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Intrahepatic portal venous systems in adult patients with cavernous transformation of portal vein: Imaging features and a new classification 被引量:1
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作者 Xin Huang Qian Lu +5 位作者 Yue-Wei Zhang Lin Zhang Zhi-Zhong Ren Xiao-Wei Yang Ying Liu Rui Tang 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2024年第5期481-486,共6页
Background: Cavernous transformation of the portal vein(CTPV) due to portal vein obstruction is a rare vascular anomaly defined as the formation of multiple collateral vessels in the hepatic hilum. This study aimed to... Background: Cavernous transformation of the portal vein(CTPV) due to portal vein obstruction is a rare vascular anomaly defined as the formation of multiple collateral vessels in the hepatic hilum. This study aimed to investigate the imaging features of intrahepatic portal vein in adult patients with CTPV and establish the relationship between the manifestations of intrahepatic portal vein and the progression of CTPV. Methods: We retrospectively analyzed 14 CTPV patients in Beijing Tsinghua Changgung Hospital. All patients underwent both direct portal venography(DPV) and computed tomography angiography(CTA) to reveal the manifestations of the portal venous system. The vessels measured included the left portal vein(LPV), right portal vein(RPV), main portal vein(MPV) and the portal vein bifurcation(PVB). Results: Nine males and 5 females, with a median age of 40.5 years, were included in the study. No significant difference was found in the diameters of the LPV or RPV measured by DPV and CTA. The visualization in terms of LPV, RPV and PVB measured by DPV was higher than that by CTA. There was a significant association between LPV/RPV and PVB/MPV in term of visibility revealed with DPV( P = 0.01), while this association was not observed with CTA. According to the imaging features of the portal vein measured by DPV, CTPV was classified into three categories to facilitate the diagnosis and treatment. Conclusions: DPV was more accurate than CTA for revealing the course of the intrahepatic portal vein in patients with CTPV. The classification of CTPV, that originated from the imaging features of the portal vein revealed by DPV, may provide a new perspective for the diagnosis and treatment of CTPV. 展开更多
关键词 cavernous transformation of the portal vein CLASSIFICATION Direct portal venography Intrahepatic portal venous system
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Application of transmesenteric vein extrahepatic portosystemic shunt in treatment of symptomatic portal hypertension with cavernous transformation of portal vein 被引量:2
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作者 Weixiao Li Mingzhe Cui +9 位作者 Qiang Li Kewei Zhang Shuiting Zhai Tianxiao Li Cheshire Nick Xiuling Li Heng Wang Yadong Zhu Danghui Lu Jiangbo Chen 《Journal of Interventional Medicine》 2023年第2期90-95,共6页
Purpose:To evaluate the feasibility and efficacy of a transmesenteric vein extrahepatic portosystemic shunt(TmEPS)for the treatment of cavernous transformation of the portal vein(CTPV).Materials and methods:The clinic... Purpose:To evaluate the feasibility and efficacy of a transmesenteric vein extrahepatic portosystemic shunt(TmEPS)for the treatment of cavernous transformation of the portal vein(CTPV).Materials and methods:The clinical data of 20 patients with CTPV who underwent TmEPS between December 2020and January 2022 at Henan Provincial People’s Hospital were retrospectively collected.The superior mesenteric vein(SMV)trunk was patent or partially occluded in these patients.An extrahepatic portosystemic shunt between the inferior vena cava and the SMV was established using a stent graft through an infraumbilical median