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https://www.readbyqxmd.com/read/29684966/-nutritional-assessment-and-management-for-patients-with-chronic-liver-disease
#1
REVIEW
Tae Hee Lee
When liver disease is severe, the prognosis can be worse if the patient is malnourished. Adequate nutritional support for patients with liver diseases can improve the patient's condition and prognosis. In the case of liver cirrhosis, malnutrition can occur due to a variety of causes, including poor oral intake, maldigestion, malabsorption, associated renal disease, and metabolic abnormalities. For a nutritional assessment, it is important to check the dietary intake, change in body composition, including anthropometry, and a functional assessment of muscle...
April 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29675358/persistence-of-gastric-or-esophageal-varices-on-final-angiography-increases-transjugular-intrahepatic-portosystemic-shunt-revision-rate-after-polytetrafluoroethylene-covered-stent-shunt-creation
#2
Benjamin Moulin, Olivier Chevallier, Gilles Abdulmalak, Maxime Luu, Marianne Latournerie, Anne Minello, Sophie Gehin, Jean-Pierre Cercueil, Marco Midulla, Romaric Loffroy
Background: To assess the association between final polytetrafluoroethylene (PTFE)-covered stent transjugular intrahepatic portosystemic shunt (TIPS) angiographic parameters and free shunt revision survey. Methods: Series of two comparison groups were generated with persistence of varices or not, the 25th , 50th , and 75th percentile as cutoff for each angle and a 15-mm distance as cutoff for distance D. Kaplan Meier free shunt revision curves were then created and compared with Log Rank test...
March 2018: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/29672296/predictive-factors-of-portal-hypertensive-enteropathy-exacerbation-in-patients-with-liver-cirrhosis-a-capsule-endoscopy-study
#3
Sayoko Kunihara, Shiro Oka, Shinji Tanaka, Ichiro Otani, Atsushi Igawa, Yuko Nagaoki, Hiroshi Aikata, Kazuaki Chayama
BACKGROUND/AIMS: The clinical course and exacerbation of portal hypertensive enteropathy (PHE) are yet to be fully clarified. This study aimed to identify factors related to PHE exacerbation in patients with liver cirrhosis (LC). METHODS: Fifty patients with LC (33 male; mean age, 67 years), who underwent capsule endoscopy (CE) at the Hiroshima University Hospital between February 2009 and September 2015, were followed up for >6 months. Exacerbation is defined as the appearance of new lesions or worsening of existing lesions...
April 19, 2018: Digestion
https://www.readbyqxmd.com/read/29670387/systemic-inflammatory-response-syndrome-and-model-for-end-stage-liver-disease-score-accurately-predict-the-in-hospital-mortality-of-black-african-patients-with-decompensated-cirrhosis-at-initial-hospitalization-a-retrospective-cohort-study
#4
Alassan Kouamé Mahassadi, Justine Laure Konang Nguieguia, Henriette Ya Kissi, Anthony Afum-Adjei Awuah, Aboubacar Demba Bangoura, Stanislas Adjeka Doffou, Alain Koffi Attia
Background: Systemic inflammatory response syndrome (SIRS) and model for end-stage liver disease (MELD) predict short-term mortality in patients with cirrhosis. Prediction of mortality at initial hospitalization is unknown in black African patients with decompensated cirrhosis. Aim: This study aimed to look at the role of MELD score and SIRS as the predictors of morbidity and mortality at initial hospitalization. Patients and methods: In this retrospective cohort study, we enrolled 159 patients with cirrhosis (median age: 49 years, 70...
2018: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29658768/idiopathic-portal-hypertension-with-regard-to-thiopurine-treatment
#5
Salvador Machlab, Mireia Miquel, Mercedes Vergara
Idiopathic portal hypertension (IPH) is an infrequent adverse reaction to the use of thiopurines that tends to be overlooked. Herein, we present a patient with ileocolic Crohn's disease treated with azathioprine who presented ascites, esophageal varices and splenomegaly without any signs of liver cirrhosis. A portal hemodynamics study revealed a normal portosystemic gradient compatible with presinusoidal portal hypertension. Finally, IPH was diagnosed after a liver biopsy. IPH secondary to thiopurines is due to a 6-thioguanine nucleotide (6-TGN)-dependent reaction and occurs predominantly between three months and three years after the start of treatment...
