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classification of oesophageal varices

Omar Nasher, David Devadason, Richard J Stewart
The aim of this study was to review the aetiology, presentation and management of these patients with upper gastrointestinal bleeding (UGIB) at a tertiary children's unit in the United Kingdom. This was a retrospective single-institution study on children (<16 years) who presented with acute UGIB over a period of 5 years using known International Classification of Diseases (ICD) codes. A total of 32 children (17 males, 15 females) were identified with a total median age at presentation of 5.5 years. The majority (24/32) of patients presented as an emergency...
November 3, 2017: Children
Kara Rye, Gerri Mortimore, Andrew Austin, Jan Freeman
BACKGROUND/AIMS: Cirrhosis and portal hypertension are characterised by a hyperdynamic circulation, which is independently associated with variceal size. Non-invasive techniques for measurement of systemic haemodynamics are now available. The aim of the study was to prospectively assess the accuracy of systemic haemodynamics measured non-invasively for the detection of oesophageal varices in cirrhotic patients as compared to other currently available non-invasive methods. METHODS: In a study of 29 cirrhotic patients, systemic haemodynamics were studied non-invasively using the Finometer(®) (mean arterial pressure (MAP), cardiac output (CO)/index, heart rate (HR), peripheral vascular resistance) and portal pressure was assessed by hepatic venous pressure gradient...
September 2016: Journal of Clinical and Experimental Hepatology
Cyriac Abby Philips, Amrish Sahney
Variceal disease and its management are of the utmost importance in the treatment of portal hypertension. Current guidelines are universal for management of variceal disease in portal hypertension. Classification and grading systems are numerous and differ according to geographical location. In this exhaustive review, the historical aspects of variceal disease, its classification and the grading systems in use are discussed, with self-explanatory tables and timelines. A better and clear understanding of the evolution of portal hypertension and variceal disease is provided...
August 2016: Gastroenterology Report
Ivy Shiue, David R Perkins, Nick Bearman
We aimed to understand relationships of the weather as biometeorological and hospital admissions due to diseases of arteries and veins by subtypes, which have been scarcely studied, in a national setting in recent years. This is an ecological study. Ten percent of daily hospital admissions from the included hospitals (n = 1,618) across Germany that were available between 1 January 2009 and 31 December 2011 (n = 5,235,600) were extracted from Statistisches Bundesamt, Germany. We identified I70-I79 Diseases of arteries, arterioles and capillaries and I80-I89 Diseases of veins, lymphatic vessels and lymph nodes by International Classification of Diseases version 10 as the study outcomes...
April 2016: Environmental Science and Pollution Research International
Wen-Chieh Wu, Yung-Tai Chen, Ping-Hsien Chen, Chien-Wei Su, Wei-Ming Huang, Tsung-Chieh Yang, Szu-Yuan Li, Tzeng-Ji Chen, Han-Chieh Lin, Fa-Yauh Lee, Ming-Chih Hou
BACKGROUND & AIMS: Studies concerning seasonal variations and the impact of air temperature on oesophageal variceal bleeding have yielded conflicting results. We aimed to explore the impact of air temperature on the occurrence of variceal bleeding. METHODS: A case-crossover study design was employed, and two cohorts were used, including the NHI-EVB cohort from the National Health Insurance Research Database of Taiwan from 1 January 1999 to 31 December 2010, and the VGH-EVB cohort from the Taipei Veterans General Hospital, from 4 May 2002 to 31 December 2010...
June 2016: Liver International: Official Journal of the International Association for the Study of the Liver
Lorenzo D'Antiga, Pietro Betalli, Paola De Angelis, Mark Davenport, Angelo Di Giorgio, Patrick J McKiernan, Valerie McLin, Paolo Ravelli, Ozlem Durmaz, Cecile Talbotec, Ekkehard Sturm, Marek Woynarowski, Andrew K Burroughs
OBJECTIVES: Data regarding agreement on endoscopic features of oesophageal varices in children with portal hypertension (PH) are scant. The aim of this study was to evaluate endoscopic visualisation and classification of oesophageal varices in children by several European clinicians, to build a rational basis for future multicentre trials. METHODS: Endoscopic pictures of the distal oesophagus of 100 children with a clinical diagnosis of PH were distributed to 10 endoscopists...
August 2015: Journal of Pediatric Gastroenterology and Nutrition
Maria Triantafyllou, Adrian J Stanley
Although less common than oesophageal variceal haemorrhage, gastric variceal bleeding remains a serious complication of portal hypertension, with a high associated mortality. In this review we provide an update on the aetiology, classification and management of gastric varices, including acute bleeding, prevention of rebleeding and primary prophylaxis. We describe the optimum management strategies for gastric varices including drug, endoscopic and radiological therapies, focusing on recent published evidence...
