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Maeva Guillaume, Christophe Bureau, Aurélie Plessier
No abstract text is available yet for this article.
July 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Mark A Pacult, Fraser C Henderson, Mathew D Wooster, Abhay K Varma
The authors report the case of a 76 year-old woman presenting with leg pain, numbness and weakness mimicking a lumbosacral radiculopathy. Lumbar spine magnetic resonance imaging (MRI) demonstrated mild root compression but lumbar decompression afforded only transient symptomatic relief. Post-operative MRI of the lumbosacral plexus and sciatic nerve revealed a gluteal venous varix compressing the sciatic nerve just distal to the piriformis muscle. Neurolysis and surgical resection of the offending varix resulted in resolution of her symptoms...
June 18, 2018: World Neurosurgery
Paul Tran, Joshua Carroll, Bradley A Barth, Nandini Channabasappa, David M Troendle
OBJECTIVE: There is little published experience with the use of over the scope clips (OTSCs) in pediatric patients. The aim of this study is to present our single center experience utilizing OTSCs for non-variceal gastrointestinal bleeding METHODS:: This is a retrospective case series of pediatric patients who underwent endoscopic management of gastrointestinal bleeding during which OTSCs were utilized. RESULTS: 11 cases of OTSC utilization for hemostasis were identified in 10 unique patients between 11/2014 and 5/2016...
June 20, 2018: Journal of Pediatric Gastroenterology and Nutrition
Sundeep Lakhtakia, Radhika Chavan, Mohan Ramchandani, Zaheer Nabi, D Nageshwar Reddy
No abstract text is available yet for this article.
April 2018: VideoGIE: an official video journal of the American Society for Gastrointestinal Endoscopy
Kathrin Burgmaier, Joy Brandt, Rukshana Shroff, Peter Witters, Lutz T Weber, Jörg Dötsch, Franz Schaefer, Djalila Mekahli, Max C Liebau
Introduction: Autosomal recessive polycystic kidney disease (ARPKD) is a severe hepatorenal disorder of childhood. Early renal disease in ARPKD may require renal replacement therapy and is associated with failure to thrive resulting in a need for nasogastric tube feeding or gastrostomy. In ARPKD patients, the benefit of a gastrostomy in nutrition and growth needs to be weighed against the potential risk of complications of congenital hepatic fibrosis (CHF) and portal hypertension like variceal bleeding. CHF in ARPKD has thus been considered as a relative contraindication for gastrostomy insertion...
2018: Frontiers in Pediatrics
Adnan Taş, Mehmet Suat Yalçın, Bünyamin Sarıtaş, Banu Kara
Background/aim: There are various scoring systems for evaluating prognosis in patients hospitalized in intensive care units (ICUs) with hepatic encephalopathy. These include the Child-Turcotte-Pugh (CTP) classification, Model for End-stage Liver Disease (MELD), chronic liver failure-sequential organ failure assessment (CLIF-SOFA), and Acute Physiology and Chronic Health Evaluation II (APACHE II). In this study, we aimed to compare the various scoring systems to determine the best system for showing the prognosis of patients with a prior diagnosis of cirrhosis who were hospitalized for hepatic encephalopathy...
June 14, 2018: Turkish Journal of Medical Sciences
Fang Wang, Shu Cui, Fengmei Wang, Fenghui Li, Fei Tang, Xu Zhang, Yanying Gao, Hongmin Lv
OBJECTIVE: Determine the optimal scoring system for evaluation of 6-week bleeding-related mortality in liver cirrhosis patients with acute variceal bleeding (AVB). Prediction effects of six scoring systems, AIMS65 score, Glasgow-Blatchford (GBS) score, full Rockall (FRS) score, the model for end-stage liver disease (MELD), the MELD-Na model and the Child-Turcotte-Pugh (CTP) score were analyzed in this study. METHODS: A total of 202 liver cirrhosis patients with AVB were enrolled between 1 January 2014, and 31 December 2014...
