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Noncirrhotic portal hypertension

Ricardo U Macías-Rodríguez, Astrid Ruiz-Margáin, Jose L Rodriguez-Garcia, Sergio Zepeda-Gómez, Aldo Torre
OBJECTIVE: Endoscopic retrograde cholangio-pancreatography (ERCP) is useful for the management of biliary tract diseases; in patients with cirrhosis, portal hypertension may increase the risk for complications from ERCP. We evaluated the outcome and risk factors related to ERCP in patients with cirrhosis and portal hypertension. PATIENTS AND METHODS: In this case-control study, 37 patients (71 procedures) with cirrhosis and portal hypertension (group 1) and 37 controls (group 2) undergoing ERCP were included...
October 14, 2016: European Journal of Gastroenterology & Hepatology
Luis Lizardo-Sanchez, James Burdick, James F Trotter
Gastric variceal bleeding is associated with significant morbidity and mortality in patients with portal hypertension and cirrhosis. Options are limited for patients who are not candidates for transjugular intrahepatic portosystemic shunts (TIPS). Cyanoacrylate injections have been reported to be efficacious in previous case series. The aim of this retrospective study was to report our single-center experience with the safety and efficacy of 2-octyl-cyanoacrylate in patients who were not TIPS candidates. Electronic medical records were reviewed for 16 patients who underwent a total of 18 esophagogastroduodenoscopies for acute gastric or duodenal variceal bleeding and secondary prophylaxis of gastric varices; 14 patients had cirrhosis with an average Model for End-Stage Liver Disease score of 16, and 2 patients had noncirrhotic portal hypertension...
October 2016: Proceedings of the Baylor University Medical Center
Mathieu Duché, Béatrice Ducot, Oanez Ackermann, Florent Guérin, Emmanuel Jacquemin, Olivier Bernard
BACKGROUND AND AIMS: Primary prophylaxis of bleeding is debated for children with portal hypertension because of the limited number of studies on its safety and efficacy, the lack of a known endoscopic pattern carrying a high risk of bleeding for all causes, and the assumption that the mortality of a first bleed is low. We report our experience with these issues. METHODS: From 1989 to 2014, we managed 1300 children with portal hypertension. Endoscopic features were recorded; high-risk varices were defined as: grade 3 esophageal varices, grade 2 varices with red wale markings, or gastric varices...
September 20, 2016: Journal of Hepatology
Thomas S Maldonado, Sheila N Blumberg, Sharvil U Sheth, Gabriel Perreault, Mikel Sadek, Todd Berland, Mark A Adelman, Caron B Rockman
BACKGROUND: Mesenteric venous thrombosis (MVT) is a relatively uncommon but potentially lethal condition associated with bowel ischemia and infarction. The natural history and long-term outcomes are poorly understood and under-reported. METHODS: A single-institution retrospective review of noncirrhotic patients diagnosed with MVT from 1999 to 2015 was performed using International Classification of Diseases, Ninth Revision and radiology codes. Patients were excluded if no radiographic imaging was available for review...
October 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Oliviero Riggio, Stefania Gioia, Ilaria Pentassuglio, Valeria Nicoletti, Michele Valente, Giulia d'Amati
The term idiopathic noncirrhotic portal hypertension (INCPH) has been recently proposed to replace terms, such as hepatoportal sclerosis, idiopathic portal hypertension, incomplete septal cirrhosis, and nodular regenerative hyperplasia, used to describe patients with a hepatic presinusoidal cause of portal hypertension of unknown etiology, characterized by features of portal hypertension (esophageal varices, nonmalignant ascites, porto-venous collaterals), splenomegaly, patent portal, and hepatic veins and no clinical and histological signs of cirrhosis...
2016: Hepatic Medicine: Evidence and Research
Ashish Goel, Pamela Christudoss, Renu George, Banumathi Ramakrishna, G Jayakumar Amirtharaj, Shyamkumar N Keshava, Anup Ramachandran, K A Balasubramanian, Ian Mackie, Jude J Fleming, Elwyn Elias, Chundamannil E Eapen
BACKGROUND AND AIMS: Idiopathic noncirrhotic intrahepatic portal hypertension (NCIPH), a chronic microangiopathy of the liver caused by arsenicosis from use of contaminated groundwater, was reported from Asia. This study aimed to see, if in the twenty-first century, arsenicosis was present in NCIPH patients at our hospital and, if present, to look for groundwater contamination by arsenic in their residential locality. METHODS: Twenty-seven liver biopsy proven NCIPH patients, 25 portal hypertensive controls with hepatitis B or C related cirrhosis and 25 healthy controls, matched for residential locality, were studied...
