ischemia. Seven patients (mean age: 55 years, age range: 43-66 years) with chronic mesenteric ischemia were enrolled between March 2000 and September 2003. All the patients underwent pre-procedure contrast enhanced computerized tomography to evaluate for occlusion or stenosis of the mesenteric arteries and they then underwent an angiographic procedure. A balloon-expandable metal stent was placed in the superior mesenteric artery, and this was combined with balloon angioplasty and thrombolysis. We evaluated the angiographic and procedural success after the procedures. Angiographic and procedural success was obtained in 100% of the patients and the clinical symptoms improved in 100% of the patients. The patency at 6-months and 1-year was 85% and 71%, respectively. The mean follow-up period was 12 months (range: 1-25 months). During the follow-up period, ischemic symptoms recurred in 2 patients, and restenosis in a stent was confirmed with angiography; one patient was successfully treated by stent placement in the celiac artery and the other patient died due to extensive mesenteric thrombosis. For the treatment of chronic mesenteric ischemia, percutaneous stent placement on the superior mesenteric artery showed a favorable result and it was an effective alternative to surgery for the high-risk patients.

  1. Morphology of congenital portosystemic shunts involving the left colic vein in dogs and cats.

    Science.gov (United States)

    White, R N; Parry, A T

    2016-05-01

    To describe the anatomy of congenital portosystemic shunts involving the left colic vein in dogs and cats. Retrospective review of a consecutive series of dogs and cats managed for congenital portosystemic shunts. For inclusion a shunt involving the left colic vein with recorded intraoperative mesenteric portovenography or computed tomography angiography along with direct gross surgical observations at the time of surgery was required. Six dogs and three cats met the inclusion criteria. All cases had a shunt which involved a distended left colic vein. The final communication with a systemic vein was variable; in seven cases (five dogs, two cats) it was via the caudal vena cava, in one cat it was via the common iliac vein and in the remaining dog it was via the internal iliac vein. In addition, two cats showed caudal vena cava duplication. The morphology of this shunt type appeared to be a result of an abnormal communication between either the left colic vein or the cranial rectal vein and a pelvic systemic vein (caudal vena cava, common iliac vein or internal iliac vein). This information may help with surgical planning in cases undergoing shunt closure surgery. © 2016 British Small Animal Veterinary Association.

  2. Mesenterico-portal vein resection in patients with pancreatico-duodenal cancer is safe and may increase survival

    DEFF Research Database (Denmark)

    Storkholm, Jan Henrik; Hansen, Carsten Palnæs

    2014-01-01

    and 25 women. RESULTS: A total of 44 patients (93.7%) had ductal adenocarcinomas. In all, 39 patients (83%) had T3 tumours, and 38 patients (80.9%) had involvement of lymph nodes. Furthermore, 29 patients (62%) had a pancreaticoduodenectomy, 15 patients (32%) a total pancreatectomy and three patients (6......INTRODUCTION: Pancreatic cancer is one of the most serious gastrointestinal cancers, and in the US and Europe it is a leading cause of cancer-related mortality. Radical surgery is the only option available for long-term survival. The aim of this study was to describe the surgical technique...... and the results of portal vein/superior mesenteric vein resection in patients with pancreatic cancer. MATERIAL AND METHODS: Between 1 April 2009 and 1 April 2013, 354 patients underwent resection for pancreatic malignancy. A total of 47 portal vein/superior mesenteric vein resections were performed in 22 men...

  3. Rational classification of portal vein thrombosis and its clinical significance.

    Directory of Open Access Journals (Sweden)

    Jingqin Ma

    Full Text Available Portal vein thrombosis (PVT is commonly classified into acute (symptom duration <60 days and absence of portal carvernoma and portal hypertension and chronic types. However, the rationality of this classification has received little attention. In this study, 60 patients (40 men and 20 women with PVT were examined using contrast-enhanced computed tomography (CT. The percentage of vein occlusion, including portal vein (PV and superior mesenteric vein (SMV, was measured on CT image. Of 60 patients, 17 (28.3% met the criterion of acute PVT. Symptoms occurred more frequently in patients with superior mesenteric vein thrombosis (SMVT compared to those without SMVT (p<0.001. However, there was no significant difference in PV occlusion between patients with and without symptoms. The frequency of cavernous transformation was significantly higher in patients with complete PVT than those with partial PVT (p<0.001. Complications of portal hypertension were significantly associated with cirrhosis (p<0.001 rather than with the severity of PVT and presence of cavernoma. These results suggest that the severity of PVT is only associated with the formation of portal cavernoma but unrelated to the onset of symptoms and the development of portal hypertension. We classified PVT into complete and partial types, and each was subclassified into with and without portal cavernoma. In conclusion, neither symptom duration nor cavernous transformation can clearly distinguish between acute and chronic PVT. The new classification system can determine the pathological alterations of PVT, patency of portal vein and outcome of treatment in a longitudinal study.

  4. What Is Deep Vein Thrombosis?

    Science.gov (United States)

    ... To Health Topics / Deep Vein Thrombosis Deep Vein Thrombosis Leer en español What Is Deep vein thrombosis ( ... life-threatening problems if not treated. Deep Vein Thrombosis Only about half of the people who have ...

  5. CAUSES OF ADULT SPLANCHNIC VEIN THROMBOSIS IN THE MEDITERRANEAN AREA

    Directory of Open Access Journals (Sweden)

    Valerio De Stefano

    2011-12-01

    Full Text Available The term splanchnic vein thrombosis encompasses Budd-Chiari syndrome (BCS, extrahepatic portal vein obstruction (EHPVO, and mesenteric vein thrombosis. Risk factors can be local or systemic. A local precipitating factor is rare in BCS, while it is common in  patients with portal vein thrombosis. Chronic myeloproliferative neoplasms (MPN are the leading systemic cause of splanchnic vein thrombosis, and are diagnosed in half BCS patients and one-third of EHPVO patients; the molecular marker JAK2 V617F is detectable in a large majority of patients with overt MPN and up to 40% of patients without overt MPN. Inherited thrombophilia is present in at least one-third of patients, and the factor V Leiden or the prothrombin G20210A mutations are the most common mutations found in BCS or EHPVO patients, respectively. Multiple factors are present in approximately one-third of patients with BCS and two- thirds of patients with portal vein thrombosis. In a few patient series from the Southern Mediterranean area the high prevalence of MPN and thrombophilia as underlying cause of BCS is confirmed, although the data should be considered preliminary. Peculiar risk factors present in the area are Behcet’s disease and hydatidosis; moreover, the presence of membraneous webs, typically found in Asian patients, can be found in a significant portion of cases.

  6. CAUSES OF ADULT SPLANCHNIC VEIN THROMBOSIS IN THE MEDITERRANEAN AREA

    Directory of Open Access Journals (Sweden)

    Laura Betti

    2011-01-01

    Full Text Available

    The term splanchnic vein thrombosis encompasses Budd-Chiari syndrome (BCS, extrahepatic portal vein obstruction (EHPVO, and mesenteric vein thrombosis.

    Risk factors can be local or systemic. A local precipitating factor is rare in BCS, while it is common in  patients with portal vein thrombosis. Chronic myeloproliferative neoplasms (MPN are the leading systemic cause of splanchnic vein thrombosis, and are diagnosed in half BCS patients and one-third of EHPVO patients; the molecular marker JAK2 V617F is detectable in a large majority of patients with overt MPN and up to 40% of patients without overt MPN. Inherited thrombophilia is present in at least one-third of patients, and the factor V Leiden or the prothrombin G20210A mutations are the most common mutations found in BCS or EHPVO patients, respectively. Multiple factors are present in approximately one-third of patients with BCS and two- thirds of patients with portal vein thrombosis.

    In a few patient series from the Southern Mediterranean area the high prevalence of MPN and thrombophilia as underlying cause of BCS is confirmed, although the data should be considered preliminary. Peculiar risk factors present in the area are Behcet’s disease and hydatidosis; moreover, the presence of membraneous webs, typically found in Asian patients, can be found in a significant portion of cases.

  7. Systolically gated 3D phase contrast MRA of mesenteric arteries in suspected mesenteric ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Wasser, M.N.; Schultze Kool, L.J.; Roos, A. de [Leiden Univ. Hospital (Netherlands)] [and others

    1996-03-01

    Our goal was to assess the value of MRA for detecting stenoses in the celiac (CA) and superior mesenteric (SMA) arteries in patients suspected of having chronic mesenteric ischemia, using an optimized systolically gated 3D phase contrast technique. In an initial study in 24 patients who underwent conventional angiography of the abdominal vessels for different clinical indications, a 3D phase contrast MRA technique (3D-PCA) was evaluated and optimized to image the CAs and SMAs. Subsequently, a prospective study was performed to assess the value of systolically gated 3D-PCA in evaluation of the mesenteric arteries in 10 patients with signs and symptoms of chronic mesenteric ischemia. Intraarterial digital subtraction angiography and surgical findings were used as the reference standard. In the initial study, systolic gating appeared to be essential in imaging the SMA on 3D-PCA. In 10 patients suspected of mesenteric ischemia, systolically gated 3D-PCA identified significant proximal disease in the two mesenteric vessels in 4 patients. These patients underwent successful reconstruction of their stenotic vessels. Cardiac-gated MRA may become a useful tool in selection of patients suspected of having mesenteric ischemia who may benefit from surgery. 16 refs., 6 figs., 4 tabs.

  8. Thrombosis of the Abdominal Veins in Childhood

    Directory of Open Access Journals (Sweden)

    Riten Kumar

    2017-09-01

    Full Text Available Abdominal venous thrombosis is a rare form of venous thromboembolic disease in children. While mortality rates are low, a significant proportion of affected children may suffer long-term morbidity. Additionally, given the infrequency of these thrombi, there is lack of stringent research data and evidence-based treatment guidelines. Nonetheless, pediatric hematologists and other subspecialists are likely to encounter these problems in practice. This review is therefore intended to provide a useful guide on the clinical diagnosis and management of children with these rare forms of venous thromboembolic disease. Herein, we will thus appraise the current knowledge regarding major forms of abdominal venous thrombosis in children. The discussion will focus on the epidemiology, presentation, diagnosis, management, and outcomes of (1 inferior vena cava, (2 portal, (3 mesenteric, (4 hepatic, and (5 renal vein thrombosis.

  9. Superior mesenteric artery syndrome: case report | Jani | East ...

    African Journals Online (AJOL)

    Superior Mesenteric Artery Syndrome (SMAS) is caused by trapping of the third part of the duodenum between Superior Mesenteric Artery (SMA) and aorta as result of narrowing of the angle between the two vessels due to acute loss of mesenteric fat which is secondary to rapid weight loss. A fifteen year old caucasian ...

  10. Acute occlusive mesenteric ischemia in high altitude of ...

    African Journals Online (AJOL)

    in 8 patients (38%) and venous thrombosis in 13 patients (62%). Diabetes mellitus was the most frequent risk factor ... Venous mesenteric thrombosis was more common than arterial mesenteric ischemia in our region. Keywords: Acute mesenteric ... perforated peptic ulcer or peritonitis. As intestinal ischemia progresses from ...

  11. [Portal-splenic-mesenteric venous thrombosis in a patients with protein S deficiency due to novel PROS1 gene mutation].

    Science.gov (United States)

    Hwang, Eui Tae; Kang, Won Sik; Park, Jin Woo; Lee, Ji Hyun; Han, Hyun Jeong; Shin, Sang Yong; Kim, Hee Jin; Choi, Ja Sung

    2014-08-01

    Protein S (PS), a vitamin K-dependent glycoprotein, performs an important role in the anticoagulation cascade as a cofactor of protein C. Because of the presence of a pseudogene and two different forms of PS in the plasma, protein S deficiency (PSD) is one of the most difficult thrombophilias to study and a rare blood disorder associated with an increased risk of thrombosis. We describe a unusual case of previously healthy 37-year-old man diagnosed with portal-splenic-mesenteric vein thrombosis secondary to PSD. The patient was admitted to the hospital due to continuous nonspecific abdominal pain and nausea. Abdominal computed tomography revealed acute venous thrombosis from inferior mesenteric vein to left portal vein via splenic vein, and laboratory test revealed decreased PS antigen level and PS functional activity. Conventional polymerase chain reaction and direct DNA sequencing analysis of the PROS1 gene demonstrated duplication of the 166th base in exon 2 resulting in frame-shift mutation (p.Arg56Lysfs*10) which is the first description of the new PROS1 gene mutation to our knowledge. Results from other studies suggest that the inherited PSD due to a PROS1 gene mutation may cause venous thrombosis in a healthy young man without any known predisposing factor.

  12. Endovascular management of porto-mesenteric venous thrombosis developing after trans-arterial occlusion of a superior mesenteric arteriovenous fistula.

    Science.gov (United States)

    Garg, Deepak; Lopera, Jorge Enrique; Goei, Anthony D

    2013-09-01

    Porto-mesenteric venous thrombosis following a trans-arterial occlusion of a superior mesenteric arteriovenous fistula is a rare occurrence. We present a case of endovascular management of one such case treated pharmacomechanically with catheter-directed mesenteric thrombolysis and transjugular intrahepatic portosystemic shunt creation without long-term successful outcome.

  13. CT findings of bilateral inferior vena cava: Differentiation from dilated retroperitoneal veins

    International Nuclear Information System (INIS)

    Park, Kyung Joo; Lee, Si Kyung; Lee, Joo Hyuk

    1993-01-01

    We experience five cases of bilateral inferior vena cava for recent one year. We evaluated the CT findings of the cases and of dilated veins located in the left retroperitoneum (seven left gonadal, seven inferior mesenteric, and two left ascending lumber veins) in the viewpoints of the size, location and relation with the surrounding structures. Bilateral inferior vena cava (IVC) may be asymmetric and the left IVC may be smaller than other retroperitoneal veins with a round contour. The left IVC was located anterior to the spinal body and corresponded with contralateral vena cava in the anteroposterior plane. The gonadal vein was located anterio or anterolateral side of the psoas and always crossed the ureter. Most of the inferior mesenteric vein showed similar location to the opposite site of the vena cava in the anterolateral side of the muscle, medial to the left ureter without crossing. The left ascending lumbar vein was similarly located to the left vena cava but dilated in a short segment. It is required to trace the vessel upward and downward and observe its continuity for correct differentiation. If it is impossible, some differential points suggested in the results of our study will be helpful for distinguishing them

  14. [Endovascular treatment of acute mesenteric ischaemia in thrombosis of superior mesenteric artery].

    Science.gov (United States)

    Shchegolev, A A; Papoian, S A; Mitichkin, A E; Gromov, D G; Ishevskiĭ, A G; Chevokin, A Iu; Mutaev, M M

    The article deals with the problems related to acute impairment of mesenteric blood circulation, known as a nosological entity associated with an extremely high mortality rate. The authors point out that there are currently no common approaches to appropriate management of the pathology concerned and define the role of modern minimally invasive methods, which roentgenosurgical interventions belong to, making it possible to rapidly, safely and efficiently cope with the problem of thrombosis of mesenteric vessels, as well as to decrease lethality and improve the prognosis in this cohort of patients. Also presented herein is a detailed description of a clinical case report regarding successful endovascular treatment of a patient suffering from acute thrombosis of the superior mesenteric artery. This is followed by assessing efficacy and safety of the method employed, and, finally, suggesting tactical solutions in treatment of patients presenting with acute pathology of mesenteric vessels.

  15. Angioplasty and stenting of the superior mesenteric artery in acute mesenteric ischaemia

    International Nuclear Information System (INIS)

    Lim, R.P; Dowling, R.J.; Thomson, K.R.

    2004-01-01

    Acute mesenteric ischaemia is a challenging diagnostic problem with a very high mortality. Traditionally, laparotomy is required for definitive management. We describe a successful case of angioplasty and stenting of the superior mesenteric artery in a surgically unfit patient. We recommend that stenting be considered only in situations where the diagnosis has been made prior to bowel infarction, and if the patient poses a poor operative risk. Copyright (2004) Blackwell Publishing Asia Pty Ltd

  16. Acute mesenteric ischaemia and unexpected death.

    Science.gov (United States)

    Byard, Roger W

    2012-05-01

    Acute mesenteric ischaemia is a vascular emergency that arises when blood flow to the intestine is compromised leading to tissue necrosis. It is primarily a condition of the elderly associated with significant morbidity and mortality. Causes include arterial thromboembolism, venous thrombosis and splanchnic vasoconstriction (so-called nonocclusive mesenteric ischaemia). Reperfusion injury and breakdown of the intestinal mucosal barrier lead to metabolic derangements, sepsis and death from multiorgan failure. The diagnosis may be difficult to make clinically and numbers of cases are increasing due to ageing of the population. The clinical and pathological features are reviewed with discussion of predisposing conditions. Careful dissection of the mesenteric vasculature is required at autopsy with appropriate histologic sampling and documentation of associated comorbidities. Other organs need to be checked for thrombi and the possibility of testing for inherited thombophilias should be considered. Toxicological evaluation, particularly in younger individuals, may reveal evidence of cocaine use. On occasion no obstructive lesions will be demonstrated, however the confounding effects of post-mortem autolytic and putrefactive changes may mean that nonocclusive mesenteric ischaemia may be difficult to diagnose. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  17. Mesenteric ischemia, high altitude and Hill's criteria

    African Journals Online (AJOL)

    Acute occlusive mesenteric ischemia in high altitude of southwestern region of Saudi Arabia. Ann Afr Med 2012;11: 5-10. Source of Support: Nil, Conflict of Interest: None declared. .... Relocation of residence to sea level, which in most cases in this area involves a distance of less than 50 km such as from Abha to. Ad Darb or ...

  18. Treatment outcomes and risk factors for bowel infarction in patients with acute superior mesenteric venous thrombosis.

    Science.gov (United States)

    Kim, Hyung-Kee; Hwang, Deokbi; Park, Sujin; Lee, Jong-Min; Huh, Seung

    2017-09-01

    The prognosis of acute superior mesenteric venous thrombosis (SMVT) remains obscure. We aimed to investigate the treatment outcomes and possible risk factors for bowel infarction in these patients. We retrospectively included 66 patients with acute SMVT between January 2002 and June 2016. Each patient underwent contrast-enhanced computed tomography as part of the initial diagnosis. The standard protocol for management included a nonsurgical approach with early anticoagulation and selective exploration. For the analysis of the risk factors for bowel infarction, patients were divided into bowel resection (BR) and non-BR groups. Outcomes of interest were causes of SMVT, percentage of BR after nonsurgical treatment, and risk factors for BR. Of 66 patients, 15 (23%) underwent BR; of these, 9 underwent urgent BR because of peritoneal signs and definite findings of bowel infarction on computed tomography scan, 4 underwent BR after failed anticoagulation, and 2 underwent BR because of delayed stricture. Clinically, vomiting (P = .003), abdominal distention (P = .003), rebound tenderness (P = .005), and leukocytosis (P = .001) were associated with BR. On radiologic examination, bowel wall thickening (P thrombosis in addition to SMVT. All 15 BRs occurred in patients with combined PV thrombosis and SMVT (P thrombosis of the superior mesenteric vein and PV was also associated with BR (P = .028 for superior mesenteric vein; P = .025 for PV). BR was performed in 1 (4%) of 24 patients with transient risk factors compared with 14 (33%) of 42 patients without transient risk factors (P = .006). Three patients (4.5%) died in the hospital. In patients with acute SMVT, the extent of thrombus and etiology were associated with the severity of acute SMVT. Patients with transient risk factors and isolated SMVT tended to have a benign disease course. With early anticoagulation, acute SMVT does not seem to have the grave prognosis that is associated with arterial thrombosis

  19. Bilateral meandering pulmonary veins

    Energy Technology Data Exchange (ETDEWEB)

    Thupili, Chakradhar R.; Udayasankar, Unni [Pediatric Imaging, Imaging Institute Cleveland Clinic, Cleveland, OH (United States); Renapurkar, Rahul [Imaging Institute Cleveland Clinic, Thoracic Imaging, L10, Cleveland, OH (United States)

    2015-06-15

    Meandering pulmonary veins is a rare clinical entity that can be mistaken for more complex congenital syndromes such as hypogenetic lung syndrome. We report imaging findings in a rare incidentally detected case of bilateral meandering pulmonary veins. We briefly discuss the role of imaging in diagnosing this condition, with particular emphasis on contrast-enhanced CT. (orig.)

  20. Focus on Varicose Veins

    Science.gov (United States)

    ... stagnate (pool) in the legs, leading to high blood pressure in the leg veins. This may result in further enlargement of the ... you can help delay the development of varicose veins or keep them from progressing. Some ... pressure under control. • To temporarily relieve symptoms, lie down ...

  1. Mesenteric artery complications during angioplasty and stent placement for atherosclerotic chronic mesenteric ischemia.

    Science.gov (United States)

    Oderich, Gustavo S; Tallarita, Tiziano; Gloviczki, Peter; Duncan, Audra A; Kalra, Manju; Misra, Sanjay; Cha, Stephen; Bower, Thomas C

    2012-04-01

    The purpose of this study was to describe the incidence, management, and outcomes of mesenteric artery complications (MACs) during angioplasty and stent placement (MAS) for chronic mesenteric ischemia (CMI). We retrospectively reviewed the clinical data of 156 patients treated with 173 MAS for CMI (1998-2010). MACs were defined as procedure-related mesenteric artery dissection, stent dislodgement, embolization, thrombosis, or perforation. End points were procedure-related morbidity and death. There were 113 women and 43 men (mean age, 73 ± 14 years). Eleven patients (7%) developed 14 MACs, including distal mesenteric embolization in six, branch perforation in three, dissection in two, stent dislodgement in two, and stent thrombosis in one. Five patients required adjunctive endovascular procedures, including in two patients each, catheter-directed thrombolysis or aspiration, retrieval of dislodged stents, and placement of additional stents for dissection. Five patients (45%) required conversion to open repair: two required evacuation of mesenteric hematoma, two required mesenteric revascularization, and one required bowel resection. There were four early deaths (2.5%) due to mesenteric embolization or myocardial infarction in two patients each. Patients with MACs had higher rates of mortality (18% vs 1.5%) and morbidity (64% vs 19%; P thrombosis (odds ratio, 0.2; 95% confidence interval, 0.06-0.90). Patients treated by a large-profile system had a trend toward more MACs (odds ratio, 1.8; 95% confidence interval, 0.7-26.5; P = .07). MACs occurred in 7% of patients who underwent MAS for CMI and resulted in higher mortality, morbidity, and longer hospital length of stay. Use of antiplatelet therapy reduced the risk of distal embolization or vessel thrombosis. There was a trend toward more MACs in patients who underwent interventions performed with a large-profile system. Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  2. Combined portal, splenic and mesenteric venous thrombosis in inactive ulcerative colitis with heterozygous mutation in MTHFR gene: A rare case of thrombophilia

    Directory of Open Access Journals (Sweden)

    Gül Gürsoy

    2011-01-01

    Full Text Available Thrombophilia is a rare but potentially catastrophic phenomenon occurring in patients having tendency of thrombosis. It may lead to serious complications. The etiology of thrombophilia is thought to be multifactorial and related to both acquired and inherited factors. Inflammatory bowel disease is an acquired cause of thrombophilia. Thromboembolic events are seen during inflammatory bowel disease, especially during the active period of the disease. In inflammatory bowel disease, thrombus formation in portal, splenic and mesenteric veins are not common. Besides, the association of genetic disorders related to metabolism of homocysteine with inflammatory bowel disease has been evidenced, especially in Crohn disease and rarely in ulcerative colitis. We present a rare case of ulcerative colitis in association with combined portal, splenic and mesenteric vein thrombosis. The patient was recently diagnosed with the disease which was in the inactive period. Interestingly, our patient was also heterozygous for the mutation in methylenetetrahydrofolate reductase (MTHFR gene.

  3. Mesenteric fibromatosis, apropos of a case

    International Nuclear Information System (INIS)

    Silveyra, N.; Agazharian, M.

    2010-01-01

    Introduction: Mesenteric fibromatosis is a rare type of tumour,histological benign appearance but local aggressive behavior, prone to residivar, but lacks the ability to metastasize. The called desmoid tumour is a type of aggressive fibromatosis, a rare presentation representing less than 0.03% of all tumours with an annual incidence of 2-4 cases / 100,000. Mesenteric fibromatosis can be divided into two broad categories: one superficial and deep. The processes are superficially localized, located on the palms, soles, penis and knuckles. The deep shape is more aggressive, turns easily and can cause death by local invasion. It is subdivided in abdominal, extra abdominal and intraabdominal in which we find the pelvic fibromatosis, and mesenteric associated with inherited familial polyposis. Clinically, these tumours usually appear as a mass whose symptoms depend on the location; in the abdominal region, it will normally cause intestinal obstruction and hydronephrosis, bleeding or perforation of hollow viscera, or remain asymptomatic for a long time performing diagnosis belatedly when its size is large as in our case. Objectives: To report a case of mesenteric fibromatosis low frequency with a good clinical outcome after a treatment based on a comprehensive literature review. Methodology A case history of a female patient 57 years, no history is taken. Presented with an poor performance status, overall impact, weight loss of 10kg in 6 months. Right upper quadrant pain and bloating prandrial post. He studied with computed tomography, which describes the presence of a large tumour retroperitoneal in intimate contact with the intestinal loops. No lymphadenopathy. A laparotomy was performed explorer in which the presence of the tumour conforms to level stony member mesenteric planes later. Being an unresectable tumour. Pathology describes: fibro myxoid lesion without elements malignancy, compatible with mesenteric fibromatosis. Hormone receptor positive. Currently there

  4. Portomesenteric vein gas and pneumatosis intestinalis--a rare complication after neoadjuvant radiochemotherapy in oesophageal cancer.

    Science.gov (United States)

    Duchon, R; Pindak, D; Sucha, R; Bernadic, M; Dolnik, J; Pechan, J

    2011-01-01

    Portomesenteric vein gas and pneumatosis intestinalis is most commonly caused by mesenteric ischemia and bowel necrosis but may have a variety of other causes. The etiology is multifactorial and the clinical presentation is variable. The diagnosis is based on a combination of clinical suspicion and radiographic findings. The finding of hepatic portal venous gas alone is not an indication for emergent exploration. We report portomesenteric venous gas as a rare complication after neoadjuvant radiochemotherapy of the oesophageal cancer (Fig. 3, Ref. 12).

  5. Macronodular hepatic tuberculosis associated with portal vein thrombosis and portal hypertension

    International Nuclear Information System (INIS)

    Venkatesh, S.K.; Tan, L.K.A.; Siew, E.P.Y.; Putti, T.C.

    2005-01-01

    Tuberculosis (TB) of the liver is usually associated with miliary spread. Macronodular TB of the liver is rare. A case of macronodular TB of the liver in a 31-year-old woman causing portal vein thrombosis and portal hypertension is presented. Ultrasound and CT appearances are described. There was coexistent ileo-caecal TB with extensive mesenteric and retroperitoneal lymphadenopathy. Macronodular TB should be considered in the differential diagnosis when a patient presents with multiple calcified masses in the liver with portal vein thrombosis and portal hypertension. Copyright (2005) Blackwell Science Pty Ltd

  6. Giant mesenteric fibromatosis – A case report

    Directory of Open Access Journals (Sweden)

    Liana Pleș

    2017-05-01

    Full Text Available Mesenteric fibromatosis or intra-abdominal desmoids tumor is a rare clinical entity. It is a locally aggressive tumor but not metastasizing proliferation. We report a case of a 27-year-old woman with no significant medical and a previous cesarean section, admitted for abdominal pain. The CT abdominal evaluation revealed subserosal uterine fibroid. The patient underwent an elective laparotomy and a mass measuring 20/15/15 cm in diameter to the medial wall of the cecum was discovered. Complete removal was accomplished with right hemicolectomy. Histopathological examination reported mesenteric fibromatosis. Postoperatively, patient was well and 6 month follow-up showed good recovery. Moreover the next month she became pregnant and the pregnancy and birth were uneventful.

  7. Aneurysm of the superior mesenteric artery

    International Nuclear Information System (INIS)

    Gebauer, A.

    1984-01-01

    This is a report about 4 patients with aneurysms of the superior mesenteric artery of arteriosclerotic, mycotic and probably congenital etiology together with a review of the literature as to the etiology, diagnostic possibilities and therapy. Arteriography is the method of choice even though a diagnosis may be possible by sonography or CT in special cases. Even though an aneurysm of the superior mesenteric artery is rare, it has to be considered in the differential diagnosis of persisting abdominal problems of unknown origin. This is especially true for patients with a predisposing history such as previous or existing endocarditis, sepsis, arteriosclerosis and hypertension. Because of the possibility of rupture followed by life threating bleeding an adequate diagnostic step such as arteriography has to be considered finally. (orig.) [de

  8. Proper Treatment of Acute Mesenteric Ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung Kwan; Han, Young Min [Dept. of Radiology, Chonbuk National University Hospital and School of Medicine, Jeonju (Korea, Republic of); Kwak, Hyo Sung [Research Institue of Clinical Medicine, Chonbuk National University Hospital and School of Medicine, Jeonju (Korea, Republic of); Yu, Hee Chul [Dept. of Radiology, Chonbuk National University Hospital and School of Medicine, Jeonju (Korea, Republic of)

    2011-10-15

    To evaluate the effectiveness of treatment options for Acute Mesenteric Ischemia and establish proper treatment guidelines. From January 2007 to May 2010, 14 patients (13 men and 1 woman, mean age: 52.1 years) with acute mesenteric ischemia were enrolled in this study. All of the lesions were detected by CT scan and angiography. Initially, 4 patients underwent conservative treatment. Eleven patients were managed by endovascular treatment. We evaluated the therapeutic success and survival rate of each patient. The causes of ischemia included thromboembolism in 6 patients and dissection in 8 patients. Nine patients showed bowel ischemia on CT scans, 4 dissection patients underwent conservative treatment, 3 patients had recurring symptoms, and 5 dissection patients underwent endovascular treatment. Overall success and survival rate was 100%. However, overall success was 83% and survival rate was 40% in the 6 thromboembolism patients. The choice of 20 hours as the critical time in which the procedure is ideally performed was statistically significant (p = 0.0476). A percutaneous endovascular procedure is an effective treatment for acute mesenteric ischemia, especially in patients who underwent treatment within 20 hours. However, further study and a long term follow-up are needed.

  9. Transjugular intrahepatic portosystemic shunt for the treatment of portal vein thrombus:its current status

    International Nuclear Information System (INIS)

    Qi Xingshun; Han Guohong; Fan Daiming

    2010-01-01

    The prevalence of portal vein thrombosis in the general population is about 1.1%, while it is about 10%-25% in the cirrhotic patients. The severe clinical complication in patients with acute portal vein thrombosis is ischemic intestinal infarction when the thrombus extends to the mesenteric venous arch. The complications include bleeding due to gastroesophageal varices, ascites and deterioration of live function in the patients with chronic portal vein thrombosis. The recently-published Practice Guidelines indicate that the treatment of portal vein thrombosis includes anticoagulation,thrombolysis, transjugular intrahepatic portosystemic shunt (TIPS) and surgical thrombectomy. TIPS has some advantages in treating portal vein thrombus. It can directly and effectively re-canalize the occluded portal vein. Moreover, it can accelerate portal flow and prevent recurrent thrombosis after the shunt is well-established. The disadvantages of TIPS include technical difficulties and potential complications. However, percutaneous transhepatic, transsplenic and transmesenteric approaches well facilitate the TIPS procedure. Additionally, preoperative evaluation of portal vein anatomy can provide a safe and effective choice in treating patients with portal cavernoua caver who are going to receive TIPS. Nevertheless, in the absence of relevant prospective studies, the application of TIPS for the management of portal vein thrombosis is still limited. (authors)

  10. Superior Mesenteric Artery Syndrome: An Infrequent Complication of Scoliosis Surgery

    Directory of Open Access Journals (Sweden)

    Metin Keskin

    2014-01-01

    Full Text Available Superior mesenteric artery syndrome is a rare condition that causes a proximal small intestinal obstruction due to contraction of the angle between the superior mesenteric artery and the aorta. Scoliosis surgery is one of the 15 reasons for superior mesenteric artery syndrome, which can present with acute or chronic manifestations. Although conservative treatment is usually possible, surgical treatment is required in certain cases that cannot be treated using conservative methods. In this paper, we describe a patient who developed superior mesenteric artery syndrome after scoliosis surgery and was treated with duodenojejunostomy due to failure and complications of conservative treatment.

  11. ENDOVASCULAR TREATMENT FOR ACUTE DISORDERS OF MESENTERIC CIRCULATION

    Directory of Open Access Journals (Sweden)

    S. A. Prozorov

    2016-01-01

    Full Text Available An acute disorder of mesenteric circulation is a serious disease with high mortality. It occurs much more often due to the arterial flow impairment, and less often due to the venous blood flow disturbance. Etiology: thrombosis, embolism, compression of the lumen under dissection. To restore the mesenteric blood flow endovascular techniques are performed: mechanical recanalization, balloon angioplasty, stent installation, thrombolysis, tromboaspiration and their various combinations. If recanalization of the superior mesenteric artery is unable to be performed, hybrid operations are carried out anterogradely: retrograde stent installation during laparotomy. The review shows that endovascular methods is a promising direction of treatment for acute mesenteric ischemia.

  12. The CT appearances of sclerosing mesenteritis and associated diseases

    International Nuclear Information System (INIS)

    Wat, S.Y.J.; Harish, S.; Winterbottom, A.; Choudhary, A.K.; Freeman, A.H.

    2006-01-01

    Sclerosing mesenteritis is characterized by non-specific inflammation of the mesenteric fat associated with variable amount of fibrosis. The aetiology is unclear; the pathogenesis is obscure, and even its nomenclature remains variable. It is a rare condition with imaging features that can be mistaken either for a mesenteric neoplasm or for a wide variety of non-neoplastic inflammatory conditions. Knowledge of the imaging features of this condition may prevent unwarranted aggressive therapy. This review discusses the pathogenesis, clinical manifestations of this condition, as well as illustrating the characteristic computed tomography (CT) features of sclerosing mesenteritis. A rational approach to the differential diagnosis is discussed

  13. Congenital pulmonary vein stenosis.

    Science.gov (United States)

    Manzar, Shabih

    2007-06-01

    A case of a newborn infant is described who presented with severe cyanosis at birth with rapid deterioration. The infant died at six hours of life. The diagnosis was determined at autopsy as congenital pulmonary vein stenosis.

  14. Clinical approach to splanchnic vein thrombosis: risk factors and treatment.

    Science.gov (United States)

    Riva, Nicoletta; Donadini, Marco P; Dentali, Francesco; Squizzato, Alessandro; Ageno, Walter

    2012-10-01

    Splanchnic vein thrombosis (SVT) is an unusual manifestation of venous thromboembolism which involves one or more abdominal veins (portal, splenic, mesenteric and supra-hepatic veins). SVT may be associated with different underlying disorders, either local (abdominal cancer, liver cirrhosis, intra-abdominal inflammation or surgery) or systemic (hormonal treatment, thrombophilic conditions). In the last decades, myeloproliferative neoplasm (MPN) emerged as the leading systemic cause of SVT. JAK2 mutation, even in the absence of known MPN, showed a strong association with the development of SVT, and SVT was suggested to be the first clinical manifestation of MPN. Recently, an association between SVT, in particular supra-hepatic vein thrombosis, and paroxysmal nocturnal hemoglobinuria has also been reported. SVT occurs with heterogeneous clinical presentations, ranging from incidentally detected events to extensive thrombosis associated with overt gastrointestinal bleeding, thus representing a clinical challenge for treatment decisions. In the absence of major contraindications, anticoagulant therapy is generally recommended for all patients presenting with acute symptomatic SVT, but there is no consensus about the use of anticoagulant drugs in chronic or incidentally detected SVT. High quality evidence on the acute and long-term management is substantially lacking and the risk to benefit-ratio of anticoagulant therapy in SVT still needs to be better assessed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. SPLANCHNIC VEIN THROMBOSIS IN THE MEDITERRANEAN AREA IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Hanaa El-Karaksy

    2011-07-01

    Full Text Available Abdominal venous thrombosis may present as splanchnic venous thrombosis (SVT (occlusion of portal, splenic, superior or inferior mesenteric veins or Budd- Chiari Syndrome (BCS (thrombosis of inferior vena cava and/or hepatic veins. The aim of this review is to report the scanty data available for splanchnic vein thrombosis in the South Mediterranean area. In one Egyptian study, the possible circumstantial risk factors for portal vein thrombosis were found in 30% of cases:  19% neonatal sepsis, 8.7% umbilical catheterization, 6% severe gastroenteritis and dehydration. Another Egyptian study concluded that hereditary thrombophilia was common in children with PVT (62.5%, the commonest being factor V Leiden mutation (FVL (30%. Concurrence of more than one hereditary thrombophilia was not uncommon (12.5%. The first international publication on hepatic veno-occlusive disease (VOD in Egypt was in 1965 in children who rapidly develop abdominal distention with ascites and hepatomegaly. This disease was more frequent in malnourished children coming from rural areas; infusions given at home may contain noxious substances that were hepatotoxic and Infections might play a role. VOD of childhood is rarely seen nowadays. Data from South Mediterranean area are deficient and this may be attributable to reporting in local medical journals that are difficult to access. Medical societies concerned with this topic could help distribute this information.

  16. Mesenteric lymph reperfusion exacerbates spleen injury caused by superior mesenteric artery occlusion shock

    Energy Technology Data Exchange (ETDEWEB)

    Li, L.L.; Zhang, C.H.; Liu, J.C.; Yang, L.N.; Niu, C.Y.; Zhao, Z.G. [Institute of Microcirculation, Hebei North University, Zhangjiakou, Hebei, China, Institute of Microcirculation, Hebei North University, Zhangjiakou, Hebei (China)

    2014-04-15

    The intestinal lymph pathway plays an important role in the pathogenesis of organ injury following superior mesenteric artery occlusion (SMAO) shock. We hypothesized that mesenteric lymph reperfusion (MLR) is a major cause of spleen injury after SMAO shock. To test this hypothesis, SMAO shock was induced in Wistar rats by clamping the superior mesenteric artery (SMA) for 1 h, followed by reperfusion for 2 h. Similarly, MLR was performed by clamping the mesenteric lymph duct (MLD) for 1 h, followed by reperfusion for 2 h. In the MLR+SMAO group rats, both the SMA and MLD were clamped and then released for reperfusion for 2 h. SMAO shock alone elicited: 1) splenic structure injury, 2) increased levels of malondialdehyde, nitric oxide (NO), intercellular adhesion molecule-1, endotoxin, lipopolysaccharide receptor (CD14), lipopolysaccharide-binding protein, and tumor necrosis factor-α, 3) enhanced activities of NO synthase and myeloperoxidase, and 4) decreased activities of superoxide dismutase and ATPase. MLR following SMAO shock further aggravated these deleterious effects. We conclude that MLR exacerbates spleen injury caused by SMAO shock, which itself is associated with oxidative stress, excessive release of NO, recruitment of polymorphonuclear neutrophils, endotoxin translocation, and enhanced inflammatory responses.

  17. Mesenteric lymph reperfusion exacerbates spleen injury caused by superior mesenteric artery occlusion shock.

    Science.gov (United States)

    Li, L L; Zhang, C H; Liu, J C; Yang, L N; Niu, C Y; Zhao, Z G

    2014-05-01

    The intestinal lymph pathway plays an important role in the pathogenesis of organ injury following superior mesenteric artery occlusion (SMAO) shock. We hypothesized that mesenteric lymph reperfusion (MLR) is a major cause of spleen injury after SMAO shock. To test this hypothesis, SMAO shock was induced in Wistar rats by clamping the superior mesenteric artery (SMA) for 1 h, followed by reperfusion for 2 h. Similarly, MLR was performed by clamping the mesenteric lymph duct (MLD) for 1 h, followed by reperfusion for 2 h. In the MLR+SMAO group rats, both the SMA and MLD were clamped and then released for reperfusion for 2 h. SMAO shock alone elicited: 1) splenic structure injury, 2) increased levels of malondialdehyde, nitric oxide (NO), intercellular adhesion molecule-1, endotoxin, lipopolysaccharide receptor (CD14), lipopolysaccharide-binding protein, and tumor necrosis factor-α, 3) enhanced activities of NO synthase and myeloperoxidase, and 4) decreased activities of superoxide dismutase and ATPase. MLR following SMAO shock further aggravated these deleterious effects. We conclude that MLR exacerbates spleen injury caused by SMAO shock, which itself is associated with oxidative stress, excessive release of NO, recruitment of polymorphonuclear neutrophils, endotoxin translocation, and enhanced inflammatory responses.

  18. Superior mesenteric artery syndrome: an uncommon cause of ...

    African Journals Online (AJOL)

    However, these symptoms are uncommonly produced by superior mesenteric artery (SMA) syndrome. SMA syndrome is triggered when there is narrowing of the mesenteric angle and shortening of the aortomesenteric distance. We report a case of 42‑year‑old female who presented with features of gastric outlet obstruction ...

  19. Mesenteric Cysts Presenting with Acute Intestinal Obstruction: A ...

    African Journals Online (AJOL)

    The 3 children needed bowel resection with primary anastomosis. All made uneventful recovery. A high index of suspicion is important when managing children with acute intestinal obstruction as mesenteric cyst may be an uncommon cause. (Key words: Mesenteric Cyst: Intestinal Obstruction). Sahel Medical Journal ...

  20. Early management of mesenteric cyst prevents catastrophes: A ...

    African Journals Online (AJOL)

    Background: Mesenteric cysts are rare intraabdominal masses in the paediatric age group with varied presentation, ranging from an asymptomatic mass to acute abdomen. This study reviews our experience in the diagnosis and treatment of 17 mesenteric cysts in our centre, with especial reference to acute abdominal ...

