AIM: To evaluate the clinical application of serial operations with preservation of spleen. METHODS: Serial operations with preserving spleen were performed on 211 cases in our hospital from 1980 to 2000. The patient&...AIM: To evaluate the clinical application of serial operations with preservation of spleen. METHODS: Serial operations with preserving spleen were performed on 211 cases in our hospital from 1980 to 2000. The patient's age ranged from 13 to 56 years, averaging 38 years. Diseases included splenic injury in 171 cases, portal hypertension in 9 cases, splenic cyst in 10 cases, and the lesion of pancreatic body and tail in 21 cases. RESULTS: All the cases were cured, and 129 patients were followed up from 3 months to 3 years with the leukocyte phagocytosis test, detection of immunoglubin, CT,(99m)Tc scanning and ultrasonography. The results were satisfactory. CONCLUSION: The operations with preserving spleen were safe, feasible, and worth of clinical application.展开更多
BACKGROUND Autoimmune pancreatitis(AIP)is a chronic form of pancreatitis characterized by diffused enlargement of the pancreas and irregular stenosis of the main pancreatic duct.Some studies have reported that AIP can...BACKGROUND Autoimmune pancreatitis(AIP)is a chronic form of pancreatitis characterized by diffused enlargement of the pancreas and irregular stenosis of the main pancreatic duct.Some studies have reported that AIP can cause hemorrhage of gastric varices(GV)related to portal hypertension(PH).However,such cases are rare.In addition,the association of PH with AIP is unclear.At the same time,the efficacy and duration of glucocorticoid therapy is also controversial.CASE SUMMARY In this case,we reported a case of GV in pancreatic PH associated with AIP.Enhanced abdominal computed tomography(CT)suggested splenic vein(SV)and superior mesenteric vein(SMV)thromboses.The patient received a long-term glucocorticoid therapy,that the initial dose of 40 mg is reduced weekly by 5 mg,and then reduced to 5 mg for long-term maintenance.CT and gastroscopic examination after 8 mo of treatment indicated that SV and SMV were recanalized,pancreatic stiffness and swelling were ameliorated,and the GV almost completely disappeared.CONCLUSION Long-term glucocorticoid therapy can alleviate the development of GV in patients with AIP and has potential reversibility.展开更多
BACKGROUND Pancreatic segmental portal hypertension(PSPH) is the only type of portal hypertension that can be completely cured. However, it can easily cause varicose veins in the esophagus and stomach and hemorrhage i...BACKGROUND Pancreatic segmental portal hypertension(PSPH) is the only type of portal hypertension that can be completely cured. However, it can easily cause varicose veins in the esophagus and stomach and hemorrhage in the digestive tract.AIM To explore the application of computed tomography(CT) to examine the characteristics of PSPH and assess the risk level.METHODS This was a retrospective analysis of CT images of 22 patients diagnosed with PSPH at our center. Spearman correlation analysis was performed using the range of esophageal and gastric varices(measured by the vertical gastric wall), the ratio of the width of the splenic portal vein to that of the compression site(S/C ratio), the degree of splenomegaly, and the stage determined by gastroscopy. This study examined whether patients experienced gastrointestinal bleeding within 2 wk and combined CT and gastroscopy to explore the connection between bleeding and CT findings.RESULTS The range of esophageal and gastric varices showed the best correlation in the diagnosis of PSPH(P < 0.001), and the S/C ratio(P = 0.007) was correlated with the degree of splenomegaly(P = 0.021) and PSPH(P < 0.05). This study revealed that male patients were more likely than females to progress to grade 2 or grade 3 as determined by gastroscopy. CT demonstrated excellent performance, with an area under the curve of 0.879.CONCLUSION CT can be used to effectively analyze the imaging signs of PSPH, and CT combined with gastroscopy can effectively predict the risk level of gastrointestinal bleeding.展开更多
基金Supported by Awarded the Second class Prize of National Science and Technology Advance in 2000(J-233-2-08).
文摘AIM: To evaluate the clinical application of serial operations with preservation of spleen. METHODS: Serial operations with preserving spleen were performed on 211 cases in our hospital from 1980 to 2000. The patient's age ranged from 13 to 56 years, averaging 38 years. Diseases included splenic injury in 171 cases, portal hypertension in 9 cases, splenic cyst in 10 cases, and the lesion of pancreatic body and tail in 21 cases. RESULTS: All the cases were cured, and 129 patients were followed up from 3 months to 3 years with the leukocyte phagocytosis test, detection of immunoglubin, CT,(99m)Tc scanning and ultrasonography. The results were satisfactory. CONCLUSION: The operations with preserving spleen were safe, feasible, and worth of clinical application.
基金Supported by Sichuan Science and Technology Program,China,No.MZGC20230031.
文摘BACKGROUND Autoimmune pancreatitis(AIP)is a chronic form of pancreatitis characterized by diffused enlargement of the pancreas and irregular stenosis of the main pancreatic duct.Some studies have reported that AIP can cause hemorrhage of gastric varices(GV)related to portal hypertension(PH).However,such cases are rare.In addition,the association of PH with AIP is unclear.At the same time,the efficacy and duration of glucocorticoid therapy is also controversial.CASE SUMMARY In this case,we reported a case of GV in pancreatic PH associated with AIP.Enhanced abdominal computed tomography(CT)suggested splenic vein(SV)and superior mesenteric vein(SMV)thromboses.The patient received a long-term glucocorticoid therapy,that the initial dose of 40 mg is reduced weekly by 5 mg,and then reduced to 5 mg for long-term maintenance.CT and gastroscopic examination after 8 mo of treatment indicated that SV and SMV were recanalized,pancreatic stiffness and swelling were ameliorated,and the GV almost completely disappeared.CONCLUSION Long-term glucocorticoid therapy can alleviate the development of GV in patients with AIP and has potential reversibility.
基金Supported by Shenzhen Science and Technology Plan Project,No.JCYJ20180228163333734。
文摘BACKGROUND Pancreatic segmental portal hypertension(PSPH) is the only type of portal hypertension that can be completely cured. However, it can easily cause varicose veins in the esophagus and stomach and hemorrhage in the digestive tract.AIM To explore the application of computed tomography(CT) to examine the characteristics of PSPH and assess the risk level.METHODS This was a retrospective analysis of CT images of 22 patients diagnosed with PSPH at our center. Spearman correlation analysis was performed using the range of esophageal and gastric varices(measured by the vertical gastric wall), the ratio of the width of the splenic portal vein to that of the compression site(S/C ratio), the degree of splenomegaly, and the stage determined by gastroscopy. This study examined whether patients experienced gastrointestinal bleeding within 2 wk and combined CT and gastroscopy to explore the connection between bleeding and CT findings.RESULTS The range of esophageal and gastric varices showed the best correlation in the diagnosis of PSPH(P < 0.001), and the S/C ratio(P = 0.007) was correlated with the degree of splenomegaly(P = 0.021) and PSPH(P < 0.05). This study revealed that male patients were more likely than females to progress to grade 2 or grade 3 as determined by gastroscopy. CT demonstrated excellent performance, with an area under the curve of 0.879.CONCLUSION CT can be used to effectively analyze the imaging signs of PSPH, and CT combined with gastroscopy can effectively predict the risk level of gastrointestinal bleeding.
