Refractory Ascites after Pancreato-Duodenectomy - Time to Rethink an Old Dogma
Received Date: Oct 16, 2017 / Accepted Date: Nov 23, 2017 / Published Date: Nov 28, 2017
A rare case of refractory ascites caused by benign portal vein stenosis after pancreatoduodenectomy (PD) is reported. A dogma claims that ascites is found in portal hypertension with an intrahepatic block only. However, in the postoperative state, the pathophysiologic condition is altered, which made diagnosis difficult.
A 69-year-old man who had undergone PD for lower bile duct carcinoma in situ, developed in postoperative course a pseudoaneurysm of the common hepatic artery successfully treated by stent graft. Six months later, the patient developed refractory ascites. CT scan revealed a severe stricture in the main trunk of the portal vein, probably due to extrinsic compression by the stent in the hepatic artery. Percutaneous transhepatic portography was performed and stent-graft was placed over the stenotic segment. Portal blood flow was corrected immediately. One week after the stenting procedure the patient was free of ascites and control physical and biochemical examination three years later is completely normal.
Keywords: Extrahepatic portal vein stenosis; Refractory ascites; Stent graft
Citation: Helene M, Jacques E, Gilles P, Anthony S, Marc G, et al. (2017) Refractory Ascites after Pancreato-Duodenectomy– Time to Rethink an Old Dogma. J Clin Case Rep 7: 1043. Doi: 10.4172/2165-7920.10001043
Copyright: © 2017 Helene M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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