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Non Variceal Bleed

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https://www.readbyqxmd.com/read/30306708/topical-haemostatic-powder-as-a-novel-endoscopic-therapy-for-severe-colonic-diverticular-bleeding
#1
Jia Lin Ng, Musfirah Marican, Ronnie Mathew
BACKGROUND: Although most diverticular bleeding resolve spontaneously, up to 30% can bleed torrentially, necessitating angioembolization, endoscopic or surgical intervention. Non-contact endoscopic therapies, such as topical haemostatic powders, do not require precise targeting and are attractive because identification of specific culprit diverticulum is difficult. While their use in non-variceal upper gastrointestinal bleeding is well established, its role in lower gastrointestinal bleeding remains unclear...
October 10, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/30302039/high-prevalence-of-cirrhosis-at-initial-presentation-among-safety-net-adults-with-chronic-hepatitis-b-virus-infection
#2
Elaine Tang, Sharon Torres, Benny Liu, Rachel Baden, Taft Bhuket, Robert J Wong
Background and aims: Delays in diagnosis of chronic hepatitis B virus infection (HBV) may be more common among underserved safety-net populations, contributing to more advanced disease at presentation. We aim to evaluate rates of and predictors of cirrhosis and cirrhosis-related complications among adults with chronic HBV. Methods: We retrospectively evaluated consecutive chronic HBV adults from gastroenterology clinics from July 2014 to May 2016 at a community-based safety-net hospital...
September 2018: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/30300988/mucosal-changes-in-the-small-intestines-in-portal-hypertension-first-study-using-the-pillcam-sb3-capsule-endoscopy-system
#3
Mahesh Kumar Goenka, Bhavik Bharat Shah, Vijay Kumar Rai, Surabhi Jajodia, Usha Goenka
Background/Aims: To evaluate patients with portal hypertension (PH) of varied etiologies for portal hypertensive enteropathy (PHE) using the PillCam SB3 capsule endoscopy (CE) system. Methods: Consecutive patients with PH presenting with unexplained anemia and/or occult gastrointestinal bleeding were evaluated using the PillCam SB3 CE system. Abnormal findings were categorized as vascular or non-vascular. The patients with ongoing bleeding caused by PHE were treated...
October 5, 2018: Clinical Endoscopy
https://www.readbyqxmd.com/read/30291716/peptic-ulcer-is-the-most-common-cause-of-non-variceal-upper-gastrointestinal-bleeding-nvugib-in-china
#4
Mingliang Lu, Gang Sun, Xiao-Mei Zhang, You-Qing Xv, Shi-Yao Chen, Ying Song, Xue-Liang Li, Bin Lv, Jian-Lin Ren, Xue-Qing Chen, Hui Zhang, Chen Mo, Yan-Zhi Wang, Yun-Sheng Yang
BACKGROUND This study aimed to discover the common cause of non-variceal upper-gastrointestinal bleeding (NVUGIB) by conducting a multi-center retrospective study from 2008 to 2012. MATERIAL AND METHODS Hospitalized patients ages ≥18 years old, from 8 hospitals in China, diagnosed with NVUGIB by endoscopy from 1 January 2008 to 31 December 2012 were enrolled. Questionnaires were developed and a data-entry graphical user interface was designed by using EpiData software. RESULTS Total of 2977 hospitalized patients from 8 medical centers were included...
October 6, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/30288282/terlipressin-for-variceal-bleeding-induces-large-plasma-sodium-fluctuations-in-patients-without-cirrhosis
#5
Peter Lykke Eriksen, Anne Luise Hartkopf-Mikkelsen, Peter Ott, Hendrik Vilstrup, Niels Kristian Aagaard
Background: Terlipressin is used as pharmacological treatment for variceal bleeding. The drug's physiological effect favours hyponatremia, and rapid changes in plasma sodium (PNa) may cause brain injury. Cirrhosis patients seem to be largely protected against this effect but patients without cirrhosis may not be so. Objective: The objective of this study was to examine whether terlipressin treatment of patients without cirrhosis leads to more serious fluctuations in PNa than in cirrhosis...
