Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038002 (splenomegaly)
 9,873 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The late complications in 25 patients more than 3 years after successful Kasai's operation for biliary atresia were presented. Nine (36%) of these 25 patients had episodes of variceal hemorrhage with portal hypertension, and biliary reobstruction in 3 (12%), bleeding from duodenal ulcer in 2, bleeding from gastric erosion in one, and diffuse pulmonary arterio-venous shunt in one were observed. Recently esophageal varices have been well controlled by endoscopic sclerotherapy, and the surgical treatment may be indicated in older children complicated with severe hypersplenism and marked splenomegaly, which are resistant for sclerotherapy. As a surgical procedure, splenectomy with periesophago-gastric devascularization (Hassab's operation) seems to be very useful for portal hypertension by biliary cirrhosis. The reoperation, hepaticoenterostomy, was performed in 3 patients with biliary reobstruction. All three patients are alive and well, and two of them are at 19 years (university student) and 24 years (married life) of age. Hepatic Rehepaticoenterostomy is well indicated rather than liver transplantation, if biliary reobstruction is incurable with conservative therapy. Many of the patients with complications were able to carry on an almost normal life, if suitable treatments for complications were taken.
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PMID:[Late complications after successful Kasai's operation for biliary atresia]. 258 18

We are reporting on a 62 year old female patient with portal hypertension (splenomegaly, esophageal varicosis) without signs of liver cirrhosis, who was hospitalized for sclerotherapy of her esophageal varices. Physical examination showed up palmar- and plantar hyperkeratosis and Morbus Bowen or basalioma-like skin lesions++. Anamnestic evaluation revealed, that the patient's psoriasis had been treated with arsenic for many years. This kind of treatment may have induced intraluminal proliferation and obliteration of the portal vein's endothelium, thus being the etiologic factor responsible for noncirrhotic portal hypertension in this patient.
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PMID:[Portal hypertension and chronic arsenic exposure. A differential diagnostic challenge]. 262 81

Basic data on pathomorphology and symptomatology of the alcohol-induced liver cirrhosis accompanied by portal hypertension are discussed. Respective data were compared with the group of cirrhotic patients not abusing alcohol. A high percentage of encephalopathic disorders and nearly 50% of the patients suffering from the hemorrhage from esophageal varices were the first sign of the cirrhosis in both groups. Despite hemorrhage from esophageal varices a few patients obtained surgical help preventing recurrence of the hemorrhage. Liver functional reserve, incidence of encephalopathies and the degree of liver involvement are in favour for non-alcohol cirrhosis. Inflammatory process in the liver, splenomegaly and hypersplenism were more frequent in the liver cirrhosis of non-alcohol origin.
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PMID:[Alcohol-induced liver cirrhosis as a cause of portal hypertension]. 263 Oct 74

For the detection of mild liver disease (acute viral hepatitis, chronic persistent hepatitis, fatty liver) serum bile acids levels have not proved to be superior to transaminases or other common liver tests with almost similar sensitivity and/or specificity. Indeed it has been possible to show in patients with compensated cirrhosis of the liver that the serum bile acids concentration is related to the degree of intrahepatic shunts and that there was a significant relationship between the fasting serum bile acids and the intrinsic clearance of ICG. Measurement of serum bile acids appear to be more sensitive for detection of cirrhosis than commonly used tests. The elevation of bile acids concentration in cirrhotic patients is thought to result from a reduced hepatic clearance and/or from portosystemic shunting. In order to determine the role of serum bile acid estimation in the indirect assessment of portal hypertension, fasting and two-hour postprandial serum bile acids concentration were measured in 36 patients with liver cirrhosis, classified according to Child-Pugh's criteria. Real time ultrasonography, esophagogastroscopy and static liver scintigraphy of the liver were carried out in all patients. The size of esophageal varices, the portal vein and its related structure, the nuclear criteria were graded according to the common methods. Between the clinical findings, splenomegaly, was noted and graded, though the size of spleen does not correlate well with the level of portal pressure. In our patients a good correlation (p less than 0.001) existed between the two hour postprandial bile acids concentration and ultrasonographic findings of portal hypertension. Fasting serum bile acids (SBA) were significantly higher in severe than in mild liver cirrhosis according to Pugh's criteria (p less than 0.001). In conclusion we think that SBA concentrations have a great prognostic value in assessment of major complications (upper gastrointestinal hemorrhage particularly). The reduced liver blood flow, for intra-and extrahepatic porto-systemic shuntings, is probably the main cause of reduced hepatic clearance of bile acids.
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PMID:[Serum concentration of bile acids and portal hypertension in cirrhotic patients. Possible correlations]. 264 42

