Based on this patient?s evaluation, we believe that her portal hypertension and esophageal variceal bleeding was secondary to aggressive systemic mastocytosis, likely involving the liver. Gastrointestinal involvement may be seen in up to 80% of patients with systemic mastocytosis and commonly manifests as abdominal pain, diarrhea, and nausea or vomiting.3 Bleeding from the gastrointestinal tract is typically due to peptic ulcer disease in approximately 11% of patients with systemic mastocytosis, while liver infiltration with portal hypertension is presumed to be rare. First described by Capron et al in 1978, non-cirrhotic portal hypertension as a result of systemic mastocytosis is thought to be either pre-sinusoidal or sinusoidal.4 While the exact mechanism is unknown, it is postulated that non-cirrhotic portal hypertension may develop as a result of infiltration of inflammatory mast cells within the portal vein and obstruction of the sinusoids.4 This infiltration is thought to result in ...

TY - JOUR. T1 - Prevalence of histological features of idiopathic noncirrhotic portal hypertension in general population. T2 - a retrospective study of incidental liver biopsies. AU - Zuo, Chunlai. AU - Chumbalkar, Vaibhav. AU - Ells, Peter F.. AU - Bonville, Daniel J.. AU - Lee, Hwajeong. PY - 2017/9/1. Y1 - 2017/9/1. N2 - Background: Idiopathic noncirrhotic portal hypertension (INCPH) is associated with histologic changes secondary to obliterative portal venopathy without cirrhosis. We studied the prevalence of individual histological features of INCPH in liver biopsies obtained incidentally during unrelated elective procedures and in elective liver biopsies with the diagnosis of fatty liver disease. Methods: A total of 53 incidental liver biopsies obtained intraoperatively during unrelated elective procedures and an additional 28 elective biopsies with the diagnosis of fatty liver disease without portal hypertension and cirrhosis were studied. Various histologic features of INCPH were ...

Portal hypertensive gastropathy refers to changes in the mucosa of the stomach in patients with portal hypertension; by far the most common cause of this is cirrhosis of the liver. These changes in the mucosa include friability of the mucosa and the presence of ectatic blood vessels at the surface. Patients with portal hypertensive gastropathy may experience bleeding from the stomach, which may uncommonly manifest itself in vomiting blood or melena; however, portal hypertension may cause several other more common sources of upper gastrointestinal bleeding, such as esophageal varices and gastric varices. On endoscopic evaluation of the stomach, this condition shows a characteristic mosaic or snake-skin appearance to the mucosa of the stomach. Most patients with portal hypertensive gastropathy have either a stable or improving course in the appearance of the gastropathy on endoscopy. However, according to retrospective data, roughly one in seven patients with portal hypertensive gastropathy will ...

Abstract. In this report, we present a case of isolated liver tuberculosis (TB) as a cause of non-cirrhotic portal hypertension leading to bleeding esophageal varices. Although TB has been known to cause portal hypertension in a variety of ways, this case was notable for the presence of periportal inflammation and granulomas, also seen in hepatic schistosomiasis. Herein, we discuss isolated liver TB and the differential diagnosis of non-cirrhotic portal hypertension. In endemic areas, TB should be considered in the differential diagnosis of non-cirrhotic portal hypertension.

There is no consensus about the optimal treatment of hepatocellular carcinoma (HCC) with cirrhotic portal hypertension, While this group of patients are classified as hepatectomy contraindication according to guidelines from National Comprehensive Cancer Network (NCCN) and American Association for the Study of Liver Diseases (AASLD). With improvement of surgical technique, preoperative evaluation, and perioperative management,especially the Precise Hepatectomy Technique, more and more studies confirmed the safety of surgical intervention to hepatocellular carcinoma (HCC) patients with cirrhotic portal hypertension.However, most of the previous studies were either retrospective or with small samples.. The investigators project is a prospective randomized controlled trial, planning to compare the safety, efficacy and quality of life between precise hepatectomy and combined interventional treatment on hepatocellular carcinoma (HCC) with cirrhotic portal hypertension, to make a further understanding ...

The FDA has notified healthcare professionals and patients that the use of Videx or Videx EC (didanosine, from Bristol-Myers Squibb) may cause non-cirrhotic portal hypertension, a rare but serious complication.

Didanosine linked to noncirrhotic portal hypertension. React. Wkly. 1270, 4 (2009). https://doi.org/10.2165/00128415-200912700-00008. Download ...

TY - JOUR. T1 - Liver transplantation in patients with severe portopulmonary hypertension treated with preoperative chronic intravenous epoprostenol. AU - Tan, Henkie P.. AU - Markowitz, Jay S.. AU - Montgomery, Robert A.. AU - Merritt, William T. AU - Klein, Andrew S.. AU - Thuluvath, Paul J.. AU - Poordad, F. Fred. AU - Maley, Warren R.. AU - Winters, Bradford D. AU - Akinci, Seda B.. AU - Gaine, Sean P.. PY - 2001. Y1 - 2001. N2 - Portopulmonary hypertension (PPHTN) is no longer an absolute contraindication to orthotopic liver transplantation (OLT). The pre-OLT management of patients with PPHTN requires early diagnosis and chronic therapy with intravenous epoprostenol to decrease pulmonary vascular resistance (PVR). Close follow-up is necessary to reassess pulmonary artery pressures (PAPs) and evaluate right ventricular (RV) function. This assists in the optimal timing of OLT. Successful management also necessitates reassessment of pulmonary artery hemodynamics just before OLT, with clearly ...

Four patients developed clinically important portal hypertension with histological features of idiopathic portal hypertension while they were receiving cytotoxic drugs for chronic myeloid leukaemia and Hodgkins disease. Mild sclerosis of some small portal triads was the only abnormality seen at light microscopical examination in three of the four cases. In the remaining case light microscopical findings seemed to be normal. Two cases examined by electron microscopy showed perisinusoidal fibrosis; in one case this was the only abnormality detected. There is an association between idiopathic portal hypertension and the use of chemotherapeutic agents, particularly thioguanine. Adequate histological examination of liver tissue, including electron microscopic studies, is recommended for patients who develop hepatic problems while receiving cytotoxic treatment to elucidate this problem.. ...

TY - JOUR. T1 - Pathophysiology of Portal Hypertension and Its Clinical Links. AU - Seo, Yeon Seok. AU - Shah, Vijay. PY - 2011. Y1 - 2011. N2 - Portal hypertension is a major cause of morbidity and mortality in patients with liver cirrhosis. Intrahepatic vascular resistance due to architectural distortion and intrahepatic vasoconstriction, increased portal blood flow due to splanchnic vasodilatation, and development of collateral circulation have been considered as major factors for the development of portal hypertension. Recently, sinusoidal remodeling and angiogenesis have been focused as potential etiologic factors and various researchers have tried to improve portal hypertension by modulating these new targets. This article reviews potential new treatments in the context of portal hypertension pathophysiology concepts.. AB - Portal hypertension is a major cause of morbidity and mortality in patients with liver cirrhosis. Intrahepatic vascular resistance due to architectural distortion and ...