longitudinal mini-laparotomy.The technical success,efficacy,and complication rates were evaluated,and the preand postoperative SMV pressures were compared.Patients’clinical outcomes and shunt patency were assessed.Results:TmEPS was successfully performed in 20 patients.The initial puncture success rate of the balloon-assisted puncture technique is 95%.The mean SMV pressure decreased from 29.1±2.9 mmHg to 15.6±3.3 mmHg(p<0.001).All symptoms of portal hypertension resolved.No fatal procedural complications occurred.During the follow-up period,hepatic encephalopathy occurred in two patients.The remaining patients remained asymptomatic.All shunts were patent.Conclusions:TmEPS is a feasible,safe,and effective treatment option for patients with CTPV. 展开更多
关键词 Transmesenteric vein extrahepatic portosystemic shunt cavernous transformation of portal vein portal vein thrombosis portal hypertension Liver cirrhosis
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Transjugular intrahepatic portosystemic shunt for the prevention of recurrent esophageal variceal bleeding in patients with cavernous transformation of portal vein 被引量:14
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作者 Zhao-Peng Li Sui-Sui Wang +3 位作者 Guang-Chuan Wang Guang-Jun Huang Jing-Qin Cao Chun-Qing Zhang 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2018年第6期517-523,共7页
Background: Treatment options for patients with cavernous transformation of portal vein(CTPV) are limited. This study aimed to evaluate the feasibility, efficacy and safety of transjugular intrahepatic portosystemic s... Background: Treatment options for patients with cavernous transformation of portal vein(CTPV) are limited. This study aimed to evaluate the feasibility, efficacy and safety of transjugular intrahepatic portosystemic shunt(TIPS) to prevent recurrent esophageal variceal bleeding in patients with CTPV. Methods: We retrospectively analyzed 67 consecutive patients undergone TIPS from January 2011 to December 2016. All patients were diagnosed with CTPV. The indication for TIPS was a previous episode of variceal bleeding. The data on recurrent bleeding, stent patency, hepatic encephalopathy and survival were retrieved and analyzed. Results: TIPS procedure was successfully performed in 56 out of 67(83.6%) patients with CTPV. TIPS was performed via a transjugular approach alone( n = 15), a combined transjugular/transhepatic approach( n = 33) and a combined transjugular/transsplenic approach( n = 8). Mean portosystemic pressure gradient(PSG) decreased from 28.09 ± 7.28 mmHg to 17.53 ± 6.12 mmHg after TIPS( P < 0.01). The probability of the remaining free recurrent variceal bleeding was 87.0%. The probability of TIPS patency reached 81.5%. Hepatic encephalopathy occurrence was 27.8%, and survival rate was 88.9% until the end of follow-up. Four out of 11 patients who failed TIPS died, and 4 had recurrent bleeding. Conclusions: TIPS should be considered a safe and feasible alternative therapy to prevent recurrent esophageal variceal bleeding in patients with CTPV, and to achieve clinical improvement. 展开更多
关键词 cavernous transformation portal vein Transjugular intrahepatic portosystemic shunt Variceal rebleeding portal hypertension
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Sonographic features of umbilical vein recanalization for a Rex shunt on cavernous transformation of portal vein in children 被引量:2
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作者 Yu-Qing Zhang Qing Wang +6 位作者 Mei Wu Ya Li Xiu-Liang Wei Fei-Xue Zhang Yan Li Guang-Rui Shao Juan Xiao 《World Journal of Clinical Cases》 SCIE 2020年第22期5555-5563,共9页
