-
Asian Journal of Surgery Dec 2022
Topics: Humans; Mesenteric Veins; Arteriovenous Fistula
PubMed: 35773109
DOI: 10.1016/j.asjsur.2022.06.082 -
Abdominal Radiology (New York) Apr 2019Extrahepatic portal vein obstruction (EHPVO) is the most common cause of upper gastrointestinal bleeding in children. It is defined as thrombosis of the extrahepatic... (Review)
Review
Extrahepatic portal vein obstruction (EHPVO) is the most common cause of upper gastrointestinal bleeding in children. It is defined as thrombosis of the extrahepatic portal vein with or without extension to the intrahepatic portal veins. The Meso-Rex shunt is the gold standard treatment in children with favorable anatomy since it restores physiological portal liver reperfusion. This is achieved by rerouting the splanchnic venous blood through an autologous graft from the superior mesenteric vein (SMV) into the Rex recess of the left portal vein, curing portal hypertension by doing so. General and hepatobiliary radiologists must be familiar with multimodality imaging appearances of EHPVO and with the role of imaging in identifying suitable candidates for Meso-Rex bypass surgery. Imaging might also detect complications of this procedure, some of which might be treated via interventional radiology.
Topics: Diagnostic Imaging; Humans; Mesenteric Veins; Multimodal Imaging; Portal Vein; Portasystemic Shunt, Surgical; Venous Thrombosis
PubMed: 30467724
DOI: 10.1007/s00261-018-1836-1 -
Zhong Nan Da Xue Xue Bao. Yi Xue Ban =... Jan 2017Idiopathic mesenteric phlebosclerosis (IMP) is a rare disease and it is easy to be misdiagnosed, which is characterized by intestinal obstruction symptoms, such as... (Review)
Review
Idiopathic mesenteric phlebosclerosis (IMP) is a rare disease and it is easy to be misdiagnosed, which is characterized by intestinal obstruction symptoms, such as abdominal pain, bloating and vomiting. In this study, a case of IMP was observed and the literatures were reviewed. Computed tomography shows funicular high-density shadow and vascular calcification shadow along the vessels around the bowels. Narrow band imaging (M-NBI) endoscopy revealed the disappeared honeycomb capillary, the disordered microvascular structure and the increased density of blood vessels.
Topics: Arteriosclerosis; Blood Vessels; Humans; Intestinal Obstruction; Mesenteric Veins; Narrow Band Imaging; Tomography, X-Ray Computed; Vascular Calcification; Venous Insufficiency
PubMed: 28216508
DOI: 10.11817/j.issn.1672-7347.2017.01.019 -
Computer Methods in Biomechanics and... Oct 2020Abdominal malignant tumors originated from cancers, such as vater ampulla carcinoma (VAC) and pancreatic cancer (PC), often invades the portal vein (PV) and the superior... (Comparative Study)
Comparative Study
A comparison between the mechanical properties of the hepatic round ligament and the portal vein: a clinical implication on surgical reconstruction of the portal and superior mesenteric veins.
Abdominal malignant tumors originated from cancers, such as vater ampulla carcinoma (VAC) and pancreatic cancer (PC), often invades the portal vein (PV) and the superior mesenteric vein (SMV) upon metastasis. Surgical removal of these tumors leads to sacrifice of parts of these vessels that need to be reconstructed with autograft tissues. Current options for the replacement tissue all have their limitations in certain aspects. Therefore, improved interstitial material for the reconstruction with better tissue compatibility is urgently needed. In the present study, we explored the potential of hepatic round ligament (HRL) as a candidate tissue for the task from the biomechanical point of view. We reveal that HRL and PV share similar geometrical parameters in terms of vascular cavity diameter and wall thickness. In addition, they also have similar elastic properties and tissue flexibility and intensity upon increased cavity pressure. Our study strongly supports HRL as potential replacement tissue for PV reconstruction in term of mechanical properties and encourages further biological studies to be performed on these two tissues for further verification.