April 16, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29629057/etiology-of-gastrointestinal-bleeding-in-children-referred-to-pediatric-wards-of-mashhad-hospitals-iran
#6
Seyed Ali Jafari, Mohammad Ali Kiani, Hamid Reza Kianifar, Mohammad Mansooripour, Elahe Heidari, Maryam Khalesi
Background: Gastrointestinal (GI) bleeding, which has several clinical manifestation and origins, is known as one of the most life-threatening events in children. Several etiologies have been suggested for GI bleeding. Objective: To determine the most important causes of GI bleeding in children referred to Ghaem Hospital and Dr. Sheikh Hospital, Mashhad, Iran. Methods: In this cross-sectional study, after obtaining written informed consent of their parents, 113 patients aging from newborn infants to 18-year-old children with GI bleeding admitted to Ghaem Hospital and Dr...
February 2018: Electronic Physician
https://www.readbyqxmd.com/read/29622386/long-term-outcome-of-transjugular-intrahepatic-portosystemic-shunt-for-portal-hypertension-in-autosomal-recessive-polycystic-kidney-disease
#7
Sarah Verbeeck, Djalila Mekhali, David Cassiman, Geert Maleux, Peter Witters
BACKGROUND: Autosomal recessive polycystic kidney disease (ARPKD) with congenital hepatic fibrosis (CHF) causes portal hypertension and its complications. A transjugular intrahepatic portosystemic shunt (TIPSS) could serve as a symptomatic treatment for portal hypertension-related symptoms in these children. AIMS: To study the effect of TIPSS on portal hypertension, liver and kidney function and the long term complications. MATERIALS AND METHODS: We report on 5 children with CHF treated with a TIPSS to manage severe portal hypertension related symptoms...
March 15, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29605778/cirrhosis-following-single-anastomosis-duodeno-ileal-switch-a-case-report
#8
Vincent Kirkpatrick, Rena C Moon, Andre F Teixeira, Muhammad A Jawad
INTRODUCTION: Single anastomosis duodeno-ileal switch (SADI-S) involves a single, loop duodeno-ileal anastomosis with omission of the traditional Roux-en-Y distal ileo-ileal anastomosis. Not much has been published on the complications of SADI-S. PRESENTATION OF CASE: The patient is a 40 year-old male who underwent robot-assisted SADI-S three years prior. At the time of surgery, his body mass index (BMI) was 69 kg/m2 . His BMI was 31 kg/m2 at the time of presentation...
March 17, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29601652/comparison-of-clinical-outcomes-between-variceal-and-non-variceal-gastrointestinal-bleeding-in-patients-with-cirrhosis
#9
Parul Tandon, Kirles Bishay, Stacey Fisher, Dominique Yelle, Ian Carrigan, Krista Wooller, Erin Kelly
BACKGROUND AND AIM: Acute upper gastrointestinal bleeding (UGIB) in cirrhosis is associated with significant morbidity and mortality and can be classified as acute variceal bleeding (AVB) or non-variceal bleeding (NVB). Differences in mortality, hospital length of stay (LOS) and 30-day readmission have yet to be determined. As such, we aimed to evaluate differences in these clinical outcomes in cirrhotic patients admitted with UGIB. METHODS: This retrospective study included all cirrhotic patients hospitalized for UGIB who underwent upper endoscopy from July 2014 to July 2016...
March 30, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29594199/hemospray-for-recurrent-esophageal-band-ulcer-bleeding
#10
Uday A Sanglodkar, Dinesh Jothimani, Mohamed Rela
Rebleeding after initially successful endoscopic variceal ligation (EVL) occurs in 20-60% of patients, most commonly from band ulcers, and is associated with 20-50% mortality. Although band ulcer bleeding has been treated in a number of different ways, no single therapeutic intervention has shown a clear benefit. Hemospray (Cook Medical, Winston-Salem, North Carolina, USA) is a relatively new non-contact hemostatic modality used in the management of bleeding peptic ulcers. It is a nano-powder that can be sprayed over a larger mucosal area...