Can Portal Hypertension Cause High Blood Pressure is a serious condition. Do you have Can Portal Hypertension Cause High Blood Pressure or are you at risk for Can Portal Hypertension Cause High Blood Pressure. But if you treat it carefully you can provent Can Portal Hypertension Cause High Blood Pressure. But bont worry about Can Portal Hypertension Cause High Blood Pressure? Youve come to the right place. This quick guide for Can Portal Hypertension Cause High Blood Pressure. These tutorial will get you started.

TY - JOUR. T1 - Two cases of esophageal cancer with portal hypertension treated with esophagectomy with venous shunt procedure. AU - Kikuchi, Kenji. AU - Okushiba, Shunichi. AU - Kitashiro, Shuuji. AU - Kawarada, You. AU - Shichinohe, Toshiaki. AU - Yamamoto, Yuhei. AU - Komatsu, Yoshito. AU - Morikawa, Toshiaki. AU - Kato, Hiroyuki. AU - Kondo, Satoshi. PY - 2006/2. Y1 - 2006/2. N2 - Some 4-6% of esophageal cancer patients have liver cirrhosis, and the incidence of complication after esophageal cancer surgery in portal hypertension due to liver cirrhosis is high. One serious complication is anastomotic leakage due to congestion of venous flow in the early postoperative course. We conducted a venous shunt in addition to reconstruction of the esophagus after esophagectomy using the gastric tube in two cases of esophageal cancer with portal hypertension to avoid congestion in the gastric tube. In Case 1, a patient with portal hypertension due to liver cirrhosis had esophageal cancer type-III. ...

ABSTRACT- To clarify the relation of pericentral fibrosis to portal hypertension, measurements of portal vascular resistance in vitro and blood pressures of several key points in hepatic vascular pathways in vivo were undertaken in rats given dimethylnitrosamine. Administration of dimethylnitrosamine induced tortuosity and narrowing of the peripheral branches of the hepatic vein due to pericentral fibrosis. No significant change was produced in the sinusoids and the portal vein branches. The portal vascular resistance was increased and the portal vein pressure was elevated markedly. The blood pressure gradient was steep in the intrahepatic vein, but not in the intrahepatic portal vein or the sinusoids, as compared to control. These data suggest that deformation of the peripheral branches of the hepatic vein due to pericentral fibrosis causes a marked increase in vascular resistance in the intrahepatic hepatic vein, i.e. postsinusoidal portal hypertension. ...

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Progesterone is very important because it functions to prepare the uterus for being pregnant and helps to keep up it. Exercising while pregnant is not only about keeping your body in higher form, though after all if you happen to feel better about your physique and the changes it is going by way of, this may most definitely have a knock-on effect to your mood, eating habits, sleep and well-being. Excessive dietary protein may cause issues in girls with underlying kidney disease. Theres supposedly something to it. As well as, The National Marketing campaign to Forestall Teen Being pregnanta nonpartisan, nonprofit group created in 1996 to help promote reducing the teen pregnancy price, set a aim of lowering teen pregnancies by one-third between 2006 and 2015. To feel more comfy at evening, some pregnant ladies may sleep in a light supportive sports bra, Moss recommended. If a gene triggers the event of testes, the embryo develops as a male. In Japan, the conventional size of a full-time period ...

Definition of portal hypertension in the Legal Dictionary - by Free online English dictionary and encyclopedia. What is portal hypertension? Meaning of portal hypertension as a legal term. What does portal hypertension mean in law?

The content of the Repository, unless otherwise specified, is protected with a Creative Commons license: Attribution-Non Commercial-No Derivatives 4.0 ...

Portal hypertension: Find the most comprehensive real-world symptom and treatment data on portal hypertension at PatientsLikeMe. 39 patients with portal hypertension experience fatigue, depressed mood, pain, anxious mood, and insomnia and use Gabapentin, Lisinopril, Nadolol, and Psychiatric evaluation to treat their portal hypertension and its symptoms.

Histopathological evaluation of the polyp showed numerous thick-walled capillaries in its subepithelial portion, and a few vascular ectasias suggestive of portal hypertensive duodenopathy. The most common manifestations of portal hypertension are esophageal and gastric varices. Gastric mucosal changes such as presence of mosaic pattern, cherry red spots and scarlatina rash on endoscopy are called as portal hypertensive gastropathy which are also not uncommon. {1} Duodenum can also be involved and apart from duodenal varices, there may be presence of erythema, scattered petechiae, friable mucosa, erosion, ulcer and edema. {2} This is known as portal duodenopathy. On histopathology, they may present as subepithelial edema and increase of diameter and wall thickness of the capillaries. {3} Polyp can also occur due to portal hypertension duodenopathy which on histology may show presence of multiple thick walled capillaries {1} as was seen in our patient. It is postulated that multiple polyps can ...

The aim of this study was to evaluate whether variant meso-Rex bypass with transposition of abdominal autogenous vein can be used as an alternative treatment modality for selected patients with symptomatic extrahepatic portal vein obstruction. This was a retrospective review of six consecutive patients who received this alternative procedure for the treatment of symptomatic portal hypertension secondary to idiopathic extrahepatic portal vein obstruction. Their clinical characteristics, operative procedures and outcomes were analyzed retrospectively. The procedure was attempted in six patients, and all had a patent shunt established by intraoperative portography at the end of the procedure; the coronary vein was used in four patients and the inferior mesenteric vein was used in two. During the median period of 23.5 months (range 10-30 months), follow-up was uneventful except one patient; reduced portal hypertension and no new episodes of gastrointestinal bleeding were observed in all patients, with the

The research, led by Dr. Mercedes Fernandez from the Institute of Biomedical Research of Barcelona Spain, examined the effects of sorafenib on rats with portal hypertension induced by partial portal vein ligation or bile duct ligation. The drug which can be taken orally, inhibits growth of new blood vessels. For those with tumors, the drug works to inhibit the the growth of new blood vessels which keep the tumor alive once it reaches a certain size. This type of drug is referred to as an angiogenesis inhibitor. Vascular formation is the trademark of portal hypertension, so to arrest this is key to slowing down the process of new formation, and decreasing portal pressure. ...

Cirrhosis is the most common cause of portal hypertension (PH) in adults, but non cirrhotic portal hypertension is frequent in children. On the basis of the site of resistance to blood flow causing hypertension, the PH can be classified as

Physician assistants and nurse practitioners use Clinical Advisor for updated medical guidance to diagnose and treat common medical conditions in daily practice.

de Ville de Goyet, J ; Gibbs, P ; Clapuyt, Philippe ; Reding, Raymond ; Sokal, Etienne ; et. al. Original extrahilar approach for hepatic portal revascularization and relief of extrahepatic portal hypertension related to later portal vein thrombosis after pediatric liver transplantation. Long term results.. In: Transplantation, Vol. 62, no. 1, p. 71-5 (1996 ...

