Document Detail


Indwelling mesenteric venous catheterization for early detection of portal vein thrombosis: possible application to pediatric liver transplantation.
MedLine Citation:
PMID:  8120764     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Portal vein thrombosis (PVT) is a well-recognized complication after liver transplantation, particularly in children. When it occurs early in the postoperative period, it has serious consequences, and rapid detection is essential. The purposes of this study were (1) to ascertain whether continuous monitoring of mesenteric venous pressure (MVP), via an indwelling mesenteric venous catheter, could assist in early detection of PVT and (2) to investigate the role of portography, via the catheter, in confirming this complication. An animal model of PVT was developed in pigs. At laparotomy, a heparin-coated catheter was inserted into a jejunal mesenteric vein, delivered percutaneously and connected to a pressure transducer. Conditions of PVT were simulated by progressive occlusion of the portal vein (PV) using a silastic tourniquet, and the degree of PV stenosis was assessed by Doppler ultrasound flow-velocity measurement. MVP was recorded 1 and 3 minutes after PV occlusion, and portography was performed via the indwelling catheter. There were significant increases in MVPs with all degrees of PV stenosis (P < .01, Student's t test). No significant changes in MVP were noted between 1 and 3 minutes postocclusion. Portography clearly demonstrated PV stenosis. There were no instances of PVT, despite repeated and prolonged occlusion of the PV. Progressive degrees of PV stenosis have been clearly detected by an indwelling mesenteric venous catheter in an animal model. This method may be useful for the diagnosis and treatment of PVT after pediatric liver transplantation.
Authors:
A Yamataka; S Kawamoto; M Ishikawa; J F Lancaster; T H Ong; T Miyano; S V Lynch
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  29     ISSN:  0022-3468     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  1994 Jan 
Date Detail:
Created Date:  1994-04-05     Completed Date:  1994-04-05     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  58-60     Citation Subset:  IM    
Affiliation:
Queensland Liver Transplant Service, Princess Alexandra Hospital, Brisbane, Australia.
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Pressure
Catheterization*
Catheters, Indwelling
Liver Transplantation
Mesenteric Veins*
Monitoring, Physiologic
Portal Vein*
Postoperative Complications / diagnosis
Swine
Thrombosis / diagnosis*,  etiology,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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