keyword
https://read.qxmd.com/read/37385550/eus-guided-treatment-of-bleeding-peristomal-varices-with%C3%A2-video
#21
JOURNAL ARTICLE
Yara Sarkis, Howard Masuoka, Marwan Ghabril, Aditya Gutta, Mohammad A Al-Haddad, John M DeWitt
BACKGROUND AND AIMS: The use of EUS for peristomal varices (PV) is limited to case reports. METHODS: Patients who underwent EUS-guided treatment of PV with cyanoacrylate (CYA) and/or coils between April 2013 and December 2019 were identified. All patients had failed previous therapies or had comorbidities precluding other options. Endoscopic technique, adverse events (AEs), recurrent bleeding, and repeat interventions were assessed. RESULTS: Twenty patients (12 men; median age, 62 years [interquartile range {IQR}, 54...
November 2023: Gastrointestinal Endoscopy
https://read.qxmd.com/read/37361444/ectopic-cecal-varices-as-a-cause-of-lower-gastrointestinal-bleeding
#22
Abdulrahman Qatomah, Sulaiman Almushir, Faisal Aljohani
Ectopic varices account for 1%-5% of all variceal bleeding episodes in patients with portal hypertension. They can be found at any part of gastrointestinal tract including the small intestines, colon, or rectum. We report a case of a 59-year-old man who presented with bleeding per rectum 2 days after a routine colonoscopy, in which 2 lesions were biopsied. Gastroscopy was negative for bleeding, and he was not stable enough to undergo colonoscopy. CT angiography showed a large portosystemic shunt with multiple collaterals in the right lower quadrant...
2023: Case Reports in Gastrointestinal Medicine
https://read.qxmd.com/read/37314140/ectopic-variceal-bleeding-secondary-to-porto-sinusoidal-vascular-disease
#23
JOURNAL ARTICLE
Ángela Antón RodrÍguez, Ángela María Puente Sánchez, José Ignacio Fortea, Aitor Odriozola Herrán, Víctor José Echavarría Rodríguez, Sara Alonso Fernández, Elena Montano Lumbreras
Porto-sinusoidal vascular disease (PSVD) is an uncommon cause of portal hypertension (PHT) characterized by typical manifestations of PHT in the absence of an identifiable cause such as cirrhosis or splenoportal thrombosis (1). There are different etiological factors, including oxaliplatin (2). We present the case of a 67-year-old male with a history of locally advanced rectal cancer in 2007 treated with chemotherapy (capecitabine, folinic acid, 5-fluorouracil and oxaliplatin), radiotherapy and surgery with a definitive colostomy...
June 14, 2023: Revista Española de Enfermedades Digestivas
https://read.qxmd.com/read/37256735/incidental-detection-of-ectopic-ovary-varices-by-99mtc-red-blood-cell-bleeding-scintigraphy-in-a-patient-with-cirrhosis
#24
JOURNAL ARTICLE
Xia Lu, Lijuan Feng, Wei Wang, Jigang Yang
A 72-year-old woman with cirrhosis underwent a 99mTc-labeled red blood cell (RBC) bleeding scan because of recurrent gastrointestinal bleeding. The images showed abnormal 99mTc-RBC accumulation in a mass in the region of the left ovary. Contrast-enhanced CT showed expansion of left ovary vein from the left renal vein, which twisted into an enhanced round mass in the left ovary area. Finally, a diagnosis of ectopic ovary varices was made, which is secondary to cirrhosis with portal hypertension. Ovary varices should be included as differential diagnoses of 99mTc-RBC bleeding scintigraphy...
May 29, 2023: Clinical Nuclear Medicine
https://read.qxmd.com/read/37162434/aga-clinical-practice-update-on-interventional-eus-for-vascular-investigation-and-therapy-commentary
#25
Marvin Ryou, John M DeWitt, Koushik K Das, Vanessa M Shami
DESCRIPTION: The purpose of this AGA Institute Clinical Practice Update is to review the available evidence supporting and examine opportunities for future research in endoscopic ultrasound-guided vascular investigation and therapies. METHODS: This Clinical Practice Update was commissioned and approved by the AGA Institute Clinical Practice Updates Committee and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership, and underwent internal peer review by the Clinical Practice Updates Committee and external peer review through standard procedures of Clinical Gastroenterology and Hepatology...