TY - JOUR. T1 - Portopulmonary hypertension. AU - Krowka, Michael Joseph. PY - 2012. Y1 - 2012. N2 - Portopulmonary hypertension (POPH) refers to the presence of pulmonary arterial hypertension (PAH) in patients with portal hypertension. Pulmonary hypertension in patients with liver disease or portal hypertension can be due to multiple mechanisms, including hyperdynamic (high-flow) state, increased pulmonary venous congestion, and vascular constriction or obstruction of the pulmonary arterial bed. Vascular obstruction to pulmonary arterial flow, reflected by increased pulmonary vascular resistance (PVR), is a key parameter that defines POPH. Among patients with portal hypertension, reported incidence rates of POPH range from 2 to 9%. Long-term survival in cases of POPH is poor. Favorable responses to pulmonary vasodilator/vasomodulatory therapy have been observed, but prospective, randomized trials are lacking. Severe POPH with right ventricular failure despite vasodilator therapy is associated ...

Hyposensitivity to vasopressin is a well documented phenomenon in animals with portal hypertension and patients with cirrhosis subject to haemorrhage. Haemorrhage is associated with the endogenous release of bradykinin, which may subsequently stimulate the formation of nitric oxide (NO). The present study investigated the relative contribution of NO synthase (NOS) isoforms and the role of bradykinin in the pathogenesis of splanchnic hyposensitivity to a long-acting vasopressin analogue, glypressin, in rats with portal hypertension induced by partial portal vein ligation (PVL). At 14 days after the operation, systemic and portal haemodynamics were measured in stable or bleeding PVL rats receiving an intravenous infusion of glypressin (0.07 mg/kg). In the treatment groups, NG-nitro-L-arginine methyl ester (L-NAME; a non-selective NOS inhibitor), L-canavanine (a specific inhibitor of inducible NOS) or HOE 140 (a bradykinin B2 receptor antagonist) was administered 45 min before the infusion of ...

Chronic portal vein thrombosis (PVT) is a rare disease, affecting young patients, characterized by permanent obstruction of the portal vein trunk causing portal hypertension. In 60-70% of cases it is related to high risk, moderate or mild prothrombotic risk factors.. Accordingly, there are 2 types of complications from PVT :(i) gastrointestinal haemorrhage related to portal hypertension; and (ii) recurrent thrombosis.. Recurrent thrombosis its most dreaded complication as it may lead to intestinal infarction with a related mortality of 20-60% and a high risk of intestinal insufficiency.. Gastrointestinal haemorrhage related to portal hypertension occurs in 20% patients/year. It is less frequent in patients treated with medical or endoscopic prophylaxis for variceal bleeding.. Retrospective data shows that anticoagulation does not worsen the prognosis, and may conversely improve it. Thus, in patients at risk for gastrointestinal bleeding due to portal hypertension and a mild or moderate risk of ...

TY - JOUR. T1 - Portopulmonary hypertension. T2 - An update. AU - Safdar, Zeenat. AU - Bartolome, Sonja. AU - Sussman, Norman. PY - 2012/8. Y1 - 2012/8. N2 - Portopulmonary hypertension (POPH) is a serious complication of cirrhosis that is associated with mortality beyond that predicted by the Model for End-Stage Liver Disease (MELD) score. Increased pulmonary vascular resistance (PVR) may be initiated by pulmonary vasoconstriction, altered levels of circulating mediators, or shear stress, and can eventually lead to the classic vascular remodeling (plexiform lesion) that characterizes POPH. Portal hypertension is a prerequisite for the diagnosis of POPH, although the severity of pulmonary hypertension is unrelated to the severity of portal hypertension or the nature or severity of liver disease. POPH precludes liver transplantation (LT) unless the mean pulmonary artery pressure (MPAP) can be reduced to a safe level. The concept of an acceptable pressure has changed: we now consider both MPAP and ...

Chronic liver disease and cirrhosis are the 12th leading cause of death in the United States leading to nearly 28,000 deaths per year.1 Portal hypertension in patients with cirrhosis accounts for a great deal of morbidity and mortality. It is associated with gastroesophageal varices, ascites, and variceal hemorrhage and increased risk of bacterial infection. Treatment of portal hypertension can reduce the incidence of these sequelae. The mainstay of treatment in portal hypertension is non-selective beta-blockers such as propranolol or nadolol. However, many patients are unable to tolerate the titration of these drugs to appropriate therapeutic doses or have relative contraindications to beta blocker therapy such as asthma or insulin dependent diabetes with risk of hypoglycemia.1,2 Additional treatment options either in addition to or instead of beta blockers, that act selectively on the hepatic circulation are needed. HMG-CoA reductase inhibitors have been proposed as a class of drugs that may ...

Liver cirrhosis portal hypertension patients to reduce the number of blood cells are common in clinical, and often affect the prognosis. This paper discusses cirrhotic portal hypertension patients complicated by the reason of the decrease in the number of peripheral blood cells and what is the clinical significance of these reasons so as to provide theoretical support for the choice of treatment. Splenomegaly and hypersplenism caused should be the main reason for reducing the number of blood cells, but not all, other reasons are alcohol and virus inhibition of bone marrow, liver function impairment, autoimmune damage and loss of blood, etc. If it is a function of the spleen hyperfunction caused by blood cells decreases, blood should rise to normal after splenectomy, or consider other reason or there are other reasons at the same time.

Ectopic varices (EcV) accounting for 1-5% of all varices in portal hypertension are composed of dilated portosystemic collaterals located in unusual sites instead of the most known gastroesophageal region. The difficulty in localization of bleeding is a great burden on the management of these patients. Herein, we present patients with EcV as well as with portal hypertension and recurrent intestinal bleeding. The sites of EcV were identified with computed tomographic angiography, after a series of inconclusive endoscopies, and moreover a selective celiac arteriographic examination of one of the patients. Eur J Gastroenterol Hepatol 23:620-622 (c) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. ...

