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Esophagus varices

Jan Pfeiffenberger, Karl-Heinz Weiss, Wolfgang Stremmel
Wilson disease leads to symptomatic impairment of liver function or liver cirrhosis. Strict adherence to decoppering agents is essential in these patients. Secondary prevention of additional hepatic damage by avoidance of other toxic substances (e.g., alcohol, drugs) and sufficient calorie intake is recommended. Routine examinations in cirrhotic patients include screening for signs of portal hypertension (esophagus varices), development of ascites, and hepatic encephalopathy. Where varices are present, primary or secondary preventive interventions may include treatment with nonselective beta-blockers or variceal ligation, similar to the approach in patients with liver cirrhosis due to other etiologies...
2017: Handbook of Clinical Neurology
T S Chandrasekar, Gokul Bollu Janakan, Viveksandeep Thoguluva Chandrasekar, Raja Yogesh Kalamegam, Sathiamoorthy Suriyanarayanan, Prasad Menta Sanjeevaraya
BACKGROUND: Bleeding from small intestinal ectopic varices and persistent anemia caused by portal hypertensive enteropathy (PHE) can be very challenging. Capsule endoscopy (CE) is one of the best noninvasive modalities in identifying such lesions. AIM: The aims of this study are to study the prevalence of small-bowel changes related to portal hypertension (PHT) and to correlate them with the observations related to the effects of portal hypertension in the esophagus, stomach, and colon...
January 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Shou-Wu Lee, Han-Chung Lien, Chi-Sen Chang, Teng-Yu Lee, Yen-Chun Peng, Hong-Zen Yeh
BACKGROUND: Metabolic syndrome has been highlighted as a risk factor for several gastrointestinal diseases, including gastroesophageal reflux disease and Barrett's esophagus (BE). The aim of this study was to investigate the association of metabolic syndrome with erosive esophagitis (EE) and BE. METHODS: Data were retrospectively collected from patients who visited the Medical Screening Center at Taichung Veterans General Hospital, Taichung, Taiwan from January 2006 to December 2009...
January 2017: Journal of the Chinese Medical Association: JCMA
Mathieu Duché, Béatrice Ducot, Oanez Ackermann, Florent Guérin, Emmanuel Jacquemin, Olivier Bernard
BACKGROUND & 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...
February 2017: Journal of Hepatology
Dan M Livovsky, Orit Pappo, Galina Skarzhinsky, Asaf Peretz, Elliot Turvall, Zvi Ackerman
BACKGROUND: We recently observed patients with chronic liver disease (CLD) or chronic reflux symptoms (CRS) who developed gastric polyps (GPs) while undergoing surveillance gastroscopies for the detection of esophageal varices or Barrett's esophagus, respectively. OBJECTIVES: To identify risk factors for GP growth and estimate its growth rate. METHODS: GP growth rate was defined as the number of days since the first gastroscopy (without polyps) in the surveillance program, until the gastroscopy when a GP was discovered...
May 2016: Israel Medical Association Journal: IMAJ
M Gurgenidze, N Lomidze, K Chelidze, G Nemsadze, Z Manijashvili
Hypo-agenesis of the right lobe of the liver is an extremely rare finding. It is defined as the complete or partial absence of liver tissue on the right side without previous disease or surgery. It is usually an incidental finding. A 32-year-old female patient came to Emergency Department of TSMU the First University Clinic 22.10.2015 with an initial diagnosis of upper gastrointestinal bleeding. Her medical history showed no previous diseases of the liver or episodes of hemorrhage. Dizziness, nausea, vomiting with red blood, melena was presented on admission...
April 2016: Georgian Medical News
Manish Parikh, Jennifer Liu, Dorice Vieira, Demetrios Tzimas, Daniel Horwitz, Andrew Antony, John K Saunders, Akuezunkpa Ude-Welcome, Adam Goodman
BACKGROUND: There is debate regarding preoperative endoscopy (EGD) in patients undergoing bariatric surgery. Some centers perform EGD routinely in all patients; others perform EGD selectively. The objective of this study was to perform a systematic review and meta-analysis of the existing literature to estimate how frequently preoperative EGD changes management. METHODS: Our review yielded 28 studies encompassing 6616 patients. Baseline characteristics including age and body mass index (BMI) were included...
