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Variceal bleeding

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https://www.readbyqxmd.com/read/29453469/demographic-and-clinical-profile-in-patients-with-liver-cirrhosis-in-a-tertiary-care-hospital-in-central-nepal
#1
Subash Bhattarai, Merina Gyawali, Khus Raj Dewan, Gaurav Shrestha
INTRODUCTION: Liver cirrhosis is an important health problem worldwide and is a common disease in Nepal. The profile of cirrhosis may vary due to different factors. This study was undertaken to see the demographic and clinical profiles of patients with cirrhosis of liver attending a tertiary care hospital in Central Nepal. METHODS: Six hundred patients with clinical features, laboratory and sonological findings suggestive of chronic liver dysfunction and endoscopic evidence of portal hypertension were included in the study...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29451184/the-long-term-outcomes-of-cirrhotic-patients-with-pleural-effusion
#2
Tsung-Hsing Hung, Chih-Wei Tseng, Chih-Chun Tsai, Chen-Chi Tsai, Kuo-Chih Tseng, Yu-Hsi Hsieh
Background/Aim: A pleural effusion is an abnormal collection of fluid in the pleural space and may cause related morbidity or mortality in cirrhotic patients. Currently, there are insufficient data to support the long-term prognosis for cirrhotic patients with pleural effusion. In this study, we investigated the short- and long-term effects of pleural effusion on mortality in cirrhotic patients and evaluated the benefit of liver transplantation in these patients. Patients and Methods: The National Health Insurance Database, derived from the Taiwan National Health Insurance Program, was used to identify 3,487 cirrhotic patients with pleural effusion requiring drainage between January 1, 2007 and December 31, 2010...
January 2018: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/29451181/the-use-of-nonselective-beta-blockers-is-a-risk-factor-for-portal-vein-thrombosis-in-cirrhotic-patients
#3
Rosa Zampino, Rita Lebano, Nicola Coppola, Margherita Macera, Anna Grandone, Luca Rinaldi, Ilario De Sio, Antonella Tufano, Gianfranca Stornaiuolo, Luigi E Adinolfi, Emanuele Durante-Mangoni, Gaeta G Battista, Alferio Niglio
Background/Aim: A reduction in portal vein inflow velocity seems to predispose to the emergence of portal vein thrombosis (PVT). Nonselective β-blockers (NSBBs), used to prevent variceal bleeding, may increase the development of PVT by reducing portal vein inflow velocity. In this retrospective case-control study, we evaluated the risk factors and clinical features of a first event of PVT in 130 cirrhotics, 19 (15%) with (PVT group) and 111 (85%) without PVT (non-PVT group). Patients and Methods: Patient evaluation and NNBB treatment were carried out according to the AASLD guidelines...
January 2018: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/29450749/an-analysis-of-the-clinical-laboratory-and-histological-features-of-striped-punctate-and-nodular-gastric-antral-vascular-ectasia
#4
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
https://www.readbyqxmd.com/read/29439827/refractory-gastric-variceal-bleeding-treated-through-endoscopic-ultrasound-guided-coiling-and-n-butyl-2-cyanoacrylate-application
#5
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
https://www.readbyqxmd.com/read/29430470/transjugular-intrahepatic-portosystemic-shunt-for-refractory-variceal-bleeding-in-a-patient-with-a-left-ventricular-assist-device
#6
Anusha Shirwaikar Thomas, Jerry Estep, David W Victor
Transjugular intrahepatic portosystemic shunt (TIPS) is an attractive therapeutic option in cirrhotic patients with recurrent variceal bleeding refractory to medical and endoscopic therapy. There is little known about the use of TIPS in patients with left ventricular assist devices (LVAD). We describe a patient with a durable continuous-flow LVAD and concurrent decompensated cardiac cirrhosis who underwent successful TIPS placement for recurrent variceal bleeding. The patient has had no rebleeding or encephalopathy in >12 months since TIPS placement...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29429910/natural-history-of-patients-with-non-cirrhotic-portal-hypertension-comparison-with-patients-with-compensated-cirrhosis
#7
Stefania Gioia, Silvia Nardelli, Chiara Pasquale, Ilaria Pentassuglio, Valeria Nicoletti, Francesca Aprile, Manuela Merli, Oliviero Riggio
BACKGROUND: The knowledge of natural history of patients with portal hypertension (PH) not due to cirrhosis is less well known than that of cirrhotic patients. AIM: To describe the clinical presentation and the outcomes of 89 patients with non-cirrhotic PH (25 with non-cirrhotic portal hypertension, INCPH, and 64 with chronic portal vein thrombosis, PVT) in comparison with 77 patients with Child A cirrhosis. METHODS: The patients were submitted to a standardized clinical, laboratory, ultrasonographic and endoscopic follow-up...
