Search results for "esophageal varices"

Multidisciplinary approach to the complex treatment for non-cirrhotic portal hypertension - case-report-based discussion.

2021

Non-cirrhotic portal vein thrombosis (PVT) in patients with antiphospholipid syndrome (APS) is a rare complication, and the management has to be determined individually based on the extent and severity of the presentation. We report on a 37-year-old male patient with non-cirrhotic chronic PVT related to a severe thrombophilia, comprising APS, antithrombin-, factor V- and factor X-deficiency. Three years after the initial diagnosis of non-cirrhotic PVT, the patient presented with severe hemorrhagic shock related to acute bleeding from esophageal varices, requiring an emergency transjugular intrahepatic portosystemic stent shunt (TIPSS). TIPSS was revised after a recurrent bleeding episode du…

Including Ratio of Platelets to Liver Stiffness Improves Accuracy of Screening for Esophageal Varices That Require Treatment

2021

International audience; Background & aims: Based on platelets and liver stiffness measurements, the Baveno VI criteria (B6C), the expanded B6C (EB6C), and the ANTICIPATE score can be used to rule out varices needing treatment (VNT) in patients with compensated chronic liver disease. We aimed to improve these tests by including data on the ratio of platelets to liver stiffness.Methods: In a retrospective analysis of data from 10 study populations, collected from 2004 through 2018, we randomly assigned data from 2368 patients with chronic liver disease of different etiologies to a derivation population (n = 1579; 15.1% with VNT, 50.2% with viral hepatitis, 28.9% with nonalcoholic fatty liver …

Prevention of Upper Gastrointestinal Bleeding in Cirrhotic Patients

1987

The prevalence of varices in patients with cirrhosis is stated to be about 50% and the risk of variceal bleeding 40% with mortality ranging from 30% to 60%. Differences may be due to patient selection and diagnostic criteria. The death risk of first bleeding seems to be higher than that of subsequent episodes (Christensen et al. 1981; D’Amico et al. 1986), indicating that the first bleeding episode causes a selection.

Zur therapie der �sophagusvarizenblutung in der Bundesrepublik Deutschland (West) ? Ergebnisse einer Urnfrage

1991

An 1076 chirurgischen und internistischen Abteilung in der BRD (West) wurde eine Umfrage zur Behandlung der Osophagusvarizenblutung durchgefuhrt. Es uberwiegt die Akutsklerosierung bzw. die Ballonsondenbehandlung mit nachfolgender Sklerosierung bei der aktiven Blutung. Die abdominelle Sperroperation wird bei der konservativ nicht stillbaren Blutung noch vor dem portokavalen Notshunt bevorzugt. Betablocker werden vor allem in internistischen Abteilungen zur Rezidivprophylaxe eingesetzt. Erst nach mehrfacher Rezidivblutung trotz Sklerosierung sehen etwa die Halfte der Abteilungen eine Indikation zum elektiven Shunt. Der distale splenorenale Shunt nach Warren and die portokavale Anastomose dom…

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2009

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2009

Effects of Eradicating Hepatitis C Virus Infection in Patients With Cirrhosis Differ With Stage of Portal Hypertension.

2016

Clearance of hepatitis C virus (HCV) via antiviral treatment changes the course of liver disease. We evaluated the benefit of sustained virologic response (SVR) in patients with HCV and cirrhosis without (stage 1) and with (stage 2) esophageal varices (EV).We performed a prospective cohort study of 444 patients with HCV and compensated cirrhosis (218 with stage 1 and 226 with stage 2 disease) treated with peg-interferon and ribavirin from June 2001 through December 2009 at the University of Palermo, Italy and followed for a median of 7.6 years (range, 1-12.6 years). We used Cox regression analysis to identify variables associated with appearance or progression of EVs, development of hepatoc…

A New Sampling Method for Spleen Stiffness Measurement Based on Quantitative Acoustic Radiation Force Impulse Elastography for Noninvasive Assessment…

2014

In our study, we evaluated the feasibility of a new sampling method for splenic stiffness (SS) measurement by Quantitative Acoustic Radiation Force Impulse Elastography (Virtual Touch Tissue Quantification (VTTQ)).We measured SS in 54 patients with HCV-related cirrhosis of whom 28 with esophageal varices (EV), 27 with Chronic Hepatitis C (CHC) F1–F3, and 63 healthy controls. VTTQ-SS was significantly higher among cirrhotic patients with EV (3.37 m/s) in comparison with controls (2.19 m/s,P<0.001), CHC patients (2.37 m/s,P<0.001), and cirrhotic patients without EV (2.7 m/s,P<0.001). Moreover, VTTQ-SS was significantly higher among cirrhotic patients without EV in comparison with bot…

Serological Tests Do Not Predict Residual Fibrosis in Hepatitis C Cirrhotics with a Sustained Virological Response to Interferon

2016

BACKGROUND AND AIM: Liver biopsy (LB) has lost popularity to stage liver fibrosis in the era of highly effective anti-hepatitis C virus (HCV) therapy, yet diagnosis of persistent cirrhosis may have important implications following HCV eradication. As performance of serological non-invasive tests (NITs) to predict residual fibrosis in non-viremic HCV patients is unknown, we investigated accuracy of NITs to predict residual fibrosis in cirrhotics after a sustained virological response (SVR) to interferon (IFN). METHODS: Thirty-eight patients with a pre-treatment histological diagnosis of cirrhosis and a 48–104 months post-SVR LB were tested with APRI, CDS, FIB-4, FibroQ, Forns Score, GUCI Ind…

Survival and prognostic indicators in compensated and decompensated cirrhosis

1986

Six-year survival of cirrhosis was assessed in a series of 1155 consecutive patients (751 men, 404 women). Among the men, 33% were alcoholics and 18% were HBsAg positive; corresponding figures for the women were 15% and 6%, respectively. Features of decompensation at first presentation were observed in 63% of the patients. Six-year survival was 54% in compensated and 21% in decompensated patients. No significant differences in survival were found between alcoholics and nonalcoholics. Leading causes of death were liver failure (49%), hepatocellular carcinoma (22%), and bleeding (13%). The prognostic role of 21 variables was evaluated separately in compensated and decompensated patients by th…