In cirrhotic livers, the balance of vasoactive substances is in favour of vasoconstrictors with relatively insufficient nitric oxide. Endothelial dysfunction has been documented in cirrhotic rat livers leading to a lower activity of endothelial nitric oxide synthase but this might not be sufficient to explain the low nitric oxide presence. We compared the amount of all nitric oxide synthase isoforms and other factors that influence nitric oxide bioavailability in livers of two portal hypertensive rat models: prehepatic portal hypertension and carbon tetrachloride induced cirrhosis, in comparison with healthy controls. Endothelial nitric oxide synthase was the solely detected isoform by Western blotting in all livers. In cirrhotic livers, the amount of endothelial nitric oxide synthase protein was lower than in healthy controls, although an overlap existed. Levels of caveolin-1 messenger RNA were within the normal range but endothelin-1 messenger RNA levels were significantly higher in cirrhotic livers

Healthcare providers treat portal hypertension in several ways. You might need to take beta blockers, or medicines that improve how your heart and blood vessels work. These medicines often also reduce the risk of bleeding from swollen veins. If you have internal bleeding because of portal hypertension, your healthcare provider might inject medicine into the vein to help stop the bleeding. Or he or she may place bands around veins to stop the bleeding. In more severe situations, your healthcare provider may treat portal hypertension with shunting. This involves putting stents in the portal vein to open it and improve blood flow. Shunting can be done with or without surgery. Surgical shunting can cause more complications than the nonsurgical method. A liver transplant may be needed.. ...

Abstract of Paper: Effect Of Angiotensin-II Receptor Blockade On Experimental Portal hypertension In Rabbits , Author: Sherif w. Mansour, Mohamed Abd El Homed and Mohamed Adel El-Sayed * , Year: 2003 , Faculty of Medicine, Benha University

See Article on [Related article:] 34. Portal hypertension (PH) is a major consequence of liver tissue fibrogenesis in chronic liver disease (CLD) [1]. During progression of CLD, the intrahepatic vasculature is remodeled and excess endogenous vasodilators are released, causing splanchnic arteriolar vasodilatation. Consequently, blood flow in the portal venous system would be increased, leading to PH. As the degree of PH becomes severe, it can result in complications such as the development of esophageal varices, variceal bleeding, ascites, spontaneous bacterial peritonitis and hepatorenal syndrome [2]. Particularly in patients with decompensated cirrhosis, PH is responsible for significant morbidity and mortality [1-4]. In this regard, precise assessment of PH allows accurate prediction of prognosis and is essential for managing CLD appropriately. Measurement of the hepatic venous pressure gradient (HVPG), the gradient between the wedged (i.e., balloon-occluded) hepatic venous pressure and the ...

TY - JOUR. T1 - Portopulmonary Hypertension. T2 - A Survey of Practice Patterns and Provider Attitudes. AU - Dubrock, Hilary M.. AU - Salgia, Reena J.. AU - Sussman, Norman L.. AU - Bartolome, Sonja D.. AU - Kadry, Zakiyah. AU - Mulligan, David C.. AU - Jenkins, Sarah. AU - Lackore, Kandace. AU - Channick, Richard N.. AU - Kawut, Steven M.. AU - Krowka, Michael J.. N1 - Publisher Copyright: © 2019 Wolters Kluwer Health. All rights reserved.. PY - 2019/6/1. Y1 - 2019/6/1. N2 - Background. The role of liver transplantation (LT) in the management of portopulmonary hypertension (POPH) is poorly understood. The aim of this study was to better understand provider attitudes and practice patterns regarding the management of patients with POPH and to assess the concordance between clinical practice and current guidelines. Methods. We performed a multicenter survey study of hepatologists and pulmonary hypertension (PH) physicians at US LT centers that performed ,50 transplants per year. Survey responses ...

Purpose: The aim of the study was to investigate the sonographic characteristics of the varices of pancreas in portal hypertension.Methods: We retrospectively reviewed the sonographic findings, case records and other diagnostic procedures of 11 patients with clinical features of portal hypertension of different etiology, all having sonographical changes suggesting presence of the pancreatic varices. Size, echogenicity, margins, location and type of vascularity were analyzed. All patients underwent subsequent upper gastrointestinal endoscopy.Results: Gray-scale sonography demonstrated either anechoic oval lesions or tortuous tubular structures located in different parts of pancreas. The vascular nature of the structures was proven by detection of blood flow on color Doppler and power Doppler sonography and categorized as venous by means of pulsed Doppler sonography. CT revealed pancreatic varices in 9 patients. Of the 11 subjects with upper gastrointestinal endoscopy performed, 9 had esophageal

To assess correlation between liver or spleen stiffness measurement by transient elastography (TE) and hepatic venous pressure gradient (HVPG) in patients with chronic liver disease as well find optimal and rule in/rule out cut-offs for prognosis of clinically significant (CSPH) and severe (SPH) portal hypertension. In this prospective study patients with different chronic liver diseases were included. TE was performed at the same day prior to HVPG measurement. HVPG was measured using catheter tip occlusion technique. Based on HVPG, patients were categorized into groups of CSPH and SPH. Cut-off values were established by applying ROC curve analysis. The study included 107 consecutive patients referred for HVPG measurement or transjugular liver biopsy. Successful spleen TE was performed in 99 of the patients. Liver and spleen TE strongly correlated with HVPG, r = 0.75 and r = 0.62, respectively. Accuracy to detect CSPH was 88.7 % for liver stiffness of 17.4 kPa and 77.7 % for spleen stiffness of 47.6 kPa

Many conditions are associated with portal hypertension, with cirrhosis being the most common cause of this disorder. Two important factors-vascular resistance and blood flow-exist in the development of portal hypertension.

TY - JOUR. T1 - Prognostic value of acute hemodynamic response to i.v. propranolol in patients with cirrhosis and portal hypertension. AU - La Mura, Vincenzo. AU - Abraldes, Juan G.. AU - Raffa, Sebastian. AU - Retto, Oswaldo. AU - Berzigotti, Annalisa. AU - García-Pagán, Juan Carlos. AU - Bosch, Jaume. PY - 2009/8. Y1 - 2009/8. N2 - Background/Aims: Cirrhotic patients chronically treated with beta-blockers who achieve a decrease of hepatic venous pressure gradient (HVPG) ≥20% from baseline or to ≤12 mmHg have a marked reduction of first bleeding or re-bleeding. However, two HVPG measurements are needed to evaluate response. This study was aimed at investigating the predictive role of acute HVPG response to i.v. propranolol for bleeding and survival. Methods: We retrospectively studied 166 cirrhotic patients with varices with HVPG response to i.v. propranolol (0.15 mg/kg). All patients subsequently received non-selective beta-blockers to prevent first bleeding (n = 78) or re-bleeding (n = ...

Portopulmonary hypertension (PPH) is defined by the coexistence of portal and pulmonary hypertension. PPH is a serious complication of liver disease, present in 0.25 to 4% of all patients suffering from cirrhosis. Once an absolute contraindication to liver transplantation, it is no longer, thanks to rapid advances in the treatment of this condition. Today, PPH is comorbid in 4-6% of those referred for a liver transplant. PPH presents roughly equally in male and female cirrhotics; 71% female in an American series and 57% male in a larger French series. Typically, patients present in their fifth decade, aged 49 +/- 11 years on average. In general, PPH is diagnosed 4-7 years after the patient is diagnosed with portal hypertension and in roughly 65% of cases, the diagnosis is actually made at the time of invasive hemodynamic monitoring following anesthesia induction prior to liver transplantation. Once patients are symptomatic, they present with right heart dysfunction secondary to pulmonary ...