May 20, 2016: Obesity Surgery
Ze-Hao Zhuang, Ai-Fang Lin, Du-Peng Tang, Jing-Jing Wei, Zheng-Ji Liu, Xiao-Mei Xin, Yu-Feng Pan
OBJECTIVE: To determine the frequency of duodenal ulcer (DU), as well as other clinical characteristics occurring after endoscopic variceal ligation (EVL) of the esophagus. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: The First Affiliated Hospital of Fujian Medical University, Fuzhou, China, from April 2012 to April 2013. METHODOLOGY: A total of 47 patients with esophageal varices (EVr) who had also undergone EVL and gastroscopic follow-up within 3 months of the procedure was retrospectively analyzed...
April 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Lanyan Qiu, Xiaoli Zhang, Dong Liu, Linxue Qian, Xiangdong Hu
The purpose of this study was to clarify the usefulness of contrast-enhanced ultrasonography (CEUS) for the diagnosis of esophageal varices (EVs) in patients with cirrhosis. A total of 81 cases (56 patients with EVs and 25 control subjects without EV) were examined by CEUS and by esophagogastroduodenoscopy. According to the esophagogastroduodenoscopy results, we divided the subjects into 3 groups: G0, G1, and G2. The G0 group had 25 patients who exhibited no liver abnormality other than liver cyst or hemangioma without EVs, G1 comprised 9 patients with small EVs and 13 with medium EVs...
June 2016: Ultrasound Quarterly
Dong Hun Kang, Ji Won Park, Eui Yong Jeon, Sung Eun Kim, Jong Hyeok Kim, Young Seok Kwon, Seung Ah Park, Choong Kee Park
Variceal bleeding occurs primarily in the esophagus or stomach in patients with liver cirrhosis, but can also occur rarely in the duodenum. Duodenal variceal bleeding has a high mortality and poor prognosis due to heavy blood flow originating from the portal vein (PV) and the technical difficulty of hemostatic procedures. Treatments including endoscopic sclerotherapy, endoscopic ligations, endoscopic clipping and transjugular intrahepatic portosystemic shunt have been tried, with only moderate and variable success...
November 2015: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Yue-Ming Zhang, David F Boerwinkel, Xiumin Qin, Shun He, Liyan Xue, Bas L A M Weusten, Sanford M Dawsey, David E Fleischer, Li-Zhou Dou, Yong Liu, Ning Lu, Jacques J G H M Bergman, Gui-Qi Wang
BACKGROUND AND AIM: Piecemeal endoscopic resection for esophageal high grade intraepithelial neoplasia (HGIN) or early squamous cell carcinoma (ESCC) is usually performed by cap-assisted endoscopic resection. This requires submucosal lifting and multiple snares. Multiband mucosectomy (MBM) uses a modified variceal band ligator without submucosal lifting. In high-risk areas where ESCC is common and endoscopic expertise is limited, MBM may be a better technique. We aimed to compare MBM to the cap-assisted technique for piecemeal endoscopic resection of esophageal ESCCs...
April 2016: Endoscopy
Kinesh Changela, Mel A Ona, Sury Anand, Sushil Duddempudi
BACKGROUND: Acute variceal bleeding (AVB) is a life-threatening complication of liver cirrhosis or less commonly splenic vein thrombosis. Pharmacological and endoscopic interventions are cornerstones in the management of variceal bleeding but may fail in 10 - 15 % of patients. Rescue therapy with balloon tamponade (BT) or transjugular intrahepatic portosystemic shunt (TIPS) may be required to control refractory acute variceal bleeding effectively but with some limitations. The self-expanding metal stent (SEMS) is a covered, removable tool that can be deployed in the lower esophagus under endoscopic guidance as a rescue therapy to achieve hemostasis for refractory AVB...
December 2014: Endoscopy International Open
Y-K Tsou, W-Y Chuang, C-Y Liu, K Ohata, C-H Lin, M-S Lee, H-T Cheng, C-T Chiu
There is a significant learning curve for endoscopic submucosal dissection of esophageal neoplasms that has not been fully characterized. This retrospective study included 33 consecutive superficial esophageal neoplasms for analysis of the learning curve for esophageal endoscopic submucosal dissection based on a single, novice endoscopist's experience. The study was divided into three periods (T1, T2, and T3) of 10 endoscopic submucosal dissection procedures in chronological order, with 13 procedures in the last period...
August 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Andrej Wagner, Ulrike W Denzer, Daniel Neureiter, Tobias Kiesslich, Andreas Puespoeck, Erik A J Rauws, Klaus Emmanuel, Nora Degenhardt, Ulrich Frick, Ulrich Beuers, Ansgar W Lohse, Frieder Berr, Gernot W Wolkersdörfer
UNLABELLED: Photodynamic therapy using porfimer (P-PDT) improves palliation and survival in nonresectable hilar bile duct cancer. Tumoricidal penetration depth of temoporfin-PDT (T-PDT) is twice that of P-PDT. In a single-arm phase II study we investigated the safety, efficacy, survival time, and adverse events of T-PDT compared with previous data on P-PDT. Twenty-nine patients (median 71 [range 47-88] years) with nonresectable hilar bile duct cancer were treated with T-PDT (median 1 [range 1-4] sessions) plus stenting and followed up every 3 months...
