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Splenic Artery (splenic + artery)
Terms modified by Splenic Artery Selected AbstractsArterial anastomosis in a pediatric patient receiving a right extended split liver transplant: A case reportPEDIATRIC TRANSPLANTATION, Issue 4 2009Roberto Verzaro Abstract:, We report a case of a pediatric patient who received a right-extended liver transplant. The size of the recipient hepatic artery did not match with the donor right hepatic arterial stump. Moreover, recipient arterial anatomy made the direct anastomosis difficult or at increased risk for complications. The recipient's splenic artery was then mobilized, divided and anastomosed to the donor's right hepatic artery. The spleen was preserved and revascularization through collaterals is demonstrated by Angio CT Scan. Doppler US of the transplanted liver demonstrated good flow through the liver and the patient was discharged with perfect liver function. Splenic artery is perfectly suited for hepatic artery anastomosis. The use of splenic artery is favored in particular situations as in the case of a pediatric recipient receiving a right-extended liver graft with small caliber artery. [source] Case,control study of calcification of the hepatic artery in chronic hemodialysis patients: Comparison with the abdominal aorta and splenic arteryJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 1 2002KUNIO OKUDA Abstract Background and Aims: Studies of the hepatic artery are scarce. We have observed that hepatic artery calcification is very uncommon in patients with hyperparathyroidism that expedites calcification. Methods: Plain abdominal CT was studied in 221 patients on chronic hemodialysis. Control consisted of 442 sex- and age-matched patients with other diseases. Calcification was graded as a percentage of the entire wall circumference for the aorta, and as a percentage of the entire length of the hepatic and splenic arteries from the celiac trunk to the hilum of each organ. Results: Aortic calcification was seen in 79.2% of male dialysis patients, 22.1% of controls, 74.1% of female dialysis patients and 17.3% of controls (P < 0.0001). Hepatic artery calcification was seen in only 13 dialysis patients. The degree of calcification of the abdominal aorta was correlated with the length of hemodialysis period (P = 0.008), but not with serum calcium, serum phosphate or their product. Although serum parathormone levels were not correlated with calcification, seven of eight dialysis patients with hepatic artery calcification had very high parathormone levels. Conclusions: The hepatic artery is far less frequently calcified than are the abdominal aorta and splenic artery. This may be a teleologic phenomenon of the liver. [source] Successful treatment of extensive splanchnic arterial and portal vein thrombosis associated with ulcerative colitisCOLORECTAL DISEASE, Issue 6 2009F. Di Fabio Venous and arterial thromboembolism is a significant cause of morbidity and mortality in patients with ulcerative colitis (UC). Arterial thrombosis of the splanchnic region is a rare event with a very high mortality rate. Furthermore, it represents a challenging complication since it tends to be overlooked and misinterpreted as a clinical exacerbation of UC. We present the case of a 62-year-old female with pancolonic UC complicated by an extensive arterial thrombosis involving the aorta, the celiac trunk, the hepatic, gastric and splenic arteries and the superior mesenteric artery. A thrombosis of the splenic vein extending into the proximal portal vein was also present. The patient was successfully treated by a combined interventional-radiological and surgical treatment. We discuss the rationale behind our management of this case and review the literature on splanchnic arterial thrombosis associated with UC. [source] Pseudoxanthoma elasticum with recurrent gastric hemorrhage managed by endoscopic mechanical hemostasisDIGESTIVE ENDOSCOPY, Issue 2 2004Hitoshi Nishiyama A 24-year-old-woman was admitted to our hospital for further examination of recurrent upper gastrointestinal tract hemorrhage. The characteristic xanthomatous papular rash, retinal angioid streaks, and stenosis of cardiac coronary artery confirmed the diagnosis of pseudoxanthoma elasticum. Upper gastrointestinal endoscopy revealed vascular dilation in the gastric body to fornix. The vessel showing conspicuous dilation covered with the discolored mucosa was suspected as the source of the bleeding. The vessel was identified as a dilated vein located in the submucosa by endoscopic ultrasonography and pulsed-wave Doppler ultrasonography. Abdominal angiography demonstrated aneurysmal dilation in the splenic artery, but not in the gastric artery. Endoscopic band ligation was chosen as an initial treatment for the prevention of recurrent bleeding. The procedure seemed to be successful, but rebleeding occurred on the next day, which was again treated with hemostatic clipping. There have been no further episodes of gastrointestinal hemorrhage during the 15-month follow up. [source] Guidelines for the treatment of chronic hepatitis and cirrhosis due to