Therefore, an alternative, non-invasive technique allowing clinicians to diagnose and grade PH in patients with cirrhosis and that could replace HVPG is needed. Transient elastography (TE) has been established as a non-invasive method of measuring liver stiffness due to its diagnostic accuracy in hepatic fibrosis [7]. Accumulating evidence suggests that TE adequately reflects the findings of HVPG, indicating that it is a useful modality for evaluating PH and cirrhotic complications [8-14]. However, some studies have reported conflicting results indicating TE is not sufficiently accurate to replace HVPG due to its insufficient sensitivity or specificity [15]. Hence, controversy remains regarding the usefulness of TE for assessing PH. Systematic reviews (SRs) and meta-analyses (MAs) have facilitated objective evaluation of existing evidence [16-20]. Shi et al. [21] reported the results of their MA for TE in the diagnosis of PH and esophageal varices and further studies should be performed to ...

Information on portal hypertension or high blood pressure in children including causes, symptoms and treatment from St. Louis Childrens Hospital. Learn more about blood conditions in children.

Atıf İçin Kopyala Yildirim B., Ozenirler S., Sancak A., Unal S., Demirci T., AKYOL G. JOURNAL OF GASTROINTESTINAL AND LIVER DISEASES, cilt.16, sa.4, ss.467-468, 2007 (SCI İndekslerine Giren Dergi) ...

Results: In patients with left-sided portal hypertension, gastroesophageal varices were greatly favored by two conditions: collateral pathways directed to the gastric fundus and hypertension in the left gastric vein. This last condition typically occurs when the left gastric vein inflows into an already obstructed splenic trunk, or in the case of concomitant portal hypertension. On the contrary, patients with left-sided portal hypertension and collaterals connected with the left renal or adrenal veins have minor risk of gastroesophageal varices ...

TY - JOUR. T1 - A new stent-graft for transjugular intrahepatic portosystemic shunts. AU - Rose, J. D.G.. AU - Pimpalwar, S.. AU - Jackson, R. W.. PY - 2001/1/1. Y1 - 2001/1/1. N2 - The transjugular intrahepatic portosystemic shunt (TIPSS) has become an effective method of treatment for the complications of portal hypertension, however shunt dysfunction is common. Covered stent-grafts have been tested in animal models, and customized or home-made devices have been deployed in several institutions. We report the use of a new commercially available TIPSS stent-graft in six patients undergoing primary shunting as well as two cases of revision or secondary TIPSS. The device has proved relatively easy to handle and appears to have the technical features likely to improve primary patency. Further follow-up is required to properly assess shunt patency and re-intervention rates.. AB - The transjugular intrahepatic portosystemic shunt (TIPSS) has become an effective method of treatment for the ...

Chest pain in ESRD from ADPKD has a list of differential diagnosis which includes uremic pericarditis, acute coronary artery disease, pericardial effusion and rarely pericardial cysts, among others. We present a case of pleuritic chest pain secondary to portal hypertensive gastropathy (PHG) in a 24-year old Caucasian male patient with ADPKD who was on maintenance hemodialysis for ESRD, and who previously had been misdiagnosed as acute recurrent pericarditis. The management options for PHG are briefly discussed. Finally, we propose that PHG should be kept in the differential diagnosis of chest pain, pleuritic or non-pleuritic, with or without gastrointestinal symptoms, in patients with ADPKD, with or without renal failure. Moreover, the importance of a detailed medical history in the management of these patients cannot be over emphasized.

1. The effects of propranolol on heart rate, arterial pressure, portal venous pressure and fractional hepatic blood flow were studied in rats with hepatic artery ligature or with portal vein stenosis, and in sham-operated rats. The effect of propranolol on cardiac output was also studied in normal rats.. 2. In rats with hepatic artery ligature or with portal vein stenosis, and in sham-operated rats, propranolol decreased heart rate and portal venous pressure significantly and did not alter arterial pressure. Propranolol decreased fractional hepatic blood flow significantly in rats with hepatic artery ligature, but did not change hepatic blood flow in rats with portal vein stenosis or in sham-operated rats.. 3. We conclude therefore that: (a) propranolol decreases portal venous pressure in rats; (b) this decrease in portal venous pressure results in a reduction in portal blood flow which is related, in part, to a reduction in cardiac output; (c) propranolol does not alter hepatic blood flow in ...

Saxon RR, Mendel-Hartvig J, Corless CL, Rabkin J, Uchida BT, Nishimine K, et al. Bile duct injury as a major cause of stenosis and occlusion in transjugular intrahepatic portosystemic shunts: comparative histopathologic analysis in humans and swine. J Vasc Interv Radiol 1996; 7: 487-497 ...

Portal hypertension due to intrahepatic disease or extrahepatic portal vein obstruction (EHPVO) is an important cause of upper gastrointestinal bleeding in children. About 50% of children with EHPVO present with bleeding from oesophageal varices.1-3 Improvements in the management of children with intrahepatic disease have led to increased survival, consequently contributing to the long-term burden of portal hypertension.1, 3-5. The peak age of variceal bleeding, although not clearly defined, relates to a critical point where wall tension exceeds variceal wall strength. Other determinants of a herald bleed include upper respiratory infection, fever and aspirin ingestion.6 These factors directly or indirectly increase portal venous pressure or result in fever-related tachycardia which increases cardiac output.. Since its introduction, endoscopic sclerotherapy of bleeding oesophageal varices, where variceal banding is not feasible, has remained the mainstay treatment for haemodynamically stable ...

Portal hypertension due to intrahepatic disease or extrahepatic portal vein obstruction (EHPVO) is an important cause of upper gastrointestinal bleeding in children. About 50% of children with EHPVO present with bleeding from oesophageal varices.1-3 Improvements in the management of children with intrahepatic disease have led to increased survival, consequently contributing to the long-term burden of portal hypertension.1, 3-5. The peak age of variceal bleeding, although not clearly defined, relates to a critical point where wall tension exceeds variceal wall strength. Other determinants of a herald bleed include upper respiratory infection, fever and aspirin ingestion.6 These factors directly or indirectly increase portal venous pressure or result in fever-related tachycardia which increases cardiac output.. Since its introduction, endoscopic sclerotherapy of bleeding oesophageal varices, where variceal banding is not feasible, has remained the mainstay treatment for haemodynamically stable ...

The researchers ensured that the groups were individually matched 1:1 according to age, sex, Child-Turcotte-Pugh class, and cause of cirrhosis. A stratified Cox model was used by the researchers to assess risk of hepatocelullar carcinoma development.. The investigators found that he median time of follow-up was similar in transjugular intrahepatic portosystemic shunt and non- transjugular intrahepatic portosystemic shunt cohorts; 30.3 and 31.4 months, respectively. The researchers also showed that the probability of developing hepatocelullar carcinoma at 1, 3, and 5 years was 3%, 24%, and 34% for the transjugular intrahepatic portosystemic shunt cohort and 1%, 6%, and 25%, for the control, respectively, with a hazard ratio of 1.52.. Hepatitis C virus infection and age were independent predictors of hepatocelullar carcinoma development in patients without transjugular intrahepatic portosystemic shunt. Dr Ba ares concluded, Patients with cirrhosis who are treated with transjugular intrahepatic ...

Care guide for Transjugular Intrahepatic Portosystemic Shunt (Inpatient Care). Includes: possible causes, signs and symptoms, standard treatment options and means of care and support.

Objectives The aim of this study was to prospectively evaluate effective dose (E) of operators performing transjugular intrahepatic portosystemic shunts (TIPS) in a single centre. Patients radiation...

FLAGSTAFF, Ariz. - August 1, 2017 - The GORE® VIATORR® TIPS Endoprosthesis with Controlled Expansion, a new device configuration developed by W. L. Gore & Associates, Inc. (Gore), may further reduce portal hypertension treatment complications, even compared to the GORE® VIATORR® TIPS Endoprosthesis, Gores legacy TIPS device, which has a strong history of patency and proven performance at fixed diameters. These findings were obtained from the abstract presented at The International Liver Congress 2017 in Amsterdam.1 The preliminary data at three months also confirmed that hospital readmissions from cirrhosis-related complications, including refractory ascites and sepsis, were significantly reduced using either of the GORE VIATORR TIPS Endoprosthesis products compared to bare metal stents.. Portal hypertension is an increase in the pressure in the vein that connects the digestive organs to the liver and is most often caused by cirrhosis. Transjugular intrahepatic portosystemic shunt (TIPS) ...

FLAGSTAFF, Ariz. - August 1, 2017 - The GORE® VIATORR® TIPS Endoprosthesis with Controlled Expansion, a new device configuration developed by W. L. Gore & Associates, Inc. (Gore), may further reduce portal hypertension treatment complications, even compared to the GORE® VIATORR® TIPS Endoprosthesis, Gores legacy TIPS device, which has a strong history of patency and proven performance at fixed diameters. These findings were obtained from the abstract presented at The International Liver Congress 2017 in Amsterdam.1 The preliminary data at three months also confirmed that hospital readmissions from cirrhosis-related complications, including refractory ascites and sepsis, were significantly reduced using either of the GORE VIATORR TIPS Endoprosthesis products compared to bare metal stents.. Portal hypertension is an increase in the pressure in the vein that connects the digestive organs to the liver and is most often caused by cirrhosis. Transjugular intrahepatic portosystemic shunt (TIPS) ...

TY - JOUR. T1 - Predictors of Waitlist Mortality in Portopulmonary Hypertension. AU - Dubrock, Hilary M.. AU - Goldberg, David S.. AU - Sussman, Norman L.. AU - Bartolome, Sonja D.. AU - Kadry, Zakiyah. AU - Salgia, Reena J.. AU - Mulligan, David C.. AU - Kremers, Walter K.. AU - Kawut, Steven M.. AU - Krowka, Michael J.. AU - Channick, Richard N.. N1 - Publisher Copyright: © 2017 Wolters Kluwer Health, Inc. All rights reserved.. PY - 2017/7/1. Y1 - 2017/7/1. N2 - Background The current Organ Procurement Transplantation Network policy grants Model for End-Stage Liver Disease (MELD) exception points to patients with portopulmonary hypertension (POPH), but potentially important factors, such as severity of liver disease and pulmonary hypertension, are not included in the exception score, and may affect survival. The purpose of this study was to identify significant predictors of waitlist mortality in patients with POPH. Methods We performed a retrospective cohort study of patients in the Organ ...

Portal hypertension is a clinical syndrome associated with increased blood pressure in the portal vein. Increased blood pressure may be caused by several entities, which can be divided into three groups depending on which part of the portal system was affected.. The most common cause of portal hypertension in the world is liver cirrhosis - also the most common cause of portal hypertension in the analysed group of patients (98%).. The greatest concern in the clinical course of cirrhotic patients is a bleeding from oesophageal varices. This life-threatening condition often requires immediate surgical treatment including the creation of an intrahepatic portosystemic shunt.. Patent paraumbilical vein is a common finding in patients with portal hypertension; it can be found in 6-30% of patients with cirrhosis of the liver [19]. According to Sacerdoti et al. [20] and Chen et al. [21], patent PUV is most often present in patients with alcoholic liver cirrhosis (alcoholic vs. viral - 56% vs. 29%, p = ...

Vascular diseases of the liver are a heterogeneous group of rare and if untreated fatal disorders that include portal vein thrombosis, Budd-Chiari syndrome, non-cirrhotic portal hypertension, sinusoidal obstruction syndrome, hereditary hemorrhagic teleangiectasia and others.. Current knowledge about patients suffering from these disorders is insufficient and no biological samples are available to study the mechanisms of these diseases and the effects of treatments.. Therefore, with the support of a grant from EASL, we are running this cohort study by including and following up patients on the platform redcap.ctu.unibe.ch. If you are member of VALDIG you can request a password and username (contact [email protected]) to participate to this study by including patients from your center into the database (a complete set of data) or into the registry (a limited set of data).. ...

Portal Hypertension - Networking Resource. A resource guide for those diagnosed with portal hypertension or portal vein thrombosis (PVT) - by Clint Steenson. ...

Dr. Ekong specializes in treating babies and children with a wide range of liver diseases including autoimmune diseases, biliary atresia, progressive familial intrahepatic cholestasis syndromes, other genetic/metabolic liver diseases, non-cirrhotic portal hypertension, and chronic hepatitis B and C. Pediatric Gastroenterology Transplant Surgery

These results suggest that the transjugular placement of an intrahepatic portosystemic stent is an effective and safe treatment for variceal hemorrhage in patients with portal hypertension due to cirrhosis.

Portopulmonary hypertension (POPH) is defined as pulmonary arterial hypertension (PAH) complicated by portal hypertension, with or without advanced hepatic disease. Significant percentage of patients with cirrhotic liver disease has high cardiac output and subsequently elevated pulmonary arterial pressures (PAP). However, patients with POPH develop a progressive increase in pulmonary vascular resistance (PVR), which is generally lower than that observed in other forms of PAH. The prognosis of untreated patients with POPH is very poor and the outcome of liver transplant (LT) in those patients is determined by the degree of severity of the associated pulmonary hemodynamics. In this narrative review, we describe the clinical presentation of POPH, the pathobiology, and the clinical implication of pulmonary hemodynamics. We also provide evidence-based recommendations for the diagnosic and management approaches of POPH ...

