Document Detail

Intrahepatic portal venous systems in children with noncirrhotic prehepatic portal hypertension: Anatomy and clinical relevance.
MedLine Citation:
PMID:  25092088     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Children with extrahepatic portal hypertension typically present with cavernomatous transformation of the portal vein and a poorly defined intrahepatic portal vein system on conventional imaging. With the Meso-Rex Bypass becoming the gold-standard intervention for a cure, a precise assessment of the intrahepatic portal vein system provides helpful data for deciding whether a Meso-Rex Bypass is feasible or not.
METHODS: All children with extrahepatic portal hypertension were prospectively assessed by wedged hepatic venous portography. Venous anatomy was categorized into five subtypes (A to E), depending on the presence of thrombosis in the Rex recessus, or not, and its extension within the intrahepatic portal venous system.
RESULTS: Eighty-nine children entered the study. Previous umbilical vein catheterization is usually associated with Rex thrombosis, while the Rex recessus and the intrahepatic portal venous system are patent in idiopathic cases, thus allowing for the performance of a Meso-Rex Bypass with a good outcome.
CONCLUSIONS: Wedged hepatic venous portography is a very effective tool for detailed preoperative assessment and identification of children being considered for Meso-Rex Bypass surgery. An anatomic-radiological classification is useful in selecting patients for Meso-Rex Bypass with anticipation of a high rate of success.
Arianna Bertocchini; Pierluigi Falappa; Chiara Grimaldi; Giuseppe Bolla; Lidia Monti; Jean de Ville de Goyet
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Publication Detail:
Type:  Journal Article     Date:  2013-11-15
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  49     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-08-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1268-75     Citation Subset:  IM    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
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