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endoscopic variceal ligation

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https://www.readbyqxmd.com/read/27875848/multimodal-therapy-of-recurrent-and-refractory-bleeding-from-esophageal-varices-case-report-and-review-of-the-literature
#1
Matthias Buechter, Volker Penndorf, Ali Canbay, Jens M Theysohn, Alexander Dechêne
Bleeding from esophageal varices is a major cause of mortality in patients with advanced liver disease. Although standard treatment and secondary prophylaxis are effective, in some patients sustained hemostasis cannot be achieved. We report the case of a woman with alcoholic liver disease in whom pharmacological, endoscopic, and intravascular therapies failed to control variceal bleeding. Only a combination of (repeated) band ligation, insertion of a self-expanding metal stent, TIPS implantation and redilatation, transjugular variceal embolization, and finally implantation of a portocaval shunt proved to be successful...
November 22, 2016: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27812446/successful-hemostasis-and-resection-of-a-bleeding-gastric-polyp-by-endoscopic-banding-ligation-in-a-uremic-patient-taking-antiplatelet-agent
#2
Ping-I Hsu, Kwok-Hung Lai, Feng-Woei Tsay, Jin-Shiung Cheng, E-Ming Wang, Rong-Jer Lai, Tsair-Fwu Lee
The modalities to treat bleeding polyps include electrocautery snare polypectomy, adrenaline injection, clipping, argon plasma coagulation and surgery. We hereby describe an endoscopic banding ligation method for the management of bleeding gastric polyp in a patient receiving antiplatelet therapy. A 66-year-old man presented with a five month-history of intermittent tarry stool passage, nausea and fatigue. He had a past history of peripheral arterial occlusive disease and non-insulin dependent diabetes mellitus with end stage renal disease, and regularly took antiplatelet agent (ticlopidine 100 mg thrice daily) for cardiovascular prophylaxis...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27807564/downhill-esophageal-varices-associated-with-central-venous-catheter-related-thrombosis-managed-with-endoscopic-and-surgical-therapy
#3
Joshua C Berkowitz, Sushma Bhusal, Deepak Desai, Maurice A Cerulli, Sumant Inamdar
Downhill esophageal varices are a rare cause of upper gastrointestinal hemorrhage. We present a case of downhill variceal bleeding due to superior vena cava thrombosis resulting from a prior central venous catheter. The patient was managed with endoscopic band ligation and later with surgical axillary vein to right atrium bypass grafting. Successful long-term resolution of varices was achieved at 1 year of follow-up. This is the longest follow-up described for combined endoscopic and surgical management in the existing literature for catheter-associated downhill varices...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27801752/survey-on-clinical-practice-of-primary-prophylaxis-in-portal-hypertension-in-children
#4
Odile Jeanniard-Malet, Mathieu Duché, Alexandre Fabre
Primary prophylaxis in portal hypertension in children is controversial, as there are few studies documenting its efficacy on the risk of bleeding.28 centres out of the 38 we contacted returned a completed questionnaire about their clinical practices. More than 75% of the centres use endoscopy to screen patients diagnosed with portal cavernoma, biliary atresia, cystic fibrosis and other fibrotic chronic liver diseases with suspected portal hypertension.In cases of grade 2 varices with red marks and grade 3 varices more than 90% of centres perform sclerotherapy or endoscopic variceal ligation (EVL)...
October 31, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27784425/-risk-factors-for-early-rebleeding-after-esophageal-variceal-ligation-in-patients-with-liver-cirrhosis
#5
J N Zhou, Z Wei, Z Q Sun
Objective: To investigate the risk factors for early rebleeding after esophageal variceal ligation (EVL) through a multicenter retrospective study. Methods: A total of 3289 patients who were hospitalized and underwent EVL in 17 upper second-class hospitals or hospitals of higher classes from January 1999 to May 2015 were collected and screened according to the exclusion criteria. A total of 2531 patients were screened out, and a retrospective analysis was performed for their clinical data including age, sex, endoscopic findings, and results of laboratory examination (liver function, biochemical results, routine blood test, and coagulation function) to collect related data...
