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Esophageal varices

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https://www.readbyqxmd.com/read/28515596/balloon-occluded-retrograde-transvenous-obliteration-for-bleeding-gastric-varices-eyes-see-what-the-mind-knows
#1
Pushpinder S Khera, Lee Myungsu, Choi Joonsung
Approximately one in six patients with portal hypertension who develop varices at sites of portosystemic venous collaterals has gastric varices due to hepatofugal flow into the gastric veins. Bleeding from gastric varices, though less common, has a higher mortality and morbidity compared to bleeding esophageal varices, which are easier to manage endoscopically. The efferent channel for gastric varices is mostly the gastrorenal shunt (GRS) which opens into the left renal vein. Balloon-occluded transvenous obliteration (BRTO) involves accessing the GRS with an aim to temporarily occlude its outflow using a balloon catheter and at the same time injecting sclerosant mixture within the varix so as to cause its thrombosis and thereby obliteration...
January 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28503308/portal-hypertension-as-the-initial-manifestation-of-poems-syndrome-a-case-report
#2
Lina Wu, Yue Li, Fang Yao, Chongmei Lu, Jian Li, Weixun Zhou, Jiaming Qian
BACKGROUND: Portal hypertension has a broad differential diagnosis. POEMS syndrome is an uncommon cause of it. POEMS syndrome is a rare disease involving multiple organs. In differential diagnosis of portal hypertension, POEMS syndrome should be considered especially when other symptoms such as numbness, organomegaly, endocrine alteration and skin changes also present, as it is highlighted by our case. CASE PRESENTATION: We report a 46-year-old Chinese male, a teacher, presenting with portal hypertension...
2017: BMC Hematology
https://www.readbyqxmd.com/read/28501536/multicenter-external-validation-of-risk-stratification-criteria-for-patients-with-variceal-bleeding
#3
Irene Conejo, Maria Anna Guardascione, Puneeta Tandon, Alba Cachero, Josep Castellote, Juan G Abraldes, Lucio Amitrano, Joan Genescà, Salvador Augustin
BACKGROUND & AIMS: Early placement of a transjugular intrahepatic porto-systemic shunts (TIPS) is considered the treatment of choice for patients with acute variceal bleeding (AVB) and cirrhosis who have a high risk of death (Child-Pugh class B with active bleeding at endoscopy or Child-Pugh class C). It has been proposed that patients of Child-Pugh class B, even with active bleeding, should not be considered high risk. Alternative criteria have been proposed for identification of high-risk patients, such as Child-Pugh class C with plasma level of creatinine of 1 mg/dl or more (ChildC-C1) and a model for end-stage liver disease (MELD) score of 19 or more...
May 10, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28500570/narrow-band-imaging-can-increase-the-visibility-of-fibrin-caps-after-bleeding-of-esophageal-varices-a-case-with-extensive-esophageal-candidiasis
#4
Yoshihiro Furuichi, Yoshitaka Kasai, Hirohito Takeuchi, Yuu Yoshimasu, Takashi Kawai, Katsutoshi Sugimoto, Yoshiyuki Kobayashi, Ikuo Nakamura, Takao Itoi
A 58-year-old man with hepatitis B cirrhosis noticed black stools and underwent an endoscopy at a community hospital. The presence of esophageal varices (EVs) was confirmed, but the bleeding point was not found. He was referred to our institution and underwent a second endoscopy. Extensive white patches of esophageal candidiasis were visible on endoscopy by white-light imaging (WLI), but it was difficult to find the fibrin cap of the EVs. This was easier under narrow-band imaging (NBI), however, as the color turned red from absorption by hemoglobin adhered to it...
May 12, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28496092/usefulness-of-contrast-enhanced-ultrasonography-for-predicting-esophageal-varices-in-patients-with-hepatitis-b-virus-hbv-related-cirrhosis
#5
Jun Li, Jin-Chun Feng, Xin-Yu Peng, Xiang-Wei Wu, Ting-Ting Du, Jia-Jia Wang, Shu-Xin Tian, Gui-Lin Lu
BACKGROUND The aim of this study was to investigate the usefulness of contrast-enhanced ultrasonography (CEUS) in predicting of esophageal varices (EV) and assessing high-risk EV in patients with hepatitis B virus (HBV)-related cirrhosis. MATERIAL AND METHODS Patients with HBV-related cirrhosis who had undergone endoscopy were prospectively recruited. Hepatic dynamic CEUS was performed. Regions of interest (ROI) were drawn on the hepatic artery, hepatic vein, portal vein, and liver parenchyma to measure the corresponding features, such as arrival times...