October 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/30280108/endoscopic-doppler-probe-in-the-diagnosis-and-management-of-upper-gastrointestinal-hemorrhage
#6
Sagarika Satyavada, Perica Davitkov, Meer Akbar Ali, Gregory Cooper, Richard C K Wong, Amitabh Chak
Through-the-scope (TTS) endoscopic Doppler ultrasound probe technology is a tool that has garnered interest for the evaluation of variceal and non-variceal bleeding. In previous studies, this technology has been proposed as a more objective method of identifying the bleeding subsurface blood vessel in peptic ulcer hemorrhage. We describe 3 cases where the use of an endoscopic Doppler probe guided the diagnosis and management of upper gastrointestinal (GI) hemorrhage due to causes other than peptic ulcer disease...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/30269128/colposcopy-in-evaluating-bleeding-during-the-second-and-third-trimesters-short-term-and-postpartum-implications
#7
Maya Frank Wolf, Reut Elon, Dunia Hassan, Doron Zarfati, Benjamin Diker, Oleg Shnaider, Jacob Bornstein
BACKGROUND: The etiology of vaginal bleeding during pregnancy may be obstetric or non-obstetric. Though colposcopy is generally not part of the routine evaluation of 2nd- or 3rd-trimester vaginal bleeding without obvious obstetrical cause, our department does perform colposcopy and cervical cytology testing in these patients. This study assessed the need and possible contribution of colposcopy in diagnosing the etiology of 2nd- and 3rd-trimester bleeding. METHODS: Retrospective analysis of colposcopy findings from 2012-2015 in patients with 2nd- or 3rd-trimester bleeding where an obstetrical cause was not found...
September 28, 2018: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/30265706/branched-chain-amino-acid-transaminase-1-bcat1-is-overexpressed-and-hypomethylated-in-patients-with-non-alcoholic-fatty-liver-disease-who-experience-adverse-clinical-events-a-pilot-study
#8
Kara Wegermann, Ricardo Henao, Anna Mae Diehl, Susan K Murphy, Manal F Abdelmalek, Cynthia A Moylan
BACKGROUND AND OBJECTIVES: Although the burden of non-alcoholic fatty liver disease (NAFLD) continues to increase worldwide, genetic factors predicting progression to cirrhosis and decompensation in NAFLD remain poorly understood. We sought to determine whether gene expression profiling was associated with clinical decompensation and death in patients with NAFLD, and to assess whether altered DNA methylation contributes to these changes in gene expression. METHODS: We performed a retrospective analysis of 86 patients in the Duke NAFLD Clinical Database and Biorepository with biopsy-proven NAFLD whose liver tissue was previously evaluated for gene expression and DNA methylation using array based technologies...
2018: PloS One
https://www.readbyqxmd.com/read/30259158/eus-guided-fine-needle-injection-is-superior-to-direct-endoscopic-injection-of-2-octyl-cyanoacrylate-for-the-treatment-of-gastric-variceal-bleeding
#9
Benjamin L Bick, Mohammad Al-Haddad, Suthat Liangpunsakul, Marwan S Ghabril, John M DeWitt
BACKGROUND: Endoscopic injection of cyanoacrylate into gastric varices may be performed by EUS-guided fine needle injection (EUS-FNI) or direct endoscopic injection (DEI). The aim of this study is to compare the rate of recurrent GV bleeding and adverse events between DEI and EUS-FNI for treatment of GV. METHODS: In a single-center study, a retrospective cohort of patients with actively/recently bleeding or high-risk GV treated with DEI were compared with a prospective cohort of similar patients treated with EUS-FNI...
September 26, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/30249560/safety-and-effectiveness-of-midazolam-for-cirrhotic-patients-undergoing-endoscopic-variceal-ligation
#10
Hee Bum Jo, Jun Kyu Lee, Dong Kee Jang, Hyoun Woo Kang, Jae Hak Kim, Yun Jeong Lim, Moon-Soo Koh, Jin Ho Lee
BACKGROUND/AIMS: Endoscopic variceal ligation (EVL) is an established treatment for esophageal variceal bleeding. Midazolam (MDZ) is most commonly used for sedation during endoscopic procedures. However, adverse events (AEs) may occur more frequently in patients with cirrhosis due to altered MDZ metabolism. MATERIALS AND METHODS: We retrospectively reviewed the records of 325 patients with cirrhosis who received EVL. RESULTS: No significant differences were found in treatment outcome and procedure time among 151 patients in the MDZ group and 169 patients in the non-MDZ group...