July 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/27779613/child-turcotte-pugh-class-is-best-at-stratifying-risk-in-variceal-hemorrhage-analysis-of-a-us-multicenter-prospective-study
#6
Brett E Fortune, Guadalupe Garcia-Tsao, Maria Ciarleglio, Yanhong Deng, Michael B Fallon, Samuel Sigal, Naga P Chalasani, Joseph K Lim, Adrian Reuben, Hugo E Vargas, Gary Abrams, Michele D Lewis, Tarek Hassanein, James F Trotter, Arun J Sanyal, Kimberly L Beavers, Daniel Ganger, Paul J Thuluvath, Norman D Grace, Roberto J Groszmann
GOALS/BACKGROUND: Data on acute variceal hemorrhage (AVH) in the United States is limited and the best method to stratify risk is not clear. Taking advantage of a prospective US cohort study, we aimed to (1) describe clinical outcomes of AVH and their predictors; (2) compare predictors of 6-week mortality. STUDY: Prospective 15-center US cohort of patients with cirrhosis presenting with endoscopically proven AVH, all of whom received antibiotics, vapreotide (a somatostain analog) infusion and endoscopic band ligation...
October 24, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27776486/bleeding-downhill-esophageal-varices-associated-with-benign-superior-vena-cava-obstruction-case-report-and-literature-review
#7
Michael Loudin, Sharon Anderson, Barry Schlansky
BACKGROUND: Proximal or 'downhill' esophageal varices are a rare cause of upper gastrointestinal hemorrhage. Unlike the much more common distal esophageal varices, which are most commonly a result of portal hypertension, downhill esophageal varices result from vascular obstruction of the superior vena cava (SVC). While SVC obstruction is most commonly secondary to malignant causes, our review of the literature suggests that benign causes of SVC obstruction are the most common cause actual bleeding from downhill varices...
October 24, 2016: BMC Gastroenterology
https://www.readbyqxmd.com/read/27761198/percutaneous-transhepatic-embolization-of-bleeding-rectal-varices-using-a-new-embolic-and-sclerotic-mixture-augmented-by-amplatzer-vascular-plug-2
#8
Ahmed Kamel Abdel-Aal, Nabila Dawoud, Amr Soliman Moustafa, Maysoon F Hamed, Souheil Saddekni
We report a case of 59-year-old female with non-alcoholic-steato-hepatitis (NASH) induced cirrhosis, who presented with hematochezia. The patient had a history of bleeding esophageal varices treated with endoscopic variceal ligation (EVL). Colonoscopy showed large rectal varices which were the source of her lower gastrointestinal bleeding (LGIB). Since endoscopic treatment for LGIB are limited, and because the patient had portal vein thrombosis which contraindicated transjugular intrahepatic portosystemic shunt (TIPS), we performed percutaneous transhepatic embolization of her rectal varices using a new mixture of embolic and sclerotic agents, followed by Amplatzer plug 2 (AVP 2)...
September 2016: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/27716736/banding-ligation-or-beta-blockers-for-primary-prevention-of-variceal-bleeding
#9
Petre Cotoras Viedma, Roberto Candia
Variceal bleeding is one of the most serious complications of liver cirrhosis. Nonselective beta-blockers and endoscopic ligation are considered effective strategies for primary prevention of variceal bleeding, but there is no consensus about which alternative constitutes the best option. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified seven systematic reviews including 21 randomized controlled trials addressing the question of this article. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach...
October 4, 2016: Medwave
https://www.readbyqxmd.com/read/27706456/evaluation-of-primary-prophylaxis-with-propranolol-and-elastic-band-ligation-in-variceal-bleeding-in-cirrhotic-children-and-adolescents
#10
Júlio Rocha Pimenta, Alexandre Rodrigues Ferreira, Paulo Fernando Souto Bittencourt, Camilo Brandão de Resende, Eleonora Druve Tavares Fagundes, Isabela Maria Lopes da Silva
Background: The efficacy of nonselective β-blocker and endoscopic procedures, such as endoscopic variceal ligation, as primary prophylaxis of variceal hemorrhage in cirrhotic adults was demonstrated by numerous controlled trials, but in pediatric population, few are the number of studies. Objective: The objective of this study is to evaluate the primary prophylaxis with β-blocker in cirrhotic children and adolescents with portal hypertension. Methods: This is a cohort study encompassing 26 cirrhotic patients...
