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Varicous veins

Chaeyoun Oh, Joong Kee Youn, Ji-Won Han, Gi Beom Kim, Hyun-Young Kim, Sung-Eun Jung
INTRODUCTION: The Fontan procedure (FP) has become the standard operation for patients with single ventricle physiology. However, a long period of elevated systemic venous pressure and low cardiac output after the procedure result in chronic inflammation and liver cirrhosis, which may eventually lead to the occurrence of hepatocellular carcinoma (HCC). CLINICAL FINDINGS: We described the case of a 16-year-old female who developed HCC after the FP. At 21 months, the patient received a lateral tunnel FP, and 14 years later, she began complaining of abdominal distension, telangiectasia, and fatigue...
October 2016: Medicine (Baltimore)
L Spinedi, M Aschwanden, P Broz, S Imfeld, T Baldi, K Jaeger, D Staub, H Uthoff
Part one addressed the value of duplex ultrasound in the diagnostic workup of varicosis. The present article discusses the use of preinterventional, intrainterventional and postinterventional duplex ultrasound in endoluminal methods for the treatment of varices. It is a prerequisite for the planning, implementation, and follow-up of this form of therapy.
October 13, 2016: Ultraschall in der Medizin
Yasir Furkan Cagin, Yahya Atayan, Mehmet Ali Erdogan, Firat Dagtekin, Cemil Colak
BACKGROUND: Portal vein thrombosis (PVT) is due to many risk factors, but its pathogenesis is still not clearly understood. To identify the risk factors for PVT, we analyzed the clinical characteristics and complications associated with PVT in cirrhotic patients. METHODS: We studied patients with liver cirrhosis who were admitted to our unit from April 2009 to December 2014. The patients were divided into the PVT and non-PVT groups, and were compared by variables including gender, age, the etiology of cirrhosis, stage of cirrhosis, complications, imaging, and treatment...
October 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Jing Zhou, Lu Ke, Dongliang Yang, Yizhe Chen, Gang Li, Zhihui Tong, Weiqin Li, Jieshou Li
BACKGROUND: Splanchnic venous thrombosis (SVT) is a relatively rare but important complication of necrotizing acute pancreatitis (NAP). Clinical manifestations and severity of this complication in different patients vary greatly, ranging from mild abdominal discomfort even asymptomatic to lethal gastrorrhagia or hepatic failure. The aim of the present study was to develop a model to predict the clinical manifestations of SVT in NAP patients. METHODS: This retrospective cohort study was conducted in the surgical intensive care unit (SICU) of Jinling Hospital...
October 3, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Quraish Ghadiali, Anna Tan, K Bailey Freund
PURPOSE: We describe a patient with an unusually posterior varix of a vortex vein ampulla. METHODS: Case report. RESULTS: An unusually posterior varix of a vortex vein ampulla mimicking a choroidal neoplasm was identified. The diagnosis was obscured by the presence of overlying drusen. Through a combination of indocyanine green angiography and enhanced depth imaging optical coherence tomography, the varix was identified as an engorged vascular process correlating to ophthalmoscopic and tomographic examination...
August 23, 2016: Retinal Cases & Brief Reports
Tea Lund Laursen, Sidsel Rødgaard-Hansen, Holger Jon Møller, Christian Mortensen, Stine Karlsen, Dennis Tønner Nielsen, Susanne Frevert, Jens Otto Clemmesen, Søren Møller, Jørgen Skov Jensen, Flemming Bendtsen, Henning Grønbaek
BACKGROUND AND AIMS: Intestinal bacterial translocation (BT) is involved in activation of liver macrophages in cirrhotic patients. Macrophages play a key role in liver inflammation and are involved in the pathogenesis of cirrhosis and complications. BT may be determined by presence of bacterial DNA (bDNA) and macrophage activation by the soluble mannose receptor (sMR). We hypothesize that sMR is released from hepatic macrophages in cirrhosis and associated with bDNA, portal pressure and complications...