We report the case of a 37-year-old man with necrotizing pancreatitis associated with inflammatory extrahepatic portal vein stenosis and progressive ascites. Four months after the acute onset, when no signs of infection were present, portal decompression was performed to treat refractory ascites. Transjugulartranshepatic venoplasty failed to dilate the stenosis in the extrahepatic portion of the portal vein sufficiently. Therefore a Wallstent was implanted, resulting in almost normal diameter of the vessel. In follow-up imaging studies the stent and the portal vein were still patent 12 months after the intervention and total resolution of the ascites was observed. ...

Hepatic encephalopathy can arise from portal-systemic shunting in the absence of intrinsic liver disease. However, there are few descriptions of this form of encephalopathy. Portal vein thrombosis is an infrequent disease that causes portal-systemic shunting. Episodic hepatic encephalopathy has been …

Transjugular intrahepatic portosystemic shunt Intervention:Transjugular intrahepatic portosystemic shunt ICD-10 code: ICD-9 code: 39.1 Other codes: A

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Results 56 patients were included into the final analysis. In AH patients (n = 18) mean age was 48 years (30-65), mean discriminant function (DF) was 51 (24-87) and mean MELD score was 22. The 6 month mortality was 50%(9/18) with (7/9) dying within 30 days. The median HVPG (mmHg) pre-TIPS and post-TIPS were 16.5 and 6.5 respectively. In non-AH patient (n = 38) average age was 51y (25-70) mean MELD score was 14 (22-7). The mortality was 13% (5/38) at 6 months, (3/5) died by day 30. The median HVPG (mmHg) pre-TIPS and post-TIPS was 23 and 10 respectively.. ...

Images in a 59-year-old man with posthepatitic cirrhosis (Child-Pugh class C) who had undergone TIPS creation for refractory ascites; a Viatorr stent (10 mm ...

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The portal venous system is located between two capillary beds: the splanchnic capillaries and the hepatic sinusoids. Sinusoids are the specialized liver capillaries and they receive blood both from the portal vein and the hepatic artery. The branches of the portal vein and hepatic artery form the portal triad along with the interlobular bile ducts in the portal tracts. The blood flows in the sinusoid from the portal tract to the central hepatic venule. The endothelial cells that line the sinusoids are fenestrated and are devoid of a basement membrane. The sinusoids therefore have a unique structure with high permeability that allows direct contact between plasma and hepatocyte surface through the space of Disse. The sinusoidal blood drains into the tributaries of the hepatic veins through the terminal hepatic venules, and subsequently into the inferior vena cava and right atrium. Portal venous system is a low pressure system. The difference between the hepatic vein and portal vein pressure is ...

The portal venous system is located between two capillary beds: the splanchnic capillaries and the hepatic sinusoids. Sinusoids are the specialized liver capillaries and they receive blood both from the portal vein and the hepatic artery. The branches of the portal vein and hepatic artery form the portal triad along with the interlobular bile ducts in the portal tracts. The blood flows in the sinusoid from the portal tract to the central hepatic venule.. The endothelial cells that line the sinusoids are fenestrated and are devoid of a basement membrane. The sinusoids therefore have a unique structure with high permeability that allows direct contact between plasma and hepatocyte surface through the space of Disse. The sinusoidal blood drains into the tributaries of the hepatic veins through the terminal hepatic venules, and subsequently into the inferior vena cava and right atrium.. Portal venous system is a low pressure system. The difference between the hepatic vein and portal vein pressure is ...

TY - JOUR. T1 - A new mdr2-/- mouse model of sclerosing cholangitis with rapid fibrosis progression, early-onset portal hypertension, and liver cancer. AU - Ikenaga, Naoki. AU - Liu, Susan B.. AU - Sverdlov, Deanna Y.. AU - Yoshida, Shuhei. AU - Nasser, Imad. AU - Ke, Qingen. AU - Kang, Peter M.. AU - Popov, Yury. PY - 2015/1/1. Y1 - 2015/1/1. N2 - We previously characterized the Mdr2(Abcb4)-/- mouse as a reproducible model of chronic biliary liver disease. However, it demonstrates relatively slow fibrosis progression, possibly due to its fibrosisresistant genetic background. We aimed to improve the model by moving it onto a fibrosis-susceptible background. We generated novel BALB/c.Mdr2-/- mouse via genetic backcross onto highly fibrosissusceptible BALB/c substrain, identified in inbred mouse strain screening. Liver fibrosis, portal pressure, and hepatic tumor burden in BALB/c.Mdr2-/-mice were studied up to 1 year of age in direct comparison to parental strain FVB.Mdr2-/-. BALB/c.Mdr2-/-mice ...

Fatty liver disease: natural treatments.: Pathophysiology Of Fatty Liver And Portal Hypertension. The Fatty Liver Site, Tips and natural treatments for fatty liver.

Tratamiento de la hipertensión portal propranolol dosis hipertension portal y propranolol dosis hipertension portal profilaxis del sangrado de las no se requieren reajustes en la dosis. CARDIOLOGIA . Abstract Objectives. PROPRANOLOL Tabletas Antihiperte - facmed. Unam. Y establecer dosis Todos los contenidos publicados en el portal de salud y medicina. El Propranolol ocasionalmente causa hipoglucemia, la dosis puede ser reducida. Summary of Carvedilol or propranolol in portal hypertension? 2009 recommendations for the treatment of patients with cirrhosis and portal hypertension, dosage or a heart effects of propranolol on portal. Dosage Forms & Strengths. Por este El Carvedilol para amoxicillin and stomach acid la Profilaxis del Sangrado Variceal dosis de propranolol Propranolol-A medical treatment for portal. Propranolol side effects mood changes, propranolol 5mg side effects, prescription free propranolol dosis hipertension portal propranolol, propranolol mechanism of action in portal ...

TY - JOUR. T1 - Portosystemic shunting in children during the era of endoscopic therapy. T2 - Improved postoperative growth parameters. AU - Kato, Tomoaki. AU - Romero, Rene. AU - Koutouby, Raghad. AU - Mittal, Naveen K.. AU - Thompson, John F.. AU - Schleien, Charles L.. AU - Tzakis, Andreas G.. PY - 2000/4/1. Y1 - 2000/4/1. N2 - Background: Surgical portosystemic shunting has been performed less frequently in recent years. In this retrospective study, recent outcomes of portosystemic shunting in children are described, to evaluate its role in the era of endoscopic therapy. Methods: Retrospective chart review of children who underwent surgical portosystemic shunt procedures between October 1994 and October 1997. Results: Twelve children (age range, 1-16 years) underwent shunting procedures. The causes of portal hypertension were extrahepatic portal vein thrombosis (n = 6), congenital hepatic fibrosis (n = 2), hepatic cirrhosis (n = 2), and other (n = 2). None of the patients were immediate ...