May 16, 2014: World Journal of Gastrointestinal Endoscopy
Valter Perilli, Paola Aceto, Teresa Sacco, Nunzia Martella, Maria Teresa Cazzato, Liliana Sollazzi
BACKGROUND: The use of suction catheter (SC) has been shown to improve success rate during ProSeal laryngeal mask airway (PLMA) insertion in expert users. AIMS: The aim of this study was to compare insertion of PLMA performed by untrained physicians using a SC or the digital technique (DT) in anaesthetised non-paralysed patients. METHODS: In this prospective randomised double-blind study, conducted in the operating setting, 254 patients (American Society of Anaesthesiologists I-II, aged 18-65 years), undergoing minor surgery were enrolled...
January 2014: Indian Journal of Anaesthesia
Abdul Rabb Bhutto, Amanullah Abbasi, Nazish Butt, Azizullah Khan, Syed Mohammed Munir
OBJECTIVE: To determine the correlation of hepatic venous waveform changes with severity of hepatic dysfunction and grading of oesophageal varices. METHODS: A cross-sectional analytical study was conducted at Jinnah Postgraduate Medical Centre, Karachi, Medical Unit-III, Ward-7 from January 2009 to December 2009. Cirrhotic patients with portal hypertension were included in study. Patients presented with acute variceal bleeding, previous treatment with beta blockers or nitrates, sclerotherapy endoscopic band ligation, portal vein thrombosis, severe clotting defects, hepatic encephalopathy grade III or IV and noncirrhotic portal hypertension; were excluded from the study...
August 2012: JPMA. the Journal of the Pakistan Medical Association
Iván Mosca, Regina Ligorría, Francisco Tufare, Augusto Villaverde, Fernando Baldoni, Horacio Martínez, Néstor Chopita
OBJECTIVE: To evaluate the success of the treatment with cyanoacrylate in primary hemostasis, rebleeding, and gastric varices eradication. MATERIAL AND METHODS: In this retrospective study 65 patients with gastric varices treated with N-butyl-2-cyanoacrylate (Histoacryl) were included from January 1999 to January 2008. We used a solution of 0,5 mL of cyanoacrylate and 0.9 mL of lipiodol, utilizing an average of 3.46 mL of this mixture per session (range 1 to 6 mL)...
March 2012: Acta Gastroenterologica Latinoamericana
Antonio Pesce, Roberto Scilletta, Angela Branca, Luciano Nigro, Arturo Montineri, Licia Larocca, Filippo Fatuzzo, Marine Castaing, Stefano Puleo
OBJECTIVES: Portal hypertension has been reported as a negative prognostic factor and a relative contraindication for liver resection. This study considers a possible role of fibrosis evaluation by transient elastography (FibroScan(®)) and its correlation with portal hypertension in patients with cirrhosis, and discusses the use of this technique in planning therapeutic options in patients with hepatocellular carcinoma (HCC). METHODS: A total of 77 patients with cirrhosis, 42 (54...
June 2012: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
V N Shipovskiĭ, M Sh Tsitsiashvili, A M Saakian, D V Monakhov, Ch Khuan, A I Nechaev
The authors share their experience with transjugular intrahepatic portosystemic shunt (TIPS) procedures preformed in a total of fifty-nine patients diagnosed with and hence operated on for class B and C hepatocirrhosis (according to the Child-Turcotte-Pugh classification), portal hypertension, grade 3 varicosely dilated oesophageal veins, or ascites. Of these, there were 12 women and 47 men (average age 56.3 years). Three types of stents were used: matrix stents (PERICO), self-expanding (ZA-stents, OptiMedsinus-SuperFlex- Visualstents, Zilverstents, SMART), and coated self-expanding stents (Gore Viatorr TIPS Endoprosthesis)...
2010: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Luigi Addario, Giovanni Tritto, Enrico Cavaglià, Francesco Amodio, Eduardo Giannelli, Giovan Giuseppe Di Costanzo
BACKGROUND: Extrahepatic metastases represent a major obstacle for further improving prognosis of hepatocellular carcinoma. AIM: To assess clinical predictors of extrahepatic metastases in a large cohort followed in a single centre. METHODS: We evaluated clinical files of 520 consecutive patients with hepatocellular carcinoma admitted from 1994 to 2002 to our Liver Unit. The following risk factors were assessed: age, gender, hepatitis viruses, alcohol, diabetes, size, number and differentiation of hepatocellular carcinoma, percutaneous biopsy, portal thrombosis, alpha-fetoprotein, Child-Pugh, Cancer Liver Italian Program and Model for End-stage Liver Disease scores, Barcelona Clinic Liver Cancer classification, varices, hepatocellular carcinoma treatment...
