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Gastric varices

Sofia Simona Jakab, Guadalupe Garcia-Tsao
Gastro-esophageal varices (GEV) and variceal hemorrhage (VH) are clinical milestones in the natural history of cirrhosis, as they are closely related to the severity of portal hypertension and define specific stages in disease progression. Variceal hemorrhage is a life-threatening complication of cirrhosis and is one of the clinical complications that defines cirrhosis decompensation. The goal of screening and surveillance of varices is to identify patients with GEV at a high risk of bleeding, so that prevention strategies can be implemented...
March 15, 2018: Clinical Gastroenterology and Hepatology
Ikram Hussain, Andrew Eu Boon Kwek, Veeraraghavan Meyyur Aravamudan, Chern Hao Chong, Tiing Leong Ang
Background . Injection with N-butyl-2-cyanoacrylate is a proven and successful therapeutic modality for treatment of patients with bleeding gastric varices. However, a variety of complications have also been associated with its use. Here, we report a rare case of retrogastric abscess which occurred almost six months after this therapy. This abscess was attributed to the hampered microbial clearance caused by the venous obliterations from N-butyl-2-cyanoacrylate. The abscess was successfully treated with 3 months of antibiotics...
2018: Case Reports in Medicine
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...
March 1, 2018: Surgical Innovation
Dong Il Gwon, Gi-Young Ko, Young Baek Kwon, Hyun-Ki Yoon, Kyu-Bo Sung
Objective: To investigate the technical and clinical outcomes of plug-assisted retrograde transvenous obliteration (PARTO) for the treatment of gastric varices (GV) and to evaluate the role of intra-procedural cone-beam computed tomography (CBCT) performed during PARTO to confirm its technical success. Materials and Methods: From January 2016 to December 2016, 17 patients with GV who had undergone PARTO were retrospectively evaluated. When the proximal part of the afferent vein was identified on a fluoroscopy, non-contrast CBCT images were obtained...
March 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Joohwan Bae, Dong Hyun Sinn, Wonseok Kang, Geum-Youn Gwak, Moon Seok Choi, Yong-Han Paik, Joon Hyeok Lee, Kwang Cheol Koh, Seung Woon Paik
BACKGROUND AND AIMS: The Baveno VI and the expanded Baveno VI criteria were proposed to help identify patients who could safely avoid screening endoscopies for clinically significant varices among patients with compensated advanced chronic liver disease (cACLD). However, these criteria require cross-validation, especially in Asian populations where the etiologies of liver disease is different. METHODS: A total of 1,035 patients, including 282 patients with cACLD of different etiology, were analyzed...
March 1, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Seyyed Reza Sadat Ebrahimi, Elgar Enamzadeh, Hossein Babaei
BACKGROUND: Polidocanol is approved for its competence in 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...
February 23, 2018: Current Clinical Pharmacology
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
Ju Shuai, Li Ying, Ji Chang-Xue, Zhang Biao
OBJECTIVE: To discuss the application of the degree of portal systemic shunting in assessing the upper gastrointestinal bleeding in patients with hepatic schistosomiasis. METHODS: Thirty-three patients with upper gastrointestinal bleeding caused by hepatic schistosomiasis (a bleeding group) and 29 schistosomiasis cirrhosis patients without bleeding (a non-bleeding group) were enrolled as investigation subjects in Jinshan Hospital. The subjects were scanned by the 128 abdominal slice spiral CT...
March 27, 2017: Zhongguo Xue Xi Chong Bing Fang Zhi za Zhi, Chinese Journal of Schistosomiasis Control
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
Arul Thomas, David Koch, William Marsteller, David Lewin, Adrian Reuben
BACKGROUND: Gastric antral vascular ectasia (GAVE) commonly presents as linear striped ("watermelon stomach") or punctate phenotypes, to which a newly discovered nodular form was recently added. AIMS: We performed a retrospective cohort study to detail and compare the clinical and histological characteristics of major GAVE phenotypes. METHODS: In 136 GAVE patients (tertiary care ambulatory and inpatient, median age 61.3 years, 73 men, and 63 women), clinical and laboratory results were recorded, with comorbidities, endoscopy indications, and complications of cirrhosis...
February 15, 2018: Digestive Diseases and Sciences
H Jer Hwang, Ignacio Málaga, C Curvale, M Guidi, R Matano
No abstract text is available yet for this article.
February 10, 2018: Revista de Gastroenterología de México
Huixian Li, Dong Ye, Derun Kong
No abstract text is available yet for this article.
