Read by QxMD icon Read

Portosystemic shunt

Junfu Zheng, Yuening Zhang, Peng Li, Shibin Zhang, Yue Li, Lei Li, Huiguo Ding
BACKGROUND: The recurrence of esophageal varices remains high in patients with hepatic portal hypertension after the endoscopic esophageal variceal eradication therapies, including endoscopic variceal band ligation (EVL), injection sclerotherapy (EIS) or EVL plus EIS. The aim of this study was to evaluate the endoscopic ultrasound probe examinations (EUP) findings in the prediction of recurrence following esophageal variceal eradication in a prospective cohort. METHODS: A total of 206 cirrhotic portal hypertension patients with esophageal variceal eradication, who underwent endoscopic variceal therapy (EVL or EIS or EVL plus EIS) were initially enrolled...
February 19, 2019: BMC Gastroenterology
Cyriac Abby Philips, Sasidharan Rajesh, Philip Augustine, Guruprasad Padsalgi, Rizwan Ahamed
Portosystemic shunt (PS) syndrome encompasses a spectrum of disease manifestations ranging from asymptomatic portal hypertension to recurrent and refractory hepatic encephalopathy, ultimately culminating in progressive hepatic failure in patients of cirrhosis and associated large PSs. PSs commonly seen in cirrhosis include splenorenal, gastrorenal, and dilated paraumbilical veins, all of which can present with recurrent or refractory hepatic encephalopathy. In this exhaustive review, we describe the anatomy of PSs, elucidate new theories on their pathophysiology, discuss the clinical implications of PSs in cirrhosis, provide details on different techniques (classical and novel) of shunt embolization, and explore all the pertinent current literature on shunt embolization for refractory and recurrent hepatic encephalopathy, all of which are enumerated with extensive images and illustrations...
2019: Hepatic Medicine: Evidence and Research
J van Son, R C Rietbroek, F M Vaz, C E M Hollak
This case report presents an adult patient with decreased levels of consciousness and bizarre behavior. A silent delirium was first suspected however, symptoms did not improve and further examination revealed elevated ammonia levels. A hepatic cause and portosystemic shunting were excluded and eventually a diagnosis of ornithine transcarbamylase deficiency was made. After treatment with high carbohydrate intake, a low protein diet and supplementation with arginine and sodium benzoate, the patient recovered.
January 2019: Netherlands Journal of Medicine
Matthew J Armstrong, Farhan Gohar, Amritpal Dhaliwal, Peter Nightingale, Graham Baker, Daniel Greaves, Kam Mangat, Zergum Zia, Salil Karkhanis, Simon Olliff, Homoyon Mehrzad, Rick P Steeds, Dhiraj Tripathi
BACKGROUND: Cardiac dysfunction is frequently observed in patients with cirrhosis. There remains a paucity of data from routine clinical practice regarding the role of echocardiography in the pre-assessment of transjugular intrahepatic portosystemic stent-shunt. AIM: Our study aimed to investigate if echocardiography parameters predict outcomes after transjugular intrahepatic portosystemic stent-shunt insertion in cirrhosis. METHODS: Patients who underwent echocardiography and transjugular intrahepatic portosystemic stent-shunt insertion at the liver unit (Birmingham, UK) between 1999 and 2016 were included...
February 17, 2019: Alimentary Pharmacology & Therapeutics
Tawfik Khoury, Muhammad Massarwa, Saleh Daher, Ariel A Benson, Wadi Hazou, Eran Israeli, Harold Jacob, Julia Epstein, Rifaat Safadi
There are limited efficacious therapeutic options for management of gastric variceal bleeding. Treatment modalities include transjugular intrahepatic portosystemic shunt, surgical shunts, and endoscopic interventions, including the recent advancement of endoscopic ultrasound (EUS)-guided coiling. We present a case series of 10 patients with portal hypertension (7 with liver cirrhosis and 3 without cirrhosis), complicated by gastric varices (GV) with bleeding. All cases were treated successfully with EUS-guided coiling leading to variceal eradication...
February 2019: Hepatology Communications
Amey D Sonavane, Deepak N Amarapurkar, Krantikumar R Rathod, Sundeep J Punamiya
Background: There has been significant improvement in understanding the etiology and management of Budd-Chiari Syndrome (BCS). Patients with chronic or acute-on-chronic BCS need radiological interventions in the form of angioplasty, hepatic vein/inferior vena cava stenting or Transjugular Intrahepatic Portosystemic Shunt (TIPS). Data regarding the long term follow up of patients undergoing TIPS is limited. We thus prospectively followed-up BCS patients who underwent TIPS at our center...