hepatitis C virus infection for the fiscal year 2008 in JapanHEPATOLOGY RESEARCH, Issue 1 2010Hiromitsu Kumada In the 2008 guidelines for the treatment of patients with chronic hepatitis C, pegylated interferon (Peg-IFN) combined with ribavirin for 48 weeks are indicated for treatment-naive patients infected with hepatitis C virus (HCV) of genotype 1. Treatment is continued for an additional 24 weeks (72 weeks total) in the patients who have remained positive for HCV RNA detectable by the real-time polymerase chain reaction at 12 weeks after the start of treatment, but who turn negative for HCV RNA during 13,36 weeks on treatment. Re-treatment is aimed to either eradicate HCV or normalize transaminase levels for preventing the development of hepatocellular carcinoma (HCC). For patients with compensated cirrhosis, the clearance of HCV RNA is aimed toward improving histological damages and decreasing the development of HCC. The recommended therapeutic regimen is the initial daily dose of 6 million international units (MIU) IFN continued for 2,8 weeks that is extended to longer than 48 weeks, if possible. IFN dose is reduced to 3 MIU daily in patients who fail to clear HCV RNA by 12 weeks for preventing the development of HCC. Splenectomy or embolization of the splenic artery is recommended to patients with platelet counts of less than 50 × 103/mm3 prior to the commencement of IFN treatment. When the prevention of HCC is at issue, not only IFN, but also liver supportive therapy such as stronger neo-minophagen C, ursodeoxycholic acid, phlebotomy, branched chain amino acids (BCAA), either alone or in combination, are given. In patients with decompensated cirrhosis, by contrast, reversal to compensation is attempted. [source] Case,control study of calcification of the hepatic artery in chronic hemodialysis patients: Comparison with the abdominal aorta and splenic arteryJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 1 2002KUNIO OKUDA Abstract Background and Aims: Studies of the hepatic artery are scarce. We have observed that hepatic artery calcification is very uncommon in patients with hyperparathyroidism that expedites calcification. Methods: Plain abdominal CT was studied in 221 patients on chronic hemodialysis. Control consisted of 442 sex- and age-matched patients with other diseases. Calcification was graded as a percentage of the entire wall circumference for the aorta, and as a percentage of the entire length of the hepatic and splenic arteries from the celiac trunk to the hilum of each organ. Results: Aortic calcification was seen in 79.2% of male dialysis patients, 22.1% of controls, 74.1% of female dialysis patients and 17.3% of controls (P < 0.0001). Hepatic artery calcification was seen in only 13 dialysis patients. The degree of calcification of the abdominal aorta was correlated with the length of hemodialysis period (P = 0.008), but not with serum calcium, serum phosphate or their product. Although serum parathormone levels were not correlated with calcification, seven of eight dialysis patients with hepatic artery calcification had very high parathormone levels. Conclusions: The hepatic artery is far less frequently calcified than are the abdominal aorta and splenic artery. This may be a teleologic phenomenon of the liver. [source] Spontaneous coeliac artery dissectionJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 4 2006B McGuinness Summary A patient with spontaneous coeliac artery dissection that presented as upper abdominal pain is reported. This was diagnosed on contrast-enhanced multislice helical CT. The patient was treated conservatively and follow-up CT showed mild aneurysmal change of the splenic artery and a small splenic infarct. Isolated dissection of the visceral arteries (and, in particular, the coeliac artery) is extremely rare. With such limited evidence, decisions over best management are difficult, but depend on initial severity and progression at follow up. [source] Hepatic arterial cannulation using the side holed catheterJOURNAL OF SURGICAL ONCOLOGY, Issue 2 2005Masashi Watanabe MD Abstract Background Hepatic arterial infusion chemotherapy (HAIC) has been recognized as one of the effective treatments for patients with hepatic metastatic tumor. However it is difficult to perform HAIC in the long term without complications. This report describes the laparotomic approach using the side holed catheter, which is a novel method of implanting a catheter-port system. Methods and Results We designed a new anti-thrombotic catheter for HAIC. This catheter is tapered from 5F (diameter of shaft) to 3.3F (diameter at tip), and a side hole is opened 7 cm from the tip of catheter. This catheter is inserted from the gastroduodenal artery to the common hepatic artery (CHA), and the tip is put in the aorta or in the splenic artery. The side hole is adjusted distal to the CHA. In our surgical department, our new catheter was inserted in four patients at the time of their abdominal surgery. The cannulation was performed successfully in all patients. In two of them, HAIC was finished without problems at 6 months after starting, and two were still treated by HAIC at 9 and 8 months after starting. Conclusions Initial results from a study of a new method of implanting a catheter-port system in the hepatic artery using the new tapering side hole catheter suggest that this method may enable operators to avoid complicated selective coiling and may lower the incidence of hepatic artery occlusion in patients receiving long-term HAIC. J. Surg. Oncol. 