BACKGROUND The Rex shunt was widely used as the preferred surgical approach for cavernous transformation of the portal vein(CTPV)in children that creates a bypass between the superior mesenteric vein and the intrahepa... BACKGROUND The Rex shunt was widely used as the preferred surgical approach for cavernous transformation of the portal vein(CTPV)in children that creates a bypass between the superior mesenteric vein and the intrahepatic left portal vein(LPV).This procedure can relieve portal hypertension and restore physiological hepatopetal flow.However,the modified procedure is technically demanding because it is difficult to make an end-to-end anastomosis of a bypass to a hypoplastic LPV.Many studies reported using a recanalized umbilical vein as a conduit to resolve this problem.However,the feasibility of umbilical vein recanalization for a Rex shunt has not been fully investigated.AIM To investigate the efficacy of a recanalized umbilical vein as a conduit for a Rex shunt on CTPV in children by ultrasonography.METHODS A total of 47 children who were diagnosed with CTPV with prehepatic portal hypertension in the Second Hospital,Cheeloo College of Medicine,Shandong University,were enrolled in this study.Fifteen children received a recanalized umbilical vein as a conduit for a Rex shunt surgery and were enrolled in group I.Thirty-two children received the classic Rex shunt surgery and were enrolled in group II.The sonographic features of the two groups related to intraoperative and postoperative variation in terms of bypass vessel and the LPV were compared.RESULTS The patency rate of group I(60.0%,9/15)was significantly lower than that of group II(87.5%,28/32)7 d after(on the 8th d)operation(P<0.05).After clinical anticoagulation treatment for 3 mo,there was no significant difference in the patency rate between group I(86.7%,13/15)and group II(90.6%,29/32)(P>0.05).Moreover,3 mo after(at the beginning of the 4th mo)surgery,the inner diameter significantly widened and flow velocity notably increased for the bypass vessels and the sagittal part of the LPV compared to intraoperative values in both shunt groups(P<0.05).However,there was no significant difference between the two surgical groups 3 mo after surgery(P>0.05).CONCLUSION For children with hypoplastic LPV in the Rex recessus,using a recanalized umbilical vein as a conduit for a Rex shunt may be an effective procedure for CTPV treatment. 展开更多
关键词 cavernous transformation of the portal vein Rex shunt RECANALIZATION Umbilical vein ULTRASONOGRAPHY
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Sixty-four-slice computed tomography in surgical strategy of portal vein cavernous transformation 被引量:9
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作者 Ming-Man Zhang Cong-Lun Pu Ying-Cun Li Chun-Bao Guo 《World Journal of Gastroenterology》 SCIE CAS CSCD 2011年第38期4334-4338,共5页
AIM:To investigate the role of 64-slice computed tomography(CT) in portal vein cavernous transformation to determine surgical strategy.METHODS:The site of lesions and extent of collateral circulation in 12 pediatric c... AIM:To investigate the role of 64-slice computed tomography(CT) in portal vein cavernous transformation to determine surgical strategy.METHODS:The site of lesions and extent of collateral circulation in 12 pediatric cases of cavernous transformation of the portal vein with surgical treatment were analyzed.RESULTS:Eleven of 12 children had esophageal varices and were treated with lower esophageal and gastric devascularization and splenectomy,and the other case was only treated with splenectomy.There were eight cases with spontaneous spleen/stomach-renal shunt,four with Retzius vein opening,which was reserved during surgery.Three cases of lesions involving the intrahepatic portal vein(PV) were treated with living donor liver transplantation.One patient died from PV thrombosis after liver transplantation,and the rest had no significant complications.CONCLUSION:The PV,its branches and collateral circulation were clearly seen by 64-slice spiral CT angiography,which helped with preoperative surgical planning. 展开更多