June 17, 2018: Scandinavian Journal of Gastroenterology
Abid Shoukat, Mosin S Khan, Syed Mudassar, Zaffar Kawoosa, Altaf H Shah, Showkat Ali Zargar
Background: In hepatitis C virus (HCV), infection viral and IL28B genotype along with many clinical and biochemical factors can influence response rates to pegylated interferon plus ribavirin (Peg-IFN-a/R) therapy and progression to chronic hepatitis C (CHC). Aims: The present study was conducted to determine the effect of biochemical and risk factors on treatment outcome in CHC patients in relation to their viral and host genotype. Settings and Design: The present study was a prospective Pe- IFN efficacy study consisting of Peg-IFN-a/R therapy for 24-48 weeks including 250 HCV infected patients...
April 2018: Journal of Global Infectious Diseases
H A Rudman, M C Stott, M Y Loh, E C Clark
A 79-year-old woman presented with a large fresh rectal bleed. Computed tomography revealed that she had a large type IV hiatus hernia, which contained the stomach and pancreas. Compression of the inferior mesenteric vein and splenic vein had led to thrombosis within these vessels and retrograde flow within the inferior mesenteric vein. This had led to the formation of portosystemic rectal varices. Ectopic varices occasionally form in the rectum, often in the context of liver cirrhosis. At the time of writing, ours is the first reported case of portosystemic rectal varices formulated in response to obstruction of vessels within a hiatus hernia...
June 18, 2018: Annals of the Royal College of Surgeons of England
Indira Bhavsar, Anthony W Rooney, Brooke Corning, Neeral L Shah
A newly diagnosed 53-year-old woman with cirrhosis has repeated gastrointestinal bleeding with resulting symptomatic anaemia. She underwent routine diagnostic endoscopic evaluation without localisation of the aetiology of her bleed. Ultimately, she was found to have ectopic varices in the small bowel as a result of underlying high portal pressures. She underwent transjugular intrahepatic portosystemic shunt for portal system decompression with resolution in her bleeding.
June 15, 2018: BMJ Case Reports
Krista L Haines, Suresh Agarwal, Hee Soo Jung
INTRODUCTION: Asian-Americans and Pacific Islanders are often considered as a uniform group when examining race in health outcomes. However, the generally favorable economic outcomes in this group belie significant socioeconomic variance between its heterogeneous subgroups. This study evaluates the impact of socioeconomic status on the health outcomes of Asian trauma patients. METHODS: From 2012 to 2015, 52,704 Asians who presented to trauma centers were registered with the National Trauma Data Bank with known disposition...
August 2018: Journal of Surgical Research
Saikiran Raghavapuram, Nayana George, Mohit Girotra, Sameer Siddique, Benjamin Tharian
No abstract text is available yet for this article.
September 2017: VideoGIE: an official video journal of the American Society for Gastrointestinal Endoscopy
Anna Piekarska, Ewa K Berkan, Kamila M Wójcik
Non-invasive liver fibrosis assessment techniques are under development for evaluating the severity of liver disease and portal hypertension. The paper presents practical arrangements for the diagnosis and treatment of portal hypertension in patients with chronic liver disease, established in the Baveno VI Consensus Workshop for diagnosis and treatment of portal hypertension. Currently, the diagnostic standard of liver disease severity is transient elastography, which can identify patients with clinically significant portal hypertension (liver stiffness > 20 kPa)...
June 2018: Clinical and experimental hepatology
Koichi Masuda, Shinsuke Takenaga, Hirokazu Ashida, Hiroya Ojiri
Rupture of small intestinal varices associated with portal hypertension can be a serious condition that is difficult to diagnose early and to manage. Moreover, optimal guidelines for the treatment of small intestinal varices have not yet been established. We herein report a case of a 73-year-old man with small intestinal varices. The man presented with bleeding from a stoma in the small intestine, which subsequently led to hemorrhagic shock. We successfully treated the patient with balloon-occluded retrograde transvenous obliteration via the right inferior epigastric vein using N-butyl-2-cyanoacrylate...