  1. Huge Mesenteric Lymphangioma – A Rare Cause of Acute Abdomen

    African Journals Online (AJOL)

    Lymphangiomas are benign congenital masses which occur most commonly in head and neck of children and incidence of mesenteric lymphangiomas is very rare. We report such a case of huge mesenteric lymphangioma in a 20 year old male who presented to us with acute abdomen. Pre-operative diagnosis is difficult ...

  2. Mesenteric venous thrombosis in Uganda: a retrospective study of ...

    African Journals Online (AJOL)

    Introduction: Mesenteric venous thrombosis is a rare but lethal form of mesenteric ischemia. Diagnosis before frank thrombosis and gangrene is a challenge. Documented experience in the East African region is scanty. This short series suggest renal dysfunction as a consequence of delayed diagnosis, intussusception as a ...

  3. Mesenteric Panniculitis Mimicking Acute Pancreatitis: A Case Report ...

    African Journals Online (AJOL)

    Mesenteric panniculitis is a rare disease characterized by an chronic non-specific inflammation of the adipose tissue of the mesentery of the small intestine and colon. The specific etiology of the disease is unknown. The condition is referred to as retractile mesenteritis when fibrosis predominates but generally sclerosing ...

  4. Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy

    International Nuclear Information System (INIS)

    Trompeter, Markus; Brazda, Thurid; Remy, Christopher T.; Reimer, Peter; Vestring, Thomas

    2002-01-01

    Non-occlusive mesenteric ischemia (NOMI) compromises all forms of mesenteric ischemia with patent mesenteric arteries. It generally affects patients over 50 years of age suffering from myocardial infarction, congestive heart failure, aortic insufficiency, renal or hepatic disease and patients following cardiac surgery. Non-occlusive disease accounts for 20-30% of all cases of acute mesenteric ischemia with a mortality rate of the order of 50%. Acute abdominal pain may be the only early presenting symptom of mesenteric ischemia. Non-invasive imaging modalities, such as CT, MRI, and ultrasound, are able to evaluate the aorta and the origins of splanchnic arteries. Despite the technical evolution of those methods, selective angiography of mesenteric arteries is still the gold standard in diagnosing peripheral splanchnic vessel disease. In early non-occlusive mesenteric ischemia, as opposed to occlusive disease, there is no surgical therapy. It is known that mesenteric vasospasm persists even after correction of the precipitating event. Vasospasm frequently responds to direct intra-arterial vasodilator therapy, which is the only treatment that has been shown to be effective. (orig.)

  5. Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy

    Energy Technology Data Exchange (ETDEWEB)

    Trompeter, Markus; Brazda, Thurid; Remy, Christopher T.; Reimer, Peter [Department of Radiology, Staedtisches Klinikum Karlsruhe (Germany); Vestring, Thomas [Department of Radiology, Diakonie-Krankenhaus Rotenburg/Wuemme, Goettingen (Germany)

    2002-05-01

    Non-occlusive mesenteric ischemia (NOMI) compromises all forms of mesenteric ischemia with patent mesenteric arteries. It generally affects patients over 50 years of age suffering from myocardial infarction, congestive heart failure, aortic insufficiency, renal or hepatic disease and patients following cardiac surgery. Non-occlusive disease accounts for 20-30% of all cases of acute mesenteric ischemia with a mortality rate of the order of 50%. Acute abdominal pain may be the only early presenting symptom of mesenteric ischemia. Non-invasive imaging modalities, such as CT, MRI, and ultrasound, are able to evaluate the aorta and the origins of splanchnic arteries. Despite the technical evolution of those methods, selective angiography of mesenteric arteries is still the gold standard in diagnosing peripheral splanchnic vessel disease. In early non-occlusive mesenteric ischemia, as opposed to occlusive disease, there is no surgical therapy. It is known that mesenteric vasospasm persists even after correction of the precipitating event. Vasospasm frequently responds to direct intra-arterial vasodilator therapy, which is the only treatment that has been shown to be effective. (orig.)

  6. Spontaneous Dissection of the Superior Mesenteric Artery

    International Nuclear Information System (INIS)

    Sheldon, Patrick J.; Esther, James B.; Sheldon, Elana L.; Sparks, Steven R.; Brophy, David P.; Oglevie, Steven B.

    2001-01-01

    Spontaneous dissection of the superior mesenteric artery (SMA) is a rare occurrence, especially when not associated with aortic dissection. Currently, only 28 cases appear to have been reported. Due to the scarcity of cases in the literature, the natural history of isolated, spontaneous SMA dissection is unclear. CT has been reported to be useful for the initial diagnosis of SMA dissection [2-5]. We present two recent cases of spontaneous SMA dissection in which enhanced spiral CT was instrumental in following the disease process and guiding clinical decision making

  7. Diagnosis of mesenteric venous thrombosis with 99mTc-labelled Erythrocytes

    International Nuclear Information System (INIS)

    Uccheddu, A.; Murgia, C.; Licheri, S.; Cagetti, M.; Piga, M.; Satta, L.; Balestrieri, A.

    1985-01-01

    The role of radionuclide scanning in mesenteric venous thrombosis (MVT) was studied in rats in which MVT was produced by clamping the superior mesenteric vein (SMV). The experiment was performed using 30 male Sprague-Dowley rats in which red blood cells (RBCs)were labelled in vivo with Sn-pyrophophate- 99m Tc. The rats were divided into three groups of ten animals each. Group A: RBCs labelling was performed 30 minutes after SMV clamping. Group B: RBCs labelling was performed 90 minutes after SMV clamping. Group C: RBCs labelling was performed in normal rats (control group). Abdominal scans were obtained at regular intervals, and the intestinal/heart (I/H) ratio was determined by selecting adequate regions of interest (ROI) in the serial images. The results showed a mean I/H ratio (60 minutes after labelling) equal to 1.77±0.18 in Group A (early MVT), 0.44±0.03 in Group B (advanced MVT), and 0.21±0.02 in Group C (controls). The differences between groups were highly significant (P<0.0005). The technique utilized in this study allows diagnosis of MVT and also assessment of its evaluation, by discriminating between early and advanced lesions. The results of this simple and fast technique stimulate further investigations on the possible clinical application both for the diagnosis and the follow-up of patients with MVT

  8. Establishment of mesenteric venous thrombosis in a porcine model using a transhepatic endovascular approach.

    Science.gov (United States)

    Kai, Liu; Jiaxiang, Meng; Xinxin, Fan; Baochen, Liu; Weiwei, Ding; Xingjiang, Wu; Shuofei, Yang; Jieshou, Li

    2015-12-01

    By using endovascular techniques, we set up an animal model of mesenteric venous thrombosis to avoid surgical laparotomy. Ten pigs underwent percutaneous transhepatic puncture to create animal model of acute superior mesenteric venous thrombosis. Experimental animals were injected with thrombin via indwelling catheter, while sham-operated animals with receiving physiological saline instead of thrombin. Animals were divided into three groups according to the time of thrombosis: the control (n=3, sham group), group A (n=3, 24h follow up) and group B (n=4, 72 h follow up). Blood samples were collected and tested at the baseline and end of the experiment from the systemic circulation (jugular vein). A pathologist, blinded to the performed interventions, graded the ischemic lesions. Nine pigs were successfully conducted MVT model, while one died of liver rupture during the experiment. White blood cell (WBC) count (group A: 18.77 ± 1.29, group B: 28.93 ± 3.13), D-dimer (group A: 8.30 ± 1.93, group B: 17.30 ± 2.48) and lactate dehydrogenase (LDH) (group A: 452.13 ± 53.14, group B: 753.97 ± 65.29) showed a rapid step-up between the experimental animals and control animals (Pmesenteric ischemia by statistical analysis (Pmesenteric venous thrombosis was feasible. Moreover, further animal studies are underway to evaluate the effectiveness and reproducibility of endovascular technique for MVT model. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  9. Prognosis of 10 cases of short bowel syndrome following acute superior mesenteric arterial occlusion

    International Nuclear Information System (INIS)

    Furumoto, Katsuyoshi; Mizuno, Rei; Mori, Tomohiko; Ito, Daisuke; Kogire, Masafumi

    2009-01-01

    In evaluating the long-term intensive treatments essential for short bowel syndrome, we analyzed 10 cases of acute superior mesenteric arterial (SMA) occlusion. Abdominal CT scan detected a smaller superior mesenteric vein (SMV) sign in five out of seven cases, which was useful in making preoperative diagnosis even in noncontrast-enhanced CT. The greater part of the small intestine and part of the colon which became necrotic were resected in all 10 cases. Six patients who were able to be eventually discharged from the hospital had a mean residual jejunum length of 75 cm. Four patients requiring no parenteral nutrition had a mean intestinal length of 95 cm, compared to 35 cm for the two still requiring parenteral nutrition. We report here a case of a 68-year-old man with a 20-cm residual jejunum after surgery for SMA occlusion. He has been unable to eat orally and requiring total parenteral home nutrition, and suffered from catheter infection requiring 24 catheter replacements. Despite survival exceeding for more than 5 years, longer than that of reported cases so far, his quality of life is not necessarily good. (author)

  10. Bypass iliac-mesenteric-cava inpatients under two years of age. Case report and literature review

    Directory of Open Access Journals (Sweden)

    Villanueva López Noé

    2014-07-01

    Full Text Available Introduction: In the treatment of portal hypertension in pediatric patients, some type of porto-systemic shunt is indicated, which is an unusual surgical procedure in patients under two years of age, due to the low incidence of this disease at this age and the increase in the number of complications. Objective: We present our experience and results with this procedure in patients under two years of age seen in the Hepatobiliopancreatic general surgery service at Instituto Nacional de PediatríaDiscussion: The causes of portal hypertension in children are varied. Among the extrahepatic causes, the most common is cavernomatous portal degeneration. Children with portal hypertension under two years have severe symptoms such as recurrent gastrointestinal bleeding or anemia; others have hypersplenism data. In many cases medical management is useless and a surgical procedure require such as a portosystemic shunt in order to decrease the size of varicose esophageal veins and prevent bleeding that threatens the patient’s life. Conclusion: The iliac-mesenteric-caval shunt in patients under two years is a feasible alternative that improves the clinical status of the patient, reducing the risk of bleeding. However long-term studies are needed to determine the outcome of these patients. Keywords: Iliac-mesenteric-caval shunt, portal hypertension.

  11. Interventional embolectomy for acute superior mesenteric artery embolism

    International Nuclear Information System (INIS)

    Li Xuan; Ouyang Qiang; Xiao Xiangsheng

    2006-01-01

    Objective: To evaluate the effects of percutaneous embolectomy for treatment of acute superior mesenteric artery embolism. Methods: 34 cases (atrial fibrillation 14 cases; left atrium myxoma 2 cases; SMA thrombosis 15 cases and chronic mesenteric ischemia 3 cases) of acute mesenteric artery embolism were treated with percutaneous embolectomy using long sheath aspiration method and/or thrombolysis via catheterization of the SMA. Results: Successful recanalizations were achieved in all of the 34 superior mesenteric arterial embolism including recovery in 31 cases, laparotomy for 2 cases, and 1 died within 24 hours. Conclusions: Percutaneous embolectomy using long sheath aspiration is a simple and effective method for treatment of acute superior mesenteric artery embolism. A correct pathogenetic diagnosis is the key to improve the curative effect and avoid the severe complication. (authors)

  12. Acquired Jugular Vein Aneurysm

    Science.gov (United States)

    Hopsu, Erkki; Tarkkanen, Jussi; Vento, Seija I.; Pitkäranta, Anne

    2009-01-01

    Venous malformations of the jugular veins are rare findings. Aneurysms and phlebectasias are the lesions most often reported. We report on an adult patient with an abruptly appearing large tumorous mass on the left side of the neck identified as a jugular vein aneurysm. Upon clinical examination with ultrasound, a lateral neck cyst was primarily suspected. Surgery revealed a saccular aneurysm in intimate connection with the internal jugular vein. Histology showed an organized hematoma inside the aneurysmal sac, which had a focally thinned muscular layer. The terminology and the treatment guidelines of venous dilatation lesions are discussed. For phlebectasias, conservative treatment is usually recommended, whereas for saccular aneurysms, surgical resection is the treatment of choice. While an exact classification based on etiology and pathophysiology is not possible, a more uniform taxonomy would clarify the guidelines for different therapeutic modalities for venous dilatation lesions. PMID:20107571

  13. Exclusive Phlebosclerosis of Submucosal Veins Leading to Ischemic Necrosis and Perforation of the Large Bowel: First European Case

    Directory of Open Access Journals (Sweden)

    Sebastian Klein

    2018-04-01

    Full Text Available Phlebosclerotic colitis (PC is a rare, potentially life-threatening disease of unclear pathogenesis almost exclusively reported in Asian patients of both genders. A fibrous degeneration of venous walls leads to threadlike calcifications along mesenteric vessels and colonic wall thickening, detectable by CT. This causes disturbed blood drainage and hemorrhagic infarction of the right-sided colonic wall. This is a report of PC in a Caucasian woman in Europe without Asian background and no history of herbal medications, a suspected cause in Asian patients. CT revealed no calcification of the mesenteric vein or its tributaries. Instead, submucosal veins of the left-sided colonic wall were calcified, leading to subsequent transmural necrosis. Clinically, the patient developed a paralytic ileus and sigmoidal perforation during a 2-week hospitalization due to a bleeding cerebral vascular aneurysm. This case of a European woman with PC is unique in its course as well as its radiologic, clinical, and pathologic presentation.

  14. Mesenterico-portal vein resection in patients with pancreatico-duodenal cancer is safe and may increase survival.

    Science.gov (United States)

    Storkholm, Jan Henrik; Hansen, Carsten Palnæs

    2014-01-01

    Pancreatic cancer is one of the most serious gastrointestinal cancers, and in the US and Europe it is a leading cause of cancer-related mortality. Radical surgery is the only option available for long-term survival. The aim of this study was to describe the surgical technique and the results of portal vein/superior mesenteric vein resection in patients with pancreatic cancer. Between 1 April 2009 and 1 April 2013, 354 patients underwent resection for pancreatic malignancy. A total of 47 portal vein/superior mesenteric vein resections were performed in 22 men and 25 women. A total of 44 patients (93.7%) had ductal adenocarcinomas. In all, 39 patients (83%) had T3 tumours, and 38 patients (80.9%) had involvement of lymph nodes. Furthermore, 29 patients (62%) had a pancreaticoduodenectomy, 15 patients (32%) a total pancreatectomy and three patients (6%) had a distal pancreatectomy. Six patients (17%) were reconstructed with interposition grafts, and vessels (83%) were reconstructed with an end-to-end anastomosis in the remaining 39 patients. Surgical morbidity was 29.8%, and 19.1% had non-surgical complications. The perioperative mortality (30 days) was 0%. The median survival was 25.2 months (confidence interval: 19-31.4). Resection of the portal vein/superior mesenteric vein is a safe procedure. It is not associated with an increased perioperative morbidity and mortality. This latter finding is in accordance with the findings in other high-volume centres. The median survival was far better than expected, especially since our material included a considerable number of patients with lymph node metastases. not relevant. not relevant.

  15. Scintiangiographic diagnosis of acute mesenteric venous thrombosis. [/sup 99m/Tc-sulfur colloid

    Energy Technology Data Exchange (ETDEWEB)

    Smith, R.W. (Medical Univ. of South Carolina, Charleston); Selby, J.B.

    1979-01-01

    Scintiangiographic findings of prolonged mesenteric activity in a case of acute mesenteric thrombosis is described and 105 cases with abdominal scintiangiography are reviewed. Usual peak mesenteric blush occurred 5 to 15 sec after initial visualization of the aorta. Normal clearance of this activity was 15 to 30 sec. Future cases should confirm the importance of this observation in early diagnosis of mesenteric venous thrombosis.

  16. 'Dilatation' of the left renal vein on computed tomography in children: A normal variant

    International Nuclear Information System (INIS)

    Zerin, J.M.; Hernandez, R.J.; Sedman, A.B.; Kelsch, R.C.

    1991-01-01

    Compression of the left renal vein (LRV) between the superior mesenteric artery and the aorta is thought to be a cause of hematuria, periureteral and gonadal varices, and varicocele ('Nutcracker phenomenon'). Previous investigators have suggested that this diagnosis can be made on computed tomography when the LRV ratio ≥1.5 (the diameter of the LRV proximal to the aorto-mesenteric angle divided by the diameter of the LRV distal to the aorto-mesenteric angle). This study was designed to establish the normal range for the LRV ratio on CT in children. The LRV ratio was measured in thirty-nine consecutive children undergoing intravenously enhanced CT of the abdomen. None of the children had hematuria on urinalysis immediately before or after the CT. Children with any known abnormality involving the kidneys, adrenal glands, IVC, or renal or gonadal veins were excluded. The patients ranged in age from 3.4 to 18.5 years (mean=10.6 years). LRV ratio ranged from 0.78 to 2.00 (mean=1.46; S.D.=0.312). Twenty of the 39 children (51.3%) had a LRV ratio ≥ 1.50. The conclusion is that the normal range for the LRV ratios is too wide for it to be useful in diagnosing LRV entrapment and that a LRV ratio ≥ 1.5 on CT is normal in children. (orig.)

  17. The vein collar

    DEFF Research Database (Denmark)

    Lundgren, F; Schroeder, Torben Veith

    2012-01-01

    Randomized studies evaluating the effect of a vein collar at the distal anastomosis of PTFE-grafts show conflicting results. The study of the Joint Vascular Research Group (JVRG) of UK found improved primary patency while the Scandinavian Miller Collar Study (SCAMICOS) found neither any effect on...

  18. Portal vein thrombosis.

    Science.gov (United States)

    Chawla, Yogesh K; Bodh, Vijay

    2015-03-01

    Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion.

  19. Deep Vein Thrombosis

    Centers for Disease Control (CDC) Podcasts

    2012-04-05

    This podcast discusses the risk for deep vein thrombosis in long-distance travelers and ways to minimize that risk.  Created: 4/5/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 4/5/2012.

  20. Portal Vein Thrombosis

    Science.gov (United States)

    Chawla, Yogesh K.; Bodh, Vijay

    2015-01-01

    Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion. PMID:25941431

  1. The vein collar

    DEFF Research Database (Denmark)

    Lundgren, F; Schroeder, Torben Veith

    2012-01-01

    Randomized studies evaluating the effect of a vein collar at the distal anastomosis of PTFE-grafts show conflicting results. The study of the Joint Vascular Research Group (JVRG) of UK found improved primary patency while the Scandinavian Miller Collar Study (SCAMICOS) found neither any effect...

  2. What Are Varicose Veins?

    Science.gov (United States)

    ... Examples of these factors include family history, older age, gender, pregnancy, overweight or obesity , lack of movement, and leg trauma. Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve ...

  3. Deep Vein Thrombosis

    African Journals Online (AJOL)

    OWNER

    ABSTRACT. BACKGROUND: Deep vein thrombosis (DVT) is a cause of preventable morbidity and mortality in hospitalized surgical patients. The occurrence of the disease is related to presence of risk factors, which are related primarily to trauma, venous stasis and hyper-coagulability. DVT seems not to be taken seriously ...

  4. Time course study of intestinal epithelial barrier disruption in acute mesenteric venous thrombosis.

    Science.gov (United States)

    Yang, Shuofei; Chen, Jiaquan; Ni, Qihong; Qi, Haozhe; Guo, Xiangjiang; Zhang, Lan; Xue, Guanhua

    2018-04-01

    Acute superior mesenteric venous thrombosis (ASMVT) is an abdominal vascular condition. Early recanalization is essential to successful treatment. The aim of the study was to establish rabbit models of ASMVT and assess the time course of intestinal epithelial barrier disruption. After surgical exposure of superior mesenteric vein (Sham group), large-vessel (L-group) and small-vessel (S-group) models were established by endothelium damage, stenosis creation, and thrombin injection. At baseline, 6, 9, and 12 h, hemodynamic and serum parameters were tested. Serum from ASMVT patients diagnosed at 24, 36, 48, and 60 h from symptom onset was collected. Intestinal barrier disruption was assessed by tight junction (TJ) protein expression, morphology changes, and bacterial translocation. Mesenteric arteriospasm was measured by flow velocity and intestinal wet/dry weight ratio. The serum level of intestinal fatty acid-binding protein and endotoxin in patients was also measured as an indicator for intestinal barrier function. Severe acidosis and lacticemia were observed in both the groups. The L-group experienced greater hemodynamic alteration than the S-group. Intestinal barrier disruption was detected by significantly decreased TJ protein expression, histology and ultrastructure injury of TJ, increased permeability, and bacterial translocation, at 9 h in the S-group and 12 h in the L-group. Secondary mesenteric arteriospasm occurred at the same time of complete intestinal barrier disruption and could be a significant cause of bowel necrosis. Significant increased level of intestinal fatty acid-binding protein and endotoxin was found in patients at 48 h in the S-group type and 60 h in the L-group type. The ASMVT animal models of both the types were first established. The loss of intestinal barrier function occurred at 6 h in the S-group model and 9 h in the L-group model. For clinical patients, the time window extended to 36 h in the S-group type and 48 h in the L

  5. Pancreatic portal cavernoma in patients with cavernous transformation of the portal vein: MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Vilgrain, Valerie [Universite Paris 7 Denis Diderot, Paris (France); AP-HP, Hopital Beaujon, Department of Radiology, Clichy (France); INSERM, Centre de recherche Biomedicale Bichat-beaujon, CRB3, Paris (France); Hopital Beaujon, Department of Radiology, Paris (France); Condat, Bertrand; Plessier, Aurelie [AP-HP, Hopital Beaujon, Department of Gastroenterology, Clichy (France); O' Toole, Dermot [Centre de reference des maladies vasculaires du foie, AP-HP, Hopital Beaujon, Department of Hepatology, PMAD, Clichy (France); Ruszniewski, Philippe [Universite Paris 7 Denis Diderot, Paris (France); INSERM, Centre de recherche Biomedicale Bichat-beaujon, CRB3, Paris (France); Centre de reference des maladies vasculaires du foie, AP-HP, Hopital Beaujon, Department of Hepatology, PMAD, Clichy (France); Valla, Dominique C. [Universite Paris 7 Denis Diderot, Paris (France); INSERM, Centre de recherche Biomedicale Bichat-beaujon, CRB3, Paris (France); AP-HP, Hopital Beaujon, Department of Gastroenterology, Clichy (France)

    2009-11-15

    The purpose of the article was to prospectively evaluate the MR findings of pancreatic portal cavernoma in a consecutive series of patients with cavernous transformation of the portal vein. This study was approved by the review board of our institution, and informed consent was obtained. The clinical and biological data and the MR imaging for 20 patients (11 female, 9 male; median age, 49 years) with cavernous transformation of the portal vein and no evidence of previous pancreatic disease were reviewed. The presence of pancreatic portal cavernoma (defined as intra- and/or peripancreatic portal cavernoma), morphological changes in the pancreas, biliary and ductal pancreatic abnormalities, and extension of the portal venous thrombosis were qualitatively assessed. Fifteen patients (75%) had pancreatic portal cavernoma with collateral formation in the pancreas and/or collaterals around the pancreas seen on dynamic contrast-enhanced MR sequences: three patients had both intra- and peripancreatic portal cavernoma, six had intrapancreatic portal cavernoma alone and six had peripancreatic portal cavernoma only. The presence of intra- or peripancreatic portal cavernoma was significantly associated with extension of the thrombosis to the splenic and superior mesenteric veins (p = 0.05). Morphological changes in the pancreas, heterogeneity on T2-weighted sequences and main ductal pancreatic abnormalities were seen in two, four and two patients, respectively. All these patients had intrapancreatic portal cavernoma. Bile duct dilatation was observed in 13 (65%) patients: among them three had extrahepatic dilatation only and these three patients had associated intrapancreatic portal cavernoma. In patients with cavernous transformation of the portal vein, intra- or peripancreatic portal cavernoma is common. In conclusion, intra- or peripancreatic portal cavernoma was only observed in patients with extension of the thrombosis to the splenic vein and/or the superior mesenteric

  6. Pancreatic portal cavernoma in patients with cavernous transformation of the portal vein: MR findings

    International Nuclear Information System (INIS)

    Vilgrain, Valerie; Condat, Bertrand; Plessier, Aurelie; O'Toole, Dermot; Ruszniewski, Philippe; Valla, Dominique C.

    2009-01-01

    The purpose of the article was to prospectively evaluate the MR findings of pancreatic portal cavernoma in a consecutive series of patients with cavernous transformation of the portal vein. This study was approved by the review board of our institution, and informed consent was obtained. The clinical and biological data and the MR imaging for 20 patients (11 female, 9 male; median age, 49 years) with cavernous transformation of the portal vein and no evidence of previous pancreatic disease were reviewed. The presence of pancreatic portal cavernoma (defined as intra- and/or peripancreatic portal cavernoma), morphological changes in the pancreas, biliary and ductal pancreatic abnormalities, and extension of the portal venous thrombosis were qualitatively assessed. Fifteen patients (75%) had pancreatic portal cavernoma with collateral formation in the pancreas and/or collaterals around the pancreas seen on dynamic contrast-enhanced MR sequences: three patients had both intra- and peripancreatic portal cavernoma, six had intrapancreatic portal cavernoma alone and six had peripancreatic portal cavernoma only. The presence of intra- or peripancreatic portal cavernoma was significantly associated with extension of the thrombosis to the splenic and superior mesenteric veins (p = 0.05). Morphological changes in the pancreas, heterogeneity on T2-weighted sequences and main ductal pancreatic abnormalities were seen in two, four and two patients, respectively. All these patients had intrapancreatic portal cavernoma. Bile duct dilatation was observed in 13 (65%) patients: among them three had extrahepatic dilatation only and these three patients had associated intrapancreatic portal cavernoma. In patients with cavernous transformation of the portal vein, intra- or peripancreatic portal cavernoma is common. In conclusion, intra- or peripancreatic portal cavernoma was only observed in patients with extension of the thrombosis to the splenic vein and/or the superior mesenteric

  7. Splanchnic Vein Thrombosis - an Uncommon Complication after Laparoscopic Sleeve Gastrectomy

    Directory of Open Access Journals (Sweden)

    Tanja Carli

    2016-04-01

    Full Text Available Background: Laparoscopic sleeve gastrectomy (LSG is an innovative and relatively safe surgical approach for weight reduction in morbidly obese people. Splanchnic vein thrombosis (SVT is an extremely rare complication of LSG and, if not recognized, carries a high mortality rate. This paper highlights a potentially lethal condition of SVT after LSG. Case Report: A 37-year-old morbidly obese woman was referred to our institution for LSG. Three weeks after the intervention, she was readmitted with abdominal pain, vomiting, nausea, diarrhea, and fever with positive family anamnesis to viral disease. Abdominal X-ray as well as utrasonography were both normal, and no X-ray contrast medium leakage was observed. One week later, she was readmitted with septic condition. An abdominal computed tomography scan diagnosed lienal vein thrombosis along its whole length and partial thrombosis of the superior mesenteric vein. Conclusion: SVT presents very heterogeneously, which makes it extremely challenging to diagnose and to make an appropriate treatment decision. With regard to the high prevalence of obesity and the increasing frequency of LSG, prompt diagnosis and management are crucial.

  8. Collateral veins in left renal vein stenosis demonstrated via CT

    International Nuclear Information System (INIS)

    Lien, H.H.; Lund, G.; Talle, K.

    1983-01-01

    Twelve patients with left renal vein stenosis from tumor compression were studied with CT. All had distended collateral veins in the perirenal space which either formed a radiating or a cobweb pattern or appeared as marked longitudinal veins. Inferior phrenic vein branches were seen in seven patients and were considerably enlarged in two. Other major veins possibly taking part in collateral circulation could not be recognized due to obliteration of fat planes. The renal fascia was thickened in eleven patients, probably due to edema. A close study of the perirenal space with CT may give valuable information about collateral development. (orig.)

  9. Acute Mesenteric Venous Thrombosis with a Vaginal Contraceptive Ring

    Directory of Open Access Journals (Sweden)

    Wesley Eilbert

    2014-07-01

    Full Text Available Mesenteric venous thrombosis is a rare cause of abdominal pain, which if left untreated may result in bowel infarction, peritonitis and death. The majority of patients with this illness have a recognizable, predisposing prothrombotic condition. Oral contraceptives have been identified as a predisposing factor for mesenteric venous thrombosis in reproductive-aged women. In the last fifteen years new methods of hormonal birth control have been introduced, including a transdermal patch and an intravaginal ring. In this report, we describe a case of mesenteric venous thrombosis in a young woman caused by a vaginal contraceptive ring. [West J Emerg Med. 2014;15(4:395-397.

  10. Superior mesenteric artery thrombosis after abrupt discontinuation of rivaroxaban.

    Science.gov (United States)

    Adams, Christopher B; Acquisto, Nicole M; Rotoli, Jason M; LoStracco, Thomas; Shamaskin, Ann R; Pasternack, Joel S

    2016-04-01

    We report a case of superior mesenteric artery thrombosis after the abrupt discontinuation of rivaroxaban in a 59-year-old male patient. The initial presentation was of sudden onset abdominal pain, nausea, vomiting, diarrhea, and hematochezia in the setting of recently holding rivaroxaban anticoagulation for an atrial flutter ablative procedure. Imaging revealed thrombosis of the superior mesenteric artery and acute mesenteric ischemia requiring emergent surgical intervention for embolectomy. Upon exploratory laparotomy, the bowel was found to be viable, and an embolectomy with patch angioplasty was successful without complication. This case illustrates the need for emergency medicine clinician familiarity with this possible medication adverse event with rivaroxaban.

  11. Acute mesenteric venous thrombosis with a vaginal contraceptive ring.

    Science.gov (United States)

    Eilbert, Wesley; Hecht, Benjamin; Zuiderveld, Loren

    2014-07-01

    Mesenteric venous thrombosis is a rare cause of abdominal pain, which if left untreated may result in bowel infarction, peritonitis and death. The majority of patients with this illness have a recognizable, predisposing prothrombotic condition. Oral contraceptives have been identified as a predisposing factor for mesenteric venous thrombosis in reproductive-aged women. In the last fifteen years new methods of hormonal birth control have been introduced, including a transdermal patch and an intravaginal ring. In this report, we describe a case of mesenteric venous thrombosis in a young woman caused by a vaginal contraceptive ring.

  12. Emergency Endovascular Treatment of a Superior Mesenteric Artery Occlusion

    International Nuclear Information System (INIS)

    Brountzos, Elias N.; Critselis, Antonios; Magoulas, Dimitrios; Kagianni, Eleni; Kelekis, Dimitrios A.

    2001-01-01

    Endovascular treatment of acute mesenteric ischemia is rarely reported. We report a patient with a 1-year history of chronic mesenteric ischemia who presented with acute worsening of his symptoms and peritoneal signs. Aortography depicted an occlusion of the superior mesenteric artery, which was successfully managed with immediate percutaneous angioplasty (PTA) and stent placement. The patient's clinical condition improved markedly and an exploratory laparotomy performed the following day confirmed the viability of the intestine. He remains symptom-free 12 months after the procedure, and color Doppler follow-up showed that the stent is patent

  13. [Two cases of fulminant myocarditis with mesenteric ischemia].

    Science.gov (United States)

    Katahira, Shintaro; Akiyama, Masatoshi; Tadano, Yasunori; Hosoyama, Katsuhiro; Masaki, Naoki; Kanada, Keisuke; Suzuki, Tomoyuki; Kawatsu, Satoshi; Kumagai, Kiichiro; Adachi, Osamu; Kawamoto, Shunsuke; Saiki, Yoshikatsu

    2015-03-01

    Fulminant myocarditis (FM) can lead to a refractory cardiogenic shock and multiple organ failure. Mechanical circulatory support (MCS) is not infrequency required to salvage patients in a profound shock. Advanced technology in MCS such as a temporary ventricular assist device can yield improved early outcome. However, incessant mesenteric ischemia remains a challenge to be resolved even with MCS. We here-in report 2 cases of FM associated with mesenteric ischemia that was extremely difficult to diagnose and treat. Therapeutic strategy for FM with mesenteric ischemia is discussed.

  14. Superior Mesenteric Artery Syndrome or Wilkie Syndrome

    International Nuclear Information System (INIS)

    Castano Llano, Rodrigo; Chams Anturi, Abraham; Arango Vargas, Paula

    2009-01-01

    We described three cases of superior mesenteric artery (SMA) syndrome, also known as Wilkie's syndrome, chronic duodenal ileus, or cast syndrome. This syndrome occurs when the third portion of the duodenum is compressed between the SMA and the aorta. The major risk factors for development of SMA syndrome are rapid weight loss and surgical correction of spinal deformities. The clinical presentation of SMA syndrome is variable and nonspecific, including nausea, vomiting, abdominal pain, and weight loss. The diagnosis is based on endoscopic, radiographic and tomographic findings of duodenal compression by the SMA. The treatment of SMA syndrome is aimed at the precipitating factor, which usually is related to weight loss. Therefore, conservative therapy with nutritional supplementation is the initial approach, and surgery is reserved for those who do not respond to nutritional therapy.

  15. Deep Cerebral Vein Thrombosis: A Clinical Masquerader

    OpenAIRE

    Kumar, Prabhat; Sasmal, Gargi; Mahto, Subodh Kumar; Gupta, Shreya; Gupta, Harish

    2017-01-01

    Cerebral Vein Thrombosis (CVT) is an uncommon cause of stroke. Thrombosis can occur in superficial veins, deep venous system or cortical veins of brain. The term Deep Cerebral Vein Thrombosis (DCVT) is used for thrombosis of internal cerebral vein, vein of Galen and basal vein of Rosenthal. Only 10% cases of CVT are because of thrombosis of deep cerebral vein. The diagnosis of DCVT is often missed because of its heterogenous presentation. Herein, we present a case of DCVT which was initially ...

  16. Transsinusoidal Portal Vein Embolization with Ethylene Vinyl Alcohol Copolymer (Onyx): A Feasibility Study in Pigs

    Energy Technology Data Exchange (ETDEWEB)

    Smits, Maarten L. J., E-mail: m.l.j.smits-3@umcutrecht.nl [University Medical Center Utrecht, Department of Radiology (Netherlands); Vanlangenhove, Peter, E-mail: peter.vanlangenhove@uzgent.be; Sturm, Emiel J. C., E-mail: ejcsturm@gmail.com [Ghent University Hospital, Department of Vascular and Interventional Radiology (Belgium); Bosch, Maurice A. A. J. van den, E-mail: mbosch@umcutrecht.nl [University Medical Center Utrecht, Department of Radiology (Netherlands); Hav, Monirath, E-mail: hav.monirath@gmail.com; Praet, Marleen, E-mail: marleen.praet@ugent.be [Ghent University Hospital, N. Goormaghtigh Institute of Pathology (Belgium); Vente, Maarten A. D., E-mail: m.vente@umcutrecht.nl [University Medical Center Utrecht, Department of Radiology (Netherlands); Snaps, Frederic R., E-mail: fsnaps@ulg.ac.be [University of Liege, Department of Clinical Sciences, Faculty of Veterinary Medicine (Belgium); Defreyne, Luc, E-mail: luc.defreyne@ugent.be [Ghent University Hospital, Department of Vascular and Interventional Radiology (Belgium)

    2012-10-15

    Purpose: Portal vein embolization is performed to increase the future liver remnant before liver surgery in patients with liver malignancies. This study assesses the feasibility of a transsinusoidal approach for portal vein embolization (PVE) with the ethylene vinyl alcohol copolymer, Onyx. Methods: Indirect portography through contrast injection in the cranial mesenteric artery was performed in eight healthy pigs. Onyx was slowly injected through a microcatheter from a wedged position in the hepatic vein and advanced through the liver lobules into the portal system. The progression of Onyx was followed under fluoroscopy, and the extent of embolization was monitored by indirect portography. The pigs were euthanized immediately (n = 2), at 7 days (n = 4), or at 21 days postprocedure (n = 2). All pigs underwent necropsy and the ex vivo livers were grossly and histopathologically analyzed. Results: Transsinusoidal PVE was successfully performed in five of eight pigs (63%). In 14 of 21 injections (67%), a segmental portal vein could be filled completely. A mean of 1.6 liver lobes per pig was embolized (range 1-2 lobes). There were no periprocedural adverse events. Focal capsular scarring was visible on the surface of two resected livers, yet the capsules remained intact. Histopathological examination showed no signs of recanalization or abscess formation. Mild inflammatory reaction to Onyx was observed in the perivascular parenchyma. Conclusions: The porcine portal vein can be embolized through injection of Onyx from a wedged position in the hepatic vein. Possible complications of transsinusoidal PVE and the effect on contralateral hypertrophy need further study.

  17. Accessory hepatic vein: MR imaging

    International Nuclear Information System (INIS)

    Lee, Chang Hee; Rho, Tack Soo; Cha, Sang Hoon; Park, Cheol Min; Cha, In Ho

    1995-01-01

    To evaluate the MR appearance of the accessory hepatic veins. The study included 87 consecutive patients for whom abdominal MR images were obtained. The subjects who had liver lesion or hepatic vascular abnormalities were excluded. Couinaud classified accessory hepatic veins into inferior and middle right hepatic veins. Our major interests were evaluation of the incidence, morphology, and location of the accessory hepatic vein. Inferior right hepatic vein was demonstrated in 43 out of 87 patients (49%). The morphology was linear in 35 patients (80.5%), and V-shaped in 8 patients (19.5%). In 40 patients (93%), the inferior right hepatic vein was located in the posteroinferior aspect of the right lobe. Middle right hepatic vein was demonstrated in 7 out of 87 patients (8%). All were single linear in morphology, combined with the inferior right hepatic vein, and located between the right hepatic vein and inferior right hepatic vein. The accessory hepatic vein was demonstrated in 49% among the Korean adult population, and was located in posteroinferior portion of the liver, in 93%

  18. Interposition vein cuffs.

    Science.gov (United States)

    Harris, P; Da Silva, T; How, T

    1996-01-01

    A vein cuff interposed at the distal anastomosis between a prosthetic vascular graft and a recipient infrageniculate artery improves the chances of continued patency of the graft, at least in the short and medium term. The mode of effect appears to be suppression or modification of anastomotic myointimal hyperplasia (MIH). In the event of graft failure the recipient artery and run-off vessels remain free from MIH and their patency is preserved thereby improving the prospects for further vascular reconstruction and limb salvage. The mechanisms by which interposition vein cuffs might modulate MIH are reviewed. Experimental evidence is described to show that the geometry of a cuffed anastomosis promotes a characteristic haemodynamic flow structure with a stable vortex. It is suggested that this vortex exerts greater shear stress upon the wall of the artery than the normal laminar flow observed in conventional anastomoses. High shear stress is known to inhibit MIH.

  19. Mesenteric, coeliac and splanchnic blood flow in humans during exercise

    DEFF Research Database (Denmark)

    Perko, M J; Nielsen, H B; Skak, C

    1998-01-01

    1. Exercise reduces splanchnic blood flow, but the mesenteric contribution to this response is uncertain. 2. In nineteen humans, superior mesenteric and coeliac artery flows were determined by duplex ultrasonography during fasting and postprandial submaximal cycling and compared with the splanchnic...... blood flow as assessed by the Indocyanine Green dye-elimination technique. 3. Cycling increased arterial pressure, heart rate and cardiac output, while it reduced total vascular resistance. These responses were not altered in the postprandial state. During fasting, cycling increased mesenteric, coeliac...... the coeliac circulation was not influenced. Postprandial cycling did not influence the mesenteric resistance significantly, but its blood flow decreased by 22 % (0.46 +/- 0.28 l min-1). Coeliac and splanchnic resistance increased by 150 and 63 %, respectively, and the corresponding regional blood flow...

