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Esophageal variceal bleeding treatment

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https://www.readbyqxmd.com/read/29773783/cholesteryl-ester-storage-disease-fatal-outcome-without-causal-therapy-in-a-female-patient-with-the-preventable-sequelae-of-progressive-liver-disease-after-many-years-of-mild-symptoms
#1
Ali Canbay, Meike N Müller, Stathis Philippou, Guido Gerken, Andreas Tromm
BACKGROUND Cholesteryl ester storage disease (CESD), also known as lysosomal acid lipase deficiency (LAL-D), is a rare autosomal-recessive inheritable lysosomal storage disease. Since 2015, a causal treatment with sebelipase alfa, which replaces the missing LAL enzyme, has been approved. We report a fatal course of LAL-D in a female patient. CASE REPORT In 1979, CESD was first diagnosed in a 13-year-old female with marked hepatomegaly. At that time, no specific treatment for CESD was available and the spontaneous course of the disease had to be awaited...
May 18, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29739920/a-rare-case-of-complete-esophageal-obstruction-following-esophageal-variceal-band-ligation-evbl-for-esophageal-varices-performed-by-esophagogastroduodenoscopy-egd
#2
Muhammad Aziz, Beth Floyd, Tuba Esfandyari
BACKGROUND Esophageal variceal band ligation (EVBL) performed by esophagogastroduodenoscopy (EGD) is a routinely performed procedure for the treatment of esophageal varices that is undertaken to control bleeding and prevent further complications. This report is of a case of a rare complication of complete esophageal obstruction following EVBL. CASE REPORT A 69-year-old woman underwent EVBL for esophageal varices. She subsequently presented with complete obstruction of the esophageal lumen with ulceration, which was seen on repeat EGD...
May 9, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29696582/a-case-of-colonic-varices-complicated-by-alcoholic-cirrhosis-treated-using-balloon-occluded-retrograde-transvenous-obliteration
#3
Keisuke Matsumoto, Yukinori Imai, Masashi Takano, Manabu Nakazawa, Satsuki Ando, Kayoko Sugawara, Nobuaki Nakayama, Tomoaki Tomiya, Satoshi Mochida
A 44-year-old man with cirrhosis arising from alcohol abuse manifested melena caused by the rupture of esophageal varices. He received endoscopic variceal ligation for the initial hemostasis, followed by endoscopic injection sclerotherapy as an additional consolidation therapy. A CT examination performed at the time of admission revealed collateral veins developing around the ascending colon, in which the feeding and draining vessels were identified as the superior mesenteric vein and the right testicular vein, respectively...
April 25, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29546610/surgical-treatment-for-rebleeding-caused-by-bypass-failure-after-rex-shunt-re-rex-shunt-or-warren-shunt
#4
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...
May 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29529940/a-novel-technique-for-synchronous-laparoscopic-splenectomy-and-azygoportal-disconnection-with-hepatectomy
#5
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...
June 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
#6
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
#7
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/29505477/transparent-cap-assisted-endoscopic-sclerotherapy-in-esophageal-varices-a-randomized-controlled-trial
#8
Lili Ma, Xiaoquan Huang, Jingjing Lian, Jian Wang, Shiyao Chen
BACKGROUND AND AIM: Endoscopic treatment is widely accepted as the first-line therapy selection for esophageal variceal bleeding. Nevertheless, endoscopic injection sclerotherapy requires experienced endoscopists and is associated with a high risk of bleeding. Our study evaluates the feasibility and efficacy of transparent cap-assisted endoscopic sclerotherapy in the management of esophageal varices. PATIENTS AND METHODS: A randomized-controlled trial was conducted in a tertiary referral center from April 2015 to May 2016...
June 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29473522/an-evidence-based-review-of-off-label-uses-of-polidocanol
#9
Seyyed Reza Sadat Ebrahimi, Elgar Enamzadeh, Hossein Babaei
BACKGROUND: Polidocanol is approved for its competence in the treatment of varicose veins and spider veins; however, unfortunately, many of its off-label uses are still underappreciated. OBJECTIVE: Lack of an appropriate comprehensive review for off-label uses of this medication troubles physicians about making evidence-based decisions on prescribing it for its various outstanding off-label uses. This article attempts to provide physicians with the latest information concerning successful and unsuccessful use of polidocanol as an alternative treatment for esophageal and gastric varices, tendinopathy and epicondylitis, vascular malformations, varicocele, hydrocele and spermatocele, aneurysmal bone cysts, itching, management of gastrointestinal bleeding, simple renal cysts, reducing the incidence and severity of radio-induced dermatitis and hemorrhoids...
