Browsing by Subject "Noncirrhotic portal hypertension"

Now showing 1 - 2 of 2
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    Biliary Obstruction After Transjugular Intrahepatic Portosystemic Shunt Placement
    (Wolters Kluwer, 2021-06-21) Patel, Feenalie; Bick, Benjamin; Pediatrics, School of Medicine
    A 19-year-old man with noncirrhotic portal hypertension status post transjugular intrahepatic portosystemic shunt, gastric esophageal varices status post coil embolization, and thrombophilia because of Factor V Leiden heterozygosity presented with jaundice and elevated liver enzymes. His cholangiogram during endoscopic retrograde cholangiopancreatography demonstrated biliary tract obstruction at the bifurcation of the right and left hepatic ducts. With the aid of digital single-operator cholangioscopy, the patient was found to have a perforation of the common hepatic duct from the shunt. This case presents a novel use for digital single-operator cholangioscopy in identifying this rare complication and appropriately differentiating biliary compression vs perforation from transjugular intrahepatic portosystemic shunt.
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    Ruptured idiopathic hepatic artery pseudoaneurysm causing portal vein thrombosis with portal hypertension and variceal bleeding
    (Elsevier, 2021-01-27) Ni, Kevin; Jansson-Knodell, Claire; Krosin, Matthew E.; Obaitan, Itegbemie; Haste, Paul M.; Nephew, Lauren D.; Sagi, Sashidhar V.; Radiology and Imaging Sciences, School of Medicine
    Portal vein thrombosis (PVT) is an important cause of noncirrhotic portal hypertension. Noncancerous extrinsic compression of portal vein to drive PVT formation is rare, but important to identify. A 64-year-old female with idiopathic hepatic artery pseudoaneurysm (HAPA) rupture 7 months prior presented with acute-onset hematemesis and melena and was found to have prehepatic portal hypertensive variceal bleeding. Her HAPA-related retroperitoneal hematoma had resulted in portal vein compression, thrombosis, and cavernous transformation despite prompt stent graft placement across the ruptured HAPA, and required definitive treatment by transjugular intrahepatic portosystemic shunt creation with portal vein reconstruction utilizing a trans-splenic access. This case highlights the importance of interval abdominal imaging and hypercoagulability screening for noncirrhotic patients at-risk for PVT, which identified the patient as a heterozygous carrier of Factor V Leiden.