  20. Initial transcatheter thrombolysis for acute superior mesenteric venous thrombosis.

    Science.gov (United States)

    Yang, Shuo-Fei; Liu, Bao-Chen; Ding, Wei-Wei; He, Chang-Sheng; Wu, Xing-Jiang; Li, Jie-Shou

    2014-05-14

    To determine the optimal initial treatment modality for acute superior mesenteric vein thrombosis (ASMVT) in patients with circumscribed peritonitis. A retrospective review was made of the Vascular Surgery Department's medical records to identify adult patients (≥ 18 years old) presenting with circumscribed peritonitis and diagnosed with ASMVT by imaging or endoscopic examination. Patients were selected from the time period between October 2009 and October 2012 to assess the overall performance of a new first-line treatment policy implemented in May 2011 for patients with circumscribed peritonitis, which recommends transcatheter thrombolysis with local anticoagulation and endovascular mechanical thrombectomy. Of the 25 patients selected for study inclusion, 12 had undergone emergency surgical exploration (group 1) and 13 had undergone the initial catheter-directed thrombolysis (group 2). Data extracted from each patient's records for statistical analyses included method of diagnosis, symptoms, etiology and risk factors, thrombus location, initial management, morbidity, mortality, duration and total cost of hospitalization (in Renminbi, RMB), secondary operation, total length of bowel resection, duration of and findings in follow-up, and death/survival. The two treatment groups showed similar rates of morbidity, 30-d mortality, and 1-year survival, as well as similar demographic characteristics, etiology or risk factors, computed tomography characteristics, symptoms, findings of blood testing at admission, complications, secondary operations, and follow-up outcomes. In contrast, the patients who received the initial non-operative treatment of transcatheter thrombolysis had significantly shorter durations of admission to symptom elimination (group 1: 18.25 ± 7.69 d vs group 2: 7.23 ± 2.42 d) and hospital stay (43.00 ± 13.77 d vs 20.46 ± 6.59 d), and early enteral or oral nutrition restoration (20.50 ± 5.13 d vs 8.92 ± 1.89 d), as well as significantly less

  1. Pulmonary vein stenosis and the pathophysiology of "upstream" pulmonary veins.

    Science.gov (United States)

    Kato, Hideyuki; Fu, Yaqin Yana; Zhu, Jiaquan; Wang, Lixing; Aafaqi, Shabana; Rahkonen, Otto; Slorach, Cameron; Traister, Alexandra; Leung, Chung Ho; Chiasson, David; Mertens, Luc; Benson, Lee; Weisel, Richard D; Hinz, Boris; Maynes, Jason T; Coles, John G; Caldarone, Christopher A

    2014-07-01

    Surgical and catheter-based interventions on pulmonary veins are associated with pulmonary vein stenosis (PVS), which can progress diffusely through the "upstream" pulmonary veins. The mechanism has been rarely studied. We used a porcine model of PVS to assess disease progression with emphasis on the potential role of endothelial-mesenchymal transition (EndMT). Neonatal piglets underwent bilateral pulmonary vein banding (banded, n = 6) or sham operations (sham, n = 6). Additional piglets underwent identical banding and stent implantation in a single-banded pulmonary vein 3 weeks postbanding (stented, n = 6). At 7 weeks postbanding, hemodynamics and upstream PV pathology were assessed. Banded piglets developed pulmonary hypertension. The upstream pulmonary veins exhibited intimal thickening associated with features of EndMT, including increased transforming growth factor (TGF)-β1 and Smad expression, loss of endothelial and gain of mesenchymal marker expression, and coexpression of endothelial and mesenchymal markers in banded pulmonary vein intimal cells. These immunopathologic changes and a prominent myofibroblast phenotype in the remodeled pulmonary veins were consistently identified in specimens from patients with PVS, in vitro TGF-β1-stimulated cells isolated from piglet and human pulmonary veins, and human umbilical vein endothelial cells. After stent implantation, decompression of a pulmonary vein was associated with reappearance of endothelial marker expression, suggesting the potential for plasticity in the observed pathologic changes, followed by rapid in-stent restenosis. Neonatal pulmonary vein banding in piglets recapitulates critical aspects of clinical PVS and highlights a pathologic profile consistent with EndMT, supporting the rationale for evaluating therapeutic strategies designed to exploit reversibility of upstream pulmonary vein pathology. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All

  2. Vein grafting in fingertip replantations.

    Science.gov (United States)

    Yan, Hede; Jackson, William D; Songcharoen, Somjade; Akdemir, Ovunc; Li, Zhijie; Chen, Xinglong; Jiang, Liangfu; Gao, Weiyang

    2009-01-01

    In this retrospective study, the survival rates of fingertip replantation with and without vein grafting were evaluated along with their postoperative functional and cosmetic results. One hundred twenty-one-fingertip amputations were performed in 103 patients between September 2002 and July 2007. Thirty-four amputated fingertips were replanted without vein grafting, while 87 amputated fingertips were replanted with vein grafting for arterial and/or venous repairs. The overall survival rates of the replantations with and without vein grafting were 90% (78/87) and 85% (29/34), respectively. The survival rates were 88% (36/41) with venous repair, 93% (25/27) with arterial repair, and 89% (17/19) with both. Nineteen patients without vein grafting and 48 patients with vein grafting had a follow-up period of more than one year. Good cosmetic and functional outcomes were observed in both groups of patients. The results show that vein grafting is a reliable technique in fingertip replantations, showing no significant difference (P > 0.05) in survival between those with and without vein grafting. Furthermore, no significant difference (P > 0.05) in survival was found between cases with vein grafts for arterial and/or venous repairs. In fingertip replantations with vein grafting, favorable functional and esthetic results can be achieved without sacrificing replantation survival. (c) 2009 Wiley-Liss, Inc.

  3. Percutaneous Retrograde Recanalization of the Celiac Artery by Way of the Superior Mesenteric Artery for Chronic Mesenteric Ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Joseph, George, E-mail: joseph59@gmail.com; Chacko, Sujith Thomas [Christian Medical College, Department of Cardiology (India)

    2013-02-15

    A 52-year-old man presented with recurrent postprandial abdominal pain, sitophobia, and progressive weight loss. Chronic mesenteric ischemia (CMI) due to subtotal occlusion of the superior mesenteric artery (SMA) and flush occlusion of the celiac artery (CA) was diagnosed. Retrograde recanalization of the CA by way of a collateral channel from the SMA was performed using contemporary recanalization equipment. The CA and SMA were then stented, resulting in sustained resolution of CMI-related symptoms.

  4. A single hospital study on portal vein thrombosis in cirrhotic patients - clinical characteristics & risk factors

    Directory of Open Access Journals (Sweden)

    Huisong Chen

    2014-01-01

    Full Text Available Background & objectives: Discrepancies exist in the reported prevalence of portal vein thrombosis (PVT, and its clinical characteristics and sites of occurrence need to be elucidated. The risk factors for PVT are also poorly understood. This single centre study was undertaken to determine the clinical characteristics, sites of occurrence, and risk factors associated with PVT in patients with liver cirrhosis. Methods: Hospitalized cirrhotic patients (N = 162 were segregated into the PVT and non-PVT groups. Indices possibly associated with PVT were measured and PVT was detected by both Doppler ultrasonography and computed tomography portal angiography. The portal vein diameter and flow velocity and splenic thickness were measured by ultrasonography. Results: PVT was found in 40 patients (24.7%; in 34 PVT patients (85%, the liver cirrhosis resulted from hepatitis B virus infections. Most (90% patients were Child-Pugh classes B and C, with similar distribution between the groups. PVT was seen in 20 patients in the portal and superior mesenteric veins; ascites, abdominal pain, gastrointestinal bleeding, and jaundice were common findings in PVT patients. Haemoglobin levels and blood platelet counts (BPCs were significantly lower and splenic thickness was greater in PVT than in non-PVT patients (P<0.01. There was a significant positive correlation between BPCs and platelet aggregation rates (R = 0.533, P<0.01. Interpretation & conclusions: The occurrence of PVT was 24.7 per cent, primarily in post-hepatitis B liver cirrhosis patients. PVT occurred mainly in the portal vein trunk and superior mesenteric vein. Different PVT sites may account for the differing clinical presentations. The lower levels of haemoglobin and BPCs as well as splenic thickening were associated with PVT. Splenic thickening may be a risk factor for PVT.

  5. CT findings at lupus mesenteric vasculitis

    International Nuclear Information System (INIS)

    Ko, S.F.; Lee, T.Y.; Cheng, T.T.; Ng, S.H.; Lai, H.M.; Cheng, Y.F.; Tsai, C.C.

    1997-01-01

    Purpose: To describe the spectrum of early CT findings of lupus mesenteric vasculitis (LMV) and to assess the utility of CT in the management of this uncommon entity. Methods: Abdominal CT was performed within 1-4 days (average 2.2 days) of the onset of severe abdominal pain and tenderness in 15 women with systemic lupus erythematosus. Prompt high-dose i.v. corticosteroid in 11 patients after the CT diagnosis of LMV was made. CT was performed after abdominal symptoms subsided. Results: Eleven cases revealed CT features suggestive of LMV including conspicuous prominence of mesentric vessels with palisade pattern or comb-like appearance (CT comb sign) supplying focal or diffuse dilated bowel loops (n=11), ascites with slightly increased peritoneal enhancement (n=11), small bowel wall thickening (n=10) with double halo or target sign (n=8). Follow-up CT before high-dose steroid therapy revealed complete or marked resolution of the abnormal CT findings. Conclusion: CT is helpful for confirming the diagnosis of LMV, especially the comb sign which may be an early sign. Bowel ischemia due to LMV is less ominous than previously expected, and the abnormal CT findings were reversible when early diagnosis and prompt i.v. steroid therapy could be achieved. (orig.)

  6. CT findings at lupus mesenteric vasculitis

    Energy Technology Data Exchange (ETDEWEB)

    Ko, S.F. [Chang Gung Medical College and Memorial Hospital, Dept. of Radiology, Kaohsiung Hsien (Taiwan); Lee, T.Y. [Chang Gung Medical College and Memorial Hospital, Dept. of Radiology, Kaohsiung Hsien (Taiwan); Cheng, T.T. [Chang Gung Medical College and Memorial Hospital, Dept. of Rheumatology, Kaohsiung Hsien (Taiwan); Ng, S.H. [Chang Gung Medical College and Memorial Hospital, Dept. of Radiology, Kaohsiung Hsien (Taiwan); Lai, H.M. [Chang Gung Medical College and Memorial Hospital, Dept. of Rheumatology, Kaohsiung Hsien (Taiwan); Cheng, Y.F. [Chang Gung Medical College and Memorial Hospital, Dept. of Radiology, Kaohsiung Hsien (Taiwan); Tsai, C.C. [Chang Gung Medical College and Memorial Hospital, Dept. of Radiology, Kaohsiung Hsien (Taiwan)

    1997-01-01

    Purpose: To describe the spectrum of early CT findings of lupus mesenteric vasculitis (LMV) and to assess the utility of CT in the management of this uncommon entity. Methods: Abdominal CT was performed within 1-4 days (average 2.2 days) of the onset of severe abdominal pain and tenderness in 15 women with systemic lupus erythematosus. Prompt high-dose i.v. corticosteroid in 11 patients after the CT diagnosis of LMV was made. CT was performed after abdominal symptoms subsided. Results: Eleven cases revealed CT features suggestive of LMV including conspicuous prominence of mesentric vessels with palisade pattern or comb-like appearance (CT comb sign) supplying focal or diffuse dilated bowel loops (n=11), ascites with slightly increased peritoneal enhancement (n=11), small bowel wall thickening (n=10) with double halo or target sign (n=8). Follow-up CT before high-dose steroid therapy revealed complete or marked resolution of the abnormal CT findings. Conclusion: CT is helpful for confirming the diagnosis of LMV, especially the comb sign which may be an early sign. Bowel ischemia due to LMV is less ominous than previously expected, and the abnormal CT findings were reversible when early diagnosis and prompt i.v. steroid therapy could be achieved. (orig.).

  7. Importance of vascular morphology for selective coeliae and mesenteric angiography

    Energy Technology Data Exchange (ETDEWEB)

    Glueck, E.; Gerhardt, P.; Schroeder, J.

    1983-06-01

    By means of 192 lateral aortograms the vascular morphology of the coeliac and superior mesenteric artery were correlated to age, sex and body weight. Independently of these parameters 90% of the exit angles of the coeliac artery were situated between 15/sup 0/ and 90/sup 0/ degrees with a median of 45/sup 0/. In persons with less than 65 kg body weight the median origin angle of the superior mesenteric artery corresponded to 45/sup 0/, too, whereas in heavier patients they were bigger (60/sup 0/). The vascular diameter and the further course of the superior mesenteric artery significantly depended on the constitutional type. In 40.5% we saw a cranial eccentric stenosis of the coeliac artery. Frequency and intensity were not influenced by age, sex or body weight, but accompanied by smaller origin angles of the coeliac artery and bigger ones of the superior mesenteric artery. In conclusion different catheter shapes in dependence of the constitutional type are recommended for combined coeliac and mesenteric angiography.

  8. Leiomyosarcoma of the renal vein

    Directory of Open Access Journals (Sweden)

    Lemos Gustavo C.

    2003-01-01

    Full Text Available Leiomyosarcoma of the renal vein is a rare tumor of complex diagnosis. We presented a case of renal vein leiomyosarcoma detected in a routine study. The primary treatment was complete surgical removal of the mass. In cases where surgical removal is not possible the prognosis is poor, with high rates of local recurrence and distant spread.

  9. Chronic dissection of the superior mesenteric artery: case report

    International Nuclear Information System (INIS)

    Common, A.A.; Pressacco, J.

    1999-01-01

    Acute dissection of the thoracic aorta is a well-recognized, often fatal condition that frequently extends to involve the abdominal aorta and iliac vessels. The ostia of the renal and mesenteric vessels may be compromised, and the resulting visceral ischemia may necessitate surgical intervention. However, visceral perfusion may be restored if blood flow from true to false lumen is re-established or if the false lumen is obliterated, either spontaneously or by surgical or interventional techniques. Isolated dissections of mesenteric, renal, and carotid vessels are rarely reported. These may be spontaneous, related to high blood pressure and underlying disease of the vessel wall, or caused by abdominal trauma or medical intervention, including angiographic procedures. They are usually associated with pain and other signs and symptoms of ischemia in the appropriate territory. We present a case of chronic superior mesenteric artery (SMA) dissection, an incidental angiographic finding, in an asymptomatic patient being evaluated for resection of an abdominal aortic aneurysm (AAA). (author)

  10. Chronic dissection of the superior mesenteric artery: case report

    Energy Technology Data Exchange (ETDEWEB)

    Common, A.A.; Pressacco, J. [Univ. of Toronto, St. Michael' s Hospital, Dept. of Medical Imaging, Toronto, Ontario (Canada)

    1999-02-01

    Acute dissection of the thoracic aorta is a well-recognized, often fatal condition that frequently extends to involve the abdominal aorta and iliac vessels. The ostia of the renal and mesenteric vessels may be compromised, and the resulting visceral ischemia may necessitate surgical intervention. However, visceral perfusion may be restored if blood flow from true to false lumen is re-established or if the false lumen is obliterated, either spontaneously or by surgical or interventional techniques. Isolated dissections of mesenteric, renal, and carotid vessels are rarely reported. These may be spontaneous, related to high blood pressure and underlying disease of the vessel wall, or caused by abdominal trauma or medical intervention, including angiographic procedures. They are usually associated with pain and other signs and symptoms of ischemia in the appropriate territory. We present a case of chronic superior mesenteric artery (SMA) dissection, an incidental angiographic finding, in an asymptomatic patient being evaluated for resection of an abdominal aortic aneurysm (AAA). (author)

  11. Percutaneous Mechanical Thrombectomy Treatment of Acute Superior Mesenteric Artery Embolism

    Directory of Open Access Journals (Sweden)

    Z. Zhang

    Full Text Available : Objective/Background: This report presents a superior mesenteric artery (SMA embolism managed by percutaneous mechanical thrombectomy (PMT. Methods: A 61 year old woman diagnosed with SMA embolism was admitted. Emboli were found in the middle and distal segments of the SMA on abdominal computed tomography angiography. Under local anaesthesia, a 6 F Rotarex system was used to remove the emboli via left brachial artery access. Emboli were successfully removed and patency was restored to the SMA and its branches. Results: Post-operatively, the patient's symptoms were significantly relieved. No post-operative complications were observed and no discomfort was documented during follow-up. Conclusion: Endovascular treatment of SMA embolism using PMT is a feasible and alternative option. Keywords: Acute mesenteric ischaemia, Embolism, Endovascular treatment, Percutaneous mechanical thrombectomy, Superior mesenteric artery

  12. Vein type uranium deposits

    International Nuclear Information System (INIS)

    1986-01-01

    Veins are tabular- or sheet-like masses of minerals occupying or following a fracture or a set of fractures in the enclosing rock. They have been formed later than the country rock and fractures, either by filling of the open spaces or by partial or complete replacement of the adjoining rock or most commonly by both of these processes combined. This volume begins with the occurrences and deposits known from old shield areas and the sedimentary belts surrounding them. They are followed by papers describing the European deposits mostly of Variscan age, and by similar deposits known from China being of Jurassic age. The volume is completed by two papers which do not fit exactly in the given scheme. A separate abstract was prepared for each of the 25 papers in this report

  13. Liver Abscess and Portal Vein Thrombosis Due to Ileal Diverticulitis Mediated by Barium Fluoroscopy.

    Science.gov (United States)

    Kubo, Haremaru; Asai, Genki; Haraguchi, Kou; Shibahara, Yu; Kihara, Toshihiro; Yamakawa, Genta; Kira, Fumitaka; Higashi, Hisato; Morishita, Shinji; Fujie, Hajime; Matsumoto, Masao; Shimura, Wahei

    2017-12-01

    We report a case of liver abscess and portal vein thrombosis, which occurred due to diverticulitis at the terminal ileum in a 59-year-old man. The patient underwent a barium fluoroscopic examination 1 month before presenting to our hospital. He also showed liver dysfunction due to thrombosis at the superior mesenteric and portal veins. His inflammation gradually subsided after the initiation of treatment, but the recovery was not sufficient. Thus, surgery was performed. The patient condition improved after surgery and he was discharged. Barium examinations are relatively safe, but can sometimes cause severe adverse effects in patients with certain risk factors, and an appropriate diagnosis and treatment are necessary when symptoms appear.

  14. Acute and chronic mesenteric ischemia: Multidetector CT and CT angiographic findings

    Directory of Open Access Journals (Sweden)

    Mohamed A. Amin

    2014-12-01

    Conclusion: MDCT and CTA are fast, safe, accurate and non-invasive imaging modalities of choice in patients with suspected mesenteric ischemia which are able to evaluate not only mesenteric vascular structures but also evaluate bowel wall changes and adjacent mesentery, thus detecting the primary cause of mesenteric ischemia that can lead to earlier diagnosis and intervention.

  15. Celiac artery thrombosis and superior mesenteric artery stenosis

    Directory of Open Access Journals (Sweden)

    Mohit Sharma

    2016-01-01

    Full Text Available Acute thrombosis of the celiac artery trunk or elsewhere in mesenteric blood supply is a rare cause of acute abdominal pain. Celiac artery thrombosis carries high mortality and morbidity rates if the diagnosis and treatment are delayed. It is frequently associated with other cardiovascular events. The most common etiology is atherosclerosis. The main goal of the treatment is to revascularize and start the diminished or stopped mesenteric blood flow and to avoid end-organ ischemia. Thrombolysis with urokinase followed by anticoagulation with heparin in an emergency situation can save the life of the patient before surgical intervention.

  16. Superior Mesenteric Artery Syndrome in a Patient with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Adi Neuman

    2014-01-01

    Full Text Available Superior mesenteric artery syndrome involves compression of the third part of the duodenum due to narrowing of the area between the aorta and the superior mesenteric artery (SMA. We will describe the case of a 34-year-old with cerebral palsy who presented with abdominal pain, nausea, vomiting, and weight loss and was diagnosed with SMA syndrome via CT-imaging. With failure of conservative measures, our patient underwent a duodenojejunostomy after which improvement in her weight as well as relief of her abdominal symptoms was noted. Given the rarity of this syndrome, physicians need to keep a high index of suspicion in order to prevent the damaging consequences.

  17. The occurrence of a pseudoaneurysm of the hepatic artery within the thrombosed portal vein of a patient with chronic pancreatitis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Soo; Jang, Kyung Mi; Kim, Min Jeong; Yoon, Hoi Soo; Lee, Hyun; Jeon, Eui Yong; Lee, Kwan Seop; Lee, Yul [College of Medicine, Hallym University, Anyang (Korea, Republic of)

    2008-04-15

    A pseudoaneurysm is an uncommon but important life threatening complication of chronic pancreatitis. The arteries most commonly affected by a pseudoaneurysm are (in decreasing percent occurrence), the splenic (40%), gastroduodenal (30%), pancreaticoduodenal (20%), gastric (5%), hepatic (2%), and others (superior mesenteric, jejunal, ileocecal, and aorta) (1-3%). Thrombosis of the splenic or portal vein is another important complication of chronic pancreatitis. In this case report, we present a rare complication in the form of a right hepatic artery pseudoaneurysm which developed within the thrombosed right portal vein of a 35-year-old woman afflicted with chronic pancreatitis.

  18. The occurrence of a pseudoaneurysm of the hepatic artery within the thrombosed portal vein of a patient with chronic pancreatitis: a case report

    International Nuclear Information System (INIS)

    Kim, Eun Soo; Jang, Kyung Mi; Kim, Min Jeong; Yoon, Hoi Soo; Lee, Hyun; Jeon, Eui Yong; Lee, Kwan Seop; Lee, Yul

    2008-01-01

    A pseudoaneurysm is an uncommon but important life threatening complication of chronic pancreatitis. The arteries most commonly affected by a pseudoaneurysm are (in decreasing percent occurrence), the splenic (40%), gastroduodenal (30%), pancreaticoduodenal (20%), gastric (5%), hepatic (2%), and others (superior mesenteric, jejunal, ileocecal, and aorta) (1-3%). Thrombosis of the splenic or portal vein is another important complication of chronic pancreatitis. In this case report, we present a rare complication in the form of a right hepatic artery pseudoaneurysm which developed within the thrombosed right portal vein of a 35-year-old woman afflicted with chronic pancreatitis

  19. Deep Cerebral Vein Thrombosis: A Clinical Masquerader.

    Science.gov (United States)

    Kumar, Prabhat; Sasmal, Gargi; Mahto, Subodh Kumar; Gupta, Shreya; Gupta, Harish

    2017-04-01

    Cerebral Vein Thrombosis (CVT) is an uncommon cause of stroke. Thrombosis can occur in superficial veins, deep venous system or cortical veins of brain. The term Deep Cerebral Vein Thrombosis (DCVT) is used for thrombosis of internal cerebral vein, vein of Galen and basal vein of Rosenthal. Only 10% cases of CVT are because of thrombosis of deep cerebral vein. The diagnosis of DCVT is often missed because of its heterogenous presentation. Herein, we present a case of DCVT which was initially treated as meningoencephalitis. A timely advised brain imaging helped in making the diagnosis and patient recovered completely after institution of anticoagulation.

  20. Superficial vein thrombosis and deep vein thrombosis – a comparison

    OpenAIRE

    Krasiński, Zbigniew; Aniukiewicz, Krzysztof; Krasińska, Aleksandra; Krasińska, Beata; Gabriel, Marcin

    2017-01-01

    Although superficial vein thrombosis is commonly considered a rather minor condition, a number of studies indicate that its consequences can be much more severe. Since the introduction of Doppler ultrasonography to common diagnosis of venous diseases, the approach to threats associated with superficial vein thrombosis has changed, mainly in the context of venous thromboembolism. Superficial thrombosis in varicose veins must be differentiated from that occurring in patients without...

  1. Varicose Vein Treatment (Endovenous Ablation of Varicose Veins)

    Science.gov (United States)

    ... surgery. Most of the veins treated are effectively invisible even to ultrasound 12 months after the procedure. ... understanding of the possible charges you will incur. Web page review process: This Web page is reviewed ...

  2. Vein matching using artificial neural network in vein authentication systems

    Science.gov (United States)

    Noori Hoshyar, Azadeh; Sulaiman, Riza

    2011-10-01

    Personal identification technology as security systems is developing rapidly. Traditional authentication modes like key; password; card are not safe enough because they could be stolen or easily forgotten. Biometric as developed technology has been applied to a wide range of systems. According to different researchers, vein biometric is a good candidate among other biometric traits such as fingerprint, hand geometry, voice, DNA and etc for authentication systems. Vein authentication systems can be designed by different methodologies. All the methodologies consist of matching stage which is too important for final verification of the system. Neural Network is an effective methodology for matching and recognizing individuals in authentication systems. Therefore, this paper explains and implements the Neural Network methodology for finger vein authentication system. Neural Network is trained in Matlab to match the vein features of authentication system. The Network simulation shows the quality of matching as 95% which is a good performance for authentication system matching.

  3. Acute partial Budd-Chiari syndrome and portal vein thrombosis in cytomegalovirus primary infection: a case report

    Directory of Open Access Journals (Sweden)

    Morard Isabelle

    2006-03-01

    Full Text Available Abstract Background Splanchnic vein thrombosis may complicate inherited thrombotic disorders. Acute cytomegalovirus infection is a rare cause of acquired venous thrombosis in the portal or mesenteric territory, but has never been described extending into a main hepatic vein. Case presentation A 36-year-old immunocompetent woman presented with acute primary cytomegalovirus infection in association with extensive thrombosis in the portal and splenic vein. In addition, a fresh thrombus was evident in the right hepatic vein. A thorough evaluation for a hypercoagulable state was negative. The clinical course, biological evolution, radiological and histological findings were consistent with cytomegalovirus hepatitis complicated by a partial acute Budd-Chiari syndrome and portal thrombosis. Therapeutic anticoagulation was associated with a slow clinical improvement and partial vascular recanalization. Conclusion We described in details a new association between cytomegalovirus infection and acute venous thrombosis both in the portal vein and in the right hepatic vein, realizing a partial Budd-Chiari syndrome. One should be aware that this rare thrombotic event may be complicated by partial venous outflow block.

  4. Giant Splenorenal Shunt in a Young Patient with Autoimmune Hepatitis/Primary Biliary Cholangitis Overlap Syndrome and Portal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    F. Chegai

    2017-01-01

    Full Text Available We present a case of giant Splenorenal Shunt (SRS associated with portal vein thrombosis in a 37-year-old woman with a twelve-year history of autoimmune hepatitis/primary biliary cholangitis overlap syndrome. At the moment of the CT examination laboratory tests showed creatinine 1.5 mg/dl, bilirubin 1.5 mg/dl, INR 3, and Na 145 mmol/l and the Model End-Stage Liver Disease score was 24. Extensive calcified thrombosis causing complete occlusion of the portal vein lumen and partially occluding the origin of the superior mesenteric vein was present and a small calcified thrombus in the Splenic Vein lumen was also evident. SRS was located among the spleen hilum and the left kidney with a maximum diameter of 3.25 cm and was associated with dilatation of left renal vein and inferior vena cava. After a multidisciplinary evaluation the patient was put on the Regional Liver Transplant waiting list and liver transplantation was performed successfully. Although portal vein thrombosis and SRS are common occurrences in cirrhotic patients, the impact in the natural history of the disease is still unclear. Careful management and accurate imaging protocols are essential in the evaluation of those patients.

  5. Endovascular Treatment of Totally Occluded Superior Mesenteric Artery by Retrograde Crossing via the Villemin Arcade

    Energy Technology Data Exchange (ETDEWEB)

    Ferro, Carlo; Rossi, Umberto G., E-mail: urossi76@hotmail.com; Seitun, Sara; Bovio, Giulio [IRCCS San Martino University Hospital-IST-National Institute for Cancer Research, Department of Radiology and Interventional Radiology (Italy); Fornaro, Rosario [IRCCS San Martino University Hospital-IST-National Institute for Cancer Research, Department of Surgery (Italy)

    2013-06-15

    Chronic mesenteric ischemia (CMI) is a rare disorder that is commonly caused by progressive atherosclerotic stenosis or occlusion of one or more mesenteric arteries. Endovascular treatment for symptomatic CMI represents a viable option, especially in high-operative risk patients. We report a case of acute symptomatic CMI with chronic totally occlusion of the superior mesenteric artery (SMA) associated with significant stenosis of celiac trunk (CT) and inferior mesenteric artery (IMA) that underwent endovascular treatment of all the three mesenteric arteries: stenting of CT and IMA stenosis, and recanalization of the SMA occlusion by retrograde crossing via the Villemin arcade.

  6. Endovascular Treatment of Totally Occluded Superior Mesenteric Artery by Retrograde Crossing via the Villemin Arcade

    International Nuclear Information System (INIS)

    Ferro, Carlo; Rossi, Umberto G.; Seitun, Sara; Bovio, Giulio; Fornaro, Rosario

    2013-01-01

    Chronic mesenteric ischemia (CMI) is a rare disorder that is commonly caused by progressive atherosclerotic stenosis or occlusion of one or more mesenteric arteries. Endovascular treatment for symptomatic CMI represents a viable option, especially in high-operative risk patients. We report a case of acute symptomatic CMI with chronic totally occlusion of the superior mesenteric artery (SMA) associated with significant stenosis of celiac trunk (CT) and inferior mesenteric artery (IMA) that underwent endovascular treatment of all the three mesenteric arteries: stenting of CT and IMA stenosis, and recanalization of the SMA occlusion by retrograde crossing via the Villemin arcade.

  7. Functional Testing in the Diagnosis of Chronic Mesenteric Ischemia

    NARCIS (Netherlands)

    J. Harki (Jihan); E.T.T.L. Tjwa (Eric); D. van Noord (Désirée)

    2014-01-01

    textabstractChronic mesenteric ischemia (CMI) is a diagnostic challenge. There is no single, simple test with high sensitivity and specificity to diagnose or exclude this condition. In the previous years, functional tests such as tonometry and visible light spectroscopy (VLS) have been developed and

  8. Endovascular Treatment of Chronic Mesenteric Ischemia: Results in 14 Patients

    International Nuclear Information System (INIS)

    Chahid, Tamam; Alfidja, Agaicha T.; Biard, Marie; Ravel, Anne; Garcier, Jean Marc; Boyer, L.

    2004-01-01

    We evaluated immediate and long-term results of percutaneous transluminal angioplasty (PTA) and stent placement to treat stenotic and occluded arteries in patients with chronic mesenteric ischemia. Fourteen patients were treated by 3 exclusive celiac artery (CA) PTAs (2 stentings), 3 cases with both Superior Mesenteric Artery (SMA) and CA angioplasties, and 8 exclusive SMA angioplasties (3 stentings). Eleven patients had atheromatous stenoses with one case of an early onset atheroma in an HIV patient with antiphospholipid syndrome. The other etiologies of mesenteric arterial lesions were Takayashu arteritis (2 cases) and a postradiation stenoses (1 case). Technical success was achieved in all cases. Two major complications were observed: one hematoma and one false aneurysm occurring at the brachial puncture site (14.3%). An immediate clinical success was obtained in all patients. During a follow-up of 1-83 months (mean: 29 months), 11 patients were symptom free; 3 patients had recurrent pain; in one patient with inflammatory syndrome, pain relief was obtained with medical treatment; in 2 patients abdominal pain was due to restenosis 36 and 6 months after PTA, respectively. Restenosis was treated by PTA (postirradiation stenosis), and by surgical bypass (atheromatous stenosis). Percutaneous endovascular techniques are safe and accurate. They are an alternative to surgery in patients with chronic mesenteric ischemia due to short and proximal occlusive lesions of SMA and CA

  9. A Rare Case of Mesenteric Gastrointestinal Stromal Tumor ...

    African Journals Online (AJOL)

    regions. Abdominal ultrasound showed 18 cm × 15 cm mass with solid and cystic components arising from small bowel mesentery with loops of bowel adherent to it. A clinical diagnosis of mesenteric cyst with small bowel obstruction was made. Emergency laparotomy done for acute abdomen showed a huge mass of.

  10. Obstructive mesenteric cyst is not always the cause of obstruction

    NARCIS (Netherlands)

    Rassouli-Kirchmeier, R.; Hulscher, J. B. F.; de Langen, Z. J.

    2008-01-01

    Background: In newborns presenting with clinical signs of obstruction of the small bowel, atresia of the small bowel as well as mesenteric cyst can be one of the differential diagnoses. Whereas clinically these two different diagnoses cannot be distinguished from each other, the operative therapy is

  11. Isolated Mesenteric Vascular Injury Due to Seatbelt Trauma ...

    African Journals Online (AJOL)

    Mesenteric vascular injuries following blunt abdominal trauma are uncommon and diffi cult to diagnose. A 33-year old restrained front seat passenger presented with chest and abdominal pain following a head-on collision. Initial evaluation was unremarkable except for diagonal chest and transverse lap seatbelt marks.

  12. CHRONIC MESENTERIC ISCHEMIA - DIAGNOSTIC CHALLENGES AND TREATMENT OPTIONS

    NARCIS (Netherlands)

    HOOGENBERG, K; VANESSEN, LH; VANDENDUNGEN, JJAM; LIMBURG, AJ; BOEVE, WJ; KLEIBEUKER, JH

    Objectives. A description of the clinical presentation, diagnostic procedure and mode of therapy in three patients suffering from chronic mesenteric ischaemia. Design and interventions. In all cases, the diagnosis was made on the basis of abdominal complaints in combination with angiographic

  13. Commentary: Mesenteric ischemia, high altitude and Hill's criteria ...

    African Journals Online (AJOL)

    Commentary: Mesenteric ischemia, high altitude and Hill's criteria. R Sanda. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's ...

  14. A Rare Case of Mesenteric Gastrointestinal Stromal Tumor ...

    African Journals Online (AJOL)

    Gastrointestinal stromal tumours (GIST) are rare tumours arising from mesenchyme of gastrointestinal tract and overexpress C-kit protein. Mainly seen in stomach and small bowel. Mesenteric GIST are rarely reported as they constitute less than 1% of total GIST. We here report such a rare case of GIST arising from ...

  15. A Simple Technique for Safe Mesenteric Defect Closure Following ...

    African Journals Online (AJOL)

    mesentery, inadvertent ligation of blood vessels and/or mesenteric hematoma formation and could, therefore, compromise the blood supply to the bowel anastomosis and lead to anastomotic dehiscence.[6,7] Here we propose a simple technique, applicable to both open and laparoscopy-assisted colectomies, that enables ...

  16. Mesenteric ischemia: Results of surgical treatment and a review of ...

    African Journals Online (AJOL)

    Background: Acute Mesenteric Ischemia (AMI) is one of the causes of acute abdomen which occurs because of significant decrement in bowel perfusion. Mortality rates of 60 to 100 percent have been reported in different studies in relation to this fatal disease(1, 5, ,11, 16,18,28). In this study, we review clinical features, ...

  17. Acute occlusive mesenteric ischemia in high altitude of ...

    African Journals Online (AJOL)

    Background and Objectives: Mesenteric ischemia which can be acute or chronic depending on the rapidity of compromised blood flow produces bowel ischemia, infarction, bacterial transmigration, endotoxemia, multisystem organ failure and death. High altitude can precipitate thrombosis because of hypobaric hypoxia and ...

  18. A Rare Case of Mesenteric Gastrointestinal Stromal Tumor ...

    African Journals Online (AJOL)

    We here report such a rare case of GIST arising from mesentery of small bowel and presenting as acute abdomen. Good surgical clearance ensures good survival whereas incomplete resection results in a high incidence of recurrences with distant metastasis. Keywords: Gastrointestinal stromal tumors, imatinib, mesenteric ...

  19. Superior Mesenteric Artery Syndrome: An Uncommon Cause of ...

    African Journals Online (AJOL)

    19, Anupam Society, Jetalpur Road,. Vadodara ‑ 390 007, Gujarat, India. E‑mail: digishdr@gmail.com. Introduction. Superior mesenteric artery (SMA) syndrome was first described in 1861 by Von Rokitansky but remained an unknown entity until 1927 when Wilkie published the first comprehensive series of 75 patients.

  20. The Role of Phosphoramidon on the Biological Activity of Big Endothelin-1 in the Rat Mesenteric Microcirculation in Vivo

    International Nuclear Information System (INIS)

    Abdelhalim, Mohamed A K

    2008-01-01

    The goal of the present study was to clarify the role of metalloprotease inhibitor phosphoramidon on the effects induced by big endothelin-1 (big ET-1) in the rat mesenteric microcirculation in vivo, through investigating the systemic blood pressure, diameter and blood flow velocity of arterioles and venules of the rat mesentery. For this purpose, the rat mesentery was arranged for in situ intravital microscopic observation under transillumination and separate cumulative injections of big ET-1 and phosphoramidon were infused into the right jugular vein, respectively. In these experiments twenty-five rats (Charles River, 130 - 140 g) were used. The experiments were divided into two groups. In the first group of experiments, cumulative injections of big ET-1 (1000-8000 pmole/kg) were infused through a catheter inserted into the right jugular vein. Each dose of big ET-1 was infused 25 min prior to the infusion of the following dose. Infusion of big ET-1 (1000-8000 pmole/kg) elicited a long-lasting pressor effect. The infusion of low doses of big ET-1 (1000-2000 pmole/kg) elicited a significant (p < 0.05) dose-dependent increase in the microvascular blood flow velocity both in arterioles (20 - 30 ?m) and venules (30 - 50 ?m), and diameters of arterioles and venules exhibited a slight not significant vasodilator effect. The infusion of high doses of big ET-1 (4000-8000 pmole/kg) elicited significant dose-dependant decrease in the blood flow velocity of arterioles and venules, and diameters returned to the control runs. This may be attributed to the gradual conversion of big ET-1 to ET-1, and ET-1 is a potent vasoconstrictor. In the second group of experiments, cumulative injections of phosphoramidon (30 mg/kg /10 min) were administered 10 min prior to the infusion of big ET-1. These findings suggested that phosphoramidon significantly suppressed long-lasting pressor effect, dose-dependent increase, dose-dependent decrease and slow vasodilator effect produced by big ET-1

  1. Mesenteric artery contraction and relaxation studies using automated wire myography.

    Science.gov (United States)

    Bridges, Lakeesha E; Williams, Cicely L; Pointer, Mildred A; Awumey, Emmanuel M

    2011-09-22

    Proximal resistance vessels, such as the mesenteric arteries, contribute substantially to the peripheral resistance. These small vessels of between 100-400 μm in diameter function primarily in directing blood flow to various organs according to the overall requirements of the body. The rat mesenteric artery has a diameter greater than 100 μm. The myography technique, first described by Mulvay and Halpern(1), was based on the method proposed by Bevan and Osher(2). The technique provides information about small vessels under isometric conditions, where substantial shortening of the muscle preparation is prevented. Since force production and sensitivity of vessels to different agonists is dependent on the extent of stretch, according to active tension-length relation, it is essential to conduct contraction studies under isometric conditions to prevent compliance of the mounting wires. Stainless steel wires are preferred to tungsten wires because of oxidation of the latter, which affects recorded responses(3).The technique allows for the comparison of agonist-induced contractions of mounted vessels to obtain evidence for normal function of vascular smooth muscle cell receptors. We have shown in several studies that isolated mesenteric arteries that are contracted with phenylyephrine relax upon addition of cumulative concentrations of extracellular calcium (Ca(2+)(e;)). The findings led us to conclude that perivascular sensory nerves, which express the G protein-coupled Ca(2+)-sensing receptor (CaR), mediate this vasorelaxation response. Using an automated wire myography method, we show here that mesenteric arteries from Wistar, Dahl salt-sensitive(DS) and Dahl salt-resistant (DR) rats respond differently to Ca(2+)(e;). Tissues from Wistar rats showed higher Ca(2+)-sensitivity compared to those from DR and DS. Reduced CaR expression in mesenteric arteries from DS rats correlates with reduced Ca(2+)(e;)-induced relaxation of isolated, pre-contracted arteries. The data

  2. A Vein Map Biometric System

    Directory of Open Access Journals (Sweden)

    Felix Fuentes

    2013-08-01

    Full Text Available There is increasing demand world-wide, from government agencies and the private sector for cutting-edge biometric security technology that is difficult to breach but userfriendly at the same time. Some of the older tools, such as fingerprint, retina and iris scanning, and facial recognition software have all been found to have flaws and often viewed negatively because of many cultural and hygienic issues associated with them. Comparatively, mapping veins as a human barcode, a new technology, has many advantages over older technologies. Specifically, reproducing a three-dimensional model of a human vein system is impossible to replicate. Vein map technology is distinctive because of its state-of-the-art sensors are only able to recognize vein patterns if hemoglobin is actively flowing through the person

  3. [Management of superficial vein thrombosis].

    Science.gov (United States)

    Frappé, Paul; Bertoletti, Laurent; Moulin, Nathalie; Décousus, Hervé

    2015-02-01

    Recent epidemiological studies have highlighted the potential severity of superficial vein thrombosis of the lower limbs (SVT). Diagnosis is based on clinical and Doppler ultrasonography evaluation, and define its therapeutic management. If SVT is associated with objectively confirmed deep vein thrombosis or pulmonary embolism, curative anticoagulation is indicated. If SVT is isolated and measured over 5 cm long, prophylactic dosage of fondaparinux may be provided for 45 days.

  4. Comparative analysis of pulsed doppler ultrasonography of portal vein vs indirect photography

    International Nuclear Information System (INIS)

    Chang, Jae Chun; Kwon, Huck Po; Hwang, Mi Soo; Kim, Sun Youn; Park, Bok Hwan; Lee, Hyun Ju; Kim, Hong Jin

    1990-01-01

    There are some limitation of interpretation in indirect photography via superior mesenteric artery. In order to supplement and predict indirect photography, we compared indirect photographic findings with pulsed doppler flowmetry in 38 hepatobiliary patients, and the results were as follow: 1. In case of normal main portal vein(MPV) filling, Pulsed Doppler always showed antegrade, continuous parabolic wave form and cases of abnormal MPV filling, showed unusual wave form and flow direction. 2. In normal filling case of proximal right portal vein, Pulsed Doppler almost showed normal continuous parabolic wave form but in normal filling cases of proximal left portal vein, occasionally showed undulating wave form. 3. In each side proximal portal vein abnormal filling case, we could observe abnormal doppler wave form and could obtain additional information using doppler wave form. 4. Mean portal flow velocity was significantly increased in higher photography grade(p=0.01) and congestion index was significantly decreased in higher photography grade(p=0.01). 5. We concluded that doppler ultrasonography could supplement incomplete indirect photography

  5. Locating difficult veins for venepuncture and cannulation.

    Science.gov (United States)

    Shaw, Sally Jane

    2017-02-15

    Vein location and assessment are essential to improve the success rates for vascular access. However, problems remain with first attempt success rates for peripheral cannulation and locating difficult veins. Practitioners may not be aware of developments in technology and aids to assist in the location and assessment of veins to achieve vascular access. This article provides an overview of two vein location aids that can be used to locate difficult veins: the IV-eye vein imager and the Vacuderm tourniquet. It discusses the patient factors that can increase the difficulty of vein assessment and location, and emphasises the importance of vessel health and preservation, and vein palpation. Practitioners should be experienced and skilled in the assessment of veins, and they are encouraged to revisit how they locate and assess veins.