April 2018: Radiology Case Reports
Karen Tran-Harding, Michael Winkler, Driss Raissi
We report a case of a 50-year-old man with a history of liver cirrhosis and colon cancer post end colostomy presenting to the emergency department with stomal bleeding and passage of clots into the colostomy bag. The patient was treated with transjugular intrahepatic portosystemic shunt (TIPS) and concomitant embolization of the stomal varices via the TIPS shunt using N-butyl cyanoacrylate mixed with ethiodol. Although stomal variceal bleeding is uncommon, this entity can have up to 40% mortality upon initial presentation, given the challenges in diagnosis and management...
April 2018: Radiology Case Reports
Dong Ho Lee, Jhii-Hyun Ahn, Jin Wook Chung, Young Ju Kim, Seung-Whan Cha, Moon Young Kim, Soon Koo Baik
BACKGROUND & AIMS: To investigate prognostic value of varices on CT and redefine surrogate criteria for clinically significant portal hypertension (CSPH). METHOD: We retrospectively enrolled 241 patients with compensated cirrhosis who underwent hepatic venous pressure gradient (HVPG) measurement from 2008 to 2013. Using CT and upper endoscopy findings obtained within 3 months from HVPG measurement, patients were classified into three groups: presence of standard surrogate for CSPH, defined as presence of varices on upper endoscopy and/or splenomegaly associated with thrombocytopenia (Group 1, n=139); varices on CT without standard surrogate for CSPH (Group 2, n=41); and free from both (Group 3, n=61)...
June 14, 2018: Journal of Gastroenterology and Hepatology
Edward Wolfgang Lee, Sammy Saab, Fady Kaldas, Savannah Fletcher, Ronald W Busuttil, Francisco Durazo, Justin P McWilliams, Joseph DiNorcia, Siddharth A Padia, Stephen T Kee
BACKGROUND: Overt hepatic encephalopathy (OHE) is a serious complication of liver dysfunction, which is associated with severe morbidity/mortality and healthcare resource utilization. OHE can be medically refractory due to spontaneous portosystemic shunts (SPSSs) and therefore a new treatment option for these SPSSs is critical. METHODS: This is a retrospective study of 43 patients with medically refractory OHE, who underwent CARTO (Coil-Assisted Retrograde Transvenous Obliteration) procedures between June 2012 and October 2016...
June 14, 2018: American Journal of Gastroenterology
Gunadi, Timotheus Allen Gunawan, Galih Widiyanto, Amalia Yuanita, Nenny Sri Mulyani, Akhmad Makhmudi
OBJECTIVES: Recently, a scoring system has been developed to predict which patients with biliary atresia (BA) who underwent a Kasai procedure should be considered for liver transplant. Here, we applied the scoring system to predict the survival of BA patients following the Kasai procedure at Dr. Sardjito Hospital, Yogyakarta, Indonesia from January 2012 to January 2016. RESULTS: There were 26 patients, of whom 14 were males and 12 females. Outcomes of BA patients after the Kasai surgery were 15 survived and 11 died...
June 13, 2018: BMC Research Notes
Subhash Chandra, Adrian Holm, Rami G El Abiad, Henning Gerke
Background/Aims: Although endoscopic cyanoacrylate glue injection (ECGI) is recommended as first-line treatment for bleeding gastric varices (GV) there is still limited experience with this method in the US. Our aim was to analyze our 10-year experience of ECGI for treatment and prophylaxis of gastric variceal bleeding. Methods: Records of patients undergoing ECGI of GV at our US tertiary care center between 6/2005 and 5/2015 were reviewed. Assessed outcomes were primary hemostasis, early rebleeding during hospitalization, recurrent bleeding during follow-up, eradication and recurrence of GV...
June 2018: Journal of Clinical and Experimental Hepatology
Camille A Kezer, Neil Gupta
PURPOSE OF REVIEW: This article aims to review current therapeutic endoscopic treatments available for the management of gastrointestinal bleeding related to cirrhosis. RECENT FINDINGS: Endoscopic band ligation is an effective treatment for primary prophylaxis, acute bleeding, and secondary prophylaxis of esophageal varices as well as for acute bleeding and secondary prophylaxis of select gastric varices. Sclerotherapy is a treatment option for acute bleeding and secondary prophylaxis of esophageal varices when band ligation is technically difficult...
June 9, 2018: Current Gastroenterology Reports
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