May 12, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28494001/partial-spleen-embolization-reduces-the-risk-of-portal-hypertension-induced-upper-gastrointestinal-bleeding-in-patients-not-eligible-for-tips-implantation
#6
Matthias Buechter, Alisan Kahraman, Paul Manka, Guido Gerken, Alexander Dechêne, Ali Canbay, Axel Wetter, Lale Umutlu, Jens M Theysohn
INTRODUCTION: Upper gastrointestinal bleeding (UGIB) is a severe and life-threatening complication among patients with portal hypertension (PH). Covered transjugular intrahepatic portosystemic shunt (TIPS) is the treatment of choice for patients with refractory or recurrent UGIB despite pharmacological and endoscopic therapy. In some patients, TIPS implantation is not possible due to co-morbidity or vascular disorders. Spleen embolization (SE) may be a promising alternative in this setting...
2017: PloS One
https://www.readbyqxmd.com/read/28492370/non-invasive-diagnosis-of-esophageal-varices-after-baveno-vi
#7
REVIEW
Carlos Moctezuma Velázquez, Juan G Abraldes
A major complication of portal hypertension in patients with cirrhosis is the development of esophageal varices with the associated risk of variceal bleeding. Hence, the Baveno consensus on portal hypertension in its first five editions had recommended surveillance with periodic upper endoscopies in these patients to identify in a timely fashion the development of esophageal varices and initiate a primary prophylaxis strategy in those at a high risk of bleeding. For the first time, the Sixth Baveno Consensus on Portal Hypertension (Baveno VI) recommended using non-invasive tools to rule out the presence of varices with a high risk of bleeding...
May 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28491877/nodular-regenerative-hyperplasia-a-case-of-rare-prognosis
#8
Mindy Lee, Manhal Izzy, Ashwin Akki, Kathryn Tanaka, Harmit Kalia
Introduction: Nodular regenerative hyperplasia (NRH) is a known etiology of noncirrhotic portal hypertension. Cases of biopsy-proven NRH in human immunodeficiency virus (HIV)-positive patients have been described. While these patients often have normal synthetic liver function, several reports described disease progression to liver failure. Case: We here present a 26-year-old woman with history of congenital HIV on antiretroviral therapy complicated by Pneumocystis carinii pneumonia at age 14. CD4 counts have been >300 with undetectable viral load...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28489830/-clinical-and-laboratory-characteristics-of-patients-with-pulmonary-hypertension-and-pulmonary-vascular-complications-hospitalized-at-the-instituto-nacional-de-salud-del-ni%C3%A3-o
#9
Alexis Jose Ormeño Julca, Carlos Melchor Alvarez Murillo, Pedro Miguel Amoretti Alvino, Angel Aladino Florian Florian, Rosa Aurora Castro Johanson, Maria Danisa Celi Perez, Olga Rocío Huamán Prado
The hepatopulmonary syndrome (HPS) and portopulmonary hypertension (PPHN) are distinct pulmonary vascular complications of portal hypertension (PHT) and are associated with increased morbidity and mortality. OBJECTIVES: To describe the clinical and laboratory characteristics of patients with pulmonary hypertension and pulmonary vascular complications hospitalized at the Instituto Nacional de Salud del Niño. MATERIALS AND METHODS: We included patients with HTP hospitalized from January 2012 to June 2013 and that during its evolution progressed with SHP or HTPP...
