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Portal hypertension

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https://www.readbyqxmd.com/read/28335998/point-shear-wave-elastography-to-evaluate-and-monitor-changing-portal-venous-pressure-in-patients-with-decompensated-cirrhosis
#1
Hao Han, Jian Yang, Yu-Zheng Zhuge, Ming Zhang, Min Wu
This study evaluated whether the stiffness of the liver and spleen, measured using the point shear wave elastography (pSWE) technique, correlates with portal venous pressure (PVP) and whether the result extends to estimate the diminishing change in PVP (ΔPVP) in patients with decompensated cirrhosis. We evaluated the data of 67 prospectively enrolled patients who underwent both transjugular intrahepatic portosystemic shunt (TIPS) and pSWE. The stiffness of liver and spleen were evaluated by measuring shear wave velocity (SWV) to determine the statistical correlation with PVP...
March 20, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28331456/primary-care-practice-reengineering-and-associations-with-patient-portal-use-service-utilization-and-disease-control-among-patients-with-hypertension-and-or-diabetes
#2
Eboni G Price-Haywood, Qingyang Luo
BACKGROUND: We describe the role of primary care reengineering in the Ochsner Health System (OHS) patient portal implementation strategy and compare subsequent trends in service utilization and disease control among portal users vs nonusers within this context. METHODS: This retrospective cohort study includes 101,019 patients with hypertension or diabetes who saw an OHS primary care provider (PCP) between 2012 and 2014. Inverse probability treatment weighting was used to reduce case-mix differences between study groups...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28321540/ct-perfusion-imaging-of-the-liver-and-the-spleen-in-patients-with-cirrhosis-is-there-a-correlation-between-perfusion-and-portal-venous-hypertension
#3
Emina Talakić, Silvia Schaffellner, Daniela Kniepeiss, Helmut Mueller, Rudolf Stauber, Franz Quehenberger, Helmut Schoellnast
OBJECTIVES: To correlate hepatic and splenic CT perfusion parameters with hepatic venous pressure gradient (HVPG) measurements in patients with cirrhosis. METHODS: Twenty-one patients with cirrhosis (males, 17; females, 4; mean ± SD age, 57 ± 7 years) underwent hepatic and splenic perfusion CT on a 320-detector row volume scanner as well as invasive measurement of HVPG. Different CT perfusion algorithms (maximum slope analysis and Patlak plot) were used to measure hepatic arterial flow (HAF), portal venous flow (PVF), hepatic perfusion index (HPI), splenic arterial flow (SAF), splenic blood volume (SBV) and splenic clearance (SCL)...
March 20, 2017: European Radiology
https://www.readbyqxmd.com/read/28319252/physiologic-reduction-of-hepatic-venous-blood-flow-by-the-valsalva-maneuver-decreases-liver-stiffness
#4
Selcan Ipek-Ugay, Heiko Tzschätzsch, Jürgen Braun, Thomas Fischer, Ingolf Sack
OBJECTIVES: Liver stiffness increases after intake of food or water, suggesting that hepatic venous blood flow affects the results of elastographic measurements. This study investigated the correlation between in vivo liver stiffness and hepatic blood flow using the Valsalva maneuver for reducing intrahepatic venous blood flow. METHODS: Intrahepatic changes in venous blood flow were assessed by sonography based on the pulsed wave Doppler velocity, vessel diameter assessment, and blood flow volume measurements in the portal vein and right hepatic vein...
March 20, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28316323/a-rare-cause-of-upper-gastrointestinal-hemorrhage-chronic-thrombosis-of-the-splenic-artery
#5
Sevtap Arslan, Mehmet Ruhi Onur, Erhan Akpınar
Upper gastrointestinal bleeding (UGIB) represents one of the most serious conditions of the gastrointestinal tract with a mortality rate of 10%. The main cause of UGIB is peptic ulcer, accounting for 28%-59% of cases. A rare cause of UGIB is submucosal arterial collaterals, which develop after splenic artery thrombosis. UGIB secondary to gastric submucosal collateral arteries should be considered in patients with endoscopic appearance of varicose veins in the absence of portal hypertension. Computed tomography angiography (CTA) is the only fast and noninvasive definitive imaging technique for such patients...
March 17, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28303875/-endoscopic-ligation-in-treatment-and-prevention-of-bleeding-from-esophageal-varices
#6
S A Gabriel', A Ya Guchetl', V M Durleshter, V Yu Dyn'ko, D S Murashko, V S Krushel'nitsky
AIM: To demonstrate the efficacy of endoscopic ligation in treatment and prevention of bleeding from esophageal varices in patients with liver cirrhosis and portal hypertension. MATERIAL AND METHODS: We performed a retrospective analysis of 338 patients with liver cirrhosis who underwent ligation for the period 2009 - May 2016. There were 209 (61.8%) men and 129 (38.2%) women. In this group 511 ligations were performed. The total number of ligated nodes was 4086...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28302230/distal-duodenal-varices-first-presentation-of-upper-gastrointestinal-bleeding
#7
Inam -Ul- Haq, Amir Ali Shah, S Chandramohan
Varices are abnormal dilated veins which result from increased pressure in the portal circulation. Although the oesophagus and stomach are the most common sites for varices to develop, they may also occur as ectopic varices in the duodenum, rectum, and retroperitoneal areas. Isolated duodenal varices involving distal duodenum, particularly the fourth part of the duodenum, are extremely rare. However, such ectopic varices are associated with an increased risk of bleeding and mortality. Not only are they a diagnostic challenge, particularly if they present as a first manifestation of portal hypertension, they are also very difficult to treat due to their location...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28299974/causes-of-peripheral-cytopenia-in-hepatitic-cirrhosis-and-portal-hypertensive-splenomegaly
#8
Yunfu Lv, Wan Yee Lau, Hongfei Wu, XiaoYu Han, Xiaoguang Gong, Ning Liu, Jie Yue, Qingqing Li, YeJuan Li, Jie Deng
The clinical data of 183 patients with hepatitic cirrhosis and portal hypertensive splenomegaly complicated by peripheral cytopenia were retrospectively analyzed to investigate the causes of peripheral cytopenia, as well as the proportion of the causes in these patients. All patients underwent splenectomy. Before operation, these patients had one or more types of peripheral cytopenia (cumulative cytopenia: 390 patient-times). After splenectomy, blood counts in 79.2% (309/390) returned to normal, while in 15...
April 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28298957/the-intersection-of-pulmonary-hypertension-and-solid-organ-transplantation
#9
Adaani E Frost
Pulmonary hypertension (PH) is a complication and marker of disease severity in many parenchymal lung diseases. It also is a frequent complication of portal hypertension and negatively impacts survival with liver transplant. Pulmonary hypertension is frequently diagnosed in patients with end-stage renal disease who are undergoing dialysis, and it has recently been demonstrated to adversely affect posttransplant outcome in this patient population even though the mechanism of PH is substantially different from that associated with liver disease...
October 2016: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28298943/hepatic-vein-transit-time-of-second-generation-ultrasound-contrast-agent-new-tool-in-the-assessment-of-portal-hypertension
#10
Siciliani Luisa, Giovanna Vitale, Anna Rita Sorbo, Pompili Maurizio, Rapaccini Gian Lodovico
PURPOSE: It has been demonstrated that Doppler waveform of the hepatic vein (normally triphasic) is transformed into a biphasic or monophasic waveform in cirrhotic patients. The compressive mechanism of liver tissue has been considered up till now the cause of this change. Moreover, cirrhotics show, after USCA injection, a much earlier HVTT due to intrahepatic shunts. Our aim was to prospectively evaluate the correlation between Doppler pattern of hepatic vein and HVTT of a second-generation USCA; we also correlated HVTT with the most common indexes of portal hypertension...
March 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28297782/-clinical-diagnosis-and-treatment-of-regional-portal-hypertension-an-analysis-of-7-cases-and-literature-review
#11
S H Tang, W Z Zeng, X L Wu, J P Qin, C He, Z Wang, M D Jiang
No abstract text is available yet for this article.
January 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28296808/waitlisted-candidates-with-polycystic-liver-disease-are-more-likely-to-be-transplanted-than-those-with-chronic-liver-failure
#12
Sahil D Doshi, Therese Bittermann, Thomas D Schiano, David Seth Goldberg
BACKGROUND: Polycystic liver disease (PCLD) is characterized by cystic replacement of the hepatic parenchyma, leading to hepatic dysfunction, portal hypertension, and hepatomegaly. Patients with liver dysfunction and/or symptomatic disease are eligible for liver transplantation. However, little is known about these patients' waitlist outcomes relative to others with chronic liver disease. METHODS: We used OPTN/UNOS data from February 27, 2002 to December 31, 2015 to compare waitlist outcomes of adult patients with PCLD to those with chronic liver failure (CLF) and hepatocellular carcinoma (HCC)...
March 15, 2017: Transplantation
https://www.readbyqxmd.com/read/28296630/effective-prevention-for-portal-venous-system-thrombosis-after-splenectomy-a-meta-analysis
#13
Xiao Zhang, Yadong Wang, Miao Yu, Jinzhao Huang, Dongfeng Deng, Huanzhou Xue
PURPOSE: Portal venous system thrombosis (PVST) is a common and potentially life-threatening complication of splenectomy for portal hypertension due to cirrhosis. METHODS: A meta-analysis was conducted to study the necessity of pharmacologic prophylaxis of PVST after splenectomy and how to select the feasible treatment method. Articles were searched through the PubMed, EMBASE, Cochrane Library databases, and CNKI. RESULTS: Overall, 404 articles were initially identified, and 11 of them were eligible...
March 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28295923/effect-of-viral-suppression-on-hepatic-venous-pressure-gradient-in-hepatitis-c-with-cirrhosis-and-portal-hypertension
#14
Nezam Afdhal, Gregory T Everson, Jose Luis Calleja, Geoffrey W McCaughan, Jaime Bosch, Diana M Brainard, John G McHutchison, Shampa De-Oertel, Di An, Michael Charlton, Rajender K Reddy, Tarik Asselah, Edward Gane, Michael P Curry, Xavier Forns
BACKGROUND&AIMS: Portal hypertension is a predictor of liver-related clinical events and mortality in patients with hepatitis C and cirrhosis. The effect of interferon-free hepatitis C treatment on portal pressure is unknown. METHODS: Fifty patients with Child-Pugh-Turcotte (CPT) A and B cirrhosis and portal hypertension (hepatic venous pressure gradient [HVPG] >6 mmHg) were randomized to receive 48 weeks of open-label sofosbuvir plus ribavirin at Day 1 or after a 24-week observation period...
March 10, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28295661/noncirrhotic-portal-hypertension-in-necrobiotic-xanthogranuloma-associated-with-monoclonal-gammopathy
#15
M Vignon, L Placais, M Malphettes, J D Bouaziz, B Asli, P Bedossa, J Rivet, R Szalat, A M Zagdanski, M Rybojad, J P Fermand, M Baron, P E Rautou, B Arnulf
We report two cases of patients with necrobiotic xanthogranuloma (NXG) associated with monoclonal gammopathy. Besides cutaneous lesions, they both presented idiopathic non-cirrhotic portal hypertension (INCPH). In 2007, a 65-year-old woman was referred for nodular eruption (Fig. 1 - A) located around the neck. Cervical skin biopsy showed normal epidermis and a layer of inflammatory elements on the reticular dermis. This article is protected by copyright. All rights reserved.
March 10, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28295621/hepatic-and-plasma-endothelin-1-in-dogs-with-chronic-hepatitis
#16
Y Sakamoto, M Sakai, T Watari
BACKGROUND: Endothelin (ET)-1 is a 21-amino-acid peptide with potent vasoactive properties, which increases intrahepatic resistance in patients with chronic hepatitis (CH) or cirrhosis. ET-1 concentrations have not been investigated in dogs with CH. HYPOTHESIS/OBJECTIVES: This study compared hepatic and plasma ET-1 levels in healthy dogs and in dogs with CH, and examined the relationship between the plasma ET-1 level and portal vein pressure in dogs with CH. ANIMALS: Fourteen healthy dogs and twenty dogs with CH were used in this study...
March 14, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28293094/competing-risk-analysis-on-outcome-after-hepatic-resection-of-hepatocellular-carcinoma-in-cirrhotic-patients
#17
Alessandro Cucchetti, Carlo Sposito, Antonio Daniele Pinna, Davide Citterio, Matteo Cescon, Marco Bongini, Giorgio Ercolani, Christian Cotsoglou, Lorenzo Maroni, Vincenzo Mazzaferro
AIM: To investigate death for liver failure and for tumor recurrence as competing events after hepatectomy of hepatocellular carcinoma. METHODS: Data from 864 cirrhotic Child-Pugh class A consecutive patients, submitted to curative hepatectomy (1997-2013) at two tertiary referral hospitals, were used for competing-risk analysis through the Fine and Gray method, aimed at assessing in which circumstances the oncological benefit from tumour removal is greater than the risk of dying from hepatic decompensation...
February 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28288507/anticoagulation-in-cirrhosis-a-new-paradigm
#18
Filippo Leonardi, Nicola De Maria, Erica Villa
The liver plays a crucial role in coagulation cascade. Global hemostatic process is profoundly influenced by the presence of liver disease and its complications. Patients with cirrhosis have impaired synthesis of most of the factors involved in coagulation and fibrinolysis process due to a reduced liver function and altered platelet count secondary to portal hypertension. Altered routine tests and thrombocytopenia were considered in the past as associated with increased risk of bleeding. These concepts explain both the routine use of plasma and/or platelets transfusion in patients with liver cirrhosis, especially before invasive procedures, and why these patients were considered "auto-anticoagulated"...
March 14, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28286795/systemic-mastocytosis-complicated-by-non-cirrhotic-portal-hypertension-and-variceal-bleeding
#19
Thomas R McCarty, Adelina Hung, Arpan Mohanty, John I Allen
Systemic mastocytosis is a myeloproliferative disorder characterized by extracutaneous involvement of at least one organ. Although rare, infiltration of inflammatory mast cells within the portal vein may lead to obstruction of the sinusoids resulting in non-cirrhotic portal hypertension. We present a patient with known history of systemic mastocytosis with bone marrow involvement presenting with new-onset esophageal variceal bleeding. Although systemic mastocytosis is uncommon, the subsequent development of hepatic involvement and non-cirrhotic portal hypertension are discussed...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28286557/covered-versus-bare-stents-for-transjugular-intrahepatic-portosystemic-shunt-an-updated-meta-analysis-of-randomized-controlled-trials
#20
Xingshun Qi, Yulong Tian, Wei Zhang, Zhiping Yang, Xiaozhong Guo
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) is a standard treatment option for the management of portal hypertension in liver cirrhosis. Since the introduction of covered stents, shunt patency has been greatly improved. However, it remains uncertain about whether covered stents could improve survival. A meta-analysis of randomized controlled trials has been performed to compare the outcomes of covered versus bare stents for TIPS. METHODS: PubMed, EMBASE, and Cochrane Library databases were searched to identify the relevant randomized controlled trials...
January 2017: Therapeutic Advances in Gastroenterology
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