关键词 cavernous transformation portal vein Co4-slicecomputed tomography Liver transplantation portal hyper-tension Esophageal devascularization Gastric devascularization
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CT diagnosis of cavernous transformation of portal vein
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作者 赵修义 张雪林 《Journal of Medical Colleges of PLA(China)》 CAS 2000年第1期73-75,共3页
Objective: To study the CT features of cavernous transformation of the portal vein (CTPV) and to evaluate the diagnostic reliability of CT. Methods: Ten patients with CTPV underwent abdominal precontrast and contrast ... Objective: To study the CT features of cavernous transformation of the portal vein (CTPV) and to evaluate the diagnostic reliability of CT. Methods: Ten patients with CTPV underwent abdominal precontrast and contrast CT. The CT findings were compared with DSA and surgical findings. Results: Characteristic features included loss of the normal structure of the portal system and the presence of multiple, sinuous, periportal vascular structures which were enhanced during the portal phase. Transient abnormality of hepatic perfusion, characterized by the image of homogeneous bands, can be observed in arterial phase, which is not detectable in venous phase. Conclusion: CT proved to be reliable for the diagnosis of CTPV, and provides essential information for clinical treatment planning. Additional DSA examination and US were indicated for atypical patients for a more reliable diagnosis. 展开更多
关键词 cavernous transformation portal vein TOMOGRAPHY X-ray COMPUTED TOMOGRAPHY
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How can portal vein cavernous transformation cause chronic incomplete biliary obstruction? 被引量:19
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作者 Ozgur Harmanci Yusuf Bayraktar 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第26期3375-3378,共4页
Biliary disease in the setting of non-cirrhotic portal vein thrombosis(and similarly in portal vein cavernous transformation) can become a serious problem during the evolution of disease.This is mostly due to portal b... Biliary disease in the setting of non-cirrhotic portal vein thrombosis(and similarly in portal vein cavernous transformation) can become a serious problem during the evolution of disease.This is mostly due to portal biliary ductopathy.There are several mechanisms that play a role in the development of portal biliary ductopathy,such as induction of fibrosis in the biliary tract(due to direct action of dilated peribiliary collaterals and/or recurrent cholangitis),loss of biliary motility,chronic cholestasis(due to fibrosis or choledocholithiasis) and increased formation of cholelithiasis(due to various factors).The management of cholelithiasis in cases with portal vein cavernous transformation merits special attention.Because of a heterogeneous clinical presentation and concomitant pathophysiological changes that take place in biliary anatomy,diagnosis and therapy can become very complicated.Due to increased incidence and complications of cholelithiasis,standard treatment modalities like sphincterotomy or balloon sweeping of bile ducts can cause serious problems.Cholangitis,biliary strictures and hemobilia are the most common complications that occur during management of these patients.In this review,we specifically discuss important issues about bile stones related to bile duct obstruction in non-cirrhotic portal vein thrombosis and present evidence in the current literature. 展开更多
关键词 portal vein cavernous transformation Chole-lithiasis HEMOBILIA portal ductopathy portal biliopathy
