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https://www.readbyqxmd.com/read/29904721/surveillance-for-portal-hypertension-in-the-course-of-liver-cirrhosis
#1
REVIEW
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
https://www.readbyqxmd.com/read/29729368/a-combined-model-based-on-spleen-stiffness-measurement-and-baveno-vi-criteria-to-rule-out-high-risk-varices-in-advanced-chronic-liver-disease
#2
Antonio Colecchia, Federico Ravaioli, Giovanni Marasco, Agostino Colli, Elton Dajti, Annarita Di Biase, Maria Letizia Bacchi Reggiani, Annalisa Berzigotti, Massimo Pinzani, Davide Festi
BACKGROUND & AIMS: Recently, Baveno VI guidelines suggested that esophagogastroduodenoscopy (EGD) can be avoided in patients with cACLD who have a liver stiffness measurement (LSM) < 20 kPa and platelet count >150,000/mm3 . We aimed to: assess the performance of spleen stiffness measurement (SSM) in ruling out patients with high-risk varices (HRV); validate Baveno VI criteria in a large population and assess how the sequential use of Baveno VI criteria and SSM could safely avoid the need for endoscopy...
May 2, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29657612/deal-a-death-blow-hcc-in-cirrhotics-thrombotic-complications-their-frequency-characteristics-and-risk-factors
#3
Khalid Mahmood, Iftikhar Haider Naqvi, Aamer Mahmood, Syed Muhammad, Noor Muhammad
Introduction: The hepatocellular carcinoma (HCC), being the commonest primary cancer, holds the sixth slot in the list of common cancers worldwide. Thrombotic complications in the form of portal vein tumour thrombosis (PVTT) and bland portal vein thrombosis with HCC are common with a bad prognosis. Aim: The study aims to determine the demographic, clinical, and biochemical parameters of HCC patients. The study also compares the clinical and biochemical parameters among patients having HCC with and without thrombotic complication...
2018: Przegla̜d Gastroenterologiczny
https://www.readbyqxmd.com/read/29504330/correlation-between-severity-of-portal-hypertensive-gastropathy-and-size-of-oesophageal-varices-in-cirrhotic-hepatitis-c-patients
#4
Khurram Saleem, Faisal Amin Baig, Mahwish Nida, Munaza Javed
BACKGROUND: Portal hypertension can lead to oesophageal varices (EV) and portal hypertensive gastropathy (PHG). The aim of this study is to determine the relationship between severity of Portal hypertensive gastropathy and size of oesophageal varices. METHODS: One hundred and ninety-five patients of hepatitis C positive chronic liver disease having oesophageal varices were assessed for severity of portal hypertensive gastropathy. RESULTS: Mild Portal Hypertensive Gastropathy was observed in 16 (8...
January 2018: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29467124/gastric-and-duodenal-ischaemia-after-transarterial-chemoembolisation-for-hepatocellular-carcinoma-an-unexpected-but-significant-complication
#5
Sai Pavan Chintalapati, Arpan Patel, Hari Conjeevaram
Transarterial chemoembolisation (TACE) is commonly used for unresectable intermediate-stage hepatocellular carcinoma (HCC). TACE is usually well-tolerated. We report a case of a patient who presented with a gastrointestinal bleed from TACE. A 64-year-old man presented with chronic hepatitis C cirrhosis and multifocal bilobar HCC. He had previously undergone multiple TACE sessions, radiofrequency ablation and stereotactic body radiation therapy. In the evening of his TACE procedure, he developed abdominal pain and haematemesis...
