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Esophagogastric varices

Yuan-Qiang Lin, Bo Jiang, He-Qun Li, Chun-Xiang Jin, Hui Wang
OBJECTIVES: To analyze the clinical significance of using hepatic transit time (HTT) to evaluate portal vein pressure in gastroesophageal varices patients. METHODS: For the observation group, we enrolled 50 gastroesophageal varices patients who had received esophagogastric variceal embolization in our hospital between January 2015 and February 2018. Patients without liver disease populated the control group and were recruited during the same time period. All patients underwent contrast-enhanced sonography...
January 4, 2019: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Shunzhen Zheng, Ping Sun, Xihan Liu, Guangbing Li, Wei Gong, Jun Liu
Many patients in China have portal hypertension secondary to liver cirrhosis. Splenectomy and devascularization have become an efficacious surgical procedure for portal hypertension, and has been recommended in China as the first choice for the treatment of portal hypertension for a long time. As a result of advances in laparoscopic equipment and techniques, splenectomy and esophagogastric devascularization have been carried out with laparoscope.From January 2012 to December 2017, 453 patients who were diagnosed with portal hypertension and serious gastroesophageal varices received surgical management in our institution...
December 2018: Medicine (Baltimore)
Haoxiong Zhou, Jieying Xuan, Xianyi Lin, Yunwei Guo
Background and study aims  Esophagogastric variceal bleeding (EGVB) is common in patients with portal vein thrombosis (PVT). Hereditary deficiencies in natural anticoagulant proteins, such as protein S, might contribute to PVT. However, recurrent EGVB caused by PVT in patients with protein S deficiency is seldom reported. Herein, we present the case of a 38-year-old man with protein S deficiency complicated with PVT. The patient suffered recurrent EGVB for 7 years. He underwent splenectomy plus pericardial revascularization and sequential endoscopic therapy, including one gastric variceal obturation (GVO) procedure and two esophageal variceal ligations (EVL) to eradicate the varices...
November 2018: Endoscopy International Open
Mingguo Tian, Yong Yang, Dong Jia
BACKGROUND: Distal splenorenal shunt and coronary caval shunt are commonly used for selective decompression of esophagogastric varices, but they may not solve severe hypersplenism and their application may be hampered by the presence of splenic venous thrombosis or a left gastric vein (LGV) situated deeply behind the pancreas. On the other hand, some patients have an LGV entering the splenic vein (SV). We tried to work out a new selective shunt for this group of patients. METHODS: Sixteen patients with severe hypersplenism and esophagogastric varices received coronary renal shunt using the SV following splenectomy...
September 17, 2018: World Journal of Surgery
Walter De Biase da Silva Neto, Thiago Miranda Tredicci, Fabricio Ferreira Coelho, Fabio Ferrari Makdissi, Paulo Herman
BACKGROUND: Schistosomiasis is an endemic health problem affecting about four million people. The hepatosplenic form of the disease is characterized by periportal hepatic fibrosis, pre-sinusoidal portal hypertension and splenomegaly. Liver function is preserved, being varices bleeding the main complication of the disease. The surgical treatment used in the majority of centers for the prevention of rebleeding is esophagogastric devascularization and splenectomy. Most authors reported better results with the association of surgical and postoperative endoscopic treatment...
April 2018: Arquivos de Gastroenterologia
J Wang, X N Zhu, Y R Zhang, Y Q Gao, Y P Yang
Portal hypertension refers to a series of clinical manifestations caused by elevated pressure of the portal vein system, which can cause portal hypertension by causing portal venous obstruction and / or increased blood flow. A typical clinical manifestation in patients with decompensated cirrhosis is portal hypertension. A severe complication of portal hypertension is esophagogastric varices bleeding, refractory ascites, and hepatic encephalopathy. The effective reduction of portal pressure can reduce the incidence of complications, improve the prognosis and reduce the mortality...
April 20, 2018: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
S Wang, W Zhang, F Zhang, Z Qian, L F Wang, L J Ren, S Yang
Objective: To investigate the predictive value of transient elastography (FibroScan), aspartate aminotransferase-to-platelet ratio index (APRI) in the detection of esophagogastric varices in patients with liver cirrhosis. Methods: 236 patients with liver cirrhosis who met the criteria were selected. All patients underwent gastroscopy. According to the degree of esophagogastric varices, patients were divided into four groups: none, mild, moderate, and severe. The patient's liver stiffness (LSM) and aspartate aminotransferase- to-platelet ratio index (APRI) were measured within 3 days of gastroscopy...