January 31, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29428942/outcomes-of-patients-undergoing-endoscopic-hemostasis-for-the-upper-gastrointestinal-bleeding-were-not-influenced-by-the-timing-of-hospital-emergency-visits-a-situation-prevailing-in-japan
#8
Satoko Matsuura, Yasuhisa Sakata, Nanae Tsuruoka, Koichi Miyahara, Megumi Hara, Yoichiro Ito, Kenichiro Nakayama, Takuya Shimamura, Takahiro Noda, Takahiro Yukimoto, Ryo Shimoda, Ryuichi Iwakiri, Kazuma Fujimoto
BACKGROUND: The aim of the present study was to determine differences in the prognosis of patients in Japan who underwent emergency endoscopic hemostasis (i) during regular hours versus off hours and (ii) as outpatients versus hospitalized patients. METHODS: The present retrospective study included 443 patients who underwent emergency endoscopic hemostasis for non-variceal upper gastrointestinal bleeding from January 2008 to December 2014. These patients were classified into 2 groups: hospitalized patients and outpatients...
February 9, 2018: Digestion
https://www.readbyqxmd.com/read/29417267/modified-balloon-occluded-retrograde-transvenous-obliteration-brto-techniques-for-the-treatment-of-gastric-varices-vascular-plug-assisted-retrograde-transvenous-obliteration-parto-coil-assisted-retrograde-transvenous-obliteration-carto-balloon-occluded-antegrade
#9
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
https://www.readbyqxmd.com/read/29415371/effectiveness-of-the-polysaccharide-hemostatic-powder-in-non-variceal-upper-gastrointestinal-bleeding-using-propensity-score-matching
#10
Jun Chul Park, Yeong Jin Kim, Eun Hye Kim, Jinae Lee, Hyun Su Yang, Eun Hwa Kim, Kyu Yeon Hahn, Sung Kwan Shin, Sang Kil Lee, Yong Chan Lee
BACKGROUND AND AIM: Recently, the application of hemostatic powder to the bleeding site has been used to treat active upper gastrointestinal bleeding (UGIB). We aimed to assess the effectiveness of the polysaccharide hemostatic powder (PHP) in patients with non-variceal UGIB. METHODS: We reviewed prospectively collected 40 patients with UGIB treated with PHP therapy between April 2016 and January 2017 (PHP group) and 303 patients with UGIB treated with conventional therapy between April 2012 and October 2014 (conventional therapy group)...
February 7, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29413215/management-of-acute-gastrointestinal-bleed
#11
REVIEW
Francisca Cisneros Farrar
Acute gastrointestinal bleeding is a common problem found in critically ill patients that can range from self-limited bleeding to a hemorrhaging emergency. Patients can quickly develop shock and altered mental status when they develop hemodynamic instability. Therefore, it is essential that the frontline critical care nurse develop self-efficacy for management of these disorders. This article overviews standards of practice for the management of upper and lower acute gastrointestinal bleeding. Common bleeding disorders are reviewed with expanded focus on peptic ulcer, acute variceal hemorrhage, colonic diverticular bleeding, and angiodysplasias, which are commonly found in the critical care setting...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29407630/low-molecular-weight-heparin-treatment-for-portal-vein-thrombosis-in-liver-cirrhosis-efficacy-and-the-risk-of-hemorrhagic-complications
#12
Jihyun Kwon, Youngil Koh, Su Jong Yu, Jung-Hwan Yoon
INTRODUCTION: Portal vein thrombosis (PVT) is a well-known complication in patients with liver cirrhosis (LC). The aim of this study is to investigate the outcomes of cirrhotic patients with PVT treated with low-molecular-weight heparin (LMWH). METHOD: Ninety-one LC patients with PVT were treated with dalteparin or enoxaparin for six months. Patients with major bleeding during the last three months, severe thrombocytopenia, or impaired renal function were excluded...
February 1, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29396732/primary-prophylaxis-of-variceal-bleeding
#13
EDITORIAL
Marcus Robertson, Peter Hayes
No abstract text is available yet for this article.
February 2, 2018: Hepatology International
https://www.readbyqxmd.com/read/29394240/beneficial-effects-of-adrenal-androgen-supplement-in-bleeding-cirrhotic-rats
#14
Hui-Chun Huang, Shao-Jung Hsu, Ching-Chih Chang, Ming-Hung Tsai, Fa-Yauh Lee, Ming-Chih Hou, Shou-Dong Lee
Critical illness is accompanied by hypothalamic-pituitary-adrenal axis activation, but adrenal insufficiency characterized by inadequate glucocorticoid synthesis is common in critically ill cirrhotic patients, the 'hepato-adrenal syndrome'. Adrenal cortex also synthesizes androgen (dehydroepiandrosterone, DHEA). DHEA maintains microcirculation by enhancing vascular endothelial nitric oxide synthase (eNOS) activity. In critical patients of other disease entities, a shift of adrenal steroidogenesis away from androgens towards glucocorticoid has been noted, arousing interests in androgen replacement in critical settings...
