Journal of Clinical Case Reports

Ewald Jacques

Publications

• Case Report
  Refractory Ascites after Pancreato-Duodenectomy - Time to Rethink an Old Dogma
  Author(s): Meillat Helene, Ewald Jacques, Piana Gilles, Sarran Anthony, Giovannini Marc, Bories Erwan, Turrini Olivier and Delpero Jean- RobertMeillat Helene, Ewald Jacques, Piana Gilles, Sarran Anthony, Giovannini Marc, Bories Erwan, Turrini Olivier and Delpero Jean- Robert
  
  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. O.. Read More»
  DOI: 10.4172/2165-7920.10001043

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