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Variceal bleeding

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https://www.readbyqxmd.com/read/29224657/cta-as-an-adjuvant-tool-for-acute-intra-abdominal-or-gastrointestinal-bleeding
#1
Mitchell Storace, Jonathan G Martin, Jay Shah, Zachary Bercu
Hematemesis and acute postsurgical upper gastrointestinal hemorrhage are common emergent on-call consultations for the interventional radiologist. Upper GI bleleding (UGIB) is a relatively frequent problem. The incidence and mortality vary among patient populations, but studies have shown an overall incidence ranging from 36-172 cases per 100,000 adults per year, with a mortality rate of 5%-14%. The incidence is significantly higher in men. Peptic ulcer disease is the predominant etiology, responsible for 28%-59% of UGIB...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29218132/portal-vein-thrombosis-in-adult-omani-patients-a-retrospective-cohort-study
#2
Khalid Al Hashmi, Lamya Al Aamri, Sulayma Al Lamki, Anil Pathare
OBJECTIVES: We sought to study the occurrence of portal vein thrombosis (PVT) in adult Omani patients. Methods: We conducted a retrospective cross-sectional study in patients diagnosed with PVT, which was confirmed by radiological imaging, from two tertiary hospitals over a 10-year period. Results: Amongst the 39 patients enrolled in the study, 15 (38.4%) had cirrhosis of the liver, and 24 (61.5%) were non-cirrhotic. In the non-cirrhotic PVT patients, 15 (62.5%) had acute PVT, whereas nine (37...
November 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/29214793/mesocaval-shunt-creation-for-jejunal-variceal-bleeding-with-chronic-portal-vein-thrombosis
#3
Ja Kyung Yoon, Man Deuk Kim, Do Yun Lee, Seok Joo Han
The creation of transjugular intrahepatic portosystemic shunt (TIPS) is a widely performed technique to relieve portal hypertension, and to manage recurrent variceal bleeding and refractory ascites in patients where medical and/or endoscopic treatments have failed. However, portosystemic shunt creation can be challenging in the presence of chronic portal vein occlusion. In this case report, we describe a minimally invasive endovascular mesocaval shunt creation with transsplenic approach for the management of recurrent variceal bleeding in a portal hypertension patient with intra- and extrahepatic portal vein occlusion...
January 2018: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29214053/severe-carvedilol-toxicity-without-overdose-caution-in-cirrhosis
#4
Satish Maharaj, Karan Seegobin, Julio Perez-Downes, Belinda Bajric, Simone Chang, Pramod Reddy
Background: Carvedilol is used in the management of hypertension, ischemic heart disease, heart failure and most recently, portal hypertension. It has been associated with improved outcomes regarding variceal bleeding, hepatic decompensation and death when compared to propranolol and endoscopic band ligation. The main cause of portal hypertension is cirrhosis and therefore carvedilol is increasingly used in these patients. Due to its extensive hepatic metabolism, carvedilol is contraindicated in severe hepatic impairment...
2017: Clinical Hypertension
https://www.readbyqxmd.com/read/29210030/pharmacologic-prevention-of-variceal-bleeding-and-rebleeding
#5
REVIEW
Anna Baiges, Virginia Hernández-Gea, Jaime Bosch
BACKGROUND: Variceal bleeding is a major complication of portal hypertension, which is associated with significant mortality. Moreover, patients surviving a variceal bleeding episode have very high risk of rebleeding, which is associated with mortality as high as that of the first bleed. Because of this, prevention of bleeding from gastroesophageal varices has been one of the main therapeutic goals since the advent of the first effective therapies for portal hypertension. AIM: This review deals with the present day state-of-the-art pharmacological prevention of variceal bleeding in primary and secondary prophylaxis...
