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American Journal of Surgery Jul 2010It is important to be aware of mesenteric venous variants to perform peripancreatic surgery. We investigated the usefulness of 3-dimensional (3-D) portography.
BACKGROUND
It is important to be aware of mesenteric venous variants to perform peripancreatic surgery. We investigated the usefulness of 3-dimensional (3-D) portography.
METHODS
Vessels were reconstructed using computer software in 102 patients undergoing multidetector-row computed tomography (MDCT) scheduled for gastrointestinal or hepatobiliary-pancreatic surgery.
RESULTS
The superior mesenteric vein (SMV) was composed of single and double trunks around the splenoportal confluence in 78 and 24 patients, respectively. The inferior mesenteric vein joined the splenic vein (68.5%), SMV (18.5%), and splenoportal confluence (7.6%). The left gastric vein joined the splenic vein (46.3%), portal vein (39.0%), and splenoportal confluence (14.7%). Seventy-nine patients showed a gastrocolic trunk, mostly composed of the right gastroepiploic vein and veins from the colonic hepatic flexure. Intraoperative findings were identical to 3-D diagnosis in 68 gastrectomized and 9 pancreatectomized patients.
CONCLUSION
Although mesenteric venous tributaries are complex, 3-D portography is helpful for surgeons to safely perform peripancreatic surgery.
Topics: Adult; Aged; Aged, 80 and over; Cohort Studies; Digestive System Surgical Procedures; Female; Humans; Imaging, Three-Dimensional; Male; Mesenteric Veins; Middle Aged; Pancreas; Portography; Predictive Value of Tests; Preoperative Care; Reproducibility of Results; Retrospective Studies; Tomography, X-Ray Computed; Young Adult
PubMed: 20074695
DOI: 10.1016/j.amjsurg.2009.05.017 -
The Korean Journal of Gastroenterology... Jan 2016
Topics: Abdomen; Adult; Colonoscopy; Humans; Hyperplasia; Male; Mesenteric Veins; Tomography, X-Ray Computed
PubMed: 27213200
DOI: 10.4166/kjg.2016.67.1.54 -
Cardiovascular Surgery (London, England) Jun 1995Mesenteric vascular disease is a relatively rare disease; however the morbidity and mortality are significant. Improved diagnosis and treatment of mesenteric obstructive... (Review)
Review
Mesenteric vascular disease is a relatively rare disease; however the morbidity and mortality are significant. Improved diagnosis and treatment of mesenteric obstructive arterial disease and its complications have occurred. Biplanar angiography of the mesenteric arteries remains the best method of diagnosing mesenteric vascular diseases, though duplex sonography of the mesenteric arteries appears to be a valuable screening tool. Magnetic resonance angiography has the potential to improve on the diagnostic accuracy. Mesenteric artery reconstructive surgery remains the treatment of choice. Newer surveillance techniques such as tonometry may enhance perioperative monitoring and consequently improve the results of mesenteric artery reconstructive surgery. Aggressive support medical therapy plays a significant role in the treatment and reduces patient morbidity and mortality in carefully selected cases. There remains a dearth of prospective controlled trials in patients with this condition.
Topics: Angiography; Embolism; Humans; Magnetic Resonance Imaging; Mesenteric Arteries; Mesenteric Vascular Occlusion; Mesenteric Veins; Prognosis; Thrombosis; Ultrasonography
PubMed: 7655837
DOI: 10.1016/0967-2109(95)93872-m -
BMC Surgery Feb 2022Congenital abnormalities are not very common and are even rarer when two or more are combined. Congenital malformation of the superior mesenteric vein may not affect...
BACKGROUND
Congenital abnormalities are not very common and are even rarer when two or more are combined. Congenital malformation of the superior mesenteric vein may not affect normal development, or it may lead to moderate or even severe symptoms. In combination with intestinal malrotation, however, it may lead to the need for surgical intervention in the early years of life.
CASE PRESENTATION
We present the case of a 22-year-old patient who had been diagnosed with iron deficiency anaemia at the age of two months. As a result of the absence of the proximal section of the superior mesenteric vein, the patient has always needed iron supplements and an occasional erythrocyte transfusion. This has resulted from the formation of collaterals throughout the small bowel, causing chronic blood loss with its clinical manifestation. Although, there are some congenital abnormalities of the superior mesenteric vein, the absence of the superior mesenteric vein is rare, and in this case the clinical course was quite severe. Therefore, we planned bypass surgery for this patient to reduce the duodenal collaterals and resolve the persistent anaemia caused by chronic blood loss from the duodenum. We successfully performed the surgery consisting of the formation of anastomosis between the large collateral vein from the distal end of the superior mesenteric vein and the anterior inferior pancreaticoduodenal vein.
CONCLUSION
The purpose of this case report is to describe the rare anatomical malformation of the superior mesenteric vein accompanied by intestinal malrotation, with its potential clinical implications regarding symptoms, clinical presentation, and the impact on potential surgery planning.