March 2018: Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29575962/inhospital-and-delayed-mortality-after-upper-gastrointestinal-bleeding-an-analysis-of-risk-factors-in-a-prospective-series
#11
Rita Jiménez-Rosales, Francisco Valverde-López, Francisco Vadillo-Calles, Juan Gabriel Martínez-Cara, Mercedes López de Hierro, Eduardo Redondo-Cerezo
BACKGROUND: Detailed analyses of mortality after upper gastrointestinal (GI) bleeding are lacking. Follow-up rarely extends beyond 30 days. AIMS: Our aim was to analyze in-hospital and delayed 6-months mortality, identifying risk factors. METHODS: This was a prospective study on patients with upper GI bleeding over 36 months. Clinical outcomes were in-hospital and delayed-6 month-mortality. RESULTS: Four hundred and forty-none patients were included...
March 26, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29560669/ectopic-variceal-bleeding-due-to-portosystemic-shunt-via-dilated-mesenteric-veins-and-a-varicous-left-ovarian-vein-case-report-and-literature-review-of-ectopic-varices
#12
REVIEW
Mathieu Struyve, Geert Robaeys
Ectopic varices are dilated portosystemic venous collaterals located outside of the gastro-esophageal region. Whereas they are common endoscopic findings in patients with portal hypertension, ectopic variceal bleeding is rather rare and accounts for only 1 to 5 % of all variceal bleedings. The rectum and the duodenum are the most common sites for ectopic varices, but they can be present along the whole intestinal tract and neighborhood. At present, there is no consensus well established on diagnostic workup for ectopic variceal bleeding and their therapeutic strategies...
July 2017: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/29560646/esophageal-lesions-detected-during-small-bowel-capsule-endoscopy-incidence-diagnostic-and-therapeutic-impact
#13
J F Juanmartiñena Fernández, I Fernández-Urién Sainz, C Saldaña Dueñas, A Elosua González, M Montañés Guimera, B Zabalza Ollo, S Pardo González, J J Vila Costas
BACKGROUND: Nowadays, capsule endoscopy is the first-line procedure for the visualization of the small bowel. Although it was primarily designed with this goal, it may also identify other segments of the gastrointestinal tract. The aim of the current study is to evaluate the incidence of esophageal abnormalities detected in patients undergoing small bowel capsule endoscopy and its impact on patient management. PATIENTS AND METHODS: This study is a retrospective analysis of data from 2217 consecutive capsule endoscopy procedures performed at a single tertiary-care centre between January 2008 and February 2016...
October 2017: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/29551741/screening-and-surveillance-of-varices-in-patients-with-cirrhosis
#14
Sofia Simona Jakab, Guadalupe Garcia-Tsao
Gastro-esophageal varices (GEV) and variceal hemorrhage (VH) are clinical milestones in the natural history of cirrhosis, as they are closely related to the severity of portal hypertension and define specific stages in disease progression. Variceal hemorrhage is a life-threatening complication of cirrhosis and is one of the clinical complications that defines cirrhosis decompensation. The goal of screening and surveillance of varices is to identify patients with GEV at a high risk of bleeding, so that prevention strategies can be implemented...
March 15, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29546610/surgical-treatment-for-rebleeding-caused-by-bypass-failure-after-rex-shunt-re-rex-shunt-or-warren-shunt
#15
Jin-Shan Zhang, Long Li, Wei Cheng
PURPOSE: Although Rex shunt is an effective treatment for extrahepatic portal venous obstruction (EHPVO), 4-20% children develop rebleeding postoperatively. This study was used to evaluate the surgical treatment of rebleeding after Rex shunt in our center. METHOD: From June 2008 to Jan 2017, 12 of 122 children with EHPVO underwent a second operation due to graft stenosis and occlusion after Rex shunt in our center. The abdominal ultrasound and computed tomography (CT) showed the occlusion of bypass vein in nine children, stenosis of bypass vein in two children, and the patency of bypass vein in one child with dysplasia of intrahepatic portal vein...
