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https://www.readbyqxmd.com/read/28223101/non-invasive-evaluation-of-portal-hypertension-using-ultrasound-elastography
#1
REVIEW
Annalisa Berzigotti
Portal hypertension (PH) leads to serious complications such as bleeding from gastro-esophageal varices, ascites and porto-systemic encephalopathy in patients with chronic liver disease (CLD). Since the gold-standard methods for assessing PH and its complications (measurement of hepatic venous pressure gradient, HVPG; endoscopy), are invasive expensive and not available at all centers, non-invasive methods have been increasingly investigated in the last 20 years. The present review focuses on the role of ultrasound elastography, a novel group of non-invasive techniques able to measure stiffness in target organs, to identify the presence, severity and risk of complications of PH...
February 13, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28221819/a-prospective-study-of-endoscopic-injection-sclerotherapy-and-endoscopic-variceal-ligation-in-the-treatment-of-esophageal-varices
#2
Syed Mohsin Ali, Shanbin Wu, Hongwei Xu, Hui Liu, Jinghua Hao, Chengyong Qin
INTRODUCTION: The aim of this study was to compare the effectiveness and safety of endoscopic injection sclerotherapy (EIS) with endoscopic variceal ligation (EVL) in the management of esophageal variceal bleeding (EVB). PATIENTS AND METHODS: In this prospective study, we compared the EIS and EVL in 124 patients who had endoscopically proved bleeding from esophageal varices. According to different treatment methods, they were randomly divided into the EIS and the EVL groups...
October 24, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28213164/carvedilol-use-is-associated-with-improved-survival-in-patients-with-liver-cirrhosis-and-ascites
#3
Rohit Sinha, Khalida A Lockman, Nethmee Mallawaarachchi, Marcus Robertson, John N Plevris, Peter C Hayes
BACKGROUND AND AIMS: Carvedilol, a non-selective beta-blocker (NSBB) with additional anti-alpha 1 receptor activity, is a potent portal hypotensive agent. It has been used as prophylaxis against variceal bleed. However, its safety in decompensated liver cirrhosis with ascites is still disputed. In this study, we examined whether long-term use of carvedilol in the presence of ascites is a risk factor for mortality. METHODS: This was a single-centre retrospective analysis of 325 consecutive patients with liver cirrhosis and ascites presenting to our Liver Unit between 1(st) of January 2009 to 31(st) August 2012...
February 14, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28210086/prognostic-factors-associated-with-mortality-in-patients-with-gastric-fundal-variceal-bleeding
#4
Keishi Komori, Masaru Kubokawa, Eikichi Ihara, Kazuya Akahoshi, Kazuhiko Nakamura, Kenta Motomura, Akihide Masumoto
AIM: To determine the prognostic factors associated with mortality in patients with gastric fundal variceal (GFV) bleeding. METHODS: In total, 42 patients were endoscopically diagnosed with GFV bleeding from January 2000 to March 2014. We retrospectively reviewed the patients' medical records and assessed their history, etiology of liver cirrhosis, disease conditions, treatment options for GFV bleeding, medications administered before and after onset of GFV bleeding, blood test results (hemoglobin, albumin, and bilirubin concentrations), and imaging results (including computed tomography and abdominal ultrasonography)...
January 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28203136/massive-hemorrhage-from-ectopic-duodenal-varices-importance-of-a-multidisciplinary-approach
#5
Tyler House, Patrick Webb, Chad Baarson
Duodenal variceal bleeding is an uncommon complication of portal hypertension that can easily go unrecognized and reach mortality rates as high as 40%. Cirrhosis is the most common cause of duodenal varices. In most cases, duodenal varices occur concomitantly with esophageal varices, further complicating identification with initial endoscopy. Although many modalities have been explored with respect to management and treatment approaches, guidelines have yet to be established owing to the infrequency in which bleeding occurs from ectopic duodenal varices...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28195875/endoscopic-variceal-ligation-combined-with-argon-plasma-coagulation-versus-ligation-alone-for-the-secondary-prophylaxis-of-variceal-bleeding-a-systematic-review-and-meta-analysis
#6
Xiaoyan Li, Tingting Jiang, Jian Gao
Endoscopic variceal ligation (EVL) is often recommended as an effective method for the treatment of esophageal varices, despite the important tendency of variceal recurrence. Recent studies indicate that combining EVL with argon plasma coagulation (APC) may be a more effective therapy than ligation alone. To investigate these findings, we carried out a systematic review and meta-analysis to compare the safety and efficacy of EVL combined with APC versus ligation alone for the secondary prophylaxis of esophageal variceal hemorrhage...