May 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Amr S Hanafy
BACKGROUND AND AIM: Serum-ascites albumin gradient (SAAG) has been used in the classification of ascites for the last 20 years but it has some drawbacks. This study searches for possible correlations between ascitic fluid viscosity and the etiology of ascites, renal impairment, and length of ICU stay. MATERIALS AND METHODS: The study was conducted in Zagazig University Hospital, Egypt. It included 240 patients with ascites due to various causes. The patients were divided into two groups: the cirrhotic ascites group, which included 120 patients, and the noncirrhotic ascites group, which included 120 patients...
September 2016: European Journal of Gastroenterology & Hepatology
Servet Karagul, Mehmet Ali Yagci, Ali Tardu, Ismail Ertugrul, Serdar Kirmizi, Fatih Sumer, Burak Isik, Cuneyt Kayaalp, Sezai Yilmaz
BACKGROUND Idiopathic noncirrhotic portal hypertension (INCPH) is a rare disease characterized by increased portal venous pressure in the absence of cirrhosis and other causes of liver diseases. The aim of the present study was to present our results in using portosystemic shunt surgery in patients with INCPH. MATERIAL AND METHODS Patients who had been referred to our Liver Transplantation Institute for liver transplantation and who had undergone surgery from January 2010 to December 2015 were retrospectively analyzed...
2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Henriette J Scherpbier, Valeska Terpstra, Dasja Pajkrt, Thanyawee Puthakanit, Jintanat Ananworanich, Caroline Foster, Marius van den Bergh Weerman, Eline E Deurloo, Marc van der Valk, Taco W Kuijpers, Bart G Koot
BACKGROUND: Noncirrhotic portal hypertension (NCPH) has been reported in HIV-infected adults. Antiretroviral drugs, as well as genetic and thrombophilic predisposition, have been suggested as possible etiologic factors. METHODS: Clinical data were collected from 6 HIV-infected patients attending the Infectious Diseases Departments at respectively Emma Children's Hospital Academic Medical Centre in Amsterdam, The Thai Red Cross AIDS Research Centre, Bangkok, Imperial College Healthcare NHS Trust, London who were diagnosed with NCPH...
August 2016: Pediatric Infectious Disease Journal
Julien Bissonnette, Juan Carlos Garcia-Pagán, Agustín Albillos, Fanny Turon, Carlos Ferreira, Luis Tellez, Jean-Charles Nault, Nicolas Carbonell, Jean-Paul Cervoni, Mohamed Abdel Rehim, Annie Sibert, Louis Bouchard, Pierre Perreault, Jonel Trebicka, Félix Trottier-Tellier, Pierre-Emmanuel Rautou, Dominique-Charles Valla, Aurélie Plessier
UNLABELLED: Idiopathic noncirrhotic portal hypertension is a heterogeneous group of diseases characterized by portal hypertension in the absence of cirrhosis. The efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) in this population are unknown. The charts of patients with idiopathic noncirrhotic portal hypertension undergoing TIPS in seven centers between 2000 and 2014 were retrospectively reviewed. Forty-one patients were included. Indications for TIPS were recurrent variceal bleeding (n = 25) and refractory ascites (n = 16)...
July 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Saman Ratnayake, Ali Ammar, Rodd Rezvani, Greti Petersen
We present a case of a 65-year-old Hispanic man with a history of disseminated cutaneous coccidioidomycosis who presented to the emergency room for progressively worsening abdominal pain associated with shortness of breath. The patient was found to have pleural effusion and moderate ascites on physical examination. Abdominal ultrasound and computed tomography scan were consistent with moderate ascites and portal hypertension but negative for both liver cirrhosis and for venous or arterial thrombosis. Cytology of ascitic fluid was suggestive of portal hypertension and was negative for infection...
October 2015: Journal of Investigative Medicine High Impact Case Reports
David J Worhunsky, Monica M Dua, Thuy B Tran, Bernard Siu, George A Poultsides, Jeffrey A Norton, Brendan C Visser
BACKGROUND: Minimally invasive liver surgery is a growing field, and a small number of recent reports have suggested that laparoscopic liver resection (LLR) is feasible even in patients with cirrhosis. However, parenchymal transection of the cirrhotic liver is challenging due to fibrosis and portal hypertension. There is a paucity of data regarding the technical modifications necessary to safely transect the diseased parenchyma. METHODS: Patients undergoing LLR by a single surgeon between 2008 and 2015 were reviewed...
