Tag Archives: oesophageal bleeding

Update on Sonya … 7 Months Post Op

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Sonya with her mother Tatyana

Almost 1 year ago I brought you the story of Sonya Danilenko, a little girl from Zaporozhye, Ukraine who was dangerously ill with portal hypertension and subsequent bleeding esophogeal varices.  Sonya’s mom, Tatyana was searching for information on the Rex Shunt procedure and happened upon this blog where she learned of the wonderful work of a specialist at Children’s Memorial Hospital in Chicago Illinois by the name of Dr. Riccardo Superina.  Initially, after some very close calls in the Ukraine, Tatyana, who is an emergency physician herself, decided to take Sonya to Germany to see if doctor’s there could assess and perform this rare procedure.  As is the case for many countries in the world, Ukraine does not have the resources or specialists that are able to handle such a complex condition as portal hypertension.  Unfortunately the German doctors were also unable to perform the operation, so Tatyana made arrangements to send her imaging to Dr. Superina and as they say, “the rest is history”.

 After successfully raising the necessary funds to fly to the US (a story in itself), Tatyana arrived in Chicago with Sonya at the end of August 2011, and shortly thereafter Sonya had her surgery.  In the 11.5 hours of surgery Dr. Superina attempted to connect the shunt 5 times, but it clotted off almost immediately on every try. In the end he ended up doing a mesocaval shunt  which is the least desirable, but nevertheless it  is open and flowing.  Sonya is scheduled for her follow-up appointment with Dr. Superina this May in Chicago.  She will need to be continually monitored, but so far she continues to thrive.  In my mind I credit Sonya’s overall improvement to the great care and expertise of Dr. Superina, the staff at Children’s Memorial, her mom Tatyana,  and not to mention the  prayers of many people around the world!

In conclusion it seems that both portal hypertension and its dangerous side effects outweigh any attempt at surgical intervention if the candidate is suitable.  If what I have been told is correct I think that Dr. Superina maybe nearing around the 140 mark for operations on children with the large majority of those being successful.  There are other specialists in the world who have also realized success in treating children and that number combined with what has been done at Children’s Memorial is around 300.   I stand corrected on this information so if you’ve heard of anything different please let me know!

To read more about Sonya’s story click the following links:

http://www.portal-hypertension.com/little-sonyas-plight-update/

http://www.portal-hypertension.com/2011/08/28/rex-shunt-for-sonya-update-08-28-11/

http://www.portal-hypertension.com/rex-shunt-sonya/

http://www.portal-hypertension.com/post_op_6_days/

http://www.portal-hypertension.com/sonya-post-op-one-week-later/

http://www.portal-hypertension.com/follow-up-help-for-sonya-post-op-2-weeks/

http://www.portal-hypertension.com/little-sonya-2-month-post-op-update/

Sugiura Procedure … A Last Resort for Variceal Bleeding

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Since first learning about the Sugiura Procedure for oesophageal bleeding, I have wanted to write something about it but had difficulty actually deciphering the material from medical terminology into language that was understandable for most.   Besides scouring the internet I also tried to find understandable information in book form at my local library, and surprisingly I came up short.  Before trying to explain (albeit briefly below) online medical dictionaries define the procedure in the following manner, “Oesophageal transection with paraoesophageal devascularisation, for oesophageal varices”. 

As best as I can describe the Sugiura procedure, surgeons would ligate (tie-off) the penetrating oesophageal veins that originate from the portal system in order to stop the bleeding.  To maintain critical venous drainage of the oesophagus and stomach the left gastric and paraesophageal veins are left intact.  A splenectomy (removal of the spleen) is performed because it is usually congested and non-functioning.  Some articles I have read indicate that there have been some modifications to the procedure and with that there has been some reported success.  Although the Japanese (University of Tokyo) have reported favourable long-term results, the technique has not been widely accepted in the Western Hemisphere (except for Mexico) because of high postoperative mortality rates.  On a recent visit to my gastroenterologist I inquired about the procedure, and she confirmed what I read and stated that it is only performed as a last resort where all other procedures have failed.

Through personal research, personal interaction I have had with other sufferers, plus the advice of a few of my own specialists I remain committed to the task of posting accurate information on new techniques and medical findings for this most disconcerting condition of portal hypertension.   The Sugiura procedure is much more complicated than what I have tried to explain here, so maybe you have more information to share than what I have provided?  At any rate your comments or questions are always welcome!

Until next time,

Clint