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https://www.readbyqxmd.com/read/28079668/noninvasive-assessment-of-portal-hypertension-and-detection-of-esophageal-varices-in-cirrhosis-state-of-the-art
#1
Ana C de Oliveira
Portal hypertension (PHT) is a major consequence of any chronic liver disease and it is the main cause of complications in patients with cirrhosis. Measurement of hepatic vein pressure gradient is considered the gold standard for PHT assessment, together with its diagnosis and prognosis relevance. Even though hepatic vein pressure gradient measurement is a safe procedure, it is still considered an invasive technique and not widely available. There is thus a need for noninvasive methods that can predict the progression of PHT as well as the presence and the risk of complications related to esophageal varices...
January 10, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28076514/evaluation-of-embolization-for-periuterine-varices-involving-chronic-pelvic-pain-secondary-to-pelvic-congestion-syndrome
#2
Flavio Meirelles Siqueira, Lucas Moretti Monsignore, Julio Cesar Rosa-E-Silva, Omero Benedicto Poli-Neto, Luis Henrique de Castro-Afonso, Guilherme Seizem Nakiri, Valdair Francisco Muglia, Daniel Giansante Abud
OBJECTIVES: To evaluate the clinical response and success rate after periuterine varices embolization in patients with chronic pelvic pain secondary to pelvic congestion syndrome and to report the safety of endovascular treatment and its rate of complications. METHODS: Retrospective cohort of patients undergoing endovascular treatment of pelvic congestion syndrome in our department from January 2012 to November 2015. Data were analyzed based on patient background, imaging findings, embolized veins, rate of complications, and clinical response as indicated by the visual analog pain scale...
December 1, 2016: Clinics
https://www.readbyqxmd.com/read/28065374/predictive-value-of-ct-for-first-esophageal-variceal-bleeding-in-patients-with-cirrhosis-value-of-para-umbilical-vein-patency
#3
Paul Calame, Maxime Ronot, Sébastien Bouveresse, Jean-Paul Cervoni, Valérie Vilgrain, Éric Delabrousse
PURPOSE: To evaluate if the presence/size of a para-umbilical vein (PUV) on computed tomography (CT) are associated with a first esophageal variceal hemorrhage (EVH) in patients with cirrhosis and whether imaging features can help identify patients at increased risk of EVH. MATERIALS AND METHODS: From January 2010 to June 2012 patients with cirrhosis who underwent CT and upper gastrointestinal endoscopy within six months were included. The presence/size of PUV was noted...
February 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28045757/left-colonic-bleeding-secondary-to-inferior-mesenteric-vein-stenosis
#4
Thang Q Le, Donald Romanelli
Lower gastrointestinal bleeding is most commonly associated with diverticulosis, ischemic colitis, vascular ectasia, and anorectal disease and less commonly associated with colonic malignancy. Infrequently, it is associated with mesenteric varices, a rare etiology that is not well documented in the radiology literature. We present a case of a 50-year-old man diagnosed as having intermittent left colonic bleeding from mesenteric varices due to a critical stenosis at the portal vein-inferior mesenteric vein confluence...
December 29, 2016: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/28005626/vulvar-varicosities-a-review
#5
Anna S Kim, Laura A Greyling, Loretta S Davis
BACKGROUND: Vulvar varicosities (VV) are dilated and tortuous veins occurring within the external female genitalia. Patients may seek treatment of these varices for both medical and cosmetic purposes. In some patients, VV may be associated with a chronic pelvic pain syndrome called pelvic congestion syndrome (PCS). OBJECTIVE: To review the English language literature on VV in both pregnant and nonpregnant women. MATERIALS AND METHODS: A literature search pertaining to vulvar varicosities and PCS was performed using PubMed and Google Scholar databases...