February 13, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28180928/safety-and-efficacy-of-sodium-tetradecyl-sulfate-and-lipiodol-foam-in-balloon-occluded-retrograde-transvenous-obliteration-brto-for-large-porto-systemic-shunts
#7
Amar Mukund, Ganesh Deogaonkar, S Rajesh, Saggerre Muralikrishna Shasthry, Shiv Kumar Sarin
OBJECTIVE: To evaluate the safety and efficacy sodium tetradecyl sulfate and lipiodol foam (STS foam) in BRTO for large (caliber ≥15 mm) porto-systemic shunt and gastric fundal varices. MATERIALS AND METHODS: It is a retrospective record-based study of patients who underwent BRTO using STS foam at the Institute of Liver and Biliary Sciences, New Delhi, for gastric variceal bleed or refractory hepatic encephalopathy (HE) who had large porto-systemic shunt (diameter ≥15 mm) with or without associated gastric varices...
February 8, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28167214/doppler-endoscopic-probe-monitoring-of-blood-flow-improves-risk-stratification-and-outcomes-of-patients-with-severe-non-variceal-upper-gastrointestinal-hemorrhage
#8
Dennis M Jensen, Thomas Og Kovacs, Gordon V Ohning, Kevin Ghassemi, Gustavo A Machicado, Gareth S Dulai, Alireza Sedarat, Rome Jutabha, Jeffrey Gornbein
BACKGROUND & AIMS: For 4 decades, stigmata of recent hemorrhages in patients with non-variceal lesions have been used for risk stratification and endoscopic hemostasis. The arterial blood flow that underlies the stigmata is rarely monitored, but can be used to determine risk for rebleeding. We performed a randomized controlled trial to determine whether Doppler endoscopic probe monitoring of blood flow improves risk stratification and outcomes in patients with severe non-variceal upper gastrointestinal hemorrhage...
February 3, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28160373/validating-deconstructing-and-refining-baveno-criteria-for-ruling-out-high-risk-varices-in-patients-with-compensated-cirrhosis
#9
Parastoo Jangouk, Laura Turco, Ana De Oliveira, Filippo Schepis, Erica Villa, Guadalupe Garcia-Tsao
Guidelines recommend variceal screening in patients with cirrhosis to identify varices at high-risk of bleeding requiring primary prophylaxis. Non-invasive criteria to rule out high-risk varices (HRV) will avoid unnecessary endoscopies. Recent Baveno VI criteria define patients with compensated cirrhosis in whom endoscopy can be avoided as those with a liver stiffness (LS) by transient elastography <20 kPa and a platelet count >150,000/mm(3) AIMS: To validate Baveno criteria in two cohorts with a different prevalence of HRV and 2) to determine whether alternate parameters not including LS would be equal/more accurate in ruling out HRV METHODS: Retrospective study evaluating patients with LS >10 kPa who had LS and endoscopy within one year of each other RESULTS: The study included 161 patients from a U...
February 3, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28147475/over-the-scope-clip-in-the-management-of-gastrointestinal-defect-and-intractable-non-variceal-bleeding
#10
Hyungkil Kim
No abstract text is available yet for this article.
January 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28144391/impact-of-transjugular-intrahepatic-porto-systemic-shunt-on-post-liver-transplantation-outcomes-study-based-on-the-united-network-for-organ-sharing-database
#11
Khalid Mumtaz, Sherif Metwally, Rohan M Modi, Nishi Patel, Dmitry Tumin, Anthony J Michaels, James Hanje, Ashraf El-Hinnawi, Don Hayes, Sylvester M Black
AIM: To determine the impact of transjugular intrahepatic porto-systemic shunt (TIPS) on post liver transplantation (LT) outcomes. METHODS: Utilizing the United Network for Organ Sharing (UNOS) database, we compared patients who underwent LT from 2002 to 2013 who had underwent TIPS to those without TIPS for the management of ascites while on the LT waitlist. The impact of TIPS on 30-d mortality, length of stay (LOS), and need for re-LT were studied. For evaluation of mean differences between baseline characteristics for patients with and without TIPS, we used unpaired t-tests for continuous measures and χ(2) tests for categorical measures...