January 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28489785/effect-of-psoas-muscle-mass-after-endoscopic-therapy-for-patients-with-esophageal-varices
#10
Hiroki Nishikawa, Yukihisa Yuri, Hirayuki Enomoto, Akio Ishii, Yoshinori Iwata, Yuho Miyamoto, Noriko Ishii, Kunihiro Hasegawa, Chikage Nakano, Takashi Nishimura, Kazunori Yoh, Nobuhiro Aizawa, Yoshiyuki Sakai, Naoto Ikeda, Tomoyuki Takashima, Ryo Takata, Hiroko Iijima, Shuhei Nishiguchi
We aimed to investigate the impact of decrease of muscle mass on survival after eradication of esophageal varices (EVs) treated by endoscopic therapies as a primary prophylaxis in patients with liver cirrhosis (LC). In all, 177 LC individuals with EVs undergoing endoscopic therapies were analyzed. We retrospectively examined the impact of muscle mass decrease as determined by psoas muscle mass (PMM) at the third lumber on computed tomography (depletion of PMM [DPMM]) on survival as compared with serum sodium combined Model for End-stage Liver Disease (MELD-Na)...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28487619/one-step-minilaparotomy-assisted-transmesenteric-portal-vein-recanalization-combined-with-transjugular-intrahepatic-portosystemic-shunt-placement-a-novel-surgical-proposal-in-pediatrics
#11
Gloria Pelizzo, Pietro Quaretti, Lorenzo Paolo Moramarco, Riccardo Corti, Marcello Maestri, Giulio Iacob, Valeria Calcaterra
Transjugular intrahepatic portosystemic shunt (TIPS) placement is a standard procedure for the treatment of portal hypertension complications. When this conventional approach is not feasible, alternative procedures for systemic diversion of portal blood have been proposed. A one-step interventional approach, combining minilaparotomy-assisted transmesenteric (MAT) antegrade portal recanalization and TIPS, is described in an adolescent with recurrent esophageal varice bleeding and portal cavernoma (PC). A 16-year-old girl was admitted to our Unit because of repeated bleeding episodes over a short period of time due to esophageal varices in the context of a PC...
April 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28483304/short-term-safety-and-efficacy-of-balloon-occluded-retrograde-transvenous-obliteration-using-ethanolamine-oleate-results-of-a-prospective-multicenter-single-arm-trial
#12
Masao Kobayakawa, Shigehiro Kokubu, Shozo Hirota, Jun Koizumi, Norifumi Nishida, Taku Yasumoto, Satoshi Mochida, Hisashi Hidaka, Noriko Tanaka, Tsuyoshi Tajima
PURPOSE: To evaluate 90-day outcomes after balloon-occluded retrograde transvenous obliteration (BRTO) with ethanolamine oleate (EO) in patients with gastric varices (GVs). MATERIALS AND METHODS: An 8-site prospective single-arm clinical trial was conducted. Patients who had endoscopically confirmed GVs with a gastrorenal shunt were eligible for the study. Overnight BRTO was performed, and efficacy was evaluated by endoscopy and contrast-enhanced computed tomography (CT)...
May 5, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28482406/-a-prognostic-analysis-of-cirrhotic-esophageal-variceal-bleeding-treated-with-standardized-endoscopic-therapy
#13
Y P Dai, Q Gao
Objective: To analyze the clinical effect of standardized endoscopic esophageal variceal ligation alone or in combination with tissue adhesive injection for gastric varices (GV) after the first cirrhotic esophageal variceal bleeding. Methods: A total of 97 patients who underwent a successful endoscopic therapy in our hospital due to the first cirrhotic esophageal variceal bleeding were enrolled, and according to the subsequent therapeutic regimen, they were divided into control group (48 patients) and treatment group (49 patients)...
March 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28480856/comparative-study-of-fib-4-index-and-transient-elastography-among-patients-with-chronic-hepatitis-c-virus-infection-in-georgia
#14
E Dolmazashvili, M Karchava, A Abutidze, L Sharvadze, T Tsertsvadze
Liver biopsy remains the reference standard for fibrosis staging. However, it has several limitations, which have led to the development of non-invasive methods. We evaluated liver fibrosis severity among HCV infected patients by comparing transient elastography (TE) and FIB-4 index. Retrospective study was conducted. Clinical data for 750 patients were obtained. The mean age of the study population was 51 years; 595 (79.3%) were male and 155 (20.7%) were female. TE and tests on biological samples were performed within one-week timeframe...