  6. ROLE OF ULTRASONOGRAPHY, CONVENTIONAL ANGIOGRAPHY, CT AND CT ANGIOGRAPHY IN ASSESSMENT OF MESENTERIC ISCHAEMIA

    Directory of Open Access Journals (Sweden)

    Reena

    2016-05-01

    Full Text Available AIM The aim of the study was to evaluate efficacy, sensitivity, specificity of ultrasonography, conventional angiography, CT Angiography in mesenteric ischaemia. MATERIALS AND METHODS Prospective study was performed. 35 patients with clinically suspected mesenteric ischaemia were included in the study. The study was conducted from month of November 2013 to August 2015. The patients age ranged from 35 to 70 years (Mean age was 57±11.2 years. All cases met the criteria of acute nontraumatic or chronic abdominal pain and suspected mesenteric vascular ischaemia. All 35 cases were evaluated in surgery department, then underwent USG, conventional angiography, CTA. Out of 20 patients, 2 patients were inconclusive and 4 patients had other findings of abdominal pain. USG and CT angiographic findings were correlated with surgical findings in acute mesenteric ischaemia (AMI cases & conventional angiography in chronic mesenteric ischaemia (CMI cases. RESULT Ultrasonography has lower sensitivity and high specificity. Conventional angiography has moderate sensitivity and high specificity. CT angiography is highly sensitive and specific in detecting mesenteric ischaemia. CONCLUSION Conventional angiography is considered as the gold standard test for patients with acute and chronic mesenteric ischaemia except for hemodynamically unstable patients with acute mesenteric ischaemia. CTA is an emerging diagnostic test with high sensitivity and specificity in the setting of both acute and chronic mesenteric ischaemia and should be considered the first-line imaging test. CT can also accurately assess for other causes of acute and chronic abdominal pain, and it provides excellent anatomic mapping of the mesenteric vasculature, which is essential in the preoperative planning. US of the abdomen with Doppler waveform analysis can depict proximal mesenteric thrombosis and secondary signs of bowel compromise, but it is limited in the diagnosis of distal occlusions

  7. Commercialization of vein contrast enhancement

    Science.gov (United States)

    Lovhoiden, Gunnar; Deshmukh, Harshal; Vrancken, Carlos; Zhang, Yong; Zeman, Herbert D.; Weinberg, Devin

    2003-07-01

    An ongoing clinical study of an experimental infrared (IR) device, the Vein Contrast Enhancer (VCE) that visualizes surface veins for medical access, indicates that a commercial device with the performance of the existing VCE would have significant clinical utility for even a very skilled phlebotomist. A proof-of-principle prototype VCE device has now been designed and constructed that captures IR images of surface veins with a commercial CCD camera, transfers the images to a PC for real-time software image processing to enhance the vein contrast, and projects the enhanced images back onto the skin with a modified commercial LCD projector. The camera and projector are mounted on precision slides allowing for precise mechanical alignment of the two optical axes and for measuring the effects of axes misalignment. Precision alignment of the captured and projected images over the entire field-of-view is accomplished electronically by software adjustments of the translation, scaling, and rotation of the enhanced images before they are projected back onto the skin. This proof-of-principle prototype will be clinically tested and the experience gained will lead to the development of a commercial device, OnTarget!, that is compact, easy to use, and will visualize accessible veins in almost all subjects needing venipuncture.

  8. Clonal populations of hematopoietic cells with paroxysmal nocturnal hemoglobinuria phenotype in patients with splanchnic vein thrombosis.

    Science.gov (United States)

    Ageno, Walter; Dentali, Francesco; De Stefano, Valerio; Barco, Stefano; Lerede, Teresa; Bazzan, Mario; Piana, Antonietta; Santoro, Rita; Duce, Rita; Poli, Daniela; Martinelli, Ida; Siragusa, Sergio; Barillari, Giovanni; Cattaneo, Marco; Vidili, Gianpaolo; Carpenedo, Monica; Rancan, Elena; Giaretta, Ilaria; Tosetto, Alberto

    2014-06-01

    Splanchnic vein thrombosis (SVT) is a serious complication in patients with paroxysmal nocturnal hemoglobinuria (PNH). Mutant PNH clones can be associated with an increased risk of SVT even in the absence of overt disease, but their prevalence in non-selected SVT patients remains unknown. Patients with objective diagnosis of SVT and without known PNH were tested for the presence of PNH clone using high-sensitivity flow cytometric analysis. A total of 202 SVT patients were eligible, 58.4% were males, mean age was 54.6years (range 17-94), site of thrombosis was portal in 103 patients, mesenteric in 67, splenic in 37, and supra-hepatic in 10. SVT was associated with JAK2 V6167F in 28 of 126 (22.2%) screened patients, liver cirrhosis in 15.3% patients, recent surgery in 10.9%, and myeloproliferative neoplasm in 10.6%, whereas in 34.6% of patients neither permanent nor transient risk factors were detected. None of the patients had a clearly demonstrable PNH clone, but in two patients (0.99%, 95% CI 0.17-3.91) we observed very small PNH clones (size 0.014% and 0.16%) confirmed in two independent samples. One patient had portal vein thrombosis and no associated risk factors, the second had superior mesenteric vein thrombosis and inflammatory bowel disease. Very small PNH clones can be detected in patients with SVT and no clinical manifestations of disease. Future studies are needed to explore the potential role of this finding in the pathogenesis of SVT. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Vortex veins: anatomic investigations on human eyes.

    Science.gov (United States)

    Kutoglu, Tunc; Yalcin, Bulent; Kocabiyik, Necdet; Ozan, Hasan

    2005-05-01

    The aim of this study was to determine number of ocular vortex veins, their scleral coordinates, and their relationship with nearby extraocular muscles. Sixty intact cadaver orbits having no history of eye or orbital disorders during life were carefully dissected under stereomicroscopic magnification to expose vortex veins and their exit sites from the eyeball. The number of vortex veins per eye varied from four to eight. Eyes having four (35%) or five (30%) vortex veins were observed most frequently. Three eyes (5%) had eight vortex veins. Although the incidence of the vortex veins was variable, there was at least one vein in each quadrant of the sclera. Knowledge of the approximate location of the vortex vein exit sites is very important for surgeons because damage to these veins during eye surgery could produce potential complications, especially choroidal detachment. Copyright 2005 Wiley-Liss, Inc.

  10. Autobuttressing of colorectal anastomoses using a mesenteric flap.

    LENUS (Irish Health Repository)

    Mohan, H M

    2013-12-01

    Anastomotic leakage is a common and dreaded complication of colorectal surgery. Many different approaches have been tried to attempt to reduce leakage and associated morbidity. The concept of reinforcement of an anastomosis by buttressing is well established. Techniques described include using sutures, native omentum, animal or synthetic material. We report a technique for buttressing using a mesenteric flap to envelope the anastomosis. The primary rationale is to reduce clinical sequelae of anastomotic leakage by promoting local containment, as well as providing a scaffold for healing. Using autologous tissue provides a safe, time-efficient and cost-effective buttress without the risks of infection or reaction associated with foreign material. A mesenteric flap is particularly useful in patients in whom omentum is not available due to previous surgery, or to fill the dead space posterior to a low anastomosis within the pelvis.

  11. Superior mesenteric venous thrombosis treated by direct aspiration thrombectomy.

    Science.gov (United States)

    Nakayama, Satoshi; Murashima, Naoya; Isobe, Yoshinori

    2008-01-01

    A 69-year-old man, with hepatits C virus-related liver cirrhosis and hemophilia B, developed massive ascites and watery diarrhea after endoscopic injection sclerotherapy for esophageal varices. A multi detector row computed tomography revealed a superior mesenteric venous thrombus without bowel infarction. It was assumed that the thrombus was caused by transient congestion of the portal system after retrograde propagation of the sclerosant agent, in a condition where anticoagulation proteins, such as proteins C and S, had decreased. Because long systemic thrombolytic therapy was hazardous for the patient with hemorrhagic diathesis due to impaired coagulation, a direct thrombolysis was performed with urokinase followed by aspiration thrombectomy, with cannulation of the portal venous system using a transjugular intrahepatic approach. The patient had no complications in this procedure and subsequently diarrhea and refractory ascites were resolved. Direct thrombectomy via the transjugular intrahepatic route may be a useful therapy for mesenteric venous thrombus in the cirrhotic patient.

  12. A rare cause of recurrent gastrointestinal bleeding: mesenteric hemangioma

    Directory of Open Access Journals (Sweden)

    Zeytunlu Murat

    2009-01-01

    Full Text Available Abstract Lower gastrointestinal hemorrhage accounts for approximately 20% of gastrointestinal hemorrhage. The most common causes of lower gastrointestinal hemorrhage in adults are diverticular disease, inflammatory bowel disease, benign anorectal diseases, intestinal neoplasias, coagulopathies and arterio-venous malformations. Hemangiomas of gastrointestinal tract are rare. Mesenteric hemangiomas are also extremely rare. We present a 25-year-old female who was admitted to the emergency room with recurrent lower gastrointestinal bleeding. An intraluminal bleeding mass inside the small intestinal segment was detected during explorative laparotomy as the cause of the recurrent lower gastrointestinal bleeding. After partial resection of small bowel segment, the histopathologic examination revealed a cavernous hemagioma of mesenteric origin. Although rare, gastrointestinal hemangioma should be thought in differential diagnosis as a cause of recurrent lower gastrointestinal bleeding.

  13. Mesenteric ischaemia after endovascular coiling of ruptured cerebral aneurysms.

    LENUS (Irish Health Repository)

    Kamel, M H

    2012-02-03

    Three patients were referred to a national neurosurgical centre following CT evidence of subarachnoid haemorrhage. The three patients, who were referred from different institutions within a seven week period, were Fisher grade 3 and WFNS Grade I at all times. Angiography showed a PCOM aneurysm in one case, a ruptured Basilar tip aneurysm and an unruptured ACOM aneurysm in another case, and an ACOM aneurysm in the third case. It was decided that the aneurysms were suitable for endovascular coiling. These patients had unremarkable intraoperative catheterizations and coiling but subsequently deteriorated post-operatively due to mesenteric ischaemia. Two patients required colectomy for mesenteric ischaemia, and the third arrested secondary to sepsis from bowel perforation. We discuss the various causes that may explain this association, and we alert the neurosurgical community for this complication which has not been reported before.

  14. Postsurgical segmental mesenteric ischemic thrombosis in a horse

    OpenAIRE

    Martín-Cuervo, María; Gracia, Luis A.; Vieitez, Verónica; Jiménez, Joquin; Durán, Esther; Ezquerra, Luis J.

    2013-01-01

    A 16-year-old, Lusitanian stallion was admitted to the Veterinary Teaching Hospital with a 12-hour history of signs of abdominal pain. Exploratory celiotomy was performed due to an inguinal hernia, and a second celiotomy was performed in response to the abdominal pain. The horse was euthanized and mesenteric venous thrombosis was diagnosed and considered likely due to peritonitis and systemic inflammatory response syndrome (SIRS).

  15. Postsurgical segmental mesenteric ischemic thrombosis in a horse.

    Science.gov (United States)

    Martín-Cuervo, María; Gracia, Luis A; Vieitez, Verónica; Jiménez, Joquin; Durán, Esther; Ezquerra, Luis J

    2013-01-01

    A 16-year-old, Lusitanian stallion was admitted to the Veterinary Teaching Hospital with a 12-hour history of signs of abdominal pain. Exploratory celiotomy was performed due to an inguinal hernia, and a second celiotomy was performed in response to the abdominal pain. The horse was euthanized and mesenteric venous thrombosis was diagnosed and considered likely due to peritonitis and systemic inflammatory response syndrome (SIRS).

  16. Massive superior mesenteric venous aneurysm with portal venous thrombosis.

    Science.gov (United States)

    Starikov, Anna; Bartolotta, Roger J

    2015-01-01

    Portal venous aneurysm is a rare and sometimes dangerous vascular pathology, which can result in thrombosis or rupture. We present the computed tomography, magnetic resonance, and sonographic imaging of a 27-year-old man with superior mesenteric venous aneurysm and subsequent thrombosis following acute pancreatitis. This multimodality imaging approach can prove useful in the evaluation of these rare aneurysms. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Adult necrotizing enterocolitis and non occlusive mesenteric ischemia

    OpenAIRE

    Zachariah, Sanoop Koshy

    2011-01-01

    Adult necrotizing enterocolitis and non occlusive mesenteric ischemia are rare causes of acute abdomen in adults. Accurate preoperative diagnosis is often difficult in these cases. Here, four cases of massive bowel necrosis with varying segments of small and large bowel involvement are described, all of whom underwent surgery. These cases give an opportunity to review the literature on such lethal diseases including non occlusive intestinal necrosis, neonatal necrotizing enterocolitis and adu...

  18. Management of superficial vein thrombosis.

    Science.gov (United States)

    Cosmi, B

    2015-07-01

    Superficial vein thrombosis (SVT) is less well studied than deep vein thrombosis (DVT), because it has been considered to be a minor, self-limiting disease that is easily diagnosed on clinical grounds and that requires only symptomatic relief. The most frequently involved sites of the superficial vein system are the lower limbs, especially the saphenous veins, mostly in relation to varicosities. Lower-limb SVT shares the same risk factors as DVT; it can propagate into the deep veins, and have a complicated course with pulmonary embolism. Clinical diagnosis may not be accurate, and ultrasonography is currently indicated for both confirmation and evaluation of SVT extension. Treatment aims are symptom relief and prevention of venous thromboembolism (VTE) in relation to the thrombotic burden. SVT of the long saphenous vein within 3 cm of the saphenofemoral junction (SFJ) is considered to be equivalent to a DVT, and thus deserving of therapeutic anticoagulation. Less severe forms of lower-limb SVT not involving the SFJ have been included in randomized clinical trials of surgery, compression hosiery, non-steroidal anti-inflammatory drugs, unfractionated heparin, and low molecular weight heparins, with inconclusive results. The largest randomized clinical trial available, on 3004 patients with lower-limb SVT not involving the SFJ, showed that fondaparinux 2.5 mg once daily for 6 weeks is more effective than placebo in reducing the risk of the composite of death from any cause and symptomatic VTE (0.9% versus 5.9%). Further studies are needed to define the optimal management strategies for SVT of the lower limbs and other sites, such as the upper limbs. © 2015 International Society on Thrombosis and Haemostasis.

  19. Acute thrombosis of a mesenteric artery drug-eluting stent following clopidogrel cessation.

    Science.gov (United States)

    Sutphin, Daniel; Stevens, Scott; Kirzeder, Daniel; Gash, Judson

    To describe thrombosis of sirolimus-coated mesenteric arterial stents following cessation of clopidogrel therapy. Cardiac drug-eluting stent thrombosis following cessation of antiplatelet therapy with clopidogrel has been associated with increased mortality. The application of such stents in the mesenteric arterial system and the subsequent need for clopidogrel therapy has not been studied. This is the first case report of acute thrombosis of a drug-coated stent in the mesenteric circulation. Acute mesenteric ischemia secondary to thrombosis of a mesenteric arterial stent following clopidogrel cessation is described. Drug-eluting stents represent an option for mesenteric revascularization in the surgically complicated abdomen. As in the setting of cardiac stenting, acute thrombosis of these devices following cessation of clopidogrel therapy is a concern. Indefinite clopidogrel therapy following deployment of drug-coated stents should be considered.

  20. [Mesenteric ischemia--late diagnosis or managed disease?].

    Science.gov (United States)

    Radonak, J; Lakyová, L; Toporcer, T; Bober, J

    2010-04-01

    Diagnosis and therapy of mesenteric ischaemia as the cause of an acute abdomen is a serious problem because of its 60-80% mortality. The study presents experience with diagnosis and therapy of this disease and it compares its results with those in the literature. Throughout the years 2000-2009, there were 39 patients surgically treated with mesenteric ischaemia (17 men, 21 women, the average age 73 I 9.43). 38.46% of patients underwent resection of small and large bowel, in 33.3% only a part of small intestinum was resected, and in two cases (5.13%), the resection was combined with the embolectomy of artery mesenteric superior. In 23.1% of patients, only an explorative laparatomy was performed, because of an extended affection. Four patients were reoperated (dehiscence of anastomosis, perforation of small bowel, dehiscence of the wound, enterocutaneous fistula). 23% of patients needed ventilation because of postoperative complications such as respiratory insufficiency, sepsis and heart failure. There was 53.8% mortality. The abdominal pain (79%), vomitus (61.5%) and subileus (35.9%) predominated in the clinical picture. Leucocyts were elevated in 58.97% of patients. X ray examination showed non specific findings, and ultrasonography has proven to be successful in 42.3% of cases. Mortality of patients is significantly increased by low success rate of the depictive methods, non-specific clinical picture, co-morbidity in elderly patients and by late arrival to hospital.

  1. Successful Treatment of Isolated Spontaneous Superior Mesenteric Artery Dissection with Stent Placement

    International Nuclear Information System (INIS)

    Yoon, Young-Won; Choi, Donghoon; Cho, Seung-Yun; Lee, Do Yun

    2003-01-01

    Isolated dissection of superior mesenteric artery is a rare condition and is usually treated surgically. We treated a patient with severe abdominal pain who was angiographically confirmed to have superior mesenteric artery thrombosis associated with isolated spontaneous dissection. He was treated initially by thrombolysis and oral anticoagulation, but recurrent symptoms developed with radiologic evidence of disease progression. We performed superior mesenteric artery stenting and recovery was uneventful

  2. Conservative treatment of spontaneous and isolated dissection of mesenteric arteries.

    Science.gov (United States)

    Amabile, Philippe; Ouaïssi, Mehdi; Cohen, Serge; Piquet, Philippe

    2009-01-01

    Isolated and spontaneous dissection of mesenteric arteries is a rare entity; a little more than 50 cases have been reported in medical literature. There is no therapeutic consensus concerning this type of lesion. In this study, we report the results of our treatment based on a conservative approach. This retrospective study concerns eight patients with dissection of the celiac trunk and/or of the upper mesenteric artery (UMA) who were treated between 2002 and 2006. Because these patients were not presenting with acute intestinal ischemia diagnosed by clinical examination or paraclinical tests (medical imaging/biology) or with vital complications, they were treated with an efficient anticoagulation (heparin followed by anti-vitamin K) for 3 to 6 months. Endovascular or surgical treatment was used as the first option in patients with obvious intestinal ischemia or likely to have an arterial rupture, and also when medical treatment had failed. Clinical and radiological follow-up was at 1 month, 3 months, 6 months, and 1 year and then every year. Seven men and one woman (mean age, 48.2; age range, 38-53 years) were treated. Six patients presented with isolated dissection (celiac trunk=4, UMA=2). One patient had a celiac trunk and a UMA dissection and one had a celiac trunk and a UMA dissection along with a dissection of his two renal arteries. On entering the hospital, a patient was operated on for mesenteric ischemia related to a stenosis of the upper mesenteric artery (upper aortomesenteric bypass); a covered stent was implanted in the celiac trunk of another patient presenting with a contained rupture. Both patients were successfully treated. Six patients were medically treated. One of them required an aortohepatic bypass to treat an aneurysmal evolution of the celiac trunk revealed by a computed tomography scan obtained 1 month after the symptoms had begun. In one patient, the dissection remained stable on imaging. Four patients were cured, with a mean 20.1-month

  3. Anticoagulation and delayed bowel resection in the management of mesenteric venous thrombosis.

    Science.gov (United States)

    Kim, Hyung-Kee; Chun, Jae Min; Huh, Seung

    2013-08-14

    Acute mesenteric venous thrombosis is potentially lethal because it can result in mesenteric ischemia and, ultimately, bowel infarction requiring surgical intervention. Systemic anticoagulation for the prevention of thrombus propagation is a well-recognized treatment modality and the current mainstay therapy for patients with acute mesenteric venous thrombosis. However, the decision between prompt surgical exploration vs conservative treatment with anticoagulation is somewhat difficult in patients with suspected bowel ischemia. Here we describe a patient with acute mesenteric venous thrombosis who presented with bowel ischemia and was treated with anticoagulation and delayed short-segment bowel resection.

  4. Preoperative ultrasound mapping of the saphenous vein

    DEFF Research Database (Denmark)

    Levi, Niels; Schroeder, T

    1997-01-01

    A prospective series of 92 patients had their greater saphenous vein assessed with duplex ultrasound scanning prior to planned infrainguinal bypass procedures. Sixteen (17%) bypass procedures thrombosed within the first week postoperatively. A naturally occurring optimal vein diameter was discove...

  5. Phlebectasia of Internal Jugular Vein

    African Journals Online (AJOL)

    Internal jugular phlebectasia (IJP) is a congenital fusiform dilatation of the internal jugular vein that appears as a soft, compressible mass in the neck during straining or is triggered by the Valsalva maneuver. The possible differential diagnosis for the swelling could include a laryngocele, branchial cyst, cystic hygroma, ...

  6. Renal arcuate veins: new microangiogrphic observations

    International Nuclear Information System (INIS)

    Clark, R.L.; Klein, S.

    1983-01-01

    Standard references state that arcuate veins at the corticomedullary junction form continuous arcades. Because some preliminary anatomic observations seemed to disagree with this traditional teaching, the arcuate veins were systematically studied in normal human kidneys. Microangiographic studies indicate that, unlike the occasional anastomoses that exist between proximal interlobar and segmental veins, arcuate venous communications in human are extremely rare. Arcuate veins, like the corresponding arteries, should be considered end vessels

  7. Preoperative mapping of the saphenous vein

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Sillesen, H; Nielsen, Tina G

    1995-01-01

    A consecutive series of 92 patients had their greater saphenous vein assessed with duplex ultrasound scanning prior to planned infrainguinal bypass procedures. A naturally occurring optimal vein diameter was discovered. It was significantly correlated with higher postoperative ankle-brachial pres......-brachial pressure index (ABI) and lesser early postoperative thrombosis. A significant linear regression was found between the pre and postoperative vein diameter....

  8. Collateral veins in inferior caval vein occlusion demonstrated via CT

    International Nuclear Information System (INIS)

    Lien, H.H.; Lund, G.

    1983-01-01

    CT-scans of 12 patients with tumour-induced occlusion of the inferior vena cava were studied with regard to collateral veins. A comparison was performed with findings at phlebography in 10 patients and at autopsy in 2. The site and appearance of the main collateral pathway are presented. A close study of vascular structures renders useful information on collateral circulation in occlusion of the inferior vena cava. (orig.)

  9. Recurrence of superficial vein thrombosis in patients with varicose veins.

    Science.gov (United States)

    Karathanos, Christos; Spanos, Konstantinos; Saleptsis, Vassileios; Tsezou, Aspasia; Kyriakou, Despina; Giannoukas, Athanasios D

    2016-08-01

    To investigate which factors other than history of superficial vein thrombosis (SVT) are associated with recurrent spontaneous SVT episodes in patients with varicose veins (VVs). Patients with a history of spontaneous SVT and VVs were followed up for a mean period of 55 months. Demographics, comorbidities, and thrombophilia screening test were analyzed. Patients were grouped according to the clinical-etiology-anatomy-pathophysiology classification. A multiple logistic regression analysis with the forward likelihood ratio method was undertaken. Thirteen patients out of 97 had a recurrence SVT episode during the follow-up period. All those patients were identified to have a thrombophilia defect. Protein C and S, antithrombin, and plasminogen deficiencies were more frequently present in patients without recurrence. Gene mutations were present in 38% in the nonrecurrence group and 77% in the recurrence group. After logistic regression analysis, patients with dislipidemia and mutation in prothrombin G20210A (FII) had an increased risk for recurrence by 5.4-fold and 4.6-fold, respectively. No deep vein thrombosis or pulmonary embolism occurred. Dislipidemia and gene mutations of F II are associated with SVT recurrence in patients with VVs. A selection of patients may benefit from anticoagulation in the short term and from VVs intervention in the long term. © The Author(s) 2015.

  10. Unusual termination of the right testicular vein | Woldeyes | Anatomy ...

    African Journals Online (AJOL)

    The testicular veins are formed by the veins emerging from the testis and epididymis forming the pampiniform venous plexus. The right testicular vein drains into inferior vena cava and the left testicular vein to the left renal vein. Testicular veins display a great variability with regard to their number, course and sites of ...

  11. Blood sampling from adrenal gland vein

    International Nuclear Information System (INIS)

    Sun Yong; Ni Caifang

    2009-01-01

    Adrenal gland vein sampling is an interventional method to get the blood samples from the adrenal gland vein. The blood is obtained via a catheter which is selectively inserted in the adrenal gland vein. This technique is mainly used to be diagnostic for primary hyperaldosteronism. A full knowledge of the anatomy and variations of the adrenal gland vein, serious preoperative preparation and skilled catheterization manipulation are necessary for obtaining sufficient blood sample and for reducing the occurrence of complications. Providing the physicians with definite diagnostic evidence and being technically feasible, adrenal gland vein sampling should become one of the routine examinations for clarifying the cause of primary hyperaldosteronism. (authors)

  12. Levobupivacaine induces vasodilatation, but not vasoconstriction, in rat mesenteric artery

    Directory of Open Access Journals (Sweden)

    Liciane dos Santos MENEZES

    Full Text Available Abstract Introduction Levobupivacaine (LEVO can replace analgesia because it exhibits low toxicity and causes minor vasoconstriction, enabling its use in patients in whom vasoconstrictors are contraindicated. Objective We aimed to evaluate the effects of LEVO in isolated rat superior mesenteric artery by using the vascular reactivity technique and compare its effect to that of lidocaine. Material and method Arterial rings were obtained from the mesenteric artery of male Wistar rats and kept in organ baths. For recording isometric contractions, each ring was suspended by cotton threads from a force transducer, which was connected to a data acquisition system. Result Both lidocaine and LEVO did not show a vasoconstrictor effect on the basal tone of the arterial rings with functional endothelium. However, when the rings were pre-contracted with phenylephrine, both drugs were able to induce concentration-dependent vasodilatation. The vasodilator effect induced by LEVO did not change after removal of the endothelium, or with the addition of tetraethylammonium (1 mM, a non-selective K+ channel blocker. In the rings without functional endothelium, which were pre-contracted with depolarizing Tyrode’s solution (KCl 80 mM, LEVO-induced vasodilatation was not significantly different from that observed in the rings pre-contracted with phenylephrine. Moreover, it did not show a significant additional vasodilator effect compared to the maximal vasodilator effect of nifedipine. Conclusion This study demonstrated that LEVO produces a vasodilator effect in the rat superior mesenteric artery in an endothelium-independent manner. This effect seems to be mediated via Ca2+ channel blockade in the vascular smooth muscle cells.

  13. Varicose veins show enhanced chemokine expression.

    Science.gov (United States)

    Solá, L del Rio; Aceves, M; Dueñas, A I; González-Fajardo, J A; Vaquero, C; Crespo, M Sanchez; García-Rodríguez, C

    2009-11-01

    Leucocyte infiltration in the wall of varicose veins has been reported previously. This study was designed to investigate the expression of pro-inflammatory cytokines and chemokines in control and in patients with varicose veins and to test the effect of treating varicose vein patients with acetylsalicylic acid (ASA) on cytokine expression prior to removal of varices. Sections of vein were removed during operation from both patient groups, and ribonuclease protection assays (RPAs) were performed to assess the expression of chemokines. Group I included non-varicose saphenous veins from healthy patients undergoing amputation for trauma. Varicose veins were obtained from patients with primary varicose undergoing surgical treatment who received no drug (group II) or treatment with 300 mg day(-1) of ASA for 15 days before surgery (group III). Non-varicose veins constitutively expressed low levels of monocyte-chemoattractant protein (MCP-1) and interleukin (IL)-8 mRNA. Varicose veins had a distinct chemokine expression pattern, since significant up-regulation of MCP-1 and IL-8 and a marked expression of IP-10, RANTES, MIP-1alpha and MIP-1beta mRNA were detected. Removal of the endothelium did not alter this pattern. Varicose veins obtained from patients treated with ASA showed a consistent decrease in chemokine expression, although it did not reach statistical significance. Varicose veins showed increased expression of several chemokines compared to control veins. A non-significant reduction of activation was observed following treatment with ASA for 15 days.

  14. [Application of percutaneous AngioJet thrombectomy in patients with acute symptomatic portal and superior mesenteric venous thrombosis].

    Science.gov (United States)

    Song, J H; He, X; Lou, W S; Chen, L; Chen, G P; Su, H B; Shi, W Y; Wang, T; Zhao, B X; Gu, J P

    2017-04-04

    Objective: To evaluate the clinical value of percutaneous AngioJet thrombectomy in treatment of acute symptomatic portal and superior mesenteric venous thrombosis venous thrombosis (PVMVT) . Method: From January 2014 to January 2016, a total of 8 patients in Nanjing First Hospital with PVMVT verified by color Doppler ultrasound and computed tomographic angiography (CTA) were analyzed retrospectively. Under ultrasound guidance , the branch of the right portal vein(PV) was punctured with a micropuncture set and a 4-F infusion catheter was advanced to the superior mesenteric vein(SMV). The venogram demonstrated the thrombosis in the PV/SMV and a 6-F AngioJet Xpeeedior catheter was advanced over the guidewire and positioned in the distal SMV. Percutaneous thrombectomy was performed after a mixture of 250 000 U of urokinase in 100 ml of normal saline for mechanical pulse spray of thrombus in all patients for approximately 15 minutes. 2 patients underwent PTA and stent implantation after the thrombectomy procedure, 1 of them and the others 6 patients received continuous transcatheter infusion of urokinase (500 000 U/d) for 24 or 48 hours until the thrombosis was completely dissolved confirmed by angiography at 24 and 48 hours.After procedure and the thrombolytic therapy was discontinued, removal of the infusion catheter and the sheath from the liver, the transhepatic tract was embolized with coils or gelfoam to reduce the risk of bleeding. The patency rate of PV /SMV was assessed by CTA at 1 and 6 months after the procedure. Patients were discharged with oral anticoagulation regimen for at least 6 months.The following criteria were used in evaluation of thrombolysis: grade Ⅰ90% thrombus removal. Results: All 8 patients with PVMVT were treated by AngioJet thrombectomy. Angiography after the thrombectomy procedure showed complete thrombus removal (>90%) was in 3 cases, substantial thrombus removal (50%~90%) in 5 cases. Grade Ⅲ (complete) thrombolysis was achieved in 7

  15. Intravascular lipoma of the renal vein

    Directory of Open Access Journals (Sweden)

    Z Doyle

    2015-06-01

    Full Text Available Lipomas are benign neoplasms composed of adipocytes encased in a fibrous capsule. Intravascular lipomas are rare and almost always incidental findings. In the published literature, the majority are described within the inferior vena cava (IVC and less frequently reported in the superior vena cava, brachiocephalic vein, subclavian vein, internal jugular vein, external iliac vein and common femoral vein. We present the case of a 59-year-old male who presented with a symptomatic ureteral calculus and was found to have an intravascular lipoma of the right renal vein with extension into the IVC. To our knowledge, this is the first ever report of an intravascular lipoma in the renal vein. We discuss the imaging characteristics of intravascular lipomas and the differential diagnosis that should be considered.

  16. Deep vein thrombosis in pregnancy.

    Science.gov (United States)

    Colman-Brochu, Stephanie

    2004-01-01

    This article provides a review of the incidence, pathophysiology, and treatment of deep vein thrombosis (DVT) in pregnancy, a rare but serious complication of pregnancy. The incidence of DVT in pregnancy varies widely, but it is a leading cause of maternal morbidity in both the United States and the United Kingdom. Risk factors during pregnancy include prolonged bed rest or immobility, pelvic or leg trauma, and obesity. Additional risk factors are preeclampsia, Cesarean section, instrument-assisted delivery, hemorrhage, multiparity, varicose veins, a previous history of a thromboembolic event, and hereditary or acquired thrombophilias such as Factor V Leiden. Heparin is the anticoagulant of choice to treat active thromboembolic disease or to administer for thromboprophylaxis, but low molecular-weight heparin is being used with increasing frequency in the pregnant woman. Perinatal nurses should be aware of the symptoms, diagnostic tools, and treatment options available to manage active thrombosis during pregnancy and in the intrapartum and postpartum periods.

  17. Importance of diastolic velocities in the detection of celiac and mesenteric artery disease by duplex ultrasound

    DEFF Research Database (Denmark)

    Perko, M J; Just, S; Schroeder, T V

    1997-01-01

    To assess the predictive value of ultrasound duplex scanning in the detection of superior mesenteric artery (SMA) and celiac artery (CA) occlusive disease.......To assess the predictive value of ultrasound duplex scanning in the detection of superior mesenteric artery (SMA) and celiac artery (CA) occlusive disease....

  18. Does the closure of mesenteric defects during laparoscopic gastric bypass surgery cause complications?

    DEFF Research Database (Denmark)

    Kristensen, Sara Danshøj; Floyd, Andrea Karen; Naver, Lars

    2015-01-01

    BACKGROUND: A well-known complication of laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) is bowel obstruction due to internal herniation (IH). Evidence suggests that mesenteric defects should be closed during LRYGB to reduce the risk of IH. Therefore, surgeons are now closing mesenteric...

  19. Superior mesenteric arterial branch occlusion causing partial jejunal ischemia: a case report

    Directory of Open Access Journals (Sweden)

    Van De Winkel Nele

    2012-02-01

    Full Text Available Abstract Introduction Ischemic bowel disease comprises both mesenteric ischemia and colonic ischemia. Mesenteric ischemia can be divided into acute and chronic ischemia. These are two separate entities, each with their specific clinical presentation and diagnostic and therapeutic modalities. However, diagnosis may be difficult due to the vague symptomatology and subtle signs. Case presentation We report the case of a 68-year-old Caucasian woman who presented with abdominal discomfort, anorexia, melena and fever. A physical examination revealed left lower quadrant tenderness and an irregular pulse. Computed tomography of her abdomen as well as computed tomography enterography, enteroscopy, angiography and small bowel enteroclysis demonstrated an ischemic jejunal segment caused by occlusion of a branch of the superior mesenteric artery. The ischemic segment was resected and an end-to-end anastomosis was performed. The diagnosis of segmental small bowel ischemia was confirmed by histopathological study. Conclusion Mesenteric ischemia is a pathology well-known by surgeons, gastroenterologists and radiologists. Acute and chronic mesenteric ischemia are two separate entities with their own specific clinical presentation, radiological signs and therapeutic modalities. We present the case of a patient with symptoms and signs of chronic mesenteric ischemia despite an acute etiology. To the best of our knowledge, this is the first report presenting a case of acute mesenteric ischemia with segmental superior mesenteric artery occlusion.

  20. Systematic review of survival after acute mesenteric ischaemia according to disease aetiology

    NARCIS (Netherlands)

    Schoots, I. G.; Koffeman, G. I.; Legemate, D. A.; Levi, M. [=Marcel M.; van Gulik, T. M.

    2004-01-01

    BACKGROUND: Differentiation of acute mesenteric ischaemia on the basis of aetiology is of great importance because of variation in disease progression, response to treatment and outcome. The aim of this study was to analyse the published data on survival following acute mesenteric ischaemia over the

  1. Endoluminal compression clip : full-thickness resection of the mesenteric bowel wall in a porcine model

    NARCIS (Netherlands)

    Kopelman, Yael; Siersema, Peter D.; Nir, Yael; Szold, Amir; Bapaye, Amol; Segol, Ori; Willenz, Ehud P.; Lelcuk, Shlomo; Geller, Alexander; Kopelman, Doron

    2009-01-01

    Background: Performing a full-thickness intestinal wall resection Of a sessile polyp located on the mesenteric side with a compression clip may lead to compression of mesenteric vessels. The application of such a clip may therefore cause a compromised blood supply in the particular bowel segment,

  2. Polyarteritis nodosa in superior mesenteric artery : a case report

    International Nuclear Information System (INIS)

    Seo, Young Lan; Choi, Chul Soon; Kim, Ho Chul; Bae, Sang Hoon; Lee, Eil Seong; Nam, Eun Sook

    1998-01-01

    Polyarteritis nodosa (PAN) is a multisystem disease characterized by necrotizing vasculitis of small and medium-sized arteries, and in 50 % of all cases there is gastrointestinal involvement. We describe a patient with PAN involving the gastrointestinal tract. A small bowel series showed nodular fold thickening, submucosal filling defects, shallow ulcerations, segmental luminal narrowing, and decreased peristalsis at the duodenum, jejunum, and ileum; superior mesenteric arteriography showed hypervascularity and microaneurysm. Segmental resection of the small bowel indicated the presence of PAN. (author). 10 refs.,3 figs

  3. Polyarteritis nodosa in superior mesenteric artery : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Young Lan; Choi, Chul Soon; Kim, Ho Chul; Bae, Sang Hoon; Lee, Eil Seong; Nam, Eun Sook [Hallym Univ., Choonchun (Korea, Republic of). Coll. of Medicine

    1998-03-01

    Polyarteritis nodosa (PAN) is a multisystem disease characterized by necrotizing vasculitis of small and medium-sized arteries, and in 50 % of all cases there is gastrointestinal involvement. We describe a patient with PAN involving the gastrointestinal tract. A small bowel series showed nodular fold thickening, submucosal filling defects, shallow ulcerations, segmental luminal narrowing, and decreased peristalsis at the duodenum, jejunum, and ileum; superior mesenteric arteriography showed hypervascularity and microaneurysm. Segmental resection of the small bowel indicated the presence of PAN. (author). 10 refs.,3 figs.

  4. Simultaneous Idiopathic Dissections of the Coronary and Superior Mesenteric Arteries

    Science.gov (United States)

    Nishi, Masato; Sueta, Daisuke; Miyazaki, Takashi; Sakamoto, Kenji; Yamamoto, Eiichiro; Izumiya, Yasuhiro; Tsujita, Kenichi; Kojima, Sunao; Kaikita, Koichi; Ikeda, Osamu; Yamashita, Yasuyuki; Hokimoto, Seiji

    2017-01-01

    A 49-year-old man complained of sudden upper abdominal pain but was not given a definitive diagnosis. The day after he was discharged, he noticed left chest pain. An in-depth electrocardiogram indicated acute myocardial infarction, and emergent coronary angiography revealed 99% stenosis of his left coronary artery. An intravascular ultrasound revealed spontaneous coronary artery dissection (SCAD), and the lesion was successfully stented. In an atherosclerosis screening, superior mesenteric artery dissection (SMAD) was confirmed, after which the lesion was successfully stented. This case suggests that SCAD and SMAD might have similar pathological backgrounds. PMID:28566599

  5. Coil compaction after embolization of the superior mesenteric artery pseudoaneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Hama, Yukihiro; Iwasaki, Yoshie; Kaji, Tatsumi; Kusano, Shoichi [Department of Radiology, National Defense Medical College, 3-2 Namiki, Tokorozawa, 3590042 Saitama (Japan); Hatsuse, Kazuo [Department of Surgery I, National Defense Medical College, 3-2 Namiki, Tokorozawa, 3590042 Saitama (Japan)

    2002-07-01

    A 58-year-old man with an abscess of the psoas muscle was returned to our hospital with hematemesis. Two years earlier, he had undergone coil embolization for a superior mesenteric artery (SMA) pseudoaneurysm secondary to pancreatitis. Based on the physical examination, serum amylase level, and abdominal radiographs, a diagnosis of acute exacerbation of pancreatitis and coil compaction of the SMA pseudoaneurysm was made. The patient underwent re-embolization for the coil compaction using interlocking detachable coils. His condition improved gradually, and he was discharged 3 weeks later. To our knowledge, this is the first report of coil compaction of SMA pseudoaneurysm. (orig.)

  6. Primary mesenteric extraskeletal osteosarcoma in the pelvic cavity

    Energy Technology Data Exchange (ETDEWEB)

    Choudur, H.N.; Munk, P.L.; Ryan, A.G.M.J. [Vancouver General Hospital, Department of Radiology, Vancouver, BC (Canada); Nielson, T.O. [Vancouver General Hospital, Department of Pathology, Vancouver, BC (Canada)

    2005-10-01

    A middle-aged man was being investigated for constipation. Abdominal radiographs incidentally revealed a large, densely calcified, rounded mass within the pelvic cavity. A CT scan was performed followed by surgical excision with a differential diagnosis of calcified hematoma and an enlarged calcified lymph nodal mass. Histopathological investigation revealed a primary mesenteric extraskeletal osteosarcoma. To the best of our knowledge, a primary extraskeletal osteosarcoma arising from the mesentery has not been described previously in the English literature. The radiological features and differential diagnosis are discussed. (orig.)

  7. Mesenteric Castleman's Disease: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Said Al-Natour

    2010-07-01

    Full Text Available A 41-year-old man was discovered to have a pelvic mass during investigation for hypertension 2 years ago. Otherwise, he was asymptomatic, and abdominal magnetic resonance imaging revealed a highly vascular solid mass superior to the urinary bladder. A 131I-meta-iodobenzylguanidine whole body scan was reported as normal, which ruled out the possibility of extra-adrenal pheochromocytoma. No definitive preoperative diagnosis could be established. Surgical resection of the tumour revealed mesenteric Castleman's disease, hyaline vascular type. Such a diagnosis should be considered for any abdominal vascular mass.

  8. A Vein Map Biometric System

    OpenAIRE

    Felix Fuentes; Dulal C. Kar

    2013-01-01

    There is increasing demand world-wide, from government agencies and the private sector for cutting-edge biometric security technology that is difficult to breach but userfriendly at the same time. Some of the older tools, such as fingerprint, retina and iris scanning, and facial recognition software have all been found to have flaws and often viewed negatively because of many cultural and hygienic issues associated with them. Comparatively, mapping veins as a human barcode, a new technology, ...

  9. Vein-type uranium deposits

    International Nuclear Information System (INIS)

    Rich, R.A.; Holland, H.D.; Petersen, U.

