检索结果-南通市图书馆

World Journal of Gastrointestinal Endoscopy 2024年第3期16卷 108-111页

作者： Yu-Hang Zhang Bing Hu Department of Gastroenterology and Hepatology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

In this editorial,we comment on the minireview by Martino A,published in the recent issue of World Journal of Gastrointestinal Endoscopy 2023;15(12):*** focused mainly on the possibility of replacing the hepatic venous pressure gradient(HVPG)and endoscopy with noninvasive methods for predicting esophageal variceal *** risk factors for bleeding were the size of the varices,the red sign and the Child-Pugh *** intrinsic core factor that drove these changes was the ***,the present studies investigating noninvasive methods,including computed tomography,magnetic resonance imaging,elastography,and laboratory tests,are working on correlating imaging or serum marker data with intravenous pressure and clinical outcomes,such as bleeding.A single parameter is usually not enough to construct an efficient ***,multiple factors were used in most of the studies to construct predictive *** results have been obtained,in which bleeding prediction was partly ***,these methods are not satisfactory enough to replace invasive methods,due to the many drawbacks of different *** is still plenty of room for future *** of the precise timing of bleeding using various models,and extracting the texture of variceal walls using high-definition imaging modalities to predict the red sign are interesting directions to lay investment on.

关键词： esophageal variceal bleeding Prediction noninvasive Computed tomography Hepatic venous pressure gradient Endoscopy

Computed tomography for prediction of esophageal variceal bleeding

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Endoscopy 2024年第3期16卷 175-177页

作者： Mohammed Elhendawy Ferial Elkalla Department of Tropical Medicine and Infectious Diseases Tanta UniversityTanta 31111Egypt

This letter to the editor relates to the study entitled“The role of computed tomography for the prediction of esophageal variceal bleeding:Current status and future perspectives”.esophageal variceal bleeding(EVB)is one of the most common and severe complications related to portal hypertension(PH).Despite marked advances in its management during the last three decades,EVB is still associated with significant morbidity and *** risk of first EVB is related to the severity of both PH and liver disease,and to the size and endoscopic appearance of esophageal ***,hepatic venous pressure gradient(HVPG)and esophagogastroduodenoscopy(EGD)are currently recognized as the“gold standard”and the diagnostic reference standard for the prediction of EVB,***,HVPG is an invasive,expensive,and technically complex procedure,not widely available in clinical practice,whereas EGD is mainly limited by its invasive *** this scenario,computed tomography(CT)has been recently proposed as a promising modality for the non-invasive prediction of *** CT serves solely as a diagnostic tool and cannot replace EGD or HVPG for delivering therapeutic and physiological information,it has the potential to enhance the prediction of EVB more effectively when combined with liver disease scores,HVPG,and ***,to date,evidence concerning the role of CT in this setting is still lacking,therefore we aim to summarize and discuss the current evidence concerning the role of CT in predicting the risk of EVB.

关键词： esophageal variceal bleeding variceal upper gastrointestinal bleeding Portal hypertension Computed tomography Computed tomography angiography

Behcet’s disease manifesting as esophageal variceal bleeding: A case report

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2021年第12期9卷 2854-2861页

作者： Wen-Xing Xie Hai-Tao Jiang Guo-Qing Shi Li-Na Yang Hong Wang Department of Gastroenterology Affiliated Hospital of Zunyi Medical UniversityZunyi 563000Guizhou ProvinceChina

BACKGROUND Behcet’s disease(BD)is a chronic disease characterized by oral and vulvar ulcers as well as eye and skin damage and involves multiple *** presents as an alternating process of repeated attacks and *** venous rupture and bleeding caused by BD is rarely reported at home and *** paper reports a case of bleeding from oesophageal varices caused by BD,aiming to provide an additional dimension for considering the cause of bleeding from esophageal varices in the *** SUMMARY A 38-year-old female patient was admitted due to a gradual increase in shortness of breath and chest tightness after the activity,and was admitted to our hospital for *** admission,relevant examinations showed that the patient had multiple blood *** days after admission,she suddenly experienced massive *** esophagogastroduodenoscopy revealed bleeding from esophageal and gastric *** patient had no history of viral hepatitis or drinking habits,and no history of special genetic diseases or congenital vascular *** is no obvious abnormality in liver *** reviewing the medical history,it was found that the patient had recurred oral ulcers since childhood,ulcers were visible in the perineum during menstruation,and there was an intermittent red nodular rash and *** current skin acupuncture reaction is positive,combined with the evaluation of the external hospital and our hospital,the main diagnosis is *** received methylprednisolone,cyclophosphamide,immunomodulation,acid suppression,gastric protection,and anticoagulation and anti-infection treatments,and was discharged from the *** the 1-year follow-up period,the patient did not vomit blood *** This case highlights bleeding from esophageal varices caused by BD, aiming toprovide an additional dimension concerning the cause of bleeding fromesophageal varices in the future.