December 21, 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28003724/balloon-occluded-retrograde-transvenous-obliteration-brto-a-novel-method-of-control-of-bleeding-from-post-glue-ulcer-over-gastric-varices-report-of-two-cases-and-review-of-literature
#6
Ritesh Prajapati, Piyush Ranjan, Arun Gupta, Ajit K Yadav
Bleeding gastric varices (GV) are managed by cyanoacrylate glue injection with transjugular intrahepatic portosystemic shunt (TIPSS) as modality for treatment failure. Ulcer can form at the site of glue injection over GV and it can cause bleeding. Treatment approach for such bleed is not well described. Balloon-occluded retrograde transvenous obliteration (BRTO), TIPSS, and devascularization remain the treatment options in this scenario. BRTO is an endovascular procedure where a balloon catheter is inserted into a draining vein of GV, and the sclerosant can be injected into the varices through the catheter during balloon occlusion...
December 2016: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/27984174/emergency-tips-in-a-child-pugh-b-patient-when-does-the-window-of-opportunity-open-and-close
#7
REVIEW
Jonel Trebicka
Transjugular intrahepatic portosystemic shunt (TIPS) is used to treat complications of cirrhosis such as variceal bleeding and refractory ascites, but it also bears the risk of liver failure, overt hepatic encephalopathy (HE) and cardiac decompensation. Variceal bleeding may be controlled using endoscopic and medical treatment in patients with compensated cirrhosis; in decompensated patients, however, TIPS improves survival. Therefore, an early TIPS (within 72h or if later, still early after bleeding) might improve the survival of patients by preventing an inflammatory response and bacterial translocation...
October 29, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27958689/predictive-value-of-a-day-orthostatic-loading-test-for-the-reversibility-of-the-great-saphenous-vein-reflux-after-phlebectomy-of-all-varicous-tributaries
#8
Yurii T Tsukanov, Anton Y Tsukanov
BACKGROUND: To evaluate predictive value of a day orthostatic loading test (DOL-test) for the reversibility of the great saphenous vein (GSV) reflux after phlebectomy of all varicose tributaries (VTs). METHODS: Prospective cohort study.Patients with reflux in the GSV were included. Patients were treated by phlebectomy for all VTs of the GSV. GSV reflux was measured during a duplex ultrasound examination with DOL-test according to: 1) reflux location and donor vein; 2) reflux extent (RE) of the GSV was evaluated according to the number of zones of reflux (NZR) which included three thigh and three calf zones; 3) reflux duration (RD); 4) peak reflux velocity (PRV) in GSV reflux point of initiation; 5) the diameter of the GSV; 6) orthostatic gradient (OG) - difference between evening and morning values of the GSV diameter...
December 13, 2016: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/27920863/balloon-occluded-retrograde-transvenous-obliteration-for-treatment-of-bleeding-gastric-varices-case-report-and-review-of-literature
#9
Sana Basseri, Christopher B Lightfoot
Gastric variceal bleeding is a major complication of portal hypertension and is associated with high morbidity and mortality. While esophageal varices are more common, gastric varices are often more challenging to treat. Balloon-Occluded Retrograde Transvenous Obliteration is an interventional procedure whereby the portosystemic gastrorenal shunt is accessed via the left renal vein and the gastric varix outflow tract obliterated using direct sclerotherapy. Herein, we present a case of a 68-year-old female patient with cirrhosis who presented with bleeding gastric varices and successfully treated...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27920646/successful-treatment-of-small-intestinal-bleeding-in-a-crohn-s-patient-with-noncirrhotic-portal-hypertension-by-transjugular-portosystemic-shunt-placement-and-infliximab-treatment
#10