February 1, 2018: Shock
https://www.readbyqxmd.com/read/29391766/beneficial-long-term-effect-of-a-phosphodiesterase-5-inhibitor-in-cirrhotic-portal-hypertension-a-case-report-with-8-years-follow-up
#15
Peter Deibert, Adhara Lazaro, Zoran Stankovic, Denise Schaffner, Martin Rössle, Wolfgang Kreisel
Non-selective beta-blockers are the mainstay of medical therapy for portal hypertension in liver cirrhosis. Inhibitors of phosphodiesterase-5 (PDE-5-inhibitors) reduce portal pressure in the acute setting by > 10% which may suggest a long-term beneficial effect. Currently, there is no available data on long-term treatment of portal hypertension with PDE-5-inhibitors. This case of a patient with liver cirrhosis secondary to autoimmune liver disease with episodes of bleeding from esophageal varices is the first documented case in which a treatment with a PDE-5-inhibitor for eight years was monitored...
January 21, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29390375/hepatic-artery-embolization-cures-the-acute-pancreatitis-associated-with-a-tiny-arteriobiliary-fistula-after-tips-a-case-report
#16
Xiuli Yin, Xiaofei Lei, Changqing Xu, Jing Yang, Yingying Zhao, Kun Li
RATIONALE: Esophageal variceal bleeding caused by portal hypertension is massive and life-threatening to those patients with decompensated liver cirrhosis. A transjugular intrahepatic portosystemic shunt (TIPS) can effectively stop bleeding. But the process of puncture may lead to bile duct injury and even form fistulas between the hepatic artery and bile duct. PATIENT CONCERNS: The case report illustrated a 52-year-old Chinese female patient who underwent TIPS...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29388229/betablockers-do-not-increase-efficacy-of-band-ligation-in-primary-prophylaxis-but-they-improve-survival-in-secondary-prophylaxis-of-variceal-bleeding
#17
N Pfisterer, C Dexheimer, E-M Fuchs, T Bucsics, P Schwabl, M Mandorfer, I Gessl, L Sandrieser, L Baumann, F Riedl, B Scheiner, T Pachofszky, W Dolak, C Schrutka-Kölbl, A Ferlitsch, M Schöniger-Hekele, M Peck-Radosavljevic, M Trauner, C Madl, T Reiberger
BACKGROUND: Endoscopic band ligation (EBL) is used for primary (PP) and secondary prophylaxis (SP) of variceal bleeding. Current guidelines recommend combined use of non-selective beta-blockers (NSBBs) and EBL for SP, while in PP either NSBB or EBL should be used. AIM: To assess (re-)bleeding rates and mortality in cirrhotic patients receiving EBL for PP or SP for variceal bleeding. METHODS: (Re-)bleeding rates and mortality were retrospectively assessed with and without concomitant NSBB therapy after first EBL in PP and SP...
February 1, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29388020/challenging-tips-in-liver-transplant-recipients-the-pull-through-technique-to-address-piggyback-anastomosis
#18
Valentina Schembri, Christophe Cassinotto, Fabrizio Panaro, Julien Delicque, Marie-Ange Pierredon, Lauranne Piron, Astrid Herrero, Laure Escal, José Ursic-Bedoya, Boris Guiu
PURPOSE: The hepatic vein access during transjugular intrahepatic portosystemic shunt (TIPS) can be challenging in liver transplant recipient patients, especially when piggyback anastomosis was performed. We described a modified technique and reviewed the clinical outcomes of TIPS in transplanted patients. MATERIALS AND METHODS: From 2015 to 2016, 8 patients with history of liver transplantation using a three-hepatic vein piggyback technique for venous anastomosis underwent a TIPS in our institution...
January 31, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29381977/bleeding-from-isolated-gastric-varices-as-complication-of-a-mucinous-cystic-neoplasm-of-the-pancreas-a-case-report
#19
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)
https://www.readbyqxmd.com/read/29380820/severity-and-outcomes-of-upper-gastrointestinal-bleeding-with-bloody-vs-coffee-grounds-hematemesis
#20
Loren Laine, Stig B Laursen, Liam Zakko, Harry R Dalton, Jing H Ngu, Michael Schultz, Adrian J Stanley
OBJECTIVES: Numerous reviews indicate bloody hematemesis signifies more severe bleeding than coffee-grounds hematemesis. We assessed severity and outcomes related to bleeding symptoms in a prospective study. METHODS: Consecutive patients presenting with hematemesis or melena were categorized as bloody emesis (N=1209), coffee-grounds emesis without bloody emesis (N=701), or melena without hematemesis (N=1069). We assessed bleeding severity (pulse, blood pressure) and predictors of outcome (hemoglobin, risk stratification scores) at presentation, and outcomes of bleeding episodes...
January 30, 2018: American Journal of Gastroenterology
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