October 5, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
T Stuber, B Schmitz, H J Brambs
Introduction: Portal hypertension may lead to severe esophageal or rectal variceal bleeding. Case report: We present a case of a 67-year-old patient presenting with recurrent rectal variceal bleeding who was non-responsive to endoscopic treatment. We are reporting on an interventional therapeutic approach found in interdisciplinary consensus. Discussion: Endoscopy, surgery or TIPS (transjugular intrahepatic portosystemic shunt) can be performed in patients with gastrointestinal bleeding due to portal hypertension in liver cirrhosis...
October 5, 2016: Zeitschrift Für Gastroenterologie
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
Jason Y Huang, Jason B Samarasena, Takeshi Tsujino, John Lee, Ke-Qin Hu, Christine E McLaren, Wen-Pin Chen, Kenneth J Chang
BACKGROUND & AIMS: Portal hypertension (PH) is a serious adverse event of liver cirrhosis. The hepatic venous pressure gradient or portal pressure gradient (PPG) accurately reflects the degree of PH and is the single best prognostic indicator in liver disease. This is usually obtained by interventional radiology (IR) although it is not routinely performed. Recently, we developed a simple novel technique for EUS-guided PPG measurement (PPGM). Our animal studies showed excellent correlation between EUS-PPGM and IR-PPGM...
September 29, 2016: Gastrointestinal Endoscopy
Adriana Cavași, Voicu Mercea, Ofelia Anton, Ion Cosmin Puia
Although transjugular intrahepatic portosystemic shunts are most frequently used for the management of portal hypertension, the surgical approach is preferred for symptomatic portal cavernoma cholangiopathy. We present the case of a 25-year old female patient with a portal cavernoma secondary to catheterization of the umbilical vein at birth. She had had two episodes of esophageal variceal bleeding, successfully treated by endoscopic banding. and an episode of acute cholangitis secondary to portal cavernoma cholangiopathy...
September 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
Marco Apperti, Ermenegildo Furino, Antonio Sellitti, Gennaro Quarto
AIM: To explain the mode of using and the obtained results during EVLA procedures and sclerotherapies with support of Visioven®, a laser transillumination instrument. MATERIALS AND METHODS: 205 patients suffering from Chronic Venous Insufficiency - CEAP-C stage 1-2 enrolled (103 females and 102 males) and divided into two groups. A Group: patients candidate for sclerotherapy; B Group: patients to be subjected to endovascular laser ablation (EVLA). In both groups patients were divided into two sub-groups on the basis of the use of Visioven® or not during the procedure...
2016: Annali Italiani di Chirurgia
Mariangela Giunta, Dario Conte, Mirella Fraquelli
The development of liver cirrhosis and portal hypertension (PH), one of its major complications, are structural and functional alterations of the liver, occurring in many patients with chronic liver diseases (CLD). Actually the progressive deposition of hepatic fibrosis has a key role in the prognosis of CLD patients. The subsequent development of PH leads to its major complications, such as ascites, hepatic encephalopathy, variceal bleeding and decompensation. Liver biopsy is still considered the reference standard for the assessment of hepatic fibrosis, whereas the measurement of hepatic vein pressure gradient is the standard to ascertain the presence of PH and upper endoscopy is the method of choice to detect the presence of oesophageal varices...
September 21, 2016: World Journal of Gastroenterology: WJG
Masashi Shimohira, Takuya Hashizume, Shigeru Sasaki, Kengo Ohta, Kazushi Suzuki, Motoo Nakagawa, Yoshiyuki Ozawa, Keita Sakurai, Hiroko Nishikawa, Masaki Hara, Yuta Shibamoto
PURPOSE: To assess the usefulness of transcatheter arterial embolization (TAE) for the hepatic arterial injury related to percutaneous transhepatic portal intervention (PTPI). MATERIALS AND METHODS: Fifty-four patients, 32 males and 22 females with a median age of 68 years (range 43-82 years), underwent PTPI. The procedures consisted of 33 percutaneous transhepatic portal vein embolizations, 19 percutaneous transhepatic variceal embolizations, and 2 percutaneous transhepatic portal venous stent placements...