December 5, 2017: Hepatology International
https://www.readbyqxmd.com/read/29209118/chronic-liver-disease-is-universal-in-children-with-biliary-atresia-living-with-native-liver
#6
Way Seah Lee, Sik Yong Ong, Hee Wei Foo, Shin Yee Wong, Chen Xi Kong, Ru Bin Seah, Ruey Terng Ng
AIM: To examine the medical status of children with biliary atresia (BA) surviving with native livers. METHODS: In this cross-sectional review, data collected included complications of chronic liver disease (CLD) (cholangitis in the preceding 12 mo, portal hypertension, variceal bleeding, fractures, hepatopulmonary syndrome, portopulmonary hypertension) and laboratory indices (white cell and platelet counts, total bilirubin, albumin, international normalized ratio, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase)...
November 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29209115/procedure-related-complications-in-gastric-variceal-obturation-with-tissue-glue
#7
Yun-Wei Guo, Hui-Biao Miao, Zhuo-Fu Wen, Jie-Ying Xuan, Hao-Xiong Zhou
AIM: To focus on procedure-related complications, evaluate their incidence, analyze the reasons and discuss the solutions. METHODS: Overall, 628 endoscopic gastric variceal obturation (EGVO) procedures (case-times) with NBC were performed in 519 patients in the Department of Endoscopy of the Third Affiliated Hospital of Sun Yat-Sen University from January 2011 to December 2016. The clinical data of patients and procedure-related complications of EGVO were retrospectively analyzed...
November 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29208551/a-simplified-prognostic-model-to-predict-mortality-in-patients-with-acute-variceal-bleeding
#8
Han Hee Lee, Jae Myung Park, Seunghoon Han, Sung Min Park, Hee Yeon Kim, Jung Hwan Oh, Chang Wook Kim, Seung Kew Yoon, Myung-Gyu Choi
BACKGROUND: Acute variceal bleeding (AVB) is a major cause of death in patients with liver cirrhosis. The aim of this study was to investigate mortality predictors and develop a new simple prognostic model using easily verified factors at admission in AVB patients. METHODS: Between January 2009 and May 2015, 333 consecutive patients with AVB were included. A simplified prognostic model was developed using multiple logistic regression after identifying significant predictors of 6-week mortality...
November 24, 2017: Digestive and Liver Disease
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
#9
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
#10
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
#11
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/29185168/trans-splenic-embolization-plus-partial-splenic-embolization-for-management-of-variceal-bleeding-due-to-left-sided-portal-hypertension
#12
Roberto Gandini, Stefano Merolla, Fabrizio Chegai, Sergio Abrignani, Ilaria Lenci, Martina Milana, Mario Angelico
No abstract text is available yet for this article.
November 28, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29185106/efficacy-of-carvedilol-versus-propranolol-versus-variceal-band-ligation-for-primary-prevention-of-variceal-bleeding
#13
Ayman Yosry Abd ElRahim, Rabab Fouad, Marwa Khairy, Aisha Elsharkawy, Waleed Fathalah, Haytham Khatamish, Omayma Khorshid, Mona Moussa, Moataz Seyam
BACKGROUND AND AIMS: Band ligation and propranolol are the current therapies for primary prevention of variceal bleeding. Carvedilol is a rising nonselective beta-blocker used for reducing portal pressure with favorable outcome. The aim of this study to assess the efficacy of carvedilol, propranolol, and band ligation for primary prevention of variceal bleeding based on the effect of each regimen on progression of Child score and portal hypertensive gastropathy after 1 year. METHODS: The study included 264 cirrhotic patients with medium/large-sized varices who were candidates for primary prophylaxis of variceal bleeding...
November 28, 2017: Hepatology International
https://www.readbyqxmd.com/read/29183764/clinical-outcome-of-portal-vein-thrombosis-in-patients-with-digestive-cancers-a-large-ageo-multicenter-study
#14
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/29177197/foam-sclerotherapy-during-shunt-surgery-for-portal-hypertension-and-varices
#15
Zhe Zhang, Xueming Chen, Chenyu Li, Hai Feng, Hongzhi Yu, Renming Zhu, Tianyou Wang
Objective: This preliminary study investigated the clinical safety and efficacy of foam sclerotherapy during shunt surgery to treat portal hypertension and gastroesophageal varices. Methods: Seven patients with confirmed portal hypertension and a variceal bleeding history underwent mesocaval shunt with simultaneous polidocanol foam injection into the varices. Computed tomography and endoscopic reviews were conducted within two weeks following the procedures and around six months later...