October 2016: Surgical Endoscopy
Hwajeong Lee, Aseeb Ur Rehman, M Isabel Fiel
Idiopathic noncirrhotic portal hypertension is a poorly defined clinical condition of unknown etiology. Patients present with signs and symptoms of portal hypertension without evidence of cirrhosis. The disease course appears to be indolent and benign with an overall better outcome than cirrhosis, as long as the complications of portal hypertension are properly managed. This condition has been recognized in different parts of the world in diverse ethnic groups with variable risk factors, resulting in numerous terminologies and lack of standardized diagnostic criteria...
January 2016: Journal of Pathology and Translational Medicine
Leon Adrian Muti, Alina Elena Pârvu, Alexandra M Crăciun, Nicolae Miron, Monica Acalovschi
BACKGROUND AND AIMS: Nitro-oxidative stress may have pathophysiological consequences. The study aimed to assess the nitro-oxidative stress, the vascular growth factor, and metalloproteinase-9 levels in patients with noncirrohic and cirrhotic portal hypertension. METHODS: Patients with noncirrhotic portal hypertension (n=50) and cirrhotic portal hypertension (n=50) from the 3rd Medical Clinic in Cluj-Napoca Romania were prospectively enrolled between October 2004 and October 2006...
2015: Clujul Medical (1957)
Rajiv N Srinivasa, Patrick D Sutphin, Matthew E Anderson, Sanjeeva P Kalva
Portosystemic shunts (PSS) are common in patients with chronic liver disease and portal hypertension, however, their occurrence in noncirrhotic individuals is likely under appreciated. Patients may present with symptoms of hepatic encephalopathy and/or gastrointestinal bleeding and undergo extensive work up for liver disease to no avail. Often, these patients suffer for years with accruing medical expenses and numerous hospitalizations related to repeated episodes of encephalopathy. The underlying cause may go undiagnosed or misdiagnosed as occult hepatic dysfunction or even a neuropsychological disorder...
May 2015: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Aída de Fátima Thomé Barbosa Gouvêa, Daisy Maria Machado, Suênia Cordeiro de Vasconcelos Beltrão, Fabiana Bononi do Carmo, Regina Helena Guedes Motta Mattar, Regina Célia de Menezes Succi
OBJECTIVE: To alert the pediatrician who is following up HIV-infected patients about the possibility of non-cirrhotic portal hypertension (NCPH) in this period of life, in order to avoid the catastrophic consequences of this disease as bleeding esophageal varices. CASE DESCRIPTION: A 13 years old HIV-infected patient by vertical route was receiving didanosine (ddI) for 12 years. Although the HIV viral load had been undetectable for 12 years, this patient showed gradual decrease of CD4+ T cells, prolonged thrombocytopenia and high alkaline phosphatase...
April 2015: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
Hwajeong Lee, Sanaz Ainechi, Mandeep Singh, Peter F Ells, Christine E Sheehan, Jingmei Lin
OBJECTIVES: Liver biopsy is performed for various indications in dialysis patients. Being a less-common subset, the hepatic pathology in renal dialysis is not well documented. Idiopathic noncirrhotic portal hypertension (INCPH) is a clinical entity associated with unexplained portal hypertension and/or a spectrum of histopathological vascular changes in the liver. After encountering INCPH and vascular changes of INCPH in 2 renal dialysis patients, we sought to further investigate this noteworthy association...
September 2015: International Journal of Surgical Pathology
Brandon M Wojcik, Sarwar Zahid, Shijie Cai, Michael J Englesbe
BACKGROUND/OBJECTIVES: The optimal management of children with noncirrhotic portal hypertension is controversial. Some groups suggest early and aggressive surgical intervention, while others report long-term success with conservative management. METHODS: We conducted a retrospective study of 26 patients with noncirrhotic portal hypertension treated at our institution. We compared platelet counts, white blood cell (WBC) counts, spleen size, hospital admissions, gastrointestinal bleeds, and longitudinal trends of specific clinical parameters using standard univariate and time-trend analytic techniques...
December 2011: Journal of Clinical and Experimental Hepatology
Harshal Rajekar, Rakesh K Vasishta, Yogesh K Chawla, Radha K Dhiman
Portal hypertension is characterized by an increase in portal pressure (> 10 mmHg) and could be a result of cirrhosis of the liver or of noncirrhotic diseases. When portal hypertension occurs in the absence of liver cirrhosis, noncirrhotic portal hypertension (NCPH) must be considered. The prognosis of this disease is much better than that of cirrhosis. Noncirrhotic diseases are the common cause of portal hypertension in developing countries, especially in Asia. NCPH is a heterogeneous group of diseases that is due to intrahepatic or extrahepatic etiologies...
September 2011: Journal of Clinical and Experimental Hepatology
Radha K Dhiman
No abstract text is available yet for this article.
September 2011: Journal of Clinical and Experimental Hepatology
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