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Anda Carmen Achim, Stefan Cristian Vesa, Eugen Dumitru
BACKGROUND: Diagnosis of portal hypertensive gastropathy (PHG) is based on endoscopic criteria. I-scan technology, a new technique of virtual chromoendoscopy, increases the diagnostic accuracy for lesions in the gastrointestinal tract. AIM: To establish the role of i-scan endoscopy in the diagnosis of PHG. METHOD: In this prospective study, endoscopic examination was conducted first by using white light and after that i-scan 1 and i-scan 2 technology in a group of 50 consecutive cirrhotic patients...
September 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
M Praktiknjo, C Meyer, C P Strassburg, J Trebicka
Recent non-cirrhotic and non-malignant splanchnic vein thrombosis is now defined as extrahepatic portal vein thrombosis with or without involvement of the mesenteric vein according to the Baveno VI consensus from 2015. An early diagnosis is often challenging due to unspecific symptoms with abdominal pain or diarrhea but extremely important because of the potential acute and chronic complications, such as mesenteric ischemia and portal hypertension; therefore, rapid treatment is crucial. We present two cases of severe splanchnic vein thrombosis, which were treated with catheter-directed local thrombolysis and thrombus aspiration...
August 29, 2016: Der Internist
James Maurice, Edgar Brodkin, Frances Arnold, Annalan Navaratnam, Heidi Paine, Sabrina Khawar, Ameet Dhar, David Patch, James O'Beirne, Raj Mookerjee, Massimo Pinzani, Emmanouil Tsochatzis, Rachel H Westbrook
BACKGROUND: The Baveno VI guidelines propose that cirrhotic patients with a liver stiffness measurement (LSM) <20kPa and a platelet count >150000/μL can avoid screening endoscopy as their combination is highly specific for excluding clinically significant varices. The aim of the study was to validate these criteria. METHODS: Transient elastography data was collected from two institutions from 2006-2015. Inclusion criteria were a LSM ⩾10kPa and an upper gastrointestinal endoscopy within 12 months, with a diagnosis of compensated chronic liver disease...
July 4, 2016: Journal of Hepatology
Mohammed N Quraishi, Faisal Khan, Dhiraj Tripathi
Variceal bleeding is a serious complication of portal hypertension with high morbidity and mortality. Advances in our understanding of screening and risk stratification along with evidence-based management strategies for acute variceal bleeding as well as primary and secondary prevention have improved overall outcomes in patients with portal hypertension. The guidelines recently published by the British Society of Gastroenterology (BSG) and Baveno 6 consensus have aimed to enhance the standard of care in the management of varices and their complications...
2016: Polskie Archiwum Medycyny Wewnętrznej
Lourdes Cabrera, Puneeta Tandon, Juan G Abraldes
The mortality rate in acute variceal haemorrhage remains high (around 15%). Treatment is based on the combined use of vasoactive drugs, endoscopic band ligation, and prophylactic antibiotics. Effective resuscitation (haemostasis, volume management) is essential to prevent complications. Treatment failure is best managed by transjugular intrahepatic portosystemic shunt (TIPS). Balloon tamponade or specifically designed covered oesophageal stents can be used as a bridge to definitive therapy in unstable patients...
March 2, 2016: Gastroenterología y Hepatología
Reda Elwakil, Ashraf Mohammad Al Breedy, Hoda Hassan Abou Gabal
INTRODUCTION AND AIM: A few studies have shown that the degree of portal hypertensive gastropathy (PHG) and duodenopathy (PHD) has been worsening after the introduction of therapeutic endoscopic interventions. This study aimed to determine the impact of esophageal variceal eradication by endoscopic variceal ligation (EVL) on PHG and PHD using endoscopic and histopathologic assessment. METHODS: Fifty patients with esophageal varices for which EVL was indicated were included...
March 1, 2016: Hepatology International
Andres Cardenas, Angela Mendez-Bocanegra
No abstract text is available yet for this article.
