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A Case Report on Duodenal Variceal Bleeding Treated with Glue Injection

Open Journal of Gastroenterology 2022年第11期12卷 324-329页

作者： Nov Neang Chey Vithiarithy Kang Khounthai Khuon Viseth Mon Panha Uong Panha Un Seiha Um Sokchay Unn Keoseyla Chhit Dimanche kann sovannvireak Kaing Kimyi Ny Tharuom SOU Syphanna Khmer Soviet Friendship Hospital Phnom Penh Cambodia University of Health Sciences Phnom Penh Cambodia

Introduction: We present a case of upper gastrointestinal bleeding in a woman aged 56 years with liver cirrhosis who was diagnosed with isolated duodenal variceal bleeding, which was successfully treated with histoacryl injection. Case Presentation: A 57-year female cirrhotic patient presented with melena. She had been diagnosed with duodenal variceal bleeding and treated successfully with 2.4 ml histoacryl using a normal gastroscope. The patient subsequently remained stable and free of any further GI bleeding. She was discharged 48 hours later. Her hemoglobin remained stable at 9 g/L. Conclusion: The histoacryl glue injection provides an effective treatment. Hence, this should ideally be performed by an experienced endoscopist who is aware of and vigilant for the serious complications of this treatment option.

关键词： Upper Gastrointestinal Bleeding Portal Hypertension Duodenal Variceal Bleeding Glue Injection

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Correlation of Platelet Count with Grading of Esophageal Varices in Cirrhotic Patients

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Open Journal of Gastroenterology 2023年第1期13卷 12-27页

作者： Panha Uong Vithiarithy Chey Keoseyla Unn Neang Nov Khounthai Kang Seiha Un Kimyi Kaing Viseth Khuon Tharuom Ny Panha Mon sovannvireak kann Dimanche Chhit Sokchay Um Kimpav Chhay Syphanna Sou Khmer Soviet Friendship Hospital Phnom Penh Cambodia University of Health Sciences Phnom Penh Cambodia

Background/Aims: Cirrhosis represents a late stage of progressive hepatic fibrosis and is generally considered to be irreversible in its advanced stages. Esophageal varix is a complication of liver cirrhosis and is the consequence of portal hypertension. The aim of this study was to determine the correlation between the severity of thrombocytopenia and the presenting of esophageal varices (EVs) in cirrhotic patient. Patients and Methods: This study was a retrospective, descriptive, analytic and monocentric study, which was carried out at Gastroenterology Department, Khmer Soviet Friendship Hospital, Phnom Penh, Cambodia. It was conducted from 1st September 2020 to 31st January 2021. All patients were diagnosed as liver cirrhosis by clinic, biology and ultrasound. Patients’ data were noted in standardized questionnaire with information such as age, sex, address, laboratory result, and the result of endoscopic finding. All data were registered into a data set and then analyzed by SPSS program version 23. Results: 1445 patients were enrolled for gastroscopy. Only 303 patients (21%) were suggested for variceal screening after the exclusions. Male was predominant with sex ratio F/M (1/2.03). Patients’ age varied between 21 and 80 years old, with the mean age of 55 ± 11 years old. 199 patients (66%) were found with EVs, while EVs grade 1 and 2 without red signs were predominated, accounting to 22.8% and 19.5% respectively. The majority of the patients with platelet count between 50 - 99 giga/l had EVs vs platelet count > 150 giga/l had no EVs (p Conclusion: Thrombocytopenia is a non-invasive parameter with high accuracy for the prediction of EVs in cirrhosis. The severity of thrombocytopenia increased as the grading of EVs increased. Thus, it can assist in triaging cirrhotic patients for endoscopy to identify EVs.

关键词： Liver Cirrhosis Portal Hypertension Esophageal Varices Thrombocytopenia Esophagogastroduodenoscopy

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Gastric Variceal Bleeding: The Efficacy and Safety of N-Butyl-2-Cyanoacrylate Glue Injection

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Open Journal of Gastroenterology 2023年第2期13卷 80-90页

作者： Syphanna Sou Roman Meas Vattanak Ek Panha Uong Keoseyla Unn Neang Nov Seiha Un Kimyi Kaing Viseth Khuon Tharuom Ny Panha Mon sovannvireak kann Dimanche Chhit Sokchay Um Vithiarithy Chey Khmer Soviet Friendship Hospital Phnom Penh Cambodia University of Health Sciences Phnom Penh Cambodia

Aims: To assess N-2-butyl cyanoacrylate injection’s effectiveness and safety in the treatment of gastric varix hemorrhage. Methods: Endoscopic treatment with N-Butyl-2-cyanoacrylate injection was performed on 32 patients (21 males and 11 females) with gastric variceal bleeding. The socioeconomic status of the patients, initial hemostasis, rebleeding rate, complications, and mortality rate were all reviewed retrospectively. Patients with liver cirrhosis who presented with hematemesis or melena or whose endoscopy revealed gastric variceal bleeding were included. Therefore, patients with hemodynamic instability were excluded. Results: A total of 32 patients underwent Histoacryl® glue injection to treat bleeding gastric varices. The mean age was 56.09 ± 9.29 (mean ± SD) years old. Viral hepatitis is the leading cause of chronic liver disease, both hepatitis B and C accounted for 11 cases (34.4%). IGV1 was the most commonly seen, according to the Sarin classification, with 15 cases (46.8%), followed by GOV1 with 10 cases (31.3%) and GOV2 with 7 cases (21.9%). With 15 cases (46.9%), the majority of patients had a Child-Pugh (CTP) B score. 12 cases (37.5%) and 11 (34.4%), respectively, of hematemesis and melena, were reported. In all patients, initial hemostasis was achieved, and there was no documented complication rate. Conclusion: Given the higher rate of hemostasis and great results, our study’s findings indicate that the injection of N-butyl-2-cyanoacrylate under endoscopic guidance is safe and effective in the management of GV hemorrhage. After the initial injection, hemostasis was achieved in all of our patients.

关键词： Upper Gastrointestinal Bleeding Portal Hypertension Gastric Varix Initial Hemostasis Cyanoacrylate (Hystoacryl) Injection

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