February 21, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29453469/demographic-and-clinical-profile-in-patients-with-liver-cirrhosis-in-a-tertiary-care-hospital-in-central-nepal
#6
Subash Bhattarai, Merina Gyawali, Khus Raj Dewan, Gaurav Shrestha
INTRODUCTION: Liver cirrhosis is an important health problem worldwide and is a common disease in Nepal. The profile of cirrhosis may vary due to different factors. This study was undertaken to see the demographic and clinical profiles of patients with cirrhosis of liver attending a tertiary care hospital in Central Nepal. METHODS: Six hundred patients with clinical features, laboratory and sonological findings suggestive of chronic liver dysfunction and endoscopic evidence of portal hypertension were included in the study...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29388229/betablockers-do-not-increase-efficacy-of-band-ligation-in-primary-prophylaxis-but-they-improve-survival-in-secondary-prophylaxis-of-variceal-bleeding
#7
N Pfisterer, C Dexheimer, E-M Fuchs, T Bucsics, P Schwabl, M Mandorfer, I Gessl, L Sandrieser, L Baumann, F Riedl, B Scheiner, T Pachofszky, W Dolak, C Schrutka-Kölbl, A Ferlitsch, M Schöniger-Hekele, M Peck-Radosavljevic, M Trauner, C Madl, T Reiberger
BACKGROUND: Endoscopic band ligation (EBL) is used for primary (PP) and secondary prophylaxis (SP) of variceal bleeding. Current guidelines recommend combined use of non-selective beta-blockers (NSBBs) and EBL for SP, while in PP either NSBB or EBL should be used. AIM: To assess (re-)bleeding rates and mortality in cirrhotic patients receiving EBL for PP or SP for variceal bleeding. METHODS: (Re-)bleeding rates and mortality were retrospectively assessed with and without concomitant NSBB therapy after first EBL in PP and SP...
April 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29177064/efficacy-of-capsule-endoscopy-in-patients-with-cirrhosis-for-the-diagnosis-of-upper-gastrointestinal-lesions-and-small-bowel-abnormalities-a-study-protocol-for-prospective-interventional-study
#8
Yoshinori Iwata, Hiroki Nishikawa, Hirayuki Enomoto, Kazunori Yoh, Akio Ishii, Yukihisa Yuri, Noriko Ishii, Yuho Miyamoto, Kunihiro Hasegawa, Chikage Nakano, Ryo Takata, Takashi Nishimura, Nobuhiro Aizawa, Yoshiyuki Sakai, Naoto Ikeda, Tomoyuki Takashima, Hiroko Iijima, Shuhei Nishiguchi
Introduction and aims: The role of capsule endoscopy (CE) in patients with liver cirrhosis (LC) has yet to be established; however, it is likely that it will remain a valuable diagnostic modality in several groups of patients with LC. The primary aims of the current prospective interventional study are to examine the prevalence for small bowel lesions and transit time of CE in the gastrointestinal tract in patients with LC with oesophageal varices (EVs) requiring endoscopic therapies...
2017: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/29099778/upper-gastrointestinal-bleeding-in-children-a-tertiary-united-kingdom-children-s-hospital-experience
#9
Omar Nasher, David Devadason, Richard J Stewart
The aim of this study was to review the aetiology, presentation and management of these patients with upper gastrointestinal bleeding (UGIB) at a tertiary children's unit in the United Kingdom. This was a retrospective single-institution study on children (<16 years) who presented with acute UGIB over a period of 5 years using known International Classification of Diseases (ICD) codes. A total of 32 children (17 males, 15 females) were identified with a total median age at presentation of 5.5 years. The majority (24/32) of patients presented as an emergency...
November 3, 2017: Children
https://www.readbyqxmd.com/read/28968053/improving-the-identification-and-monitoring-of-cirrhosis
#10
Margaret G Keane, Charles Hensher, Stephen P Pereira
Morbidity and mortality associated with cirrhosis are on the increase. In a recent UK cohort study the incidence of cirrhosis increased by 50.6% between 1998 and 2009. Although all causes of liver disease increased during this period, this trend was primarily attributed to rising levels of alcohol misuse and obesity. Cirrhosis generally results from chronic liver damage over many years. It is characterised by fibrosis and nodularity of the parenchyma, which interferes with the synthetic, metabolic and excretory functions of the liver...