March 2016: Annals of Hepatology
Benjamin L Shneider, Jean de Ville de Goyet, Daniel H Leung, Anshu Srivastava, Simon C Ling, Mathieu Duché, Patrick McKiernan, Riccardo Superina, Robert H Squires, Jaime Bosch, Roberto Groszmann, Shiv K Sarin, Roberto de Franchis, George V Mazariegos
UNLABELLED: Approaches to the management of portal hypertension and variceal hemorrhage in pediatrics remain controversial, in large part because they are not well informed by rigorous clinical studies. Fundamental biological and clinical differences preclude automatic application of approaches used for adults to children. On April 11-12, 2015, experts in the field convened at the first Baveno Pediatric Satellite Meeting to discuss and explore current available evidence regarding indications for MesoRex bypass (MRB) in extrahepatic portal vein obstruction and the role of primary prophylaxis of variceal hemorrhage in children...
April 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Tammy T Hshieh, Aung Kaung, Syed Hussain, Michael P Curry, Vinay Sundaram
BACKGROUND/AIMS: The international normalized ratio (INR) has not been validated as a predictor of bleeding risk in cirrhotics. The aim of this study was to determine whether elevation in the INR correlated with risk of esophageal variceal hemorrhage and whether correction of the INR prior to endoscopic therapy affects failure to control bleeding. PATIENTS AND METHODS: Patient records were retrospectively reviewed from January 1, 2000 to December 31, 2010. Cases were cirrhotics admitted to the hospital due to bleeding esophageal varices...
July 2015: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Pietro Lampertico, Federica Invernizzi, Mauro Viganò, Alessandro Loglio, Giampaolo Mangia, Floriana Facchetti, Massimo Primignani, Manol Jovani, Massimo Iavarone, Mirella Fraquelli, Giovanni Casazza, Roberto de Franchis, Massimo Colombo
BACKGROUND & AIMS: Esophageal varices (EV) are a marker of disease severity in compensated cirrhosis due to hepatitis B virus (HBV) which predicts also the risk of hepatocellular carcinoma (HCC), clinical decompensation and anticipated liver related death. The dynamics and prognostic significance of EV in patients under long-term HBV suppression by nucleos(t)ide analogs (NUC), are poorly known. METHODS: A standardized protocol (Baveno) including 414 upper gastrointestinal (GI) endoscopies was applied to 107 HBeAg-negative compensated cirrhotic patients (93% Child-Pugh A) during a median of 12 (range 2 to 17) years of NUC therapy...
November 2015: Journal of Hepatology
Roberto de Franchis
No abstract text is available yet for this article.
September 2015: Journal of Hepatology
Sudhagar Rengasamy, Sheik M Ali, Sarath C Sistla, Chandrasekharan P Lakshmi, Kottyen T Harichandra Kumar
BACKGROUND: Variceal bleeding is a medical emergency with 20% mortality at 6 weeks. The role of vasoactive agents in achieving hemostasis and preventing rebleeding has been well documented. The optimal duration of these agents has not been well established. There are no previous studies yielding the exact duration of octreotide to be administered to prevent rebleed and mortality from esophageal varices. The aim of this study is to evaluate the effect of combination therapy (octreotide and endoscopy), the exact duration of octreotide infusion, its cost-effectiveness, and the outcome in terms of rebleed and mortality...
April 2015: European Journal of Gastroenterology & Hepatology
Shahab Abid, Abdullah B Khalid, Safia Awan, Hasnain A Shah, Saeed Hamid, Wasim Jafri
INTRODUCTION: Variceal bleeding is a serious complication in patients with cirrhosis. Among the criteria that were proposed in Baveno conferences, the Adjusted Blood Requirement Index (ABRI) has not been validated prospectively in clinical practice. We therefore aim to evaluate the measurement of ABRI as a marker of failure to control bleeding and to evaluate the consistency of ABRI in relation to other criteria of failure to control variceal bleeding. PATIENTS AND METHODS: All patients with variceal bleeding who presented to Aga Khan University Hospital from January 2010 to December 2012 who were administered transfusion of packed red blood cells were included after obtaining informed consent...
March 2015: European Journal of Gastroenterology & Hepatology
Sun Young Ahn, Soo Young Park, Won Young Tak, Yu Rim Lee, Eun Jeong Kang, Jung Gil Park, Won Kee Lee, Kwan Lee, Young Oh Kweon
UNLABELLED: New definitions and criteria were released at the Baveno V consensus meeting. The purposes of this study were to verify Baveno V definitions and criteria for failure to control bleeding and to determine the usefulness of the combined use of the Adjusted Blood Requirement Index [ABRI: (number of blood units)/(final hematocrit-initial hematocrit)+0.01] with Baveno V criteria. In all, 246 consecutive liver cirrhosis patients with acute bleeding associated with portal hypertension were enrolled prospectively between January 2010 and October 2012...
