???Downhill??? Esophageal Varices and Occlusion of Superior and Inferior Vena Cavas Due to a Systemic Venulitis

Maton, Paul N.; Allison, D J; Chadwick, V. S.

doi:10.1097/00004836-198508000-00013

Cited by 20 publications

(21 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the human medical literature, DEVs have been often described in cases of SVC obstruction or compression due to lung tumors or mediastinal masses. 3 Alternatively, this type of esophageal varices may develop as a result of excessive blood drainage into the esophageal veins caused by systemic venulitis, 4 thyroid disease or intervention, 5 Bechet's disease, 6 Castleman's disease, 7 or pulmonary hypertension. 2 Predominant factors influencing downward extension of esophageal varices are obstruction level and duration.…”

mentioning

confidence: 99%

Esophageal Varices due to a Probable Arteriovenous Communication in a Dog

Bertolini

Lorenzi

Ledda

et al. 2007

Veterinary Internal Medicne

View full text Add to dashboard Cite

A 6-year-old 40-kg castrated male Samoyed dog was presented for evaluation of chronic remittent lameness of the right forelimb. The dog had a history of polyuria-polydipsia (PU/PD) and lethargy over the previous year. Physical examination was unremarkable except for a grade II systolic murmur at the apex of the heart on the left side. A 6-lead ECG was within normal limits. Arterial blood gas analysis indicated mild respiratory alkalosis (pH, 7.457, reference range, 7.370-7.450 Thoracic radiographs disclosed a generalized increase in the size of the cardiac silhouette and pulmonary vascular enlargement, suggesting pulmonary overcirculation. An ELISA for Dirofilaria immitis antigen was negative. Two-dimensional, M-mode echocardiography a (transducer frequency, 2.0-3.0 MHz) revealed left atrial enlargement, left ventricular eccentric hypertrophy, and impaired systolic function (end-diastolic dimension, 65.7 mm; end-systolic dimension, 44.2 mm; shortening fraction, 32.7%) with normal valves. Spectral and colorflow Doppler examination disclosed mild mitral, aortic, and pulmonic valve insufficiency. Both the tricuspid and the telediastolic pulmonic valvular peak regurgitant jet velocities were increased as follows: 3.26 m/s (normal, #2.5 m/s) and 2.44 m/s (normal, #2.0 m/s), respectively. According to the Bernoulli's equation modification, the systolic pulmonary artery pressure was estimated to be 42.5 mm Hg and the diastolic pulmonary artery pressure was estimated to be 23.9 mm Hg, values consistent with mild pulmonary hypertension.The dog was anesthetized and subjected to radiography of the right forelimb and total body multidetector computed tomography b (MDCT). The radiographs were negative for abnormalities, and synovial fluid examination of the shoulder and stifle joints did not indicate evidence of any inflammatory pathology. MDCT scans of the brain, thorax, and abdomen were obtained. For the thoracic and abdominal scans, the dog was positioned in dorsal recumbency, and we employed the following parameters: helical modality, 120 kV, 200 mA, 0.7-second rotation tube, 0.526 pitch, and 1.2-mm slice thickness. For the brain scan, the dog was positioned in sternal recumbency and the scanner parameters were as follows: axial modality, 120 kV, 310 mA, 2-second rotation tube, 0.625 slice thickness, and 10-mm intervals. For an enhanced series, 2-mL/kg iodixanol c 320 mg I/mL was injected via a 22-gauge catheter into the right cephalic vein at a 3 mL/second infusion rate, through a computed tomography injector system. d The brain and abdominal MDCT scans were normal. However, MDCT of the neck and chest revealed 12 pairs of ribs, an enlarged heart, and enlarged pulmonary vessels. Both of the bronchoesophageal arteries were enlarged and connected with an enormous network of homogeneously enhancing serpentine structures involving the thoracic esophagus (esophageal and paraesophageal varices). The bronchoesophageal vein was extremely dilated (Figs 1, 2). The right azygous and hemizygous veins were normal. The cranial vena ca...

show abstract

mentioning

confidence: 99%

Esophageal Varices due to a Probable Arteriovenous Communication in a Dog

Bertolini

Lorenzi

Ledda

et al. 2007

Veterinary Internal Medicne

View full text Add to dashboard Cite

show abstract

“…There is a long list of etiologies described in the literature including central venous catheterization [2,6,7], mediastinal fibrosis [8][9][10][11][12][13][14], primary and metastatic mediastinal tumors [3,10,11,[15][16][17][18][19], mediastinal lymphadenopathy secondary to head and neck cancers such as carcinoma of the tongue [20], substernal goiters and thyroid masses [21][22][23], thyroid carcinoma [3,[21][22][23][24][25], lung cancer [3,10,16,[18][19][20]26,27,28], thymoma [3,29], systemic venulitis [30], Behcet's disease [31][32][33][34][35][36], Castleman's disease (angiofollicular lymph node hyperplasia) [4], and as a late complication after correction of congenital heart defect <...>…”

Section: Etiologies Of "Downhill" Esophageal Varicesmentioning

confidence: 99%

“…"Downhill" esophageal varices that are presenting with bleeding are extremely rare in the literature [21,30,51,18,12,14,48]. It was reported that 7 to 9 % of patients with "Downhill" esophageal varices presented with upper gastrointestinal hemorrhage [5,3,30], with some cases of life-threatening bleeding [6,30].…”

Section: Complications Of "Downhill" Esophageal Varicesmentioning

confidence: 99%

“…It was reported that 7 to 9 % of patients with "Downhill" esophageal varices presented with upper gastrointestinal hemorrhage [5,3,30], with some cases of life-threatening bleeding [6,30]. Most of the bleeding varices are caused by vena cava obstruction due to tumors or mediastinal fibrosis [21,51,18,12,14].…”

Section: Complications Of "Downhill" Esophageal Varicesmentioning

confidence: 99%

“…In surgical candidates a vascular bypass of the superior vena cava can be attempted [6]. Treatment of the underlying medical condition was sufficient in some cases to resolve the varices, such as steroids and dapsone in systemic vasculitis [30], chemoradiotherapy or resection of a tumor [4,26,15,59,60], thyroidectomy [41,43,21,45] and radioactive iodine therapy [40] in case of goiter, and surgical resection for Castleman's disease [4]. Inferior thyroid artery embolization was attempted in a case of downhill varices caused by a goiter [39].…”

Section: Treatmentmentioning

confidence: 99%

See 2 more Smart Citations