Volume 79 - 2016 - Fasc.1 - Case reports
Pharmacomechanical thrombectomy for salvage of TIPss via successful clearance of occlusive porto-splenic venous thrombosis
Transjugular intrahepatic porto-systemic shunt (TIPss) is in- creasingly used to treat chronic portal vein thrombosis. However shunt thrombosis is a recognised early complication, particularly in those with thrombophilia. We outline a case of non-cirrhotic portal hypertension secondary to chronic portal vein occlusion where TIPss was successfully performed but rapidly complicated by shunt thrombosis with extension into the portal and splenic veins. Mechanical thrombectomy and low dose systemic pharmaco- logical thrombolysis were of limited benefit. Combined pharma- comechanical thrombectomy with the Trellis system restored patency of the TIPss, portal and splenic veins, with resultant good flow into the TIPss. The patient remains well three months post- procedure. We describe the first case where the Trellis system has been successfully used to clear occlusive porto-splenic thrombus and restore flow through a blocked TIPss. (Acta gastroenterol. belg., 2016, 79, 47-51).
Plesiomonas shigelloides : an extremely rare cause of Spontaneous Bacterial Peritonitis
Plesiomonas shigelloides, a rare cause of gastroenteritis in humans, is a gram negative rod belonging to the Enterobacteriaceae family. In addition, it has also been implicated in extra-intestinal infection, but prevalence data on such infections have been limited to case reports. To date there has been only one published case of P. shigel- loides causing spontaneous bacterial peritonitis (SBP). We describe another patient with P. shigelloides SBP and compare our findings with those from the original case. (Acta gastroenterol. belg., 2016, 79, 52-53).
Familial alpha 1 antitrypsin deficiency cases that are diagnosed in adulthood
Alpha 1 antitrypsin (AAT) deficiency is a hereditary disorder leading to severe lung and liver diseases worldwide. An accumula- tion of insoluble heterodimer AAT molecules in hepatocytes is the main cause of liver disorders. The most commonly detected allele worldwide is the PIMM allele, which fulfills the AAT function. The most common missing variant is PiZZ. Serum AAT level is a benefi- cial but not a reliable determinant for diagnosis. Liver biopsy yields more reliable results. AAT deficiency has no specific treat- ment. The only treatment modality in children with end stage liver disease is the hepatic transplant. We wanted to present in our arti- cle four cases from same family, diagnosed alpha-1 antitrypsindefi- ciency in adulthood. (Acta gastroenterol. belg., 2016, 79, 54-57).