|
Portacaval Shunt
A portacaval shunt (or portal caval shunt) is a treatment for portal hypertension. A connection is made between the portal vein, which supplies 75% of the liver's blood, and the inferior vena cava, the vein that drains blood from the lower two-thirds of the body. The most common causes of liver disease resulting in portal hypertension are Budd–Chiari Syndrome or Cirrhosis. Budd–Chiari should not be mistaken for Cirrhosis. Less common causes include diseases such as hemochromatosis, primary biliary cirrhosis (PBC), and portal vein thrombosis. Cirrhotic patients often develop hepatic encephalopathy (HE) following the procedure, sometimes resulting in coma. The high risk of developing HE may be a consequence of increased intestinal absorption of encephalopathogenic substances in combination with the reduced hepatic blood flow. See also * Shunt (medical) * Portacaval anastomosis A portocaval anastomosis or porto-systemic anastomosis is a specific type of anastomosis that occ ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Portal Hypertension
Portal hypertension is abnormally increased portal venous pressure – blood pressure in the portal vein and its branches, that drain from most of the intestine to the liver. Portal hypertension is defined as a hepatic venous pressure gradient greater than 5 mmHg. Cirrhosis (a form of chronic liver failure) is the most common cause of portal hypertension; other, less frequent causes are therefore grouped as non-cirrhotic portal hypertension. When it becomes severe enough to cause symptoms or complications, treatment may be given to decrease portal hypertension itself or to manage its complications. Signs and symptoms Signs and symptoms of portal hypertension include: * Ascites (free fluid in the peritoneal cavity), ** Abdominal pain or tenderness (when bacteria infect the ascites, as in spontaneous bacterial peritonitis). * Increased spleen size ( splenomegaly), which may lead to lower platelet counts ( thrombocytopenia) * Anorectal varices * Swollen veins on the anterior a ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Portal Vein
The portal vein or hepatic portal vein (HPV) is a blood vessel that carries blood from the gastrointestinal tract, gallbladder, pancreas and spleen to the liver. This blood contains nutrients and toxins extracted from digested contents. Approximately 75% of total liver blood flow is through the portal vein, with the remainder coming from the hepatic artery proper. The blood leaves the liver to the heart in the hepatic veins. The portal vein is not a true vein, because it conducts blood to capillary beds in the liver and not directly to the heart. It is a major component of the hepatic portal system, one of only two portal venous systems in the body – with the hypophyseal portal system being the other. The portal vein is usually formed by the confluence of the superior mesenteric, splenic veins, inferior mesenteric, left, right gastric veins and the pancreatic vein. Conditions involving the portal vein cause considerable illness and death. An important example of suc ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Inferior Vena Cava
The inferior vena cava is a large vein that carries the deoxygenated blood from the lower and middle body into the right atrium of the heart. It is formed by the joining of the right and the left common iliac veins, usually at the level of the fifth lumbar vertebra. The inferior vena cava is the lower (" inferior") of the two venae cavae, the two large veins that carry deoxygenated blood from the body to the right atrium of the heart: the inferior vena cava carries blood from the lower half of the body whilst the superior vena cava carries blood from the upper half of the body. Together, the venae cavae (in addition to the coronary sinus, which carries blood from the muscle of the heart itself) form the venous counterparts of the aorta. It is a large retroperitoneal vein that lies posterior to the abdominal cavity and runs along the right side of the vertebral column. It enters the right auricle at the lower right, back side of the heart. The name derives from la, ve ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Hemochromatosis
Iron overload or hemochromatosis (also spelled ''haemochromatosis'' in British English) indicates increased total accumulation of iron in the body from any cause and resulting organ damage. The most important causes are hereditary haemochromatosis (HH or HHC), a genetic disorder, and transfusional iron overload, which can result from repeated blood transfusions. Signs and symptoms Organs most commonly affected by hemochromatosis include the liver, heart, and endocrine glands. Hemochromatosis may present with the following clinical syndromes: * liver: chronic liver disease and cirrhosis of the liver. * heart: heart failure, cardiac arrhythmia. * hormones: diabetes (see below) and hypogonadism (insufficiency of the sex hormone producing glands) which leads to low sex drive and/or loss of fertility in men and loss of menstrual cycle in women. * metabolism: diabetes in people with iron overload occurs as a result of selective iron deposition in islet beta cells in the pancreas le ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Primary Biliary Cirrhosis
Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis, is an autoimmune disease of the liver. It results from a slow, progressive destruction of the small bile ducts of the liver, causing bile and other toxins to build up in the liver, a condition called cholestasis. Further slow damage to the liver tissue can lead to scarring, fibrosis, and eventually cirrhosis. Common symptoms are tiredness, itching, and in more advanced cases, jaundice. In early cases, the only changes may be those seen in blood tests. PBC is a relatively rare disease, affecting up to one in 3,000–4,000 people. It is much more common in women, with a sex ratio of at least 9:1 female to male. The condition has been recognised since at least 1851, and was named "primary biliary cirrhosis" in 1949. Because cirrhosis is a feature only of advanced disease, a change of its name to "primary biliary cholangitis" was proposed by patient advocacy groups in 2014. Signs and symptoms ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Portal Vein Thrombosis
Portal vein thrombosis (PVT) is a vascular disease of the liver that occurs when a blood clot occurs in the hepatic portal vein, which can lead to increased pressure in the portal vein system and reduced blood supply to the liver. The mortality rate is approximately 1 in 10. An equivalent clot in the vasculature that exits the liver carrying deoxygenated blood to the right atrium via the inferior vena cava, is known as hepatic vein thrombosis or Budd-Chiari syndrome. Signs and symptoms Portal vein thrombosis causes upper abdominal pain, possibly accompanied by nausea and an enlarged liver and/or spleen; the abdomen may be filled with fluid (ascites). A persistent fever may result from the generalized inflammation. While abdominal pain may come and go if the thrombus forms suddenly, long-standing clot build-up can also develop without causing symptoms, leading to portal hypertension before it is diagnosed. Other symptoms can develop based on the cause. For example, if portal ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Hepatic Encephalopathy
Hepatic encephalopathy (HE) is an altered level of consciousness as a result of liver failure. Its onset may be gradual or sudden. Other symptoms may include movement problems, changes in mood, or changes in personality. In the advanced stages it can result in a coma. Hepatic encephalopathy can occur in those with acute or chronic liver disease. Episodes can be triggered by infections, GI bleeding, constipation, electrolyte problems, or certain medications. The underlying mechanism is believed to involve the buildup of ammonia in the blood, a substance that is normally removed by the liver. The diagnosis is typically based on symptoms after ruling out other potential causes. It may be supported by blood ammonia levels, an electroencephalogram, or a CT scan of the brain. Hepatic encephalopathy is possibly reversible with treatment. This typically involves supportive care and addressing the triggers of the event. Lactulose is frequently used to decrease ammonia levels. ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Shunt (medical)
In medicine, a shunt is a hole or a small passage that moves, or allows movement of, fluid from one part of the body to another. The term may describe either congenital or acquired shunts; acquired shunts (sometimes referred to as iatrogenic shunts) may be either biological or mechanical. __TOC__ Types * Cardiac shunts may be described as right-to-left, left-to-right or bidirectional, or as systemic-to-pulmonary or pulmonary-to-systemic. * Cerebral shunt: In cases of hydrocephalus and other conditions that cause chronic increased intracranial pressure, a one-way valve is used to drain excess cerebrospinal fluid from the brain and carry it to other parts of the body. This valve usually sits outside the skull but beneath the skin, somewhere behind the ear. Cerebral shunts that drain fluid to the peritoneal cavity (located in the upper abdomen) are called ''ventriculoperitoneal'' (''VP'') shunts. * Lumbar-peritoneal shunt (a.k.a. ''lumboperitoneal'', ''LP''): In cases of chron ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Portacaval Anastomosis
A portocaval anastomosis or porto-systemic anastomosis is a specific type of anastomosis that occurs between the veins of the portal circulation and those of the systemic circulation. When there is a blockage of the portal system, portocaval anastomosis enables the blood to still reach the systemic venous circulation. The inferior end of the esophagus and the superior part of the rectum are potential sites of a harmful portocaval anastomosis. In portal hypertension, as in the case of cirrhosis of the liver, the anastomoses become congested and form venous dilatations. Such dilatation can lead to esophageal varices and anorectal varices. Caput medusae can also result.'' Gray's Anatomy for Students'' Gray H, Drake R, Vogl W, Mitchell A, Tibbitts R, Richardson P. Philadelphia: Elsevier/Churchill Livingstone; 2010. p. 226 __TOC__ Presentation Clinical presentations of portal hypertension include: A dilated inferior mesenteric vein may or may not be related to portal hypertension. ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Vascular Surgery
Vascular surgery is a surgical subspecialty in which diseases of the vascular system, or arteries, veins and lymphatic circulation, are managed by medical therapy, minimally-invasive catheter procedures and surgical reconstruction. The specialty evolved from general and cardiac surgery and includes treatment of the body's other major and essential veins and arteries. Open surgery techniques, as well as endovascular techniques are used to treat vascular diseases. The vascular surgeon is trained in the diagnosis and management of diseases affecting all parts of the vascular system excluding the coronaries and intracranial vasculature. Vascular surgeons often assist other physicians to address traumatic vascular injury, hemorrhage control, and safe exposure of vascular structures. History Early leaders of the field included Russian surgeon Nikolai Korotkov, noted for developing early surgical techniques, American interventional radiologist Charles Theodore Dotter who is credite ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
