| 1 | Gastrointestinal bleeding caused by extrahepatic arterioportal fistula associated with portal vein thrombosis显示文摘An extrahepatic arterioportal fistula(APF) involving the gastroduodenal artery and superior mesenteric vein is rare and mostly results from iatrogenic injuries.The clinical symptoms associated with APFs may include abdominal pain,gastrointestinal bleeding,ascites,nausea,vomiting,diarrhea,or even congestive heart failure.We present the case of a 70-year-old man who presented with chronic abdominal pain and gastrointestinal bleeding secondary to APF and portal vein thrombosis.The endovascular embolization of APF was accomplished successfully,and symptoms of portal hypertension resolved immediately after intervention.Unfortunately,the patient did not respond well to anticoagulation therapy with warfarin.Therefore,the patient underwent implantation of a transjugular intrahepatic portosystemic shunt,and the complications of portal hypertension resolved.In conclusion,the embolization of APF is technically feasible and effective and can be considered the first-choice therapy in selected patients. | Ling Nie Xue-Feng Luo Xiao Li | 2012 | World Journal of Gastroenterology2012，18，44： | 4 |
| 2 | Contrast-enhanced ultrasound in portal venous system aneurysms: A multi-center study显示文摘AIM:To investigate contrast-enhanced ultrasound(CEUS)findings in portal venous system aneurysms(PVSAs).METHODS:In this multi-center,retrospective,case series study,we evaluated CEUS features of seven cases of PVSAs that were found incidentally on conventional ultrasound in the period 2007-2013.Three Ultrasound Centers were involved(Chieti,Italy,Bad Mergentheim,Germany,and Cluj-Napoca,Romania).All patients underwent CEUS with Sonovue?(Bracco,Milan,Italy)at a standard dose of 2.4 m L,followed by10 m L of 0.9%saline solution.The examinations were performed using multifrequency transducers and low mechanical index.We considered aneurysmal a focal dilatation of the portal venous system with a size that was significantly greater than the remaining segments of the same vein,and that was equal or larger than21 mm for the extrahepatic segments of portal venous system,main portal vein and bifurcation,and 9 mm for the intrahepatic branches.RESULTS:After contrast agent injection,all PVSAs were not enhanced in the arterial phase(starting 8-22s).All PVSAs were then rapidly enhanced in the early portal venous phase(starting three to five seconds after the arterial phase,11-30 s),with persistence and slow washout of the contrast agent in the late phase(starting 120 s).In all patients,CEUS confirmed the presence of a'to-and-fro'flow by showing a swirling pattern within the dilatation in the early portal venous phase.CEUS also improved the delineation of the lumen,and was reliable in showing its patency degree and integrity of walls.In one patient,CEUS showed a partial enhancement of the lumen with a uniformly nonenhancing area in the portal venous and late phases,suggesting thrombosis.CONCLUSION:In our case series,we found that CEUS could be useful in the assessment and follow-up of a PVSA.Further studies are needed to validate its diagnostic accuracy. | Claudio Tana Christoph F Dietrich Radu Badea Liliana Chiorean Vincenzo Carrieri Cosima Schiavone | 2014 | World Journal of Gastroenterology2014，20，48： | 1 |
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