July 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/30234702/transient-elastography-measurements-of-spleen-stiffness-as-a-predictor-of-clinically-significant-varices-in-children
#11
Harry Sutton, Emer Fitzpatrick, Mark Davenport, Charlotte Burford, Emma Alexander, Anil Dhawan, Tassos Grammatikopoulos
OBJECTIVES: Investigate the use of spleen stiffness measurements (SSMs), measured by transient elastography (TE), for the prediction of clinically significant varices (CSV) in children with portal hypertension. METHODS: This observational cohort study included children selected for endoscopy, as per department protocol, between September 2015 and June 2016. Those included underwent single TE FibroScan for liver stiffness measurements and SSM. Clinical and laboratory data were collected and variceal prediction scores were calculated at time of elastography...
October 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/30229463/what-is-the-best-endoscopic-strategy-in-acute-non-variceal-gastrointestinal-bleeding
#12
REVIEW
Livio Cipolletta, Fabio Cipolletta, Antonino Granata, Dario Ligresti, Luca Barresi, Ilaria Tarantino, Mario Traina
OPINION STATEMENT: PURPOSE OF REVIEW: Upper non-variceal gastrointestinal bleeding (UNVGIB) remains an important clinical challenge for endoscopists, requiring skill and expertise for correct management. In this paper, we suggest the best strategy for an effective treatment of this complex category of patients. RECENT FINDINGS: Early endoscopic examination, the increasingly widespread use of endoscopic hemostasis methods, and the most powerful antisecretory agents that induce clot stabilization have radically modified the clinical scenario for treating this pathology...
September 18, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/30218583/validation-of-risk-score-in-predicting-early-readmissions-in-decompensated-cirrhotic-patients-a-model-based-on-the-administrative-database
#13
Khalid Mumtaz, Abdulfatah Issak, Kyle Porter, Sean Kelly, James Hanje, Anthony J Michaels, Lanla F Conteh, Ashraf El-Hinnawi, Sylvester M Black, Marwan S Abougergi
INTRODUCTION: The early readmission in patients with decompensated liver cirrhosis leads to enormous burden on healthcare utilization. METHODS: Retrospective cohort study using the 2013 and 2014 Nationwide Readmission Database (NRD) was conducted. Patients with diagnoses of cirrhosis and at least one feature of decompensation were included. The primary outcome was to develop a validated risk model for early readmission. Secondary outcomes were to study 30-day all cause-readmission rate and most common reasons for readmission...
September 15, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/30216560/presumptive-non-cirrhotic-bleeding-esophageal-varices-in-a-dog
#14
Marc Myers, Peter V Scrivani, Kenneth W Simpson
An 8-year-old male American Staffordshire terrier was admitted for evaluation of chronic episodes of ptyalism and hematemesis after exercise. Abnormalities were not detected on routine clinicopathological tests, thoracic radiography, and abdominal ultrasonography. Endoscopic examination revealed a labyrinthine network of severely distended, hemorrhagic esophageal blood vessels. Computed tomography angiography demonstrated a network of para-esophageal vessels that communicated with the celiac artery caudally and the brachiocephalic trunk cranially, consistent with a diagnosis of non-cirrhotic esophageal varices...
September 2018: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/30212817/treatment-of-oesophageal-varices-in-liver-cirrhosis
#15
Tilman Sauerbruch, Florence Wong
BACKGROUND: The development of cirrhosis with resultant portal hypertension can lead to oesophageal varices at a rate of 7% per annum. Bleeding from varices happens when the portal pressure is ≥12 mm Hg and can threaten life. SUMMARY: Eliminating the aetiology of cirrhosis is a pivotal step to prevent the formation of varices. In patients with established varices, primary prophylaxis with non-selective beta blockers (NSBB) may slow down the progression of varices and prevent the first variceal bleed...