2005;91:145,149. © 2005 Wiley-Liss, Inc. [source] Characteristics and management of splenic artery aneurysms in adult living donor liver transplant recipientsLIVER TRANSPLANTATION, Issue 11 2009Deok-Bog Moon Splenic artery aneurysms (SAAs), occurring in 7% to 17% of patients with cirrhosis, often result in catastrophic rupture after liver transplantation. We had experienced 3 cases of ruptured SAAs after adult living donor liver transplantation (LDLT), and we then performed this study to find risk factors for coexisting SAAs in liver transplant candidates with cirrhosis and to propose ideal approaches for them. Preoperative and postoperative computed tomography angiograms and axial views were reviewed for 310 adult LDLT recipients who had cirrhosis from January 2004 to August 2005. The recorded variables were the preoperative diagnosis, the presence of SAA and its characteristics, the splenic artery (SA) diameter, and the presence and size of portosystemic collaterals. Devastating SAA rupture accompanied by hypovolemic shock occurred on postoperative days 6, 82, and 8, respectively, and it was treated emergently by embolization in cases 1 and 2 and by splenectomy in case 3. Cases 1 and 3 recovered well, but case 2 died of an unrelated cause with a long hospital stay. The incidence of SAA during the study period was 14.2% (44/310), and the size was 16.6 ± 5.7 mm. Most SAAs were single (70.6%, 31/44) and were located in the distal one-third of the SA (82.4%, 36/44). Large portosystemic collaterals demonstrating longstanding severe portal hypertension were significantly correlated with the occurrence of SAAs. Nine patients with SAAs were preventively treated by proximal ligation (n = 4) intraoperatively and by embolization (n = 5) 1 day before or after LDLT. No patient showed severe postembolization syndrome. In conclusion, a careful preoperative evaluation of SAAs by high-resolution 3-dimensional computed tomography in liver transplant candidates, especially in those showing large portosystemic collaterals, is merited. Preventive treatment should be encouraged regardless of the size in order to avoid severe morbidity and mortality related to SAA rupture, and methods such as radiological and surgical interventions need to be individualized according to the location and number of SAAs. Liver Transpl 15:1535,1541, 2009. © 2009 AASLD. [source] Arterial anastomosis in a pediatric patient receiving a right extended split liver transplant: A case reportPEDIATRIC TRANSPLANTATION, Issue 4 2009Roberto Verzaro Abstract:, We report a case of a pediatric patient who received a right-extended liver transplant. The size of the recipient hepatic artery did not match with the donor right hepatic arterial stump. Moreover, recipient arterial anatomy made the direct anastomosis difficult or at increased risk for complications. The recipient's splenic artery was then mobilized, divided and anastomosed to the donor's right hepatic artery. The spleen was preserved and revascularization through collaterals is demonstrated by Angio CT Scan. Doppler US of the transplanted liver demonstrated good flow through the liver and the patient was discharged with perfect liver function. Splenic artery is perfectly suited for hepatic artery anastomosis. The use of splenic artery is favored in particular situations as in the case of a pediatric recipient receiving a right-extended liver graft with small caliber artery. [source] Effects of atrial natriuretic peptide on the extrasplenic microvasculature and lymphatics in the rat in vivoTHE JOURNAL OF PHYSIOLOGY, Issue 1 2005Zoë L. S. Brookes We developed a novel model using fluorescent intravital microscopy to study the effect of atrial natriuretic peptide (ANP) on the extrasplenic microcirculation. Continuous infusion of ANP into the splenic artery (10 ng min,1 for 60 min) of male Long,Evans rats (220,250 g, n= 24) induced constriction of the splenic arterioles after 15 min (,7.2 ± 6.6% from baseline diameter of 96 ± 18.3 ,m, mean ±s.e.m.) and venules (,14.4 ± 4.0% from 249 ± 25.8 ,m; P < 0.05). At the same time flow did not change in the arterioles (from 1.58 ± 0.34 to 1.27 ± 0.27 ml min,1), although it decreased in venules (from 1.67 ± 0.23 to 1.15 ± 0.20 ml min,1) and increased in the lymphatics (from 0.007 ± 0.001 to 0.034 ± 0.008 ml min,1; P < 0.05). There was no significant change in mean arterial pressure (from 118 ± 5 to 112 ± 5 mmHg). After continuous ANP infusion for 60 min, the arterioles were dilated (108 ± 16 ,m, P < 0.05) but the venules remained constricted (223 ± 24 ,m). Blood flow decreased in both arterioles (0.76 ± 0.12 ml min,1) and venules (1.03 ± 0.18 ml min,1; P < 0.05), but was now unchanged from baseline in the lymphatics (0.01 ± 0.001 ml min,1). This was