November 2015: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
A Bisserbe, G Tertian, C Buffet, A Turhan, O Lambotte, G Nasser, P Alvin, M Tardieu, F Riant, F Bergametti, E Tournier-Lasserve, C Denier
Cerebro-retinal microangiopathy with calcifications and cysts (CRMCC) or Coats plus syndrome is a pleiotropic disorder affecting the eyes, brain, bone and gastrointestinal tract. Its primary pathogenesis involves small vessel obliterative microangiopathy. Recently, autosomal recessively inherited mutations in CTC1 have been reported in CRMCC patients. We herein report an adolescent referred to our hospital following new seizures in a context of an undefined multisystem disorder. Cerebral imaging disclosed asymmetrical leukopathy, intracranial calcifications and cysts...
May 2015: Revue Neurologique
Fei-Zhen Xia, Zhe Shen, Hong-Tan Chen, Chao-Hui Yu, Wei-Xing Chen
Endoscopic band ligation for variceal bleeding in cirrhosis has been proved its safety and efficacy. We tried to treat submucosal tumors the gastrointestinal (GI) tract by endoscopic band ligation. The aim of this study was to evaluate the efficacy and safety of endoscopic band ligation in the treatment of submucosal tumors of the GI tract. There are 29 patients (15 men, 14 women, age range: 25-67 years old) with 30 submucosal lesions of the GI tract, including 15 lesions in the esophagus, 14 lesions in the of stomach and 1 lesion in the duodenal bulb...
2015: International Journal of Clinical and Experimental Medicine
Sylvie Sacher-Huvelin, Paul Calès, Christophe Bureau, Dominique Valla, Jean Pierre Vinel, Clotilde Duburque, Alain Attar, Isabelle Archambeaud, Robert Benamouzig, Marianne Gaudric, Dominique Luet, Patrice Couzigou, Lucie Planche, Jean Paul Galmiche, Emmanuel Coron
BACKGROUND AND STUDY AIM: Esophageal video capsule endoscopy (ECE) is a new technique that allows examination of the esophagus using a noninvasive approach. The aim of this study was to compare ECE with esophagogastroduodenoscopy (EGD) for the diagnosis of esophageal varices in patients with cirrhosis. PATIENTS AND METHODS: A total of 330 patients with cirrhosis and with no known esophageal varices were prospectively enrolled. Patients underwent ECE first, followed by EGD (gold standard)...
June 2015: Endoscopy
Laxmi Kokatnur, Mohan Rudrappa
Aorto-esophageal fistula is a rare cause of upper gastrointestinal bleeding. Thoracic aneurysm, the most common cause of this condition, will slowly increase over time and can erode the wall of the aorta creating a fistula and leading to torrential bleeding. High clinical suspicion is required for timely diagnosis as common investigations routinely done for gastrointestinal (GI) bleeding, including esophagogastroduodenoscopy, fails to detect most cases. The classical triad of midthoracic pain, herald bleeding and fatal hematemesis described in this condition is seen in only one-third of cases...
February 2015: Indian Journal of Critical Care Medicine
Bulent Yasar, Evren Abut
'Downhill' varices are located in the proximal part of the esophagus. Their etiology differs from the distal types, with most of them usually being related to superior vena cava obstruction. Although bleeding due to 'downhill' varices is very rare, it can be life-threatening. Here, we present a case of upper gastrointestinal bleeding due to mediastinal fibrosis associated with chest radiotherapy for seminoma metastasis sixteen years previously, which was successfully treated conservatively.
April 2015: Clinical Journal of Gastroenterology
Wen-jing Wang, Yong Tang, Yu Zhang, Qing Chen
This study was aimed to explore prevention and treatment of hemorrhage during laparoscopic splenectomy plus devascularization (LSD) for portal hypertension by modified and simplified operation. From June 2012 to June 2014, LSD was performed on 138 patients with portal hypertension. The patients were allocated into two groups: earlier stage (ES) group, in which 45 patients received traditional LSD from June 2012 to Sep. 2012; later stage (LS) group, in which 93 patients underwent modified LSD from Jan. 2013 to June 2014...
February 2015: Journal of Huazhong University of Science and Technology. Medical Sciences
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