关键词： Behcet's disease Vasculitis Vascular embolism esophageal variceal bleeding Case report

New index to predict esophageal variceal bleeding in cirrhotic patients

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2014年第22期20卷 6989-6994页

作者： Xiao-Dan Xu Jian-Jun Dai Jian-Qing Qian Xun Pin Wei-Jun Wang Department of Gastroenterology Changshu Affiliated Hospital of Suzhou University

AIM: To develop a safe, simple, noninvasive and affordable system to predict esophageal variceal bleeding (EVB) in decompensated cirrhosis patients.

关键词： Portal hypertension Ultrasound-Doppler esophageal variceal bleeding Decompensated cirrhosis Endoscopy

Restrictive versus Liberal Blood Transfusion Strategies in Egyptian Patients with esophageal variceal bleeding

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Open Journal of Gastroenterology 2016年第5期6卷 151-157页

作者： Sherif M. Galal Soha A. Elhawari Hosam M. Dawod Ibrahim M. Ibrahim Tropical Medicine Department Faculty of Medicine Zagazig University Zagazig Egypt

Background and Study Aim: esophageal variceal bleeding is a major medical emergency and one of the most important indications for hospital admission and for blood transfusion. However, the safest and the effective blood transfusion strategy is controversial. Here, we studied the safety and the effectiveness of the restrictive versus liberal transfusion strategies in patients with esophageal variceal bleeding. Patients and Methods: The study included 342 patients with esophageal variceal bleeding. Patients were divided into 2 groups: group I (Restrictive strategy) transfusion when the hemoglobin level is ≤7 g/dl and group II (Liberal strategy): transfusion when the hemoglobin level is ≤9 g/dl. All patients were subjected to complete blood counts, liver and kidney profiles, coagulation profile, pelvi-abdominal ultrasonography and upper GI endoscopy. Clinical outcome measures include rebleeding, infection, allergic transfusion reactions thromboembolic events, and mortality. Results: Of all patients admitted to hospital with esophageal variceal bleeding, the number of transfused RBCs units and hospital stay were more in the liberal transfusion strategy. Also, the overall rate of complications was higher in the liberal transfusion strategy (49.7% versus 38.5% in the restrictive transfusion strategy). The most common complications were rebleeding (26.9%) and infection (21.6%). As regard the death rate, 13 cases (7.6%) died in the restrictive transfusion strategy versus 25 cases (14.6%) in the liberal transfusion one. Conclusions: For esophageal variceal bleeding, restrictive transfusion strategy is better than the liberal one as regard cost-effectiveness, risk of complications and hospital stay with no harm and less mortality as compared to liberal strategy.

关键词： esophageal variceal bleeding Blood Transfusion Restrictive Strategy Liberal Strategy

The role of computed tomography for the prediction of esophageal variceal bleeding:Current status and future perspectives

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Endoscopy 2023年第12期15卷 681-689页

作者： Alberto Martino Lucio Amitrano Marianna Guardascione Marco Di Serafino Raffaele Bennato Rossana Martino Annalisa de Leone Luigi Orsini Luigia Romano Giovanni Lombardi Department of Gastroenterology and Digestive Endoscopy AORN“Antonio Cardarelli”Napoli 80131Italy Department of General and Emergency Radiology AORN“Antonio Cardarelli”Napoli 80131Italy

esophageal variceal bleeding(EVB)is one of the most common and severe complications related to portal hypertension(PH).Despite marked advances in its management during the last three decades,EVB is still associated with significant morbidity and *** risk of first EVB is related to the severity of both PH and liver disease,and to the size and endoscopic appearance of esophageal ***,hepatic venous pressure gradient(HVPG)and esophagogastroduodenoscopy(EGD)are currently recognized as the“gold standard”and the diagnostic reference standard for the prediction of EVB,***,HVPG is an invasive,expensive,and technically complex procedure,not widely available in clinical practice,whereas EGD is mainly limited by its invasive *** this scenario,computed tomography(CT)has been recently proposed as a promising modality for the non-invasive prediction of *** CT is only a diagnostic modality,thus being not capable of supplanting EGD or HVPG in providing therapeutic and physiological data,it could potentially assist liver disease scores,HVPG,and EGD in a more effective prediction of ***,to date,evidence concerning the role of CT in this setting is still *** review aimed to summarize and discuss the current evidence concerning the role of CT in predicting the risk of EVB.