March 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28468020/novel-approaches-to-reducing-the-risk-of-variceal-hemorrhage
#15
Frederik Nevens
BACKGROUND: Complications of advanced liver disease occur at the moment of clinical significant portal hypertension. Nitric oxide (NO) dysfunction and fibrosis play an important role in the pathophysiology of PH, but other mechanisms are also involved. Non-selective beta blockers (NSBB) stay the cornerstone in the primary and secondary prevention of variceal bleeding, but their safety in advanced cirrhosis has been recently debated and new drugs are under investigation. Transjugular intrahepatic portosystemic shunt and balloon tamponade are the standard therapy in case of refractory variceal bleeding, but both interventions have drawbacks...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/28467587/beh%C3%A3-et-s-disease-related-superior-vena-cava-syndrome-and-bleeding-downhill-varices-a-rare-complication
#16
Bülent Yaşar, Gamze Kılıçoğlu
Obstruction of the superior vena cava (SVC) due to any cause results in development of venous collaterals in the upper part of the esophagus, known as "downhill" varices. Although rare, bleeding can be life-threatening. Presently described is case of Behçet's diseaserelated SVC occlusion in a patient who presented with gastrointestinal bleeding from upper esophageal varices.
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28463673/cholecystolithotomy-combined-armillarisin-a-versus-cholecystectomy-in-cirrhotic-portal-hypertension-patients-with-symptomatic-cholelithiasis
#17
Yang Fei, Wei-Qin Li, Guang-Quan Zong, Jian Chen, Wei Wang
OBJECT: To discover whether cirrhotic portal hypertension patients with symptomatic cholelithiasis would benefit from cholecystolithotomy combined with Armillarisin A in the authors hospital. Methods: Sixty-one patients with cirrhotic portal hypertension and symptomatic gallstone disease who underwent either cholecystolithotomy combined with Armillarisin A (group A) or cholecystectomy (group B) for cholelithiasis from Feb 2007 to March 2011 were retrospectively reviewed. These patients were undergoing simultaneous procedure for esophageal varices...
March 2017: Chirurgia
https://www.readbyqxmd.com/read/28461093/over-the-scope-clip-in-the-management-of-fibrotic-esophageal-variceal-bleeding-with-video
#18
Carlos Robles-Medranda, Miguel Puga-Tejada, Jesenia Ospina, Manuel Valero, Hannah Pitanga Lukashok
No abstract text is available yet for this article.
April 28, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28460805/outcomes-in-variceal-hemorrhage-following-the-use-of-a-balloon-tamponade-device
#19
Jonathan Nadler, Nikola Stankovic, Amy Uber, Mathias J Holmberg, Leon D Sanchez, Richard E Wolfe, Maureen Chase, Michael W Donnino, Michael N Cocchi
BACKGROUND: Variceal hemorrhage is associated with high morbidity and mortality. A balloon tamponade device (BTD), such as the Sengstaken-Blakemore or Minnesota tube, may be used in cases of variceal hemorrhage. While these devices may be effective at controlling acute bleeding, the effect on patient outcomes remains less clear. We sought to describe the number of patients with variceal hemorrhage and a BTD who survive to discharge, survive to one-year, and develop complications related to a BTD...
April 20, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28445299/endoscopic-ultrasonography-predicts-early-esophageal-variceal-bleeding-in-liver-cirrhosis-a-case-report
#20
Changjun Men, Guoliang Zhang
RATIONALE: Bleeding esophageal and gastric varices constitute a serious complication in liver cirrhosis. Previous studies have shown that endoscopic ultrasonography (EUS) can be used to predict early esophageal variceal bleeding in liver cirrhosis. PATIENT CONCERNS: We report a case of a 46-year-old man with hepatitis B liver cirrhosis (CTP score, 5; Child-Pugh class, A) who was admitted to our hospital due to a decreased appetite lasting 1 week. DIAGNOSIS: He was initially diagnosed with decompensated hepatitis B cirrhosis; an abdominal computed tomography (CT) scan indicated a diagnosis of liver cirrhosis and portal hypertension (PHT)...
April 2017: Medicine (Baltimore)
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