January 2019: Journal of Clinical and Experimental Hepatology
Feifan Xie, An Vermeulen, Pieter Colin, Zeneng Cheng
AIMS: Agomelatine is an antidepressant for major depressive disorders. It undergoes extensive first-pass hepatic metabolism, and displays irregular absorption profiles and large interindividual variability (IIV) and interoccasion variability (IOV) of pharmacokinetics. The objective of this study was to characterize the complex pharmacokinetics of agomelatine and its metabolites in healthy subjects. METHODS: Plasma concentration-time data of agomelatine and its metabolites were collected from a four period, cross-over bioequivalence study, in which 44 healthy subjects received 25 mg agomelatine tablets orally...
February 14, 2019: British Journal of Clinical Pharmacology
Lijian Xie, Yun Li, Xunwei Jiang, Jian Zhao, Tingting Xiao
BACKGROUND: Abernethy malformation is an extremely rare congenital malformation characterised by an extrahepatic portosystemic shunt. Children with Abernathy malformation can develop hepatopulmonary syndrome (HPS) with pulmonary arteriovenous fistulas (PAVF) or pulmonary hypertension. PAVF manifests as central cyanosis with effort intolerance. We report a case of PAVF in a Ten-year-old Boy. Persistent symptoms identified Abernathy malformation as the cause of progressive symptoms and current understanding of this rare malformation is reviewed...
February 11, 2019: BMC Pediatrics
Nelson Valentin, Ilan Weisberg
No abstract text is available yet for this article.
March 2019: European Journal of Gastroenterology & Hepatology
Elton Dajti, Federico Ravaioli, Antonio Colecchia, Giovanni Marasco, Amanda Vestito, Davide Festi
Aims: Budd-Chiari Syndrome (BCS) is a rare vascular disease of the liver caused by the obstruction of the hepatic venous outflow located from the small hepatic venules up to the entrance of the inferior vena cava (IVC) into the right atrium. Current prognostic indexes are suboptimal for an individual prognostic assessment and subsequent management of patients with BCS. Liver (LSM) and spleen (SSM) stiffness measurements are widely validated prognostic tools in hepatology, but the evidence in patients with BCS is limited...
2019: Canadian Journal of Gastroenterology & Hepatology
Daniel J Stein, Christian Salinas, Saher Sabri, Rose Onyeali, Stephen Caldwell, Zachary Henry
PURPOSE: To assess short- and long-term mortality and rebleeding with endoscopic cyanoacrylate (EC) versus balloon-occluded retrograde transvenous obliteration (BRTO). MATERIALS AND METHODS: A retrospective cohort comparison was conducted of 90 EC patients and 71 BRTO patients from 1997 through 2015 with portal hypertension who presented due to endoscopically confirmed bleeding cardiofundal gastric varices. Patients underwent either endoscopic intra-varix injection of 4-carbon-n-butyl-2-cyanoacrylate or sclerosis with sodium tetradecyl sulfate with balloon occlusion for primary variceal treatment...
February 2019: Journal of Vascular and Interventional Radiology: JVIR
Frederic Bertino, C Matthew Hawkins, Giri Shivaram, Anne E Gill, Matthew P Lungren, Aaron Reposar, Daniel Y Sze, Gloria L Hwang, Kevin Koo, Eric Monroe
PURPOSE: To examine the technical feasibility and clinical efficacy of transjugular intrahepatic portosystemic shunt (TIPS) creation in children and adolescents. MATERIALS AND METHODS: Retrospective review was performed of 59 patients (mean age 12.6 y [range, 1.5-20 y], mean weight 47.5 kg [range, 11.4-112.2 kg], mean Model for End-stage Liver Disease/Pediatric End-stage Liver Disease score 12.5 [range, 6-33]) who underwent 61 TIPS attempts at 3 tertiary children's hospitals from 2001 to 2017 for acute esophageal or gastroesophageal variceal bleeding, primary and secondary prevention of variceal bleeding, and refractory ascites...
February 2019: Journal of Vascular and Interventional Radiology: JVIR
Jiaywei Tsauo, He Zhao, Xiaowu Zhang, Huaiyuan Ma, Mingshan Jiang, Ningna Weng, Xiao Li
PURPOSE: To evaluate effect of transjugular intrahepatic portosystemic shunt (TIPS) creation on pulmonary gas exchange in patients with hepatopulmonary syndrome (HPS). MATERIALS AND METHODS: All patients with cirrhosis or Budd-Chiari syndrome undergoing elective TIPS creation at a single institution between June 2014 and June 2015 were eligible for inclusion. Twenty-three patients with HPS (age 55.0 y ± 14.4; 11 men; Model for End-Stage Liver Disease score 10.2 ± 2...
February 2019: Journal of Vascular and Interventional Radiology: JVIR
Mohamed Galal Shoreibah, Khalid Mahmoud, Noha A Aboueldahab, Patrick Vande Lune, Mustafa Massoud, Sejong Bae, Husameddin El Khudari, Andrew J Gunn, Ahmed Kamel Abdel Aal
PURPOSE: To examine the role of psoas muscle density (PD) measurement before transjugular intrahepatic portosystemic shunt (TIPS) creation in predicting survival when combined with Model for End-stage Liver Disease (MELD) score. MATERIALS AND METHODS: The medical records of 241 patients with cirrhosis who underwent TIPS creation between June 2005 and June 2015 were retrospectively reviewed. The patients were divided into 2 groups: those with variceal bleeding (VB; n = 113) and those with volume overload (VO; n = 128)...