July 2023: Clinical Gastroenterology and Hepatology
https://read.qxmd.com/read/37109397/the-role-of-the-transjugular-intrahepatic-porto-systemic-shunt-in-an-emergency-setting
#26
REVIEW
Alessandro Posa, Lorenzo Tenore, Pierluigi Barbieri, Giulia Mazza, Evis Sala, Roberto Iezzi
Transjugular intrahepatic porto-systemic shunt (TIPSS) is an interventional radiology procedure whose aim is to create artificial communication between the portal and the hepatic blood flow in order to reduce the pressure gradient in portal hypertension. The indications to perform a TIPSS procedure can be framed in an elective or emergency setting: refractory ascites to diuretic therapy and secondary prophylaxis of variceal hemorrhage are the most frequent reasons for executing a TIPSS in an election context, while acute uncontrolled variceal bleeding is the principal indication that a TIPSS needs to be performed in an emergency setting...
March 24, 2023: Life
https://read.qxmd.com/read/37034972/aluminum-phosphate-gel-reduces-early-rebleeding-in-cirrhotic-patients-with-gastric-variceal-bleeding-treated-with-histoacryl-injection-therapy
#27
JOURNAL ARTICLE
Hao-Tian Zeng, Zhu-Liang Zhang, Xi-Min Lin, Min-Si Peng, Li-Sheng Wang, Zheng-Lei Xu
BACKGROUND: Esophageal-gastro varices bleeding (EGVB) is the most widely known cause of mortality in individuals with cirrhosis, with an occurrence rate of 5% to 15%. Among them, gastric varices bleeding (GVB) is less frequent than esophageal varices bleeding (EVB), but the former is a more critical illness and has a higher mortality rate. At present, endoscopic variceal histoacryl injection therapy (EVHT) is safe and effective, and it has been recommended by relevant guidelines as the primary method for the treatment of GVB...
March 16, 2023: World Journal of Gastrointestinal Endoscopy
https://read.qxmd.com/read/36976877/balloon-occluded-retrograde-transvenous-obliteration-for-treatment-of-portal-hypertensive-related-varices
#28
JOURNAL ARTICLE
Gianna Stoleru, Zachary Henry
PURPOSE OF REVIEW: Balloon-occluded retrograde transvenous obliteration (BRTO) is becoming a more commonly used procedure to manage various complications of liver disease. It is important to understand the technique of the procedure, the indications for its use, and also potential associated complications. RECENT FINDINGS: BRTO is superior to endoscopic cyanoacrylate injection and transjugular intrahepatic portosystemic shunt for bleeding gastric varices associated with a portosystemic shunt and should be considered a first line therapy in these patients...
March 2, 2023: Current Opinion in Gastroenterology
https://read.qxmd.com/read/36842632/a-case-of-peri-stomal-ectopic-variceal-bleeding-in-a-patient-with-decompensated-cirrhosis-treated-with-tips-placement
#29
JOURNAL ARTICLE
Giulia Iannone, Enrico Pompili, Matteo Renzulli, Paolo Caraceni
Peri-stomal variceal bleeding is an underestimated complication in patients with colostomy and portal hypertension. Due to the small number of reported cases, there is currently no unified consensus on the best treatment and several options may be available. We report a case in which TIPS placement was effective. A 59-year old male with alcohol-induced cirrhosis complicated by ascites, hepatic encephalopathy and low-risk esophageal varices (MELD-Na 15, Child-Pugh C11) was referred to us in 09/19. Thereafter, his conditions greatly improved with alcohol abstinence and medical treatment...
February 24, 2023: Clinics and Research in Hepatology and Gastroenterology
https://read.qxmd.com/read/36705374/large-intramural-hematoma-of-the-esophagus-after-endoscopic-injection-sclerotherapy-a-case-report
#30
JOURNAL ARTICLE
Bo Wu, Xincheng Xie, Xiao Li, Qun Zhu, Chunhua Zhou
RATIONALE: Endoscopic injection sclerotherapy (EIS) is a common treatment for patients with liver cirrhosis and esophageal varices. It can effectively treat variceal rupture and bleeding caused by liver cirrhosis. However, EIS has many complications, including postoperative bleeding, retrosternal pain, esophageal ulcers, esophageal stenosis, and ectopic embolism. Intramural hematoma of the esophagus (IHE) is a rare complication of EIS that can lead to chest tightness, chest pain, and dysphagia...