November 2016: Practitioner
https://www.readbyqxmd.com/read/28918404/combined-caesarean-with-splenectomy-in-pregnancy-with-portal-hypertension-defining-plausibility
#11
Manjunath Maruti Pol, Latika Uniyal Chawla, Yashwant Singh Rathore, Ritesh Goel
24-year-old woman at 28 weeks gestation was referred from peripheral hospital with diagnosis of pregnancy with portal hypertension. She had received multiple transfusion for pancytopaenia in the past and had undergone endoscopic sclerotherapy for oesophageal varices. Initially, she was admitted in our hospital at 28 weeks gestation for blood transfusion and was evaluated by multispecialty team of doctors. She was advised splenectomy for transfusion-dependent pancytopaenia secondary to hypersplenism in non-cirrhotic portal hypertension...
September 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28892958/correlation-of-serum-prolactin-level-to-child-pugh-scoring-system-in-cirrhosis-of-liver
#12
Chaitanya H Balakrishnan, H Rajeev
INTRODUCTION: With the growing incidence of liver cirrhosis among Asians, the use of a biomarker such as prolactin, indicates the severity of the disease, its complications and serves as a tool for early intervention. AIM: To compare the efficacy of serum prolactin to the Child Pugh scoring system in cirrhosis of the liver and establish that serum prolactin is an early marker for complications of cirrhosis of the liver. MATERIALS AND METHODS: This was a comparative study on 60 patients admitted to the Department of General Medicine, KIMS from June 2014 to November 2015...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28856972/elastography-methods-for-the-non-invasive-assessment-of-portal-hypertension
#13
Davide Roccarina, Matteo Rosselli, Joan Genesca, Emmanuel A Tsochatzis
The gold standard to assess the presence and severity of portal hypertension remains the hepatic vein pressure gradient, however the recent development of non-invasive assessment using elastography techniques offers valuable alternatives. In this review, we discuss the diagnostic accuracy and utility of such techniques in patients with portal hypertension due to cirrhosis. Areas covered: A literature search focused on liver and spleen stiffness measurement with different elastographic techniques for the assessment of the presence and severity of portal hypertension and oesophageal varices in people with chronic liver disease...
February 2018: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28845498/non-invasive-diagnosis-of-portal-hypertension-in-cirrhosis-using-ultrasound-based-elastography
#14
REVIEW
Ivica Grgurevic, Tomislav Bokun, Tonci Bozin, Vladimir Matic, Sara Haberle, Ioan Sporea
Liver stiffness measurement (LSM) by ultrasound-based elastography may be used to non-invasively discriminate between the stages of liver fibrosis, rule out cirrhosis and follow its evolution, including the prediction of the presence of oesophageal varices. The same is possible in order to diagnose clinically significant portal hypertension, referring primarilyto transient elastography and LSM values ≥20-25 kPa. The same approach may be used to reliably rule out the presence ofoesophageal varices (LSM <20 kPa + platelets >150x109/L)...
May 3, 2017: Medical Ultrasonography
https://www.readbyqxmd.com/read/28801510/therapeutic-options-for-bleeding-oesophageal-varices-cyanoacrylate-and-balloon-occluded-retrograde-obliteration-brto
#15
Helena L Frischtak, Jessica P Davis, Neeral L Shah
A 56-year-old male with cirrhosis presented with acute bleeding from cardiofundal gastroesophageal varices (GOV) and was treated with endoscopic cyanoacrylate glue. Glue therapy achieved stabilisation of the patient in the emergent setting. Three months later, the patient suffered rebleeding. At that time, he underwent retreatment with balloon-occluded retrograde obliteration (BRTO), with no recurrence at a follow-up of 14 months.Available treatments for bleeding GOV include methods to (a) directly obstruct the varices (endoscopic variceal ligation , sclerotherapy and cyanoacrylate glue, BRTO) or to (b) decrease portal pressure (surgical portacaval shunts; transportal intrahepatic portosystemic shunt)...