March 2015: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Dominique Thabut, Marika Rudler, Nina Dib, Nicolas Carbonell, Philippe Mathurin, Faouzi Saliba, Alain Mallet, Julien Massard, Brigitte Bernard-Chabert, Frederic Oberti, Paul Cales, Jean-Louis Golmard, Christophe Bureau
UNLABELLED: The criteria for defining failure to control bleeding in cirrhosis patients were introduced at the Baveno II/III meetings and were widely used as endpoints in clinical trials. Because they lacked specificity, the Baveno IV criteria were proposed in 2005 and slightly modified in 2010 (Baveno V). These criteria included a new index for patients undergoing transfusion, called adjusted-blood-requirement-index (ABRI=number of blood units/(final-initial hematocrit+0.01)), with a cutoff value of 0...
March 2015: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Christos Triantos, Maria Kalafateli
Variceal bleeding is a life threatening situation with mortality rates of at least 20%. Prophylactic treatment with non-selective beta blockers (NSBBs) is recommended for patients with small varices that have not bled but with increased risk for bleeding. The recommended treatment strategies on primary prevention of variceal bleeding in patients with medium and large-sized varices are NSBBs or endoscopic band ligation. Nitrates, shunt surgery and sclerotherapy are not recommended in this setting. In this review, the most recent data on prevention of esophageal variceal bleeding are presented...
June 27, 2014: World Journal of Hepatology
Sherif Mogawer, Heba Morad, Heba Sherif, Nagwa Ramadan, Atef Abdel Aziz
BACKGROUND AND STUDY AIMS: There are many criteria and definitions used to evaluate the failure to control and prevent variceal bleeding. Baveno criteria were developed in Baveno consensus workshops I-III. Some of these criteria are fairly difficult to apply and do not adequately reflect common situations that are observed in clinical practice. Therefore, new criteria were developed at the Baveno-IV workshop. In the present study, we aimed to evaluate the validity of Baveno II-IV criteria in the prediction of bleeding recurrence among patients with liver cirrhosis who presented with bleeding oesophageal varices...
December 2013: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
Sonia Ratib, Kate M Fleming, Colin J Crooks, Guruprasad P Aithal, Joe West
BACKGROUND & AIMS: Large, population-based studies that have included the full spectrum of cirrhosis estimating survival, taking into account time-at-risk are lacking. We aimed to report 1- and 5-year average survival rates for people with cirrhosis to be used in a clinical and healthcare policy setting. METHODS: We used the Clinical Practice Research Datalink and linked English Hospital Episode Statistics to identify adult cases of cirrhosis from January 1998 to December 2009...
February 2014: Journal of Hepatology
Abdul Rabb Bhutto, Amanullah Abbasi, Nazish Butt, Azizullah Khan, Syed Mohammed Munir
OBJECTIVE: To determine the correlation of hepatic venous waveform changes with severity of hepatic dysfunction and grading of oesophageal varices. METHODS: A cross-sectional analytical study was conducted at Jinnah Postgraduate Medical Centre, Karachi, Medical Unit-III, Ward-7 from January 2009 to December 2009. Cirrhotic patients with portal hypertension were included in study. Patients presented with acute variceal bleeding, previous treatment with beta blockers or nitrates, sclerotherapy endoscopic band ligation, portal vein thrombosis, severe clotting defects, hepatic encephalopathy grade III or IV and noncirrhotic portal hypertension; were excluded from the study...
August 2012: JPMA. the Journal of the Pakistan Medical Association
George Fred Soares de Macedo, Fabio Gonçalves Ferreira, Maurício Alves Ribeiro, Luiz Arnaldo Szutan, Mauricio Saab Assef, Lucio Giovanni Battista Rossini
AIM: To analyze reliability among endoscopists in diagnosing portal hypertensive gastropathy (PHG) and to determine which criteria from the most utilized classifications are the most suitable. METHODS: From January to July 2009, in an academic quaternary referral center at Santa Casa of São Paulo Endoscopy Service, Brazil, we performed this single-center prospective study. In this period, we included 100 patients, including 50 sequential patients who had portal hypertension of various etiologies; who were previously diagnosed based on clinical, laboratory and imaging exams; and who presented with esophageal varices...
July 16, 2013: World Journal of Gastrointestinal Endoscopy
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