January 27, 2023: Medicine (Baltimore)
https://read.qxmd.com/read/36660056/an-obscure-cause-of-gastrointestinal-bleeding-recurrent-duodenal-variceal-hemorrhage-treated-with-intramuscular-octreotide-in-the-absence-of-portal-hypertension
#31
Robert S O'Neill, William J Wang, Patrick Chan, Vincent Ho, Christine Verdon, Ian Turner, Priya Acharya
Duodenal varices (DVs) are ectopic gastrointestinal varices (ECVs) associated with portal hypertension (PH). We present the case of an 82-year-old woman who presented with symptomatic anemia secondary to DV hemorrhage diagnosed on oesophagogastroduodenoscopy. This lesion was treated with endoscopic adrenaline injection and clip application. The patient re-presented on multiple occasions with bleeding recurrence localized to the duodenum, which was managed with intramuscular octreotide and oral beta-blockade resulting in sustained remission of bleeding...
January 2023: JGH Open: An Open Access Journal of Gastroenterology and Hepatology
https://read.qxmd.com/read/36592728/a-rare-cause-of-gastrointestinal-bleeding-after-pancreaticoduodenectomy
#32
JOURNAL ARTICLE
Peter D Block, James J Farrell, Darrick K Li
No abstract text is available yet for this article.
December 30, 2022: Gastroenterology
https://read.qxmd.com/read/36582761/percutaneous-transsplenic-venous-embolization-of-elevated-jejunal-varices-after-pancreaticoduodenectomy-a-case-report
#33
Nobuyuki Higashino, Nobuyuki Kawai, Tetsuo Sonomura, Kodai Fukuda, Hirotatsu Sato, Akira Ikoma, Manabu Kawai, Hiroki Minamiguchi
Recent advances in chemotherapy and radiotherapy have led to an increase in the number of long-term survivors of pancreatic cancer. However, this has also increased the number of patients suffering from ectopic varices and bleeding owing to left-sided portal hypertension and thrombocytopenia caused by splenomegaly after pancreaticoduodenectomy combined with resection of the splenic vein. A 65-year-old woman with varices of the elevated jejunum due to left sided portal hypertension after pancreaticoduodenectomy had repeated melena, which started about 1 year before admission...
March 2023: Radiology Case Reports
https://read.qxmd.com/read/36510864/eus-guided-coil-placement-and-cyanoacrylate-glue-injection-for-gastric-variceal-bleeding-with-obvious-spontaneous-portosystemic-shunts
#34
JOURNAL ARTICLE
Li Tang, Xu Li, Jun Cui, Liu-Ye Huang
BACKGROUND AND OBJECTIVE: Ectopic embolism caused by cyanoacrylate glue for the treatment of gastric varices with obvious spontaneous portosystemic shunts is a serious complication of endoscopic therapy. This study was performed to investigate the safety and therapeutic effect of EUS-guided coil placement and cyanoacrylate glue injection for gastric varices with obvious spontaneous portosystemic shunts. MATERIALS AND METHODS: Six patients with gastric variceal bleeding and obvious spontaneous portosystemic shunts were included in this study...
November 30, 2022: Endoscopic Ultrasound
https://read.qxmd.com/read/36250174/managing-gastric-varices
#35
JOURNAL ARTICLE
Deema Sallout, Eric Tatro, Douglas G Adler
Gastric varices (GV) are a type of ectopic varix, which is a natural portosystemic shunt occurring in response to an increase in intrahepatic vascular resistance, mostly commonly from portal hypertension. GV are present in up to 20% of patients with portal hypertension. Although oesophageal varices are more common than GV, and oesophageal variceal bleeding (EVB) happens more often than gastric variceal bleeding (GVB), GVB tends to be more severe, to have higher associated hospital costs, length of stay, higher rebleeding rates and have higher mortality...
