portal hypertention varices

BACKGROUND: Portal hypertension monitoring is important throughout the natural course of cirrhosis. Hepatic venous pressure gradient (HVPG), regarded as the golden standard, is limited by invasiveness and technical difficulties. Portal hypertension is increasingly being assessed non-invasively, and hematological indices, imaging data, and statistical or computational models are studied to surrogate HVPG. This paper discusses the existing non-invasive methods based on measurement principles and reviews the methodological developments in the last 20 years...

BACKGROUND AND AIM: This study aims to evaluate and compare the survival and other portal hypertension-related complications of patients with portal pressure gradient (PPG) ≥ 25 mmHg using transjugular intrahepatic portosystemic shunt (TIPS) as the first-line and second-line therapies in secondary prophylaxis of variceal hemorrhage. METHODS: Fifty patients diagnosed with liver cirrhosis were enrolled in this retrospective study, with 35 of whom received TIPS as the first-line therapy in secondary prophylaxis of variceal hemorrhage and 15 of whom as second-line treatment...

The article highlights modern approaches to the treatment of portal hypertension. The differential tactics is based on the type of portal hypertension, functional liver state, urgency of the situation and severity of blood loss, localization and stage of varices, concomitant diseases, etc. The role of miniinvasive methods is stressed. The reasonability of general treatment algorithm of portal hypertention in specialized centers is proved.

Extrahepatic portal venous obstruction (EHPVO) is a common cause of portal hypertention in children. Esophageal variceal hemorrhage is a major cause of morbidity and mortality in these patients. For many decades, portal systemic shunts were considered as the most effective treatment of variceal hemorrhage. Endoscopic injection sclerotherapy (EIS) was first introduced for emergency management of bleeding varices and subsequently as definitive treatment to prevent recurrent hemorrhage. The purpose of the study was to compare the safety and efficacy of shunt surgery and endoscopic sclerotherapy for patients with proven esophageal variceal bleeding due to EHPVO...

Transcatheter arterial embolizations of severe arterioportal shunt (A-P shunt) were performed with steel coils in 3 patients with hepatocellurlar carcinoma (HCC) as shown below. Case 1: A 56-year-old man with HCC associated with portal hypertension (esophageal varices and ascites abnominal pain), portal vein tumor thrombus and severe A-P shunt was performed in critical conditions. Case 2: A 51-year-old man with HCC, lung and adrenal gland metastases was accompanied with severe portal hypertention caused by A-P shunt and was in a harmful condition similar to case 1...

INTRODUCTION: SDPCS (The small diameter portacaval shunt) published originally by Rypins and Sarfeh in Los Angeles in 1983 has recieved little attention in our comunity to control bleeding in patients with portal hypertention. The bleeding of esophageal varices represents the must frequent and dramatic complication caused by cirrhosis, with a 50% of mortality without treatment. BACKGROUND: Comunicate the indications, thecnique and results with the Small Diameter Portocaval shunt...

OBJECTIVE: To document the frequency of rectal varices in patients with cirrhosis of liver and compare it with that of oesophageal varices in liver and to compare the frequency of rectal varices with non-cirrhotic controls. DESIGN: A cross-sectional analytical survey. PLACE AND DURATION OF STUDY: The study was conducted in the medical wards of Civil Hospital, Karachi from August 2000 to July 2001. PATIENTS AND METHODS: All patients of confirmed cirrhosis of liver, presenting during the study period, were selected for initial workup...

The results of inferior mesenteric vein-inferior vena cava shunt coupled with splenectomy and gastroesophageal devascularization in 16 patients with cirrhotic portal hypertention were reviewed. The mean diameter of the shunt stoma was 6.46 +/- 0.78 mm, and the portal pressure decreased from 4.25 +/- 0.54 kPa to 3.39 +/- 0.41 kPa. Variceal bleeding stopped in all 16 patients with no severe postoperative complications. This procedure should preserve satisfactory portal perfusion to the liver, and technically is easier than other shunt procedures...