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Segmental portal hypertension secondary to chronic pancreatitis
Karla Correa-Cedeño, Carlos M. Martinez-Escanamé, Carlos A. de-la-Torre-Cabral, Viviana Herrera-Muñoz, Graciela Rodriguez-Gonzalez, Diego A. Martinez
Hospital Central“Dr. Ignacio Morones Prieto”
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="para0008" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Ethical statement</span></p><p id="para0009" class="elsevierStylePara elsevierViewall">The identity of the patients is protected&#46; Consentment was obtained&#46;</p><p id="para0010" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Declaration of interests</span></p><p id="para0011" class="elsevierStylePara elsevierViewall">None</p><p id="para0012" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Funding</span></p><p id="para0013" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public&#44; commercial&#44; or not-for-profit sectors&#46;</p></span>"
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        "resumen" => "<span id="abss0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0001">Introduction and objectives</span><p id="spara001" class="elsevierStyleSimplePara elsevierViewall">Case presentation of a male patient with portal hypertension secondary to chronic pancreatitis</p></span> <span id="abss0002" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0002">Materials and Patients</span><p id="spara002" class="elsevierStyleSimplePara elsevierViewall">This is a 38-year-old male patient&#44; occasional drinker&#44; risky consumption&#44; history of diagnosis of diabetes mellitus&#44; with adequate adherence to hypoglycemic treatment with metformin&#44; presented a clinical picture of 3 years of evolution consisting of severe pain in the upper abdomen with irradiation to the back on the left side&#44; which required emergency admissions with stabilization and discharge with subsequent recurrence&#44; as well as significant weight loss of 10&#37; over a period of 8 months&#46; He was admitted to the emergency department with clinical symptoms compatible with upper gastrointestinal bleeding due to the presence of melaenic bowel movements on multiple occasions&#44; associated with anemic syndrome&#44; biochemically highlighting a Hb of 2&#46;4 mg&#47;dl&#44; with normal liver function tests and other laboratories&#44; with no changes of chronic hepatopathy by ultrasound&#46;</p></span> <span id="abss0003" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0003">Results</span><p id="spara003" class="elsevierStyleSimplePara elsevierViewall">Regarding the approach to the digestive tract bleeding&#44; Panendoscopy was performed&#44; showing mucosa without alterations&#44; without observing bleeding during the study&#44; ruling out the presence of varices at esophageal level&#44; proceeding to the realization of contrasted Angio Tomography&#44; where findings of segmental portal hypertension with spleno-portal collateral vessels&#44; splenic thrombosis and pancreatic calcifications suggestive of changes due to chronic pancreatitis were observed&#44; with an area of enhancement at the level of the gastric fundus at the site of gastric varices&#44; splenomegaly was not reported&#46; For treatment selection&#44; interventional radiology was evaluated&#44; offering as a therapeutic option the recanalization of the splenic vein with stent placement&#59; however&#44; since Splenectomy was still considered as the definitive treatment for segmental portal hypertension&#44; the latter intervention was chosen for resolution&#44; with adequate evolution after the procedure&#44; remission of bleeding and corroborating adequate flow redistribution after surgery by means of new Angio-CT&#46; The patient attends his consultations on a regular basis&#44; with good evolution&#44; good glycemic control and improvement in nutritional status&#46;</p></span> <span id="abss0004" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0004">Conclusions</span><p id="spara004" class="elsevierStyleSimplePara elsevierViewall">Segmental portal hypertension &#40;SPH&#41; is due to the presence of isolated obstruction of the splenic vein by thrombosis or extrinsic compression&#46;</p><p id="spara005" class="elsevierStyleSimplePara elsevierViewall">Pancreatitis conditions the development of thrombosis because the inflammatory state induces stasis and damage of the intima related to the contact of the splenic vein and the pancreas&#46;</p><p id="spara006" class="elsevierStyleSimplePara elsevierViewall">The presence of isolated gastric varices makes it necessary to rule out splenic venous thrombosis&#46;</p><p id="spara007" class="elsevierStyleSimplePara elsevierViewall">The definitive treatment continues to be splenectomy&#44; reducing the flow to the varices and collateral circulation&#46;</p></span>"
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Article information
ISSN: 16652681
Original language: English
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