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REVIEW
Juan Carlos Q Velez, Nyan Latt, Roger A Rodby
Hepatorenal syndrome type 1 (HRS-1) is a unique form of acute kidney injury that affects individuals with decompensated cirrhosis with ascites. The primary mechanism leading to reduction of kidney function in HRS-1 is hemodynamic in nature. Cumulative evidence points to a cascade of events that led to a profound reduction in kidney perfusion. A state of increased intrahepatic vascular resistance characteristic of advanced cirrhosis and portal hypertension is accompanied by maladaptive peripheral arterial vasodilation and reduction in systemic vascular resistance and mean arterial pressure...
March 2024: Adv Kidney Dis Health
#2
Assim Saad Eddin, Umar Ramzan, Ehab Saad Aldin
Budd-Chiari syndrome is an uncommon disorder characterized by occlusion of hepatic veins. It can lead to portal hypertension. Most common causes of this syndrome are hypercoagulability states. Transjugular intrahepatic portosystemic shunt is often not possible given the portal venous thrombosis. In these cases, direct intrahepatic portocaval shunt, involving the creation of an access between the portal vein and the systemic circulation via the intrahepatic inferior vena cava has proven to be a feasible alternative, and can improve portal hypertension in these patients...
July 2024: Radiology Case Reports
#3
JOURNAL ARTICLE
Takako Ikegami, Hiroto Ishiki, Toru Kadono, Tetsuya Ito, Naosuke Yokomichi
BACKGROUND AND OBJECTIVE: Malignant ascites (MA) is common in patients with advanced cancer, and about 60% of patients with MA experience distressing symptoms. In addition, MA has been identified as a poor prognostic factor, therefore, making the management of MA an important issue. We aimed to review literature describing MA provide a narrative synthesis of relevant studies. METHODS: A literature search of articles published between 1971 and May 2023 was performed in PubMed, and Cochrane library using the words "ascites/malignant ascites" and the theme of each section...
April 18, 2024: Annals of Palliative Medicine
#4
REVIEW
Sergi Guixé-Muntet, Sergio Quesada-Vázquez, Jordi Gracia-Sancho
Portal hypertension represents the primary non-neoplastic complication of liver cirrhosis and has life-threatening consequences, such as oesophageal variceal bleeding, ascites, and hepatic encephalopathy. Portal hypertension occurs due to increased resistance of the cirrhotic liver vasculature to portal blood flow and is further aggravated by the hyperdynamic circulatory syndrome. Existing knowledge indicates that the profibrogenic phenotype acquired by sinusoidal cells is the initial factor leading to increased hepatic vascular tone and fibrosis, which cause increased vascular resistance and portal hypertension...
April 17, 2024: Lancet. Gastroenterology & Hepatology
#5
JOURNAL ARTICLE
Vishal C Patel, Mark J McPhail, Ruhama Uddin, Hassan Jafari, Vanessa Lawrence, Clair Le Boutillier, James Shearer, Nahel Yaziji, Angela Cape, Haroon Ahmed, Christopher Ward, Peter Walsh, Kevin Besly, Ane Zamalloa, Joanna Kelly, Ben Carter
BACKGROUND: Liver disease is within the top five causes of premature death in adults. Deaths caused by complications of cirrhosis continue to rise, whilst deaths related to other non-liver disease areas are declining. Portal hypertension is the primary sequelae of cirrhosis and is associated with the development of variceal haemorrhage, ascites, hepatic encephalopathy and infection, collectively termed hepatic decompensation, which leads to hospitalisation and mortality. It remains uncertain whether administering a non-selective beta-blocker (NSBB), specifically carvedilol, at an earlier stage, i...