    1975-01-01

    A critical review is presented of published data bearing on the mineralogy, paragenesis, geochemistry, and origin of veiw-type uranium deposits. Its aim is to serve as a starting point for new research and as a basis for the development of new exploration strategies. During the formation of both vein and sandstone types of deposits uranium seems to have been dissolved by and transported in rather oxidized solutions, and deposited where these solutions encountered reducing agents such as carbon, sulfides, ferrous minerals and hydrocarbons. Granitic rocks abnormally enriched in uranium have apparently been the most common source for uranium in vein-type deposits. Oxidizing solutions have been derived either from the surface or from depth. Surface solutions saturated with atmospheric oxygen have frequently passed through red bed or clean sandstone conduits on their way to and from uranium source rocks. Deep solutions of non-surface origin have apparently become sufficiently oxidizing by passage through and equilibration with red beds. The common association of clean sandstones or red beds with uranium-rich granites in the vicinity of vein-type uranium deposits is probably not fortuitous, and areas where these rock types are found together are considered particularly favorable targets for uranium exploration

  10. Pancreatitis, panniculitis and polyarthritis (PPP-) syndrome caused by post-pancreatitis pseudocyst with mesenteric fistula. Diagnosis and successful surgical treatment. Case report and review of literature.

    Science.gov (United States)

    Dieker, Wulf; Derer, Johannes; Henzler, Thomas; Schneider, Alexander; Rückert, Felix; Wilhelm, Torsten J; Krüger, Bernd

    2017-01-01

    Pancreatitis, panniculitis and polyarthritis syndrome is a very rare extra-pancreatic complication of pancreatic diseases. While in most cases this syndrome is caused by acute or chronic pancreatitis, we report a case of a 62-year-old man presenting with extensive intraosseous fat necrosis, polyarthritis and panniculitis caused by a post-pancreatitis pseudocyst with a fistula to the superior mesenteric vein and extremely high blood levels of lipase. This became symptomatic 2.5 years after an episode of acute pancreatitis and as in most cases abdominal symptoms were absent. Treatment by surgical resection of the pancreatic head with the pseudocyst and mesenteric fistula led to complete remission of all symptoms. A review of the literature revealed that all publications are limited to case reports. Most authors hypothesize that an unspecific damage can cause a secretion of pancreatic enzymes to the bloodstream leading to a systemic lipolysis and fat tissue necrosis, especially of subcutaneous tissue, bone marrow, inducing panniculitis, polyarthritis and osteonecrosis. Even if caused by an acute pancreatitis abdominal symptoms are often mild or absent in most cases leading to misdiagnosis and poor prognosis. While symptomatic treatment with NSAR and cortisone showed poor to moderate response, causal treatment can be successful depending on the underlying pancreatic disease. Copyright © 2017. Published by Elsevier Ltd.

  11. Acute retroperitoneal bleeding due to inferior mesenteric artery aneurysm: Case report

    Directory of Open Access Journals (Sweden)

    Ferrón JA

    2010-06-01

    Full Text Available Abstract Background Visceral artery aneurysms (VAA, although uncommon, are increasingly being detected. We describe a case of spontaneous retroperitoneal hemorrhage from a ruptured IMA aneurysm associated with stenosis of the superior mesenteric artery (SMA and celiac trunk, successfully treated with surgery. Methods A 65-year-old man presented with abdominal pain and hypovolemic shock. Abdominal CT scan showed an aneurysm of the inferior mesenteric artery with retroperitoneal hematoma. In addition, an obstructive disease of the superior mesenteric artery and celiac axis was observed. Results Upon emergency laparotomy a ruptured inferior mesenteric artery aneurysm was detected. The aneurysm was excised and the artery reconstructed by end-to-end anastomosis. Conclusions This report discusses the etiology, presentation, diagnosis and case management of inferior mesenteric artery aneurysms.

  12. How to manage a case of aymptomatic thoraco-abdominal aortic aneurysm with occluded mesenteric arteries

    Directory of Open Access Journals (Sweden)

    Abhisekh Mohanty

    2015-12-01

    Full Text Available We report a unique case of a 57-year-old male having a suprarenal thoraco-abdominal aortic aneurysm which is extending till the origin of superior mesenteric artery (SMA. The origins of celiac artery and SMA were totally occluded and filled retrogradely through dense collateral vessels arising from the inferior mesenteric artery. Surprisingly, the patient was not having any symptoms related to mesenteric ischemia. We decided to use a conventional aortic aneurysm stent graft to repair it without revascularizing the occluded mesenteric arteries. After 1 month, CT aortogram was repeated which revealed a well-apposed stent graft with no endoleaks. He did not have any clinical signs and symptoms attributable to mesenteric ischemia.

  13. Prevalence of Splanchnic Vein Thrombosis in Pancreatitis: A Systematic Review and Meta-Analysis of Observational Studies.

    Science.gov (United States)

    Xu, Wenda; Qi, Xingshun; Chen, Jiang; Su, Chunping; Guo, Xiaozhong

    2015-01-01

    Splanchnic vein thrombosis (SVT) may be negatively associated with the prognosis of pancreatitis. We performed a systematic review and meta-analysis of literatures to explore the prevalence of SVT in pancreatitis. All observational studies regarding the prevalence of SVT in pancreatitis were identified via PubMed and EMBASE databases. The prevalence of SVT was pooled in the total of patients with pancreatitis. And it was also pooled in the subgroup analyses according to the stage and causes of pancreatitis, location of SVT, and regions where the studies were performed. After the review of 714 studies, 44 studies fulfilled the inclusion criteria. Meta-analyses showed a pooled prevalence of SVT of 13.6% in pancreatitis. According to the stage of pancreatitis, the pooled prevalence of SVT was 16.6% and 11.6% in patients with acute and chronic pancreatitis, respectively. According to the causes of pancreatitis, the pooled prevalence of SVT was 12.2% and 14.6% in patients with hereditary and autoimmune pancreatitis. According to the location of SVT, the pooled prevalence of portal vein, splenic vein, and mesenteric vein thrombosis was 6.2%, 11.2%, and 2.7% in pancreatitis. The prevalence of SVT in pancreatitis was 16.9%, 11.5%, and 8.5% in Europe, America, and Asia, respectively.

  14. Prevalence of Splanchnic Vein Thrombosis in Pancreatitis: A Systematic Review and Meta-Analysis of Observational Studies

    Directory of Open Access Journals (Sweden)

    Wenda Xu

    2015-01-01

    Full Text Available Splanchnic vein thrombosis (SVT may be negatively associated with the prognosis of pancreatitis. We performed a systematic review and meta-analysis of literatures to explore the prevalence of SVT in pancreatitis. All observational studies regarding the prevalence of SVT in pancreatitis were identified via PubMed and EMBASE databases. The prevalence of SVT was pooled in the total of patients with pancreatitis. And it was also pooled in the subgroup analyses according to the stage and causes of pancreatitis, location of SVT, and regions where the studies were performed. After the review of 714 studies, 44 studies fulfilled the inclusion criteria. Meta-analyses showed a pooled prevalence of SVT of 13.6% in pancreatitis. According to the stage of pancreatitis, the pooled prevalence of SVT was 16.6% and 11.6% in patients with acute and chronic pancreatitis, respectively. According to the causes of pancreatitis, the pooled prevalence of SVT was 12.2% and 14.6% in patients with hereditary and autoimmune pancreatitis. According to the location of SVT, the pooled prevalence of portal vein, splenic vein, and mesenteric vein thrombosis was 6.2%, 11.2%, and 2.7% in pancreatitis. The prevalence of SVT in pancreatitis was 16.9%, 11.5%, and 8.5% in Europe, America, and Asia, respectively.

  15. Comparison of image quality and portal vein visualization in IADSP using iopamidol, 76 % urografin, and 38 % urografin

    International Nuclear Information System (INIS)

    Shibata, Toshiya; Yamashita, Keiji; Konishi, Junji; Hayakawa, Katsumi; Hamanaka, Daizaburo; Okumura, Ryouji; Ishi, Yasushi.

    1988-01-01

    The image quality of intra-arterial digital subtraction portography (IADSP) was studied in 50 randomly assigned patients using one of three contrast agents: iopamidol, (IOP, 20 cases), 76 % Na-meglumine diatrzioate (76 % UG, 20 cases), and 38 % Na-meglumine diatrizoate (38 % UG, 10 cases). Sharpness and contrast of images, and portal vein visualization were evaluated in these groups. IOP provided better image quality and portal vein visualization than 76 % UG. There was no significant difference between them in terms of side effects, such as contrast medium-induced pain and feeling of warmth, or changes in physiological parameters like blood pressure and heart rate. When a low osmolar contrast agent like IOP passes through the mesentery capillary bed, the eflux of the contrast agent into the interstitial space and the influex of water into the capillary may be less, resulting in less dilution of the contrast agent in the superior mesenteric vein. This might explain the better image quality and portal vein visualization of IOP. (author)

  16. Deep venous drainage in great cerebral vein (vein of Galen) absence and malformations

    International Nuclear Information System (INIS)

    Lasjaunias, P.; Garcia-Monaco, R.; Rodesch, G.; Terbrugge, K.

    1991-01-01

    We report two types of venous patterns associated with great cerebral vein (vein of Galen) absence or unavailability. Developmental venous anomalies or vein of Galen arteriovenous malformations (VGAM) serve as an illustrative material. A diencephalic pattern that collects the thalamo-striate veins into the tentorial sinus is recognized in most VGAM. A telencephalic arrangement connecting the striate veins with the rostral afferents to the basal vein is less frequent. Both patterns reproduce embryonic stages preceeding the development of the great cerebral vein, thus confirming Raybaud's hypothesis that in VGAM the pouch is not the vein of Galen but the medial vein of the prosencephalon. The prognostic value of each pattern can then be appreciated and the therapeutic strategies rationalized; some unexplained complications of the venous approach for non-selected VGAM can thus be avoided. (orig.)

  17. Phlegmonous gastritis secondary to superior mesenteric artery syndrome.

    Science.gov (United States)

    Nomura, Kosuke; Iizuka, Toshiro; Yamashita, Satoshi; Kuribayashi, Yasutaka; Toba, Takahito; Yamada, Akihiro; Furuhata, Tsukasa; Kikuchi, Daisuke; Matsui, Akira; Mitani, Toshifumi; Ogawa, Osamu; Hoteya, Shu; Inoshita, Naoko; Kaise, Mitsuru

    2015-01-01

    We herein report a case of phlegmonous gastritis secondary to superior mesenteric artery syndrome. An 80-year-old woman visited the hospital emergency department with the chief complaints of epigastric pain and vomiting. She was hospitalized urgently following the diagnosis of superior mesenteric artery syndrome based on abdominal computed tomography findings. Conservative therapy was not effective, and phlegmonous gastritis was diagnosed based on the findings of upper gastrointestinal endoscopy and biopsy performed on the 12th day of the disease. Undernutrition and reduced physical activity were observed on hospital admission, and proactive nutritional therapy with enteral nutrition was started. An upper gastrointestinal series, performed approximately 1 month later, confirmed the persistence of strictures and impaired gastric emptying. Because conservative therapy was unlikely to improve oral food intake, open total gastrectomy was performed on the 94th day of the disease. Examination of surgically resected specimens revealed marked inflammation and fibrosis, especially in the body of the stomach. Following a good postoperative recovery, the patient was able to commence oral intake and left our hospital on foot approximately 1 month after surgery.

  18. Phlegmonous gastritis secondary to superior mesenteric artery syndrome

    Directory of Open Access Journals (Sweden)

    Kosuke Nomura

    2015-12-01

    Full Text Available We herein report a case of phlegmonous gastritis secondary to superior mesenteric artery syndrome. An 80-year-old woman visited the hospital emergency department with the chief complaints of epigastric pain and vomiting. She was hospitalized urgently following the diagnosis of superior mesenteric artery syndrome based on abdominal computed tomography findings. Conservative therapy was not effective, and phlegmonous gastritis was diagnosed based on the findings of upper gastrointestinal endoscopy and biopsy performed on the 12th day of the disease. Undernutrition and reduced physical activity were observed on hospital admission, and proactive nutritional therapy with enteral nutrition was started. An upper gastrointestinal series, performed approximately 1 month later, confirmed the persistence of strictures and impaired gastric emptying. Because conservative therapy was unlikely to improve oral food intake, open total gastrectomy was performed on the 94th day of the disease. Examination of surgically resected specimens revealed marked inflammation and fibrosis, especially in the body of the stomach. Following a good postoperative recovery, the patient was able to commence oral intake and left our hospital on foot approximately 1 month after surgery.

  19. Twist buckling of veins under torsional loading.

    Science.gov (United States)

    Garcia, Justin R; Sanyal, Arnav; Fatemifar, Fatemeh; Mottahedi, Mohammad; Han, Hai-Chao

    2017-06-14

    Veins are often subjected to torsion and twisted veins can hinder and disrupt normal blood flow but their mechanical behavior under torsion is poorly understood. The objective of this study was to investigate the twist deformation and buckling behavior of veins under torsion. Twist buckling tests were performed on porcine internal jugular veins (IJVs) and human great saphenous veins (GSVs) at various axial stretch ratio and lumen pressure conditions to determine their critical buckling torques and critical buckling twist angles. The mechanical behavior under torsion was characterized using a two-fiber strain energy density function and the buckling behavior was then simulated using finite element analysis. Our results demonstrated that twist buckling occurred in all veins under excessive torque characterized by a sudden kink formation. The critical buckling torque increased significantly with increasing lumen pressure for both porcine IJV and human GSV. But lumen pressure and axial stretch had little effect on the critical twist angle. The human GSVs are stiffer than the porcine IJVs. Finite element simulations captured the buckling behavior for individual veins under simultaneous extension, inflation, and torsion with strong correlation between predicted critical buckling torques and experimental data (R 2 =0.96). We conclude that veins can buckle under torsion loading and the lumen pressure significantly affects the critical buckling torque. These results improve our understanding of vein twist behavior and help identify key factors associated in the formation of twisted veins. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Evaluation of apoptosis in varicose vein disease complicated by superficial vein thrombosis.

    Science.gov (United States)

    Filis, Konstantinos; Kavantzas, Nikolaos; Dalainas, Ilias; Galyfos, George; Karanikola, Evridiki; Toutouzas, Konstantinos; Tsioufis, Constantinos; Sigala, Fragiska

    2014-07-01

    The factors contributing to superficial vein thrombosis (SVT) in patients with varicose vein disease are unclear. Differences in vein wall apoptotic activity could be associated with the pathogenesis of SVT. The aim of the study is to address the role of the programmed cell death in the vein wall by comparing varicose veins with history of SVT to uncomplicated varicose veins. Vein segments from the proximal part of the great saphenous vein (GSV), the distal part of the vein and from a varicose tributary, from 16 patients with varicose vein disease and one episode of SVT, were evaluated for the immunohistochemical expression of pro-apoptotic (Bax, p53, Caspase 3, BCL-6, BCL-xs), anti-apoptotic (BCL-xl and BCL-2) and proliferation (Ki-67) markers. The results of this study were compared to the results from the evaluation of 19 patients suffering from uncomplicated varicose vein disease and 10 healthy GSVs as controls. Overall, there was increased apoptosis in the distal part of GSV compared to the proximal part documented by increased expression of Bax (p veins and patients with a history of SVT showed significant differences among the three different anatomic locations. In the proximal GSV, only BCL-xs was higher in patients with SVT (p = 0.029). In the tributaries, Bax, BCL-xl and Ki-67 were higher in patients with SVT (p thrombosis group compared to uncomplicated veins (p vein wall in SVT shows increased pro-apoptotic activity compared to uncomplicated disease and normal veins. Whether increased vein wall cell apoptosis is a causative factor for SVT in varicose veins disease or a repairing mechanism of the thrombosis itself needs further research.

  1. Gold Veins near Great Falls, Maryland

    Science.gov (United States)

    Reed, John Calvin; Reed, John C.

    1969-01-01

    Small deposits of native gold are present along an anastomosing system of quartz veins and shear zones just east of Great Falls, Montgomery County, Md. The deposits were discovered in 1861 and were worked sporadically until 1951, yielding more than 5,000 ounces of gold. The vein system and the principal veins within it strike a few degrees west of north, at an appreciable angle to foliation and fold axial planes in enclosing rocks of the Wissahickon Formation of late Precambrian (?) age. The veins cut granitic rocks of Devonian or pre-Devonian age and may be as young as Triassic. Further development of the deposits is unlikely under present economic conditions because of their generally low gold content and because much of the vein system lies on park property, but study of the Great Falls vein system may be useful in the search for similar deposits elsewhere in the Appalachian Piedmont.

  2. Congenital Agenesis of the Portal Vein: Case

    International Nuclear Information System (INIS)

    Puerta R, Andres F; Vargas B, Maria C; Gomez, Eduardo

    2011-01-01

    Portal vein agenesis is an uncommon anomaly in which the venous drainage from the intestine and spleen bypasses the liver and drains into the systemic veins through shunts. We report a case of a newborn with a prenatal diagnosis of congenital absence of the portal vein, as well as a medical literature review about the main radiological features of this condition and the different associated venous shunts.

  3. A complicated case of deep vein thrombosis

    OpenAIRE

    Cerutti, Elena; Colagrande, Paola; Provera, Edoardo; Giusti, Massimo

    2011-01-01

    We report a case of a patient with deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) associated to portal vein thrombosis (PVT), complicated by hospital-acquired pneumonia (HAP). The pathogenesis of DVT is multifactorial; among risk factors we can list: transitory situations (surgical interventions, infectious diseases with fever, traumas), acquired conditions (neoplasms, antiphospholipid syndrome) or genetically determined situations (thrombophilia). PVT of the sovrahepatic vein...

  4. Interposition vein cuff in infrainguinal prosthetic bypasses.

    Science.gov (United States)

    D'Andrea, V; Biancari, F; Catania, A; Di Matteo, F M; Sorrenti, S; Spyrou, M; Dibra, A; Foti, N; Ortensi, A

    1999-01-01

    The Authors describe the interposition vein cuff technique as an adjuvant method to infrainguinal prosthetic bypass grafts. The haemodynamic, mechanical and humoral factors thought to be involved in the beneficial effects of the vein cuff are herein discussed. The results of the main series suggest the use of this method particularly in patients without any available autologous vein conduit requiring a below-knee popliteal or crural reconstruction.

  5. Mesenteric Lymphadenopathy in Childhood Epidemic Aseptic Meningitis: Sonographic Features and Clinical Significance

    Energy Technology Data Exchange (ETDEWEB)

    Mun, Sung Hee; Park, Young Chan; Lee, Young Hwan [Catholic University of Daegu, College of Medicine, Daegu (Korea, Republic of)

    2006-09-15

    To evaluate the sonographic features of mesenteric lymphadenopathy in childhood epidemic aseptic meningitis and to assess their clinical significance. Thirty-three patients (25 male, 8 female: mean age, 8.6 years) with a diagnosis of aseptic meningitis were prospectively evaluated with abdominal ultrasonography for the presence of enlarged mesenteric nodes. The size and number of enlarged mesenteric lymph nodes were analyzed in relationship with the patient's age, between the patients with abdominal pain or diarrhea (16 cases, 48%) and asymptomatic patients (17 cases, 52%). Mesenteric lymphadenopathy was seen in 31 patients (94%), all 16 symptomatic and 15 of the 17 asymptomatic patients. The number of enlarged nodes was most prevalent between 6-10, seen in 16 patients (52%) and the largest node ranged in size from 4 to 8 mm. Among the 31 patients with mesenteric lymphadenopathy, the mean size of the largest node was statistically different between the symptomatic (6.0 mm) and asymptomatic (5.0 mm) groups (p = 0.021). The number of enlarged nodes and the patient's age were not statistically different between the two groups. Mesenteric lymphadenopathy was seen in almost all cases of childhood epidemic aseptic meningitis, and may be related to the mesenteric lymphadenitis caused by enterovirus

  6. Mesenteric Lymphadenopathy in Childhood Epidemic Aseptic Meningitis: Sonographic Features and Clinical Significance

    International Nuclear Information System (INIS)

    Mun, Sung Hee; Park, Young Chan; Lee, Young Hwan

    2006-01-01

    To evaluate the sonographic features of mesenteric lymphadenopathy in childhood epidemic aseptic meningitis and to assess their clinical significance. Thirty-three patients (25 male, 8 female: mean age, 8.6 years) with a diagnosis of aseptic meningitis were prospectively evaluated with abdominal ultrasonography for the presence of enlarged mesenteric nodes. The size and number of enlarged mesenteric lymph nodes were analyzed in relationship with the patient's age, between the patients with abdominal pain or diarrhea (16 cases, 48%) and asymptomatic patients (17 cases, 52%). Mesenteric lymphadenopathy was seen in 31 patients (94%), all 16 symptomatic and 15 of the 17 asymptomatic patients. The number of enlarged nodes was most prevalent between 6-10, seen in 16 patients (52%) and the largest node ranged in size from 4 to 8 mm. Among the 31 patients with mesenteric lymphadenopathy, the mean size of the largest node was statistically different between the symptomatic (6.0 mm) and asymptomatic (5.0 mm) groups (p = 0.021). The number of enlarged nodes and the patient's age were not statistically different between the two groups. Mesenteric lymphadenopathy was seen in almost all cases of childhood epidemic aseptic meningitis, and may be related to the mesenteric lymphadenitis caused by enterovirus

  7. Deep Vein Thrombosis (DVT) / Pulmonary Embolism (PE) - Blood Clot Forming in a Vein

    Science.gov (United States)

    ... Recommend on Facebook Tweet Share Compartir Deep Vein Thrombosis and Pulmonary Embolism (DVT/PE) are often underdiagnosed and serious, but preventable medical conditions. Deep vein thrombosis (DVT) is a medical condition that occurs when ...

  8. Cephalic Vein Transposition versus Vein Grafts for Venous Outflow in Free-flap Breast Reconstruction

    Directory of Open Access Journals (Sweden)

    Edward I. Chang, MD

    2014-05-01

    Conclusions: The CVT is a reliable alternate venous outflow that can be used as a primary recipient vein or as a salvage option following venous thrombosis. Surgeons should consider a CVT when primary recipient veins are compromised or unavailable.

  9. Clinically silent deep vein thrombosis in patients with superficial thrombophlebitis and varicose veins at legs.

    Science.gov (United States)

    Jerkic, Zoran; Karic, Alen; Karic, Amela

    2009-01-01

    Although superficial thrombophlebitis is a common disorder until recently it was considered as benign disorder. Also it is associated with varicose vein at legs and it was treated effectively with conservative methods, walking and non-steroid anti-inflammatory drugs. Aims of our investigation were: determine frequency of clinically silent deep vein thrombosis at legs in patient with and without superficial thrombophlebitis, determine correlation between superficial thrombophlebitis and deep vein thrombosis regardless of localization of superficial thrombophlebitis in superficial veins of legs and determine adequacy and safety vein phlebography in early diagnosis clinically silent deep vein thrombosis in patients with superficial thrombophlebitis. Using flebography in prospective study was evaluated incidence of clinically silent deep vein thrombosis in 92 patients with varicose veins at legs. By phlebograpy in patients with varicose veins at legs and superficial thrombophlebitis at legs and without clinical signs of DVT at legs of the 49 patients we detected DVT in 12 patients (24, 48%), in three male and nine female. We detected localization of DVT in ilijacofemoral junction in 4,08% patients, although localization of DVT in femoropopliteal region was observed in 6, 12% patients and localization in crural region was in 14.28% patients. Localization of DVT at legs was detected in iliac vein in 16.66% patients, in femoral vein in 25% patients, popliteal vein 8.33% patients, anterior tibial vein 16.66%, posterior tibial vein in 25% and crural veins 8.33% patients. Also we deduced significant difference between two group of patients (chi2 = 10, 76). Such result proves thesis that in most patients with superficial thrombophlebitis and varicose veins is possibility of developing of DVT.

  10. Iloprost, Prostaglandin E1, and Papaverine Relax Human Mesenteric Arteries With Similar Potency.

    Science.gov (United States)

    Mahlke, Christoph; Kühn, Jens-Peter; Mensel, Birger; Schreiber, André; Juretzko, Annett; Steinbach, Antje; Grisk, Olaf

    2017-09-01

    Nonocclusive mesenteric ischemia (NOMI) is accompanied by mesenteric artery spasms that are at least in part due to endothelin system activation. Acute treatment includes intra-arterial infusion of vasodilators such as iloprost, prostaglandin E1 (PGE1), and papaverine. Their effectiveness is not well characterized in human mesenteric arteries. We directly compared their potency to relax isolated human mesenteric arteries. To explore the potential of Rock inhibition to treat mesenteric artery spasms, we tested if endothelin-1 (ET-1)-induced mesenteric artery constrictions depend on rho kinase (Rock). Mesenteric artery segments were obtained from patients who underwent elective abdominal surgery. Vasodilator concentration-response curves were recorded from ET-1-preconstricted vessels by small vessel myography. Rock expression was investigated by Western blot and the potency of Rock inhibition to blunt ET-1-induced mesenteric artery constriction was tested. Iloprost, PGE1, and papaverine similarly reduced vascular tone to 20% to 30% of ET-1-induced wall tension. In human mesenteric arteries, logEC50 was significantly less for iloprost than for PGE1 or papaverine. Respective logEC50 values were -7.72 ± 0.08 mol/L, -6.58 ± 0.17 mol/L, and -6.73 ± 0.19 mol/L in 150 μm to 300 μm lumen diameter arteries. These vessels were also more sensitive to iloprost than 500 μm to 1,000 μm lumen diameter arteries (logEC50 -7.29 ± 0.07 mol/L). Rock1 and Rock2 were expressed in human mesenteric arteries but Rock inhibition did not significantly affect ET-1-induced vasoconstrictions. Iloprost, PGE1, and papaverine have a similar potency to relax mesenteric arteries. Our data suggest that iloprost but not Rock inhibition may be particularly useful to treat ET-1-induced spasms of distal mesenteric arteries.

  11. Non-surgical management of superior mesenteric artery thrombosis using spinal cord stimulation.

    Science.gov (United States)

    Tod, Laura; Ghosh, Jonathan; Lieberman, Ilan; Baguneid, Mohamed

    2013-08-05

    We report the use of a spinal cord stimulator (SCS) for non-surgical management of superior mesenteric artery thrombosis. A 59-year-old woman with polycythaemia rubra vera presented with extensive superior mesenteric artery thrombosis not amenable to surgical or endovascular revascularisation. A SCS was implanted for analgesia thereby allowing enteral feeding to be tolerated during the acute period. Four months later the patient developed a focal ischaemic jejunal stricture and underwent resection of a short segment of small bowel with primary anastomosis that healed without complication. Spinal cord stimulation can facilitate non-surgical management of mesenteric ischaemia.

  12. Mesenteric vascular thrombosis associated with disseminated abdominal visceral hemangiosarcoma in a cat.

    Science.gov (United States)

    Currao, Rachael L; Buote, Nicole J; Flory, Andrea B; Liu, Serena M

    2011-01-01

    An adult castrated male cat was evaluated because of a 4 day history of lethargy and partial anorexia. Physical examination revealed abdominal pain with a palpable fluid wave. Cytologic and biochemical analyses of peritoneal effusion were suggestive of septic peritonitis. On surgical exploration of the abdomen, the mesenteric vessels had no palpable pulses and they contained gross thromboses. The intestines were white with no visible peristalsis. Necropsy findings included disseminated, poorly differentiated hemangiosarcoma throughout the abdomen. Mesenteric arterioles contained fibrin thrombi. To the author's knowledge, no previous reports exist of complete mesenteric vascular thrombosis associated with disseminated abdominal visceral hemangiosarcoma in a cat.

  13. Superficial vein thrombosis and deep vein thrombosis – a comparison

    Directory of Open Access Journals (Sweden)

    Zbigniew Krasiński

    2017-09-01

    Full Text Available Although superficial vein thrombosis is commonly considered a rather minor condition, a number of studies indicate that its consequences can be much more severe. Since the introduction of Doppler ultrasonography to common diagnosis of venous diseases, the approach to threats associated with superficial vein thrombosis has changed, mainly in the context of venous thromboembolism. Superficial thrombosis in varicose veins must be differentiated from that occurring in patients without varicosities. In the former case, superficial vein thrombosis is usually caused by haemodynamic disorders (slower flow, while in the latter, it is caused by thrombophilia or inflammation, but it can also be a prodromal sign of cancer. Ultrasonography enables one to distinguish deep vein thrombosis caused by superficial vein thrombosis progression (by extension through perforator veins or the great/small saphenous vein ostium into the deep venous system from deep vein thrombosis occurring at a certain distance from the site of superficial vein thrombosis. The authors emphasise that due to the possibility of concomitant deep vein thrombosis or pulmonary embolism, our attitude to the diagnostic process, potential complications and treatment of superficial vein thrombosis should be changed.

  14. Fetal Sheep Mesenteric Resistance Arteries: Functional and Structural Maturation.

    Science.gov (United States)

    Müller, Julia J; Schwab, Matthias; Rosenfeld, Charles R; Antonow-Schlorke, Iwa; Nathanielsz, Peter W; Rakers, Florian; Schubert, Harald; Witte, Otto W; Rupprecht, Sven

    2017-01-01

    Fetal blood pressure increases during late gestation; however, the underlying vascular mechanisms are unclear. Knowledge of the maturation of resistance arteries is important to identify the mechanisms and vulnerable periods for the development of vascular dysfunction in adulthood. We determined the functional and structural development of fetal sheep mesenteric resistance arteries using wire myography and immunohistochemistry. Media mass and distribution of myosin heavy-chain isoforms showed no changes between 0.7 (100 ± 3 days) and 0.9 (130 ± 3 days) gestation. However, from 0.7 to 0.9 gestation, the resting wall tension increased accompanied by non-receptor-dependent (potassium) and receptor-dependent (noradrenaline; endothelin-1) increases in vasocontraction. Angiotensin II had no contractile effect at both ages. Endothelium-dependent relaxation to acetylcholine and prostaglandin E2 was absent at 0.7 but present at 0.9 gestation. Augmented vascular responsiveness was paralleled by the maturation of sympathetic and sensory vascular innervation. Non-endothelium-dependent relaxation to nitric oxide showed no maturational changes. The expression of vasoregulator receptors/enzymes did not increase between 0.7 and 0.9 gestation. Vascular maturation during late ovine gestation involves an increase in resting wall tension and the vasoconstrictor and vasodilator capacity of the mesenteric resistance arteries. Absence of structural changes in the tunica media and the lack of an increase in vasoregulator receptor/enzyme expression suggest that vasoactive responses are due to the maturation of intracellular pathways at this gestational age. © 2017 S. Karger AG, Basel.

  15. Interventional treatment of iliac vein compression syndrome

    International Nuclear Information System (INIS)

    Li Xiaoqiang; Zhou Weiming; Nie Zhonglin; Yu Chaowen

    2002-01-01

    Objective: To explore the clinical significance of interventional treatment of iliac vein compression syndrome (IVCS). Methods: Percutaneous transluminal angioplasty (PTA) was performed in 40 cases. Thirty-three cases underwent endovascular stent implantation and 27 cases underwent second-stage left saphenous vein ligation and stripping and the valves of left femoral veins narrowing. Thirty-one cases were followed-up postoperatively and the duration was 6-66 months (mean 28 months). Results: The dilation of iliac veins was successful in 36 cases and there were god efficacy in all patients when they discharged from hospital. Followed-up during post-operation, all the limbs ulcers were cured and varicose veins disappeared. The skin pigmentation disappeared in 17 of 19 cases and markedly relieved in 2 cases. Left lower limb swelling disappeared in 15 of 17 cases and relieved in 2 cases. Conclusion: There is good efficacy in the interventional treatment of left iliac vein lesions, but second-stage procedures should be performed in secondary lesions of saphenous veins and valves of femoral veins

  16. 'Closed' in Situ Vein Infrainguinal Bypass

    NARCIS (Netherlands)

    L.C. van Dijk (Lukas)

    1996-01-01

    textabstractThe autologous greater saphenous vein is considered to be the best bypass material for below knee femoropopliteal and femorocnual arterial reconstructions . . The history of the greater saphenous vein arterial bypass in humans started in 1949, with its first introduction by Kunlin. Upto

  17. Geology and geochemistry of giant quartz veins

    Indian Academy of Sciences (India)

    They show imprints of strong brittle to ductile–brittle deformation, and in places are associated with base metal and gold incidences, and pyrophyllite-diaspore mineralization. The geochemistry of giant quartz veins were studied. Apart from presenting new data on the geology and geochemistry of these veins, an attempt has ...

  18. Preoperative mapping of the saphenous vein

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Sillesen, H; Nielsen, Tina G

    1996-01-01

    A series of 124 patients had their greater saphenous vein assessed with duplex ultrasound scanning prior to planned infrainguinal bypass procedures. 33 (27%) bypass procedures thrombosed within the first year. A naturally occurring optimal vein diameter was discovered: 5.0-6.5 mm at mid-thigh lev...

  19. Preoperative mapping of the saphenous vein

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Sillesen, H; Nielsen, Tina G

    1995-01-01

    A consecutive series of 92 patients had their greater saphenous vein assessed with duplex ultrasound scanning prior to planned infrainguinal bypass procedures. A naturally occurring optimal vein diameter was discovered. It was significantly correlated with higher postoperative ankle-brachial pres...

  20. Deep vein thrombosis and pulmonary embolism

    NARCIS (Netherlands)

    Di Nisio, Marcello; van Es, Nick; Büller, Harry R.

    2016-01-01

    Deep vein thrombosis and pulmonary embolism, collectively referred to as venous thromboembolism, constitute a major global burden of disease. The diagnostic work-up of suspected deep vein thrombosis or pulmonary embolism includes the sequential application of a clinical decision rule and D-dimer

  1. Anatomic study of portal vein: transpancreatic vessels injuries approach Estudo anatômico da veia porta-hepática: abordagem cirúrgica portal transpancreática

    Directory of Open Access Journals (Sweden)

    Mario Mantovani

    2002-08-01

    Full Text Available Introduction: The commitment of the great blood-vessels make up a situation of great complexity and a high rate of the complications and mortality patients with abdominal trauma. The injury of the portal vein matters because of the difficulty on the diagnosis and the approach surgery. Objective: To set the standard on the transverse section of the pancreas looking for a safer surgical access to repair the portal vein injuries. Methods: A quantitative analysis was performed to characterize the anatomical relationship between the portal vein and their tributaries relating them to the pancreas. On these corpses, the measurements of a anatomical triangle were studied. It base was the upper limit of the superior mesenteric vein and the initial portion of the portal vein; the apex, a point located on the upper limit of the confluence of the splenic vein and superior mesenteric vein, situated at the middle line of the superior mesenteric_ vein. Results: The portal vein is formed 3.24cm from the internal border of the duodenal arc at a distance of 1.61cm and 1.07 from the inferior and superior pancreas borders, respectively. Conclusion: The present study allow us to conclude that, to have access to the origin of the portal vein, in case of trauma of this vessel, one should proceed a transverse section of the neck of the pancreas next to the superior mesenteric vein, because its confluence with splenic vein occur, on average, 1.07cm and 1.61cm from the superior and inferior border of the gland, respectively.Introdução: No trauma abdominal, o comprometimento dos grandes vasos constitui uma situação de grande complexidade com altos índices de complicações e mortalidade. Nestes pacientes, a lesão da veia porta-hepática tem interesse em razão da dificuldade no diagnóstico e na abordagem cirúrgica. Objetivo: Padronizar o plano de transecção do pâncreas visando o acesso cirúrgico mais seguro para os reparos das lesões da veia porta

  2. Assessment and management of patients with varicose veins.

    Science.gov (United States)

    Allen, Louise

    Varicose veins are enlarged superficial veins found in the legs. This article explores the anatomy and physiology of the venous system to assist nurses to assess, manage and treat patients with varicose veins.

  3. Superior mesenteric artery syndrome following initiation of cisplatin-containing chemotherapy: a case report

    Directory of Open Access Journals (Sweden)

    Ushiki Atsuhito

    2012-01-01

    Full Text Available Abstract Introduction Superior mesenteric artery syndrome is a rare cause of upper intestinal obstruction resulting from compression of the duodenum by the superior mesenteric artery and abdominal aorta. Case presentation We describe a case of superior mesenteric artery syndrome in a 61-year-old Japanese man with non-small cell lung cancer who had been treated with cisplatin-containing chemotherapy and had lost 7 kg in weight. The diagnosis was confirmed by the typical findings of abdominal computed tomography showing distended stomach resulting from compression of the third portion of the duodenum and reduction of an aortomesenteric distance and aortomesenteric angle. Conclusions This case highlights the importance of considering the possibility of superior mesenteric artery syndrome in patients treated with chemotherapy, especially those presenting with a low body mass index and showing weight loss during chemotherapy.

  4. Mesenteric cyst(s presenting as acute intestinal obstruction in children: Three cases and literature review

    Directory of Open Access Journals (Sweden)

    Deepa Makhija

    2016-09-01

    Conclusions: Presentation of mesenteric cyst as acute obstruction in paediatric age group is rare and preoperative diagnosis is difficult. The larger cysts are more likely to have an acute presentation.

  5. Oral contraceptive and acute intestinal ischemia with mesenteric venous thrombosis: a case report.

    Science.gov (United States)

    Béliard, Aude; Verreth, Lucie; Grandjean, Pascale

    2017-01-01

    Venous thrombosis is a serious complication of combined contraceptive usage. However, mesenteric venous thrombosis and intestinal necrosis are infrequently seen in women using oral contraceptives, and in such cases diagnosis is often delayed. We report the case of a 38-year-old obese female patient who presented with acute abdominal pain. A bowel infection was first diagnosed and treated with antibiotics. Contrast-enhanced tomography of the abdomen revealed diffuse ischemia of the small intestine with superior mesenteric thrombosis. Laparotomy with segmental resection of both small and large bowel was performed. No predisposing factor of mesenteric venous thrombosis was demonstrated except association of the combined contraceptive with obesity. This report highlights the need for clinicians to suspect venous mesenteric thrombosis in women of reproductive age with acute abdominal pain and poor physical findings. Detailed personal history including prescriptions should help to quickly and accurately determine the problem.

  6. Metastatic malignant melanoma representing a multiple mesenteric cystic tumor: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Lim; Woo, Ji Young [Kangnam Sacred Heart, College of Medicine, Hallym University, Seoul (Korea, Republic of)

    2008-05-15

    A metastatic malignant melanoma is a malignant tumor which can involve virtually every organ system. It has variable radiographic findings which mostly indicate solid masses in the mesentery. We report here on a case of a metastatic malignant melanoma, which is made up of multiple mesenteric cystic tumors that need to differentiate from the mesenteric cystic tumor. These include the cystic spindle cell tumor, cystic teratoma, cystic mesothelioma as well as the mesenteric cystic and the solid tumor, which in turn comprises the gastrointestinal stromal tumor, lymphoma and metastatic lesion. The metastatic malignant melanoma can offer a differential diagnosis when the image findings indicate multiple mesenteric cystic masses, multiple organic metastases, and subcutaneous nodules.

  7. Undiagnosed Sjögren’s Syndrome Presenting as Mesenteric Panniculitis

    Directory of Open Access Journals (Sweden)

    Rebecca L. Burns

    2016-01-01

    Full Text Available Mesenteric panniculitis is a rare inflammatory and fibrotic process that affects the small intestine mesentery. It may occur following abdominal surgery or in association with a variety of conditions, including malignancy, infection, and certain autoimmune and inflammatory conditions. Herein, an unusual case of mesenteric panniculitis in a patient with primary Sjögren’s syndrome will be presented. The patient presented with abdominal pain, weight loss, sicca symptoms, fatigue, and arthralgia. An abdominal CT revealed mesenteric fat stranding and prominent lymph nodes of the small intestine mesentery. She was found on laboratory workup to have positive antinuclear and anti-SSa antibodies. Minor salivary gland lip biopsy revealed focal lymphocytic sialadenitis. The patient’s symptoms and CT findings improved with corticosteroids. This case suggests that Sjögren’s syndrome should be considered as an underlying disease process in the evaluation of patients with mesenteric panniculitis.

  8. The veining phenomenon in unalloyed plutonium

    International Nuclear Information System (INIS)

    White, J.S.

    1976-01-01

    An investigation has been made of the veining phenomenon in unalloyed plutonium. The surface markings, or veins, which are sometimes seen on α-phase plutonium samples, arise as a result of the β→α transformation. As far as is known, this veining is unrivalled in its scale and form as compared with the solid state surface transformation effects shown by any other metal. The phenomenon has been explained by the application of the Le Chatelier principle to the phase change. In this instance, the large (10%) volume contraction associated with the β→α reaction and the anisotropy of the nonoclinic α-phase structure, account for the fact that the veins are so prominent in plutonium. On the basis of the proposed model, the veins can only form at temperatures where the transformation mechanism is non-martensitic. (Auth.)

  9. Ultrasound assessment of great saphenous vein insufficiency

    Directory of Open Access Journals (Sweden)

    Chander RK

    2015-06-01

    Full Text Available Rajiv K Chander,1 Thomas S Monahan1,2 1Section of Vascular Surgery, Department of Surgery, University of Maryland School of Medicine, 2Department of Surgery, Baltimore Veterans Affairs Medical Center, Baltimore, MD, USA Abstract: Duplex ultrasonography is the ideal modality to assess great saphenous vein insufficiency. Duplex ultrasonography incorporates both gray scale images to delineate anatomy and color-Doppler imaging that visualizes the flow of blood in a structure. Assessment of great saphenous vein requires definition of the anatomy, augmentation of flow, evaluation for both superficial and deep vein thrombosis, and determining the presence of reflux. Currently, evolution in the treatment of reflux also relies on ultrasound for the treatment of the disease. Understanding the utilization of the ultrasound for the diagnosis and treatment of greater saphenous vein reflux is important for practitioners treating reflux disease. Keywords: duplex ultrasonography, small saphenous vein 

  10. Cavernous transformation of the portal vein

    International Nuclear Information System (INIS)

    Lehotska, V.; Dostalova, K.; Durkovsky, A.; Samal, V.