April 2011: Digestive and Liver Disease
M Mazen Jamal, Jason B Samarasena, Mehrtash Hashemzadeh
BACKGROUND: To date, no study has analyzed nationwide trends of in-hospital mortality related to oesophageal variceal hemorrhage in the USA. The aim of this study was to analyze trends of in-hospital mortality related to oesophageal variceal bleeding over the past two decades using a large national database. In addition, our aim was to study patient demographics and to identify risk factors for in-hospital mortality based on administrative data routinely collected in this population. METHODS: The nationwide inpatient sample database was used from 1988 to 2004...
October 2008: European Journal of Gastroenterology & Hepatology
Tadeusz Wróblewski, Olgierd Rowiński, Jerzy Zurakowski, Bogna Ziarkiewicz-Wróblewska, Krzysztof Zieniewicz, Paweł Nyckowski, Marek Krawczyk
BACKGROUND: TIPS, as non-operative treatment of portal hypertension allows for safe awaiting liver transplantation for patients otherwise at high risk of hemorrhage from oesophageal varices veins. When endoscopic treatment fails, TIPS is a plausible and less hazardous alternative for surgical porto-systemic shunts. It is of particular importance in patients with liver failure and unacceptable operative risk (group C in Child-Pugh classification). MATERIAL/METHODS: TIPS was done in 96 patients aged 16-68 years (average 52 years)...
2008: Annals of Transplantation: Quarterly of the Polish Transplantation Society
M A Madwar, M K Shaker, M A Atta, T H El Khashaab, M K Mohamed
A prospective study was conducted on liver disease patients without previous history of bleeding (haematemesis and/or melena) to identify those at highest risk of bleeding. A hundred and twenty non-alcoholic patients (96 males and 24 females), ages ranging from 30 to 60 years were studied. Patients were followed for up to two years or to time of bleeding (mean 18 +/- 7.3 months), during which 34 (28.3%) patients bled. Schistosomal patients showed less incidence of bleeding (12.1%, p < 0.05) than those with mixed aetiology (Schistosoma and cirrhosis 23...
1997: Journal of the Egyptian Public Health Association
J Golánová, L Hrdlicka, J St'ovícek, J Lochmanová, M Tyburec, J Drábek, R Keil
INTRODUCTION: Acute upper gastrointestinal tract bleeding is a cause of significant morbidity and mortality and is a reason for urgent endoscopy. Besides an age and associated diseases, prognosis of patients influence also localisation and type of bleeding. The aim of our retrospective analysis was to discover causes of bleeding into upper GI tract and its characteristics over a 4 year period. METHODOLOGY: A survey of urgent upper GI tract endoscopies in the Clinic of Internal Medicine in Motol in Prague because of an acute GI tract bleeding (hematemesis or melena) was done...
April 2004: Vnitr̆ní Lékar̆ství
K J Paquet
Portal hypertension is a common clinical syndrome with chronic liver diseases and is characterised by a pathological increase in portal pressure. Moreover, portal hypertension is associated with increased portal blood flow. Increased vascular resistance in portal hypertension is because of an increase in both intrahepatic and portosystemic collateral resistance. Chronic elevations in systemic and splanchnic blood flow have been documented as key elements of hyperdynamic circulatory state of hypertensive animals and humans...
September 2000: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
K J Paquet, H A Gad, A Lazar, P Koussouris, M A Mercado, W D Heine, V Jachman-Jahn, W Ruppert
OBJECTIVE: To review our policy of screening patients at risk of developing hepatocellular carcinoma (HCC), and to present 10 years' experience of hepatic resection for small HCC (< 5 cm). DESIGN: Retrospective study. SETTING: Teaching hospital, Germany. SUBJECTS: 861 patients with hepatic cirrhosis and oesophageal varices of whom 151 (18%) had HCC confirmed histologically; 30 of these tumours (20%) were less than 5 cm in diameter and suitable for resection...
July 1998: European Journal of Surgery, Acta Chirurgica
C H Kao, S C Tsai, S J Wang, G H Chen
Thirty-seven patients aged 36-75 years with cirrhosis of the liver secondary to chronic hepatitis were included in the study. They were divided into three groups according to the modified Child's classification for cirrhotic severity, where A = good, B = fair and C = poor. In addition, the patients were divided according to the presence or absence of each of the following: ascites, splenomegaly and oesophageal varices. Radionuclide-labelled solid meals were used to evaluate gastric emptying and the 14C-urea breath test was used to detect Helicobacter pylori infection...
October 1996: Nuclear Medicine Communications
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