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A case of portal vein thrombosis associated with acute cholecystitis/pancreatitis or coincidence 被引量:5
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作者 Mohamed El-Wahsh 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS 2006年第2期308-310,共3页
BACKGROUND: Portal vein thrombosis (PVT) is complex and risk factors include local precipitating factors and acquired and inherited factors. It occurs secondary to abdominal malignancy, infection or surgical intervent... BACKGROUND: Portal vein thrombosis (PVT) is complex and risk factors include local precipitating factors and acquired and inherited factors. It occurs secondary to abdominal malignancy, infection or surgical intervention. PVT is commonly forgotten as a possible cause of abdominal pain. The clinical picture may vary but abdominal pain and low grade fever are the most characteristic picture. METHODS: A 58-year-old male patient was admitted to our hospital complaining of abdominal pain for three days. CT scan revealed an edematous area around the portal vein. Doppler ultrasonography showed evidence of a portal vein thrombosis. RESULTS: PVT can be diagnosed with CT and Doppler ultrasonography. Fresh thrombus can be undetected by sonography because of the low echogenity but can be recognised by color Doppler ultrasonography. Treatment ranges from observation and bowel rest to surgical resection of bowel. CONCLUSIONS: When we suspect a case of PVT, it should be treated at an early stage to prevent being lost in a diagnostic dilemma. The immediate use of anticoagulant could be important in preventing serious consequences of PVT. 展开更多
关键词 portal vein thrombosis HYPERCOAGULATION ENOXAPARIN cavernomatous transformation
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Progress of transformational therapy in colorectal liver metastases
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作者 Fang Xiang Xianli Yin 《Oncology and Translational Medicine》 CAS 2015年第3期115-119,共5页
Colorectal cancer liver metastases (CLM) treatment is very important given the high incidence of colorectal cancer with liver metastases, which are primarily treated by surgical resection. Transformational therapy s... Colorectal cancer liver metastases (CLM) treatment is very important given the high incidence of colorectal cancer with liver metastases, which are primarily treated by surgical resection. Transformational therapy such as systemic chemotherapy, hepatic arterial infusion (HAl), portal vein embolization (PVE), ablation therapy, and targeted therapy, should be applied to CLM patients who are unable to undergo immediate surgery to improve patients' survival and quality of life. 展开更多
关键词 colorectal cancer liver metastases colorectal liver metastases (CLM) transformational therapy hepatic arterial infusion (HAl) portal vein embolization (PVE) ablation targeted therapy CETUXIMAB BEVACIZUMAB
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Successful liver allograft inflow reconstruction with the right gastroepiploic vein 被引量:2
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作者 Rafael S Pinheiro Ruy J Cruz Jr +2 位作者 Lucas S Nacif Matheus F Vane Luiz AC D'Albuquerque 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2016年第1期106-110,共5页
Portal vein thrombosis is a common complica- tion in cirrhotic patients. When portal vein thrombectomy is not a suitable option, a large collateral vessel can be used for allograft venous inflow reconstruction. We des... Portal vein thrombosis is a common complica- tion in cirrhotic patients. When portal vein thrombectomy is not a suitable option, a large collateral vessel can be used for allograft venous inflow reconstruction. We describe an unusu- al case of successful portal revascularization using the right gastroepiploic vein. The patient underwent a cadaveric or- thotropic liver transplantation with end-to-end anastomosis of the portal vein to the right gastroepiploic vein. Six months after liver transplantation the patient is well with good liver function. The use of the right gastroepiploic vein for allograft venous reconstruction is feasible and safe, with a great advan- tage of avoiding the need of venous jump graft. 展开更多
