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Variceal bleeding

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https://www.readbyqxmd.com/read/28814595/bleeding-ectopic-duodenal-varix-use-of-a-new-microvascular-plug-mvp-device-along-with-transjugular-intrahepatic-portosystemic-shunt-tipss
#1
Richa Bhardwaj, Gaurav Bhardwaj, Erik Bee, Raffi Karagozian
Ectopic varices (ECV) occur along the gastrointestinal (GI) tract outside the common variceal sites and represent 2%-5% of all GI variceal bleeds with mortality rates up to 40%. Management is challenging because of inaccessibility and increased risk of rebleeding. We report what is to our knowledge the first clinical use of a new microvascular plug (MVP) with transjugular intrahepatic portosystemic shunt (TIPSS) for a bleeding duodenal varix (DV). A 68-year-old man presented with melena. Endoscopy demonstrated a grade II varix in the second part of the duodenum with red wale sign...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28814423/portal-hypertension-and-its-management-in-children
#2
REVIEW
Tassos Grammatikopoulos, Patrick James McKiernan, Anil Dhawan
Portal hypertension (PHT), defined as raised intravascular pressure in the portal system, is a complication of chronic liver disease or liver vascular occlusion. Advances in our ability to diagnose and monitor the condition but also predict the risk of gastrointestinal bleeding have enabled us to optimise the management of children with PHT either at a surveillance or at a postbleeding stage. A consensus among paediatric centres in the classification of varices can be beneficial in streamlining future paediatric studies...
August 16, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28801510/therapeutic-options-for-bleeding-oesophageal-varices-cyanoacrylate-and-balloon-occluded-retrograde-obliteration-brto
#3
Helena L Frischtak, Jessica P Davis, Neeral L Shah
A 56-year-old male with cirrhosis presented with acute bleeding from cardiofundal gastroesophageal varices (GOV) and was treated with endoscopic cyanoacrylate glue. Glue therapy achieved stabilisation of the patient in the emergent setting. Three months later, the patient suffered rebleeding. At that time, he underwent retreatment with balloon-occluded retrograde obliteration (BRTO), with no recurrence at a follow-up of 14 months.Available treatments for bleeding GOV include methods to (a) directly obstruct the varices (endoscopic variceal ligation , sclerotherapy and cyanoacrylate glue, BRTO) or to (b) decrease portal pressure (surgical portacaval shunts; transportal intrahepatic portosystemic shunt)...
August 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28798285/is-the-aims-65-score-useful-in-prepdicting-clinical-outcomes-in-korean-patients-with-variceal-and-nonvariceal-upper-gastrointestinal-bleeding
#4
Jung Wan Choe, Seung Young Kim, Jong Jin Hyun, Sung Woo Jung, Young Kul Jung, Ja Seol Koo, Hyung Joon Yim, Sang Woo Lee
Background/Aims: Various clinical scoring systems, including the Glasgow-Blatchford score (GBS), Rockall risk score (RS), and AIMS65 score (AIMS65), have been validated to predict the clinical outcomes in patients with upper gastrointestinal bleeding (UGIB). We compared the performance of these three scoring systems in predicting clinical outcomes in patients with UGIB in Korea. Methods: We retrospectively evaluated 286 patients with UGIB who visited emergency department...
August 14, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28797992/an-unusual-cause-of-dysphagia-after-gastric-variceal-bleeding
#5
Ankur Jindal
No abstract text is available yet for this article.