Benjamin Heimgartner, Heather Dawson, Andrea De Gottardi, Reiner Wiest, Jan Hendrik Niess
Small intestinal bleeding in Crohn's disease patients with noncirrhotic portal hypertension and partial portal and superior mesenteric vein thrombosis is a life-threatening event. Here, a case is reported in which treatment with azathioprine may have resulted in nodular regenerative hyperplasia, portal hypertension and portal vein thrombosis. The 56-year-old patient with Crohn's disease developed nodular regenerative hyperplasia under treatment with azathioprine. He was admitted with severe bleeding. Gastroscopy showed small esophageal varices without bleeding stigmata...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27917332/a-rare-case-of-diploic-venous-anomaly-asymptomatic-venous-sac-expanding-in-the-diploe
#11
Hirokazu Iwamuro, Shunsuke Ikeda, Makoto Taniguchi
BACKGROUND: Vascular anomalies accompanied with the diploic veins are rare. Among them, sinus pericranii, which is characterized by abnormal connections between intra- and extracranial venous systems, is relatively common. Besides sinus pericranii, a few cases of subepicranial varix with connections to diploic veins have been reported, but these varices had no connections to intracranial venous sinuses. Herein, we present a rare case of an expanding venous sac in the diploe which communicated with the intracranial sinus but not with the extracranial venous systems...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27898181/endovenous-ablation-therapy-laser-or-radiofrequency-or-foam-sclerotherapy-versus-conventional-surgical-repair-for-short-saphenous-varicose-veins
#12
REVIEW
Sharath Chandra Vikram Paravastu, Margaret Horne, P Dominic F Dodd
BACKGROUND: Short (or small) saphenous vein (SSV) varices occur as a result of an incompetent sapheno-popliteal junction, where the SSV joins the popliteal vein, resulting in reflux in the SSV; they account for about 15% of varicose veins. Untreated varicose veins may sometimes lead to ulceration of the leg, which is difficult to manage. Traditionally, treatment was restricted to surgery or conservative management. Since the 1990s, however, a number of minimally invasive techniques have been developed; these do not normally require a general anaesthetic, are day-case procedures with a quicker return to normal activities and avoid the risk of wound infection which may occur following surgery...
29, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27896406/evaluation-of-rex-shunt-on-cavernous-transformation-of-the-portal-vein-in-children
#13
Ruo-Yi Wang, Jun-Feng Wang, Xiao-Gang Sun, Qian Liu, Jia-Long Xu, Qi-Gang Lv, Wei-Xiu Chen, Jin-Liang Li
BACKGROUND: Children with cavernous transformation of the portal vein (CTPV) develop severe complications from prehepatic portal hypertension, such as recurrent variceal bleeding and thrombocytopenia. In this study, we reported the results of 30 children with symptomatic CTPV that were treated by a Rex shunt. The effectiveness of this surgical approach was evaluated. METHODS: A retrospective review was performed of 30 children aged between 3 and 18 years with CTPV, who underwent a Rex shunt between 2008 and 2015...
November 28, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27895860/hydatid-liver-cyst-causing-portal-vein-thrombosis-and-cavernous-transformation-a-case-report-and-literature-review
#14
Serdar Kirmizi, Cuneyt Kayaalp, Sezai Yilmaz
A 33-year-old male with abdominal distention after meals was admitted to the hospital. He had a history of surgery for hydatid liver cyst. The cyst was located at the liver hilum and there were portal venous thrombosis and cavernous transformation. It had been treated with partial cystectomy, omentoplasty and albendazole. Two years later at the admission to our center, his laboratory tests were in normal ranges. Abdominal imaging methods revealed splenomegaly, portal vein thrombosis, cavernous transformation and the previously operated hydatid liver cyst...
