Case Report: Interventional therapy for portal venous stenosis caused by systemic vasculitis
Systemic vasculitis are multisystem blood vessel disorders. However, Portal venous involvement is extremely rare, which represents a diagnostic and therapeutic challenge due to the heterogeneous nature, a lack of diagnostic criteria and limited effective therapy of vasculitis. We have reported a 48-...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-10-01
|
| Series: | Frontiers in Immunology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1005300/full |
| _version_ | 1798019776191135744 |
|---|---|
| author | Qiuyu Cai Qiuyu Cai Bo Wei Yang Tai Yang Tai Hao Wu |
| author_facet | Qiuyu Cai Qiuyu Cai Bo Wei Yang Tai Yang Tai Hao Wu |
| author_sort | Qiuyu Cai |
| collection | DOAJ |
| description | Systemic vasculitis are multisystem blood vessel disorders. However, Portal venous involvement is extremely rare, which represents a diagnostic and therapeutic challenge due to the heterogeneous nature, a lack of diagnostic criteria and limited effective therapy of vasculitis. We have reported a 48-year-old woman who was previously diagnosed with systemic vasculitis and was treated with prednisone, presented with gastrointestinal (GI) bleeding on admission. Further abdominal contrast-enhanced computed tomography (CT) with three-dimensional reconstruction suggested atrophic left hepatic lobe, enlarged spleen, and severe stenosis of main portal vein. Liver biopsy showed no evidence of fibrosis/cirrhosis. To prevent rebleeding, portal venous angioplasty by balloon dilation with collateral varices embolization was performed, and the GI hemorrhage was resolved completely. However, refractory ascites presented 8 months postoperatively. Abdominal CT angiography confirmed the recurrence of portal venous stenosis. Portal venous angioplasty by stent implantation was then performed to treat the portal hypertension (PHT)-related complications. After the intervention, the patient received anticoagulation therapy and continued immunosuppressive therapy. During the 5-year follow-up, the patient did not experience any onset of GI bleeding or ascites. Therefore, portal venous angioplasty with stent placement could be an effective treatment to prevent PHT-related complications when immunosuppression therapy failed. |
| first_indexed | 2024-04-11T16:46:24Z |
| format | Article |
| id | doaj.art-ad3bf5b6463f423f9c76ada782d3a44d |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-11T16:46:24Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-ad3bf5b6463f423f9c76ada782d3a44d2022-12-22T04:13:33ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-10-011310.3389/fimmu.2022.10053001005300Case Report: Interventional therapy for portal venous stenosis caused by systemic vasculitisQiuyu Cai0Qiuyu Cai1Bo Wei2Yang Tai3Yang Tai4Hao Wu5Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, ChinaLaboratory of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Gastroenterology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Gastroenterology, West China Hospital, Sichuan University, Chengdu, ChinaLaboratory of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Gastroenterology, West China Hospital, Sichuan University, Chengdu, ChinaSystemic vasculitis are multisystem blood vessel disorders. However, Portal venous involvement is extremely rare, which represents a diagnostic and therapeutic challenge due to the heterogeneous nature, a lack of diagnostic criteria and limited effective therapy of vasculitis. We have reported a 48-year-old woman who was previously diagnosed with systemic vasculitis and was treated with prednisone, presented with gastrointestinal (GI) bleeding on admission. Further abdominal contrast-enhanced computed tomography (CT) with three-dimensional reconstruction suggested atrophic left hepatic lobe, enlarged spleen, and severe stenosis of main portal vein. Liver biopsy showed no evidence of fibrosis/cirrhosis. To prevent rebleeding, portal venous angioplasty by balloon dilation with collateral varices embolization was performed, and the GI hemorrhage was resolved completely. However, refractory ascites presented 8 months postoperatively. Abdominal CT angiography confirmed the recurrence of portal venous stenosis. Portal venous angioplasty by stent implantation was then performed to treat the portal hypertension (PHT)-related complications. After the intervention, the patient received anticoagulation therapy and continued immunosuppressive therapy. During the 5-year follow-up, the patient did not experience any onset of GI bleeding or ascites. Therefore, portal venous angioplasty with stent placement could be an effective treatment to prevent PHT-related complications when immunosuppression therapy failed.https://www.frontiersin.org/articles/10.3389/fimmu.2022.1005300/fullsystemic vasculitisportal venous stenosisportal hypertensionangioplastystent implantation |
| spellingShingle | Qiuyu Cai Qiuyu Cai Bo Wei Yang Tai Yang Tai Hao Wu Case Report: Interventional therapy for portal venous stenosis caused by systemic vasculitis Frontiers in Immunology systemic vasculitis portal venous stenosis portal hypertension angioplasty stent implantation |
| title | Case Report: Interventional therapy for portal venous stenosis caused by systemic vasculitis |
| title_full | Case Report: Interventional therapy for portal venous stenosis caused by systemic vasculitis |
| title_fullStr | Case Report: Interventional therapy for portal venous stenosis caused by systemic vasculitis |
| title_full_unstemmed | Case Report: Interventional therapy for portal venous stenosis caused by systemic vasculitis |
| title_short | Case Report: Interventional therapy for portal venous stenosis caused by systemic vasculitis |
| title_sort | case report interventional therapy for portal venous stenosis caused by systemic vasculitis |
| topic | systemic vasculitis portal venous stenosis portal hypertension angioplasty stent implantation |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1005300/full |
| work_keys_str_mv | AT qiuyucai casereportinterventionaltherapyforportalvenousstenosiscausedbysystemicvasculitis AT qiuyucai casereportinterventionaltherapyforportalvenousstenosiscausedbysystemicvasculitis AT bowei casereportinterventionaltherapyforportalvenousstenosiscausedbysystemicvasculitis AT yangtai casereportinterventionaltherapyforportalvenousstenosiscausedbysystemicvasculitis AT yangtai casereportinterventionaltherapyforportalvenousstenosiscausedbysystemicvasculitis AT haowu casereportinterventionaltherapyforportalvenousstenosiscausedbysystemicvasculitis |