关键词 liver transplantation vascular grafting portal vein cavernous transformation of varicose veins hypertension portal
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Portal Biliopathy: A Review of Imaging Features of Nine Patients
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作者 Ali Nawaz Khan Ken Uzoka +2 位作者 Sumaira Macdonald Abeeku Afedzi Hammond Anthony Kodzo-Grey Venyo 《International Journal of Clinical Medicine》 2017年第11期604-617,共14页
Aim: To discuss the etiology, pathogenesis, diagnosis and management of PB, supported by a series of 9 cases from a personal series. Methods: Radiological images of 9 cases of PB were retrieved from different hospital... Aim: To discuss the etiology, pathogenesis, diagnosis and management of PB, supported by a series of 9 cases from a personal series. Methods: Radiological images of 9 cases of PB were retrieved from different hospitals and studied and information relating to PB was obtained from various internet databases including PUB Med, Google, Google Scholar and Educus. Results: Portal biliopathy (PB) is a rare complication of extra-portal venous obstruction. Most patients remain asymptomatic, but some may present with raised alkaline phosphatase level, abdominal pain, fever, and cholangitis. It tends to be associated with gallbladder (GB) wall abnormalities, a cavernous transformation of the portal vein and choledochal varices. Extrinsic compression of the common bile duct, (CBD), by dilated venous collaterals together with pericholedochal fibrosis from the inflammatory process can cause portal thrombosis, which may lead to biliary stricture and dilatation of the proximal biliary tree. These strictures set the scene for formation biliary stones and cholangitis. Liver function test abnormalities are common but remain non-specific. Imaging features are instrumental in the diagnosis of PB. This paper presents 9 of such cases of portal biliopathy, with discussions on their causation, the course of the disease process and management particularly minimally invasive procedure. The role of ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), endoscopic retrograde cholangiopancreatography (ERCP) and direct puncture cholangiography is discussed. Surgical management is evaluated. An imaging atlas is provided. Conclusions: PB is a rare but significant complication of portal venous obstruction that has an insidious onset and may remain asymptomatic until late. PB has associated coagulopathies, and a variety of other disorders, which are discussed, illustrated and the diagnosis-elaborated. The role of MRI as a non-invasive imaging tool is emphasized. 展开更多
关键词 portal Biliopathy portal Hypertension portal VENOUS THROMBOSIS cavernous transformation BILIARY STRICTURES Imaging portal Biliopathy
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经颈静脉肝内门体分流术治疗门静脉高压伴门静脉血栓的疗效与安全性
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作者 温晨 袁凯 +3 位作者 马鹍鹏 向涛 王茂强 段峰 《介入放射学杂志》 CSCD 北大核心 2024年第5期537-542,共6页
