Esplenomegalia El hiperesplenismo se caracteriza por: esplenomegalia. disminución de cifras de hematíes, leucocitos y plaquetas. Hiperesplenismo recurrente secundario a cardiomiopatia alcoholica despues de una anastomosis esplenorenal distal. Warren L. Garner. x. Warren L. Garner. vol número1 Hiperesplenismo secundario a compresión del eje esplenoportal por quiste hepático gigante Underwater hybrid endoscopic submucosal.

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The pre-lengthening citrulline level increased from The postoperative course was uneventful. A year-old man with a history of mid-gut volvulus was referred to our center for intestinal transplant evaluation.

Long-term outcome of home parenteral nutrition in patients with ultra-short bowel syndrome.

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Nevertheless, due to our prior successful experience with duodenal lengthening procedures in children 4the patient secundaril to be considered for duodenal lengthening. The third portion of the duodenum had been stapled, leaving a duodenal stump. The final duodenal length was 83 cm.

Upper gastrointestinal tract X-rays and barium enema demonstrated a dilated and elongated duodenum and a small-caliber defunctionalized colon, respectively Fig. Measurement of plasma citrulline a non-protein amino acid mainly produced by enterocytes of the small bowel has been proposed as a biomarker of remnant small bowel mass and hipereslpenismo permanent versus transient intestinal failure 9 Therefore, whenever possible, autologous intestinal reconstruction should be considered before intestinal transplantation.

Duodenal lengthening in an adult with ultra-short bowel syndrome. A case report

The final length of the duodenum after huperesplenismo procedure reached 83 cm Fig. J Pediatr Surg ; This technique increases bowel length via the application of sequential stapling on alternating sides in a plane perpendicular to the long axis of the bowel. To date, there are no reported experiences of duodenal lengthening in adults.


Since these anatomical structures are situated inside the thickness of the pancreatic parenchyma, the risk of injury is hipreesplenismo by stapling the anterior and posterior aspects of the duodenum at a sufficient distance from the pancreas. The colonic mucous fistula was taken down and stapled with the construction of an end-to-side duodeno-colonic anastomosis. In addition, the plasma citrulline level was Herein, we report hiperesplenisml successful application of this technique in an adult with ultra-short bowel syndrome.

Citrulline blood levels as indicators of residual intestinal absorption in patients with short bowel syndrome. Only a megaduodenum stump that reached as far as the third secuncario 30 cm of length and the colon up to the hepatic flexure in the form of a mucous fistula was retained.

Serial transverse duodenoplasty not only gains an additional intestinal length when combined with simultaneous STEP but can also be applied successfully in patients with ultra-SBS. Due to the clinical scenario, the patient was placed on the intestinal transplant list combined with pancreas and kidney allografts.


We have recently demonstrated the feasibility of lengthening the duodenum in children with short bowel syndrome and a dilated duodenum. At 12 months post-surgery, citrulline plasma level had increased to An iterative mid-line incision was made under general anesthesia. This increases the hiperesplenksmo of achieving enteral autonomy while avoiding the need for intestinal transplantation 1 2.

He also follows an oral low-fiber diet ad libitum. The gastrostomy tube hiperesp,enismo ranged from 2. This procedure is reserved for cases with life-threatening complications from TPN.


In summary, although this is only one case, the result obtained demonstrates the feasibility and effectiveness of duodenal hipresplenismo and lengthening as part of the autologous intestinal reconstruction armamentarium in adults with a dilated duodenum and SBS.

This procedure gains additional intestinal length in a challenging area of autologous gut reconstruction. The next firing was similar from the opposite side, creating a duodenal channel 3 cm in diameter. In the present case, the need for a simultaneous pancreas and kidney transplant was based on the difficulty of diabetes control and problematic future scenario of adverse effects of immunosuppressors post-transplant due to chronic nephropathy.

Duodenal lengthening in short bowel with dilated duodenum. The lengthened duodenum measured 83 cm.


Tapering duodenoplasty and gastrojejunostomy in the management of idiopathic megaduodenum in children. The volume and calorie requirements were also reduced by half.

Similarly, the improvement in quality of life was questionable as the high gastrostomy output could result in a significant postoperative diarrhea following the establishment of the continuity of the intestinal tract. This is an open-access article distributed under the terms of the Creative Commons Attribution License.