alexa Refractory Ascites after Pancreato-Duodenectomyand#160;- Time to Rethink an Old Dogma | OMICS International| Abstract
ISSN: 2165-7920

Journal of Clinical Case Reports
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  • Case Report   
  • J Clin Case Rep 2017, Vol 7(11): 1043
  • DOI: 10.4172/2165-7920.10001043

Refractory Ascites after Pancreato-Duodenectomy - Time to Rethink an Old Dogma

Meillat Helene1*, Ewald Jacques1, Piana Gilles2, Sarran Anthony2, Giovannini Marc3, Bories Erwan3, Turrini Olivier1 and Delpero Jean- Robert1
1Department of Surgical Oncology, Institute Paoli-Calmettes and Université de la Méditerranée, , Marseille, France
2Department of Radiology, Institute Paoli Calmettes, , Marseille, France
3Department of Digestive Endoscopy, Institute Paoli Calmettes, , Marseille, France
*Corresponding Author : Meillat Helene, Department of Surgical Oncology, Institute Paoli-Calmettes and Université de la Méditerranée, Marseille, France, Tel: 0491223660, Fax: 0491223550, Email: [email protected]

Received Date: Oct 16, 2017 / Accepted Date: Nov 23, 2017 / Published Date: Nov 28, 2017

Abstract

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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