Publication Name	World Journal of Gastrointestinal Surgery
Manuscript ID	50622
Country	India

Category	Gastroenterology & Hepatology
Manuscript Type	Basic Study
Article Title	Pathological abnormalities in splenic vasculature in non-cirrhotic portal hypertension: Its relevance in the management of portal hypertension
Manuscript Source	Unsolicited Manuscript
All Author List	Shahana Gupta, Biju Pottakkat, Surendra Kumar Verma, Raja Kalayarasan, Sandip Chandrasekar A and Ajith Ananthakrishna Pillai
Funding Agency and Grant Number
Corresponding Author	Biju Pottakkat, MD, Professor, Department of Surgical Gastroenterology, JIPMER, Super-speciality Block 4th Floor, Pondycherry 605006, India. bijupottakkat@gmail.com
Key Words	Portal hypertensive vasculopathy; Non cirrhotic portal hypertension; Splenic vasculature; Hyperdynamic circulation; Shunt surgery;
Core Tip	Portal hypertensive vasculopathy is well investigated in cirrhotics. Raised portal pressure and hyperdynamic circulation are thought to be the underlying cause. Pathological changes in splenic vein are similar in cirrhotic and non-cirrhotic portal hypertensive (NCPH). They are not primarily due to venous degenerative changes and are similar to those observed in pulmonary vasculature in pulmonary hypertension. Portal hypertensive in NCPH should be viewed as systemic and pulmonary hypertension equivalent in the gastrointestinal tract. We show that these pathological venous changes in NCPH are observed in greater proportion of patients in the delayed presentation group (P < 0.003). Interventions to reduce portal pressure should therefore be initiated at diagnosis of NCPH. The damage to the vasculature starts early and can be prevented from progressing to venous thrombosis and its sequelae if early surgical intervention to reduce portal pressure is initiated.
Citation	Gupta S, Pottakkat B, Verma SK, Kalayarasan R, Chandrasekar A S, Pillai AA. Pathological abnormalities in splenic vasculature in non-cirrhotic portal hypertension: Its relevance in the management of portal hypertension. World J Gastrointest Surg 2020; 12(1): 1-8

Received	2019-08-05 17:27
Peer-Review Started	2019-08-05 17:27
To Make the First Decision	2019-09-02 01:36
Return for Revision	2019-09-06 08:18
Revised	2019-09-25 17:26
Second Decision	2019-11-05 03:47
Accepted by Journal Editor-in-Chief
Accepted by Company Editor-in-Chief	2019-11-07 20:58
Articles in Press	2019-11-07 20:58
Publication Fee Transferred
Edit the Manuscript by Language Editor	2019-11-18 21:47
Typeset the Manuscript	2019-12-21 07:29

ISSN	1948-9366 (online)
Open Access	This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Copyright	© The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Permissions	For details, please visit: http://www.wjgnet.com/bpg/gerinfo/207
Publisher	Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Website	http://www.wjgnet.com