Xiaoyu Wu, K. Ye, Ruihua Wang, J. Qin, Zhiyou Peng, Xinwu Lu
{"title":"Checklists for left subclavian artery reconstruction in thoracic endovascular aortic repair","authors":"Xiaoyu Wu, K. Ye, Ruihua Wang, J. Qin, Zhiyou Peng, Xinwu Lu","doi":"10.4103/ts.ts_2_20","DOIUrl":"https://doi.org/10.4103/ts.ts_2_20","url":null,"abstract":"","PeriodicalId":102077,"journal":{"name":"Translational Surgery","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129637487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abdominal aortic aneurysm (AAA) is a prevalent and potentially life-threatening disease. Many animal models have been developed to simulate the natural history of the disease or test preclinical endovascular devices and surgical procedures. The aim of this review is to describe different methods of AAA induction in animal models and report on the effectiveness of the methods described in inducing an analog of a human AAA. The PubMed database was searched for publications with titles containing the following terms “animal” or ''animal model(s)'' and keywords “research,” “aneurysm(s),” “aorta,” “pancreatic elastase,” “angiotensin,” “AngII” “calcium chloride” or “CaCl2.” Starting date for this search was set to 2010. We focused on animal studies that reported a model of aneurysm development and progression. A number of different approaches of AAA induction in animal models have been developed, used, and combined since the first report in the 1960s. Although specific methods are successful in AAA induction in animal models, it is necessary that these methods and their respective results are in line with the pathophysiology and the mechanisms involved in human AAA development. A researcher should know the advantages or disadvantages of each animal model and choose the appropriate model.
{"title":"Animal models in experimental abdominal aortic aneurysm","authors":"Fang Xu, Xu Zhang, Yuehong Zheng","doi":"10.4103/ts.ts_10_20","DOIUrl":"https://doi.org/10.4103/ts.ts_10_20","url":null,"abstract":"Abdominal aortic aneurysm (AAA) is a prevalent and potentially life-threatening disease. Many animal models have been developed to simulate the natural history of the disease or test preclinical endovascular devices and surgical procedures. The aim of this review is to describe different methods of AAA induction in animal models and report on the effectiveness of the methods described in inducing an analog of a human AAA. The PubMed database was searched for publications with titles containing the following terms “animal” or ''animal model(s)'' and keywords “research,” “aneurysm(s),” “aorta,” “pancreatic elastase,” “angiotensin,” “AngII” “calcium chloride” or “CaCl2.” Starting date for this search was set to 2010. We focused on animal studies that reported a model of aneurysm development and progression. A number of different approaches of AAA induction in animal models have been developed, used, and combined since the first report in the 1960s. Although specific methods are successful in AAA induction in animal models, it is necessary that these methods and their respective results are in line with the pathophysiology and the mechanisms involved in human AAA development. A researcher should know the advantages or disadvantages of each animal model and choose the appropriate model.","PeriodicalId":102077,"journal":{"name":"Translational Surgery","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121487770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
As 23-Year-old patient suffered from intermittent headache, dizziness and palpitation especially after physical activity for 1 month. A remarked rise of blood pressure as high as 200/100mmHg was found. The CTA revealed a severe stenosis of right renal artery. 5 months ago, he underwent a laparoscopic adrenalectomy. The TVH was totally relived by renal arterial angioplasty.
{"title":"Renovascular hypertension after laparoscopic adrenalectomy in a young patient","authors":"Chunmin Li, Hua-Liang Ren, Chuan-Jun Liao, Wang-de Zhang","doi":"10.4103/ts.ts_11_19","DOIUrl":"https://doi.org/10.4103/ts.ts_11_19","url":null,"abstract":"As 23-Year-old patient suffered from intermittent headache, dizziness and palpitation especially after physical activity for 1 month. A remarked rise of blood pressure as high as 200/100mmHg was found. The CTA revealed a severe stenosis of right renal artery. 5 months ago, he underwent a laparoscopic adrenalectomy. The TVH was totally relived by renal arterial angioplasty.","PeriodicalId":102077,"journal":{"name":"Translational Surgery","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126330836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carotid body tumors (CBTs) are rare neoplasms at the carotid bifurcation. Surgical excision is currently the only curable treatment for CBTs but is associated with high incidence of morbidities and mortality, due to the hyper-vascularity and proximity to carotid vessels and cranial nerves of the tumors. In the last decades, endovascular interventions, including preoperative trans-arterial embolization and carotid stents, have been utilized in surgical excision of CBTs with the attempt to reduce perioperative complications and improve surgical outcomes. However, controversial results have been reported with regard to the efficacy of such techniques. This review summarized the current application of endovascular interventions in surgical treatment of CBTs, with emphasis on their impacts on surgical conducting and perioperative complications.