关键词： esophageal variceal bleeding variceal upper gastrointestinal bleeding Portal hypertension Computed tomography Computed tomography angiography

Comprehensive treatment of acute-on-chronic liver failure in a patient with hepatitis B： a case report

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Frontiers of Medicine 2014年第2期8卷 250-253页

作者： Lei Li Yimei Liu Tiancheng Luo Jian Zhou Yingyong Hou Xizhong Shen Jiyao Wang Department of Gastroenterology Zhongshan Hospital Fudan University Shanghai 200032 China Department of Liver Surgery Zhongshan Hospital Fudan University Shanghai 200032 China Department of Pathology Zhongshan Hospital Fudan University Shanghai 200032 China Shanghai Institute of Liver Diseases Shanghai 200032 China

The clinical data of a patient with acute-on-chronic liver failure were analyzed retrospectively. The patient has suffered from hepatitis B for 30 years. His liver function deteriorated, yielding Child-Pugh grade C and reaching a model for end-stage liver disease score of 33 points within a short period; this condition was complicated with highly active variceal bleeding and coagulation system failure （PT 〉 100 s）. The patient also presented hepatocellular carcinoma. Comprehensive treatments included effective inhibition of hepatitis B virus replication and intensive care support. Piggyback orthotopic liver transplantation was performed as the final treatment. The patient recovered uneventfully and was discharged after surgery.

关键词： acute-on-chronic liver failure submassive necrosis viral hepatitis B esophageal variceal bleeding liver transplantation

Effect of aluminum phosphate gel on prevention of early rebleeding after ligation of esophageal variceal hemorrhage

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Surgery 2021年第12期13卷 1651-1659页

作者： Zhu-Liang Zhang Min-Si Peng Ze-Ming Chen Ting Long Li-Sheng Wang Zheng-Lei Xu The Second Clinical Medical College of Jinan University Shenzhen 518000Guangdong ProvinceChina Department of Gastroenterology Shenzhen People's HospitalShenzhen 518020Guangdong ProvinceChina Department of Pathology Shenzhen People’s HospitalShenzhen 518020Guangdong ProvinceChina

BACKGROUND Liver cirrhosis is the main cause of portal *** leading cause of death in patients with liver cirrhosis is its most common complication,esophageal variceal bleeding(EVB).Endoscopic variceal ligation(EVL)is recommended by many guidelines to treat EVB and prevent rebleeding;however,esophageal ulcers occur after *** healing of ulcers and unhealed ulcers lead to high rebleeding and mortality ***,the prevention of early postoperative rebleeding is of great significance in improving the quality of life and prognosis of *** To evaluate the efficacy of aluminum phosphate gel(APG)plus a proton pump inhibitor(PPI)in the prevention of early rebleeding after EVL in patients with *** The medical records of 792 patients who were diagnosed with EVB and in whom bleeding was successfully stopped by EVL at Shenzhen People’s Hospital,Guangdong Province,China from January 2015 to December 2020 were *** to the study inclusion and exclusion criteria,401 cases were included in a PPI-monotherapy group(PPI group),and 377 cases were included in a PPI and APG combination therapy(PPI+APG)*** compared the incidence rates of early rebleeding and other complications within 6 wk after treatment between the two *** two-sample t-test,Wilcoxon rank-sum test,and chisquared test were adopted for statistical *** No significant differences in age,sex,model for end-stage liver disease score,coagulation function,serum albumin level,or hemoglobin level were found between the two *** incidence of early rebleeding in the PPI+APG group(9/337;2.39%)was significantly lower than that in the PPI group(30/401;7.48%)(P=0.001).Causes of early rebleeding in the PPI group were esophageal ulcer(3.99%,16/401)and esophageal varices(3.49%,14/401),while those in the PPI+APG group were also esophageal ulcers(5/377;1.33%)and esophageal varices(4/377;1.06%);such causes were significantly less frequent in the PPI+APG gr

关键词： esophageal variceal bleeding esophageal variceal ligation Proton pump inhibitor Endoscopic variceal ligation Aluminum phosphate gel

Risk factors for predicting early variceal rebleeding after endoscopic variceal ligation

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2011年第28期17卷 3347-3352页

作者： Liang Xu Feng Ji Qin-Wei Xu Mie-Qing Zhang Departmemof Gastroenterology First Affiliated Hospital Zhejiang Univer-sity School of Medicine 79 Qingchun Road Hangzhou 310003Zhejiang Province China

AIM: To analyze the clinical risk factors for early variceal rebleeding after endoscopic variceal ligation (EVL).METHODS: 342 cirrhotic patients with esophageal varices who received elective EVL to prevent bleeding or rebleeding at our endoscopy center between January 2005 and July *** included in this *** early rebleeding cases after EVL were confirmed by clinical signs or endoscopy.A case-control study was performed comparing the patients presenting with early rebleeding with those without this ***: The incidence of early rebleeding after EVL was 7.60%,and the morbidity of rebleeding was 26.9%.Stepwise multivariate logistic regression analysis showed that four variables were independent risk factors for early rebleeding: moderate to excessive ascites [odds ratio (OR) 62.83,95% CI: 9.39-420.56,P 18 s (OR 11.35,95% CI: 1.93-66.70,P = 0.007).CONCLUSION: The early rebleeding rate after EVL is mainly affected by the volume of ascites,number of rubber bands used to ligate,severity of varices and prolonged *** measures for prevention and treatment should be adopted before and after EVL.

关键词： esophageal variceal bleeding Endoscopic variceal ligation Loop ligature Early rebleeding Risk factor