Document Detail


Portal vein stenting for portal hypertension caused by local recurrence after pancreatoduodenectomy for periampullary cancer.
MedLine Citation:
PMID:  17458607     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Portal hypertension after extensive abdominal surgery is an unusual cause of repetitive gastrointestinal bleeding. We report on a 68-year-old male patient with intermittent gastrointestinal bleeding secondary to portal vein stenosis caused by local recurrence of the distal bile duct cancer after pancreatoduodenectomy. Severe portal vein stenosis without sufficient development of portal venous collaterals was detected 25 months after pancreatoduodenectomy. Direct portography using a percutaneous transhepatic approach showed that there was a pressure gradient of 18 mmHg across the portal vein stenosis. Portal vein stenting successfully relieved portal hypertension and bowel congestion. Gastrointestinal bleeding episodes ceased after stenting. The patient died from liver metastasis 14 months after stent insertion and 39 months after pancreatoduodenectomy. Based on this case and literature reports, the possibility of portal vein stenosis should be considered for patients who have undergone pancreatoduodenectomy and then showed unexplained gastrointestinal bleeding. Percutaneous transhepatic stent insertion appears to be the treatment of choice for focal portal vein stenosis.
Authors:
Shin Hwang; Kyu-Bo Sung; Yo-Han Park; Dong-Hwan Jung; Sung-Gyu Lee
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  11     ISSN:  1091-255X     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-04-26     Completed Date:  2007-09-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  333-7     Citation Subset:  IM    
Affiliation:
Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, South Korea. shwang@amc.seoul.kr
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / pathology,  surgery*
Aged
Bile Duct Neoplasms / pathology,  surgery*
Constriction, Pathologic
Humans
Hypertension, Portal / etiology,  surgery*
Male
Neoplasm Recurrence, Local / complications*
Pancreaticoduodenectomy / adverse effects*
Portal Vein* / pathology
Recurrence
Stents*

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


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