{"title":"Current application of endovascular interventions in surgical management of carotid body tumor","authors":"Guangchao Gu, Yue-hong Zheng","doi":"10.4103/ts.ts_9_20","DOIUrl":"https://doi.org/10.4103/ts.ts_9_20","url":null,"abstract":"Carotid body tumors (CBTs) are rare neoplasms at the carotid bifurcation. Surgical excision is currently the only curable treatment for CBTs but is associated with high incidence of morbidities and mortality, due to the hyper-vascularity and proximity to carotid vessels and cranial nerves of the tumors. In the last decades, endovascular interventions, including preoperative trans-arterial embolization and carotid stents, have been utilized in surgical excision of CBTs with the attempt to reduce perioperative complications and improve surgical outcomes. However, controversial results have been reported with regard to the efficacy of such techniques. This review summarized the current application of endovascular interventions in surgical treatment of CBTs, with emphasis on their impacts on surgical conducting and perioperative complications.","PeriodicalId":102077,"journal":{"name":"Translational Surgery","volume":"2008 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125592662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Computational fluid dynamics (CFD) is a branch of fluid mechanics, referring to the numerical analysis of flow fields. CFD is widely applied in blood flow analysis of abdominal aortic aneurysms (AAAs) and thoracoabdominal aortic aneurysms (TAAAs), providing precision information of the blood flow field and wall stresses of the cardiovascular system. It has the advantages of individualization and noninvasiveness. It is used to predict the risk of growth and rupture of AAA and to evaluate the outcomes after endovascular aortic repair. Focused on AAA and TAAA, this review introduces the principles and clinical research progresses of CFD and looks forward to the future research directions.
{"title":"Principles and clinical applications of computational fluid dynamics in aneurysms of the abdominal aorta","authors":"Haoxuan Kan, Xiaoning Sun, Yuexin Chen, Yue-hong Zheng","doi":"10.4103/ts.ts_7_20","DOIUrl":"https://doi.org/10.4103/ts.ts_7_20","url":null,"abstract":"Computational fluid dynamics (CFD) is a branch of fluid mechanics, referring to the numerical analysis of flow fields. CFD is widely applied in blood flow analysis of abdominal aortic aneurysms (AAAs) and thoracoabdominal aortic aneurysms (TAAAs), providing precision information of the blood flow field and wall stresses of the cardiovascular system. It has the advantages of individualization and noninvasiveness. It is used to predict the risk of growth and rupture of AAA and to evaluate the outcomes after endovascular aortic repair. Focused on AAA and TAAA, this review introduces the principles and clinical research progresses of CFD and looks forward to the future research directions.","PeriodicalId":102077,"journal":{"name":"Translational Surgery","volume":"16 7","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113936375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: The aim of this study was to assess the effect of the pro-inflammatory interleukin (IL)-17A in deep venous thrombosis (DVT) resolution. Materials and Methods: A total of 45 DVT patients, 30 primary deep venous insufficiencies (DVI) patients, and 18 healthy volunteers were divided into three groups: (a) Control group, (b) DVT group, and (c) DVI group. The venous blood samples of the lower extremity with DVT were collected to evaluate the expression of IL-17A in plasma. Samples of superficial venous thrombus and superficial vein without thrombosis were collected to evaluate the expression of IL-17A in tissue. Male C57/BL mice DVT model was established and was randomly divided into five groups: (1) Control group, no treatment or surgical intervention; (2) Sham group, no treatment and sham operation; (3) DVT group, each mouse intravenous (iv) injected with phosphate-buffered saline (PBS); (4) IL-17A group, each mouse was iv injected with IL-17A; and (5) IL-17A-neutralizing antibody (NA) group, each mouse was iv injected with IL17A NA. Inferior vena cava (IVC) with thrombi were collected to measure their length and weight and analysis CD31(+) endothelial cells in thrombus of internal cerebral vein. Results: Western blot suggested that the expression of IL-17A in superficial vein with thrombosis was higher than superficial vein without thrombosis from human samples (P < 0.05). Comparing the plasma IL-17A levels in human samples, it was found that the expression of IL-17A in DVT and DVI groups was higher than those control group (P < 0.05). In C57/BL mice DVT model, immunofluorescence showed that CD31(+) endothelial cells in thrombus in IL-17A intervention group were more than those in other groups (P < 0.05). The weight of IVC with thrombi in IL-17A intervention group were less than those in other groups (P < 0.05), however, without statistical difference compared with the DVT group and IL-17A-NA group. Conclusions: Venous thrombus neovascularization can be increased by pro-inflammatory chemokine IL-17A but do not appear to decrease thrombus size.