September 23, 2016: Cardiovascular and Interventional Radiology
Renata P Colaneri, Fabrício F Coelho, Roberto de Cleva, Paulo Herman
AIM: To propose a laparoscopic treatment for schistosomal portal hypertension. METHODS: Ten patients with schistosomiasis and portal hypertension, with previous gastrointestinal hemorrhage from esophageal varices rupture, were evaluated. Patients were subjected to a laparoscopic procedure, with ligature of splenic artery and left gastric vein. Upper gastrointestinal endoscopy was performed on the 30th postoperative day, when esophageal varices diameter was measured and band ligature performed...
September 22, 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Xiaoli Fan, Maoyao Wen, Yi Shen, Wanqin Wang, Xiaoxue Yang, Li Yang
The Child-Turcotte-Pugh (CTP) score is widely used worldwide to predict outcomes across a broad spectrum of liver diseases, mainly cirrhosis. Portal hypertension and variceal bleed are significant causes of morbidity and mortality in cirrhotic patients, although the variceal status is not incorporated into the classical CTP score. We sought to determine whether the inclusion of variceal status, specifically the Child-Turcotte-Pugh-Kumar (CTPK) score, would improve the utility of the classical CTP score to predict the clinical outcomes of cirrhotic patients in a single but high-volume center in China...
September 2016: Medicine (Baltimore)
Guoyong Chen, Sidong Wei, Zhongwu Zou, Jianjun Sun, Gaofeng Tang, Jianbin Chen, Shaotang Zhou
BACKGROUND: Liver transplantation (LT) accompanied by jejunectomy to treat patients with acute or chronic hepatic cirrhosis with thrombosis in the portal system is extremely rare. CASE PRESENTATION: A 47-year-old man presented with hematemesis and melena, and a diagnosis of decompensated cirrhosis, chronic portal vein thrombosis (PVT) and secondary gastro-esophageal variceal hemorrhage was made. Coagulants were administered, but portal vein thrombi occurred rapidly, and gastrointestinal bleeding recurred shortly thereafter...
2016: BMC Surgery
Hatem Elalfy, Walid Elsherbiny, Ashraf Abdel Rahman, Dina Elhammady, Shaker Wagih Shaltout, Ayman Z Elsamanoudy, Bassem El Deek
AIM: To build a diagnostic non-invasive model for screening of large varices in cirrhotic hepatitis C virus (HCV) patients. METHODS: This study was conducted on 124 post-HCV cirrhotic patients presenting to the clinics of the Endemic Medicine Department at Mansoura University Hospital for evaluation before HCV antiviral therapy: 78 were Child A and 46 were Child B (score ≤ 8). Inclusion criteria for patients enrolled in this study was presence of cirrhotic HCV (diagnosed by either biopsy or fulfillment of clinical basis)...
August 28, 2016: World Journal of Hepatology
Shahbaz Haider, Qurban Hussain, Sumera Tabassum, Bilal Hussain, Muhammad Rasheed Durrani, Fayyaz Ahmed
OBJECTIVE: To estimate the effect of portal pressure lowering drug 'octreotide', by observing the Doppler waveform before and after the administration of intravenous bolus of octreotide and thus to assess indirectly its efficacy to lower the portal pressure. METHODS: This quassi experimental study was carried out in Medical Department in collaboration with Radiology Department of Jinnah Postgraduate Medical Center Karachi Pakistan from September 10, 2015 to February 5, 2016...
July 2016: Pakistan Journal of Medical Sciences Quarterly
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
Thomas S Maldonado, Sheila N Blumberg, Sharvil U Sheth, Gabriel Perreault, Mikel Sadek, Todd Berland, Mark A Adelman, Caron B Rockman
BACKGROUND: Mesenteric venous thrombosis (MVT) is a relatively uncommon but potentially lethal condition associated with bowel ischemia and infarction. The natural history and long-term outcomes are poorly understood and under-reported. METHODS: A single-institution retrospective review of noncirrhotic patients diagnosed with MVT from 1999 to 2015 was performed using International Classification of Diseases, Ninth Revision and radiology codes. Patients were excluded if no radiographic imaging was available for review...
October 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
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