March 15, 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29529940/a-novel-technique-for-synchronous-laparoscopic-splenectomy-and-azygoportal-disconnection-with-hepatectomy
#16
Guoqing Jiang, Dousheng Bai, Ping Chen, Jianjun Qian, Shengjie Jin
BACKGROUND: Liver resection was not formerly recommended in patients with both hepatocellular carcinoma (HCC) and portal hypertension because of difficult perioperative bleeding control and postoperative liver failure. Splenectomy is a proven method with which to overcome these problems. To investigate the safety and feasibility of synchronous laparoscopic splenectomy and azygoportal disconnection with hepatectomy (LSDH) for treatment of portal hypertension accompanied with HCC, we describe a clinical cohort of 10 patients who underwent a new technique of synchronous LSDH...
March 1, 2018: Surgical Innovation
https://www.readbyqxmd.com/read/29528017/budd-chiari-syndrome-diagnosed-in-a-patient-listed-for-liver-transplant-and-considered-to-be-contraindicated-for-the-operation
#17
Kakharman Yesmembetov, Zhansaya Muratova, Sergey Borovskiy, Irina Ten, Kulpash Kaliaskarova
We report the clinical case of 23-year-old patient with liver cirrhosis of unknown genesis, significant resistant ascites, and 2 episodes of bleeding from esophageal varices. Evaluation did not find any cause of liver disease, and the patient was placed on the transplant wait list due to subcompensated liver function (Model for End-Stage Liver Disease score of 16, Child-Pugh class B) and poorly controlled severe portal hypertension. After treatment with diuretics, largevolume paracentesis, antibiotics, and vasoconstrictors, hepatorenal syndrome and spontaneous bacterial peritonitis resolved and liver function improved significantly...
March 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29525375/evaluation-and-management-of-gastrointestinal-bleeding
#18
REVIEW
Ronald Samuel, Mohammad Bilal, Obada Tayyem, Praveen Guturu
Non-variceal upper gastrointestinal bleeding continues to be an important cause of morbidity and mortality. The most common causes include peptic ulcer disease, Mallory-Weiss syndrome, erosive gastritis, duodenitis, esophagitis, malignancy, angiodysplasias and Dieulafoy's lesion. Initial assessment and early aggressive resuscitation significantly improves outcomes. Upper gastrointestinal endoscopy continues to be the gold standard for diagnosis and treatment. We present a comprehensive review of literature for the evaluation and management of non-variceal upper gastrointestinal bleeding...
March 7, 2018: Disease-a-month: DM
https://www.readbyqxmd.com/read/29515345/adult-presentation-of-noncirrhotic-portal-hypertension-and-ascites-following-treatment-for-wilms-tumor-in-childhood
#19
Linda Kievit, Pia Kræmer, Stephen Hamilton-Dutoit, Henning Grønbæk
A 37-year-old male, who at the age of 8 years had been treated for right-sided Wilms' tumor with nephrectomy, radiotherapy, and chemotherapy, presented with noncirrhotic portal hypertension (NCPH), grade 2 esophageal varices, and ascites. A CT scan demonstrated hypoplasia of liver segments 2 and 3. A liver biopsy showed portal tract fibrosis without cirrhosis, with histological features of NCPH. Liver vein catheterization showed a normal portal pressure gradient of 5 mm Hg while spleen to hepatic vein pressure was 29 mm Hg...
January 2018: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29513248/sclerotherapy-of-esophageal-varices-in-hemophilia-patients-with-liver-cirrhosis-a-prospective-controlled-clinical-study
#20
Andrzej B Szczepanik, Konrad Pielaciński, Anna M Oses-Szczepanik, Sławomir Huszcza, Andrzej Misiak, Wojciech P Dąbrowski, Sławomir Gajda
INTRODUCTION: Bleeding from esophageal varices is a serious clinical condition in hemophilia patients due to congenital deficiency or lack of clotting factors VIII (in hemophilia A) and IX (in hemophilia B), decreased clotting factor II, VII, IX, X synthesis in the course of chronic liver disease and hipersplenic thrombocytopenia. The aim of this study was to assess the efficacy and safety of endoscopic sclerotherapy in acute esophageal variceal bleeding and in secondary prophylaxis of hemorrhage...
February 28, 2018: Polski Przeglad Chirurgiczny
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