{"title":"Pro-inflammatory chemokine interleukin-17A may increase venous thrombus resolution by increasing venous thrombus neovascularization","authors":"Wang Ruihua, Wu Xiaoyu, L. Bo, Lu Xinwu","doi":"10.4103/ts.ts_8_19","DOIUrl":"https://doi.org/10.4103/ts.ts_8_19","url":null,"abstract":"Objectives: The aim of this study was to assess the effect of the pro-inflammatory interleukin (IL)-17A in deep venous thrombosis (DVT) resolution. Materials and Methods: A total of 45 DVT patients, 30 primary deep venous insufficiencies (DVI) patients, and 18 healthy volunteers were divided into three groups: (a) Control group, (b) DVT group, and (c) DVI group. The venous blood samples of the lower extremity with DVT were collected to evaluate the expression of IL-17A in plasma. Samples of superficial venous thrombus and superficial vein without thrombosis were collected to evaluate the expression of IL-17A in tissue. Male C57/BL mice DVT model was established and was randomly divided into five groups: (1) Control group, no treatment or surgical intervention; (2) Sham group, no treatment and sham operation; (3) DVT group, each mouse intravenous (iv) injected with phosphate-buffered saline (PBS); (4) IL-17A group, each mouse was iv injected with IL-17A; and (5) IL-17A-neutralizing antibody (NA) group, each mouse was iv injected with IL17A NA. Inferior vena cava (IVC) with thrombi were collected to measure their length and weight and analysis CD31(+) endothelial cells in thrombus of internal cerebral vein. Results: Western blot suggested that the expression of IL-17A in superficial vein with thrombosis was higher than superficial vein without thrombosis from human samples (P < 0.05). Comparing the plasma IL-17A levels in human samples, it was found that the expression of IL-17A in DVT and DVI groups was higher than those control group (P < 0.05). In C57/BL mice DVT model, immunofluorescence showed that CD31(+) endothelial cells in thrombus in IL-17A intervention group were more than those in other groups (P < 0.05). The weight of IVC with thrombi in IL-17A intervention group were less than those in other groups (P < 0.05), however, without statistical difference compared with the DVT group and IL-17A-NA group. Conclusions: Venous thrombus neovascularization can be increased by pro-inflammatory chemokine IL-17A but do not appear to decrease thrombus size.","PeriodicalId":102077,"journal":{"name":"Translational Surgery","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115347400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xu Zhang, Nuo Si, Yuan Li, M. Liang, Yuehong Zheng
Ehlers-Danlos syndrome (EDS) is a rare, heritable connective tissue disorder disease . Among the subtypes of EDS, vascular type EDS (VEDS), is the most catastrophic one which can lead to aortic aneurysm, aortic dissection and even aortic rupture. We report a four-generation pedigree of VEDS. We give the propositus and her sister a DNA Test and made a literature review about the treatment of VEDS. The diagnosis turned out to be VEDS, which is caused by mutations in COL3A1(c.2221G>A, p.G741S), The patient received conservative treatment and her family got the medical instructions. Although EDS is rarely seen, it is necessary to be aware of this disease to make the right diagnosis and chose the appropriate treatment strategy, Doctors' unfamiliarity with this disease may compromise care.
