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Splanchnic vein closures

Czech version

Authors: Z. Krška 1;  J. Kvasnička 2;  J. Hořejš 3;  D. Hoskovec 1
Authors‘ workplace: I. chirurgická klinika 1. lékařské fakulty Univerzity Karlovy a Všeobecná fakultní nemocnice Praha 1;  Oddělení klinické hematologie Všeobecná fakultní nemocnice Praha 2;  Radiodiagnostická klinika 1. lékařské fakulty Univerzity Karlovy a Všeobecná fakultní nemocnice Praha 3
Published in: Rozhl. Chir., 2019, roč. 98, č. 6, s. 239-244.
Category: Review

Uzávěry splanchnického žilního řečiště (SŽŘ) představují široký medicínský problém. Anatomicky mohou postihnout jednotlivé oddíly SŽŘ, případně i několik těchto současně. Hlavními oddíly SŽŘ je žilní jaterní outflow systém, dále portální žíla, horní mezenterická žíla a její povodí. Převažující příčinou uzávěru je jednoznačně trombóza. Manifestace uzávěrů může být akutní, subakutní či se může jednat o okultní či manifestní chronický průběh. Hlavními patologicko-anatomickými jednotkami jsou Budd-Chiariho syndrom (BCS), obstrukce extrahepatické portální žíly (EHPVO) a trombóza mezenterické žíly (TMŽ). Pokročilé laboratorní, zobrazovací a intervenční metody značně modifikují přístup k prevenci, diagnostice a léčbě. Své místo má i přístup chirurga. Problém SŽŘ je interdisciplinární.

Overview

Closures in the splanchnic venous system (SVS) represent a broad medical problem. Anatomically, individual or even multiple sections of SVS may be affected at the same time. Main sections of SVS include the venous liver outflow system, the portal vein, and the upper mesenteric vein and its basin. Thrombosis is clearly the predominant cause of closure. The closures can present as acute, subacute, chronic occult or chronic manifest. The main pathological and anatomical units are the Budd-Chiari syndrome (BCS), extrahepatic portal vein obstruction (EHPVO) and mesenteric vein thrombosis (MVT). Advanced laboratory, imaging and intervention methods substantially modify the approach to prevention, diagnosis and treatment; surgical approach also plays a role. The problem of SVS closures is interdisciplinary.

Keywords:

splanchnic circulation – thrombophilic states – portal vein thrombosis – upper mesenteric vein thrombosis – Budd Chiari syndrome

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Perspectives in Surgery

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2019 Issue 6
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