Pancreatic pseudocyst-portal vein fistulae are extremely rare, and cause serious complications, including life-threatening sepsis. We report a 57-year-old man with pancreatic pseudocyst who was admitted to our hospita...Pancreatic pseudocyst-portal vein fistulae are extremely rare, and cause serious complications, including life-threatening sepsis. We report a 57-year-old man with pancreatic pseudocyst who was admitted to our hospital complaining of prolonged abdominal pain. A pancreatic duct tube was placed into the main pancreatic duct, as the pseudocyst was communicated to the pancreatic duct. He fell into septic shock state two weeks later. An ultrasonography-guided percutaneous drainage of the pseudocyst was performed. The amylase level of drained pus was 80,000 U/l. Pancreatic pseudocyst-portal vein fistula was demonstrated by fisterography. Symptoms disappeared immediately after drainage. No recurrence was observed afterward.展开更多
To the Editor:Transjugularintrahepaticportosystemicshunt(TIPS)isusuallyconsideredthechoiceformanagingcomplicationsofportal hypertensionsuchasrefractoryascites,esophagogastricvariceal bleedingandrecurrentbleedinguncont...To the Editor:Transjugularintrahepaticportosystemicshunt(TIPS)isusuallyconsideredthechoiceformanagingcomplicationsofportal hypertensionsuchasrefractoryascites,esophagogastricvariceal bleedingandrecurrentbleedinguncontrolledwithfirstline treatment.Inrecentyears,TIPShasbeensuccessfullyusedto treat Budd-Chiari syndrome, hepatic hydrothorax, and portal vein thrombosis.One of the key steps during TIPS is the portal vein puncture.展开更多
We report a case of life-threatening hematemesis due to portal hypertension caused by an isolated arterioportal fistula (APF). Intrahepatic APFs are extremely rare and are a cause of presinusoidal portal hypertension....We report a case of life-threatening hematemesis due to portal hypertension caused by an isolated arterioportal fistula (APF). Intrahepatic APFs are extremely rare and are a cause of presinusoidal portal hypertension. Etiologies for APFs are comprised of precipitating trauma, malignancy, and hereditary hemorrhagic telangiectasia, but these were not the case in our patient. Idiopathic APFs are usually due to congenital vascular abnormalities and thus usually present in the pediatric setting. This is one of the first cases of adult-onset isolated APF who presented with portal hypertension and was successfully managed through endoscopic hemostasis and subsequent interventional radiological embolization.展开更多
Background: Portal vein (PV) stenosis or obstruction is sometimes observed in patients who were performed pancreatobiliary surgery. These conditions such as pancreatic fistulas (PF) and intra-abdominal infections afte...Background: Portal vein (PV) stenosis or obstruction is sometimes observed in patients who were performed pancreatobiliary surgery. These conditions such as pancreatic fistulas (PF) and intra-abdominal infections after pancreatobiliary surgery still represent significant clinical issues. In addition, insufficient attention is paid to the fact that severe stenosis of the PV can result in life-threatening complications. Material and Methods: At our institution, lymph node dissection within the hepatoduodenal ligament was performed for biliary or pancreatic neoplasms in 68 patients between October 2005 and April 2017. The diameter of the PV was measured on computed tomography scans obtained before and after the operation. PV stenosis was defined as a >50% reduction in the diameter of the PV. The degree of PF (Pancreatic Fistula) was defined by the International Study Group of Pancreatic Fistula after pancreaticoduodenectomy. Furthermore, the Clavien-Dindo (CD) classification was used to assess the complications that occurred in cases in which pancreatojejunostomy was not performed. The relationship between the degree of PV stenosis and the occurrence of postoperative complications was analyzed. Results: The overall frequency of PF was 56.3% (18 patients). Grade B or C PF occurred in 5 patients (15.6%). In the present small series, a correlation was detected between the degree of PV stenosis and the occurrence of postoperative complications after pancreatobiliary surgery (p Conclusions: Clinicians should keep in mind that the PV can narrow in cases in which grade B or C PF or intra-abdominal abscesses occur after pancreatobiliary surgery.展开更多
文摘Pancreatic pseudocyst-portal vein fistulae are extremely rare, and cause serious complications, including life-threatening sepsis. We report a 57-year-old man with pancreatic pseudocyst who was admitted to our hospital complaining of prolonged abdominal pain. A pancreatic duct tube was placed into the main pancreatic duct, as the pseudocyst was communicated to the pancreatic duct. He fell into septic shock state two weeks later. An ultrasonography-guided percutaneous drainage of the pseudocyst was performed. The amylase level of drained pus was 80,000 U/l. Pancreatic pseudocyst-portal vein fistula was demonstrated by fisterography. Symptoms disappeared immediately after drainage. No recurrence was observed afterward.
基金supported by President fund of Qingdao Municipal Hospital(ZYZJJ2017116)
文摘To the Editor:Transjugularintrahepaticportosystemicshunt(TIPS)isusuallyconsideredthechoiceformanagingcomplicationsofportal hypertensionsuchasrefractoryascites,esophagogastricvariceal bleedingandrecurrentbleedinguncontrolledwithfirstline treatment.Inrecentyears,TIPShasbeensuccessfullyusedto treat Budd-Chiari syndrome, hepatic hydrothorax, and portal vein thrombosis.One of the key steps during TIPS is the portal vein puncture.
文摘We report a case of life-threatening hematemesis due to portal hypertension caused by an isolated arterioportal fistula (APF). Intrahepatic APFs are extremely rare and are a cause of presinusoidal portal hypertension. Etiologies for APFs are comprised of precipitating trauma, malignancy, and hereditary hemorrhagic telangiectasia, but these were not the case in our patient. Idiopathic APFs are usually due to congenital vascular abnormalities and thus usually present in the pediatric setting. This is one of the first cases of adult-onset isolated APF who presented with portal hypertension and was successfully managed through endoscopic hemostasis and subsequent interventional radiological embolization.
文摘Background: Portal vein (PV) stenosis or obstruction is sometimes observed in patients who were performed pancreatobiliary surgery. These conditions such as pancreatic fistulas (PF) and intra-abdominal infections after pancreatobiliary surgery still represent significant clinical issues. In addition, insufficient attention is paid to the fact that severe stenosis of the PV can result in life-threatening complications. Material and Methods: At our institution, lymph node dissection within the hepatoduodenal ligament was performed for biliary or pancreatic neoplasms in 68 patients between October 2005 and April 2017. The diameter of the PV was measured on computed tomography scans obtained before and after the operation. PV stenosis was defined as a >50% reduction in the diameter of the PV. The degree of PF (Pancreatic Fistula) was defined by the International Study Group of Pancreatic Fistula after pancreaticoduodenectomy. Furthermore, the Clavien-Dindo (CD) classification was used to assess the complications that occurred in cases in which pancreatojejunostomy was not performed. The relationship between the degree of PV stenosis and the occurrence of postoperative complications was analyzed. Results: The overall frequency of PF was 56.3% (18 patients). Grade B or C PF occurred in 5 patients (15.6%). In the present small series, a correlation was detected between the degree of PV stenosis and the occurrence of postoperative complications after pancreatobiliary surgery (p Conclusions: Clinicians should keep in mind that the PV can narrow in cases in which grade B or C PF or intra-abdominal abscesses occur after pancreatobiliary surgery.
