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variceal gastrointestinal bleeding

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https://www.readbyqxmd.com/read/29201796/hepatic-venous-pressure-gradient-measurement-in-bangladeshi-cirrhotic-patients-a-correlation-with-child-s-status-variceal-size-and-bleeding
#1
Mamun Al Mahtab, Sheikh M Noor E Alam, Mohammad A Rahim, Mohammad A Alam, Faiz A Khondaker, Ahmed L Moben, Masuda Mohsena, Sheikh Mohammad Fazle Akbar
Background: Hepatic venous pressure gradient (HVPG) reflects the portal pressure in patients with cirrhotic portal hypertension. The aim of the study was to assess the relation of HVPG to variceal size, Child-Pugh status, and variceal bleeding. Materials and methods: A total of 96 patients with cirrhosis of liver were enrolled prospectively and each patient's HVPG level was measured via the transfemoral route. Clinical and biochemical evaluation and upper gastrointestinal (GI) endoscopy were done in each subject...
July 2017: Euroasian Journal of Hepato-Gastroenterology
https://www.readbyqxmd.com/read/29201764/predictive-value-of-mean-platelet-volume-in-variceal-bleeding-due-to-cirrhotic-portal-hypertension
#2
Mehmet A Erdogan, Ali R Benli, Serap B Acmali, Mustafa Koroglu, Yahya Atayan, Ahmet Danalioglu, Burcak Kayhan
Aim: To investigate whether mean platelet volume (MPV) is a predictor of variceal bleeding in patients with cirrhotic portal hypertension. Materials and methods: This prospective cohort was performed in the internal medicine department of our tertiary care center. Cirrhotic patients were allocated into two groups: Group I consisted of 31 cases without a history of variceal bleeding, whereas group II was made up of 31 patients with a history of variceal bleeding...
January 2017: Euroasian Journal of Hepato-Gastroenterology
https://www.readbyqxmd.com/read/29190873/-segmental-portal-hypertension-with-splenic-vein-thrombosis-caused-by-pancreatitis
#3
Luis Franco-Avilés, Federico I Hernández-Rocha, Ulises Mercado, Cristian G Malvido-Torres
BACKGROUND: Splenic vein thrombosis is a complication of pancreatic carcinoma, pancreatitis or pancreatic pseudocyst. It may lead to segmental portal hypertension and bleeding from gastric varices. CLINICAL CASE: A 31 year-old man was diagnosed with pancreatitis of two weeks of evolution and was referred to our hospital in 2013. He had a history of alcohol consumption. Physical examination showed no stigmata of liver cirrhosis. Laboratory analyses revealed hemoglobin 9...
November 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/29183764/clinical-outcome-of-portal-vein-thrombosis-in-patients-with-digestive-cancers-a-large-ageo-multicenter-study
#4
Hélène Regnault, Sheik Emambux, Thierry Lecomte, Solene Doat, Marion Dhooge, Marie Besson, Olivier Dubreuil, Frederic Moryoussef, Christine Silvain, Jean-Baptiste Bachet, David Tougeron
INTRODUCTION: Management of portal vein thrombosis (PVT) in cancer patients remains discussed. AIMS: The objective of this multicenter retrospective study was to investigate the management and outcome of PVT in patients with digestive cancers other than hepatocellular carcinoma (HCC). METHOD: Main inclusion criteria were trunk or branch PVT in patients with locally advanced or metastatic digestive cancers. Predictive factors of bleeding and overall survival (OS) were evaluated in univariate and multivariate analysis...
November 16, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29176477/noninvasive-methods-of-predicting-large-esophageal-varices-in-children-with-intrahepatic-portal-hypertension
#5
Marina R Adami, Carlos Oscar Kieling, Fernando Pereira Schwengber, Vania N Hirakata, Sandra Maria Gonçalves Vieira
OBJECTIVE: Esophageal variceal bleeding is a severe complication of portal hypertension. The standard diagnostic screening test and therapeutic procedure for esophageal varices is endoscopy, which is invasive in pediatric patients. This study aimed to evaluate the role of noninvasive parameters as predictors of large varices in children with intrahepatic portal hypertension. METHODS: Participants included in this cross-sectional study underwent a screening endoscopy...
November 22, 2017: Journal of Pediatric Gastroenterology and Nutrition
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
#6
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/29099778/upper-gastrointestinal-bleeding-in-children-a-tertiary-united-kingdom-children-s-hospital-experience
#7
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/29098897/nasogastric-aspiration-lavage-in-patients-with-gastrointestinal-bleeding-a-review-of-the-evidence
#8
Stamatis Karakonstantis, Emmanouil Tzagkarakis, Dimitra Kalemaki, Charalampos Lydakis, Gregorios Paspatis
The usefulness of nasogastric aspiration and nasogastric lavage in patients with gastrointestinal bleeding is controversial, as evidenced by conflicting recommendations, both among and within society guidelines. Areas covered: Considering these controversies, we reviewed the evidence regarding the following questions: 1) Can nasogastric lavage stop or slow down the bleeding and improve subsequent endoscopic visualization? 2) Is nasogastric aspiration helpful for the localization of bleeding? 3) Can nasogastric aspiration identify high risk patients that might benefit from earlier endoscopy? 4) Is there evidence for benefit in terms of outcomes from using nasogastric aspiration? 5) Is nasogastric intubation safe in patients with possible esophageal varices? Our review was conducted according to PRISMA guidelines...
November 10, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29063774/-massive-bleeding-in-portal-hypertension-endoscopic-surgical-or-endovascular-management
#9
J Tornikidis, J Hoch, R Pádr, R Keil
Upper gastrointestinal bleeding is a serious and potentially life-threatening abdominal emergency. An important diagnostic goal is to determine the cause and localize the bleeding site(s), which is crucial for choosing an appropriate therapy and consequently also for the long-term result. Our case report presents a patient with recurrent upper gastrointestinal bleeding where even repeated endoscopic, surgical and endovascular interventions were not sufficient to determinate the cause of bleeding and to save the patient´s life...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28994870/predictive-scores-of-early-mortality-from-variceal-gastrointestinal-bleeding-in-cirrhotic-patients
#10
Leila Mouelhi, Hend Ayadi, Yosra Zaimi, Oussama Daboussi, Mohamed Salem, Radhouane Debbech, Fatma Houissa, Taoufik Najjar
INTRODUCTION: The variceal bleeding, main complication of portal hypertension during cirrhosis, is associated with high early mortality riskestimated between 15 and 20%. This highlights the necessity of predictive models that allow identifying high-risk patients raising the issue of amore aggressive therapeutic care. OBJECTIVE: To assess the performance of four scores for the prediction of cirrhotic patients' high early mortality risk due to digestive hemorrhageand to compare them to the Child-Pugh reference score...
November 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28983161/etiological-and-endoscopic-profile-of-middle-aged-and-elderly-patients-with-upper-gastrointestinal-bleeding-in-a-tertiary-care-hospital-in-north-india-a-retrospective-analysis
#11
Pranav Mahajan, Vijant Singh Chandail
BACKGROUND: Upper gastrointestinal (GI) bleeding is a common medical emergency associated with significant morbidity and mortality. The clinical presentation depends on the amount and location of hemorrhage and the endoscopic profile varies according to different etiology. At present, there are limited epidemiological data on upper GI bleed and associated mortality from India, especially in the middle and elderly age group, which has a higher incidence and mortality from this disease...
July 2017: Journal of Mid-life Health
https://www.readbyqxmd.com/read/28971259/efficacy-and-safety-of-superselective-trans-catheter-arterial-embolization-of-upper-and-lower-gastrointestinal-bleeding-using-n-butyl-2-cyanoacrylate
#12
Jae Hyun Kwon, Yoon Hee Han
PURPOSE: To evaluate the efficacy and safety of superselective trans-catheter arterial embolization (TAE) with N-butyl-2-cyanoacrylate (NBCA) for patients with acute non-variceal upper and lower gastrointestinal (GI) bleeding. METHODS: TAE using NBCA was performed in 21 patients (13 males, 8 females, mean age 60.9 years) with acute non-variceal upper (n = 15) and lower (n = 6) GI bleeding. TAE using other embolic agents was performed in 25 patients (13 males, 12 females, mean age 69...
October 2, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28953556/uncontrolled-bleeding-of-the-gastrointestinal-tract
#13
Alain D'Hondt, Lionel Haentjens, Nicolas Brassart, Frédéric Flamme, Jean-Charles Preiser
PURPOSE OF REVIEW: Acute gastrointestinal bleeding is a frequent emergency situation, whose incidence will likely rise as a result of the increasing use of direct anticoagulants and of the medical progresses resulting in longer life expectancy with underlying comorbidities. Updated guidelines and improvements in the diagnostic and therapeutic tools are now available and will likely improve the management of massive gastrointestinal bleeding in the near future. RECENT FINDINGS: The assessment of severity has been improved by validated scores useable upon admission...
December 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28924594/can-we-now-recommend-otsc-as-first-line-therapy-in-case-of-non-variceal-upper-gastrointestinal-bleeding
#14
EDITORIAL
Shannon Melissa Chan, James Yw Lau
No abstract text is available yet for this article.
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28924593/use-of-the-over-the-scope-clip-otsc-in-non-variceal-upper-gastrointestinal-bleeding-in-patients-with-severe-cardiovascular-comorbidities-a-retrospective-study
#15
Edris Wedi, Daniel von Renteln, Susana Gonzalez, Olena Tkachenko, Carlo Jung, Sinan Orkut, Victor Roth, Selin Tumay, Juergen Hochberger
INTRODUCTION:  The over-the-scope-clip (OTSC) can potentially overcome limitations of standard clips and achieve more efficient and reliable hemostasis. Data on OTSC use for non-variceal upper gastrointestinal bleeding (NVUGIB) in patients with cardiovascular comorbidities are currently limited. PATIENTS AND METHODS:  We prospectively collected and retrospectively analyzed our database from February 2009 to September 2015 from all patients who underwent emergency endoscopy for high-risk NVUGIB in 2 academic centers and were treated with OTSC as first-line (n = 81) or second-line therapy (n = 19)...
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28923638/treatment-of-refractory-gastrointestinal-bleeding-in-patients-with-portal-hypertension-a-case-series-and-treatment-algorithm
#16
J Balogh, S Gordon-Burroughs, P Schwarz, J Galati, R A McFadden, M Cusick, M J Snyder, H R Bailey, M Weiner, A Wong, R A Ochoa, A Saharia, A O Gaber, R M Ghobrial
In patients with portal hypertension, ectopic varices can develop at any site along the gastrointestinal tract outside the classically described gastroesophageal location. Like esophageal variceal hemorrhage, bleeding from ectopic varices can be life-threatening. Diagnosis and treatment of ectopic varices can be challenging; to date, no effective treatment algorithm has been described. A systematic teamwork approach to diagnosing and treatment of ectopic varices is required to successfully manage hemorrhage from ectopic varices...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28918809/endoscopic-ultrasonography-guided-hemostasis-techniques
#17
REVIEW
Everson Luiz de Almeida Artifon, Fernando Pavinato Marson, Muhammad Ali Khan
Endoscopic ultrasonography (EUS)-guided hemostasis is an evolving technique that has the potential to improve the care of patients with refractory variceal and nonvariceal gastrointestinal bleeding. EUS-guided treatment of fundal varices with coil and/or cyanoacrylate seems to be highly effective in active bleeding, as well as for primary and secondary bleeding prophylaxis. Reports of EUS-guided treatment of refractory nonvariceal sources of bleeding are more scarce, but show high success rates. The procedures involve a medium to high technical difficulty level, and this has been replicated worldwide...
October 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28918131/cirrhotic-patients-with-portal-hypertension-related-bleeding-and-an-indication-for-early-tips-a-large-multicentre-audit-with-real-life-results
#18
Dominique Thabut, Arnaud Pauwels, Nicolas Carbonell, Andre Jean Remy, Pierre Nahon, Xavier Causse, Jean-Paul Cervoni, Jean-François Cadranel, Isabelle Archambeaud, Slim Bramli, Florent Ehrhard, Philippe Ah-Soune, Florian Rostain, Alexandre Pariente, Julien Vergniol, Jean-Pierre Dupuychaffray, Anne-Laure Pelletier, Florence Skinazi, Anne Guillygomarc'h, René-Louis Vitte, Jean Henrion, Stéphanie Combet, Marika Rudler, Christophe Bureau
BACKGROUND: The Baveno VI consensus meeting concluded that an early TIPS must be considered in high-risk cirrhotic patients presenting with variceal bleeding (VB) (Child B + active bleeding at endoscopy or Child C10-13 patients). Whether this therapeutic approach is feasible in a real-life setting remains unclear. AIMS: To determine (1) the proportion of patients eligible for early-TIPS among cirrhotic patients with VB, (2) the proportion of these patients who underwent early-TIPS placement and the main reasons for discarding TIPS, and (3) the outcomes of patients who experienced early-TIPS placement in a large, national, prospective, multicentre audit including academic and non-academic centres...
September 13, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28839866/antithrombotic-drugs-and-non-variceal-bleeding-outcomes-and-risk-scoring-systems-comparison-of-glasgow-blatchford-rockall-and-charlson-scores
#19
Ali S Taha, Caroline McCloskey, Theresa Craigen, Wilson J Angerson
OBJECTIVES: Antithrombotic drugs (ATDs) cause non-variceal upper gastrointestinal bleeding (NVUGIB). Risk scoring systems have not been validated in ATD users. We compared Blatchford, Rockall and Charlson scores in predicting outcomes of NVUGIB in ATD users and controls. METHODS: A total of 2071 patients with NVUGIB were grouped into ATD users (n=851) and controls (n=1220) in a single-centre retrospective analysis. Outcomes included duration of hospital admission, the need for blood transfusion, rebleeding requiring surgery and 30-day mortality...
October 2016: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28833912/identifying-emergency-department-patients-at-low-risk-for-a-variceal-source-of-upper-gastrointestinal-hemorrhage
#20
Lauren R Klein, Joel Money, Kaveesh Maharaj, Aaron Robinson, Tarissa Lai, Brian E Driver
BACKGROUND: Assessing the likelihood of a variceal versus nonvariceal source of upper gastrointestinal bleeding (UGIB) guides therapy, but can be difficult to determine on clinical grounds. The objective of this study was to determine if there are easily ascertainable clinical and laboratory findings that can identify a patient as low risk for a variceal source of hemorrhage. METHODS: This was a retrospective cohort study of adult ED patients with UGIB between January 2008 and December 2014 who had upper endoscopy performed during hospitalization...
November 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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