accompanied by a significant decrease in MAP (104 ± 5 mmHg; P < 0.05). At 60 min, there was macromolecular leak from the lymphatics, as indicated by increased interstitial fluorescein isothiocyanate,bovine serum albumin fluorescence (grey level: 0 = black; 255 = white; from 55.8 ± 7.6 to 71.8 ± 5.9, P < 0.05). This study confirms our previous proposition that, in the extrasplenic microcirculation, ANP causes greater increases in post- than precapillary resistance, thus increasing intrasplenic capillary hydrostatic pressure (Pc) and fluid efflux into the lymphatic system. Longer-term infusion of ANP also increases Pc, but this is accompanied by increased ,permeability' of the extrasplenic lymphatics, such that fluid is lost to perivascular third spaces. [source] Pancreatic Graft Survival Despite Partial Vascular Graft Thrombosis due to Splenocephalic AnastomosesAMERICAN JOURNAL OF TRANSPLANTATION, Issue 4 2010C. Margreiter Thrombotic complications following pancreas transplantation are still the most common cause of nonimmunologic graft loss. The aim of this study was to analyze pancreatic graft function after partial arterial graft thrombosis and the investigation of the pancreatic arterial anatomy with regard to intraparenchymal anastomoses. We retrospectively analyzed the data for 175 consecutive pancreas transplants performed between January 2002 and October 2007. Selective Y-graft angiography was performed in 10 and rubber-milk injection in 5 fresh pancreas specimens. Thrombosis of one leg of the Y-graft was diagnosed in 18 (10.3%) patients. Only one of these patients with thrombosis of the splenic artery required exogenous insulin. Sufficient graft perfusion was demonstrated in all of the remaining grafts. One graft was lost due to acute rejection. In all specimens angiography showed an excellent perfusion of the pancreaticoduodenal arcade, even after selective cannulation of the splenic artery. Arterial collaterals between the gastroduodenal, splenic artery and the superior mesenteric artery were demonstrated. Our results demonstrate that global perfusion of the pancreatic graft and sufficient graft function is sustained after the thrombotic occlusion of one branch of the Y-graft by a complex system of intraparenchymal anastomoses. These anatomical findings may have consequences for resection strategies in pancreas surgery. [source] Randomized clinical trial of splenectomy versus splenic preservation in patients with proximal gastric cancerBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 5 2006W. Yu Background: Preservation or removal of the spleen during total gastrectomy for proximal gastric cancer is a matter of debate. Methods: A randomized clinical trial included patients with gastric adenocarcinoma who underwent total gastrectomy either with (104 patients) or without (103) splenectomy. Postoperative outcome in the two groups was compared, including morbidity, mortality and survival. Results: Gastrectomy combined with splenectomy tended to be associated with slightly higher morbidity and mortality rates, a slightly greater incidence of lymph node metastasis at the splenic hilum and along the splenic artery, and marginally better survival, but there were no statistically significant differences between the groups. Splenectomy had no impact on survival in patients with metastatic lymph nodes at the hilum of the spleen or in those with metastatic lymph nodes along the splenic artery. Conclusion: These results do not support the use of prophylactic splenectomy to remove macroscopically negative lymph nodes near the spleen in patients undergoing total gastrectomy for proximal gastric cancer. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Branches of the splenic artery and splenic arterial segmentsCLINICAL ANATOMY, Issue 5 2003A. Daisy Sahni Abstract In 200 adult autopsy specimens, the arterial supply to the pancreas and spleen was studied radiologically and by manual dissection. The splenic artery divided into two or three lobar arteries, which supplied its corresponding lobe; each lobar artery subsequently divided into two to four lobular branches. Six to twelve lobular branches were observed entering the splenic substance at the hilum. Lobar arteries did not anastomose with each other, hence, the lobes of the spleen are also termed segments. The lobules, however, were not found to be independent segments and the arteries of one lobule anastomosed with those of other lobules. The branching pattern of the splenic artery varied from one specimen to another, so much so that a prevailing pattern could not be identified. Polar arteries, particularly to the superior pole, arose quite proximal to the hilum in 51% of cases and were occasionally missed. In 45% of males and 40% of females, the posterior gastric artery arose from about the middle of the splenic artery. The splenic artery was not found to be tortuous in fetuses, newborns, and young children. Tortuosity was seen in only 10% of adults; thus, the characteristic tortuosity of the splenic artery appears to develop with age. Clin. Anat. 16:371,377, 2003. © 2003 Wiley-Liss, Inc. [source] | |||||||||||||||||||||||||