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Comparison of emergency endoscopic variceal ligation plus octride or octride alone for acute esophageal variceal bleeding

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Chinese Medical Journal 2009年第24期122卷 3003-3006页

作者： LIU Jin-song LIU Jun Division of Gastroenterology Wuhan Union Hospital Tongji Medical College of Huazhong University of Science and Technology Wuhan Hubei 430022 China

Background Octride was the main method for the treatment of esophageal variceal bleeding （EVB）. The aim of this study was to compare the cost-effect and safety between esophageal variceal ligation （EVL） plus octride and octride alone in acute esophageal bleeding. Methods A total of 101 cirrhotic patients with EVB were involved in this study and received emergency EVL ± octride （EVL group） or only octride therapy randomly. The cost, efficacy and safety were analyzed and compared between the two groups. Results Among 51 patients in EVL group, 5 （10%） patients failed. Among 50 patients in the octride treatment group, 13 patients （26%） failed. The difference was significant （P 〈0.05）. The average blood transfusion volume was （2.4±2.2） units in the EVL group and （6.4±3.4） units in the octride treatment group （P〈0.05）. Hospital stay was （7.4±1.3） days in the EVL group and （11.4±3.3） days in the octride treatment group （P 〈0.05）. The average hospital cost was （10 983±1147） yuan in the EVL group and （13 921 ±2107） yuan in the octride treatment group （P 〈0.05）. Conclusion Emergency endoscopic ligation plus octride is superior to octride alone in the treatment of acute EVB with lower cost and higher efficacy with enough safety.

关键词： emergency endoscopic ligation octride acute esophageal variceal bleeding

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acute upper gastrointestinal bleeding due to portal hypertension in a patient with primary myelofibrosis:A case report

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World Journal of Clinical Cases 2024年第15期12卷 2621-2626页

作者： Yu Chen Bing-Bing Kong He Yin Hao Liu Sheng Wu Ting Xu Department of Emergency Beijing Tsinghua Changgung HospitalSchool of Clinical MedicineTsinghua UniversityBeijing 102218China Department of Pathology Beijing Tsinghua Changgung HospitalSchool of Clinical MedicineTsinghua UniversityBeijing 102218China

BACKGROUND acute upper gastrointestinal bleeding is a common medical emergency that has a 10%hospital mortality *** to the etiology,this disease can be divided into acute varicose veins and nonvaricose *** from esophageal varices is a life-threatening complication of portal *** hypertension is a clinical syndrome defined as a portal venous pressure that exceeds 10 *** is the most common cause of portal hypertension,and thrombosis of the portal system not associated with liver cirrhosis is the second most common cause of portal hypertension in the Western *** myeloproliferative disorders are the main cause of portal venous thrombosis,and somatic mutations in the Janus kinase 2 gene(JAK2 V617F)can be found in approximately 90% of polycythemia vera,50% of essential thrombocyrosis and 50% of primary *** SUMMARY We present a rare case of primary myelofibrosis with gastrointestinal bleeding as the primary manifestation that presented as portal-superior-splenic mesenteric vein *** blood tests revealed the presence of the JAK2 V617F *** marrow biopsy ultimately confirmed the diagnosis of myelofibrosis(MF-2 grade).CONCLUSION In patients with acute esophageal variceal bleeding due to portal hypertension and vein thrombosis without cirrhosis,the possibility of myeloproliferative neoplasms should be considered,and the JAK2 mutation test should be performed.

关键词： acute esophageal variceal bleeding Portal hypertension Myelofibrosis JAK2 V617F mutation Case report

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