April 16, 2024: Trials
#6
JOURNAL ARTICLE
Fabien Robert, Marie-Caroline Certain, Audrey Baron, Raphaël Thuillet, Léa Duhaut, Mina Ottaviani, Mustapha Kamel Chelgham, Corinne Normand, Nihel Berrebeh, Nicolas Ricard, Valerie Furlan, Agnès Desroches-Castan, Emmanuel Gonzales, Emmanuel Jacquemin, Olivier Sitbon, Marc Humbert, Sabine Bailly, Audrey Coilly, Christophe Guignabert, Ly Tu, Laurent Savale
RATIONALE: Hepatopulmonary syndrome (HPS) is a severe complication of liver diseases characterized by abnormal dilatation of pulmonary vessels, resulting in impaired oxygenation. Recent research highlights the pivotal role of liver-produced bone morphogenetic protein (BMP)-9 in maintaining pulmonary vascular integrity. OBJECTIVES: This study aimed to investigate the involvement of BMP-9 in human and experimental HPS. METHODS: Circulating BMP-9 levels were measured in 63 healthy controls and 203 cirrhotic patients, with or without HPS...
April 16, 2024: American Journal of Respiratory and Critical Care Medicine
#7
REVIEW
Martina Lombardi, Jacopo Troisi, Benedetta Maria Motta, Pietro Torre, Mario Masarone, Marcello Persico
Portal hypertension (PH) is a complex clinical challenge with severe complications, including variceal bleeding, ascites, hepatic encephalopathy, and hepatorenal syndrome. The gut microbiota (GM) and its interconnectedness with human health have emerged as a captivating field of research. This review explores the intricate connections between the gut and the liver, aiming to elucidate how alterations in GM, intestinal barrier function, and gut-derived molecules impact the development and progression of PH. A systematic literature search, following PRISMA guidelines, identified 12 original articles that suggest a relationship between GM, the gut-liver axis, and PH...
April 1, 2024: Nutrients
#8
JOURNAL ARTICLE
Xueyan Li, Jiandi Wu, Feifei Fang, Ying Liu, Wewei Jiang, Gangping Li, Jun Song
The mortality rate of gastric varices bleeding can reach 20% within 6 weeks. Isolated gastric varices (IGVs) refer to gastric varices without esophageal varices and typically arise as a common complication of left portal hypertension. Although IGVs commonly form in the setting of splenic vein occlusion, the combination of antiphospholipid syndrome and protein S deficiency leading to splenic vein occlusion is rare. We herein present a case of a 28-year-old woman with intermittent epigastric pain and melena. She was diagnosed with antiphospholipid syndrome based on the triad of pregnancy morbidity, unexplained venous occlusion, and positive lupus anticoagulant...
April 2024: Journal of International Medical Research
#9
REVIEW
Madhumita Premkumar, Anil C Anand
Non-cirrhotic portal hypertension (NCPH) is a well-recognized clinico-pathological entity, which is associated with clinical signs and symptoms, imaging, and endoscopic features of portal hypertension (PHT), in absence of cirrhosis. In patients with NCPH without known risk factors of PHT or extrahepatic portal vein thrombosis, the condition is called idiopathic non-cirrhotic portal hypertension (INCPH). There are multiple infectious, immune related causes, systemic diseases, drug and toxin exposures, haematological disorders, and metabolic risk factors that have been associated with this INCPH...
2024: Journal of Clinical and Experimental Hepatology
#10
REVIEW
Jordache Ellis, Tassos Grammatikopoulos, James Cook, Akash Deep
Respiratory manifestations of chronic liver disease have a profound impact on patient clinical outcomes. Certain conditions within paediatric liver disease have an associated respiratory pathology. This overlap between liver and respiratory manifestations can result in complex challenges when managing patients and requires clinicians to be able to recognise when referral to specialists is required. While liver transplantation is at the centre of treatment, it opens up further potential for respiratory complications...