September 13, 2018: Digestion
https://www.readbyqxmd.com/read/30211218/liver-retraction-using-n-butyl-2-cyanoacrylate-nbca-glue-during-laparoscopic-splenectomy-and-azygoportal-disconnection-in-cirrhotic-patients
#16
Du Kong, Wei Wang, Gang Du, Binyao Shi, Zhengchen Jiang, Bin Jin
Background: Although liver retraction using n-butyl-2-cyanoacrylate (NBCA) glue has been applied to laparoscopic upper abdominal surgery in noncirrhotic patients, there is still no consensus on its safety and feasibility for cirrhotic patients. In this study, we aimed to investigate the safety and effectiveness of liver retraction using NBCA glue during laparoscopic splenectomy and azygoportal disconnection (LSD) for gastroesophageal varices and hypersplenism secondary to liver cirrhosis and portal hypertension...
2018: BioMed Research International
https://www.readbyqxmd.com/read/30209605/impaired-activity-of-daily-living-is-a-risk-factor-for-high-medical-cost-in-patients-of-non-variceal-upper-gastrointestinal-bleeding
#17
Yusaku Takatori, Motohiko Kato, Yukie Sunata, Yuichiro Hirai, Yoko Kubosawa, Keichiro Abe, Yoshiaki Takada, Tetsu Hirata, Shigeo Banno, Michiko Wada, Satoshi Kinoshita, Hideki Mori, Kaoru Takabayashi, Miho Kikuchi, Masahiro Kikuchi, Masayuki Suzuki, Toshio Uraoka
BACKGROUND: Non-variceal upper gastrointestinal bleeding (NVUGIB) is still a common and life-threatening disease, thus it would have a big impact on medical care cost. However, little is known about risk factors for increased medical care cost in NVUGIB patients. AIM: The purpose of the study was to clarify predictor of requiring high medical care cost in NVUGIB patients. Patients who underwent endoscopic hemostasis due to NVUGIB between April 2012 and March 2015 were included in this retrospective study...
September 12, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/30178093/non-invasive-aspartate-aminotransferase-to-platelet-ratio-index-correlates-well-with-invasive-hepatic-venous-pressure-gradient-in-cirrhosis
#18
Vijendra Kirnake, Anil Arora, Praveen Sharma, Mohan Goyal, Romesh Chawlani, Jay Toshniwal, Ashish Kumar
BACKGROUND: Hepatic venous pressure gradient (HVPG) is the best recommended tool to measure portal pressure, but is invasive. HVPG helps in prognosticating cirrhosis and predict its complications. Aminotransferase to platelet ratio index (APRI) is a simple non-invasive marker of hepatic fibrosis. We aimed to correlate APRI with HVPG and to determine the usefulness of APRI in predicting complication of cirrhosis. METHODS: APRI and HVPG were measured in consecutive patients of cirrhosis aged 18 to 70 years...
July 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/30145561/low-fibrinogen-levels-are-associated-with-bleeding-after-varices-ligation-in-thrombocytopenic-cirrhotic-patients
#19
Edoardo G Giannini, Elisa Giambruno, Mattteo Brunacci, Maria Corina Plaz Torres, Manuele Furnari, Giorgia Bodini, Patrizia Zentilin, Vincenzo Savarino
INTRODUCTION AND AIM: EVBL is a procedure frequently performed in cirrhotic patients for primary prophylaxis of bleeding. Patients with cirrhosis display various degrees of alteration of common coagulation parameters, and it is not known whether these alterations may predict post-EVBL bleeding. To evaluate factors predictive of post-endoscopic variceal band ligation (EVBL) bleeding in cirrhotic patients with thrombocytopenia. METHODS: We included 109 patients with cirrhosis undergoing EVBL for primary prophylaxis of variceal bleeding...
June 5, 2018: Annals of Hepatology
https://www.readbyqxmd.com/read/30144580/the-role-of-metallic-clips-in-transcatheter-intravascular-embolization-for-non-variceal-upper-gastrointestinal-bleeding-cases-receiving-unmanageable-endoscopic-therapy-a-retrospective-cohort-study
#20
Yang Wang, Peng Jia
INTRODUCTION: This study aims to explore whether metallic clips could be a kind of localizer and guider in transcatheter arterial embolization for patients with non-variceal upper gastrointestinal bleeding, who received an unmanageable endoscopic therapy. METHODS: A total of 18 patients with non-variceal hemorrhage of the upper gastrointestinal tract, who received an unmanageable endoscopic therapy at *** Hospital of **** Province from July 2010 to December 2016, were included into this study...
October 2018: International Journal of Surgery
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