    1995-01-01

    In this contribution, the authors give an account of a rare case of a cavernous transformation of the portal vein that may have originated secondarily in a proliferative hematogenous disease with a polyglobulia and thrombosis in the periferal blood count as well as development of portal hypertension of a prehepatal type. The state of hyper-coagulation in a myeloproliferative disease may have lead to a chronic thrombosis of the portal vein with a subsequent malformation of the portal vein in terms of a cavernous transformation of the portal vein. The case is an interesting one because of the discrepancy between the gravity of the thrombotic complication and slightness of the symptoms in the clinical picture. The authors point out the importance of ultrasonography and computed tomography examination following the intravenous application of a water solution of a contrast medium in a morphologic diagnosing of a rare complication of a chronic thrombotic clot of the portal vein - the cavernous transformation. (authors)

  11. Retinal vein occlusion: current treatment.

    Science.gov (United States)

    Lattanzio, Rosangela; Torres Gimeno, Ana; Battaglia Parodi, Maurizio; Bandello, Francesco

    2011-01-01

    Retinal vein occlusion (RVO) is a pathology noted for more than 150 years. Although a lot has been written on the matter, it is still a frequent condition with multifactorial etiopathogenesis with many unclear aspects. The RVO pathogenesis has varied systemic and local implications that make it difficult to elaborate treatment guidelines. The management of the patient with RVO is very complex and a multidisciplinary approach is required in order to identify and correct the associated risk factors. Laser therapy remains the gold standard in RVO, but only modest functional improvement has been shown in branch retinal occlusion forms. Multicenter studies of intravitreal drugs present them as an option to combine with laser. Anti-vascular endothelial growth factor, corticosteroids and sustained-release implants are the future weapons to stop disease progression and get a better visual outcome. Consequently, it is useful to clarify some aspects of the pathology that allow a better patient management. Copyright © 2010 S. Karger AG, Basel.

  12. Splenic infarction complicating percutaneous transluminal coeliac artery stenting for chronic mesenteric ischaemia: a case report.

    Science.gov (United States)

    Almeida, John A; Riordan, Stephen M

    2008-08-06

    Chronic mesenteric ischaemia is an important cause of abdominal pain, especially in older patients with risk factors for vascular disease. Until recently, surgical revascularization procedures such as endarterectomy and aorto-coeliac or aorto-mesenteric bypass grafting were the only available treatment options for patients with chronic mesenteric ischaemia. Percutaneous angioplasty and stenting have recently been shown to be effective and safe alternatives to surgical revascularization in high-risk patients with chronic mesenteric ischaemia. We report an 84-year-old woman with symptoms of chronic mesenteric ischaemia, including post-prandial abdominal pain and weight loss. Investigations demonstrated calcific stenoses at the origins of the celiac, superior mesenteric and inferior mesenteric arteries, along with nonocclusive calcification in the mid-splenic artery. Coeliac artery angioplasty and stenting was performed, resulting in excellent arterial dilatation at the stenotic point and distal filling of the coeliac and superior mesenteric arteries and their branches. Within hours of successful stenting of the coeliac artery, the patient developed severe left upper quadrant pain. Progress imaging demonstrated splenic infarction, likely as a result of calcific emboli dislodged from the calcified plaque at the origin of the celiac artery at the time of angioplasty and stenting. The left upper quadrant pain resolved after 8 days and the patient remains asymptomatic 2 years post-procedure. This is the first reported case of splenic infarction complicating otherwise successful coeliac artery stenting, presumably as a consequence of distal embolization of disrupted calcific plaque. This complication, occurring on a background of non-occlusive splenic arterial calcification, represents a novel cause of abdominal pain post-procedure.

  13. Splenic infarction complicating percutaneous transluminal coeliac artery stenting for chronic mesenteric ischaemia: a case report

    Directory of Open Access Journals (Sweden)

    Almeida John A

    2008-08-01

    Full Text Available Abstract Introduction Chronic mesenteric ischaemia is an important cause of abdominal pain, especially in older patients with risk factors for vascular disease. Until recently, surgical revascularization procedures such as endarterectomy and aorto-coeliac or aorto-mesenteric bypass grafting were the only available treatment options for patients with chronic mesenteric ischaemia. Percutaneous angioplasty and stenting have recently been shown to be effective and safe alternatives to surgical revascularization in high-risk patients with chronic mesenteric ischaemia. Case Presentation We report an 84-year-old woman with symptoms of chronic mesenteric ischaemia, including post-prandial abdominal pain and weight loss. Investigations demonstrated calcific stenoses at the origins of the celiac, superior mesenteric and inferior mesenteric arteries, along with nonocclusive calcification in the mid-splenic artery. Coeliac artery angioplasty and stenting was performed, resulting in excellent arterial dilatation at the stenotic point and distal filling of the coeliac and superior mesenteric arteries and their branches. Within hours of successful stenting of the coeliac artery, the patient developed severe left upper quadrant pain. Progress imaging demonstrated splenic infarction, likely as a result of calcific emboli dislodged from the calcified plaque at the origin of the celiac artery at the time of angioplasty and stenting. The left upper quadrant pain resolved after 8 days and the patient remains asymptomatic 2 years post-procedure. Conclusion This is the first reported case of splenic infarction complicating otherwise successful coeliac artery stenting, presumably as a consequence of distal embolization of disrupted calcific plaque. This complication, occurring on a background of non-occlusive splenic arterial calcification, represents a novel cause of abdominal pain post-procedure.

  14. Binding protein for vitamin D and its metabolites in rat mesenteric lymph

    International Nuclear Information System (INIS)

    Dueland, S.; Bouillon, R.; Van Baelen, H.; Pedersen, J.I.; Helgerud, P.; Drevon, C.A.

    1985-01-01

    A protein with high affinity for vitamin D3 and 25-hydroxyvitamin D3 in rat mesenteric lymph has been studied. Mesenteric lymph was collected after duodenal instillation of radiolabeled vitamin D3 and 25-hydroxyvitamin D3. As previously described, approximately 10% of vitamin D3 and 95% of 25-hydroxyvitamin D3 recovered in mesenteric lymph were associated with the alpha-globulin fractions. The radioactive vitamin D3 recovered in the lymph fraction with d greater than 1.006 (free of chylomicrons) coeluted with purified rat serum binding protein for vitamin D and its metabolites (DBP) from an antirat DBP column. The results obtained by immunoblotting after sodium dodecyl sulfate polyacrylamide gel electrophoresis showed that this protein in mesenteric lymph had molecular weight and immunological properties identical with purified serum DBP. Purified serum DBP labeled with 125 I was injected intravenously and mesenteric lymph was collected. results suggesting that DBP may be transferred from blood to mesenteric lymph and that plasma and lymph DBP may have a similar origin

  15. Conservative approach to the acute management of a large mesenteric cyst.

    Science.gov (United States)

    Leung, Billy C; Sankey, Ruth; Fronza, Matteo; Maatouk, Mohamed

    2017-09-16

    Mesenteric cysts are rare, benign gastrointestinal cystic lesions, which are often non-troublesome and present as an incidental radiological finding. However, surgery is often performed in the acute setting to remove lesions that are symptomatic. This report highlights the case of a large, symptomatic mesenteric cyst managed successfully with initial conservative measures followed by planned elective surgery. A 44-year-old female presented with a four-day history of generalised abdominal pain associated with distension, fever, diarrhoea and vomiting. Computer tomography revealed a large (21.7 cm × 11.8 cm × 14 cm) mesenteric cyst within the left abdomen cavity. She was admitted and treated conservatively with intravenous fluids and antibiotics for four days, which lead to complete symptom resolution. Follow-up at intervals of one and three months revealed no return of symptoms. An elective laparotomy and excision of the mesenteric cyst was then scheduled and performed safely at nine months after the initial presentation. Compared to acute surgery, acute conservative management followed by planned elective resection of a symptomatic mesenteric cyst may prove safer. The withholding of an immediate operation may potentially avoid unnecessary operative risk and should be considered in patients without obstructive and peritonitic symptoms. Our case demonstrated the safe use of initial conservative management followed by planned elective surgery of a mesenteric cyst found in the acute setting, which was symptomatic but was not obstructive or causing peritonitic symptoms.

  16. Anticlockwise swirl of mesenteric vessels: A normal CT appearance, retrospective analysis of 200 pediatric patients

    International Nuclear Information System (INIS)

    Sodhi, Kushaljit S.; Bhatia, Anmol; Saxena, Akshay K.; Rao, Katragadda L.N.; Menon, Prema; Khandelwal, Niranjan

    2014-01-01

    Objective: The counterclockwise rotation of the SMV on SMA is a normal and non-specific finding, which results in an incomplete swirl formation on CT scans. However, it has a potential to be misinterpreted as ‘midgut volvulus’ resulting in serious clinical implications. The study was done to determine the frequency and degree of counterclockwise rotation of the SMV on SMA on CT in normal otherwise asymptomatic pediatric patients undergoing CT scan. Methods: In this IRB approved study, we retrospectively analyzed abdominal CT scan examinations of 200 consecutive pediatric patients (age range of 11 days to 18 years), which were performed for different clinical indications over a period of 10 months. They were evaluated for the absence or presence and degree of counterclockwise rotation of the mesenteric vessels. Results: Of the 200 patients, 128 (64%) patients showed no clockwise or anticlockwise rotation of mesenteric vessels. Counterclockwise rotation of SMV on SMA was seen in 72 (36%) patients. Further, the degree of rotation of vessels was also calculated, based on the criteria proposed by the authors. Conclusions: The counterclockwise rotation of SMV on SMA gives an appearance of mesenteric whirlpool in otherwise normal mesenteric vessels and can be misinterpreted as midgut volvulus. It is a normal CT appearance and is due to a variation in branching pattern of mesenteric vessels. Awareness of this normal branching pattern of mesenteric vessels is important to avoid an inadvertent laparotomy

  17. Anticlockwise swirl of mesenteric vessels: A normal CT appearance, retrospective analysis of 200 pediatric patients

    Energy Technology Data Exchange (ETDEWEB)

    Sodhi, Kushaljit S., E-mail: sodhiks@gmail.com [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Bhatia, Anmol, E-mail: anmol_bhatia26@yahoo.co.in [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Saxena, Akshay K., E-mail: fatakshay@yahoo.com [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Rao, Katragadda L.N., E-mail: klnrao@hotmail.com [Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Menon, Prema, E-mail: menonprema@hotmail.com [Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India); Khandelwal, Niranjan, E-mail: khandelwaln@hotmail.com [Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012 (India)

    2014-04-15

    Objective: The counterclockwise rotation of the SMV on SMA is a normal and non-specific finding, which results in an incomplete swirl formation on CT scans. However, it has a potential to be misinterpreted as ‘midgut volvulus’ resulting in serious clinical implications. The study was done to determine the frequency and degree of counterclockwise rotation of the SMV on SMA on CT in normal otherwise asymptomatic pediatric patients undergoing CT scan. Methods: In this IRB approved study, we retrospectively analyzed abdominal CT scan examinations of 200 consecutive pediatric patients (age range of 11 days to 18 years), which were performed for different clinical indications over a period of 10 months. They were evaluated for the absence or presence and degree of counterclockwise rotation of the mesenteric vessels. Results: Of the 200 patients, 128 (64%) patients showed no clockwise or anticlockwise rotation of mesenteric vessels. Counterclockwise rotation of SMV on SMA was seen in 72 (36%) patients. Further, the degree of rotation of vessels was also calculated, based on the criteria proposed by the authors. Conclusions: The counterclockwise rotation of SMV on SMA gives an appearance of mesenteric whirlpool in otherwise normal mesenteric vessels and can be misinterpreted as midgut volvulus. It is a normal CT appearance and is due to a variation in branching pattern of mesenteric vessels. Awareness of this normal branching pattern of mesenteric vessels is important to avoid an inadvertent laparotomy.

  18. Portomesenteric vein thrombosis after laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass: a 36-case series.

    Science.gov (United States)

    El Lakis, Mustapha A; Pozzi, Agostino; Chamieh, Jad; Safadi, Bassem

    2017-03-01

    Portomesenteric vein thrombosis following laparoscopic bariatric surgical procedures is a serious and potentially lethal complication. It is quite rare, and its clinical presentation, management, and sequelae remain poorly understood. We searched PubMed, Medline, Google Scholar, Ovid, and Cochrane databases for articles reporting case series and systematic reviews in the English language on patients who underwent laparoscopic bariatric surgery and had a subsequent portal or mesenteric vein thrombosis. Articles discussing laparoscopic gastric banding were excluded. A total of 14 articles reporting on 36 cases were found. We analyzed the pooled data from these case reports and series with emphasis on number of reported patients, demographics, time of diagnosis, risk factors, symptoms, management, complications, and sequelae. Portomesenteric vein thrombosis is not uncommon following laparoscopic bariatric surgery and appears to occur more after laparoscopic sleeve gastrectomy. Bariatric surgeons should have a high index of suspicion for early detection and treatment of this potentially lethal complication. Obese patients at high risk for venous thrombosis should be screened for genetic predisposition for hypercoagulable state and should be considered for extended thromboprophylaxis postoperatively.

  19. Arteries and Veins of the Cerebellum.

    Science.gov (United States)

    Delion, Matthieu; Dinomais, Mickael; Mercier, Philippe

    2017-12-01

    Surgery of the posterior fossa represents a technical challenge because of the proximity of the vessels of the cerebellum. If the arterial vascularization of the cerebellum is well known, the main arterial variations and the whole venous vascularization are probably under recognized. We describe the vascular organization and the main variations through photographs of colored latex perfused brains, obtained with a surgical microscope. The arterial vascularization of the cerebellum is based on three arteries which all originate from the vertebrobasilar system: the superior cerebellar artery (SCA), the anterior and inferior cerebellar artery (AICA), and the posterior and inferior cerebellar artery (PICA). The main arterial variations involve essentially the origin of these vessels. Concerning the SCA, its origin depends on the embryology. The AICA can arise from a common trunk AICA-PICA. It can be sometimes doubled and rarely absent. The PICA also can arise from a common trunk AICA-PICA and sometimes from the extradural segment of the vertebral artery. Concerning the venous organization, we distinguish the superficial and deep veins. The superficial veins drain the cerebellar cortex and transit on the surface of the cerebellum. The deep veins refer to the veins transiting in the fissures between the cerebellum and the brainstem. All these veins terminate as bridging veins that we can divide in three groups: a superior group emptying into the great vein, a posterior group emptying into the transtentorial sinus, and a lateral group ending into the superior petrosal sinus. The surgical implications are discussed.

  20. On dynamics of uranium vein mineralization

    International Nuclear Information System (INIS)

    Petrosyan, R.V.

    1981-01-01

    The formation of urnaium vein deposits and the essence of consanguinity of the mineralization and wall metasomatites are considered. The formation of uranium mineralization is analysed from the positions of Korzhinsky D. S. : the formation of metasomatite aureole and associated vein ores take place as a result of the development of one solution flow while the formation of mineral vein associations occurs on the background of contineous filtration of the solution during metasomato is due to a repeated (pulse) half-opening of fractures and their filling with a part of filtrating solution. The analysis of the available information on the example of two different uranium manifestations permits to reveal certain relations both in the character of wall rock alterations and between the metasomatosis and the formation of ore minerals in veins. The conclusion is made that spatial-time correlations of vein formations with wall metasomatites attest that the pulse formation of ores in veinlets occurs on the background and in interrelation with a consecutive precipitation of components in the aureole volume. The analysis of element migration dynamics in wall aureole carried out from the positions of the Korzhinsky hypothesis of the advance wave of acid components that takes into account the interaction of continuous and pulse mechanisms of solution movement permits to avoid contradictions when interpreting the processes of wall rock alterations and vein ore-forming, and permits to make a common scheme of vein ore-genesis [ru

  1. Superficial vein thrombosis in non-varicose veins of the lower limbs and thrombophilia.

    Science.gov (United States)

    Lucchi, Gabriella; Bilancini, Salvino; Tucci, Sandro; Lucchi, Massimo

    2017-01-01

    Objectives Superficial vein thrombosis in non-varicose veins of the lower limbs is rather frequent and may be underestimated. This study aims to evaluate the prevalence of inherited or acquired thrombophilia in a sample of outpatients with the disease. Method An observational study was conducted on 73 consecutive superficial vein thrombosis patients tested for inherited or acquired thrombophilia. Results Sixty of 73 patients with superficial vein thrombosis completed the testing protocol, while 13 dropped out; 46 of 60 patients were found to have a thrombophilia (76.6%). The types detected were: factor V Leiden (31/60, i.e. 51.6%), prothrombin mutation (2/60, i.e. 3.3%), MTHFR mutation (23/60, i.e. 38.3%), antiphospholipid antibodies (5/60, i.e. 8.3%), protein C deficit (1/60, i.e. 1.6%), protein S deficit (1/60, i.e. 1.6%), and antithrombin deficit (0/60, i.e. 0%). Conclusions Among patients with superficial vein thrombosis in non-varicose veins, testing demonstrated a high prevalence of thrombophilia. The most common form proved to be factor V Leiden. As thrombophilia was found to be a major cause of superficial vein thrombosis in non-varicose veins, the authors recommend that patients with superficial vein thrombosis in non-varicose veins be investigated for thrombophilia.

  2. Losartan ameliorates "upstream" pulmonary vein vasculopathy in a piglet model of pulmonary vein stenosis.

    Science.gov (United States)

    Zhu, Jiaquan; Ide, Haruki; Fu, Yaqin Yana; Teichert, Anouk-Martine; Kato, Hideyuki; Weisel, Richard D; Maynes, Jason T; Coles, John G; Caldarone, Christopher A

    2014-12-01

    Pulmonary vein stenosis (PVS) is a relentless disease with a poor prognosis. Although surgical repair can effectively treat "downstream" (near left atrial junction) PVS, residual "upstream" (deep in lung parenchyma) PVS commonly dictates long-term survival. Our initial studies revealed an association between PVS and transforming growth factor-β signaling, which led us to investigate the effect of losartan on upstream pulmonary vein vasculopathy in a piglet model of PVS. Neonatal Yorkshire piglets underwent sham surgical banding (sham, n = 6), staged bilateral pulmonary vein banding of all pulmonary veins except the right middle pulmonary vein (banded, n = 6), and staged pulmonary vein banding with losartan treatment (losartan, 1 mg/kg/d, n = 7). After 7 weeks, the hemodynamic data were obtained and the piglets killed. Pulmonary vein banding (compared with sham) was associated with continuous turbulent flow in banded pulmonary veins, pulmonary hypertension (pulmonary artery/systemic blood pressure ratio 0.51 ± 0.06 vs 0.23 ± 0.02, P < .001), and diffuse pulmonary vein intimal hyperplasia in the upstream pulmonary veins (P < .001). Losartan administration decreased the pulmonary artery/systemic blood pressure ratios compared with those in the banded piglets (0.36 ± 0.08 vs 0.51 ± 0.06, P = .007) but it remained greater than those in the sham group (P = .001). Losartan was also associated with diminished pulmonary vein intimal hyperplasia compared with that in the banded piglets (P < .001) but still remained more than that in the sham group (P = .035). Pulmonary vein banding reduced vascular endothelial-cadherin expression, indicative of diminished endothelial integrity, which was restored with losartan. Losartan treatment improved PVS-associated pulmonary hypertension and intimal hyperplasia and might be a beneficial prophylactic therapy for patients at high risk of developing PVS after pulmonary vein surgery. Copyright © 2014 The American Association for

  3. Gadolinium-enhanced magnetic resonance angiography for hepato mesenteric vascular evaluation: single and double doses comparison in schistosomiasis patients; Estudo da circulacao hepatomesenterica pela angiografia por ressonancia magnetica com gadolinio: comparacao entre doses simples e dupla no estudo de pacientes esquistossomoticos

    Energy Technology Data Exchange (ETDEWEB)

    Caldana, Rogerio Pedreschi; Bezerra, Alexandre Sergio de Araujo; D' Ippolito, Giuseppe; Szejnfeld, Jacob [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: rogercal@uol.com.br

    2006-07-15

    Objective: to evaluate the visibility of hepatomesenteric vascular segments by 3D gadolinium-enhanced magnetic resonance (MR) angiography and to compare the method effectiveness between two different gadolinium doses (single and double doses). Materials and methods: a prospective study was performed with 36 schistosomiasis patients who were submitted to 3D contrast-enhanced MR angiography. Scans were performed in a high-field equipment (1.5 T), with body coil and power injector for intravenous contrast administration. Contrast double doses (Gd-DTPA 0.2 mmol/kg) and single doses (0.1 mmol/kg) were randomly used respectively in 21 and 15 patients. Studies were interpreted by consensus between two observers who have rated the visualization degree of 25 proximal vascular segments without knowing the dose used. Results: proximal and calibrous vascular segments have presented higher visualization degree in the greatest part of the sample studied. The celiac trunk, common hepatic artery, splenic artery, proximal and medium third of superior mesenteric artery, portal vein, splenic vein and superior mesenteric vein have presented grade 2 visualization in more than 70% of the sample studied. As regards comparison between different doses, there was no significant difference (p < 0.05) in the visualization degree of several structures evaluated, between double dose and single dose groups, except for an isolate case of evaluation of right hepatic artery (p = 0.008) in which the single dose group has presented a higher frequency of grade 2 visualization with statistical significance. Conclusion: the visualization degree of hepato mesenteric vascular segments by 3D gadolinium-enhanced MR angiography is high, especially in the proximal and calibrous segments. The comparison between groups using single and double contrast doses has demonstrated similar results. (author)

  4. [A case of superior mesenteric venous thrombosis due to protein C deficiency in a patient with duodenal ulcer bleeding].

    Science.gov (United States)

    Woo, Jae Gon; Lee, Ji Eun; Kwon, Oh Un; Jung, Kyoung Won; Jung, Chang Wook; Cho, Dae Hyeon; Yu, Kil Jong; Shim, Sang Goon

    2011-01-01

    Mesenteric venous thrombosis is a clinically very rare disease, and may cause bowel infarction and gangrene. Difficulty in the diagnosis the disease due to its non-specific symptoms and low prevalence can cause a clinically fatal situation. Mesenteric venous thrombosis may be caused by both congenital and acquired factors, and protein C deficiency, which is a very rare genetic disorder, is one of many causes of mesenteric thrombosis. The authors experienced a case of mesenteric venous thrombosis caused by protein C deficiency in a patient with duodenal ulcer bleeding, so here we report a case together with literature review.

  5. Overexpression of leptin mRNA in mesenteric adipose tissue in inflammatory bowel diseases.

    Science.gov (United States)

    Barbier, Maryse; Vidal, Hubert; Desreumaux, Pierre; Dubuquoy, Laurent; Bourreille, Arnaud; Colombel, Jean-François; Cherbut, Christine; Galmiche, Jean-Paul

    2003-11-01

    Leptin, a protein with a cytokine-like structure, is produced predominantly by adipocytes. It appears to play a key role in immune responses by increasing the secretion of Th1 and pro-inflammatory cytokines. As fat-wrapping is a characteristic feature of Crohn's disease (CD), and as increased leptin levels have been reported in animal models of intestinal inflammation, this study investigated whether mesenteric adipose tissue could be a source of leptin in human inflammatory bowel disease (IBD). To quantify the expression of leptin mRNA in mesenteric adipose tissue of patients with CD or ulcerative colitis (UC). Specimens were obtained from mesenteric white adipose tissue close to healthy and inflammatory small intestine and/or colon in patients with CD or UC and, for controls, from apparently healthy mesentery of patients operated for carcinoma of the right colon. The expression of leptin mRNA was assessed by reverse transcription-competitive polymerase chain reaction. Leptin mRNA levels were significantly higher in mesenteric adipose tissue of CD and UC patients than in controls (P<0.05). In CD and UC, concentrations were not significantly different in mesenteric fat specimens, whether contiguous to macroscopically normal or grossly abnormal intestine. This study provides the first evidence of a novel abnormality of the mesentery of patients with IBD. Overexpression of leptin mRNA in mesenteric adipose tissue may contribute to (a) the inflammatory process, (b) enhancement of mesenteric TNF alpha expression in CD (as recently reported), and/or (c) the anorexia frequently reported during flares of IBD.

  6. Multidetector-row computed tomography findings of sclerosing mesenteritis with associated diseases and its prevalence

    International Nuclear Information System (INIS)

    Canyigit, M.; Koksal, A.; Akgoz, A.; Sarisahin, M.; Akhan, O.; Kara, T.

    2011-01-01

    Our aim was to report the multidetector-row computed tomography (MDCT) findings of sclerosing mesenteritis, which is a rare disease characterized by chronic nonspecific inflammation of mesenteric adipose tissue. It has associated diseases, and we explored its prevalence. A total of 2100 patients were evaluated retrospectively for sclerosing mesenteritis between December 2007 and May 2009. Signs and symptoms, associated diseases, laboratory data, surgical histories, and related findings of a misty mesentery, which corresponds to sclerosing mesenteritis on MDCT, were recorded. Misty mesentery findings were seen in 51 (2.43%; 35 men) patients. Their ages ranged between 33 and 78 years (mean 56.2 years). The most frequent complaint of patients was abdominal pain (n=19; 37.2%). The most prominent possible causative and/or associated factors in our study were malignancy (n=9; 17.6%), previous surgery (n=17; 33.3%), smoking (n=20; 39.2%), coronary artery disease (n=9; 17.6%), urolithiasis (n=10; 19.6%), hypertension (n=18; 35.2%), hyperlipidemia (n=13; 25.5%), and diabetes mellitus (n=11; 21.5%). On MDCT, density values in mesenteric fat (-62.8±18.6 Hounsfield unit (HU)) were significantly higher than the values for subcutaneous (-103.9±5.8 HU) and retroperitoneal (-105±6 HU) fatty tissues (both P<0.0001). A partially hyperdense stripe (n=37; 72.6%), well-defined soft tissue nodules (100%), hypodense fatty halo enclosing vessels (n=1; 1.9%), and nodules (n=12; 23.5%) were demonstrated in most of the patients. The diagnosis of sclerosing mesenteritis has increased with the more frequent use of MDCT and the popularization of the Digital Imaging and Communications in Medicine (DICOM) viewer. Defined hallmarks on MDCT can be helpful for differentiating sclerosing mesenteritis from other pathologies. (author)

  7. Role of multidetector CT angiography in the evaluation of suspected mesenteric ischemia

    International Nuclear Information System (INIS)

    Barmase, Meghna; Kang, Mandeep; Wig, Jaidev; Kochhar, Rakesh; Gupta, Rajesh; Khandelwal, Niranjan

    2011-01-01

    Objective: To assess the role of multidetector CT angiography (MDCTA) in the diagnosis of acute mesenteric ischemia (AMI) and to compare the diagnostic utility of axial images with reconstructed images. Materials and methods: In this Institute Review Board approved prospective study, MDCTA was performed on 31 patients who presented with the clinical suspicion of AMI (25M; 6F, age range: 16–73 years). Axial and reconstructed images of each patient were evaluated independently by two radiologists for evidence of bowel wall thickening, abnormal mucosal enhancement, bowel dilatation or obstruction, mesenteric stranding, ascites, solid organ infarcts, pneumatosis intestinalis or porto-mesenteric gas, and mesenteric arterial or venous occlusion. MDCT findings were correlated with the surgical findings and clinical outcome. Patients were later divided into two groups: a study group of patients with proven AMI and a control group of patients with an alternate diagnosis, for the purpose of statistical analysis. Results: AMI was correctly diagnosed in all 16 patients on MDCTA (100% sensitivity and specificity) of whom nine patients underwent surgical exploration. Three patients expired before surgery and the remaining 5 patients were proven based on positive clinical and laboratory findings. Mesenteric arterial occlusion was seen in 7 patients while 5 patients had portomesenteric venous thrombosis. Reconstructed images using minimum intensity projection, volume rendering and multiplanar volume reconstruction were found to perform better for the detection of vascular abnormalities and improved the diagnostic confidence of both radiologists in the evaluation of bowel and mesenteric abnormalities. Conclusion: MDCTA is an effective non-invasive modality for the diagnosis of mesenteric ischemia.

  8. Aneurysm of the vein of Galen

    International Nuclear Information System (INIS)

    Leff, S.L.; Kronfeld, G.; Leonidas, J.C.

    1989-01-01

    We report a case of a vein of Galen aneurysm in a neonate in which MR imaging provided essentially all pertinent diagnostic information prior to surgery. MR findings correlated well with selective cerebral angiography. (orig./MG)

  9. [Retinal vein occlusion in a young patient].

    Science.gov (United States)

    Zemba, Mihail; Ochinciuc, Uliana; Sarbu, Laura; Avram, Corina; Camburu, Raluca; Stamate, Alina

    2013-01-01

    We present a case report of a 27 years old pacient with central retinal vein occlussion and macular edema. The pacient has a significant reduction of the macular aedema with complete recovery of vision after the treatment.

  10. Hepatic vein obstruction (Budd-Chiari)

    Science.gov (United States)

    ... of cells in the bone marrow (myeloproliferative disorders) Cancers Chronic inflammatory or autoimmune diseases Infections Inherited (hereditary) or acquired problems with blood clotting Oral contraceptives Pregnancy Hepatic vein blockage is the most common ...

  11. A current approach to superficial vein thrombosis.

    Science.gov (United States)

    Ellis, Martin H; Fajer, Simone

    2013-02-01

    Superficial vein thrombosis (SVT) is an entity commonly encountered in practice. While the clinical diagnosis is reasonably straightforward, care must be taken to exclude concurrent thrombosis of the deep veins, and the possibility of the presence of occult systemic illness such as malignancy should be considered. Recent studies of the epidemiology of SVT demonstrate a high incidence of concurrent deep vein thrombosis emphasizing the need for surveying the deep veins using compression ultrasonography. Treatment decisions are may now be based upon the results of randomized clinical trials and should include a period of anticoagulation using fondaparinux or a low molecular weight heparin. The appropriate doses and duration of therapy are not fully established, and the cost-effectiveness of these drugs for the treatment of SVT needs further evaluation. © 2012 John Wiley & Sons A/S.

  12. Analysis of the MELD Score Impact in the Outcome of Endovascular Portal Vein Reconstruction.

    Science.gov (United States)

    Torres-Machorro, Adriana; Guerrero-Hernandez, Manuel; Anaya-Ayala, Javier E; Torre, Aldo; Laparra-Escareno, Hugo; Cuen-Ojeda, Cesar; Garcia-Alva, Ramón; Hinojosa, Carlos A

    Endovascular therapy represents a less invasive alternative to open surgery for reconstruction of the portal vein (PV) and the spleno-mesenteric venous confluence to treat Portal hypertension. The objective of this study is to determine if the Model for End-Stage Liver Disease (MELD) score is a useful method to evaluate the risk of morbidity and mortality during endovascular approaches. Patients that underwent endovascular reconstruction of the PV or spleno-mesenteric confluence were identified retrospectively. Data were collected from November 2011 to August 2016. The MELD score was calculated using international normalized ratio, serum billirubin and creatinine. Patients were grouped into moderate (≤ 15) and high (> 15) MELD. Associations of the MELD score on the postprocedural morbidity, mortality and vessels patency were assessed by two-sided Fisher's exact test. Seventeen patients were identified; MELD score distribution was: ≤ 15 in 10 patients (59%) and > 15 in 7 (41%). Even distribution of severe PV thrombosis was treated in both groups, performing predominately jugular access in the high MELD score group (OR 0.10; 95%; CI 0.014-0.89; p = 0.052) in contrast to a percutaneous transhepatic access in the moderate MELD score group. Analysis comparing moderate and high MELD scores was not able to demonstrate differences in mortality, morbidity or patency rates. MELD score did not prove to be a useful method to evaluate risk of morbidity and mortality; however a high score should not contraindicate endovascular approaches. In our experience a high technical success, good patency rates and low complication rates were observed.

  13. CT in thrombosed dilated posterior epidural vein

    Energy Technology Data Exchange (ETDEWEB)

    Bammatter, S.; Schnyder, P.; Preux, J. de

    1987-05-01

    The authors report a case of thrombosis of the distal end of an enlarged right posterior epidural vein. The patient had a markedly narrow lumbar canal due to L5 spondylolisthesis. The dilated vein and the thrombosis were displayed by computed tomography but remained unrecognized until surgery. Pathogenesis of this condition is discussed. A review of the English, French and German literature revealed no prior radiological reports of a similar condition.

  14. Varicose Vein And Ecchymosis: A Case Report

    Directory of Open Access Journals (Sweden)

    Ertan Yetkin

    2017-08-01

    Full Text Available Assessment of varicose vein and chronic venous insufficiency and making a differential diagnosis in patients suffering from a variety of sign and symptoms is sometimes a big challenge in daily clinical practice. Here, we present a female patient with varicose vein symptoms and ecchymosis on her lower extremities. Several irregular shaped ecchymotic lesions on both extremities in different stage of healing with deep purple have been treated by using micronized purified flavonoid fraction.

  15. Varicose Vein And Ecchymosis: A Case Report

    OpenAIRE

    Ertan Yetkin; Selçuk Öztürk; Mehmet ILeri

    2017-01-01

    Assessment of varicose vein and chronic venous insufficiency and making a differential diagnosis in patients suffering from a variety of sign and symptoms is sometimes a big challenge in daily clinical practice. Here, we present a female patient with varicose vein symptoms and ecchymosis on her lower extremities. Several irregular shaped ecchymotic lesions on both extremities in different stage of healing with deep purple have been treated by using micronized purified flavonoid fraction.

  16. Efficacy of varicose vein surgery with preservation of the great safenous vein

    Directory of Open Access Journals (Sweden)

    Bernardo Cunha Senra Barros

    Full Text Available OBJECTIVE: To evaluate the efficacy of surgical treatment of varicose veins with preservation of the great saphenous vein. METHODS: We conducted a prospective study of 15 female patients between 25 and 55 years of age with clinical, etiologic, anatomic and pathophysiologic (CEAP classification 2, 3 and 4. The patients underwent surgical treatment of primary varicose veins with great saphenous vein (GSV preservation. Doppler ultrasonography exams were carried out in the first and third months postoperatively. The form of clinical severity of venous disease, Venous Clinical Severity Score (VCSS was completed before and after surgery. We excluded patients with history of deep vein thrombosis, smoking or postoperatively use of elastic stockings or phlebotonics. RESULTS: All patients had improved VCSS (p <0.001 and reduction in the diameter of the great saphenous vein (p <0.001. There was a relationship between VCSS and the GSV caliber, as well as with preoperative CEAP. There was improvement in CEAP class in nine patients when compared with the preoperative period (p <0.001. CONCLUSION: The varicose vein surgery with preservation of the great saphenous vein had beneficial effects to the GSV itself, with decreasing caliber, and to the symptoms when the vein had maximum caliber of 7.5 mm, correlating directly with the CEAP. The decrease in GSV caliber, even without complete abolition of reflux, leads to clinical improvement by decreasing the reflux volume.

  17. Hepatic vein tumor thrombus as a risk factor for excessive pulmonary deposition of microspheres during TheraSphere therapy for unresectable hepatocellular carcinoma.

    Science.gov (United States)

    Fleming, Chad J; Andrews, James C; Wiseman, Gregory A; Gansen, Denise N; Roberts, Lewis R

    2009-11-01

    To evaluate the impact of identifiable hepatic vein tumor thrombus on the ability to safely deliver TheraSphere (yttrium 90-containing glass microspheres) for the treatment of hepatocellular carcinoma (HCC). A retrospective review was performed of 87 patients (71 men, 16 women; mean age, 64.5 years; age range, 25-83 y) referred for TheraSphere therapy for HCC during a 2-year period between April 2005 and May 2007. Evaluation included contrast-enhanced computed tomography or magnetic resonance imaging, selective mesenteric angiography, and radionuclide perfusion scintigraphy to measure the arteriovenous shunting through the tumor. Of the 87 patients, 83 underwent angiography and perfusion scintigraphy; 53 were ultimately treated with 65 glass microsphere infusions. Twelve of 83 were identified as having tumor thrombus in a hepatic vein or extending into the inferior vena cava. The mean lung shunt for the patients with hepatic vein tumor thrombus was 30% (range, 11%-60%), compared with 8.2% (range, 3%-23%) for patients without identifiable tumor thrombus. Two of the 12 patients were treated with reduced doses of glass microspheres, and the remaining 10 were offered alternative therapies. The presence of hepatic vein tumor thrombus is a risk factor for an increased lung shunt that may prohibit delivery of a therapeutic dose of TheraSphere to hepatic tumor.

  18. Individual Pulmonary Vein Atresia in Adults: Report of Two Cases

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyoung Nam; Kim, Young Tong; Cho, Sung Sik [Cheonan Hospital, SoonchunhyangUniversity College of Medicine, Cheonan (Korea, Republic of)

    2011-06-15

    We present two cases of individual pulmonary vein atresia without vestige of an involved pulmonary vein. On CT, we noted the absence or interruption of normal pulmonary venous structures, and the presence of abnormal vascular structures that represented collaterals for the involved lung parenchyma. On angiography, the artertic pulmonary vein was found to drain into the other ipsilateral pulmonary veins through the collaterals.

  19. Transvenous liver biopsy via the femoral vein

    International Nuclear Information System (INIS)

    Khosa, F.; McNulty, J.G.; Hickey, N.; O'Brien, P.; Tobin, A.; Noonan, N.; Ryan, B.; Keeling, P.W.N.; Kelleher, D.P.; McDonald, G.S.A.

    2003-01-01

    AIM: To study the safety, effectiveness and diagnostic value of transvenous forceps biopsy of the liver in 54 patients with coagulopathy, gross ascites or morbid obesity and suspected liver disease in whom percutaneous liver biopsy was contraindicated. MATERIAL AND METHODS: Forceps biopsy of the liver via the femoral vein was attempted in 54 adult patients with advanced liver disease of unknown aetiology who had coagulation disorders (41 cases), gross ascites (11 cases) or morbid obesity (two cases). In each patient two to six biopsies (average four) were taken using a radial jaw forceps inserted via the right or left femoral vein. RESULTS: The procedure was successful in 53 cases. Hepatic vein catheterization failed in one patient. Adequate liver tissue for diagnosis was obtained in 84% of cases. One patient developed delayed haemorrhage at 12 h from a capsular leak that was undetected during the biopsy procedure. This patient required blood transfusions and laparotomy to control bleeding. There were no deaths in the 53 patients studied. Transient minor chest and shoulder pain was encountered during sheath insertion into a hepatic vein in 23 patients. Three patients developed a femoral vein haematoma, which resolved with conservative treatment. CONCLUSION: Transvenous liver biopsy via the femoral vein is another safe, effective, simple alternative technique of biopsy when the percutaneous route is contraindicated

  20. Veins improve fracture toughness of insect wings.

    Directory of Open Access Journals (Sweden)

    Jan-Henning Dirks

    Full Text Available During the lifetime of a flying insect, its wings are subjected to mechanical forces and deformations for millions of cycles. Defects in the micrometre thin membranes or veins may reduce the insect's flight performance. How do insects prevent crack related material failure in their wings and what role does the characteristic vein pattern play? Fracture toughness is a parameter, which characterises a material's resistance to crack propagation. Our results show that, compared to other body parts, the hind wing membrane of the migratory locust S. gregaria itself is not exceptionally tough (1.04±0.25 MPa√m. However, the cross veins increase the wing's toughness by 50% by acting as barriers to crack propagation. Using fracture mechanics, we show that the morphological spacing of most wing veins matches the critical crack length of the material (1132 µm. This finding directly demonstrates how the biomechanical properties and the morphology of locust wings are functionally correlated in locusts, providing a mechanically 'optimal' solution with high toughness and low weight. The vein pattern found in insect wings thus might inspire the design of more durable and lightweight artificial 'venous' wings for micro-air-vehicles. Using the vein spacing as indicator, our approach might also provide a basis to estimate the wing properties of endangered or extinct insect species.

