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Anika Wranke, Beatriz Calle Serrano, Benjamin Heidrich, Janina Kirschner, Birgit Bremer, Patrick Lehmann, Svenja Hardtke, Katja Deterding, Kerstin Port, Max Westphal, Michael P Manns, Markus Cornberg, Heiner Wedemeyer
BACKGROUND: Hepatitis delta is the most severe form of viral hepatitis. Pegylated interferon alfa (PEG- IFNα) is effective in only 25-30% of patients and is associated with frequent side effects. The aim of this study was to analyze the clinical long-term outcome of hepatitis delta in relation to different antiviral treatment strategies. METHODS: We studied 136 anti-HDV-positive patients who were followed for at least 6 months in a retrospective single-center cohort (mean time of follow up 5...
October 22, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Yung-Kuan Tsou, Chia-Yuan Liu, Kuang-I Fu, Cheng-Hui Lin, Mu-Shien Lee, Ming-Yao Su, Ken Ohata, Cheng-Tang Chiu
BACKGROUND: Esophageal endoscopic submucosal dissection (ESD) has rarely been reported for the treatment of cirrhotic patients. AIM: To report the results of ESD treatment of superficial esophageal neoplasms (SENs) for cirrhotic patients. METHODS: Forty patients with 50 consecutive SENs undergoing 46 sessions of ESD were retrospectively reviewed. The cirrhotic group included eight patients (11 SENs) with liver cirrhosis consisting of six patients classified as Child-Pugh class A liver cirrhosis and two patients classified as class B liver cirrhosis...
October 21, 2016: Digestive Diseases and Sciences
Brian J McMahon, Dana Bruden, Lisa Townshend-Bulson, Brenna Simons, Phillip Spradling, Stephen Livingston, James Gove, Annette Hewitt, Julia Plotnik, Chriss Homan, Hannah Espera, Susan Negus, Mary Snowball, Youssef Barbour, Michael Bruce, Prabhu Gounder
BACKGROUND & AIMS: Few studies have examined factors associated with disease progression in hepatitis C virus (HCV) infection. We examined the association of 11 risk factors with adverse outcomes in a population-based prospective cohort observational study of Alaska Native/American Indian persons with chronic HCV infection. METHODS: We collected data from a population-based cohort study of liver-related adverse outcomes of infection in American Indian/Alaska Native persons with chronic HCV living in Alaska, recruited from 1995 through 2012...
October 17, 2016: Clinical Gastroenterology and Hepatology
Lee M Bass, Stanley Kim, Riccardo Superina, Saeed Mohammad
Portal hypertension secondary to portal vein obstruction following liver transplant occurs in 5%-10% of children. Jejunal varices are uncommon in this group. We present a case series of children with significant GI blood loss, negative upper endoscopy, and jejunal varices detected by CE. Case series of patients who had CE for chronic GI blood loss following liver transplantation. Three patients who had their initial transplants at a median age of 7 months were identified at our institution presenting at a median age of 8 years (range 7-16 years) with a median Hgb of 2...
October 20, 2016: Pediatric Transplantation
Mohammed Naseemuddin, Mohamed Shoreibah, Edgar Underwood, Shajan Peter
No abstract text is available yet for this article.
August 2016: ACG Case Reports Journal
Ahmed Kamel Abdel-Aal, Nabila Dawoud, Amr Soliman Moustafa, Maysoon F Hamed, Souheil Saddekni
We report a case of 59-year-old female with non-alcoholic-steato-hepatitis (NASH) induced cirrhosis, who presented with hematochezia. The patient had a history of bleeding esophageal varices treated with endoscopic variceal ligation (EVL). Colonoscopy showed large rectal varices which were the source of her lower gastrointestinal bleeding (LGIB). Since endoscopic treatment for LGIB are limited, and because the patient had portal vein thrombosis which contraindicated transjugular intrahepatic portosystemic shunt (TIPS), we performed percutaneous transhepatic embolization of her rectal varices using a new mixture of embolic and sclerotic agents, followed by Amplatzer plug 2 (AVP 2)...
September 2016: Journal of Radiology Case Reports
Jeffrey Gnerre, Yankai Sun, Andrzej Jedynak, Anthony Gilet
Gallbladder varices are a rare form of collateralization that develop in patients with portal hypertension. We present here a case of gallbladder varices accurately diagnosed by contrast enhanced CT imaging of the abdomen and confirmed by Color Doppler Sonography. A 76-year-old patient with hepatocellular carcinoma developed portal vein thrombosis due to tumor extension during the course of treatment and was incidentally discovered to have gallbladder varices. While most commonly asymptomatic, gallbladder varices are associated with increased risk of massive bleeding, either spontaneously or during cholecystectomy...
May 2016: Journal of Radiology Case Reports
Igor A Zolotukhin, Evgeny I Seliverstov, Elena A Zakharova, Alexander I Kirienko
OBJECTIVE: To establish an effect of isolated phlebectomy in patients with incompetent great saphenous vein (Ambulatory Selective Varices Ablation under Local anesthesia (ASVAL) procedure) on the reflux and diameter of the trunk and to assess recurrence rate of varicose veins at one year. MATERIAL AND METHODS: We conducted a prospective study on patients with primary varicose veins and with C2 or C2,3 or C2,3,4 or C2,4 classes of chronic venous disease and great saphenous vein incompetence...
October 19, 2016: Phlebology
Ujjal Poddar, Vibhor Borkar, Surender Kumar Yachha, Anshu Srivastava
Background and study aims: In view of the paucity of literature, we carried out this audit to evaluate the safety and efficacy of N- butyl, 2-cynoacrylate glue injection therapy in secondary prophylaxis of gastric varices in children. Patients and methods: Consecutive children (≤ 18 years) with non-cirrhotic portal hypertension who presented with bleeding from gastric varices and who had undergone cyanoacrylate glue injection therapy were included. They were evaluated for safety, efficacy and complications...
October 2016: Endoscopy International Open
Silvia De-la-Iglesia, Hugo Luzardo, Angelina Lemes, Melissa Torres, Maria Teresa Gómez-Casares, Naylen Cruz, Teresa Molero
Paroxysmal nocturnal hemoglobinuria (PNH) is associated with severe end-organ damage and a high risk of thrombosis. Budd-Chiari syndrome, which develops after thrombotic occlusion of major hepatic blood vessels, is relatively common in PNH and has been associated with increased mortality. We report the case of a 46-year-old male with PNH who presented with Budd-Chiari syndrome associated with portal cavernoma, portal hypertension and hypersplenism. In September 2010, the patient suffered gastrointestinal bleeding, hematuria, and elevated plasma lactate dehydrogenase; he started eculizumab therapy with a good response...
September 28, 2016: Hematology Reports
Shou-Wu Lee, Han-Chung Lien, Chi-Sen Chang, Teng-Yu Lee, Yen-Chun Peng, Hong-Zen Yeh
BACKGROUND: Metabolic syndrome has been highlighted as a risk factor for several gastrointestinal diseases, including gastroesophageal reflux disease and Barrett's esophagus (BE). The aim of this study was to investigate the association of metabolic syndrome with erosive esophagitis (EE) and BE. METHODS: Data were retrospectively collected from patients who visited the Medical Screening Center at Taichung Veterans General Hospital, Taichung, Taiwan from January 2006 to December 2009...
October 15, 2016: Journal of the Chinese Medical Association: JCMA
Takaki Emura, Kenji Hosoda, Shota Harai, Noboru Oyachi, Takeyuki Suzuki, Ken Takada, Koji Kobayashi, Hisatake Ikeda
BACKGROUND: Massive gastrointestinal bleeding in children, mostly caused by esophageal varices secondary to chronic liver disease, is uncommon. Dieulafoy lesion in the gastrointestinal tract is a rare but important cause of gastrointestinal bleeding; massive bleeding from this lesion can be fatal unless adequate treatment is promptly initiated. We report a case of gastric Dieulafoy lesion in a 2-year old successfully treated with endoscopic hemoclipping. CASE PRESENTATION: A 2-year-old Japanese boy was admitted to our department with sudden massive hematemesis...
October 19, 2016: Journal of Medical Case Reports
Marta Hernández Conde, Elba Llop Herrera, Juan de la Revilla Negro, Fernando Pons Renedo, Natalia Fernández Puga, José Luis Martínez Porras, María Trapero Marugan, Valentín Cuervas-Mons, Víctor Sánchez Turrión, José Luis Calleja Panero
INTRODUCTION: The prevalence of portal vein thrombosis (PVT) in patients that have undergone liver transplantation (LT) is 9.7% (SD 4.5). The aim of our study was to determine the prevalence, assess the factors that are associated with PVT and clarify their association with prognosis in patients with liver cirrhosis (LC) and LT. AIMS AND METHODS: From 2005 to 2014, laboratory, radiological and surgical data were collected from patients with LC in our center who had undergone LT for the first time...
October 19, 2016: Revista Española de Enfermedades Digestivas
Matthias Buechter, Alisan Kahraman, Paul Manka, Guido Gerken, Christoph Jochum, Ali Canbay, Alexander Dechêne
BACKGROUND/AIMS: Portal hypertension (PH) is a common complication of chronic liver disease and results in esophageal and gastric variceal bleeding, which is associated with a high mortality rate. Measurement of the hepatic venous pressure gradient (HVPG) is considered the gold standard for diagnosing PH and estimating the risk of varices and bleeding. In contrast, upper gastrointestinal (GI) endoscopy (UGE) can reliably demonstrate the presence of varices and bleeding. Both measures are invasive, and HVPG is mainly restricted to tertiary centers...
October 19, 2016: Digestion
Ricardo U Macías-Rodríguez, Astrid Ruiz-Margáin, Jose L Rodriguez-Garcia, Sergio Zepeda-Gómez, Aldo Torre
OBJECTIVE: Endoscopic retrograde cholangio-pancreatography (ERCP) is useful for the management of biliary tract diseases; in patients with cirrhosis, portal hypertension may increase the risk for complications from ERCP. We evaluated the outcome and risk factors related to ERCP in patients with cirrhosis and portal hypertension. PATIENTS AND METHODS: In this case-control study, 37 patients (71 procedures) with cirrhosis and portal hypertension (group 1) and 37 controls (group 2) undergoing ERCP were included...
October 14, 2016: European Journal of Gastroenterology & Hepatology
Mohammad Minakari, Shervin Badihian, Pooyan Jalalpour, Vahid Sebghatollahi
BACKGROUND AND AIM: Upper gastrointestinal bleeding (UGIB) is a threatening condition leading to urgent hospitalization. This study aims to investigate etiology and outcome in UGIB patients in Iran. METHODS: Medical records of GIB patients admitted to Alzahra referral hospital (in Isfahan) during 2010-2015 were retrospectively reviewed for demographic data, comorbidities, history of smoking and taking non-steroidal anti-inflammatory drugs (NSAIDs), presenting symptoms, endoscopic findings, therapeutic endoscopy, blood products' infusion, surgical intervention and mortality...
October 17, 2016: Journal of Gastroenterology and Hepatology
Peter Witters, Dominic Hughes, Palaniswamy Karthikeyan, Somashekara Ramakrishna, Mark Davenport, Anil Dhawan, Tassos Grammatikopoulos
BACKGROUND AND AIMS: Variceal haemorrhage can be a life-threatening complication of chronic liver disease in children. There is limited evidence about the optimal prophylactic management and selection criteria of children who will benefit from upper gastrointestinal endoscopy. METHODS: Children presenting in our centre with suspected portal hypertension or gastrointestinal bleeding and undergoing their first oesophagogastroduodenoscopy between 2005-2012 were included...
October 4, 2016: Journal of Pediatric Gastroenterology and Nutrition
Yundong Qu, Tao Li, Qian Ye, Lixin Zhang, Lei Wang
BACKGROUND/AIMS: To assess the accuracy of transient elastography (TE) in the prediction of esophageal varices (EV). MATERIALS AND METHODS: The literature search was conducted by using PubMed, EMBASE, Web of Science, and CENTRAL on The Cochrane Library without time or language restrictions. Terms used were "FibroScan," "transient elastography," "stiffness," and "esophageal varices." The pooled sensitivity, specificity, and other parameters were obtained using a bivariate mixed-effects regression model...
September 2016: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Malcolm M Wells
No abstract text is available yet for this article.
September 2016: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Kara Rye, Gerri Mortimore, Andrew Austin, Jan Freeman
BACKGROUND/AIMS: Cirrhosis and portal hypertension are characterised by a hyperdynamic circulation, which is independently associated with variceal size. Non-invasive techniques for measurement of systemic haemodynamics are now available. The aim of the study was to prospectively assess the accuracy of systemic haemodynamics measured non-invasively for the detection of oesophageal varices in cirrhotic patients as compared to other currently available non-invasive methods. METHODS: In a study of 29 cirrhotic patients, systemic haemodynamics were studied non-invasively using the Finometer(®) (mean arterial pressure (MAP), cardiac output (CO)/index, heart rate (HR), peripheral vascular resistance) and portal pressure was assessed by hepatic venous pressure gradient...
September 2016: Journal of Clinical and Experimental Hepatology
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