January 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28135795/-surgical-removal-of-migrated-coil-after-embolization-of-jejunal-variceal-bleeding-a-case-report
#12
Junhwan Kim, Danbi Lee, Kyunghwan Oh, Mingee Lee, Seol So, Dong Hoon Yang, Chan Wook Kim, Dong Il Gwon, Young Hwa Chung
Jejunal variceal bleeding is less common compared with esophagogastric varices in patients with portal hypertension. However, jejunal variceal bleeding can be fatal without treatment. Treatments include surgery, transjugular intrahepatic porto-systemic shunt (TIPS), endoscopic sclerotherapy, percutaneous coil embolization, and balloon-occluded retrograde transvenous obliteration (BRTO). Percutaneous coil embolization can be considered as an alternative treatment option for those where endoscopic sclerotherapy, surgery, TIPS or BRTO are not possible...
January 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28130709/mortality-following-catheter-drainage-versus-thoracentesis-in-cirrhotic-patients-with-pleural-effusion
#13
Tsung-Hsing Hung, Chih-Wei Tseng, Chen-Chi Tsai, Yu-Hsi Hsieh, Kuo-Chih Tseng, Chih-Chun Tsai
BACKGROUND: Pleural effusion is an abnormal collection of body fluids that may cause related morbidity or mortality in cirrhotic patients. There are insufficient data to determine the optimal method of drainage, for symptomatic relief in cirrhotic patients with pleural effusion. AIMS: In this study, we compare the mortality outcomes of catheter drainage versus thoracentesis in cirrhotic patients. METHODS: The National Health Insurance Database, derived from the Taiwan National Health Insurance Program, was used to identify cirrhotic patients with pleural effusion requiring drainage between January 1, 2007, and December 31, 2010...
January 27, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28130066/timing-affects-measurement-of-portal-pressure-gradient-after-placement-of-transjugular-intrahepatic-porto-systemic-shunts-in-patients-with-portal-hypertension
#14
Gilberto Silva-Junior, Fanny Turon, Anna Baiges, Eira Cerda, Ángeles García-Criado, Annabel Blasi, Ferran Torres, Virginia Hernandez-Gea, Jaume Bosch, Juan Carlos Garcia-Pagan
BACKGROUND & AIMS: A reduction in portal pressure gradient (PPG) to below 12 mmHg after placement of a transjugular intrahepatic porto-systemic shunt (TIPS) correlates with the absence of further bleeding or ascites at follow-up examinations of patients with cirrhosis. The PPG is usually measured immediately after placement of the TIPS, when different circumstances can affect PPG values - this could affect determination of risk for decompensation. We investigated variations in PPG measurements collected at different time points after TIPS, aiming to identify a time point after which PPG values were best maintained...
January 24, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28125425/usefulness-of-the-glasgow-blatchford-score-to-predict-1-week-mortality-in-patients-with-esophageal-variceal-bleeding
#15
Chikara Iino, Tadashi Shimoyama, Takasato Igarashi, Tomoyuki Aihara, Kentaro Ishii, Jyuichi Sakamoto, Hiroshi Tono, Shinsaku Fukuda
OBJECTIVES: Esophageal variceal bleeding is one of the most severe complications of liver cirrhosis, with high mortality. However, there is no established scoring system for short-term mortality in patients with esophageal variceal bleeding. The aim of this study was to evaluate the usefulness of the Glasgow-Blatchford score (GBS), the Model for End-Stage Liver Disease (MELD) score, and the Child-Pugh score for predicting short-term and hospital mortality in patients with esophageal variceal bleeding...