May 20, 2018: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
Ryuta Shigefuku, Tsunamasa Watanabe, Takuro Mizukami, Kotaro Matsunaga, Nobuhiro Hattori, Takuya Ehira, Tatsuya Suzuki, Hiroyasu Nakano, Yoshinori Sato, Yasumasa Matsuo, Kazunari Nakahara, Hiroki Ikeda, Nobuyuki Matsumoto, Takashi Tsuda, Masafumi Katayama, Satoshi Koizumi, Chiaki Okuse, Michihiro Suzuki, Takehito Otsubo, Takako Eguchi Nakajima, Hiroshi Yasuda, Fumio Itoh
Oxaliplatin, a chemotherapeutic agent for colorectal cancer, has been associated with pathological evidence of sinusoidal endothelial injury in the liver. However, esophagogastric varices are a poorly recognized outcome of oxaliplatin-based chemotherapy. We report a 78-year-old man, whose past history of colon cancer was resection and treatment with mFOLFOX6 for 20 weeks, as adjuvant chemotherapy. After 3.5-year follow-up of the oxaliplatin-based chemotherapy, he was diagnosed with esophageal varices without liver dysfunction, indicating that the hepatotoxicity caused by oxaliplatin could be prolonged after its administration...
December 2018: Clinical Journal of Gastroenterology
Xiao Ling Wen, Li Wang, Xiao Qin Song, Zhi Zhang, Xiao Fang Zhu, Shao Ping Wu
Objective To investigate the clinical value of multi-slice spiral CT(MSCT) in the diagnosis of mild digestive tract hemorrhage. Methods Thirty-five patients with mild gastrointestinal hemorrhage were examined by enhanced MSCT.CT signs were observed and compared with pathologic examination findings.Results Diseases in these 35 patients included gastric and duodenal ulcer and inflammation(n=4,11.4%),esophagogastric variceal rupture(n=7,20.0%),gastric carcinoma(n=3,8.6%),gastric stromal tumor(n=3,8.6%),gastric polyp(n=1,2...
April 28, 2018: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
Akihiro Furuta, Hiroyoshi Isoda, Tsuyoshi Ohno, Ayako Ono, Rikiya Yamashita, Shigeki Arizono, Aki Kido, Naotaka Sakashita, Kaori Togashi
Objective: To selectively visualize the left gastric vein (LGV) with hepatopetal flow information by non-contrast-enhanced magnetic resonance angiography under a hypothesis that change in the LGV flow direction can predict the development of esophageal varices; and to optimize the acquisition protocol in healthy subjects. Materials and Methods: Respiratory-gated three-dimensional balanced steady-state free-precession scans were conducted on 31 healthy subjects using two methods (A and B) for visualizing the LGV with hepatopetal flow...
January 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Natalie Lucchina, Chiara Recaldini, Monica Macchi, Valeria Molinelli, Mario Montanari, Sergio Segato, Raffaele Novario, Carlo Fugazzola
The goals of the study described here were to evaluate the feasibility and reproducibility of measuring spleen stiffness (SS) using point shear wave elastography in a series of cirrhotic patients and to investigate whether SS, liver stiffness (LS) and other non-invasive parameters are correlated with the presence of esophagogastric varices (EVs). Fifty-four cirrhotic patients with low-grade EVs or without EVs at esophago-gastro-duodenoscopy were enrolled. They underwent abdominal ultrasound and Doppler ultrasound of hepatic vessels simultaneously with p-SWE of the liver and spleen...
April 2018: Ultrasound in Medicine & Biology
Akira Yokoyama, Kenro Hirata, Rieko Nakamura, Tai Omori, Takeshi Mizukami, Junko Aida, Katsuya Maruyama, Tetsuji Yokoyama
AIM: To determine whether the presence of columnar-lined esophagus (CLE) is associated with the presence of esophageal varices (EVs) in male Japanese alcoholics. METHODS: The subjects were 1614 Japanese alcohol-dependent men (≥ 40 years of age) who had undergone upper gastrointestinal endoscopic screening. Digitalized records of high-quality endoscopic images that included the squamocolumnar junction and esophagogastric junction were retrospectively jointly reviewed by four expert endoscopists for the purpose of diagnosing CLE...
October 21, 2017: World Journal of Gastroenterology: WJG
Takashi Kobayashi, Kohei Miura, Hirosuke Ishikawa, Daiki Soma, Zhengkun Zhang, Takuya Ando, Kizuki Yuza, Yuki Hirose, Tomohiro Katada, Kazuyasu Takizawa, Masayuki Nagahashi, Jun Sakata, Hitoshi Kameyama, Toshifumi Wakai
BACKGROUND: Laparoscopic surgery for patients with portal hypertension is considered to be contraindicated because of the high risk of massive intraoperative hemorrhaging. However, recent reports have shown hand-assisted laparoscopic surgery for devascularization and splenectomy to be a safe and effective method of treating esophagogastric varices with portal hypertension. The aim of this study is to evaluate the efficacy of hand-assisted laparoscopic devascularization and splenectomy (HALS Hassab's procedure) for the treatment of esophagogastric varices with portal hypertension...