2016: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/27891150/splenic-artery-embolization-for-the-treatment-of-gastric-variceal-bleeding-secondary-to-splenic-vein-thrombosis-complicated-by-necrotizing-pancreatitis-report-of-a-case
#15
Hee Joon Kim, Eun Kyu Park, Young Hoe Hur, Yang Seok Koh, Chol Kyoon Cho
Splenic vein thrombosis is a relatively common finding in pancreatitis. Gastric variceal bleeding is a life-threatening complication of splenic vein thrombosis, resulting from increased blood flow to short gastric vein. Traditionally, splenectomy is considered the treatment of choice. However, surgery in necrotizing pancreatitis is dangerous, because of severe inflammation, adhesion, and bleeding tendency. In the Warshaw operation, gastric variceal bleeding is rare, even though splenic vein is resected. Because the splenic artery is also resected, blood flow to short gastric vein is not increased problematically...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27880982/safety-and-efficacy-of-ruxolitinib-in-splanchnic-vein-thrombosis-associated-with-myeloproliferative-neoplasms
#16
Lisa Pieri, Chiara Paoli, Umberto Arena, Fabio Marra, Fabio Mori, Mery Zucchini, Stefano Colagrande, Alessandro Castellani, Arianna Masciulli, Vittorio Rosti, Valerio De Stefano, Silvia Betti, Guido Finazzi, Maria Luisa Ferrari, Elisa Rumi, Marco Ruggeri, Ilaria Nichele, Paola Guglielmelli, Rajmonda Fjerza, Carmela Mannarelli, Tiziana Fanelli, Lucia Merli, Giuditta Corbizi Fattori, Margherita Massa, Giuseppe Cimino, Alessandro Rambaldi, Giovanni Barosi, Mario Cazzola, Tiziano Barbui, Alessandro M Vannucchi
Splanchnic vein thrombosis (SVT) is one of the vascular complications of myeloproliferative neoplasms (MPN). We designed a phase 2 clinical trial to evaluate safety and efficacy of ruxolitinib in reducing splenomegaly and improving disease-related symptoms in patients with MPN-associated SVT. Patients, diagnosed with myelofibrosis in 12 cases, polycythemia vera in 5 and essential thrombocythemia in 4, received ruxolitinib for 24 weeks in the core study period. Spleen volume was assessed by magnetic resonance imaging (MRI) and splanchnic vein circulation by echo-Doppler analysis...
November 23, 2016: American Journal of Hematology
https://www.readbyqxmd.com/read/27855353/challenging-the-limits-in-pancreatic-surgery-a-case-report
#17
Johannes Lemke, Stefan A Schmidt, Marko Kornmann, Karl-Heinz Orend, Doris Henne-Bruns
INTRODUCTION: Today, pancreatic surgery can be performed with low mortality and tolerable morbidity in specialized centers. Nevertheless, due to its anatomical localization and proximity to important vascular structures, surgical resection of the pancreas remains challenging in many cases. PRESENTATION OF CASE: Here, we present the case of a young woman who presented in our department with abdominal pain and a tumor mass located at the pancreatic head. She had undergone explorative laparotomy elsewhere before, in which the pancreatic tumor mass was reported to be unresectable due to infiltration of the mesenteric root...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27843428/a-rare-case-of-gastric-variceal-hemorrhage-secondary-to-infiltrative-b-cell-lymphoma
#18
Adrienne Lenhart, Juan Fernandez-Castillo, Keith Mullins, Reena Salgia
Portal hypertension commonly arises in the setting of advanced liver cirrhosis and is the consequence of increased resistance within the portal vasculature. Less commonly, left-sided noncirrhotic portal hypertension can develop in a patient secondary to isolated obstruction of the splenic vein. We present a rare case of left-sided portal hypertension and isolated gastric varices in a patient with large B-cell lymphoma, who was treated with splenic artery embolization. The patient is a 73-year-old male with no previous history of liver disease, who presented with coffee ground emesis and melena...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27812069/frequency-of-different-types-of-gastric-varices-in-patients-with-cirrhosis-due-to-chronic-hepatitis-c
#19
Zamir Butt, Syed Muhammad Ali Shah, Muhammad Afzal, Irfan Younis, Muhammad Waqas, Hamna Atta
OBJECTIVE: To determine the frequency of different types of gastric varices in patients with hepatitis C virus-related cirrhosis. METHODS: The observational cross-sectional study was conducted from August 2014 to August 2015 at Aziz Bhatti Shaheed Teaching Hospital, Gujrat, Pakistan, using non-probability consecutive sampling. Patients having liver cirrhosis only due to chronic hepatitis C virus, portal vein diameter >12mm or spleen size >12cm in long axis and ascites with no previous history of variceal banding were included...
November 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27807564/downhill-esophageal-varices-associated-with-central-venous-catheter-related-thrombosis-managed-with-endoscopic-and-surgical-therapy
#20
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
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