Ultrasound investigation of the abdominal vessels (the celiac artery and its branches, the hepatic veins and the portal veins) was performed in 30 patients with cholelithiasis, 20 patients with chronic acalculous cholecystitis and 100 healthy controls. Statistically significant increases in the calibers of the hepatic arteries and portal veins were detected in the patients with cholelithiasis. The diameters of these vessels in the patients with chronic acalculous cholecystitis did not differ considerably from those of the controls. Ascites, splenomegaly, vascular collaterals, varicosis of the esophageal or gastric veins were unobserved in the patients with cholelithiasis, neither was observed an increase in the calibers of the portal veins during the Valsalva test in this group as compared to the control group. It was assumed that an increase in the calibers of the hepatic vessels in cholelithiasis was caused by change in the hepatic blood flow rather than by the development of portal hypertension.
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PMID:[Ultrasonic evaluation of the state of the abdominal vessels in cholelithiasis and chronic acalculous cholecystitis]. 266 51

Splenomegaly is a cardinal manifestation of portal hypertension. We describe a case of portal hypertension with a large spontaneous spleno-renal shunt in the absence of splenic enlargement. The vascular anatomy is evaluated by the combined use of duplex Doppler ultrasonography and computed tomography (CT).
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PMID:Portal hypertension with a large spontaneous spleno-renal shunt in the absence of splenomegaly. 236 43

The aim of this work was to evaluate the efficiency, sensitivity, and specificity of ultrasonographic findings in the diagnosis of portal vein cavernous transformation and secondary splanchnic hypertension in children. Twenty patients with esophageal varices on endoscopic sclerotherapy, with ages ranging from 1 to 15 years (mean of 7.5), were compared with 20 age-matched normal asymptomatic controls. In 17 cases, diagnosis was confirmed by splenoportography. Ultrasonographic portal vein features, respiratory variations in splenic and superior mesenteric veins, lesser omentum to aorta diameter ratio and spleen size, as well as the presence of vessels in the lesser omentum and of spontaneous anastomoses, were analyzed in both groups. The efficiency of ultrasonography to establish a diagnosis of portal vein cavernous transformation reached 100%. Splenic and superior mesenteric vein respiratory variation was negligible in patients and inspiration versus expiration diameter differences ranged from 1 to 4 mm (mean of 2.4) in controls (p less than .001). Mean lesser omentum to aorta ratio was 2.07 in patients versus .9 in controls (p less than .001). Splenomegaly was found in all but two cases; lesser omentum vessels were visualized in nine cases; whereas five presented spontaneous splenorenal anastomoses and gallbladder varices were observed in five patients. Thus, ultrasonography allowed portal vein cavernous transformation to be diagnosed throughout; portal hypertension was also detected. It may be concluded that ultrasonography, either alone or associated with endoscopy, provides a reliable method for portal vein cavernous transformation diagnosis. Angiography should be reserved for preoperative or controlled hemodynamic studies.
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PMID:Ultrasonographic diagnosis of portal vein cavernous transformation in children. 266 56

Postoperative treatment after pancreas surgery is concentrated on the function of the exocrine and endocrine part of the gland. While functional disturbances of the endocrine pancreas may give rise to serious problems associated with diabetes, functional disturbances of the exocrine pancreas are less important. On the other hand, flow disorders of the exocrine pancreas may lead to pancreatitis, fistulas, cysts, and abdominal sepsis. Pancreatic tumours are not infrequently apudomas whose biology has an important bearing on the after-treatment. Thrombophlebitic splenomegaly may lead to portal and possibly to segmental portal hypertension. In this event, a careful follow-up examination will be needed to decide whether further surgery is necessary.
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PMID:[After-care following surgery of the pancreas]. 267 64

Portal hypertension in chronic lymphocytic leukemia (CLL) is rare. A 64-year-old woman with CLL for 5 years and increasing hepatosplenomegaly developed portal hypertension and bleeding gastric varices. There was no portal vein thrombus by abdominal echography and angiography. Following splenectomy and devascularization of the fornix, the gastric varices disappeared. The liver biopsy showed dense leukemic cell infiltration in portal triads, but no fibrosis. The portal hypertension in this case may be mainly due to increased portal flow from the enlarged spleen and leukemic cell infiltration in the liver. Previously reported cases are summarized.
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PMID:[Portal hypertension in chronic lymphocytic leukemia]. 269 62

Forty-two adults (22 males, 20 females) with tropical splenomegaly syndrome (TSS) were studied. Majority (88.1%) presented with complaints related to grossly enlarged spleen (greater than 10 cm). The duration of splenomegaly was 1 to 5 years in 54.8%. In 80.9% there was anaemia (Hb less than 10 g%). None of the patients had a macrocytic blood picture. Evidence of portal hypertension was observed in 56.7% and almost a similar number (58.1%) had raised intrasplenic pressure. The liver histology was entirely normal in only 8.8%. T-cell lymphopenia with B-cell lymphocytosis was a prominent feature. IgM values were raised in 73.8% and malarial antibody titres in 91.7% patients. Sixty-nine per cent of cases showed a distinct clinical and biochemical improvement after chloroquine chemoprophylaxis. Though a malarial origin in the development of TSS is favoured its precise aetiology is as yet speculative.
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PMID:A study on tropical splenomegaly syndrome and chloroquine prophylaxis. 269 86


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