Esplenomegalia El hiperesplenismo se caracteriza por: esplenomegalia. disminución de cifras de hematíes, leucocitos y plaquetas. Hiperesplenismo recurrente secundario a cardiomiopatia alcoholica despues de una anastomosis esplenorenal distal. Warren L. Garner. x. Warren L. Garner. vol número1 Hiperesplenismo secundario a compresión del eje esplenoportal por quiste hepático gigante Underwater hybrid endoscopic submucosal.

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Serum liver function test was as follows: The liver dysfunction was resolved via optimization of the parenteral formula. Am Hiperfsplenismo Transplant ;15 1: The time required on a parenteral pump has shortened from the entire day to only 9 hours at night. To date, there are no reported experiences of duodenal lengthening in adults. Citrulline blood levels as indicators of residual intestinal absorption in patients with short bowel syndrome.

Intestinal transplant registry report: Antibiotics were administered postoperatively for 3 days. The vertexes of the cutting line were reinforced with a vicryl U stitch to prevent duodenal leaks. Long-term outcome of home sevundario nutrition in patients with ultra-short bowel syndrome.

He also follows an oral low-fiber diet ad libitum. In the present case, the pre-lengthening citrulline level had increased from Glycemia control continues to be as difficult as hiperesplenimo experienced before surgery.

A Kocher maneuver was performed to mobilize the duodenum. Creatinine clearance has remained unchanged from that observed prior to surgery and the liver function test is normal.

Serial transverse duodenoplasty not only gains an additional intestinal length when combined seccundario simultaneous STEP but can also be applied successfully in patients with ultra-SBS. With a follow-up of 24 months, the patient currently weighs 47 kg and leads a normal life.

Splenectomy for splenomegaly and secondary hypersplenism

The classical standard duodenal tapering technique reduces the luminal diameter of the dilated duodenum yiperesplenismo removing its anti-pancreatic border longitudinally, usually with stapler devices 8. J Pediatr Surg ; The serial transverse enteroplasty procedure STEP is an intestinal lengthening procedure originally applied in pediatric hiperesllenismo with short bowel syndrome SBS and dilatation of the remnant small bowel.


We have recently demonstrated the feasibility of lengthening the duodenum in children with short bowel syndrome and a dilated duodenum.

The final length of the duodenum after the procedure reached 83 cm Fig. V fluids for the remaining time. Although the duodenum is a challenging segment in autologous gut reconstruction due to its close proximity to bilio-pancreatic structures and the blood supply shared with the pancreas.

Esplenomegalia – Wikipedia, a enciclopedia libre

Prior to surgery, he had a history of 3 central-line sefundario and was colonized by multi-resistant Klebsiella pneumoniae. The postoperative course was uneventful. Megaduodenum facilitates pyloric incompetence with alkaline reflux and dysmotility with stasis of intraluminal contents which may result in bacterial overgrowth and malabsorption. The next firing was similar from the opposite side, creating a duodenal channel 3 cm in diameter.

Although this young man may require an intestinal transplant in the future, the application of this procedure has resulted in an enormous social and psychological benefit as well as the avoidance of immunosuppression therapy. An iterative mid-line incision was made under general anesthesia. Duodenal lengthening may be effective as part of the autologous intestinal reconstruction armamentarium in adults with short bowel syndrome.

Written informed consent was obtained from the patient prior to the procedure. The lengthened duodenum measured 83 cm. In summary, although this is only one case, the result obtained demonstrates the feasibility and effectiveness of duodenal tapering and lengthening as part of the autologous intestinal reconstruction armamentarium in adults with a dilated duodenum and SBS. Therefore, the overall time of parenteral nutrition PN and I.

J Am Hiperdsplenismo Surg ; Duodenal lengthening was performed with 7 sequential transverse applications 5 of 45 mm and 2 of 60 mm of an endoscopic stapler Endo GIA Secundagio, Covidien LLC, Mansfield, MA, USA on secundwrio duodenal anterior and posterior walls, respecting the pancreatic parenchyma as described elsewhere 4 Fig. Nevertheless, due to our prior successful experience with duodenal lengthening procedures in children 4the patient asked to be hiperespenismo for duodenal lengthening.


seccundario Although, the patient is able to successfully treat hypoglycemia episodes via the oral route. Hiperesplensimo 12 months post-surgery, citrulline plasma level had increased to The main advantage of this new technique is that an additional intestinal absorptive surface is obtained without the need to discard any duodenal portion. Ann Nutr Metab ; Duodenal lengthening in short bowel with dilated duodenum.

The final duodenal length was 83 cm. In addition, the plasma citrulline level was Herein, we report the first successful application of this novel technique in an adult with ultra-SBS and a dilated duodenum.


The mucosal surface is increased which results in an improved nutrient absorption. Long-term follow-up of patients on home parenteral nutrition in Europe: The patient underwent duodenal lengthening and tapering with 7 sequential transverse applications 5 of 45 mm and 2 of 60 mm of an endoscopic stapler on the anterior and posterior walls of the duodenum, respecting the pancreatic parenchyma and end-to-side duodeno-colonic anastomosis.

We have demonstrated the feasibility of lengthening the duodenum via a modified version of the original STEP in a subset of children with SBS and a dilated duodenum 4.

July 27, ; Accepted: The gastrostomy tube hiepresplenismo ranged from 2. Upper gastrointestinal series one week after duodenal lengthening and a duodeno-colic anastomosis. J Pediatr Gastroenterol Nutr ;58 4: