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https://www.readbyqxmd.com/read/29166137/primary-constrained-tips-for-treating-refractory-ascites-or-variceal-bleeding-secondary-to-hepatic-cirrhosis
#1
R Rabei, S Mathesovian, J Tasse, S Madassery, B Arslan, U Turba, O Ahmed
PURPOSE: To report an initial experience using a primary constrained TIPS technique for treating cirrhotic patients with refractory ascites or variceal bleeding. METHODS: All patients undergoing primary constrained (n=9) and conventional (n=18) TIPS between July 2014 and June 2016 were retrospectively reviewed. Pre-procedure demographics, Child-Pugh (CP), MELD, and technical variables were recorded. Outcomes measured included technical and clinical success, complications, 30-day mortality, as well as necessity for TIPS revision...
November 22, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/29164762/recalibrated-meld-and-hepatic-encephalopathy-are-prognostic-factors-in-cirrhotic-patients-with-acute-variceal-bleeding
#2
Marika Rudler, Christophe Bureau, Nicolas Carbonell, Philippe Mathurin, Faouzi Saliba, Arianne Mallat, Julien Massard, Jean-Louis Golmard, Brigitte Bernard-Chabert, Nina Dib, Dominique Thabut
BACKGROUND: Early TIPS placement must be considered in patients with Child-Pugh B and active bleeding at endoscopy or in patients with Child-Pugh C 10-13 and variceal bleeding. However, active bleeding at endoscopy is a subjective criterion. Moreover, a previous study has shown that a MELD-based score accurately predicted 6-week mortality and helped to stratify patients. Using a prospective series of patients included in a multicentre study before the era of early TIPS, we aimed (1) to identify factors associated with 6-week mortality, focusing on the prognostic value of active bleeding; and (2) to assess whether a recalibrated MELD-based score accurately predicted 6-week mortality...
November 22, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29162665/the-beneficial-effects-of-curcumin-in-cirrhotic-rats-with-portal-hypertension
#3
Shao-Jung Hsu, Jing-Yi Lee, Te-Yueh Lin, Yu-Hsin Hsieh, Hui-Chun Huang, Fa-Yauh Lee, Han-Chieh Lin, Ming-Chih Hou, Shou-Dong Lee
In liver cirrhosis with portal hypertension, the uneven distribution of vasoactive substances leads to increased intrahepatic vascular resistance and splanchnic vasodilatation. Angiogenesis also induces increased portal inflow and portosystemic collaterals. The collaterals may induce lethal complications such as gastroesophageal variceal hemorrhage, but the therapeutic effect of vasoconstrictors is still suboptimal due to poor collateral vasoresponsivenss. Curcumin has aroused much attention for its anti-fibrosis, vasoactive and anti-angiogenesis actions...
November 21, 2017: Bioscience Reports
https://www.readbyqxmd.com/read/29161702/favorable-effects-of-endoscopic-ligation-combined-with-drugs-on-rebleeding-and-mortality-in-cirrhotic-patients-a-network-meta-analysis
#4
Liang Shi, Xueping Zhang, Jianye Li, Xibo Bai
BACKGROUND: To assess the effects of combination therapies (endoscopic plus drug[s], drug combinations) on variceal/any-cause rebleeding and mortality among cirrhotic patients with one previous episode of variceal hemorrhage. SUMMARY: We searched PubMed, Embase, Cochrane Library, and Web of Science for eligible studies. We included 26 randomized controlled trials involving 2,536 adults using OR to measure the effects. Endoscopic variceal ligation (EVL) plus nadolol ranked first for reducing recurrent bleeds...
November 21, 2017: Digestive Diseases
https://www.readbyqxmd.com/read/29154015/albumin-bilirubin-grade-versus-meld-score-for-predicting-survival-after-transjugular-intrahepatic-portosystemic-shunt-tips-creation
#5
J Ronald, Q Wang, S S Choi, P V Suhocki, M D Hall, T P Smith, C Y Kim
OBJECTIVES: The purpose of this study was to compare the albumin-bilirubin (ALBI) grade and model for end-stage liver disease (MELD) scores for predicting survival after transjugular intrahepatic portosystemic shunt (TIPS) creation. MATERIALS AND METHODS: A retrospective study of pre-procedure ALBI and MELD scores was performed in 197 patients who underwent TIPS from 2005 to 2012. There were 140 men and 57 women, with a mean age of 56±11 (SD) (range: 19-90years)...
November 16, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/29146727/primary-intraventricular-haemorrhage-due-to-rupture-of-giant-varix-of-the-basal-vein-of-rosenthal-in-a-patient-with-long-standing-direct-ccf-angiographic-features-and-treatment-considerations
#6
Chinmay P Nagesh, Aneesh Mohimen, Santhosh K Kannath, Jayadevan E Rajan
Direct carotid cavernous fistulae (CCF) are often detected early and treated promptly resulting in a paucity of literature regarding its long-term evolution. We present a case of high flow post-traumatic direct CCF that was neglected for over 6 years and presented with a rare manifestation of primary intraventricular haemorrhage. Occlusions of the primary venous outlets likely resulted in engorgement of the deep venous system. The segmental anatomy of the shunting basal vein is critical to the clinical presentation and may range from basal ganglia or brainstem oedema/infarctions to uniquely, as in our case, isolated intraventricular haemorrhage secondary to variceal rupture...
November 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29145280/liver-stiffness-measurement-and-spleen-diameter-as-predictors-for-the-presence-of-esophageal-varices-in-chronic-hepatitis-c-patients
#7
Mohammed Tag-Adeen, Mohamed Alsenbesy, Ali Abdelrahman Ghweil, M Ali Hussein Abd Elrazek, Elsayed A Elgohary, Mohammad M Sallam, Ali Ismael, Abdallah Nawara
Although it is an invasive and unpleasant procedure, esophagogastroduodenoscopy (EGD) is still the gold standard for esophageal varices (EV) detection. The aim of this study was to investigate liver stiffness measurement (LSM) and spleen diameter as simple noninvasive tools for EV prediction in chronic hepatitis C patients (CHC).A total of 123 Egyptian patients with CHC have been included and were classified based on screening EGD result into 2 groups; group A (without EV) and group B (with EV). Group (B) was subclassified according to EV grade into 4 subgroups: (B1, grade I), (B2, grade II), (B3, grade III), and (B4, grade IV)...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29137043/portal-vein-thrombosis-before-and-after-transjugular-intrahepatic-portosystemic-shunt-placement-an-observational-study-strobe-compliant
#8
Yue-Meng Wan, Yu-Hua Li, Hua-Mei Wu, Zhi-Yuan Xu, Ying Xu, Li-Hong Yang, Xi-Nan Wu, Jin-Hui Yang
Portal vein thrombosis (PVT) is common in patients with cirrhosis undergoing transjugular intrahepatic portosystemic shunt (TIPS). This study had 3-fold aims: to assess risk factors for PVT; to determine the efficacy of anticoagulant therapy; to investigate the impact of PVT on clinical outcomes in TIPS-treated cirrhosis.Between June 2012 and February 2016, 126 TIPS-treated patients with cirrhosis were enrolled and studied prospectively. Enrolled patients were screened for PVT before TIPS and at 3, 6, 12, and 24 months post-TIPS...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29134968/-weekend-effect-in-patients-with-upper-gastrointestinal-hemorrhage-a-systematic-review-and-meta-analysis
#9
REVIEW
Ashutosh Gupta, Rajender Agarwal, Ashwin N Ananthakrishnan
OBJECTIVES: "Weekend effect" refers to worse outcomes among patients presenting to the hospital on weekends or holidays. We performed a systematic review and meta-analysis of observational studies assessing the impact of the "weekend effect" in patients with upper gastrointestinal hemorrhage (UGIH). METHODS: We searched key bibliographic databases using keywords and MeSH terms related to gastrointestinal hemorrhage and "weekend effect". Our primary analysis evaluated mortality in patients with UGIH who were hospitalized on the weekend or after-hours compared with a weekday...
November 14, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29127060/granulocyte-colony-stimulating-factor-and-autologous-cd133-positive-stem-cell-therapy-in-liver-cirrhosis-realistic-an-open-label-randomised-controlled-phase-2-trial
#10
Philip Noel Newsome, Richard Fox, Andrew L King, Darren Barton, Nwe-Ni Than, Joanna Moore, Christopher Corbett, Sarah Townsend, James Thomas, Kathy Guo, Diana Hull, Heather A Beard, Jacqui Thompson, Anne Atkinson, Carol Bienek, Neil McGowan, Neil Guha, John Campbell, Dan Hollyman, Deborah Stocken, Christina Yap, Stuart John Forbes
BACKGROUND: Results of small-scale studies have suggested that stem-cell therapy is safe and effective in patients with liver cirrhosis, but no adequately powered randomised controlled trials have been done. We assessed the safety and efficacy of granulocyte colony-stimulating factor (G-CSF) and haemopoietic stem-cell infusions in patients with liver cirrhosis. METHODS: This multicentre, open-label, randomised, controlled phase 2 trial was done in three UK hospitals and recruited patients with compensated liver cirrhosis and MELD scores of 11·0-15·5...
November 7, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29125212/hepatobiliary-and-pancreatic-management-of-bleeding-colonic-varices-in-liver-disease
#11
L Y Zhou, Y J Ma, F Tian
No abstract text is available yet for this article.
December 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29124843/splenic-vessel-preservation-versus-splenic-vessel-resection-in-laparoscopic-spleen-preserving-distal-pancreatectomy
#12
Baohua Hou, Dailan Xiong, Sheng Chen, Tingting Ma, Chuanzhao Zhang, Yu Zhou, Zi Yin
BACKGROUND: Laparoscopic spleen-preserving distal pancreatectomy for low-grade malignant pancreas tumours was recently demonstrated and can be performed with splenic vessel preservation (SVP) or splenic vessel resection (SVR). Whether one approach is superior to another is still a matter of debate. METHODS: A systematic literature search (PubMed, Embase, Science Citation Index, Springer-Link and Cochrane Central Register of Controlled Trials) was performed. Pooled intra- and post-operative outcomes were evaluated...
November 9, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29123079/a-case-of-round-ligament-varices-presenting-in-pregnancy
#13
Luis F García-Paredes, Stephanie C Torres-Ayala, Wilmarie Rivera-Hernández, Wilma Rodriguez Mojica
BACKGROUND Round ligament varices (RLV) are rare and are almost exclusively seen in pregnant women. RLV may clinically resemble an inguinal hernia, inguinal mass, or other pathology involving the inguinal canal and round ligament. Ultrasound imaging is important to make the diagnosis of RLV. CASE REPORT A 34-year-old Hispanic woman, gravida 1 para 0, at 34 weeks gestation, presented to our outpatient department with a complaint of a small, painless, reducible right inguinal mass. Gray-scale sonography showed an asymmetric right inguinal anechoic mass composed of multiple serpentine tubular channels, which became more prominent when the patient performed a Valsalva maneuver...
November 10, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29118569/embolia-cutis-medicamentosa-an-unusual-adverse-reaction-to-terlipressin
#14
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
https://www.readbyqxmd.com/read/29118563/cardiac-dysfunction-as-an-early-predictor-of-portal-hypertension-in-chronic-hepatitis-c
#15
Cecilia Marconi, Mattia Bellan, Paola Giarda, Rosalba Minisini, Serena Favretto, Michela Emma Burlone, Lisa Franzosi, Mario Pirisi
Background: Cirrhotic cardiomyopathy is characterized by a set of cardiovascular modifications observed in advanced chronic liver disease. The aim of this study was to investigate cardiovascular alterations in chronic liver disease with different stages of fibrosis and to correlate cardiac involvement with endoscopic complications of portal hypertension. Methods: Seventy patients with chronic hepatitis C-related chronic liver disease and 20 sex- and age-matched controls underwent clinical evaluation, hepatic transient elastography, and echocardiography...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29117668/outcomes-of-patients-treated-with-sengstaken-blakemore-tube-for-uncontrolled-variceal-hemorrhage
#16
Ja Yun Choi, Yun Won Jo, Sang Soo Lee, Wan Soo Kim, Hye Won Oh, Cha Young Kim, Eun Young Yun, Jin Joo Kim, Jae Min Lee, Hong Jun Kim, Hyun Jin Kim, Tae Hyo Kim, Woon Tae Jung, Ok Jae Lee, Rock Bum Kim
Background/Aims: The aim of this study was to investigate the mortality, bleeding control rate, and their associated predictors in patients treated with Sengstaken-Blakemore (SB) tube for uncontrolled variceal hemorrhage associated with hemodynamic instability or failure of endoscopic treatment. Methods: The clinical data of 66 consecutive patients with uncontrolled variceal hemorrhage treated with SB tube at Gyeongsang National University Hospital from October 2010 to October 2015 were retrospectively analyzed...
November 10, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29114970/risk-factors-for-exacerbations-of-gastroesophageal-varices-and-portosystemic-encephalopathy-during-treatment-with-nucleos-t-ide-analogs-for-hepatitis-b-virus-related-cirrhosis
#17
Yuko Nagaoki, Hiroshi Aikata, Kana Daijyo, Yuji Teraoka, Fumi Honda, Yuki Nakamura, Masahiro Hatooka, Kei Morio, Hatsue Fujino, Takashi Nakahara, Tomokazu Kawaoka, Daiki Miki, Masataka Tsuge, Akira Hiramatsu, Michio Imamura, Yoshiiku Kawakami, Hidenori Ochi, Kazuaki Chayama
AIM: The aim of this study was to determine the risk factors for worsening of gastroesophageal varices (GEVs) and development of portosystemic encephalopathy in patients with hepatitis B virus (HBV)-related cirrhosis during nucleos(t)ide analogs (NAs) treatment. METHODS: 137 patients with HBV-related cirrhosis were enrolled in this retrospective cohort study. Findings of portal hemodynamics with CT, liver function and endoscopic examination during NAs treatment were examined...
November 8, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29113006/transjugular-portal-vein-recanalization-with-creation-of-intrahepatic-portosystemic-shunt-pvr-tips-in-patients-with-chronic-non-cirrhotic-non-malignant-portal-vein-thrombosis
#18
Christoph Klinger, Bettina Riecken, Arthur Schmidt, Andrea De Gottardi, Benjamin Meier, Jaime Bosch, Karel Caca
Purpose To determine safety and efficacy of transjugular portal vein recanalization with creation of intrahepatic portosystemic shunt (PVR-TIPS) in patients with chronic non-cirrhotic, non-malignant portal vein thrombosis (PVT). Methods This retrospective study includes 17 consecutive patients with chronic non-cirrhotic PVT (cavernous transformation n = 15). PVR-TIPS was indicated because of variceal bleeding (n = 13), refractory ascites (n = 2), portal biliopathy with recurrent cholangitis (n = 1), or abdominal pain (n = 1)...
November 7, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29110990/transjugular-intrahepatic-portosystemic-shunt-as-a-bridge-to-non-hepatic-surgery-in-cirrhotic-patients-with-severe-portal-hypertension-a-systematic-review
#19
REVIEW
Eylon Lahat, Chetana Lim, Prashant Bhangui, Liliana Fuentes, Michael Osseis, Toufic Moussallem, Chady Salloum, Daniel Azoulay
BACKGROUND: Portal hypertension (PHTN) increases the risk of non-hepatic surgery in cirrhotic patients. This first systematic review analyzes the place of transjugular intrahepatic portosystemic shunt (TIPS) in preparation for non-hepatic surgery in such patients. METHODS: Medline, EMBASE, and Scopus databases were searched from 1990 to 2017 to identify reports on outcomes of non-hepatic surgery in cirrhotic patients with PHTN prepared by TIPS. Feasibility of TIPS and the planned surgery, and the short- and long-term outcomes of the latter were assessed...
October 27, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29110128/endoscopic-treatments-for-portal-hypertension
#20
REVIEW
Gin-Ho Lo
Acute esophageal variceal hemorrhage is a dreaded complication of portal hypertension. Its management has evolved rapidly in recent years. Endoscopic therapy is often employed to arrest bleeding varices as well as to prevent early rebleeding. The combination of vasoconstrictor and endoscopic therapy is superior to vasoconstrictor or endoscopic therapy alone for control of acute esophageal variceal hemorrhage. After control of acute variceal bleeding, combination of banding ligation and beta-blockers is generally recommended to prevent variceal rebleeding...
November 7, 2017: Hepatology International
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