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Gastroenterology Report 2014年第1期2卷 21-26页

作者： robert J.gianotti Andres Cardenas Department of Gastroenterology Beth Israel Deaconess Medical CenterBoston MA GI Unit Institut Clinic de Malalties Digestives i MetaboliquesHospital ClinicUniversity of Barcelona

Hyponatraemia is a common complication of advanced cirrhosis related to an impairment in the renal capacity for eliminating solute-free water,causing a retention of water that is disproportionate to the retention of sodium,thus leading to a reduction in serum sodium concentration and *** main pathogenic factor responsible for hyponatraemia is a non-osmotic hypersecretion of arginine vasopressin(AVP)or antidiuretic hormone from the neurohypophysis,related to circulatory *** in cirrhosis is associated with increased morbidity and *** is also associated with increased morbidity and impaired short-term survival after *** current standard of care based on restricting fluids to 1-1.5 L/day is rarely *** approaches,such as albumin infusion and the use of vaptans—which act by specifically antagonizing the effects of AVP on the V2 receptors located in the kidney tubules—have been evaluated for their role in the management of *** short-term treatment with vaptans is associated with a marked increase in renal solute-free water excretion and improvement of hyponatraemia;however their use in patients with end-stage liver disease is limited by hepatotoxic effects of some of these *** administration of vaptans seems to be effective in maintaining the improvement of serum sodium concentration,but the available information is still limited.

关键词： hyponatraemia cirrhosis end-stage liver disease vaptans

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Treatment of gastric varices with partial splenic embolization in a patient with portal vein thrombosis and a myeloproliferative disorder

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World Journal of Gastroenterology 2014年第39期20卷 14495-14499页

作者： robert gianotti Hearns Charles Kenneth Hymes Hersh Chandarana Samuel Sigal Beth Israel Deaconess Medical Center Harvard Medical School Boston MA 02215 United States New York University School of Medicine New York NY 10022 United States

Therapeutic options for gastric variceal bleeding in the presence of extensive portal vein thrombosis associated with a myeloproliferative disorder are *** report a case of a young woman who presented with gastric variceal bleeding secondary to extensive splanchnic venous thrombosis due to a Janus kinase 2 mutation associated myeloproliferative disorder that was managed effectively with partial splenic embolization.

关键词： Gastric varices Partial splenic embolization Myeloproliferative disorder Janus kinase 2 Portal hypertension Portal vein thrombosis

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