August 9, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28796076/factors-affecting-mortality-and-resource-use-for-hospitalized-patients-with-cirrhosis-a-population-based-study
#6
Phunchai Charatcharoenwitthaya, Ngamphol Soonthornworasiri, Khemajira Karaketklang, Kittiyod Poovorawan, Wirichada Pan-Ngum, Watcharasak Chotiyaputta, Tawesak Tanwandee, Kamthorn Phaosawasdi
Hospitalizations for advanced liver disease are costly and associated with significant mortality. This population-based study aimed to evaluate factors associated with in-hospital mortality and resource use for the management of hospitalized patients with cirrhosis.Mortality records and resource utilization for 52,027 patients hospitalized with cirrhosis and/or complications of portal hypertension (ascites, hepatic encephalopathy, variceal bleeding, spontaneous bacterial peritonitis, or hepatorenal syndrome) were extracted from a nationally representative sample of Thai inpatients covered by Universal Coverage Scheme during 2009 to 2013...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28780608/sx-ella-stent-danis-effectively-controls-refractory-variceal-bleed-in-patients-with-acute-on-chronic-liver-failure
#7
Rakhi Maiwall, Kapil Dev Jamwal, Ankit Bhardwaj, Ajeet Singh Bhadoria, Jaswinder Singh Maras, Guresh Kumar, Ankur Jindal, Ashok Choudhury, Lovkesh Anand, Amrish Sahney, Awinash Kumar, Manoj Kumar Sharma, Barjesh Chander Sharma, Shiv Kumar Sarin
BACKGROUND AND AIMS: Almost 10% of bleeding episodes are refractory to combination of vasoactive agent and endotherapy, and are associated with a mortality up to 50%. Severity of liver disease and high portal pressure are mainly responsible for it. TIPS cannot be used in these patients due to high MELD score. We aimed to evaluate the efficacy of self-expandable DE stents for control of refractory variceal bleeds in patients with ACLF. METHODS: Acute-on-chronic liver failure patients (n = 88, mean age 47...
August 5, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28771543/population-based-prevalence-incidence-and-disease-burden-of-autoimmune-hepatitis-in-south-korea
#8
Bo Hyun Kim, Hwa Young Choi, Moran Ki, Kyung-Ah Kim, Eun Sun Jang, Sook-Hyang Jeong
BACKGROUND AND AIM: Little is known about population-based epidemiology and disease burden of autoimmune hepatitis (AIH). The aim of this study was to investigate the prevalence, incidence, comorbidity and direct medical cost of AIH in South Korea. METHODS: The data was from the nationwide, population-based National Health Insurance Service claims database and the Rare Intractable Disease registration program. Age and gender-specific prevalence rates were calculated, and data on comorbidity, diagnostic tests, prescribed drugs, and medical costs were retrieved for patients registered under the disease code K75...
2017: PloS One
https://www.readbyqxmd.com/read/28765702/predictors-of-esophageal-varices-and-first-variceal-bleeding-in-liver-cirrhosis-patients
#9
Bledar Kraja, Iris Mone, Ilir Akshija, Adea Koçollari, Skerdi Prifti, Genc Burazeri
AIM: To assess "predictors" of esophageal varices (EV) and variceal bleeding using non-invasive markers in Albanian patients diagnosed with liver cirrhosis. METHODS: One hundred thirty-nine newly diagnosed cirrhotic patients without variceal bleeding were included in this analysis. Model for end-stage liver disease (MELD), aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AST/ALT), AST to platelet ratio index (APRI), platelet count to spleen diameter (PC/SD), fibrosis-4-index (FIB-4), fibrosis index (FI) and King's Score were measured for all participants...
July 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28765699/effect-of-initial-stent-position-on-patency-of-transjugular-intrahepatic-portosystemic-shunt
#10
Shi-Hua Luo, Jian-Guo Chu, He Huang, Ke-Chun Yao
AIM: To evaluate the effect of initial stent position on transjugular intrahepatic portosystemic shunt (TIPS). METHODS: We studied 425 patients from January 2004 to January 2015 with refractory ascites or variceal bleeding who required TIPS placement. Patients were randomly divided into group A (stent in hepatic vein, n = 57), group B (stent extended to junction of hepatic vein and inferior vena cava, n = 136), group C (stent in left branch of portal vein, n = 83) and group D (stent in main portal vein, n = 149)...
July 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28763856/-endoscopic-ultrasonography-a-new-method-for-evaluation-diagnosis-and-treatment-of-portal-hypertension
#11
W Lu, S Li
Through a comprehensive scan of collateral circulation establishment in portal hypertension, endoscopic ultrasonography (EUS) can predict the risks of esophageal and gastric varices, variceal bleeding, recurrence after treatment, and rebleeding and guide and participate in the treatment of varices. With the help of these advantages, EUS provides an important reference for individualized treatment in patients with liver cirrhosis complicated by portal hypertension and can improve response rate and safety. As a new method for systematic evaluation, diagnosis, and treatment of portal hypertension, EUS has become a new research hotspot in recent years...