Topics: Adolescent; Adult; Elastic Modulus; Humans; Mesenteric Veins; Middle Aged; Pliability; Portal Vein; Round Ligament of Liver; Young Adult
PubMed: 32583688
DOI: 10.1080/10255842.2020.1780427 -
Hepatobiliary & Pancreatic Diseases... Apr 2023Open pancreaticoduodenectomy (OPD) with portal or superior mesenteric vein resection and reconstruction has been applied in pancreatic cancer patients with tumor... (Review)
Review
BACKGROUND
Open pancreaticoduodenectomy (OPD) with portal or superior mesenteric vein resection and reconstruction has been applied in pancreatic cancer patients with tumor infiltration or adherence. However, it is controversial whether laparoscopic pancreaticoduodenectomy (LPD) with major vascular resection and reconstruction is feasible. This study aimed to evaluate the safety and feasibility of LPD with major vascular resection compared with OPD with major vascular resection.
METHODS
We reviewed data for all pancreatic cancer patients undergoing LPD or OPD with vascular resection at Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, between February 2018 and May 2022. We compared the preoperative, intraoperative, and postoperative clinicopathological data of the two groups to conduct a comprehensive evaluation of LPD with major vascular resection.
RESULTS
A total of 63 patients underwent pancreaticoduodenectomy (PD) with portal or superior mesenteric vein resection and reconstruction, including 25 LPDs and 38 OPDs. The LPD group had less intraoperative blood loss (200 vs. 400 mL, P < 0.001), lower proportion of intraoperative blood transfusion (16.0% vs. 39.5%, P = 0.047), longer operation time (390 vs. 334 min, P = 0.004) and shorter postoperative hospital stay (11 vs. 14 days, P = 0.005). There was no perioperative death in all patients. There was no significant difference in the incidence of total postoperative complications, grade B/C postoperative pancreatic fistula, delayed gastric emptying and abdominal infection between the two groups. No postpancreatectomy hemorrhage nor bile leakage occurred during perioperative period. There was no significant difference in R0 resection rate and number of lymph nodes harvested between the two groups. Patency of reconstructed vessels in the two groups were 96.0% and 92.1%, respectively (P = 0.927).
CONCLUSIONS
LPD with portal or superior mesenteric vein resection and reconstruction was safe, feasible and oncologically acceptable for selected patients with pancreatic cancer, and it can achieve similar or even better perioperative results compared to open approach.
Topics: Humans; Pancreaticoduodenectomy; Mesenteric Veins; China; Pancreatic Neoplasms; Portal Vein; Laparoscopy; Postoperative Complications; Retrospective Studies
PubMed: 36690522
DOI: 10.1016/j.hbpd.2023.01.004 -
Abdominal Radiology (New York) Jul 2016
Review
Topics: Digestive System Abnormalities; Humans; Intestinal Volvulus; Mesenteric Artery, Superior; Mesenteric Veins; Radiography, Abdominal; Tomography, X-Ray Computed
PubMed: 26920004
DOI: 10.1007/s00261-016-0688-9 -
Harefuah Dec 2023Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is a rare disease of unknown etiology characterized by ischemia of intestinal segments, occuring due to...
Idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) is a rare disease of unknown etiology characterized by ischemia of intestinal segments, occuring due to intimal proliferation of the mesenteric veins and partial blockage of blood drainage. Diagnosis is performed pathologically and definitive treatment is surgical, where involved segments of the intestine are resected. Here we describe a case in which the patient underwent a comprehensive medical evaluation, finally diagnosed with IMHMV after bowel resection. The purpose of this case report is to present the diagnostic challenge to clinicians and raise awareness to this condition.
Topics: Humans; Hyperplasia; Mesenteric Veins
PubMed: 38126154
DOI: No ID Found -
Annals of Vascular Surgery Nov 1996The case of a 50-year-old woman with an extremely rare venous malformation of the portal venous system is reported. The patient presented with a true aneurysm of the...
The case of a 50-year-old woman with an extremely rare venous malformation of the portal venous system is reported. The patient presented with a true aneurysm of the superior mesenteric vein, which has thus far been reported in no more than eight cases worldwide. This malformation may be congenital or acquired. Secondary aneurysms are thought to be due to liver disease, portal hypertension, trauma, or inflammation. Aneurysms of the portomesenteric venous system may be asymptomatic or give rise to severe, often dramatic conditions such as crampy abdominal pain, jaundice, and upper gastrointestinal hemorrhage secondary to portal hypertension. The diagnosis is usually made by ultrasound (B-mode or color flow Doppler), CT scan, and MRI. Invasive procedures such as venous phase mesenteric arteriography or splenoportography may be helpful in confirming it. In our opinion aneurysms of the portal venous system, even if they are congenital and (still) asymptomatic, require early surgical control because the prognosis for patients with these aneurysms is unpredictable and potential complications (e.g., portal hypertension, fistula, contained perforation, or rupture) may be fatal. In the case presented the mesenteric venous aneurysm was resected and the confluent veins were reconstructed.