目的探讨经颈静脉肝内门体静脉分流术(transjugular intrahepatic portosystemic shunt,TIPS)治疗门静脉高压伴门静脉血栓(portal vein thrombosis,PVT)的疗效及安全性。方法纳入2017年12月至2022年10月中国人民解放军总医院收治的符合T... 目的探讨经颈静脉肝内门体静脉分流术(transjugular intrahepatic portosystemic shunt,TIPS)治疗门静脉高压伴门静脉血栓(portal vein thrombosis,PVT)的疗效及安全性。方法纳入2017年12月至2022年10月中国人民解放军总医院收治的符合TIPS治疗指征的31例门静脉高压伴PVT患者。收集患者临床资料,包括术前实验室检查、术式选择、术中门静脉压力(portal vein pressure,PVP)、术后随访超声或增强CT检查及有无肝性脑病(hepatic encephalopathy,HE)等。采用配对t检验比较支架植入前后PVP差异,Kaplan-Meier曲线分析患者术后分流道通畅率、再出血率、HE发生率及生存率。Log-rank检验分析伴或不伴有门静脉海绵样变性(cavernous transformation of portal vein,CTPV)患者的随访结果差异。结果TIPS成功率为93.55%(29/31)。手术成功的29例患者支架植入前后PVP由(30.15±4.61)mmHg降至(20.84±5.57)mmHg,差异有统计学意义(t=8.975,P<0.05)。术后随访时间为22.90(4.50,61.80)个月。随访期间,24.14%(7/29)的患者出现分流道功能障碍,17.24%(5/29)的患者出现再出血,17.24%(5/29)的患者出现HE,17.24%(5/29)的患者死亡。10例PVT患者伴有CTPV,伴有CTPV患者的分流道功能障碍5例、再出血3例、HE 1例、死亡3例,不伴有CTPV患者的分流道功能障碍2例、再出血2例、HE 4例、死亡2例。伴有CTPV的PVT患者的分流道功能障碍及再出血发生率高于不伴CTPV的患者(均P<0.05),而两组间HE发生率及术后病死率差异无统计学意义(均P>0.05)。结论TIPS可有效降低伴有PVT患者的PVP,PVT伴CTPV的患者TIPS后分流道功能障碍及再出血发生率高于不伴CTPV的患者。 展开更多
关键词 经颈静脉肝内门体分流术 门静脉血栓 门静脉海绵样变性 肝性脑病
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40例儿童门静脉海绵样变性的临床表现、手术选择及其转归评价
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作者 刘罗海 李仕青 《肝脏》 2024年第1期102-104,109,共4页
目的分析40例门静脉海绵样变性患儿的临床特征、手术选择及预后转归。方法2017年6月-2022年6月蚌埠医学院第一附属医院收治的40例门静脉海绵样变性患儿,分析其临床表现,总结手术治疗,并评价转归结局。结果儿童门静脉海绵样变性常以腹痛... 目的分析40例门静脉海绵样变性患儿的临床特征、手术选择及预后转归。方法2017年6月-2022年6月蚌埠医学院第一附属医院收治的40例门静脉海绵样变性患儿,分析其临床表现,总结手术治疗,并评价转归结局。结果儿童门静脉海绵样变性常以腹痛、腹胀、脾脏肿大为临床症状表现,伴随多项肝功能指标改变,影像学检查可见食管静脉曲张。40例门静脉海绵样变性患儿均行手术治疗,其中实施Rex手术28例(70.0%),实施脾肾分流手术8例(20.0%),实施肝移植手术4例(10.0%)。40例门静脉海绵样变性患儿术后均存活,随访结果显示,28例接受Rex手术患儿中,25例(62.5%)搭桥血管通畅,血流速度正常,无血管狭窄,剩余3例(7.5%)术后出现血管闭塞;8例接受脾肾分流手术患儿中,3例(7.5%)术后未见脾脏缩小,食管静脉曲张未缓解,但未发生呕血、黑便;4例接受肝移植手术患儿中,1例(2.5%)术后早期发生肝动脉血栓,经抗凝治疗后再通。结论儿童门静脉海绵样变性的临床表现具有一定特征,临床可根据患儿肝内外门静脉发育情况进行术式选择,其中Rex手术能够恢复门静脉系统正常解剖和生理功能,改善肝脏灌注情况,避免术后不良情形的发生。 展开更多
关键词 儿童 门静脉海绵样变性 临床表现 手术治疗 转归
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Portal ductopathy:Clinical importance and nomenclature 被引量:6
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作者 Yusuf Bayraktar 《World Journal of Gastroenterology》 SCIE CAS CSCD 2011年第11期1410-1415,共6页
Non-cirrhotic portal hypertension(PHT)accounts for about 20%of all PHT cases,portal vein thrombosis(PVT) resulting in cavernous transformation being the most common cause.All known complications of PHT may be encounte... Non-cirrhotic portal hypertension(PHT)accounts for about 20%of all PHT cases,portal vein thrombosis(PVT) resulting in cavernous transformation being the most common cause.All known complications of PHT may be encountered in patients with chronic PVT.However,the effect of this entity on the biliary tree and pancreatic duct has not yet been fully established.Additionally,a dispute remains regarding the nomenclature of common bile duct abnormalities which occur as a result of chronic PVT.Although many clinical reports have focused on biliary abnormalities,only a few have evaluated both the biliary and pancreatic ductal systems.In this review the relevant literature evaluating the effect of PVT on both ductal systems is discussed,and findings are considered with reference to results of a prominent center in Turkey,from which the term"portal ductopathy"has been put forth to replace"portal biliopathy". 展开更多
关键词 portal hypertension portal vein thrombosis portal vein cavernous transformation Congenital hepatic fibrosis Non-cirrhotic portal hypertension portal ductopathy portal double ductopathy portal biliopathy
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JAK2V617F基因突变阳性骨髓增殖性肿瘤相关门静脉海绵样变性1例
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作者 石翠翠 徐正婕 +1 位作者 周惠清 范建高 《实用肝脏病杂志》 CAS 2023年第3期443-444,共2页
骨髓增殖性肿瘤(myeloproliferative neoplasms,MPN)导致血细胞增加、血液高凝,是非肝硬化门静脉海绵样变性的重要病因。JAK2V617F基因突变可以帮助诊断MPN。我们报道1例JAK2V617F基因突变阳性的MPN患者发生门静脉海绵样变性(cavernous ... 骨髓增殖性肿瘤(myeloproliferative neoplasms,MPN)导致血细胞增加、血液高凝,是非肝硬化门静脉海绵样变性的重要病因。JAK2V617F基因突变可以帮助诊断MPN。我们报道1例JAK2V617F基因突变阳性的MPN患者发生门静脉海绵样变性(cavernous transformation of the portal vein,CTPV)。该例患者脾脏显著肿大,一方面是由于骨髓增殖性疾病本身的原因,另一方面是由于PVCT、门脉高压和脾脏淤血造成,表现为外周血血细胞计数基本在正常范围,亦是血细胞增殖和脾脏对血细胞的处理增加的共同作用的结果。抗凝治疗效果差,而应以预防食管曲张静脉破裂出血(EVB)为主。 展开更多
关键词 门静脉海绵样变性 骨髓增殖性肿瘤 JAK2 V617F基因突变 病例报道
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血栓弹力图对肝硬化患者门静脉血栓形成的预测价值
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作者 李静 陆申新 陈洁 《中国临床医学》 2023年第3期445-448,共4页
目的探讨血栓弹力图(TEG)及常规凝血试验评价肝硬化患者门静脉血栓形成(PVT)的价值。方法选择2015年12月至2017年2月复旦大学附属中山医院消化科收治的肝硬化失代偿期患者,根据是否合并PVT分组。比较PVT组与非PVT组TEG参数、常规凝血指... 目的探讨血栓弹力图(TEG)及常规凝血试验评价肝硬化患者门静脉血栓形成(PVT)的价值。方法选择2015年12月至2017年2月复旦大学附属中山医院消化科收治的肝硬化失代偿期患者,根据是否合并PVT分组。比较PVT组与非PVT组TEG参数、常规凝血指标、相关临床资料等的差异。结果共纳入199例患者,PVT组82例(41.2%)、无PVT组117例(58.8%)。两组患者TEG各项参数差异均无统计学意义。Logistic回归分析显示,女性(OR=3.061,95%CI 1.389~6.744,P=0.005)、脾切除史(OR=5.740,95%CI 1.876~17.568,P=0.002)、D-二聚体升高(OR=1.533,95%CI 1.182~1.989,P=0.001)是PVT的独立相关因素;Child B+C级(OR=12.844,95%CI 2.452~67.263,P=0.003)、R时间缩短(OR=0.526,95%CI0.294~0.942,P=0.031)、血小板增多(OR=1.013,95%CI 1.005~1.021,P=0.001)是门脉海绵样变的独立相关因素。结论TEG检测有助于预测PVT患者门脉海绵样变。 展开更多
关键词 血栓弹力图 凝血试验 门静脉血栓形成 门脉海绵样变
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骨髓增生性疾病所致门静脉海绵样变性1例报告
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作者 韩冰 涂传涛 《临床肝胆病杂志》 CAS 北大核心 2023年第6期1414-1417,共4页
1 病例资料患者男性,64岁,因“乏力1周,黑便3天”于2021年11月22日收入本院。患者于1周前无明显诱因下出现乏力,未重视未就诊,3天前进食辛辣食物后出现中上腹不适,后解黑色糊状便,每天2次,每次约200 mL,头晕乏力较前加重,无畏寒发热,无... 1 病例资料患者男性,64岁,因“乏力1周,黑便3天”于2021年11月22日收入本院。患者于1周前无明显诱因下出现乏力,未重视未就诊,3天前进食辛辣食物后出现中上腹不适,后解黑色糊状便,每天2次,每次约200 mL,头晕乏力较前加重,无畏寒发热,无恶心呕吐,无呕血,无腹痛。患者20年前有胃溃疡伴出血病史,曾行胃镜检查明确,保守治疗后好转,曾因胃溃疡穿孔行修补手术治疗。既往否认慢性病史,否认肝炎、结核、吸烟嗜酒以及特殊服药史。 展开更多
关键词 骨髓增殖性疾病 门静脉海绵样变性 食管和胃静脉曲张
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改良穿刺套件对肝硬化门静脉高压合并门静脉海绵样变上消化道大出血的疗效 被引量:2
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作者 苏慧坤 窦树彬 +1 位作者 马靖涵 张希全 《血管与腔内血管外科杂志》 2023年第7期825-828,835,共5页
目的探讨改良穿刺套件对肝硬化门静脉高压合并门静脉海绵样变(CTPV)急性上消化道大出血的临床疗效。方法收集2016年7月至2021年3月解放军联勤保障部队第九六〇医院收治的34例肝硬化门静脉高压合并CTPV急性上消化道大出血患者的临床资料... 目的探讨改良穿刺套件对肝硬化门静脉高压合并门静脉海绵样变(CTPV)急性上消化道大出血的临床疗效。方法收集2016年7月至2021年3月解放军联勤保障部队第九六〇医院收治的34例肝硬化门静脉高压合并CTPV急性上消化道大出血患者的临床资料,所有患者均行经颈静脉肝内门体分流术(TIPS),采用改良穿刺套件穿刺门静脉并植入直径均为8 mm的覆膜支架和裸支架,建立分流道后测量门静脉压力,观察患者的术中、术后情况,比较TIPS手术前后门静脉主干压力。通过随访复查彩色多普勒超声,观察患者的再出血、支架通畅性、肝性脑病及患者生存情况等。结果34例患者的手术成功率为94.1%(32/34),其中,32例患者均采用改良穿刺套件顺利完成手术。32例患者中,成功穿刺门静脉右支11例,成功穿刺门静脉左支21例,其余2例患者因门静脉完全闭塞而无法进行手术;24例CTPV患者均采用穿刺定位球囊的方法成功完成穿刺;25例患者同时行胃冠状静脉栓塞术,术中未出现手术相关并发症。TIPS术后门静脉主干压力明显低于术前,差异有统计学意义(P﹤0.01)。术后造影检查结果显示,分流道腔内血流通畅,侧支循环消失,24 h内消化道未再次出血,住院期间无患者死亡。术后3个月,32例患者均行彩色多普勒超声检查,分流道腔内血流通畅。术后6个月,1例患者失访,5例患者术后出现分流道狭窄或阻塞,支架狭窄程度为30%~50%,经球囊扩张治疗后支架内血流恢复通畅,其余26例患者术后分流道内血流通畅,临床疗效良好。结论采用改良穿刺套件治疗肝硬化门静脉高压合并CTPV所致的急性上消化道大出血的近期、中期疗效较好,安全可靠。 展开更多
关键词 门静脉高压 门静脉海绵样变 急性上消化道出血 经颈静脉肝内门体静脉分流术 改良穿刺套件
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1例肝硬化门静脉高压合并门静脉海绵样变性病人行经肠系膜上静脉肝外门体分流术的术后护理 被引量:1
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作者 陈晨 史云霞 +2 位作者 王星雅 王笑笑 张慧敏 《全科护理》 2023年第16期2299-2302,共4页
总结1例肝硬化门静脉高压合并门静脉海绵样变性病人行经肠系膜上静脉肝外门体分流术的术后护理经验。护理要点:腹部切口及颈部穿刺点的护理;抗凝管理;管道护理;营养支持;预防血栓形成,加强皮肤护理;术后并发症的预防及观察。经过精心的... 总结1例肝硬化门静脉高压合并门静脉海绵样变性病人行经肠系膜上静脉肝外门体分流术的术后护理经验。护理要点:腹部切口及颈部穿刺点的护理;抗凝管理;管道护理;营养支持;预防血栓形成,加强皮肤护理;术后并发症的预防及观察。经过精心的护理,病人术后恢复良好,术后28 d出院。 展开更多
关键词 肝硬化 门静脉高压症 门静脉海绵样变 经肠系膜上静脉肝外门体分流术 护理
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肝移植治疗小儿先天性门静脉海绵样变 被引量:9
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作者 王俊 蔡威 +4 位作者 潘伟华 葛莉 吴燕 张弛 施诚仁 《上海交通大学学报(医学版)》 CAS CSCD 北大核心 2006年第6期643-646,共4页
目的探讨肝移植治疗小儿先天性门静脉海绵样变的临床效果。方法2例患儿经CT和CTA检查诊断为肝内门静脉系统海绵样变,并伴有严重的门静脉高压症,分别于2004年12月和2005年6月施行肝移植术治疗。从临床症状、血液学指标和影像学检查方面... 目的探讨肝移植治疗小儿先天性门静脉海绵样变的临床效果。方法2例患儿经CT和CTA检查诊断为肝内门静脉系统海绵样变,并伴有严重的门静脉高压症,分别于2004年12月和2005年6月施行肝移植术治疗。从临床症状、血液学指标和影像学检查方面对手术疗效进行评价。结果2例患儿术后消化道出血症状均消失,且无复发;血红蛋白、血球压积、血小板水平等均接近或恢复正常;脾脏亦有一定程度缩小;1例患儿随访至今,情况良好;另1例患儿术后失访2月,3月后超声复查发现大量腹水,门静脉吻合口明显狭窄,再次手术重新植入另一供体门静脉,手术过程顺利,因术后出现严重肺部感染,同时合并肝、肾功能损害,于术后2周死亡。结论肝移植术可成为先天性门静脉海绵样变的有效治疗方法之一,其近期疗效良好。对肝移植的远期效果和并发症,尚需进一步积累病例和随访研究加以评价。 展开更多
关键词 肝移植 门静脉海绵样变 门脉高压 小儿
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