June 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28763854/-transjugular-intrahepatic-portosystemic-shunt-for-esophagogastric-variceal-bleeding-in-liver-cirrhosis-intended-population-and-timing
#12
Y Lyu, G H Han, D M Fan
Esophagogastric variceal bleeding is a life-threatening complication of cirrhotic portal hypertension. Transjugular intrahepatic portosystemic shunt (TIPS) is an effective method for the treatment and prevention of esophagogastric variceal bleeding; however, right timing of TIPS and selection of appropriate candidates for TIPS are of vital importance in improving patients' survival rate and reducing mortality rate. This article reviews the intended population and right timing of TIPS for the treatment and prevention of esophagogastric variceal bleeding in liver cirrhosis...
June 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28756406/surgical-shunts-compared-with-endoscopic-sclerotherapy-for-the-treatment-of-variceal-bleeding-in-adults-with-portal-hypertension-a-systematic-review-and-meta-analysis
#13
Lu Tian, Yunjun He, Donglin Li, Hongkun Zhang
AIM: Portal hypertension is a common complication of chronic liver disease and can cause variceal bleeding which is associated with high mortality. Choices for the treatment of variceal bleeding include surgical shunts and endoscopic sclerotherapy. The aim of this study was to compare the efficacy of surgical shunts and endoscopic sclerotherapy in treating variceal bleeding due to portal hypertension. DESIGN: Systematic review and meta-analysis. SETTING: Medline, PubMed, Cochrane and Google Scholar databases were searched until 12 February 2015, for relevant randomised control trials...
July 29, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28756055/efficacy-of-over-the-scope-clips-in-management-of-high-risk-gastrointestinal-bleeding
#14
Justin Brandler, Navtej Buttar, Anushka Baruah, Muhammad Zeb, Ayesha Mehfooz, Prachi Pophali, Louis Wong Kee Song, Barham AbuDayyeh, Christopher Gostout, Kristin Mara, Ross Dierkhising
BACKGROUND & AIMS: Standard endoscopic therapies do not control bleeding or produce complications in as many as 20% of patients with non-variceal gastrointestinal bleeding. Most bleeding comes from ulcers with characteristics such as high-risk vascular territories and/or large vessels. We evaluated the efficacy of using over the scope clips (OTSCs) as primary or rescue therapy for patients with bleeding from lesions that have a high-risk for adverse outcomes. METHODS: We performed a retrospective analysis of data from 67 patients with gastrointestinal bleeding from high-risk lesions who were treated with OTSC as primary (n=49) or rescue therapy (n=18) at a quaternary center, from December 2011 through February 2015...
July 26, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28753701/reprocessing-of-single-use-endoscopic-variceal-band-ligation-devices-a-pilot-study
#15
Kavel Visrodia, Abdul Haseeb, Yuri Hanada, Kelly M Pennington, Magdalen Clemens, Paul J Pearce, Pritish K Tosh, Bret T Petersen, Mark D Topazian
Background and study aims The preferred management of bleeding esophageal varices includes endoscopic band ligation. Endoscopic ligation devices (ELDs) are expensive and designed for single use, limiting their uptake in developing countries. We aimed to assess the efficacy of reprocessing ELDs using terminal microbial cultures and adenosine triphosphate (ATP) testing. Materials and methods ELDs were recovered after clinical use and their components (cap, handle, and cord) were subjected to reprocessing...
July 28, 2017: Endoscopy
https://www.readbyqxmd.com/read/28746317/acute-upper-gastrointestinal-bleeding-in-a-tertiary-care-centre-of-nepal
#16
M S Paudel, S Kc, A K Mandal, N S Poudyal, R Shrestha, B N Paudel, S Chaudhary
INTRODUCTION: AUGIB is characterized by hematemesis or melena or both. Peptic ulcers and variceal bleed account for majority of cases. Use of proton pump inhibitors in current era is associated with a gradual reduction in burden of peptic ulcer disease. We conducted this study to look into the cause of AUGIB in our community. METHODS: We studied 100 patients in one year period who presented to us with hematemesis or melena. The study was conducted in department of Gastroenterology, Bir hospital, Kathmandu...
April 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28746314/outcome-of-endoscopic-variceal-band-ligation
#17
B Shrestha, S Kc, S Chaudhary, B K Basnet, A K Mandal, N S Poudyal
INTRODUCTION: Bleeding from esophageal varices in cirrhosis is an emergent condition with high mortality. One of the preferred modality of treating esophageal varices is EVL. We aimed to find out the outcome of EVL in controlling acute esophageal variceal bleeding, prophylactic banding to prevent future bleeding and the number of sessions required for complete eradication of varices. METHODS: This descriptive observational study was carried out in Gastroenterology and Hepatology unit of Bir Hospital, NAMS from June 2016 to May 2017...
April 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28742130/association-between-complicated-liver-cirrhosis-and-the-risk-of-hepatocellular-carcinoma-in-taiwan
#18
Tsung-Hsing Hung, Chih-Ming Liang, Chien-Ning Hsu, Wei-Chen Tai, Kai-Lung Tsai, Ming-Kun Ku, Jiunn-Wei Wang, Kuo-Lun Tseng, Lan-Ting Yuan, Seng-Howe Nguang, Shih-Cheng Yang, Cheng-Kun Wu, Pin-I Hsu, Deng-Chyang Wu, Seng-Kee Chuah
Hepatic encephalopathy, ascites, and variceal bleeding are the three major complications of cirrhosis. It is well known that cirrhosis is the most important risk factor of hepatocellular carcinoma (HCC). However, little is known about whether the severity of liver cirrhosis has an effect on the incidence of HCC. This population-based cohort study aimed to explore the association between complicated cirrhosis and HCC, and identify the risk factors of HCC in patients with complicated cirrhosis. Data of the years 1997-2011 were extracted from the National Health Insurance Research Database of Taiwan...
2017: PloS One
https://www.readbyqxmd.com/read/28741138/trans-splenic-access-for-portal-venous-interventions-in-children-do-benefits-outweigh-risks
#19
Sheena Pimpalwar, Ponraj Chinnadurai, Alberto Hernandez, Kamlesh Kukreja, Shakeel Siddiqui, Henri Justino
BACKGROUND: The primary concern of trans-splenic access for portal interventions is the risk of life-threatening intraperitoneal bleeding. OBJECTIVE: To review the clinical indications and efficacy and evaluate the risk factors for intraperitoneal bleeding during trans-splenic portal interventions in children. MATERIALS AND METHODS: A retrospective review of consecutive patients who underwent trans-splenic portal interventions at a tertiary care pediatric institution between March 2011 and April 2017 was performed...
July 24, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28726433/gastric-antral-vascular-ectasia-and-solitary-rectal-ulcer-syndrome-two-rare-diagnoses-as-the-cause-of-anemia-in-a%C3%A2-single-patient-case-report
#20
Lumír Kunovský, Milan Dastych, Radek Kroupa, Beata Hemmelova, Katarina Muckova, Miroslava Chovancova, Lenka Kucerova, Jiri Dolina
Gastric antral vascular ectasia (GAVE) and solitary rectal ulcer syndrome (SRUS) are both mentioned in the literature as rare causes of iron deficiency anemia and gastrointestinal (GI) bleeding. GAVE accounts for up to 4 % of upper non-variceal GI bleeding; SRUS is a rare benign disorder that presents with rectal bleeding. We present the case of a 75-year-old patient who was admitted to our facility with anemia. In the same patient, we encountered chronic bleeding from GAVE and SRUS. Both diagnoses were treated endoscopically: GAVE by argon plasma coagulation and a subsequent treatment with proton pump inhibitors and SRUS by adrenaline injection and clipping, consecutively treated with mesalazine enemas...
2017: Vnitr̆ní Lékar̆ství
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