2017: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/29176477/noninvasive-methods-of-predicting-large-esophageal-varices-in-children-with-intrahepatic-portal-hypertension
#16
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/29171065/peptic-ulcer-bleeding-in-cirrhotic-patients-is-as-bad-as-variceal-bleeding
#17
EDITORIAL
Gin-Ho Lo, Thomas Reiberger
Peptic ulcer bleeding (PUB) is among the most common causes of hospitalization worldwide, however, advances in endoscopic and pharmacological therapies have reduced the case fatality rate to 2.1% (1). In contrast, 6-week mortality of acute variceal bleeding (AVB) remained as high as 20% (2-3). Despite the considerable incidence of peptic ulcers with 6-33% and high recurrence rate of PUB in patients with cirrhosis (4), the specific mechanisms responsible for peptic ulcers remain largely unknown in the setting of cirrhosis (4)...
November 23, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29166137/primary-constrained-tips-for-treating-refractory-ascites-or-variceal-bleeding-secondary-to-hepatic-cirrhosis
#18
R Rabei, S Mathesovian, J Tasse, S Madassery, B Arslan, U Turba, O Ahmed
PURPOSE: To report an initial experience using a primary constrained TIPS technique for treating cirrhotic patients with refractory ascites or variceal bleeding. METHODS: All patients undergoing primary constrained (n=9) and conventional (n=18) TIPS between July 2014 and June 2016 were retrospectively reviewed. Pre-procedure demographics, Child-Pugh (CP), MELD, and technical variables were recorded. Outcomes measured included technical and clinical success, complications, 30-day mortality, as well as necessity for TIPS revision...
November 22, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/29164762/recalibrated-meld-and-hepatic-encephalopathy-are-prognostic-factors-in-cirrhotic-patients-with-acute-variceal-bleeding
#19
Marika Rudler, Christophe Bureau, Nicolas Carbonell, Philippe Mathurin, Faouzi Saliba, Arianne Mallat, Julien Massard, Jean-Louis Golmard, Brigitte Bernard-Chabert, Nina Dib, Dominique Thabut
BACKGROUND: Early TIPS placement must be considered in patients with Child-Pugh B and active bleeding at endoscopy or in patients with Child-Pugh C 10-13 and variceal bleeding. However, active bleeding at endoscopy is a subjective criterion. Moreover, a previous study has shown that a MELD-based score accurately predicted 6-week mortality and helped to stratify patients. Using a prospective series of patients included in a multicentre study before the era of early TIPS, we aimed (1) to identify factors associated with 6-week mortality, focusing on the prognostic value of active bleeding; and (2) to assess whether a recalibrated MELD-based score accurately predicted 6-week mortality...
November 22, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29161702/favorable-effects-of-endoscopic-ligation-combined-with-drugs-on-rebleeding-and-mortality-in-cirrhotic-patients-a-network-meta-analysis
#20
Liang Shi, Xueping Zhang, Jianye Li, Xibo Bai
BACKGROUND: To assess the effects of combination therapies (endoscopic plus drug[s], drug combinations) on variceal/any-cause rebleeding and mortality among cirrhotic patients with one previous episode of variceal hemorrhage. SUMMARY: We searched PubMed, Embase, Cochrane Library, and Web of Science for eligible studies. We included 26 randomized controlled trials involving 2,536 adults using OR to measure the effects. Endoscopic variceal ligation (EVL) plus nadolol ranked first for reducing recurrent bleeds...
November 21, 2017: Digestive Diseases
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