February 8, 2018: Endoscopy
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
Corina Lupascu-Ursulescu, Ana-Maria Trofin, Mihai Zabara, Alexandra Vornicu, Ramona Cadar, Oana Apopei, Gabriela Stefanescu, Cristian Lupascu
INTRODUCTION: Bleeding from isolated gastric varices, though uncommon, may be life threatening and may occur as a consequence of splenic vein thrombosis by tumoral compression and subsequent left-sided portal hypertension. CASE OVERVIEW: We report the case of a 37-year old woman, previously diagnosed with a benign pancreatic cyst, who presented with severe gastric variceal bleeding. DIAGNOSIS, THERAPEUTICS INTERVENTIONS, AND OUTCOMES: Abdominal ultrasound (US) and computed-tomography (CT) revealed enlargement and changed morphology of the cystic tumor located on the body of the pancreas...
November 2017: Medicine (Baltimore)
Yue-Meng Wan, Yu-Hua Li, Ying Xu, Hua-Mei Wu, Ying-Chun Li, Xi-Nan Wu, Jin-Hui Yang
RATIONALE AND OBJECTIVES: Transjugular intrahepatic portosystemic shunt (TIPS) is an established method for portal hypertension. This study was to investigate the long-term safety, technical success, and patency of TIPS, and to determine the risk factors and clinical impacts of shunt dysfunction. MATERIALS AND METHODS: A total of 154 consecutive patients undergoing embolotherapy of gastric coronary vein and/or short gastric vein and TIPS creation were prospectively studied...
January 16, 2018: Academic Radiology
Akihiro Furuta, Hiroyoshi Isoda, Tsuyoshi Ohno, Ayako Ono, Rikiya Yamashita, Shigeki Arizono, Aki Kido, Naotaka Sakashita, Kaori Togashi
Objective: To selectively visualize the left gastric vein (LGV) with hepatopetal flow information by non-contrast-enhanced magnetic resonance angiography under a hypothesis that change in the LGV flow direction can predict the development of esophageal varices; and to optimize the acquisition protocol in healthy subjects. Materials and Methods: Respiratory-gated three-dimensional balanced steady-state free-precession scans were conducted on 31 healthy subjects using two methods (A and B) for visualizing the LGV with hepatopetal flow...
January 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Joseph D Morrison, Nasya Mendoza-Elias, Andrew J Lipnik, R Peter Lokken, James T Bui, Charles E Ray, Ron C Gaba
PURPOSE: To quantify and compare portosystemic pressure gradients (PSGs) between bleeding esophageal varices (EV) and gastric varices (GV). MATERIALS AND METHODS: In a single-center, retrospective study, 149 patients with variceal bleeding (90 men, 59 women, mean age 52 y) with EV (n = 69; 46%) or GV (n = 80; 54%) were selected from 320 consecutive patients who underwent successful transjugular intrahepatic portosystemic shunt (TIPS) creation from 1998 to 2016...
January 15, 2018: Journal of Vascular and Interventional Radiology: JVIR
Bhavtosh Dedania, Keshav Kukreja, Tomas Davee, Manoop S Bhutani
No abstract text is available yet for this article.
January 12, 2018: Endoscopy
Nam Hee Kim, Taeheon Lee, Yong Kyun Cho, Byung Ik Kim, Hong Joo Kim
BACKGROUND AND AIM: The aim of this study is to determine the impact of clinically evident portal hypertension (CEPH) on prognosis of hepatocellular carcinoma (HCC) patients with Child-Pugh A cirrhosis who underwent transarterial chemoembolization (TACE). METHODS: A retrospective data analysis was performed for a total of 388 treatment-naïve HCC patients with Child-Pugh A cirrhosis who underwent TACE as first-line treatment from January 2000 to June 2014. Cumulative occurrence rate of complete response (CR), progression-free survival (PFS), and overall survival (OS) were compared between patients with CEPH and those without CEPH (esophageal/gastric varices or low platelet count [< 100 000 per mm3 ] associated with splenomegaly)...
January 3, 2018: Journal of Gastroenterology and Hepatology
Ningning Sun, Guangjun Lu, Likun Zhang, Xiaoling Wang, Chunmin Gao, Jieliang Bi, Xiaoyi Wang
OBJECTIVE: The meta-analysis was performed to investigate the clinical efficacy of spleen-preserving distal pancreatectomy with splenic vessel preservation (SPDP-SVP) and spleen-preserving distal pancreatectomy with splenic vessel resection (SPDP-SVR). METHODS: Potential articles were searched on the databases of Pubmed, Embase, and Chinese National Knowledge Infrastructure (CNKI) from January 1988 until March 2017. Weight mean difference (WMD) with 95% confidence interval (CI) was applied to compare the efficacy of SPDP-SVP and SPDP-SVR...
December 2017: Medicine (Baltimore)
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