2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/29469530/-percutaneous-transsplenic-varices-embolization-in-treatment-of-upper-gastrointestinal-hemorrhage-of-schistosomiasis-cirrhosis
#10
Ji Chang-Xue, Li Ying, Ju Shuai, Qiang Jin-Wei
OBJECTIVE: To evaluate the application value of percutaneous transsplenic varices embolization (PTSVE) in the treatment of upper gastrointestinal hemorrhage in patients with schistosomiasis cirrhosis. METHODS: Sixteen schistosomiasis cirrhosis patients (12 males and 4 females) with portal hypertension complicated with esophageal and upper gastrointestinal hemorrhage were selected as the investigation subjects, all the patients had been treated by esophageal vein ligation and sclerotherapy, but with bleeding again post-operation...
March 27, 2017: Zhongguo Xue Xi Chong Bing Fang Zhi za Zhi, Chinese Journal of Schistosomiasis Control
https://www.readbyqxmd.com/read/29451181/the-use-of-nonselective-beta-blockers-is-a-risk-factor-for-portal-vein-thrombosis-in-cirrhotic-patients
#11
Rosa Zampino, Rita Lebano, Nicola Coppola, Margherita Macera, Anna Grandone, Luca Rinaldi, Ilario De Sio, Antonella Tufano, Gianfranca Stornaiuolo, Luigi E Adinolfi, Emanuele Durante-Mangoni, Gaeta G Battista, Alferio Niglio
Background/Aim: A reduction in portal vein inflow velocity seems to predispose to the emergence of portal vein thrombosis (PVT). Nonselective β-blockers (NSBBs), used to prevent variceal bleeding, may increase the development of PVT by reducing portal vein inflow velocity. In this retrospective case-control study, we evaluated the risk factors and clinical features of a first event of PVT in 130 cirrhotics, 19 (15%) with (PVT group) and 111 (85%) without PVT (non-PVT group). Patients and Methods: Patient evaluation and NNBB treatment were carried out according to the AASLD guidelines...
January 2018: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/29417267/modified-balloon-occluded-retrograde-transvenous-obliteration-brto-techniques-for-the-treatment-of-gastric-varices-vascular-plug-assisted-retrograde-transvenous-obliteration-parto-coil-assisted-retrograde-transvenous-obliteration-carto-balloon-occluded-antegrade
#12
David J Kim, Michael D Darcy, Naganathan B Mani, Auh Whan Park, Olaguoke Akinwande, Raja S Ramaswamy, Seung Kwon Kim
Gastric varices in the setting of portal hypertension occur less frequently than esophageal varices but occur at lower portal pressures and are associated with more massive bleeding events and higher mortality rate. Balloon-occluded retrograde transvenous obliteration (BRTO) of gastric varices has been well documented as an effective therapy for portal hypertensive gastric varices. However, BRTO requires lengthy, higher-level post-procedural monitoring and can have complications related to balloon rupture and adverse effects of sclerosing agents...
February 7, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29391766/beneficial-long-term-effect-of-a-phosphodiesterase-5-inhibitor-in-cirrhotic-portal-hypertension-a-case-report-with-8-years-follow-up
#13
Peter Deibert, Adhara Lazaro, Zoran Stankovic, Denise Schaffner, Martin Rössle, Wolfgang Kreisel
Non-selective beta-blockers are the mainstay of medical therapy for portal hypertension in liver cirrhosis. Inhibitors of phosphodiesterase-5 (PDE-5-inhibitors) reduce portal pressure in the acute setting by > 10% which may suggest a long-term beneficial effect. Currently, there is no available data on long-term treatment of portal hypertension with PDE-5-inhibitors. This case of a patient with liver cirrhosis secondary to autoimmune liver disease with episodes of bleeding from esophageal varices is the first documented case in which a treatment with a PDE-5-inhibitor for eight years was monitored...
January 21, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29342262/preliminary-study-of-1940-nm-thulium-laser-usage-in-peroral-endoscopic-myotomy-for-achalasia
#14
J Liu, Y Jiao, Y Niu, L Yu, M Ji, S Zhang
Esophageal achalasia is a type of motility disorder characterized by incomplete relaxation of lower esophageal sphincter (LES) and absence of esophageal peristalsis. Peroral endoscopic myotomy (POEM) is a new treatment option for achalasia that is less invasive, more effective, and safe as compared to surgery. High-frequency electrotome is commonly used in POEM, but takes longer time to make the tunnel in the esophagus and causes many complications. The thulium laser decreases the risk of bleeding and perforation in endoscopy but has not been reported in digestive diseases, especially in POEM...