August 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28761693/effect-of-dexmedetomidine-in-the-prophylactic-endoscopic-injection-sclerotherapy-for-oesophageal-varices-a-study-protocol-for-prospective-interventional-study
#16
Hiroki Nishikawa, Yoshinori Iwata, Akio Ishii, Hirayuki Enomoto, Yukihisa Yuri, Noriko Ishii, Yuho Miyamoto, Kunihiro Hasegawa, Chikage Nakano, Ryo Takata, Takashi Nishimura, Kazunori Yoh, Nobuhiro Aizawa, Yoshiyuki Sakai, Naoto Ikeda, Tomoyuki Takashima, Hiroko Iijima, Shuhei Nishiguchi
BACKGROUND: Dexmedetomidine (DEX) is a novel, highly selective α2-adrenoceptor agonist that elicits sedative, amnestic, sympatholytic and analgesic effects in patients. Several Japanese investigators have reported the clinical usefulness of DEX for sedation in endoscopic therapies for gastrointestinal malignancies; however, there have been limited data regarding the usefulness and safety of DEX for sedation during endoscopic procedures for oesophageal varices (OVs), such as endoscopic injection sclerotherapy (EIS)...
2017: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/28718228/early-initiation-of-beta-blockers-following-primary-endoscopic-therapy-for-bleeding-oesophageal-varices-in-cirrhotics
#17
Adnan Salim, Kashif Malik, Muhammad Omer Farooq, Umair Butt, Arshad Kamal Butt, Altaf Alam
BACKGROUND AND AIMS: Beta-blockers provide secondary prophylaxis following endoscopic therapy for variceal bleeding. Guidelines recommend starting beta-blockers 6 days after endoscopy to prevent masking hemodynamic signs of re-bleeding. We aimed to see safety of earlier initiation of betablockers. METHODS: Cirrhotic patients with upper GI bleed were given intravenous vasoactive agents until undergoing endoscopy. Patients with only oesophageal varices as source of bleed were recruited...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28553915/-oesophageal-vascular-ectasia-in-a-patient-with-anaemia
#18
Vera Crone, Lasse Bremholm
This case report describes the findings of oesophageal vascular ectasia (OVE) in a patient with known gastric antral vascular ectasia, who presented with anaemia. OVE is a very rare endoscopic finding and therefore a diagnostic challenge. An 85-year-old male was admitted due to anaemia. He went through a gastroscopic examination where severe OVE changes were seen, along with newfound oesophageal varices. There was no need for treating the OVE, but the findings coupled with the knowledge of the varices led to the diagnosis of portal thrombosis...
May 22, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28504002/development-and-evaluation-of-a-novel-score-for-prediction-of-large-oesophageal-varices-in-patients-with-hepatitis-c-virus-induced-liver-cirrhosis
#19
K Farid, M M Omran, R E Farag, M M Arafa, T M Emran
OBJECTIVE: Variceal bleeding is one of the most common life-threatening complications of liver cirrhosis. This study aimed to develop and evaluate a predictive score, named Platelet count, Alpha fetoprotein (AFP) and Prothrombin-INR (PAP) for the prediction of large oesophageal varices and to compare PAP score with eight common liver fibrosis scores (AAR, APRI, GUCI, BRC score, Fibro-Alfa, FIB4, Lok and Fibro-Q) in patients with hepatitis C virus (HCV) induced liver cirrhosis. METHODS: A total of 277 patients with HCV-induced liver cirrhosis were evaluated by upper gastrointestinal endoscopy for presence of varices...
May 15, 2017: British Journal of Biomedical Science
https://www.readbyqxmd.com/read/28444987/platelet-count-spleen-length-and-platelet-count-to-spleen-length-ratio-for-the-diagnosis-of-oesophageal-varices-in-people-with-chronic-liver-disease-or-portal-vein-thrombosis
#20
REVIEW
Agostino Colli, Juan Cristóbal Gana, Jason Yap, Thomasin Adams-Webber, Natalie Rashkovan, Simon C Ling, Giovanni Casazza
BACKGROUND: Current guidelines recommend screening of people with oesophageal varices via oesophago-gastro-duodenoscopy at the time of diagnosis of hepatic cirrhosis. This requires that people repeatedly undergo unpleasant invasive procedures with their attendant risks, although half of these people have no identifiable oesophageal varices 10 years after the initial diagnosis of cirrhosis. Platelet count, spleen length, and platelet count-to-spleen length ratio are non-invasive tests proposed as triage tests for the diagnosis of oesophageal varices...
April 26, 2017: Cochrane Database of Systematic Reviews
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