Topics: Adult; Digestive System Abnormalities; Humans; Infant; Intestinal Volvulus; Intestine, Small; Mesenteric Veins; Portal Vein; Young Adult
PubMed: 35114982
DOI: 10.1186/s12893-022-01490-6 -
HPB : the Official Journal of the... Apr 2021Contemporary practice for superior mesenteric/portal vein (SMV-PV) reconstruction during pancreatectomy with vein resection involves biological (autograft, allograft,... (Review)
Review
BACKGROUND
Contemporary practice for superior mesenteric/portal vein (SMV-PV) reconstruction during pancreatectomy with vein resection involves biological (autograft, allograft, xenograft) or synthetic grafts as a conduit or patch. The aim of this study was to systematically review the safety and feasibility of the different grafts used for SMV-PV reconstruction.
METHODS
A systematic search was performed in PubMed and Embase according to the PRISMA guidelines (January 2000-March 2020). Studies reporting on ≥ 5 patients undergoing reconstruction of the SMV-PV with grafts during pancreatectomy were included. Primary outcome was rate of graft thrombosis.
RESULTS
Thirty-four studies with 603 patients were included. Four graft types were identified (autologous vein, autologous parietal peritoneum/falciform ligament, allogeneic cadaveric vein/artery, synthetic grafts). Early and overall graft thrombosis rate was 7.5% and 22.2% for synthetic graft, 5.6% and 11.7% for autologous vein graft, 6.7% and 8.9% for autologous parietal peritoneum/falciform ligament, and 2.5% and 6.2% for allograft. Donor site complications were reported for harvesting of the femoral, saphenous, and external iliac vein. No cases of graft infection were reported for synthetic grafts.
CONCLUSION
In selected patients, autologous, allogenic or synthetic grafts for SMV-PV reconstruction are safe and feasible. Synthetic grafts seems to have a higher incidence of graft thrombosis.
Topics: Humans; Mesenteric Veins; Pancreatectomy; Pancreatic Neoplasms; Pancreaticoduodenectomy; Portal Vein; Treatment Outcome; Vascular Patency
PubMed: 33288403
DOI: 10.1016/j.hpb.2020.11.008 -
Cardiovascular and Interventional... Oct 2023
Topics: Humans; Mesenteric Veins; Liver Diseases; Portal Vein; Thrombosis
PubMed: 37640948
DOI: 10.1007/s00270-023-03517-8 -
The Surgical Clinics of North America Feb 2002This article deals with injuries to the celiac trunk, superior and inferior mesenteric arterial injuires. Surgical approaches and physiological implications of... (Review)
Review
This article deals with injuries to the celiac trunk, superior and inferior mesenteric arterial injuires. Surgical approaches and physiological implications of interruption of the mesenteric arterial circulation are addressed in detail. Surgical techniques for the management of these injuries and the need for second look operations are also examined.
Topics: Abdominal Injuries; Arteries; Celiac Artery; Humans; Mesenteric Arteries; Mesenteric Veins; Survival Rate; Veins; Viscera
PubMed: 11905939
DOI: 10.1016/S0039-6109(03)00138-5 -
Annals of Surgery Apr 1971
Topics: Adult; Aged; Female; Humans; Male; Mesenteric Veins; Middle Aged; Photomicrography; Thrombophlebitis
PubMed: 5573649
DOI: 10.1097/00000658-197104000-00013 -
Pharmacological Reviews Dec 1990
Review
Topics: Animals; Mesenteric Veins; Portal Vein; Research Design
PubMed: 2080226
DOI: No ID Found -
Revista Espanola de Enfermedades... Dec 2016Diseases causing colonic ischemia may be mistaken with other causes of segmental colitis such as inflammatory bowel disease, especially in young patients. The authors...
Diseases causing colonic ischemia may be mistaken with other causes of segmental colitis such as inflammatory bowel disease, especially in young patients. The authors present the case of a 47-year-old male with severe proctosigmoiditis. Assessment excluded infectious causes, thrombophilia and systemic vasculitis. The initial histological specimen was suggestive of inflammatory bowel disease and therapy was initiated with intravenous steroids and, at day 5, infliximab, with no response. The patient was proposed for surgery. Pathological examination of the surgical specimen revealed an idiopathic myointimal hyperplasia of mesenteric veins, a rare entity exhibiting necrotizing phlebitis with rapid progression to segmental necrosis in the rectosigmoid colon. In this paper the authors discuss the differential diagnosis of proctosigmoiditis in young ages and the approach to this exceptionally rare ischemic entity.
Topics: Biopsy; Colitis; Humans; Hyperplasia; Male; Mesenteric Veins; Middle Aged; Necrosis; Phlebitis
PubMed: 26901337
DOI: 10.17235/reed.2016.4051/2015