October 23, 2017: Surgical Case Reports
Atsushi Hiraoka, Shogo Kitahata, Hirofumi Izumoto, Hidetaro Ueki, Toshihiko Aibiki, Tomonari Okudaira, Yuji Miyamoto, Hiroka Yamago, Ryuichiro Iwasaki, Hideomi Tomida, Kenichiro Mori, Masato Kishida, Eiji Tsubouchi, Hideki Miyata, Tomoyuki Ninomiya, Masashi Hirooka, Yoshio Tokumoto, Masanori Abe, Bunzo Matsuura, Yoichi Hiasa, Kojiro Michitaka
AIM: We examined the prognosis of liver cirrhosis (LC) patients with and without portal hypertension (PHT) and muscle volume loss (MVL). METHODS: From 2006 to 2016, 346 LC outpatients (PHT/non-PHT = 173/173) were enrolled (median age, 69 years; men / women, 204/142; Child-Pugh A / B, 230/116; and presence of MVL 15.6% in each group) after propensity matching, following exclusion of those with hepatocellular carcinoma (HCC) beyond the Milan criteria and Child-Pugh C...
February 2018: Hepatology Research: the Official Journal of the Japan Society of Hepatology
Y Lyu, G H Han, D M Fan
Esophagogastric variceal bleeding is a life-threatening complication of cirrhotic portal hypertension. Transjugular intrahepatic portosystemic shunt (TIPS) is an effective method for the treatment and prevention of esophagogastric variceal bleeding; however, right timing of TIPS and selection of appropriate candidates for TIPS are of vital importance in improving patients' survival rate and reducing mortality rate. This article reviews the intended population and right timing of TIPS for the treatment and prevention of esophagogastric variceal bleeding in liver cirrhosis...
June 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
Dongdong Han, Rui Tang, Liang Wang, Ang Li, Xin Huang, Shan Shen, Jiahong Dong
RATIONALE: Portal vein thrombosis is a complication after liver transplantation and cavernous transformation of the portal vein (CTPV) is a result of portal vein thrombosis, with symptoms of portal hypertension revealed by an enhanced CT scan. Meso-Rex bypass is an artificial shunt connecting the left portal vein to the superior mesenteric vein and is mainly used for idiopathic cavernomas. This technique is also used for post-transplant portal vein thrombosis in pediatric patients thereby bypassing obstructed sites of the extrahepatic portal vein...
June 2017: Medicine (Baltimore)
Haili Bao, Qikuan He, Ninggao Dai, Ruifan Ye, Qiyu Zhang
BACKGROUND For patients with esophagogastric varices secondary to portal hypertension due to liver cirrhosis, portosystemic shunts and devascularization have become the most commonly used treatment methods. We have developed a novel surgical approach for the treatment of patients with cirrhotic portal hypertension, selective decongestive devascularization, and shunt of the gastrosplenic region (SDDS-GSR). This aim of this study was to compare the efficacy and safety of SDDS-GSR with splenectomy with pericardial devascularization (SPD)...
June 8, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Y M Nan
Liver cirrhosis is the severe period of chronic liver diseases, especially decompensated liver cirrhosis and its complications, such as ascites, esophagogastric variceal bleeding, hepatic encephalopathy, acute kidney injury, and hepatocellular carcinoma, which greatly affect patients' quality of life and even threaten their lives. Early prevention and treatment of the causes of development and progression and pathogenic mechanism may slow down or reverse liver cirrhosis and its severe complications. Once the disease progresses to portal hypertension and related complications, it is very important to select preventive measures for acute exacerbation of different complications, as well as the methods and timing for treatment in acute stage, which may help to save patients' lives and improve their prognosis...
April 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
An-Ping Su, Zhao-Da Zhang, Bo-Le Tian, Jing-Qiang Zhu
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) and open splenectomy and esophagogastric devascularization (OSED) are widely used to treat patients with portal hypertension and recurrent variceal bleeding (PHRVB). This study aimed to compare the effectiveness between TIPS and OSED for the treatment of PHRVB. METHODS: The data were retrospectively retrieved from 479 cirrhotic patients (Child-Pugh A or B class) with PHRVB, who had undergone TIPS (TIPS group) or OSED (OSED group) between January 1, 2010 and October 31, 2014...
April 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
C Gu, M Y Song, W J Sun, X Y Xu, C Q Yang, D F Chen
Esophageal and gastric varices are common complications of liver cirrhosis and are seen in 50% of patients with liver cirrhosis. The annual incidence rate of esophagogastric variceal bleeding is 5%-15%, and even if the recommended treatment is used, the 6-week mortality rate is still as high as 15%-20%. Spontaneous bacterial peritonitis (SBP) is a common complication of end-stage liver disease and has an incidence rate of 10%-30% in patients with severe liver damage. SBP refers to the bacterial infection of the peritoneum and/or ascites that occurs in the absence of any inflammation in adjacent tissues (e...
January 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
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