October 2016: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/27661550/-management-of-pediatric-patients-with-esophageal-varices
#11
Sofía Verdaguer D, Juan Cristóbal Gana A
BACKGROUND: There is a paucity of good quality research about the diagnosis of esophageal varices and the prophylaxis and treatment of variceal bleeding in pediatric patients with portal hypertension There is little consensus and practically no evidence-based approach about the management of these patients. AIM: To describe the behavior and preferences of pediatric gastroenterologists in Chile in the management of portal hypertension in children. MATERIAL AND METHODS: An online survey was sent to Chilean pediatric gastroenterologists, with questions evaluating the physicians’ approaches to screening of esophageal varices in children with portal hypertension, and their preferred methods of prophylaxis and initial management of variceal bleeding...
July 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/27643628/downhill-varices-an-uncommon-cause-of-upper-gastrointestinal-bleeding
#12
Guillermo Ontanilla Clavijo, Claudio Trigo Salado, Norberto Rojas Mercedes, Juan Antonio Caballero Gómez, Adalberto Rincón Gatica, Juan Manuel Alcívar-Vasquez, José Luis Márquez Galán
BACKGROUND: Upper gastrointestinal bleeding (UGIB) is a common condition in gastroenterology, but "Downhill Varices" (DHV) or varices of the upper oesophagus are an uncommon cause of UGIB, with different aetiology from lower third oesophageal varices and different therapeutic implications. CASE REPORT: A 28-year-old male patient, with a history of chronic kidney failure secondary undergoing haemodialysis and superior vena cava syndrome (SCVS) due to multiple catheter replacements, was admitted to the Emergency Department with haematemesis secondary to a varicose vein rupture in the proximal third of oesophagus, treated initially with ethanolamine...
July 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27624505/carvedilol-versus-propranolol-effect-on-hepatic-venous-pressure-gradient-at-1%C3%A2-month-in-patients-with-index-variceal-bleed-rct
#13
Vipin Gupta, Ramakant Rawat, Shalimar, Anoop Saraya
BACKGROUND AND AIMS: Endoscopic variceal ligation (EVL) plus beta blocker is the mainstay treatment after index bleed to prevent rebleed. Primary objective of this study was to compare EVL plus propranolol versus EVL plus carvedilol on reduction of HVPG after 1 month of therapy. METHODS: Patients of cirrhosis presenting with index esophageal variceal bleed received standard treatment (Somatostatin therapy f/b EVL) following which HVPG was measured and patients were randomized to propranolol or carvedilol group if HVPG was >12 mmHg...
September 13, 2016: Hepatology International
https://www.readbyqxmd.com/read/27583858/occurrence-of-infective-endocarditis-following-endoscopic-variceal-ligation-therapy-a-case-report
#14
Xuan Zhang, Xiaoli Liu, Meifang Yang, Huihui Dong, Lichen Xv, Lanjuan Li
BACKGROUND: Endoscopic variceal ligation (EVL) is the endoscopic treatment of acute esophageal variceal hemorrhage, however, prophylaxis antibiotic during EVL is controversial. METHODS: We reported a 60-year-old man with diabetes, liver cirrhosis and hepatocellular carcinoma who received EVL for esophageal variceal haemorrhage. RESULTS: On the second day after EVL, the patient developed fever and chills. A week after EVL, the blood cultures were viridans streptococcus positive, and echocardiogram showed a vegetation on the cardiac valve...
August 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27524533/congenital-hepatic-fibrosis-clinical-presentation-laboratory-features-and-management-at-a-tertiary-care-hospital-of-lahore
#15
Arit Parkash, Huma Arshad Cheema, Hassan Suleman Malik, Zafar Fayyaz
OBJECTIVE: To describe the clinical presentations, laboratory features and management of congenital hepatic fibrosis patients at a tertiary care hospital. METHODS: The case series was conducted at The Children Hospital and Institute of Child Health, Lahore, Pakistan, from July 2013 to June 2015, and comprised patients of congenital hepatic fibrosis diagnosed on the basis of liver biopsy. SPSS 20 was used for statistical analysis. RESULTS: The mean age of 25 patients in the study was 8...
