دورية أكاديمية
Management of Sinistral Portal Hypertension after Pancreaticoduodenectomy.
| العنوان: | Management of Sinistral Portal Hypertension after Pancreaticoduodenectomy. |
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| المؤلفون: | Mansour N; Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany., Sirtl S; Department of Medicine II, LMU University Hospital, LMU Munich, Munich, Germany., Angele MK; Department for General, Visceral and Transplantation Surgery, LMU University Hospital, LMU Munich, Munich, Germany., Wildgruber M; Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany. |
| المصدر: | Digestive diseases (Basel, Switzerland) [Dig Dis] 2024; Vol. 42 (2), pp. 178-185. Date of Electronic Publication: 2024 Jan 05. |
| نوع المنشور: | Journal Article; Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: S. Karger Country of Publication: Switzerland NLM ID: 8701186 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1421-9875 (Electronic) Linking ISSN: 02572753 NLM ISO Abbreviation: Dig Dis Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Basel ; New York : S. Karger, [c1986- |
| مواضيع طبية MeSH: | Esophageal and Gastric Varices*/complications , Hypertension, Portal*/etiology , Hypertension, Portal*/therapy , Sinistral Portal Hypertension*, Humans ; Pancreaticoduodenectomy/adverse effects ; Gastrointestinal Hemorrhage/etiology |
| مستخلص: | Background: Sinistral, or left-sided, portal hypertension (SPH) is a rare cause of upper gastrointestinal (GI) hemorrhage resulting from obstruction of the splenic vein. Venous drainage from the spleen via collaterals can result in venous hemorrhage into both the retroperitoneal and intra-abdominal spaces due to increased venous blood pressure in peripancreatic and gastroduodenal vasculature. SPH can occur secondary to pancreatitis with thrombosis of the splenic vein. Another possible cause is the surgical ligation of the splenic vein as part of pancreaticoduodenectomy (PD). Although splenectomy has been traditionally considered as the treatment of choice to relieve venous hypertension, individual concepts for each patient have to be developed. Considering the venous collateral drainage pathways, a comprehensive approach involving surgical, endoscopic, and interventional radiology interventions may be necessary to address the underlying cause of variceal bleeding. Among these approaches, splenic artery embolization (SAE) has demonstrated efficacy in mitigating the adverse effects associated with elevated venous outflow pressure. Summary: This review summarizes key imaging findings in SPH patients after PD and highlights the potential of minimally invasive embolization for curative treatment of variceal hemorrhage. Key Messages: (i) SPH is a potential consequence after major pancreas surgery. (ii) Collateral flow can lead to life-threatening abdominal bleeding. (iii) Depending on the origin and localization of the bleeding, a dedicated management is required, frequently involving interventional radiology techniques. (© 2024 The Author(s). Published by S. Karger AG, Basel.) |
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| فهرسة مساهمة: | Keywords: Pancreaticoduodenectomy; Sinistral portal hypertension; Splenic artery embolization |
| تواريخ الأحداث: | Date Created: 20240107 Date Completed: 20240404 Latest Revision: 20240407 |
| رمز التحديث: | 20240407 |
| مُعرف محوري في PubMed: | PMC10997249 |
| DOI: | 10.1159/000535774 |
| PMID: | 38185113 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1421-9875 |
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| DOI: | 10.1159/000535774 |