March 2024: Breathe
#11
EDITORIAL
Rakhi Maiwall, Satender Pal Singh, Paolo Angeli, Richard Moreau, Aleksander Krag, Virender Singh, Ashwani K Singal, S S Tan, Puneet Puri, Mamun Mahtab, George Lau, Qin Ning, Manoj Kumar Sharma, P N Rao, Dharmesh Kapoor, Subhash Gupta, Ajay Duseja, Manav Wadhawan, Dinesh Jothimani, Sanjiv Saigal, Sunil Taneja, Akash Shukla, Pankaj Puri, Deepak Govil, Gaurav Pandey, Kaushal Madan, C E Eapen, Jaya Benjamin, Ashok Chowdhury, Shweta Singh, Vaishali Salao, Jin Mo Yang, Saeed Hamid, Shalimar, Sanjiv Jasuja, Anand V Kulkarni, Madund A Niriella, Harsh Vardhan Tevethia, Vinod Arora, R P Mathur, Akash Roy, Ankur Jindal, Neeraj Saraf, Nipun Verma, Arka De, Narendra S Choudhary, Rohit Mehtani, Phool Chand, Omkar Rudra, Shiv Kumar Sarin
Acute-on-chronic liver failure (ACLF) is a syndrome that is characterized by the rapid development of organ failures predisposing these patients to a high risk of short-term early death. The main causes of organ failure in these patients are bacterial infections and systemic inflammation, both of which can be severe. For the majority of these patients, a prompt liver transplant is still the only effective course of treatment. Kidneys are one of the most frequent extrahepatic organs that are affected in patients with ACLF, since acute kidney injury (AKI) is reported in 22...
April 5, 2024: Hepatology International
#12
Belinda Sánchez Pérez, María Pérez Reyes, Jose Aranda Narvaez, Julio Santoyo Villalba, Jose Antonio Perez Daga, Claudia Sanchez-Gonzalez, Julio Santoyo-Santoyo
BACKGROUND: Due to the lack of published literature about treatment of refractory hepatopulmonary syndrome (HPS) after liver transplant (LT), this case adds information and experience on this issue along with a treatment with positive outcomes. HPS is a complication of end-stage liver disease, with a 10%-30% incidence in cirrhotic patients. LT can reverse the physiopathology of this process and restore normal oxygenation. However, in some cases, refractory hypoxemia persists, and extracorporeal membrane oxygenation (ECMO) can be used as a rescue therapy with good results...
March 18, 2024: World Journal of Transplantation
#13
REVIEW
Cyriac Abby Philips, Arif Hussain Theruvath, Resmi Ravindran, Philip Augustine
Complementary and alternative medicines (CAM) include conventional medical treatments. Patients worldwide use CAM at alarming rates; thus, reports of CAM-related DILI have been on the rise. The clinical presentations include asymptomatic liver test abnormalities, acute hepatitis with or without jaundice, acute cholestatic liver disease (bland or with hepatitis), acute liver failure, severe hepatitis with features of portal hypertension, and acute decompensation of known or unknown cirrhosis that can lead to acute-on-chronic liver failure...
April 1, 2024: Hepatology Communications
#14
REVIEW
Mohamed A Heybe, Kosha J Mehta
Cirrhosis is an advanced-stage liver disease that occurs due to persistent physiological insults such as excessive alcohol consumption, infections, or toxicity. It is characterised by scar tissue formation, portal hypertension, and ascites (accumulation of fluid in the abdominal cavity) in decompensated cirrhosis. This review evaluates how albumin infusion ameliorates cirrhosis-associated complications. Since albumin is an oncotic plasma protein, albumin infusion allows movement of water into the intravascular space, aids with fluid resuscitation, and thereby contributes to resolving cirrhosis-induced hypovolemia (loss of extracellular fluid) seen in ascites...
March 29, 2024: Clinical and Experimental Medicine
#15
REVIEW
Danielle Adebayo, Florence Wong
BACKGROUND: Better understanding of disease pathophysiology has led to advances in managing ascites and its associated complications including hepatorenal syndrome-acute kidney Injury (HRS-AKI), especially medicinal and interventional advances. AIM: To review the latest changes in the management of ascites and HRS-AKI. METHODS: A literature search was conducted in Pubmed, using the keywords cirrhosis, ascites, renal dysfunction, acute kidney injury, hepatorenal syndrome, beta-blockers, albumin, TIPS and vasoconstrictors, including only publications in English...