January 25, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28118373/the-role-of-adjuvant-acid-suppression-on-the-outcomes-of-bleeding-esophageal-varices-after-endoscopic-variceal-ligation
#16
Cheng-Kun Wu, Chih-Ming Liang, Chien-Ning Hsu, Tsung-Hsing Hung, Lan-Ting Yuan, Seng-Howe Nguang, Jiunn-Wei Wang, Kuo-Lun Tseng, Ming-Kun Ku, Shih-Cheng Yang, Wei-Chen Tai, Chih-Wei Shih, Pin-I Hsu, Deng-Chyang Wu, Seng-Kee Chuah
The impact of adjuvant acid suppression via proton pump inhibitors or histamine-2 receptor antagonists after endoscopic variceal ligation remains uncertain. We therefore aimed to evaluate the effect of adjuvant acid suppression on the rebleeding and mortality rates in patients who received endoscopic variceal ligation and vasoconstrictor therapy for bleeding esophageal varices. Data from 1997 to 2011 were extracted from the National Health Insurance Research Database in Taiwan. A total of 1576 cirrhotic patients aged > 18 years with a primary diagnosis of acute esophageal variceal bleeding who received endoscopic variceal ligation therapy were screened...
2017: PloS One
https://www.readbyqxmd.com/read/28112958/cutaneous-necrosis-secondary-to-terlipressin-therapy-a-rare-but-serious-side-effect-case-report-and-literature-review
#17
Enrique Iglesias Julián, Ester Badía Aranda, Belén Bernad Cabredo, Daniel Corrales Cruz, María José Romero Arauzo
Terlipressin is a vasopressin analogue used in esophageal variceal bleeding and hepatorenal syndrome management. It is a safe drug with mild secondary effects. However, potentially serious ischemic complications may occur, such as cutaneous necrosis. It is useful to recognize these events early, in order to withdraw terlipressin and introduce other adjuvant drugs if needed. We report a detailed case of cutaneous necrosis secondary to terlipressin administration and present a case review of patients, describing their characteristics, risk factors, lesion locations, doses, methods of administration and possible treatments...
January 23, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28110759/retrograde-antegrade-accelerated-trap-obliteration-a-modified-approach-to-transvenous-eradication-of-gastric-varices
#18
Ron C Gaba
This series presents a hybrid technique for obliteration of gastric varices (GVs) termed retrograde-antegrade accelerated trap obliteration that employs sclerosant agent instillation under concurrent inflow and outflow vessel occlusion with coils or plugs. Six patients (mean age, 56 y) with GVs were treated in 2014 and 2015. Technical success rate was 100%. Five patients completed 30-day follow-up. There were no procedure-related complications, and clinical success rate was 100%, with no bleeding recurrence over a mean follow-up of 298 days ± 178...
February 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28109636/management-of-non-variceal-upper-gastrointestinal-bleeding-position-statement-of-the-catalan-society-of-gastroenterology
#19
Pilar García-Iglesias, Josep-Maria Botargues, Faust Feu Caballé, Càndid Villanueva Sánchez, Xavier Calvet Calvo, Enric Brullet Benedi, Gabriel Cánovas Moreno, Esther Fort Martorell, Marta Gallach Montero, Emili Gené Tous, José-Manuel Hidalgo Rosas, Amelia Lago Macía, Ana Nieto Rodríguez, Michel Papo Berger, Montserrat Planella de Rubinat, Joan Saló Rich, Rafel Campo Fernández de Los Ríos
In recent years there have been advances in the management of non-variceal upper gastrointestinal bleeding that have helped reduce rebleeding and mortality. This document positioning of the Catalan Society of Digestologia is an update of evidence-based recommendations on management of gastrointestinal bleeding peptic ulcer.
January 18, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28101125/preventive-transarterial-embolization-in-upper-nonvariceal-gastrointestinal-bleeding
#20
Aleksejs Kaminskis, Aina Kratovska, Sanita Ponomarjova, Anna Tolstova, Maksims Mukans, Solvita Stabiņa, Raivis Gailums, Andrejs Bernšteins, Patricija Ivanova, Viesturs Boka, Guntars Pupelis
BACKGROUND: Transarterial embolization (TAE) is a therapeutic option for patients with a high risk of recurrent bleeding after endoscopic haemostasis. The aim of our prospective study was a preliminary assessment of the safety, efficacy, and clinical outcomes following preventive TAE in patients with non-variceal acute upper gastrointestinal bleeding (NVUGIB) with a high risk of recurrent bleeding after endoscopic haemostasis. METHODS: Preventive visceral angiography and TAE were performed after endoscopic haemostasis on patients with NVUGIB who were at a high risk of recurrent bleeding (PE+ group)...
2017: World Journal of Emergency Surgery: WJES
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