2022: Frontline Gastroenterology
https://read.qxmd.com/read/36247382/ectopic-vaginal-varices-with-hemorrhage-after-hysterectomy
#36
John K Smith, Manjushree Gautam, Phillip G Wortley, Hussien Elsiesy, Stevan A Gonzalez
Vaginal and uterine varices are well documented in pregnancy, although development of vaginal varices in patients with portal hypertension occurs in an exceptionally rare subset. Only 12 cases are reported in the literature; all but 3 of these cases involved patients with a history of hysterectomy, with 1 of the remaining 2 exhibiting partial obliteration of the uterine plexus due to radiation therapy for cervical cancer. We present a case of recurrent vaginal variceal bleeding in a patient with a history of hysterectomy, initially managed with vaginal tamponade and ultimately requiring definitive treatment with transjugular intrahepatic portosystemic shunt insertion...
October 2022: ACG Case Reports Journal
https://read.qxmd.com/read/36043231/a-case-of-spontaneous-hemothorax-with-a-ruptured-variceal-phrenic-vein
#37
Juhyun Lee, Sung Kwang Lee, Jinhong Wi, Yoo Sang Yoon, Il-Yong Han, Yang Haeng Lee
Spontaneous hemothorax is rare, with limited data available on its etiology and treatment. We report a case of massive spontaneous hemothorax with a ruptured variceal phrenic vein during pregnancy, likely a complication of the Kasai procedure. Despite closed thoracostomy, the patient's symptoms and imaging findings did not improve. Emergent open thoracotomy and bleeding control were performed.
August 31, 2022: Journal of chest surgery
https://read.qxmd.com/read/35978714/role-of-endoscopic-ultrasound-in-vascular-interventions-where-are-we-now
#38
REVIEW
Alessandro Fugazza, Kareem Khalaf, Matteo Colombo, Silvia Carrara, Marco Spadaccini, Glenn Koleth, Edoardo Troncone, Roberta Maselli, Alessandro Repici, Andrea Anderloni
From a mere diagnostic tool to an imperative treatment modality, endoscopic ultrasound (EUS) has evolved and revolutionized safer efficient options for vascular interventions. Currently it is an alternative treatment option in the management of gastrointestinal bleeding, primarily variceal type bleeding. Conventional treatment option prior to EUS incorporation had limited efficiency and high adverse events. The characterization and detail provided by EUS gives a cutting edge towards a holistically successful management choice...
June 16, 2022: World Journal of Gastrointestinal Endoscopy
https://read.qxmd.com/read/35920230/-ectopic-duodenal-varices-as-a-cause-of-difficult-diagnosis-of-bleeding-in-extrahepatic-portal-hypertension
#39
JOURNAL ARTICLE
S B Zhigalova, A G Shertsinger, G V Manukyan, S L Malov, A R Afzalutdinova, Ya S Bobyleva, T S Dolgikh
Bleeding from ectopic varicose veins is a rare life-threatening cause of upper gastrointestinal hemorrhage. Alberti first described duodenal varices in 1931. According to the literature, incidence of duodenal varicose veins in patients with portal hypertension is 1-3% of all varicose veins. Bleeding from duodenal varices makes up 17% of all bleedings from other ectopic varices. Mortality in these patients may be up to 40%. The causes are delayed diagnosis, technical difficulties in endoscopic therapeutic procedures (sclerotherapy, endoscopic ligation), as well as ineffective Blackmore tube for hemorrhage in distal stomach and bowel...
2022: Khirurgiia
https://read.qxmd.com/read/35905227/isolated-sigmoid-varicose-vein-rupture-and-hemorrhage-a-case-report
#40
JOURNAL ARTICLE
Weiwei Li, Jianli Wang, Hua Fu, Jinlong Liu
RATIONALE: Ectopic varices are the collateral circulation of portal vein located anywhere in the gastrointestinal tract other than the esophageal and gastric regions. Rupture of these varices often results in life-threatening hemorrhage. Management guidelines for ectopic variceal bleeds are not yet standardized because cases are rare and treatment approaches described in the literature vary considerably. PATIENT CONCERNS: A 53-year-old woman with a 20-year history of chronic hepatitis C cirrhosis came to our hospital for treatment due to intermittent black stools for 4 days...
July 29, 2022: Medicine (Baltimore)
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