{"title":"A four-generation pedigree of vascular-type Ehlers–Danlos syndrome with spontaneous aortic dissections and multiple aneurysms: A case report and literature review","authors":"Xu Zhang, Nuo Si, Yuan Li, M. Liang, Yuehong Zheng","doi":"10.4103/ts.ts_12_19","DOIUrl":"https://doi.org/10.4103/ts.ts_12_19","url":null,"abstract":"Ehlers-Danlos syndrome (EDS) is a rare, heritable connective tissue disorder disease . Among the subtypes of EDS, vascular type EDS (VEDS), is the most catastrophic one which can lead to aortic aneurysm, aortic dissection and even aortic rupture. We report a four-generation pedigree of VEDS. We give the propositus and her sister a DNA Test and made a literature review about the treatment of VEDS. The diagnosis turned out to be VEDS, which is caused by mutations in COL3A1(c.2221G>A, p.G741S), The patient received conservative treatment and her family got the medical instructions. Although EDS is rarely seen, it is necessary to be aware of this disease to make the right diagnosis and chose the appropriate treatment strategy, Doctors' unfamiliarity with this disease may compromise care.","PeriodicalId":102077,"journal":{"name":"Translational Surgery","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114305423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The successful resection of giant carotid body tumors (CBTs) with full protection of cranial nerve is challenging. Meanwhile, entities with fresh blood inside a CBT were commonly considered liquefactive necrosis preoperatively. However, we reported a case with an aneurysm-like entity inside the CBT instead. A patient with lump on the right neck complained of feeling dizzy. She was then reported with a giant CBT reaching lateral skull base. Preoperative imaging revealed a low-density entity inside the tumor, which was considered as liquefaction necrosis. However, during surgery, the low-density area was observed pulsing with fresh blood. Under the collaboration of vascular surgeons and otolaryngologists, the tumor was resected uneventfully. We reported a case of giant CBT over 10 cm and successful resection with no major facial nerve deficit. Moreover, an aneurysm-like entity inside the tumor was observed during the surgery, which was not reported before.
{"title":"An aneurysm-like entity inside a giant carotid body tumor reaching lateral skull base","authors":"Hui Zhang, Fang-da Li, Yue-hong Zheng","doi":"10.4103/ts.ts_10_19","DOIUrl":"https://doi.org/10.4103/ts.ts_10_19","url":null,"abstract":"The successful resection of giant carotid body tumors (CBTs) with full protection of cranial nerve is challenging. Meanwhile, entities with fresh blood inside a CBT were commonly considered liquefactive necrosis preoperatively. However, we reported a case with an aneurysm-like entity inside the CBT instead. A patient with lump on the right neck complained of feeling dizzy. She was then reported with a giant CBT reaching lateral skull base. Preoperative imaging revealed a low-density entity inside the tumor, which was considered as liquefaction necrosis. However, during surgery, the low-density area was observed pulsing with fresh blood. Under the collaboration of vascular surgeons and otolaryngologists, the tumor was resected uneventfully. We reported a case of giant CBT over 10 cm and successful resection with no major facial nerve deficit. Moreover, an aneurysm-like entity inside the tumor was observed during the surgery, which was not reported before.","PeriodicalId":102077,"journal":{"name":"Translational Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115490872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hao-cheng Li, Qingfeng Sun, Ye Yao, Chao Yuan, G. Liu, Bao Jing, Jingbo Li, Haiyang Wang
Vascular smooth muscle cells (VSMCs) are responsible for blood vessel relaxation contraction and hemodynamics. Cardiovascular diseases (CVDs) are a major cause of human death worldwide, and the pathophysiological changes to the VSMCs such as apoptosis, hypertrophy, and migration contribute to these diseases. Herein, we recapitulated the importance of molecular factors relevant to the regulation of VSMCs and how VSMCs are involved in these pathophysiological changes. This is significant to the development of therapeutic treatments for various CVDs. A literature search was conducted to identify studies assessing the regulating factors of VSMCs using the Medline and PubMed databases from inception to February 1, 2019. Search terms were applied either as single or in combination. In the present review, we will discuss some of the influential factors that may affect and regulate the changes of VSMCs in CVDs.