Topics: Aneurysm; Female; Humans; Kidney; Mesenteric Veins; Middle Aged; Tomography, X-Ray Computed; Ultrasonography, Doppler, Color
PubMed: 8989976
DOI: 10.1007/BF02000448 -
Radiographics : a Review Publication of... 2002Multi-detector row computed tomography (CT) offers important advantages over more conventional imaging methods in the evaluation of the mesenteric vasculature. It allows... (Review)
Review
Multi-detector row computed tomography (CT) offers important advantages over more conventional imaging methods in the evaluation of the mesenteric vasculature. It allows faster scanning, which practically eliminates motion and breathing artifacts, as well as thinner collimation. These advances, coupled with rapid intravenous administration of contrast material, allow excellent opacification of the mesenteric arteries and veins. This improves the quality of the three-dimensional (3D) data sets, which in turn leads to improved 3D vascular maps and more accurate assessment of various conditions such as arterial or venous encasement in patients with pancreatic cancer, mesenteric ischemia, or inflammatory bowel disease. Three-dimensional multi-detector row CT also allows better visualization of arterial and venous branching, thereby improving detection of more distal vascular involvement. In addition, 3D multi-detector row CT may help detect hemodynamic changes in patients with active inflammation and hyperemia of a bowel segment because it can be used to measure bowel wall enhancement over time. Carcinoid tumors that have infiltrated the mesentery have a characteristic CT appearance, and other conditions such as lymphoma or sclerosing mesenteritis can also manifest as an infiltrating mass that envelops mesenteric vessels. Three-dimensional multi-detector row CT represents a significant advance in CT technology and can help ensure prompt, accurate evaluation of the mesenteric vasculature.
Topics: Humans; Imaging, Three-Dimensional; Inflammatory Bowel Diseases; Intestine, Small; Ischemia; Mesenteric Arteries; Mesenteric Vascular Occlusion; Mesenteric Veins; Pancreatic Neoplasms; Tomography, X-Ray Computed
PubMed: 11796905
DOI: 10.1148/radiographics.22.1.g02ja30161 -
Annals of Surgical Oncology Apr 2009Pancreatic carcinoma frequently infiltrates the portal vein or the superior mesenteric vein; pancreatectomy combined with portal vein/superior mesenteric vein resection... (Review)
Review
BACKGROUND
Pancreatic carcinoma frequently infiltrates the portal vein or the superior mesenteric vein; pancreatectomy combined with portal vein/superior mesenteric vein resection represents a potentially curative treatment in these cases but is still a controversial procedure.
METHODS
After performing a computerized Medline search, 12 series published during the last 8 years were selected, enrolling 399 patients who underwent pancreatectomy combined with portal vein/superior mesenteric vein resection for pancreatic carcinoma. Data were examined for information about indications, operation, adjuvant therapies, histopathology of resected specimens, perioperative results, and survival. Also, previous literature regarding the issue was extensively reviewed.
RESULTS
Operative mortality and postoperative complication rates ranged from 0 to 7.7% and 16.7% to 54%, respectively. Median survival varied from 13 to 22 months; 5-year survival rate ranged from 9% to 18%.
CONCLUSIONS
The current literature suggests that portal vein/superior mesenteric vein resection combined with pancreatectomy is a safe and feasible procedure that increases the number of patients who undergo curative resection and, therefore, provides important survival benefits to selected groups of patients. This procedure should always be considered in case of suspected tumor infiltration of portal/superior mesenteric vein to achieve clear resection margins, in the absence of other contraindications for resection.
Topics: Aged; Humans; Mesenteric Veins; Middle Aged; Neoplasm Invasiveness; Pancreatectomy; Pancreatic Neoplasms; Portal Vein; Prognosis; Vascular Surgical Procedures
PubMed: 19156463
DOI: 10.1245/s10434-008-0281-8