January 9, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29283964/the-american-association-for-the-surgery-of-trauma-uniform-grading-of-hemorrhagic-emergency-general-surgery-diseases
#15
Gail T Tominaga, Carlos V R Brown, John T Schulz, Ronald R Barbosa, Suresh Agarwal, Nathaniel McQuay, Garth Utter, Marie Crandall
No abstract text is available yet for this article.
April 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29282637/changing-epidemiology-of-upper-gastrointestinal-hemorrhage-in-the-last-decade-a-nationwide-analysis
#16
Brandon A Wuerth, Don C Rockey
BACKGROUND: Upper gastrointestinal hemorrhage (UGIH) is common and carries substantial mortality requiring frequent hospitalizations. AIM: To investigate trends in etiology and outcome of UGIH in hospitalized patients in the USA. METHODS: Retrospective, observational cohort study of the Nationwide Inpatient Sample from 2002 to 2012 was carried out. UGIH was identified in hospitalizations with a principle ICD-9-CM diagnosis of UGIH or secondary diagnosis of UGIH with a principal diagnosis of hematemesis, blood in stool, or gastrointestinal bleeding...
December 27, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29245287/an-inflammatory-myofibroblastic-tumor-in-the-transplanted-liver-displaying-quick-wash-in-and-wash-out-on-contrast-enhanced-ultrasound-a-case-report
#17
Jing Shang, Yun-Yue Wang, Ying Dang, Xin-Juan Zhang, Yan Song, Li-Tao Ruan
RATIONALE: Inflammatory myofibroblastic tumor (IMT) is an uncommon mesenchymal neoplasm, and its presence in a grafted liver is exceedingly rare. PATIENT CONCERNS: A 54-year-old woman was admitted to our hospital with a half-month history of intermittent melena. She had undergone deceased-donor liver transplantation (LT) for hepatitis B virus related liver cirrhosis without hepatocellular carcinoma 5 months previously. DIAGNOSIS: Laboratory examination showed impaired liver and renal functions and Epstein-Barr virus (EBV) infection, but tumor markers within normal ranges...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29183764/clinical-outcome-of-portal-vein-thrombosis-in-patients-with-digestive-cancers-a-large-ageo-multicenter-study
#18
Hélène Regnault, Sheik Emambux, Thierry Lecomte, Solene Doat, Marion Dhooge, Marie Besson, Olivier Dubreuil, Frederic Moryoussef, Christine Silvain, Jean-Baptiste Bachet, David Tougeron
INTRODUCTION: Management of portal vein thrombosis (PVT) in cancer patients remains discussed. AIMS: The objective of this multicenter retrospective study was to investigate the management and outcome of PVT in patients with digestive cancers other than hepatocellular carcinoma (HCC). METHOD: Main inclusion criteria were trunk or branch PVT in patients with locally advanced or metastatic digestive cancers. Predictive factors of bleeding and overall survival (OS) were evaluated in univariate and multivariate analysis...
March 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29177197/foam-sclerotherapy-during-shunt-surgery-for-portal-hypertension-and-varices
#19
Zhe Zhang, Xueming Chen, Chenyu Li, Hai Feng, Hongzhi Yu, Renming Zhu, Tianyou Wang
Objective: This preliminary study investigated the clinical safety and efficacy of foam sclerotherapy during shunt surgery to treat portal hypertension and gastroesophageal varices. Methods: Seven patients with confirmed portal hypertension and a variceal bleeding history underwent mesocaval shunt with simultaneous polidocanol foam injection into the varices. Computed tomography and endoscopic reviews were conducted within two weeks following the procedures and around six months later...
2017: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/29118569/-embolia-cutis-medicamentosa-an-unusual-adverse-reaction-to-terlipressin
#20
Polychronis Gatos-Gatopoulos, Stephanos Kostantoudakis, Ioannis G Panayiotides, George D Dimitriadis, Konstantinos Triantafyllou
Terlipressin is a synthetic long-acting analog of vasopressin widely used to control variceal bleeding by lowering portal venous pressure. We report an unusual adverse reaction to terlipressin in a 78-year-old patient with esophageal variceal bleeding who developed skin necrosis soon after treatment initiation. Skin biopsy revealed embolia cutis medicamentosa.
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
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