March 25, 2024: Alimentary Pharmacology & Therapeutics
#16
JOURNAL ARTICLE
Bhumika Vaishnav, Dasaradha Ramu Barla, Pailla Ruchitha, Aniruddh N Wadivkar, Tushar Tonde, Saish Mondkar
BACKGROUND AND AIM: Respiratory complications in liver cirrhosis can occur due to various mechanisms, such as ascites causing restricted lung expansion and opening of intrapulmonary vascular shunts due to high portal pressures. We aimed to study the effects of the liver dysfunction on the lungs by evaluating arterial blood gas (ABG) and pulmonary function test (PFT) of all study subjects. SUBJECTS AND METHODS: A cross-sectional study was done between August 2020 and September 2022...
2024: International Journal of Applied and Basic Medical Research
#17
JOURNAL ARTICLE
Qian Zheng, Haiyang Zhang
RATIONALE: Hepatic sinusoidal obstruction syndrome (HSOS), which includes hepatic stasis and portal hypertension, is a rare vascular disorder of the liver. It is often associated with hematopoietic stem cell transplantation. It is also possible to treat this disease using Chinese herbal medicines that contain pyrrolizidine alkaloids (PAs). This disease is extremely rare in children and poses a serious threat to their health. To our knowledge, this is the first case of HSOS in a child with PAs...
March 15, 2024: Medicine (Baltimore)
#18
Mili Shah, Razia Gill, Priya Hotwani, Hamsika Moparty, Naresh Kumar, Dhir Gala, Vikash Kumar
Nodular regenerative hyperplasia (NRH) and obliterative portal venopathy (OPV) are two causes of non-cirrhotic portal hypertension (NCPH), which is a vascular liver disease wherein clinical signs of portal hypertension (PHT), such as esophageal varices, ascites, and splenomegaly develop in the absence of cirrhosis and portal vein thrombosis. The etiology often remains unidentified, but herein we present the case of a 56-year-old male with NCPH and refractory ascites who underwent liver biopsy confirming NRH and OPV...
February 2024: Curēus
#19
JOURNAL ARTICLE
Daniele Dondossola, Caterina Lonati, Alessia Pini, Daniela Bignamini, Alberto Zanella, Rosa Lombardi, Vittorio Scaravilli, Vincenzo La Mura, Laura Forzenigo, Pierpaolo Biondetti, Giacomo Grasselli, Anna Fracanzani, Chiara Paleari, Annalisa Cespiati, Serena Todaro, Emanuele Cattaneo, Marianna Di Feliciantonio, Giordano Sigon, Carlo Valsecchi, Amedeo Guzzardella, Michele Battistin, Federica Iuculano
OBJECTIVES: Although respiratory failure is the most common feature in coronavirus disease 2019 (COVID-19), abdominal organ involvement is likewise frequently observed. To investigate visceral and thoracic circulation and abdominal organ damage in COVID-19 patients. MATERIALS AND METHODS: A monocentric observational study was carried on. In COVID-19 patients affected by acute respiratory distress syndrome (ARDS) (n = 31) or mild pneumonia (n = 60) thoracoabdominal circulation was evaluated using Doppler-ultrasound and computed tomography...
March 9, 2024: Journal of Critical Care
#20
JOURNAL ARTICLE
Nikolaos T Pyrsopoulos, David Bernstein, Marcelo Kugelmas, Emily J Owen, K Rajender Reddy, Nancy Reau, Sammy Saab, Hani M Wadei
Decompensated cirrhosis, defined by the overt manifestations of liver failure and portal hypertension (eg, ascites, hepatic encephalopathy, variceal bleeding), is the inflection point associated with increased morbidity and mortality in chronic liver disease. Acute kidney injury in the setting of cirrhosis (hepatorenal syndrome-acute kidney injury [HRS-AKI]) is a severe and often fatal complication. The goals of treatment of HRS-AKI are to reverse renal failure and prolong survival in these critically ill patients or perhaps to allow the transplant team to complete the pretransplant evaluation and bridge the patient to transplant...
December 2023: Gastroenterology & Hepatology
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