  1. Veins Improve Fracture Toughness of Insect Wings

    Science.gov (United States)

    Dirks, Jan-Henning; Taylor, David

    2012-01-01

    During the lifetime of a flying insect, its wings are subjected to mechanical forces and deformations for millions of cycles. Defects in the micrometre thin membranes or veins may reduce the insect’s flight performance. How do insects prevent crack related material failure in their wings and what role does the characteristic vein pattern play? Fracture toughness is a parameter, which characterises a material’s resistance to crack propagation. Our results show that, compared to other body parts, the hind wing membrane of the migratory locust S. gregaria itself is not exceptionally tough (1.04±0.25 MPa√m). However, the cross veins increase the wing’s toughness by 50% by acting as barriers to crack propagation. Using fracture mechanics, we show that the morphological spacing of most wing veins matches the critical crack length of the material (1132 µm). This finding directly demonstrates how the biomechanical properties and the morphology of locust wings are functionally correlated in locusts, providing a mechanically ‘optimal’ solution with high toughness and low weight. The vein pattern found in insect wings thus might inspire the design of more durable and lightweight artificial ‘venous’ wings for micro-air-vehicles. Using the vein spacing as indicator, our approach might also provide a basis to estimate the wing properties of endangered or extinct insect species. PMID:22927966

  2. Arterial Embolization in the Management of Mesenteric Bleeding Secondary to Blunt Abdominal Trauma

    Energy Technology Data Exchange (ETDEWEB)

    Ghelfi, Julien, E-mail: JGhelfi@chu-grenoble.fr; Frandon, Julien, E-mail: JFrandon2@chu-grenoble.fr [CHU de Grenoble, Clinique Universitaire de Radiologie et Imagerie Médicale (France); Barbois, Sandrine, E-mail: SBarbois@chu-grenoble.fr [CHU de Grenoble, Clinique Universitaire de Chirurgie Digestive et d’Urgences (France); Vendrell, Anne, E-mail: AVendrell@chu-grenoble.fr; Rodiere, Mathieu, E-mail: MRodiere@chu-grenoble.fr; Sengel, Christian, E-mail: CSengel@chu-grenoble.fr; Bricault, Ivan, E-mail: IBricault@chu-grenoble.fr [CHU de Grenoble, Clinique Universitaire de Radiologie et Imagerie Médicale (France); Arvieux, Catherine, E-mail: CArvieux@chu-grenoble.fr [CHU de Grenoble, Clinique Universitaire de Chirurgie Digestive et d’Urgences (France); Ferretti, Gilbert, E-mail: GFerretti@chu-grenoble.fr; Thony, Frédéric, E-mail: FThony@chu-grenoble.fr [CHU de Grenoble, Clinique Universitaire de Radiologie et Imagerie Médicale (France)

    2016-05-15

    IntroductionMesenteric bleeding is a rare but potentially life-threatening complication of blunt abdominal trauma. It can induce active hemorrhage and a compressive hematoma leading to bowel ischemia. Emergency laparotomy remains the gold standard treatment. We aimed to study the effectiveness and complications of embolization in patients with post-traumatic mesenteric bleeding.Materials and MethodsThe medical records of 7 consecutive patients with active mesenteric bleeding treated by embolization in a level-one trauma center from 2007 to 2014 were retrospectively reviewed. All patients presented with active mesenteric bleeding on CT scans without major signs of intestinal ischemia. We focused on technical success, clinical success, and the complications of embolization.ResultsSix endovascular procedures were successful in controlling hemorrhage but 1 patient had surgery to stop associated arterial and venous bleeding. One patient suffered from bowel ischemia, a major complication of embolization, which was confirmed by surgery. No acute renal failure was noted after angiography. For 1 patient we performed combined management as the endovascular approach allowed an easier surgical exploration.ConclusionIn mesenteric trauma with active bleeding, embolization is a valuable alternative to surgery and should be considered, taking into account the risk of bowel ischemia.

  3. Mesenteric Lymph Drainage Alleviates Acute Kidney Injury Induced by Hemorrhagic Shock without Resuscitation

    Directory of Open Access Journals (Sweden)

    Zi-Gang Zhao

    2014-01-01

    Full Text Available This study aimed to investigate the effect of mesenteric lymph drainage on the acute kidney injury induced by hemorrhagic shock without resuscitation. Eighteen male Wistar rats were randomly divided into sham, shock, and drainage groups. The hemorrhagic shock model (40 mmHg, 3 h was established in shock and drainage groups; mesenteric lymph drainage was performed from 1 h to 3 h of hypotension in the drainage group. The results showed that renal tissue damage occurred; the levels of urea, creatinine, and trypsin in the plasma as well as intercellular adhesion molecule-1 (ICAM-1, receptor of advanced glycation end-products (RAGE, tumor necrosis factor-α (TNF-α, malondialdehyde (MDA, lactic acid (LA, and 2,3-DPG in the renal tissue were increased in the shock group after 3 h of hypotension. Mesenteric lymph drainage lessened the following: renal tissue damage; urea and trypsin concentrations in the plasma; ICAM-1, RAGE, TNF-α, MDA, and LA levels in the renal tissue. By contrast, mesenteric lymph drainage increased the 2,3-DPG level in the renal tissue. These findings indicated that mesenteric lymph drainage could relieve kidney injury caused by sustained hypotension, and its mechanisms involve the decrease in trypsin activity, suppression of inflammation, alleviation of free radical injury, and improvement of energy metabolism.

  4. The endovascular therapy of chronic mesenteric ischemia: how much have we known so far

    International Nuclear Information System (INIS)

    Guo Wei

    2010-01-01

    The purpose of this paper is to collect and summarize the clinical evidence related to the endovascular therapy of chronic mesenteric ischemia. The relevant medical literature in English language were collected through Medline by inputting the subject headings, including 'mesenteric ischemia', 'balloon angioplasty', 'mesenteric stenting' and 'intestinal angina'. The medical documents which reported five or more cases receiving endovascular therapy were enrolled in our study for analysis. A total of 16 series with 328 cases altogether were thus obtained. The therapeutic indication for endovascular intervention in all patients was symptomatic mesenteric arterial stenosis. The technical successful rate was 91%. In 75% patients, the clinical symptoms disappeared after the procedure and repeated intervention was not needed. During the follow-up period, re-stenosis occurred in 28% patients. Complications developed in 9% patients, including dissection, distal embolus, infection, thrombosis, bleeding at puncture site, etc. The mortality at 30 days was 3%. Endovascular intervention is a safe treatment for chronic mesenteric stenosis or occlusion. Stent implantation technique carries a higher technical successful rate. However, there are still about one third patients who will probably develop re-stenosis. (authors)

  5. Chronic Atherosclerotic Mesenteric Ischemia That Started to Develop Symptoms Just after Anaphylaxis

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    M. Goto

    2012-05-01

    Full Text Available An 83-year-old woman was referred to our emergency department with acute urticaria and sudden shortness of breath approximately 30 min after taking rectal diclofenac potassium for lumbago. After treatment with adrenaline and corticosteroids, the patient became hemodynamically stable and left the hospital on the next day. She attended our hospital 1 week after the onset of anaphylaxis because of repeated postprandial epigastric pain. No abnormal lesions were found in endoscopy. Radiographic selective catheter angiography revealed chronic mesenteric ischemia caused by atherosclerosis and abundant collateral arteries between the celiac trunk, the superior mesenteric artery and the inferior mesenteric artery. Patients with chronic mesenteric ischemia usually present with a clinical syndrome characterized by painful abdominal cramps and colic occurring typically during the postprandial phase. Fear of eating resulted in malnutrition. She was prescribed proton pump inhibitor, digestants, anticholinergic agents, serine protease inhibitors, prokinetics, antiplatelet agents and transdermal nitroglycerin intermittently, but these had no beneficial effects. It was most probable that this patient with chronic atherosclerotic mesenteric ischemia was suffering from functional abdominal pain syndrome induced by anaphylaxis. Since psychiatric disorders were associated with alterations in the processing of visceral sensation, we facilitated the patient’s understanding of functional abdominal pain syndrome with the psychologist. Postprandial abdominal pain gradually faded after administration of these drugs and the patient left the hospital. Developing a satisfactory patient-physician relationship was considered more effective for the management of persistent abdominal pain caused by complicated mechanisms.

  6. The CT appearance of the superior intercostal veins

    International Nuclear Information System (INIS)

    Lund, G.

    1982-01-01

    The CT appearance of the superior intercostal veins is described. The veins are more frequently seen on the right side. The right superior intercostal vein should not be misinterpreted as a paraspinal mass when it is large or bulges into the contour of the right lung. A case of stenosis of the left brachiocephalic vein is shown, where the left superior intercostal vein serves as a collateral. (orig.)

  7. Induced chorioretinal venous anastomosis in experimental retinal branch vein occlusion.

    OpenAIRE

    McAllister, I L; Yu, D Y; Vijayasekaran, S; Barry, C; Constable, I

    1992-01-01

    Iatrogenic retinal vein to choroidal vein anastomoses were created using laser photocoagulation in six of seven dog eyes in which a partial branch retinal vein occlusion had previously been created photochemically. A similar attempt to create an anastomosis was made in six control eyes in which no branch vein occlusion was present. In the eyes in which a branch retinal vein had been created, a venous chorioretinal anastomosis appeared to be present by 3 to 6 weeks. In three control eyes simil...

  8. Gonadal vein tumor thrombosis due to renal cell carcinoma

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    Hamidreza Haghighatkhah

    2015-01-01

    Full Text Available Renal cell carcinoma (RCC had a tendency to extend into the renal vein and inferior vena cava, while extension into the gonadal vein has been rarely reported. Gonadal vein tumor thrombosis appears as an enhancing filling defect within the dilated gonadal vein anterior to the psoas muscle and shows an enhancement pattern identical to that of the original tumor. The possibility of gonadal vein thrombosis should be kept in mind when looking at an imaging study of patients with RCC

  9. Impaired myogenic tone in mesenteric arteries from overweight rats

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    Sweazea Karen L

    2012-03-01

    Full Text Available Abstract Background Rats fed high fat (HFD or high sucrose (HSD diets develop increased adiposity as well as impaired vasodilatory responsiveness stemming from oxidative stress. Moreover, HFD rats become hypertensive compared to either control (Chow or HSD fed rats, suggesting elevated vascular tone. We hypothesized that rats with increased adiposity and oxidative stress demonstrate augmented pressure-induced vasoconstriction (i.e. myogenic tone that could account for the hypertensive state. Methods Male Sprague-Dawley rats were fed Chow, HFD or HSD for 6 weeks. The effects of oxidative stress and endogenous nitric oxide on myogenic responses were examined in small mesenteric arteries by exposing the arteries to incremental intraluminal pressure steps in the presence of antioxidants or an inhibitor of nitric oxide synthase, LNNA (100 μM. Results Contrary to the hypothesis, rats fed either HSD or HFD had significantly impaired myogenic responses despite similar vascular morphology and passive diameter responses to increasing pressures. Vascular smooth muscle (VSM calcium levels were normal in HFD arteries suggesting that diminished calcium sensitivity was responsible for the impaired myogenic response. In contrast, VSM calcium levels were reduced in HSD arteries but were increased with pre-exposure of arteries to the antioxidants tiron (10 mM and catalase (1200 U/mL, also resulting in enhanced myogenic tone. These findings show that oxidative stress impairs myogenic tone in arteries from HSD rats by decreasing VSM calcium. Similarly, VSM calcium responses were increased in arteries from HFD rats following treatment with tiron and catalase, but this did not result in improved myogenic tone. Nitric oxide is involved in the impaired myogenic response in HFD, but not HSD, rats since inhibition with LNNA resulted in maximal myogenic responses at lower intraluminal pressures and VSM calcium levels, further implicating reduced calcium sensitivity in

  10. Caudal mesenteric ganglion in the sheep - macroanatomical and immunohistochemical study.

    Science.gov (United States)

    Sienkiewicz, W; Chrószcz, A; Dudek, A; Janeczek, M; Kaleczyc, J

    2015-01-01

    The caudal mesenteric ganglion (CaMG) is a prevetrebral ganglion which provides innervation to a number of organs in the abdominal and pelvic cavity. The morphology of CaMG and the chemical coding of neurones in this ganglion have been described in humans and many animal species, but data on this topic in the sheep are entirely lacking. This prompted us to undertake a study to determine the localization and morphology of sheep CaMG as well as immunohistochemical properties of its neurons. The study was carried out on 8 adult sheep, weighing from 40 to 60 kg each. The sheep were deeply anaesthetised and transcardially perfused with 4% paraformaldehyde. CaMG-s were exposed and their location was determined. Macroanatomical observations have revealed that the ovine CaMG is located at the level of last two lumbar (L5 or L6) and the first sacral (S1) vertebrae. The ganglion represents an unpaired structure composed of several, sequentially arranged aggregates of neurons. Immunohistochemical investigations revealed that nearly all (99.5%) the neurons were DβH-IR and were richly supplied by VACHT-IR nerve terminals forming "basket-like" structures around the perikarya. VACHT-IR neurones were not determined. Many neurons (55%) contained immunoreactivity to NPY, some of them (10%) stained for Met-ENK and solitary nerve cells were GAL-positive. CGRP-IR nerve fibres were numerous and a large number of them simultaneously expressed immunoreactivity to SP. Single, weakly stained neurones were SP-IR and only very few nerve cells weakly stained for VIP.

  11. Endovascular Therapeutic Approaches for Acute Superior Mesenteric Artery Occlusion

    International Nuclear Information System (INIS)

    Acosta, S.; Sonesson, B.; Resch, T.

    2009-01-01

    The purpose of this study was to characterize the outcome of attempted endovascular intervention in patients with acute embolic or thrombotic superior mesenteric artery (SMA) occlusion. The records of 21 patients during a 3-year period between 2005 and 2008 were retrieved from the in-hospital registry. The first group included 10 patients (6 women and 4 men; median age 78 years) with acute embolic occlusion of the SMA. The median duration of symptoms from symptom onset to angiography was 30 hours (range 6 to 120). Synchronous emboli (n = 12) occurred in 6 patients. Embolus aspiration was performed in 9 patients, and 7 of these had satisfactory results. Complementary local thrombolysis was successful in 2 of 3 patients. Residual emboli were present at completion angiography in all 7 patients who underwent successful aspiration embolectomy, and bowel resection was necessary in only 1 of these patients. One serious complication occurred because of a long SMA dissection. The in-hospital survival rate was 90% (9 of 10 patients). The second group included 11 patients (10 women and 1 man; median age 68 years) with atherosclerotic acute SMA occlusions. The median time of symptom duration before intervention was 97 hours (range 17 to 384). The brachial, femoral, and SMA routes were used in 6, 7, and 5 patients, respectively. SMA stenting was performed through an antegrade (n = 7) or retrograde (n = 3) approach. Bowel resection was necessary in 4 patients. No major complications occurred. The in-hospital survival rate was 82% (9 of 11 patients). Endovascular therapy of acute SMA occlusion provides a good alternative to open surgery.

  12. Nonocclusive Mesenteric Ischemia in a Patient on Maintenance Hemodialysis

    Science.gov (United States)

    Han, Sang Youb; Kwon, Young Joo; Shin, Jin Ho; Pyo, Heui Jung; Kim, Ae Ree

    2000-01-01

    Nonocclusive mesenteric ischemia (NOMI) is known to occupy about 25% to 60% of intestinal infarction. NOMI has been reported to be responsible for 9% of the deaths in the dialysis population and the postulated causes of NOMI include intradialytic hypotension, atherosclerosis and medications, such as diuretics, digitalis and vasopressors. Clinical manifestations, such as fever, diarrhea and leukocytosis, are nonspecific, which makes early diagnosis of NOMI very difficult. Case: A 66-year-old woman on maintenance hemodialysis for 5 years was admitted with syncope, abdominal pain and chilly sensation. Since 7 days prior to admission, blood pressure on the supine position during hemodialysis had frequently fallen to 80/50 mmHg. Four days later, she complained of progressive abdominal pain. Rebound tenderness and leukocytosis (WBC 13900/mm3) with left shift were noted. Stool examination was positive for occult blood. Abdominal CT scan showed a distended gall bladder with sludge. Under the impression of acalculous cholecystitis, she was operated on. Surgical and pathologic findings of colon colon were compatible with NOMI. Because of recurrent intradialytic hypotension, we started midodrine 2.5 mg just before hemodialysis and increased the dose up to 7.5 mg. After midodrine therapy, blood pressure during dialysis became stable and the symptoms associated with hypotension did not recur. Conclusion: As NOMI may occur within several hours or days after an intradialytic hypotensive episode, abdominal pain should be carefully observed and NOMI should be considered as a differential diagnosis. In addition, we suggest that midodrine be considered to prevent intradialytic hypotensive episodes. PMID:10714097

  13. Corrosion cast study of the canine hepatic veins.

    Science.gov (United States)

    Uršič, M; Vrecl, M; Fazarinc, G

    2014-11-01

    This study presents a detailed description of the distribution, diameters and drainage patterns of hepatic veins on the basis of the corrosion cast analysis in 18 dogs. We classified the hepatic veins in three main groups: the right hepatic veins of the caudate process and right lateral liver lobe, the middle hepatic veins of the right medial and quadrate lobes and the left hepatic veins of both left liver lobes and the papillary process. The corrosion cast study showed that the number of the veins in the Nomina Anatomica Veterinaria and most anatomical textbooks is underestimated. The number of various-sized hepatic veins of the right liver division ranged from 3 to 5 and included 1 to 4 veins from the caudate process and 2 to 4 veins from the right lateral liver lobe. Generally, in all corrosion casts, one middle-sized vein from the right part of the right medial lobe, which emptied separately in the caudal vena cava, was established. The other vein was a large-sized vein from the remainder of the central division, which frequently joined the common left hepatic vein from the left liver lobes. The common left hepatic vein was the largest of all the aforementioned hepatic veins.

  14. Diagnosis and treatment of superficial vein thrombosis.

    Science.gov (United States)

    Bauersachs, R M

    2013-08-01

    Superficial vein thrombosis (SVT) is a common disease, characterized by an inflammatory-thrombotic process in a superficial vein. Typical clinical findings are pain and a warm, tender, reddish cord along the vein. Until recently, no reliable epidemiological data were available. The incidence is estimated to be higher than that of deep-vein thrombosis (DVT) (1/1000). SVT shares many risk factors with DVT, but affects twice as many women than men and frequently occurs in varicose veins. Clinically, SVT extension is commonly underestimated, and patients may have asymptomatic DVT. Therefore, ultrasound assessment and exclusion of DVT is essential. Risk factors for concomitant DVT are recent hospitalization, immobilization, autoimmune disorders, age > 75 years, prior VTE, cancer and SVT in non-varicose veins. Even though most patients with isolated SVT (without concomitant DVT or PE) are commonly treated with anticoagulation for a median of 15 days, about 8% experience symptomatic thromboembolic complications within three months. Risk factors for occurrence of complications are male gender, history of VTE, cancer, SVT in a non-varicose vein or SVT involving the sapheno-femoral junction (SFJ). As evidence supporting treatment of isolated SVT was sparse and of poor quality, the large, randomized, double-blind, placebo-controlled CALISTO trial was initiated assessing the effect of fondaparinux on symptomatic outcomes in isolated SVT. This study showed that, compared with placebo, 2.5 mg fondaparinux given for 45 days reduced the risk of symptomatic thromboembolic complications by 85% without increasing bleeding. Based on CALISTO and other observational studies, evidence-based recommendations can be made for the majority of SVT patients. Further studies can now be performed in higher risk patients to address unresolved issues.

  15. Portal vein embolization induces more liver regeneration than portal vein ligation in a standardized rabbit model

    NARCIS (Netherlands)

    van den Esschert, Jacomina W.; van Lienden, Krijn P.; de Graaf, Wilmar; Maas, Martinus A. W.; Roelofs, Joris J. T. H.; Heger, Michal; van Gulik, Thomas M.

    2011-01-01

    Background. Portal vein ligation (PVL) and portal vein embolization (PVE) are used to induce hypertrophy of the future remnant liver before major liver resection. The aim of our study was to compare the hypertrophy response of the liver after PVL versus PVE in a rabbit model. Methods. Twenty rabbits

  16. Successful Surgical Correction of a Mesenteric Volvulus with Concurrent Foreign Body Obstruction in Two Puppies.

    Science.gov (United States)

    Jones, Susan; Friedenberg, Steven G; Callard, Jason; Abernathy, Leslie; Guillaumin, Julien

    A 9 mo old female intact English mastiff (case 1) presented for anorexia and vomiting for 7 days. A 7 mo old male castrated American bulldog (case 2) presented for vomiting and anorexia for 2 days without diarrhea. Both dogs were diagnosed with mesenteric volvulus based on exploratory laparotomy, which also revealed an intestinal foreign body obstruction. Case 1 required critical care support during recovery but was ultimately discharged, whereas case 2 had an uncomplicated recovery. Both were reported to be back to normal 1 wk after surgery. Case 1 survived 3 mo and then died due to a colonic torsion diagnosed by exploratory laparotomy. Case 2 has been reported to be completely normal more than 18 mo after surgery. These two cases illustrate that mesenteric volvulus can be present with a several-day history of gastrointestinal signs and that shock may be absent on presentation. This is also the first published report of mesenteric volvulus with a concurrent foreign body obstruction.

  17. [Step-up strategy for diagnosis and treatment of acute superior mesenteric venous thrombosis].

    Science.gov (United States)

    Yang, Shuofei; Wu, Xingjiang; Li, Jieshou

    2014-05-01

    Acute superior mesenteric venous thrombosis is rare. With advance in CT venography, angiography and diagnostic laparoscopy, the incidence of acute superior mesenteric venous thrombosis has increased worldwide with more access to early diagnosis. The use of anticoagulation medication, interventional radiology, and damage control approach has resulted in better clinical outcomes. At present, the new step-up approach for acute superior mesenteric venous thrombosis includes CT venography as the main diagnostic technique, anticoagulation as the cornerstone of therapy, local transcatheter thrombolytic therapy as the key recanalization method, and adjunctive use of arterial spasmolysis and various endovascular manipulation and damage control surgery by intestinal resection plus jejunostomy and ileostomy or open abdomen. This strategy may further improve clinical outcomes. This review will present the most recent advance in this strategy.

  18. Cranial Mesenteric Arterial Obstruction Due To Strongylus vulgaris Larvae in a Donkey (Equus asinus).

    Science.gov (United States)

    Borji, Hassan; Moosavi, Zahra; Ahmadi, Fatemeh

    2014-09-01

    Arteritis due to Strongylus vulgaris is a well-known cause of colic in horses and donkeys. The current report describes a fatal incidence of arterial obstruction in cranial mesenteric artery caused by S. vulgaris infection in an adult donkey in which anthelmintic treatment was not regularly administered. Necropsy findings of the abdominal cavity revealed a complete cranial mesenteric arterial obstruction due to larvae of S. vulgaris, causing severe colic. To the authors' knowledge, a complete cranial mesenteric arterial obstruction due to verminous arteritis has rarely been described in horses and donkeys. Based on recent reports of fatal arterial obstruction due to S. vulgaris infection in donkeys, it may be evident to consider acute colic caused by this pathogenic parasite a re-emerging disease in donkeys and horses.

  19. Cranial Mesenteric Arterial Obstruction Due To Strongylus vulgaris Larvae in a Donkey (Equus asinus.

    Directory of Open Access Journals (Sweden)

    Hassan Borji

    2014-09-01

    Full Text Available Arteritis due to Strongylus vulgaris is a well-known cause of colic in horses and donkeys. The current report describes a fatal incidence of arterial obstruction in cranial mesenteric artery caused by S. vulgaris infection in an adult donkey in which anthelmintic treatment was not regularly administered. Necropsy findings of the abdominal cavity revealed a complete cranial mesenteric arterial obstruction due to larvae of S. vulgaris, causing severe colic. To the authors' knowledge, a complete cranial mesenteric arterial obstruction due to verminous arteritis has rarely been described in horses and donkeys. Based on recent reports of fatal arterial obstruction due to S. vulgaris infection in donkeys, it may be evident to consider acute colic caused by this pathogenic parasite a re-emerging disease in donkeys and horses.

  20. Disseminated tuberculosis presenting as mesenteric and cerebral abscess in HIV infection: case report

    Directory of Open Access Journals (Sweden)

    Vinay Pandit

    Full Text Available Disseminated tuberculosis in HIV infection involves multiple organs. Pulmonary and lymph node involvement are the commonest form of tuberculosis in HIV infection [1, 2]. Other forms of tuberculosis in the absence of lung and lymph node involvement are rare. Various forms of abdominal [3, 4] and neurological [5, 6] tubercular involvement in HIV infection have been reported. But tuberculosis presenting simultaneously with mesenteric and brain abscess has not been reported yet. We report a case of disseminated tuberculosis presenting as mesenteric and cerebral abscess in a HIV case without involving lung and lymph nodes. Bone marrow smears and fine needle aspiration cytology (FNAC from mesenteric lesion were positive for acid fast bacilli (AFB and the diagnosis of tuberculosis was confirmed by positive polymerase chain reaction (PCR. He responded well to treatment with anti tubercular drugs.

  1. Animal Model of Acute Deep Vein Thrombosis

    International Nuclear Information System (INIS)

    Roy, Sumit; Laerum, Frode; Brosstad, Frank; Kvernebo, Knut; Sakariassen, Kjell S.

    1998-01-01

    Purpose: To develop an animal model of acute deep vein thrombosis (DVT). Methods: In part I of the study nine juvenile domestic pigs were used. Each external iliac vein was transluminally occluded with a balloon catheter. Thrombin was infused through a microcatheter in one leg according to one of the following protocols: (1) intraarterial (IA): 1250 U at 25 U/min in the common femoral artery (n= 3); (2) intravenous (IV): 5000 U in the popliteal vein at 500 U/min (n= 3), or at 100 U/min (n= 3). Saline was administered in the opposite leg. After the animals were killed, the mass of thrombus in the iliofemoral veins was measured. The pudendoepiploic (PEV), profunda femoris (PF), and popliteal veins (PV) were examined. Thrombosis in the tributaries of the superficial femoral vein (SFVt) was graded according to a three-point scale (0, +, ++). In part II of the study IV administration was further investigated in nine pigs using the following three regimens with 1000 U at 25 U/min serving as the control: (1) 1000 U at 100 U/min, (2) 250 U at 25 U/min, (3) 250 U at 6.25 U/min. Results: All animals survived. In part I median thrombus mass in the test limbs was 1.40 g as compared with 0.25 g in the controls (p= 0.01). PEV, PFV and PV were thrombosed in all limbs infused with thrombin. IV infusion was more effective in inducing thrombosis in both the parent veins (mass 1.32-1.78 g) and SVFt (++ in 4 of 6 legs), as compared with IA infusion (mass 0.0-1.16 g; SFVt ++ in 1 of 3 legs). In part II thrombus mass in axial veins ranged from 1.23 to 2.86 g, and showed no relationship with the dose of thrombin or the rate of infusion. Tributary thrombosis was less extensive with 250 U at 25 U/min than with the other regimens. Conclusion: Slow distal intravenous thrombin infusion in the hind legs of pigs combined with proximal venous occlusion induces thrombosis in the leg veins that closely resembles clinical DVT in distribution

  2. Early management of mesenteric cyst prevents catastrophes: A single centre analysis of 17 cases

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    Prakash Advait

    2010-01-01

    Full Text Available Background: Mesenteric cysts are rare intra-abdominal masses in the paediatric age group with varied presentation, ranging from an asymptomatic mass to acute abdomen. This study reviews our experience in the diagnosis and treatment of 17 mesenteric cysts in our centre, with especial reference to acute abdominal symptoms. Patients and Methods: Seventeen patients (age less than 10 years with mesenteric cysts were managed in our hospital. The age ranged from 15 days to 10 years. Patients were admitted with acute or chronic symptoms. They were evaluated with complete history, clinical examination, blood investigations and radiological investigations (x-ray abdomen erect, ultrasound abdomen (USG and computed tomography (CT scan in selected cases to reach a provisional diagnosis. The diagnosis was proven on laparotomy and histologically confirmed. Results: The main presenting symptoms were abdominal pain or lump. The most common mode of presentation was acute small intestinal obstruction. USG was not conclusive in all. Abdominal CT scan with intravenous contrast was diagnostic in nine patients. Five patients had volvulus on exploration. Cysts were located in small intestinal mesentery in 14 cases and three were in the sigmoid mesentery. Seven patients had complete excision, intestinal resection was required in four and marsupialisation with cauterisation of margins was done in six patients. Histologically, all were lymphangiomatous mesenteric cysts. Conclusion: The diagnosis of mesenteric cysts should be kept in mind in any patient presenting with acute abdominal symptoms. Small bowel volvulus with mesenteric cyst constituted a significant number in children with acute abdominal symptoms. Early diagnosis and treatment yields excellent outcome.

  3. A new approach for sclera vein recognition

    Science.gov (United States)

    Thomas, N. L.; Du, Yingzi; Zhou, Zhi

    2010-04-01

    The vein structure in the sclera is stable over time, unique to each person, and well suited for human identification. A few researchers have performed sclera vein pattern recognition and reported promising initial results. Sclera recognition poses several challenges: the vein structure moves and deforms with the movement of the eye; images of sclera patterns are often defocused and/or saturated; and, most importantly, the vein structure in the sclera is multi-layered and has complex non-linear deformation. In this paper, we proposed a new method for sclera recognition: First, we developed a color-based sclera region estimation scheme for sclera segmentation. Second, we designed a Gabor wavelet-based sclera pattern enhancement method, and an adaptive thresholding method to emphasize and binarize the sclera vein patterns. Third, we proposed a line descriptor-based feature extraction, registration, and matching method that is illumination-, scale-, orientation-, and deformation-invariant, and can mitigate the multi-layered deformation effects exhibited in the sclera and tolerate segmentation error. It is empirically verified using the UBIRIS database that the proposed method can perform accurate sclera recognition.

  4. Management of reticular veins and telangiectases.

    Science.gov (United States)

    Smith, Philip Coleridge

    2015-11-01

    To review the literature related to the management of reticular varices and telangiectases of the lower limbs to provide guidance on the treatment of these veins. Very few randomised clinical trials are available in this field. A European Guideline has been published on the treatment of reticular varices and telangiectases, which is largely based on the opinion of experts. Older accounts written by individual phlebologists contain extensive advice from their own practice, which is valuable in identifying effective methods of sclerotherapy. All accounts indicate that a history should be taken combined with a clinical and ultrasound examination to establish the full extent of the venous disease. Sclerotherapy is commenced by injecting the larger veins first of all, usually the reticular varices. Later in the same session or in subsequent sessions, telangiectases can be treated by direct injection. Following treatment, the application of class 2 compression stockings for a period of up to three weeks is beneficial but not used universally by all phlebologists. Further sessions can follow at intervals of 2-8 weeks in which small residual veins are treated. Resistant veins can be managed by ultrasound-guided injection of underlying perforating veins and varices. Other treatments including RF diathermy and laser ablation of telangiectases have very limited efficacy in this condition. Sclerotherapy, when used with the correct technique, is the most effective method for the management of reticular varices and telangiectases. © The Author(s) 2015.

  5. Haemorrhoids are associated with internal iliac vein reflux in up to one-third of women presenting with varicose veins associated with pelvic vein reflux.

    Science.gov (United States)

    Holdstock, J M; Dos Santos, S J; Harrison, C C; Price, B A; Whiteley, M S

    2015-03-01

    To determine the prevalence of haemorrhoids in women with pelvic vein reflux, identify which pelvic veins are associated with haemorrhoids and assess if extent of pelvic vein reflux influences the prevalence of haemorrhoids. Females presenting with leg varicose veins undergo duplex ultrasonography to assess all sources of venous reflux. Those with significant reflux arising from the pelvis are offered transvaginal duplex ultrasound (TVS) to evaluate reflux in the ovarian veins and internal Iliac veins and associated pelvic varices in the adnexa, vulvar/labial veins and haemorrhoids. Patterns and severity of reflux were evaluated. Between January 2010 and December 2012, 419 female patients with leg or vulvar varicose vein patterns arising from the pelvis underwent TVS. Haemorrhoids were identified on TVS via direct tributaries from the internal Iliac veins in 152/419 patients (36.3%) and absent in 267/419 (63.7%). The prevalence of the condition increased with the number of pelvic trunks involved. There is a strong association between haemorrhoids and internal Iliac vein reflux. Untreated reflux may be a cause of subsequent symptomatic haemorrhoids. Treatment with methods proven to work in conditions caused by pelvic vein incompetence, such as pelvic vein embolisation and foam sclerotherapy, could be considered. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  6. A rare cause of chronic mesenteric ischemia from fibromuscular dysplasia: a case report

    Directory of Open Access Journals (Sweden)

    Senadhi Viplove

    2010-11-01

    Full Text Available Abstract Introduction Chronic mesenteric ischemia is a condition that is classically associated with significant atherosclerosis of the abdominal arteries, causing postprandial abdominal pain out of proportion to physical examination. The abdominal pain is exacerbated after meals due to the shunting of blood away from the intestines to the stomach, causing relative ischemia. More than 95% of chronic mesenteric ischemia cases are due to atherosclerosis. We report the first known case of chronic mesenteric ischemia from fibromuscular dysplasia. To the best of our knowledge, this is also the first known case in the literature where postprandial abdominal pain was the presenting symptom of fibromuscular dysplasia. Case presentation A 44-year-old Caucasian woman with a history of hypertension and preeclampsia, who had taken oral contraceptive pills for 15 years, presented with an intractable, colicky abdominal pain of two weeks duration. This abdominal pain worsened with oral intake. It was also associated with diarrhea and vomiting. Physical examination revealed stage III hypertension out of proportion to her risk factors and diffuse abdominal pain without peritoneal signs. An abdominal computed tomography scan, completed in the emergency room, revealed nonspecific colitis. Laboratory work revealed leukocytosis with a left shift, an erythrocyte sedimentation rate of 79 and a C-reactive protein level of 100. She was started on intravenous flagyl and intravenous ciprofloxacin. However, all microbial cultures were negative including three cultures for clostridium difficile. Urine analysis revealed nephritic range proteinuria. The laboratory profile was within normal limits for perinuclear-anti-neutrophil cytoplasmic antibody, cytoplasmic-anti-neutrophil cytoplasmic antibody, anti-saccharomyces cerevisiae antibody, antinuclear antibody test, celiac profile, lactate, carbohydrate antigen-125 and thyroid stimulating hormone. A colonoscopy was completed

  7. Usefulness of MRI compared with CT for diagnosis of mesenteric lymphoma in a dog.

    Science.gov (United States)

    Yasuda, Daiji; Fujita, Michio; Yasuda, Shuichi; Taniguchi, Akiko; Miura, Harumi; Hasegawa, Daisuke; Orima, Hiromitsu

    2004-11-01

    We evaluated the usefulness of MRI and compared it with CT for diagnosis of mesenteric lymphoma in a dog. The results in the plain CT, dynamic CT and plain MR (T1WI and T2WI) images suggested that the mass was a large single nodular lesion with abundant blood perfusion. On enhanced MRI(T1WI) , the mass was depicted as a tumor with adhesion to the gut wall. Exploratory laparotomy confirmed the mass was consistent with the findings on enhanced MRI. We think that MRI might be a useful imaging tool for diagnosis of canine mesenteric lymphoma.

  8. [Diagnosis and treatment of embolism and thrombosis of abdominal aorta and superior mesenteric artery].

    Science.gov (United States)

    Matsubara, Kentaro; Obara, Hideaki; Kitagawa, Yuko

    2014-07-01

    Although acute aortic occlusion (AAO) and acute mesenteric ischemia (AMI) are relatively rare condition, it is very important to know clinical features and managements for these because a delay in diagnosis and appropriate interventions results in high morbidity and mortality. AAO can result from aortic saddle embolus, acute thrombosis of an atherosclerotic aorta, and so on. Superior mesenteric artery embolism and thrombosis are main cause of AMI. The purpose of this article is to review the pathophysiology, clinical presentation, diagnosis, and management of these diseases. The latest information in this article may help readers to promptly make the diagnosis and effectively manage it in a timely manner.

  9. Beyond decreased bowel enhancement: acute abnormalities of the mesenteric and portal vasculature.

    Science.gov (United States)

    Sandstrom, Claire K; Ingraham, Christopher R; Monroe, Eric J; Johnson, Guy E

    2015-10-01

    Acute mesenteric ischemia (AMI) is a potentially life-threatening condition with an associated high mortality. Prompt diagnosis is crucial to achieve a favorable outcome. The radiologist plays a central role in the initial evaluation of a patient with suspected AMI. In this pictorial essay, we review the appropriate imaging evaluation of a patient with suspected AMI, and we review both the common and uncommon etiologies of mesenteric ischemia. With each etiology presented, relevant clinical and imaging findings, as well as potential treatments, are reviewed.

  10. Case Report: Ischaemic appendicitis post mesenteric biopsy [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Marianna Zukiwskyj

    2016-01-01

    Full Text Available A common indication for laparoscopic mesenteric lymph node biopsy is to provide a tissue diagnosis in the absence of palpable peripheral nodes via a minimally invasive approach.  There are no reports to date of ischaemia to the appendix as a complication of this procedure.   We report the case of a 34-year-old lady who underwent a mesenteric biopsy for a lesion found incidentally on CT to investigate longstanding abdominal pain, and 2 days later required an appendicectomy for ischaemic appendicitis.

  11. Extra-adrenal malignant paragangliomas presenting as mesenteric and pararectal masses: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sun Hye [Dept. of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Lee, Jong Mee; Kim, Baek Hui; Kim, Kyeong Ah; Park, Cheol Min [Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

    2017-07-15

    Extra-adrenal paraganglioma is a rare tumor arising from the neural crest cells. Most tumors that develop in the abdomen arise from paraganglia along the paravertebral and para-aortic areas, in particular the organ of Zuckerkandl, which is close to the origin of the inferior mesenteric artery. However, extra-adrenal paraganglioma also occurs in relatively rare places such as the urinary bladder, gallbladder, hepatoduodenal ligament, and gastrointestinal tract. Here, we report imaging findings of extra-adrenal paragangliomas presenting as mesenteric and pararectal masses with lymph node metastasis.

  12. Superficial vein thrombosis with hemorrhagic cerebral infarction

    Directory of Open Access Journals (Sweden)

    Yu-wei CONG

    2016-01-01

    Full Text Available Background Cerebral superficial vein thrombosis was rare and often misdiagnosed or missed for its various etiological factors, and complicated and nonspecific clinical manifestations. This paper reported one case of superficial vein thrombosis in right fronto-parietal lobe with hemorrhagic infarction. The anatomy of superficial vein, pathophysiological points, diagnosis and treatment of superficial vein thrombosis were reviewed to help to reduce missed diagnosis or misdiagnosis. Methods and Results A 18-year-old male patient had suffered from progressive headache for 4 years and weakness of left limbs for 2 d. Head MRI showed circular space-occupying lesion in right fronto-parietal lobe. Magnetic resonance venography (MRV examination showed the front two-thirds of the superior sagittal sinus was not clear. The lesions were removed and decompressive craniectomy was conducted, showing the brain tissue was pale, partly yellow or dark red, and superficial venous engorgement. Histological observation showed pial superficial vein thrombosis and subpial encephalomalacia, and multifocal hemorrhage of cerebral cortex and local parenchymal hemorrhage. A large number of "grid cells" and vascular "cuff" phenomenan were visible in surrounding tissue, and the parenchymal blood vessel proliferation was obvious. Left hand activity of the patient was obviously limited after the operation. Conclusions Clinical diagnosis of superficial vein thrombosis with hemorrhagic infarction is difficult, and brain imaging and serological examination can provide certain help. Much attention should be paid to the multidisciplinary diagnosis and treatment to reduce misdiagnosis or missed diagnosis, and gather clinical experience. DOI: 10.3969/j.issn.1672-6731.2016.01.007

  13. Postpartum Ovarian Vein Thrombophlebitis with Staphylococcal Bacteremia

    Science.gov (United States)

    Parino, Eduardo; Mulinaris, Eric; Saccomano, Edgardo; Gallo, Juan Cruz; Kohan, Gabriel

    2015-01-01

    A 34-year-old female patient presented with fever and right flank pain ten days after uncomplicated vaginal delivery. CT examination revealed right ovarian vein thrombosis and methicillin-resistant Staphylococcus aureus (MRSA) was isolated from blood cultures. No other source of bacteremia was found. Antibiotic therapy and anticoagulation with enoxaparin were instituted. Fourteen days after admission, she was discharged in good condition. Although a very uncommon complication after spontaneous vaginal delivery, septic ovarian vein thrombophlebitis should be suspected in cases of persistent puerperal fever when other diagnostic possibilities have been excluded. PMID:26221549

  14. Deep vein thrombosis: a clinical review

    Directory of Open Access Journals (Sweden)

    Kesieme EB

    2011-04-01

    Full Text Available Emeka Kesieme1, Chinenye Kesieme2, Nze Jebbin3, Eshiobo Irekpita1, Andrew Dongo11Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Nigeria; 2Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Nigeria; 3Department of Surgery, University of Port Harcourt Teaching Hospital, Port-Harcourt, NigeriaBackground: Deep vein thrombosis (DVT is the formation of blood clots (thrombi in the deep veins. It commonly affects the deep leg veins (such as the calf veins, femoral vein, or popliteal vein or the deep veins of the pelvis. It is a potentially dangerous condition that can lead to preventable morbidity and mortality.Aim: To present an update on the causes and management of DVT.Methods: A review of publications obtained from Medline search, medical libraries, and Google.Results: DVT affects 0.1% of persons per year. It is predominantly a disease of the elderly and has a slight male preponderance. The approach to making a diagnosis currently involves an algorithm combining pretest probability, D-dimer testing, and compression ultrasonography. This will guide further investigations if necessary. Prophylaxis is both mechanical and pharmacological. The goals of treatment are to prevent extension of thrombi, pulmonary embolism, recurrence of thrombi, and the development of complications such as pulmonary hypertension and post-thrombotic syndrome.Conclusion: DVT is a potentially dangerous condition with a myriad of risk factors. Prophylaxis is very important and can be mechanical and pharmacological. The mainstay of treatment is anticoagulant therapy. Low-molecular-weight heparin, unfractionated heparin, and vitamin K antagonists have been the treatment of choice. Currently anticoagulants specifically targeting components of the common pathway have been recommended for prophylaxis. These include fondaparinux, a selective indirect factor Xa inhibitor and the new oral selective direct thrombin inhibitors (dabigatran and selective

  15. Surgical treatment of central retinal vein occlusion.

    Science.gov (United States)

    Berker, Nilufer; Batman, Cosar

    2008-05-01

    The treatment of central retinal vein occlusion (CRVO) is still a subject of debate. Medical therapy efforts, as well as retinal laser photocoagulation, have mostly dealt with management of the sequelae of CRVO, and have shown limited success in improving visual acuity. The unsatisfactory results of such therapeutic efforts led to the development of new treatment strategies focused on the surgical treatment of the occluded retinal vein. The purpose of this review is to summarize the outcomes of commonly reported surgical treatment strategies and to review different opinions on the various surgical approaches to the treatment of CRVO.

  16. [Idiopathic thrombosis of the renal vein].

    Science.gov (United States)

    Ignjatović, I; Ilić, M; Marković, N; Stamenić, T

    1995-01-01

    Renal vein thrombosis (TVR) is not a common disease especially when is not associated with renal parenchymal nephropathy. TVR has no characteristic symptoms, so it is often late recognised. The main procedures for diagnosis of TVR are: echotomography, CT and phlebography. All these procedures, although very informative, have certain limits in the clinical use. Therapy of TVR trombolytic, anticoagulant or surgical: thrombectomy or nephrectomy. In cases where the underlying parenchymal disease exists, aggresive therapeutic approach is not recommended, but in acute idiopathic TVR immediate recanalisation of the renal vein is the most effective.