Portal hypertension is an increase in the blood pressure within a system of veins called the portal venous system. Veins coming from the stomach, intestine, spleen, and pancreas merge into the portal vein, which then branches into smaller vessels and travels through the liver. If the vessels in the liver are blocked due to liver damage, blood cannot flow properly through the liver. As a result, high pressure in the portal system develops. This increased pressure in the portal vein may lead to the development of large, swollen veins (varices) within the esophagus, stomach, rectum, or umbilical area (belly button). Varices can rupture and bleed, resulting in potentially life-threatening complications. ...

cavernous transformation. A network of collateral vessels may form around a thrombosed main portal vein at the porta, especially if the thrombosis is due to extrahepatic causes (for example pancreatitis) rather than diseased liver. The appearance of cavernous transformation of the PV is quite striking (Fig. A 1) and colour Doppler is particularly useful in its diagnosis. Make sure, before diagnosing PV thrombosis, that the vein axis is less than 60° to the transducer and that the Doppler sensitivity is set to pick up lowvelocity flow. Ultrasound is known to have a falsepositive rate for PV thrombosis but this is often due to inadequate technique or insensitive equipment. False-negative results, indicating that flow is present in a vein which is actually thrombosed, are due to the detection of flow within a collateral vessel at the porta, which can be mistaken for the main ...

TY - JOUR. T1 - Histological subclassification of cirrhosis using the Laennec fibrosis scoring system correlates with clinical stage and grade of portal hypertension. AU - Kim, Moon Young. AU - Cho, Mee Yon. AU - Baik, Soon Koo. AU - Park, Hong Jun. AU - Jeon, Hyo Keun. AU - Im, Chong Kun. AU - Won, Chan Sik. AU - Kim, Jae Woo. AU - Kim, Hyun Soo. AU - Kwon, Sang Ok. AU - Eom, Min Seob. AU - Cha, Seung Hwan. AU - Kim, Young Ju. AU - Chang, Sei Jin. AU - Lee, Samuel S.. PY - 2011/11. Y1 - 2011/11. N2 - Background & Aims: Further histological subclassification of cirrhosis may be useful because of heterogeneity of severity within cirrhosis. We aimed to determine the relationship between histological subclassification and clinical stage of cirrhosis as well as grade of portal hypertension. Methods: One hundred-twenty-three biopsy-proven cirrhosis patients, whose clinical stage of cirrhosis and hepatic venous pressure gradient (HVPG) could be estimated, were included in this prospective study. ...

Portal hypertension (PHT) is a condition with serious complications, such as variceal bleeding, refractory ascites and bowel ischemia. The cause of PHT may be pre-, intra- or post-hepatic. Initial treatment is pressure-reducing drugs and the treatment of acute symptoms.. Ten patients presented with severe abdominal pain and acute portomesenteric venous thrombosis. Their response to systemic anticoagulation was insufficient. Treatment with primary continuous thrombolysis by a transhepatic or transjugular approach in four patients resulted in major complications, incomplete recanalization and a 75% survival rate. Treatment with repeated transjugular thrombectomy (TT) combined with the creation of a transjugular intrahepatic portosystemic shunt (TIPS) achieved near complete recanalization, prompt symptom relief and 100% survival in five patients treated with this method as the primary intervention. In one patient, treated with TT and TIPS secondary to surgical thrombectomy and bowel resection, the ...

Portal hypertension can lead to life-threatening variceal bleeding (VB). Transjugular intrahepatic portosystemic shunt (TIPSS) is the standard choice for uncontrolled VB. Unavailable for TIPSS, we design a mesofemoral shunt (MFS) as an alternative method for control of VB.

Hemodynamic disorders of liver cirrhosis complicated with portal hypertension are associated with an increased angiogenesis in animal model of portal hypertension and cirrhosis which were linked to increased expression of vascular endothelial growth factor (VEGF) and nitric oxide (NO). The aim of study was to evaluate the serum concentration of VEGF and total nitric oxide (NO) in liver cirrhosis and ... Read more. ...

As a transplant surgeon, I actually do more for the care of my patients than just operate. Below is an excerpt from one of my notes describing a woman who unfortunately relapsed into alcoholism after her liver transplant.. Dear Doctors: Mrs. A (not her real initial; her A stands for alcoholic) was admitted to our service last night to evaluate her cough and ascites. As you know, she is a woman with alcoholic cirrhosis status post liver transplant several years ago that was complicated by recurrent alcoholism causing cirrhosis of her liver allograft. She began drinking one year after her transplant and went on to develop end stage liver disease with portal hypertension requiring a TIPS (transjugular intrahepatic portosystemic shunt). Over the past several months she has been readmitted to the hospital with pneumonias and complications related to her liver disease. She continued to drink alcohol despite our admonishments and efforts to get her into alcohol dependency treatment programs. During ...

We report a case of the 59-year-old men with portal hypertension and liver cirrhosis, who developed pulmonary arterial hypertension. The first line treatment with sildenafil 20 mg 3 times daily was introduced as part of a Polish National Treatment Program. At a 6-month follow-up we noticed a significant clinical improvement: the patients exercise capacity and echocardiographic parameters were substantially better. In addition, the B-type natriuretic propeptide significantly decreased. ...

Both pharamacological(B-blocker and isosorbide mononitrate) and endoscopic(banding ligation) treatment have similar results. TIPS(transjugular intrahepatic portosystemic shunting) is superior to either of them at reducing rate of rebleeding. Disadvantages of TIPS include that it is costly, increase risk of hepatic encephalopathy and does not improve mortality ...

Objectives: Evaluation of the outcome and experience in 2 years of management of portal hypertensive gastropathy (PHG) by argon plasma coagulation (APC) in a cohort of Egyptian cirrhotic patients. Methods: This study was conducted over a 2-year period from January 2011 to February 2013. Upper gastrointestinal endoscopy was performed to evaluate the degree and site of PHG. APC was applied to areas with mucosal vascular lesions. Results: In total, 200 cirrhotic patients were enrolled; 12 patients were excluded due to death (n = 6) caused by hepatic encephalopathy (n = 3), hepatorenal syndrome (n = 2), or chronic lymphatic leukemia (n = 1), or did not complete the treatment sessions (n = 6), so 188 patients completed the study ...

Pagina nueva 1 1. Introduction Hepatopulmonary syndrome is a rare complication characterized by liver disease associated with intrapulmonary vascular dilatations and hypoxemia.1 A prevalence of 9-20% has been described in children associated with biliary duct atresia, 0.5% in patients with portal thrombosis2 and 2-8% in cirrhosis and portal hypertension.2,3 Although the condition is uncommon, it is important that the clinician recognizes this disease due its progressive nature.. 2. Clinical case We report the case of an 8-year-old girl without significant perinatal or respiratory history. At 3 of years of age she was diagnosed with liver cirrhosis of unknown etiology. She was hospitalized on multiple occasions due to upper gastrointestinal (GI) bleeding from large esophageal varices. She also had portal hypertension. She was under treatment with furosemide, spirinolactone, propanolol, omeprazole, lactulose and liver transplant protocol for which she presented to the pulmonary service for ...