February 2019: Journal of Vascular and Interventional Radiology: JVIR
A David, R Liberge, J Meyer, O Morla, F Leaute, I Archambeaud, J Gournay, D Trewick, E Frampas, C Perret, F Douane
PURPOSE: The purpose of our study was to retrospectively assess the safety and efficacy of percutaneous real-time ultrasound guidance for portal vein puncture during transjugular intrahepatic portosystemic shunt (TIPS) placement. MATERIALS AND METHODS: Between January 2011 and November 2018, procedure details and outcome were retrospectively analyzed for 224 patients who underwent TIPS placement using real-time ultrasound guidance for portal vein puncture. There were 175 men and 49 women with a mean age of 52...
January 30, 2019: Diagnostic and Interventional Imaging
Ronan A Mullins, Carlos Sanchez Villamil, Hilde de Rooster, Anne Kummeling, Robert N White, Kelley M Thieman Mankin, Michael S Tivers, Donald A Yool, Davina M Anderson, Kathryn M Pratschke, Ines Gordo, Herve Brissot, Ameet Singh, Melanie Olive, Jean Phillipe Billet, Laura E Selmic, Barbara M Kirby
OBJECTIVE: To report the incidence of postattenuation seizures (PAS) in dogs that underwent single congenital extrahepatic portosystemic shunt (cEHPSS) attenuation and to compare incidence of PAS in dogs that either did or did not receive prophylactic treatment with levetiracetam (LEV). STUDY DESIGN: Multi-institutional retrospective study. POPULATION: Nine hundred forty dogs. METHODS: Medical records were reviewed to identify dogs that underwent surgical attenuation of a single cEHPSS from January 2005 through July 2017 and developed PAS within 7 days postoperatively...
February 2019: Veterinary Surgery: VS
Maiko Namba, Tomokazu Kawaoka, Hiroshi Aikata, Kenichiro Kodama, Shinsuke Uchikawa, Kazuki Ohya, Kei Morio, Hatsue Fujino, Takashi Nakahara, Eisuke Murakami, Masami Yamauchi, Masataka Tsuge, Akira Hiramatsu, Michio Imamura, Yasutaka Baba, Kazuo Awai, Kazuaki Chayama
We report a 74-year-old male patient with compensated cirrhosis after hepatic C virus eradication. After the patient underwent hepatectomy for hepatocellular carcinoma, multiple lung and lymph node metastases were detected by computed tomography. Computed tomography also revealed a portosystemic shunt from the superior mesenteric vein to the right testicular vein. He was administered lenvatinib (12 mg). Five days after the initiation of lenvatinib, he developed grade 3 hepatic encephalopathy, and his ammonia level increased...
January 31, 2019: Clinical Journal of Gastroenterology
Roger F Butterworth, Mark J W McPhail
This manuscript represents an appraisal of the evidence in support of L-ornithine-L-aspartate (LOLA) for the management and treatment of hepatic encephalopathy (HE) in cirrhosis. Meta-analyses of randomized controlled trials (RCTs) conducted over the last two decades generally reveal evidence of benefit of LOLA in a range of clinical presentations. This included improvement of mental state grade in overt HE (OHE) assessed by West Haven criteria as well as in minimal HE (MHE) assessed by psychometric testing where the oral formulation of LOLA was determined to be particularly effective...
January 31, 2019: Drugs
Maliha Naseer, Erica P Turse, Ali Syed, Francis E Dailey, Mallak Zatreh, Veysel Tahan
BACKGROUND: Sarcopenia, i.e ., muscle loss is now a well-recognized complication of cirrhosis and in cases of non-alcoholic fatty liver disease can contribute to accelerate liver fibrosis leading to cirrhosis. Hence, it is imperative to study interventions which targets to improve sarcopenia in cirrhosis. AIM: To examine the relationship between interventions such nutritional supplementation, exercise, combined life style intervention, testosterone replacement and trans jugular intrahepatic portosystemic shunt (TIPS) to improve muscle mass in cirrhosis...
January 26, 2019: World Journal of Clinical Cases
Fu-Liang He, Chuan Li, Fu-Quan Liu, Xing-Shun Qi
BACKGROUND: Collagen proportionate area (CPA) is an important index for assessing the severity of liver fibrosis. Budd-Chiari syndrome can frequently progress to liver fibrosis and cirrhosis. CPA might play an important role in the pathological progress of Budd-Chiari syndrome. AIM: To explore the role of CPA in predicting the outcomes of patients with Budd-Chiari syndrome. METHODS: Nine patients with Budd-Chiari syndrome undergoing transjugular intrahepatic portosystemic shunt (TIPS) were included...
January 26, 2019: World Journal of Clinical Cases
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"