  17. Ascending Aorta to Hepatic and Mesenteric Artery Bypassing, in Patients with Chronic Mesenteric Ischemia and Extensive Aortic Disease-A Case Report and Review of the Literature.

    Science.gov (United States)

    Barr, James; Kokotsakis, John; Tsipas, Pantelis; Papapavlou, Prodromos; Velissarios, Konstantinos; Kratimenos, Theodoros; Athanasiou, Thanos

    2017-02-01

    Chronic mesenteric ischemia (CMI) is a rare disorder caused by severe stenosis of the mesenteric arterial supply that results in postprandial pain and weight loss. Treatment options are surgical or endovascular. Surgical bypass can be performed in an antegrade fashion from the supraceliac abdominal aorta (AA) or the distal descending thoracic aorta or in a retrograde fashion from the infrarenal aorta or the common iliac artery. However, in some patients with disease of the descending thoracic aorta or the AA, another site for the proximal anastomosis needs to be found. In this article, we report the case of a 69-year-old man with a thoracoabdominal aortic aneurysm and CMI in whom we performed bypass grafts to the hepatic and superior mesenteric arteries using the ascending aorta as the site for the proximal anastomoses via a median sternolaparotomy. In addition, we performed a literature review of all similar cases and provide an analysis of this technique and an assessment of the success rates. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Is the thoracic aorta a safe site for the proximal anastomosis for bypassing the mesenteric arteries in patients with chronic mesenteric ischaemia?

    Science.gov (United States)

    Barr, James; Kokotsakis, John; Velissarios, Konstantinos; Athanasiou, Thanos

    2017-05-01

    A best evidence topic in cardiovascular surgery was written according to a structured protocol. The question addressed was whether the thoracic aorta is a safe site for the proximal anastomosis when bypassing the mesenteric arteries in patients with chronic mesenteric ischaemia. Five articles reported the use of the thoracic aorta as the site of proximal anastomosis in 35 patients with chronic mesenteric ischaemia. All of these studies were retrospective case reports or case series. The ascending aorta was the site for the proximal anastomosis in 7 patients with the descending thoracic aorta being used in the other 28 patients. The ascending aorta was used when there was disease of the descending thoracic aorta. Out of the 35 patients there was only 1 perioperative death (3%). Rates of graft patency and freedom from recurrent symptoms were excellent. The published literature supports the use of the thoracic aorta as an option for the site of the proximal anastomosis when bypass from elsewhere is not possible. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  19. Image Quality Enhancement Using the Direction and Thickness of Vein Lines for Finger-Vein Recognition

    Directory of Open Access Journals (Sweden)

    Young Ho Park

    2012-10-01

    Full Text Available On the basis of the increased emphasis placed on the protection of privacy, biometric recognition systems using physical or behavioural characteristics such as fingerprints, facial characteristics, iris and finger-vein patterns or the voice have been introduced in applications including door access control, personal certification, Internet banking and ATM machines. Among these, finger-vein recognition is advantageous in that it involves the use of inexpensive and small devices that are difficult to counterfeit. In general, finger-vein recognition systems capture images by using near infrared (NIR illumination in conjunction with a camera. However, such systems can face operational difficulties, since the scattering of light from the skin can make capturing a clear image difficult. To solve this problem, we proposed new image quality enhancement method that measures the direction and thickness of vein lines. This effort represents novel research in four respects. First, since vein lines are detected in input images based on eight directional profiles of a grey image instead of binarized images, the detection error owing to the non-uniform illumination of the finger area can be reduced. Second, our method adaptively determines a Gabor filter for the optimal direction and width on the basis of the estimated direction and thickness of a detected vein line. Third, by applying this optimized Gabor filter, a clear vein image can be obtained. Finally, the further processing of the morphological operation is applied in the Gabor filtered image and the resulting image is combined with the original one, through which finger-vein image of a higher quality is obtained. Experimental results from application of our proposed image enhancement method show that the equal error rate (EER of finger-vein recognition decreases to approximately 0.4% in the case of a local binary pattern-based recognition and to approximately 0.3% in the case of a wavelet transform

  20. Air in portal vein in an adult. Imaging study and clinical correlation

    International Nuclear Information System (INIS)

    Mallorquin, F.; Lopez, E.; Ruiz, E.; Medina, A.; Cubero, M.

    1997-01-01

    The presence of air in the portal system is observed only sporadically in radiological studies. It is associated with different clinical situations some of which can greatly jeopardize the life of the patient. We present five cases in which air was detected in the portal vein: in three cases, it was due to mesenteric ischemia, in one to gastric perforation and in the remaining case it was related to a jejunostomy tube. Four patients underwent ultrasound and all five underwent CT and plan X-ray of the abdomen. The ultrasound study was positive in the four patients in whom it was carried out (100%); air was detected by CT in three cases (60%), while plain abdominal X-ray showed no sign of air in any of the five cases. Four patients died as a consequence of their underlying disease and their poor general health. The patient with the jejunostomy tube survived after the tube was un blocked and the tube reinserted: there was no sign of air in follow-up studies. In our series, ultrasound was more sensitive than plain X-ray or CT in diagnosing this finding. Air collection in the portal vein may be a transient phenomenon when associated with benign processes, many of which are iatrogenic. However it occasionally presents as a sign of severe, or even life-threatening disease. We consider ultrasound to be the method of choice for the diagnosis of intra portal air: CT can be useful both in the diagnosis of this phenomenon and in the search for the underlying cause. (Author) 22 refs

  1. An unusual case: right proximal ureteral compression by the ovarian vein and distal ureteral compression by the external iliac vein

    Directory of Open Access Journals (Sweden)

    Halil Ibrahim Serin

    2015-12-01

    Full Text Available A 32-years old woman presented to the emergency room of Bozok University Research Hospital with right renal colic. Multidetector computed tomography (MDCT showed compression of the proximal ureter by the right ovarian vein and compression of the right distal ureter by the right external iliac vein. To the best of our knowledge, right proximal ureteral compression by the ovarian vein together with distal ureteral compression by the external iliac vein have not been reported in the literature. Ovarian vein and external iliac vein compression should be considered in patients presenting to the emergency room with renal colic or low back pain and a dilated collecting system.

  2. Histamine-dependent prolongation by aldosterone of vasoconstriction in isolated small mesenteric arteries of the mouse

    DEFF Research Database (Denmark)

    Schjerning, Jeppe; Uhrenholt, Torben R; Svenningsen, Per

    2013-01-01

    vital stain. Confocal microscopy of live mast cells showed loss of quinacrine fluorescence and swelling after aldosterone treatment indicating degranulation. RT-PCR showed expression of mineralocorticoid receptors in mesenteric arteries and in isolated mast cells. These findings suggest that aldosterone...

  3. Angiotensin II modulates conducted vasoconstriction to norepinephrine and local electrical stimulation in rat mesenteric arterioles

    DEFF Research Database (Denmark)

    Gustafsson, F; Holstein-Rathlou, N H

    1999-01-01

    the effect of intravenous infusion of angiotensin II (ANG II), losartan or methoxamine on conducted vasoconstriction to local application of norepinephrine (NE) or local electrical stimulation onto the surface of rat mesenteric arterioles in vivo. METHODS: In anesthetized male Wistar rats (n = 43) NE (0.1 m...

  4. Myogenic activation and calcium sensitivity of cannulated rat mesenteric small arteries

    NARCIS (Netherlands)

    VanBavel, E.; Wesselman, J. P.; Spaan, J. A.

    1998-01-01

    Pressure-induced activation of vascular smooth muscle may involve electromechanical as well as nonelectromechanical coupling mechanisms. We compared calcium-tone relations of cannulated rat mesenteric small arteries during pressure-induced activation, depolarization (16 to 46 mmol/L K+), and

  5. Management of spontaneous isolated dissection of the superior mesenteric artery: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Takara Hiroaki

    2011-05-01

    Full Text Available Abstract Background and method The aim of this study was to assess retrospectively the clinical presentation, management and outcome of three patients with isolated SMA dissection encountered at Okinawa Prefectural Chubu Hospital, Japan from 2005 to 2006, along with a review of the literature. We follow up the patient's clinical symptoms and the image by using enhanced dynamic CT at 1 week, 1 or 2 months, 6 months, and yearly after onset. Case presentation We present three patients with acute abdominal pain due to spontaneous dissection of the superior mesenteric artery (SMA, who were treated by surgical revascularization or conservative management. Two patients underwent surgery because of signs or symptoms of intestinal ischemia and one patient elected conservative management. The SMA was repaired by bypass graft in two cases, and in one of these, the graft was occluded because of prominent native flow from the SMA. All patients were symptom free and there was no evidence of disease recurrence after a median follow-up of 4.3 years. Conclusion Although the indications for surgery are still controversial, we should proceed with exploratory laparotomy if the patient has acute symptoms with suspicion of mesenteric ischemia. A non-operative approach for SMA dissection requires close follow-up abdominal CT, with a focus on the clinical signs of mesenteric ischemia and the vascular supply of the SMA, including collateral flow from the celiac artery and inferior mesenteric artery.

  6. Effect of closure of the mesenteric defect during laparoscopic gastric bypass and prevention of internal hernia

    DEFF Research Database (Denmark)

    Kristensen, Sara Danshøj; Naver, Lars; Jess, Per

    2014-01-01

    assigned to either conventional laparoscopic Roux-en-Y gastric bypass (LRYGB) without closing the mesenteric defects (n = 250) or RYGB with closing of the defects with hernia clips (n = 250). Follow-up is conducted at six months, one year, two years and five years after RYGB. The primary endpoint...

  7. Mesenteric lymph node cavitation in celiac disease: Ultrasound and CT findings

    International Nuclear Information System (INIS)

    Gonzalez, P.; Quiros, J.F.B. de; Nukiz, J.R.; Vicente, M.; Montes, A.

    1996-01-01

    We present a 42 years old female patient with celiac disease and mesenteric lymph node cavitation syndrome. This is a rare complication in patients with mal absorption syndrome, and in has been poorly studied. We describe the sonographic and CT changes in the earlier stage as well as later on, and we review the literature. (Author) 12 refs

  8. Is mesenteric panniculitis truely a paraneoplastic phenomenon? A matched pair analysis

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    Gögebakan, Ö., E-mail: Oezlem.Goegebakan@vivantes.de [Vivantes Klinikum Neukölln, Department for Radiology and Interventional Therapy, Berlin (Germany); Albrecht, T., E-mail: Thomas.Albrecht@vivantes.de [Vivantes Klinikum Neukölln, Department for Radiology and Interventional Therapy, Berlin (Germany); Osterhoff, M.A., E-mail: martino@dife.de [Charité – University Medicine Berlin, CBF, Department for Endocrinology, Diabetes and Nutrition, Berlin (Germany); German Institute of Human Nutrition, Potsdam-Rehbruecke, Department of Clinical Nutrition, Nuthetal (Germany); Reimann, A., E-mail: Anja.Reimann@vivantes.de [Vivantes Klinikum Neukölln, Department for Radiology and Interventional Therapy, Berlin (Germany)

    2013-11-01

    Purpose: Mesenteric panniculitis (MP) is an underdiagnosed inflammatory condition of mesenteric adipose tissue. Prior studies suggested an association of MP with malignancy. To reassess this hypothesis, we performed the first matched case–control study comparing prevalence of malignancy and other disease in patients with and without MP. Material and methods: With a keyword search we identified CT examinations of MP patients between 2010 and 2012. Each MP patient was matched with two control patients for age, gender, abdominal diameter and CT protocol. Manifestation and extent of mesenteric panniculitis was classified independently by two investigators according to established criteria. Concomitant disease, laboratory parameters and follow up CTs were recorded and analyzed for all patients. Results: 77 of 13485 CT patients were diagnosed with MP (prevalence 0.58%). 50.6% of MP patients suffered from malignancy vs. 60.2% in the control group (p = 0.157). Over up to 4 years of follow up in 35 of these 77 MP patients no association between development of MP and the course of tumor diseases could be identified. There was also no significant difference in the rate of frequent concomitant diseases such as hypertension, diabetes or previous surgery between the two groups. Conclusion: In this first case–control-study we could show that, contrary to previous reports, mesenteric panniculitis is neither paraneoplastic nor is it associated with other diseases.

  9. Mesenteric panniculitis in a child misdiagnosed as appendicular mass: a case report and review of literature

    OpenAIRE

    Rumman, Nisreen; Rumman, George; Sharabati, Barakat; Zagha, Rami; Disi, Nimer

    2014-01-01

    Mesenteric panniculitis is a chronic inflammatory process involving the adipose tissue of the mesentery. The etiology is unknown, and it is rare in children. We report a 5 year old girl who presented with abdominal symptoms and was misdiagnosed as appendicular mass. The correct diagnosis was established after surgical resection.

  10. Mesenteric panniculitis in a child misdiagnosed as appendicular mass: a case report and review of literature.

    Science.gov (United States)

    Rumman, Nisreen; Rumman, George; Sharabati, Barakat; Zagha, Rami; Disi, Nimer

    2014-01-01

    Mesenteric panniculitis is a chronic inflammatory process involving the adipose tissue of the mesentery. The etiology is unknown, and it is rare in children. We report a 5 year old girl who presented with abdominal symptoms and was misdiagnosed as appendicular mass. The correct diagnosis was established after surgical resection.

  11. Is prompt exploratory laparotomy the best attitude for mesenteric ischemia after cardiac surgery?

    Science.gov (United States)

    Abboud, Bassam; Daher, Ronald; Sleilaty, Ghassan; Madi-Jebara, Samia; El Asmar, Bechara; Achouch, Ramzi; Jebara, Victor

    2008-12-01

    Mesenteric ischemia following cardiac surgery is a life-threatening complication. Early identification of patients may help optimizing management and improving outcome. Between January 2000 and July 2007, surgical exploration was realized when mesenteric ischemia was suspected after coronary-artery bypass grafts (CABG). Patients were divided in two groups according to diagnosis confirmation upon laparotomy. Peri-operative predictors of complication and death were analyzed. Of 1634 consecutive patients, 13 (0.8%) developed acute abdomen with suspicion of mesenteric ischemia. Seven (0.4%) underwent resection for ischemic lesions (group 1), of whom two were during a second look laparotomy. The other six patients had normal bowel (group 2). Both groups were comparable according to preoperative status, clinical signs, biological and radiological findings. Delays to laparotomy were 13.7+/-19.0 and 51.4+/-29.0 h in group 1 and 2, respectively (P=0.02). Mortality rates were 46.1% (6/13) overall, 42.8% for group 1 and 50% for group 2. All deaths occurred within the first nine postoperative days. Mesenteric ischemia following CABG is a fatal complication in almost half the cases. Diagnostic tools and timely laparotomy still need to be optimized. Low threshold-based strategy for prompt surgical intervention is efficient for both diagnosis and treatment.

  12. Mid-gut volvulus and mesenteric vessel thrombosis in pregnancy: case report and literature review.

    Science.gov (United States)

    Shui, Losa Hao; Rafi, Junaid; Corder, Allan; Mowbray, David

    2011-03-01

    Mid-gut volvulus is a rare complication of pregnancy, where torsion of the small bowel around its mesentery can result in extensive bowel infarction. To our knowledge, there has been no previous reported case of mid-gut volvulus and mesenteric vessel thrombosis managed without bowel resection. A 25-year-old woman presented at 35 + 3 weeks gestation with constant abdominal pain. There was no past medical history of abdominal surgery. The patient later developed feculent vomiting. Exploratory laparotomy revealed a mid-gut volvulus causing small bowel ischaemia, which extended from the duodenojejunal (DJ) flexure to the terminal ileum. There was also mesenteric arterial and venous thrombosis. A healthy baby girl was delivered by caesarean section and the mid-gut volvulus was reduced. Further, two re-look laparotomies confirmed viable bowel following detorsion. The mesenteric vessel thrombosis was treated with intravenous heparin. The patient went on to make a full recovery. As shown in this case, the volvulus and mesenteric vessel thrombosis may occur during pregnancy even in patients without previous history of coagulopathies and abdominal surgery. It is difficult to make a clinical diagnosis, as the symptoms, physical signs and laboratory findings can be misleading. Therefore, a high index of suspicion is necessary for the early diagnosis of these conditions, as prompt treatment can prevent bowel resection and improve maternal and foetal outcomes.

  13. Very late mesenteric bare metal stent thrombosis in the setting of cessation of antiplatelet agents.

    Science.gov (United States)

    Ait-Mokhtar, O; Bayet, G; Benamara, S; Brunet, J; Hager, F X; Sainsous, J

    2015-06-01

    We report a case of a 73 year-old man admitted for acute mesenteric ischaemia. Eight years before, he had a first mesenteric ischaemic event treated by left colectomy and angioplasty of both main coeliac artery (MCA) and superior mesenteric artery (SMA); the patient was discharged on lifelong clopidogrel and aspirin. One month before his admission for the index event, he had a major haematuria; clopidogrel was stopped first, then aspirin because of recurrent haematuria. Five days after withdrawal of both antiplatelet drugs, the patient presented with acute mesenteric ischaemia. Urgent aortography showed in-stent occlusion of SMA and in-stent restenosis of MCA; we performed ad hoc thrombus aspiration of SMA and balloon angioplasty of MCA. The patient was discharged seven days after, without complications. This case shows that very late stent thrombosis in digestive artery can occur in the setting of antiplatelet arrest and urgent endovascular intervention constitutes a seductive alternative for surgery when performed early after symptoms onset. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  14. Abdominal tuberculosis: A histopathological study with special reference to intestinal perforation and mesenteric vasculopathy

    Directory of Open Access Journals (Sweden)

    Alakananda Dasgupta

    2009-01-01

    Conclusion : Involvement of mesenteric vasculature by granulomatous inflammation was commonly associated with the ulcerative type with perforation, suggesting that ischemia caused by vascular thrombosis is responsible for tissue breakdown. This implies that vasculitis plays an important role in the natural history of abdominal tuberculosis.

  15. Mesenteric venous thrombosis caused by deficiency of physiologic anti-coagulants: report of a case

    NARCIS (Netherlands)

    Bemelman, W. A.; Butzelaar, R. M.; Khargi, K.; Keeman, J. N.

    1990-01-01

    Mesenteric venous thrombosis is a clinical entity, which is rarely recognized on admission. The patients are admitted with vague abdominal complaints and, eventually, abdominal sepsis might occur requiring laparotomy. Nowadays, underlying hypercoagulable states such as antithrombin-III, protein-C

  16. Schistosomiasis Presenting as a Case of Acute Appendicitis with Chronic Mesenteric Thrombosis

    Directory of Open Access Journals (Sweden)

    Mohammed H. Mosli

    2016-01-01

    Full Text Available The manifestations of schistosomiasis typically result from the host inflammatory response to parasitic eggs that are deposited in the mucosa of either the gastrointestinal tract or bladder. We present here a case of a 50-year-old gentleman with a rare gastrointestinal presentation of both schistosomal appendicitis and mesenteric thrombosis.

  17. Cisplatin induced acute mesenteric ischaemia: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Shivun Khosla

    Full Text Available Introduction: Cisplatin is a platinum-based chemotherapeutic agent, widely used in cancer therapies for numerous solid tumours. It is becoming more recognised that a potentially life-threatening complication of cisplatin is accelerated arterial and venous thrombosis. Presentation of case: We describe a case of a 62 year-old with no risk factors for vascular disease who presented with thromboembolic acute mesenteric ischaemia of the small bowel during treatment with cisplatin for head and neck cancer. Discussion: We review the literature on the incidence and pathogenesis of cisplatin induced arterial thrombosis and discuss current treatment options of acute mesenteric ischaemia detailing our management of this case. Conclusion: Cisplatin increases the risk of arterial thrombosis and this case report details acute mesenteric ischaemia secondary to its use. We hope to raise clinician awareness of this sequelae which can occur even in patients in the absence of other identifiable risk factors. Keywords: Cisplatin, Acute mesenteric ischaemia, Arterial thrombosis, Case report

  18. Disappearance of mesenteric lymphadenopathy with gluten-free diet in celiac sprue

    NARCIS (Netherlands)

    de Boer, W. A.; Maas, M.; Tytgat, G. N.

    1993-01-01

    In an adult patient with untreated celiac sprue, mesenteric lymphadenopathy was detected by computerized tomography (CT). Although malignant lymphoma was suspected, the nodes disappeared after treatment with a gluten-free diet, as was documented by CT follow-up. This report demonstrates that

  19. Nutcracker Syndrome: laparoscopic external stenting of the renal vein (“the shield technique”

    Directory of Open Access Journals (Sweden)

    Fernando Korkes

    Full Text Available ABSTRACT Nutcracker syndrome refers to the complex of clinical symptoms caused by the compression of the left renal vein (LRV between the abdominal aorta and the superior mesenteric artery, leading to stenosis of the aortomesenteric portion of the LRV and dilatation of the distal portion. Hematuria, proteinuria, flank pain, varicocele and pelvic congestion may occur, occurring more frequently in young adults. Conservative management, might be the option whenever it is possible. When surgical treatment is required, classically open surgery have been performed, with major surgeries as LRV transposition or bypass techniques. The main caveats regards the fact that these are large and risky surgeries. Endovascular surgery with venous stent placement has gained some space as it is minimally invasive alternative. However, venous stents are associated with a high number of trombotic complications and in many cases requirement of life-long anticoagulants. External stenting of the LRV with this “shield technique” is a minimally invasive alternative, with good medium term results. We herein demonstrate our second experience with the technique of this surgery in a patient with 12 months of follow up and excellent results.

  20. Portomesenteric Vein Thrombosis After Laparoscopic Sleeve Gastrectomy: 3 Case Reports and a Literature Review

    Science.gov (United States)

    Muneer, Mohammed; Abdelrahman, Husham; El-Menyar, Ayman; Zarour, Ahmad; Awad, Ahmed; Dhaheri, Mahmood Al; Al-Thani, Hassan

    2016-01-01

    Case series Patient: Male, 27 • Female, 46 • Male, 46 Final Diagnosis: — Symptoms: Vague abdominal pain • severe nausea • vomiting • fever and diffuse abdominal tendernes Medication: — Clinical Procedure: — Specialty: — Objective: Rare co-existance of disease or pathology Background: Porto-mesenteric venous thrombosis (PMVT) is an infrequent but severe surgical complication developing in patients who underwent laparoscopic bariatric surgery (sleeve gastrectomy). Herein, we describe the clinical presentation, management, and outcome of 3 rare cases of PMVT after laparoscopic sleeve gastrectomy (LSG), successfully treated at our center. Case Report: All patients developed PMVT post-LSG and presented with diffused abdominal pain, nausea, and vomiting. Computed tomography (CT) of the abdomen confirmed the diagnosis of portal vein thrombosis. Two patients were treated conservatively with anticoagulation and thrombolytic therapy and the third patient required operative intervention with bowel resection. Conclusions: PMVT is a rare presentation after LSG, which requires early diagnosis and management. Conservative management through anticoagulants and thrombolytic therapy is quite effective and, if indicated, should always be considered as the primary treatment option. PMID:27068354

  1. Incidental retroaortic left innominate vein in adult patient

    Directory of Open Access Journals (Sweden)

    Alexandre Semionov, MD, PhD

    2017-09-01

    Full Text Available Retro-aortic left innominate vein is a rare vascular abnormality, usually associated with congenital heart disease. Here we report a case of isolated retro-aortic left innominate vein in an adult female.

  2. Varicose Veins: Role of Mechanotransduction of Venous Hypertension

    Science.gov (United States)

    Atta, Hussein M.

    2012-01-01

    Varicose veins affect approximately one-third of the adult population and result in significant psychological, physical, and financial burden. Nevertheless, the molecular pathogenesis of varicose vein formation remains unidentified. Venous hypertension exerted on veins of the lower extremity is considered the principal factor in varicose vein formation. The role of mechanotransduction of the high venous pressure in the pathogenesis of varicose vein formation has not been adequately investigated despite a good progress in understanding the mechanomolecular mechanisms involved in transduction of high blood pressure in the arterial wall. Understanding the nature of the mechanical forces, the mechanosensors and mechanotransducers in the vein wall, and the downstream signaling pathways will provide new molecular targets for the prevention and treatment of varicose veins. This paper summarized the current understanding of mechano-molecular pathways involved in transduction of hemodynamic forces induced by blood pressure and tries to relate this information to setting of venous hypertension in varicose veins. PMID:22489273

  3. Venous Thromboembolic Events After Cerebral Vein Thrombosis

    NARCIS (Netherlands)

    Miranda, Bruno; Ferro, José M.; Canhão, Patrícia; Stam, Jan; Bousser, Marie-Germaine; Barinagarrementeria, Fernando; Scoditti, Umberto

    2010-01-01

    Background and Purpose-After cerebral vein and dural sinus thrombosis (CVT), there is an increased risk of further venous thromboembolic events (VTEs). Time to a second cerebral or systemic venous thrombotic event and risk factors for recurrence have not been investigated in large prospective

  4. Portal vein thrombosis following laparoscopic gastric plication

    Science.gov (United States)

    Rikabi, S; Chang, A; Durkin, N; Ramar, S

    2017-01-01

    Portal vein thrombosis (PVT) following laparoscopic surgery including Roux-en-Y bypass, sleeve gastrectomy and Nissen’s fundoplication is a rare but recognised complication. Laparoscopic gastric plication in a new procedure that is popular in some parts of the world. We report a case of a patient suffering PVT as a complication of this surgery. PMID:27652795

  5. Portal vein thrombosis complicating appendicitis | Ayantunde | West ...

    African Journals Online (AJOL)

    Appendicitis is still the most common acute surgical abdomen all over the world and its complications may be grave. We report an adult case of acute appendicitis complicated by Portal Vein Thrombosis (PVT) and ascending portomesenteric phlebitis treated successfully with antibiotics and anticoagulation with no residual ...

  6. Combined central retinalartery and vein occlusion complicating ...

    African Journals Online (AJOL)

    Orbital Cellulitis is a dreaded ophthalmologic disease. Itmay destroy vision and the eye andmay even become life threatening. Often visual loss is the result of exposure and subsequent destruction of ocular tissue commonly the cornea and the uvea. We report a case of combined central retinal artery and vein occlusion ...

  7. Internal Jugular Vein Cannulation; Anatomical Surface Markings ...

    African Journals Online (AJOL)

    She had undergone numerous central venous cannulations and unsuccessful peripheral vein cut-downs in the past. On two separate occasions she had central venous catheters (CVCs) inserted in theatre using the surface landmark technique and ultrasound-guided technique. This paper describes these procedures and ...

  8. Endovascular vein harvest: systemic carbon dioxide absorption.

    Science.gov (United States)

    Maslow, Andrew M; Schwartz, Carl S; Bert, Arthur; Hurlburt, Peter; Gough, Jeffrey; Stearns, Gary; Singh, Arun K

    2006-06-01

    Endovascular vein harvest (EDVH) requires CO(2) insufflation to expand the subcutaneous space, allowing visualization and dissection of the saphenous vein. The purpose of this study was to assess the extent of CO(2) absorption during EDVH. Prospective observational study. Single tertiary care hospital. Sixty patients (30 EDVH and 30 open-vein harvest) undergoing isolated coronary artery bypass graft surgery. Hemodynamic, procedural, and laboratory data were collected prior to (baseline), during, and at it the conclusion (final) of vein harvesting. Data were also collected during cardiopulmonary bypass (CPB). Data were compared by using t tests, analysis of variance, and correlation statistics when needed. There were significant increases in arterial CO(2) (PaCO(2), 35%) and decreases in pH (1.35%) during EDVH. These were associated with increases in heart rate, mean blood pressure, and cardiac output. Within the EDVH group, greater elevations (>10 mmHg) in PaCO2 were more likely during difficult harvest procedures, and these patients exhibited greater increase in heart rate. Elevated CO(2) persisted during CPB, requiring higher systemic gas flows and greater use of phenylephrine to maintain desired hemodynamics. EDVH was associated with systemic absorption of CO(2). Greater absorption was more likely in difficult procedures and was associated with greater hemodynamic changes requiring medical therapy.

  9. Preduodenal portal vein: A potential laparoscopic cholecystectomy ...

    African Journals Online (AJOL)

    Variations of biliary anatomy are well described. Those of most relevance to the operative surgeon are the variations of the extrahepatic ducts and their relationships to the right hepatic artery and its branches. We describe another even rarer congenital anomaly of a preduodenal portal vein. Its embryological derivation and ...

  10. Portal vein thrombosis following laparoscopic gastric plication

    OpenAIRE

    Som, R; Rikabi, S; Chang, A; Durkin, N; Ramar, S

    2017-01-01

    Portal vein thrombosis (PVT) following laparoscopic surgery including Roux-en-Y bypass, sleeve gastrectomy and Nissen’s fundoplication is a rare but recognised complication. Laparoscopic gastric plication in a new procedure that is popular in some parts of the world. We report a case of a patient suffering PVT as a complication of this surgery.

  11. Puzzles in practice: splenic vein thrombosis.

    Science.gov (United States)

    McIntyre, Brittany; Marsh, Melanie; Walden, Jeffrey

    2016-06-01

    This report details a 58-year-old gentleman who presented to his outpatient primary care physician's clinic several times over four weeks for ongoing epigastric pain radiating into his left flank, dry heaving, and constipation. He was presumed to have gastritis at each visit and prescribed escalating doses of proton pump inhibitors. Due to the unrelenting pain, he eventually was admitted to the hospital and diagnosed with splenic vein thrombosis after computed tomography imaging of the abdomen. Our literature search revealed that pancreatic pathology is overwhelmingly the contributing factor to splenic vein thrombosis. Our patient had prominent collateral vasculature, suggesting that his splenic vein thrombosis was chronic in nature and likely the cause of his ongoing abdominal pain. Splenic vein thrombosis is an uncommon cause of abdominal pain, but one that should be included in the treating physician's differential diagnoses when abdominal pain is ongoing despite medical therapy. Although he had no evidence of initial findings on radiography, our patient was eventually diagnosed with biopsy-proven pancreatic cancer. Our case report demonstrates how patients presenting with persistent or worsening abdominal pain despite the use of proton pump inhibitors or other acid reducing agents and potential 'red flag' findings such as decreased appetite and weight loss should be worked up for other potential sources of abdominal pathology.

  12. Mesenteric near-infrared spectroscopy and risk of gastrointestinal complications in infants undergoing surgery for congenital heart disease.

    Science.gov (United States)

    Iliopoulos, Ilias; Branco, Ricardo G; Brinkhuis, Nadine; Furck, Anke; LaRovere, Joan; Cooper, David S; Pathan, Nazima

    2016-04-01

    We hypothesised that lower mesenteric near-infrared spectroscopy values would be associated with a greater incidence of gastrointestinal complications in children weighing infrared spectroscopy, central venous oxygen saturation, and arterial blood gases for 48 hours post-operatively. Enteral feeding intake, gastrointestinal complications, and markers of organ dysfunction were monitored for 7 days. A total of 50 children, with median age of 16.7 (3.2-31.6) weeks, were studied. On admission, the average mesenteric near-infrared spectroscopy value was 71±18%, and the systemic oxygen saturation was 93±7.5%. Lower admission mesenteric near-infrared spectroscopy correlated with longer time to establish enteral feeds (r=-0.58, pinfrared spectroscopy (58±18% versus 73±17%, p=0.01) and higher mesenteric arteriovenous difference of oxygen at admission [39 (23-47) % versus 19 (4-27) %, p=0.02]. Based on multiple logistic regression, admission mesenteric near-infrared spectroscopy was independently associated with gastrointestinal complications (Odds ratio, 0.95; 95% confidence interval, 0.93-0.97; p=0.03). Admission mesenteric near-infrared spectroscopy showed an area under the receiver operating characteristic curve of 0.76 to identify children who developed gastrointestinal complications, with a suggested cut-off value of 72% (78% sensitivity, 68% specificity). In this pilot study, we conclude that admission mesenteric near-infrared spectroscopy is associated with gastrointestinal complications and enteral feeding tolerance in children after cardiac surgery.

  13. Role of endothelium in angiotensin II formation by the rat aorta and mesenteric arterial bed

    Directory of Open Access Journals (Sweden)

    R. Leite

    1997-05-01

    Full Text Available We investigated the angiotensin II (Ang II-generating system by analyzing the vasoconstrictor effect of Ang II, angiotensin I (Ang I, and tetradecapeptide (TDP renin substrate in the absence and presence of inhibitors of the renin-angiotensin system in isolated rat aortic rings and mesenteric arterial beds with and without functional endothelium. Ang II, Ang I, and TDP elicited a dose-dependent vasoconstrictor effect in both vascular preparations that was completely blocked by the Ang II receptor antagonist saralasin (50 nM. The angiotensin converting enzyme (ACE inhibitor captopril (36 µM completely inhibited the vasoconstrictor effect elicited by Ang I and TDP in aortic rings without affecting that of Ang II. In contrast, captopril (36 µM significantly reduced (80-90% the response to bolus injection of Ang I, without affecting those to Ang II and TDP in mesenteric arteries. Mechanical removal of the endothelium greatly potentiated (70-95% the vasoconstrictor response to Ang II, Ang I, and TDP in aortic rings while these responses were unaffected by the removal of the endothelium of mesenteric arteries with sodium deoxycholate infusion. In addition, endothelium disruption did not change the pattern of response elicited by these peptides in the presence of captopril. These findings indicate that the endothelium may not be essential for Ang II formation in rat mesenteric arteries and aorta, but it may modulate the response to Ang II. Although Ang II formation from Ang I is essentially dependent on ACE in both vessels, our results suggest the existence of an alternative pathway in the mesenteric arterial bed that may play an important role in Ang II generation from TDP in resistance but not in large vessels during ACE inhibition

  14. Copper Induces Vasorelaxation and Antagonizes Noradrenaline -Induced Vasoconstriction in Rat Mesenteric Artery

    Directory of Open Access Journals (Sweden)

    Yu-Chun Wang

    2013-11-01

    Full Text Available Background/Aims: Copper is an essential trace element for normal cellular function and contributes to critical physiological or pathological processes. The aim of the study was to investigate the effects of copper on vascular tone of rat mesenteric artery and compare the effects of copper on noradrenaline (NA and high K+ induced vasoconstriction. Methods: The rat mesenteric arteries were isolated and the vessel tone was measured by using multi wire myograph system in vitro. Blood pressure of carotid artery in rabbits was measured by using physiological data acquisition and analysis system in vivo. Results: Copper dose-dependently blunted NA-induced vasoconstriction of rat mesenteric artery. Copper-induced vasorelaxation was inhibited when the vessels were pretreated with NG-nitro-L-arginine methyl ester (L-NAME. Copper did not blunt high K+-induced vasoconstriction. Copper preincubation inhibited NA-evoked vasoconstriction and the inhibition was not affected by the presence of L-NAME. Copper preincubation showed no effect on high K+-evoked vasoconstriction. Copper chelator diethyldithiocarbamate trihydrate (DTC antagonized the vasoactivity induced by copper in rat mesenteric artery. In vivo experiments showed that copper injection (iv significantly decreased blood pressure of rabbits and NA or DTC injection (iv did not rescue the copper-induced hypotension and animal death. Conclusion: Copper blunted NA but not high K+-induced vasoconstriction of rat mesenteric artery. The acute effect of copper on NA-induced vasoconstriction was depended on nitric oxide (NO, but the effect of copper pretreatment on NA-induced vasoconstriction was independed on NO, suggesting that copper affected NA-induced vasoconstriction by two distinct mechanisms.

  15. Isolated thrombosis of the external jugular vein.

    Science.gov (United States)

    Colomina, M J; Godet, C; Bagó, J; Pellisé, F; Puig, O; Villanueva, C

    2000-08-01

    Thrombosis of the external jugular vein (EJV) is an infrequent clinical condition that has been associated with central venous catheterization, head and neck infections, intravenous drug abuse, and compression at the affected site. The authors report a case of thrombotic obstruction of the EJV in the late postoperative period after laparoscopic anterior lumbar interbody fusion. A 40-year-old morbidly obese woman with a depressive syndrome was diagnosed with L5-S1 discopathy and was submitted to laparoscopic anterior isthmic fusion. The operation lasted approximately 6 hours, during which the patient remained in a supine decubitus and Trendelenburg position. The left radial artery, peripheral veins, and right internal jugular vein were canalized. The internal jugular vein catheter was electively withdrawn 24 hours after the intervention. The postoperative period was satisfactory, and the patient was started on prophylaxis with low-molecular-weight heparin. She sat up and began walking at 24 hours and was discharged to her home 4 days after the procedure. Eight days after discharge she returned, experiencing right cervical pain. Palpation revealed a painful induration and erythematous area under the anterior edge of the sternocleidomastoid muscle. Results of otoscopy and laryngoscopy were normal. Cervical echo-Doppler disclosed an image consistent with EJV thrombosis. The most frequent causes of jugular vein thrombosis are mentioned above. A higher incidence has been described after upper abdomen and pelvic surgery; other contributing factors are age, obesity, and associated illness. There are few references in the literature to position-induced EJV thrombosis in the late postoperative period. The authors' patient presented signs and symptoms of EJV thrombosis (probably because of various factors), which was confirmed by echo-Doppler study and treated with 10 days of calcic heparin.

  16. Adventitial cystic disease of the common femoral vein presenting as deep vein thrombosis

    Directory of Open Access Journals (Sweden)

    Young-Kyun Kim

    2016-07-01

    Full Text Available Adventitial cystic disease of the common femoral vein is a rare condition. We herein report the case of a 50-year-old woman who presented with painless swelling in her left lower leg that resembled deep vein thrombosis. She underwent femoral exploration and excision of the cystic wall. The presentation, investigation, treatment, and pathology of this condition are discussed with a literature review.

  17. 21 CFR 880.6970 - Liquid crystal vein locator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Liquid crystal vein locator. 880.6970 Section 880... Devices § 880.6970 Liquid crystal vein locator. (a) Identification. A liquid crystal vein locator is a... skin by displaying the color changes of heat sensitive liquid crystals (cholesteric esters). (b...

  18. Variant Anatomy of the External Jugular Vein | Olabu | Anatomy ...

    African Journals Online (AJOL)

    Variant communications noted included facial vein, internal jugular, and a presence of a large anastomotic vein connecting it to the anterior jugular. It was duplicated in 2.2% cases and terminated into internal jugular vein in 7.7% of cases. The most common variations were in origin, course, communications and termination.

  19. Prevalence of Isolated Asymptomatic Deep Vein Thrombosis in Varicose Vein Patients with Superficial Thrombophlebitis: A Single Center Experience in Japan.

    Science.gov (United States)

    Shirasugi, Nozomu; Horiguchi, Sadaaki; Shirato, Hiroyuki; Kawakami, Toshimitsu; Ono, Hisako; Yabuki, Shiho; Jojima, Kumiko; Niimi, Masanori

    2016-01-01

    Prevalence of asymptomatic deep vein thrombosis (DVT) in patients with primary varicose veins remains unclear. Here, we conducted a retrospective study to clarify the incidence of asymptomatic DVT in patients with varicose veins, especially focusing on those with superficial thrombophlebitis (STP). Among 431 patients with primary varicose veins with saphenous vein incompetence, 20 (4.64%) had asymptomatic DVT. The presence of STP was a significant risk factor for asymptomatic DVT as 10 of the 24 (41.7%) patients with STP had asymptomatic DVT, and all cases having calf muscle vein thrombosis. In contrast, of the patients with primary varicose veins without STP only 2.46% had asymptomatic DVT. In patients with primary varicose veins with STP, significant risk factors for DVT were being over C3 on the clinical, etiological, anatomical, and pathophysiological (CEAP) classification. (This article is a translation of Jpn J Phlebol 2014; 25: 13-19.).

  20. Endovascular Radiofrequency Ablation for Varicose Veins

    Science.gov (United States)

    2011-01-01

    Executive Summary Objective The objective of the MAS evidence review was to conduct a systematic review of the available evidence on the safety, effectiveness, durability and cost–effectiveness of endovascular radiofrequency ablation (RFA) for the treatment of primary symptomatic varicose veins. Background The Ontario Health Technology Advisory Committee (OHTAC) met on August 26th, 2010 to review the safety, effectiveness, durability, and cost-effectiveness of RFA for the treatment of primary symptomatic varicose veins based on an evidence-based review by the Medical Advisory Secretariat (MAS). Clinical Condition Varicose veins (VV) are tortuous, twisted, or elongated veins. This can be due to existing (inherited) valve dysfunction or decreased vein elasticity (primary venous reflux) or valve damage from prior thrombotic events (secondary venous reflux). The end result is pooling of blood in the veins, increased venous pressure and subsequent vein enlargement. As a result of high venous pressure, branch vessels balloon out leading to varicosities (varicose veins). Symptoms typically affect the lower extremities and include (but are not limited to): aching, swelling, throbbing, night cramps, restless legs, leg fatigue, itching and burning. Left untreated, venous reflux tends to be progressive, often leading to chronic venous insufficiency (CVI). A number of complications are associated with untreated venous reflux: including superficial thrombophlebitis as well as variceal rupture and haemorrhage. CVI often results in chronic skin changes referred to as stasis dermatitis. Stasis dermatitis is comprised of a spectrum of cutaneous abnormalities including edema, hyperpigmentation, eczema, lipodermatosclerosis and stasis ulceration. Ulceration represents the disease end point for severe CVI. CVI is associated with a reduced quality of life particularly in relation to pain, physical function and mobility. In severe cases, VV with ulcers, QOL has been rated to be as bad