{"title":"Factors regulating the change of vascular smooth muscle cells in cardiovascular diseases: A mini review","authors":"Hao-cheng Li, Qingfeng Sun, Ye Yao, Chao Yuan, G. Liu, Bao Jing, Jingbo Li, Haiyang Wang","doi":"10.4103/ts.ts_4_19","DOIUrl":"https://doi.org/10.4103/ts.ts_4_19","url":null,"abstract":"Vascular smooth muscle cells (VSMCs) are responsible for blood vessel relaxation contraction and hemodynamics. Cardiovascular diseases (CVDs) are a major cause of human death worldwide, and the pathophysiological changes to the VSMCs such as apoptosis, hypertrophy, and migration contribute to these diseases. Herein, we recapitulated the importance of molecular factors relevant to the regulation of VSMCs and how VSMCs are involved in these pathophysiological changes. This is significant to the development of therapeutic treatments for various CVDs. A literature search was conducted to identify studies assessing the regulating factors of VSMCs using the Medline and PubMed databases from inception to February 1, 2019. Search terms were applied either as single or in combination. In the present review, we will discuss some of the influential factors that may affect and regulate the changes of VSMCs in CVDs.","PeriodicalId":102077,"journal":{"name":"Translational Surgery","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114513871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Le Xiao, Lei Shang, Xuan Xu, Yi-ming Ouyang, Linhai Li, Yu Zhu, Kunmei Gong
Extrahepatic portal vein obstruction (EHPVO) refers to obstruction of the extrahepatic portal vein that is characterized by cavernous transformation, portal hypertension, and intestinal dysfunction. Radiological interventions on EHPVO are an extraordinary challenge, although being reported to be safe and effective in selected patients by pertinent experts. Chronic intestinal dysfunction is a rare complication of EHPVO; it is unknown whether portal vein re-canalization by radiological interventions can improve chronic intestinal dysfunction. We describe a 22-year-old male patient with chronic intestinal dysfunction due to EHPVO, which was not improved by portal vein re-canalization. The patient presented with acute abdominal pain and dyspepsia for 2 weeks without hematochezia in August 2016 and was diagnosed with EHPVO. Due to cavernous transformation, systemic anticoagulation therapy was administered, and although his abdominal pain was relieved, the patient still had dyspepsia and partial jejunum dysfunction. Intestinal segmentectomy was suggested but was refused, and the patient received catheter-directed thrombolysis in another hospital. Although the portal vein was partly recanalized, the intestinal obstruction was not alleviated. Four months after onset, an emergent enterectomy was performed due to severe hematochezia with pathological examination findings of necrosis, ulcer, and granulation formation. Unfortunately, the patient developed a serious systemic infection, severe thrombocytopenia and disseminated intravascular coagulation, which was assumed to be caused by intestinal bacterial translocation and serious malnutrition. The infection was subsequently controlled. In conclusion, in patients with chronic intestinal dysfunction due to EHPVO, portal vein re-canalization may not improve intestinal function. Timely enterectomy may prevent intestinal bacterial translocation and serious malnutrition.
{"title":"Portal vein recanalization failed to improve chronic intestinal obstruction due to extrahepatic portal vein obstruction","authors":"Le Xiao, Lei Shang, Xuan Xu, Yi-ming Ouyang, Linhai Li, Yu Zhu, Kunmei Gong","doi":"10.4103/ts.ts_9_19","DOIUrl":"https://doi.org/10.4103/ts.ts_9_19","url":null,"abstract":"Extrahepatic portal vein obstruction (EHPVO) refers to obstruction of the extrahepatic portal vein that is characterized by cavernous transformation, portal hypertension, and intestinal dysfunction. Radiological interventions on EHPVO are an extraordinary challenge, although being reported to be safe and effective in selected patients by pertinent experts. Chronic intestinal dysfunction is a rare complication of EHPVO; it is unknown whether portal vein re-canalization by radiological interventions can improve chronic intestinal dysfunction. We describe a 22-year-old male patient with chronic intestinal dysfunction due to EHPVO, which was not improved by portal vein re-canalization. The patient presented with acute abdominal pain and dyspepsia for 2 weeks without hematochezia in August 2016 and was diagnosed with EHPVO. Due to cavernous transformation, systemic anticoagulation therapy was administered, and although his abdominal pain was relieved, the patient still had dyspepsia and partial jejunum dysfunction. Intestinal segmentectomy was suggested but was refused, and the patient received catheter-directed thrombolysis in another hospital. Although the portal vein was partly recanalized, the intestinal obstruction was not alleviated. Four months after onset, an emergent enterectomy was performed due to severe hematochezia with pathological examination findings of necrosis, ulcer, and granulation formation. Unfortunately, the patient developed a serious systemic infection, severe thrombocytopenia and disseminated intravascular coagulation, which was assumed to be caused by intestinal bacterial translocation and serious malnutrition. The infection was subsequently controlled. In conclusion, in patients with chronic intestinal dysfunction due to EHPVO, portal vein re-canalization may not improve intestinal function. Timely enterectomy may prevent intestinal bacterial translocation and serious malnutrition.","PeriodicalId":102077,"journal":{"name":"Translational Surgery","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125322758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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