Noncirrhotic Portal Hypertension due to Nodular Regenerative Hyperplasia Treated with Surgical Portacaval Shunt
Joint Authors
Koffron, Alan
Louwers, Lisa M.
Raofi, Vandad
Stecevic, Veslav
Bortman, Jared
Cohn, Steven
Source
Issue
Vol. 2012, Issue 2012 (31 Dec. 2012), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2012-08-21
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
Nodular regenerative hyperplasia (NRH) is an uncommon condition, but an important cause of noncirrhotic intrahepatic portal hypertension (NCIPH), characterized by micronodules of regenerative hepatocytes throughout the liver without intervening fibrous septae.
Herein, we present a case of a thirty-seven-year-old female with systemic lupus erythematosus (SLE) who was discovered to have significant esophageal varices on endoscopy for dyspepsia.
Her labs revealed a slight elevation in the alkaline phosphatase and mild thrombocytopenia.
Abdominal MRI revealed seven focal hepatic masses, splenomegaly, no ascites, and a patent portal vein.
Ultrasound-guided core biopsy was reported as focal nodular hyperplasia.
However, her varices persisted despite treatment with beta-blockers and four additional upper endoscopies with banding.
She was subsequently referred for a surgical opinion.
At that time, given her history of SLE, azathioprine use, and portal hypertension, suspicion for NRH was raised.
Given her normal synthetic function and lack of parenchymal liver disease, the patient was offered surgical shunting.
During shunt surgery, a liver wedge biopsy was also performed and this confirmed NRH.
An upper endoscopy six weeks after shunting verified complete resolution of varices.
Currently, fifteen months after surgery duplex ultrasonography demonstrates shunt patency and the patient is without recurrence of her portal hypertension.
American Psychological Association (APA)
Louwers, Lisa M.& Bortman, Jared& Koffron, Alan& Stecevic, Veslav& Cohn, Steven& Raofi, Vandad. 2012. Noncirrhotic Portal Hypertension due to Nodular Regenerative Hyperplasia Treated with Surgical Portacaval Shunt. Case Reports in Medicine،Vol. 2012, no. 2012, pp.1-5.
https://search.emarefa.net/detail/BIM-512031
Modern Language Association (MLA)
Louwers, Lisa M.…[et al.]. Noncirrhotic Portal Hypertension due to Nodular Regenerative Hyperplasia Treated with Surgical Portacaval Shunt. Case Reports in Medicine No. 2012 (2012), pp.1-5.
https://search.emarefa.net/detail/BIM-512031
American Medical Association (AMA)
Louwers, Lisa M.& Bortman, Jared& Koffron, Alan& Stecevic, Veslav& Cohn, Steven& Raofi, Vandad. Noncirrhotic Portal Hypertension due to Nodular Regenerative Hyperplasia Treated with Surgical Portacaval Shunt. Case Reports in Medicine. 2012. Vol. 2012, no. 2012, pp.1-5.
https://search.emarefa.net/detail/BIM-512031
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-512031