August 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27477990/successful-endoscopic-submucosal-dissection-for-early-gastric-cancer-adjacent-to-gastric-cardia-varix
#16
Ko Watanabe, Takuto Hikichi, Jun Nakamura, Tadayuki Takagi, Rei Suzuki, Mitsuru Sugimoto, Yuichi Waragai, Hitomi Kikuchi, Naoki Konno, Hiroyuki Asama, Mika Takasumi, Hiroshi Watanabe, Katsutoshi Obara, Hiromasa Ohira
A 58-year-old man with liver cirrhosis and renal failure was diagnosed with esophageal varices (EVs) and a gastric cardia varix (GCV) by esophagogastroduodenoscopy (EGD). The patient also exhibited early gastric cancer (EGC) in the upper gastric body adjacent to the GCV. The EVs and GCV were treated using endoscopy before endoscopic submucosal dissection (ESD) of the EGC to prevent variceal bleeding during ESD. Endoscopic variceal ligation (EVL) was performed to treat the EVs. In addition, extra-variceal polidocanol injection and argon plasma coagulation (APC) were performed after EVL...
July 30, 2016: Fukushima Journal of Medical Science
https://www.readbyqxmd.com/read/27464949/laparoscopic-rfa-with-splenectomy-for-hepatocellular-carcinoma
#17
Kunpeng Hu, Purun Lei, Zhicheng Yao, Chenhu Wang, Qingliang Wang, Shilei Xu, Zhiyong Xiong, He Huang, Ruiyun Xu, Meihai Deng, Bo Liu
BACKGROUND: The treatment of hepatocellular carcinoma (HCC) is complicated and challenging because of the frequent presence of cirrhosis. Therefore, we propose a novel surgical approach to minimize the invasiveness and risk in patients with HCC, hypersplenism, and esophagogastric varices. METHODS: This was a retrospective study carried out in 25 patients with HCC and hypersplenism and who underwent simultaneous laparoscopic-guided radio-frequency ablation and laparoscopic splenectomy with endoscopic variceal ligation...
2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27455080/no-difference-in-mortality-between-terlipressin-and-somatostatin-treatments-in-cirrhotic-patients-with-esophageal-variceal-bleeding-and-renal-functional-impairment
#18
Tsung-Hsing Hung, Chen-Chi Tsai, Chih-Wei Tseng, Kuo-Chih Tseng, Yu-Hsi Hsieh, Chih-Chun Tsai
OBJECTIVE: To study the differences in mortality between terlipressin and somatostatin treatments in cirrhotic patients with esophageal variceal bleeding (EVB) and renal functional impairment (RFI). METHODS: The National Health Insurance Database, part of the Taiwan National Health Insurance Program, was used to enroll cirrhotic patients who had received endoscopic variceal ligation plus somatostatin or terlipressin for EVB and who were hospitalized between 1 January 2007 and 31 December 2010...
November 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27411533/a-novel-surgical-technique-for-bleeding-duodenal-varices-after-failure-of-balloon-occluded-retrograde-transvenous-obliteration-a-case-report
#19
Go Anegawa, Kenji Sumi, Atsushi Miyoshi, Kenji Kitahara, Seiji Satou
BACKGROUND: Duodenal varices are a low-frequency cause of gastrointestinal bleeding; however, greater than 40 % mortality has been reported after the initial bleeding episode. CASE PRESENTATION: This report describes a 72-year-old woman with bleeding duodenal varices treated by surgery after failure of balloon-occluded retrograde transvenous obliteration (B-RTO). The patient presented with profuse melena. Emergent upper endoscopy was immediately performed, and bleeding duodenal varices in the second portion of the duodenum were seen...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27356670/glasgow-blatchford-pre-endoscopic-rockall-and-aims65-scores-show-no-difference-in-predicting-rebleeding-rate-and-mortality-in-variceal-bleeding
#20
Ivan Budimir, Marina Gradišer, Marko Nikolić, Neven Baršić, Neven Ljubičić, Dominik Kralj, Ivan Budimir
OBJECTIVE: To compare the performance of the Glasgow Blatchford score (GBS), pre-endoscopic Rockall score (PRS) and AIMS65 score in predicting specific clinical endpoints following variceal upper gastrointestinal hemorrhage (UGIH). MATERIAL AND METHODS: Between January 2008 and December 2013, we retrospectively analyzed 225 consecutive hospitalized patients managed for endoscopically confirmed UGIH. RESULTS: A total of 225 patients (mean age 61...
November 2016: Scandinavian Journal of Gastroenterology
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