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Study of glue extrusion after endoscopic N-butyl-2-cyanoacrylate injection on gastric variceal bleeding

World Journal of Gastroenterology 2009年第39期15卷 4945-4951页

作者： Yan-Mei Wang Liu-Fang Cheng Nan Li Kai Wu Jun-Shan Zhai Ya-Wen Wang Department of Gastroenterology the Second Affiliated Hospital of PLA General Hospital Beijing 100091 China

AIM:To investigate glue extrusion after endoscopic N-butyl-2-cyanoacrylate injection on gastric variceal bleeding and to evaluate the long-term efficacy and safety of this ***:A total of 148 cirrhotic patients in our hospital with esophagogastric variceal bleeding(EGVB) were included in this study.N-butyl-2-cyanoacrylate was mixed with lipiodol in a 1:1 ratio and injected as a bolus of 1-3 mL according to variceal *** underwent endoscopic follow-up the next week,fourth week,second month,fourth month,and seventh month after injection and then every 6 mo to determine the cast *** abdominal X-ray fi lm and ultrasound or computed tomographic scan were also carried out in order to evaluate the time of variceal disappearance and complete extrusion of the *** average follow-up time was 13.1 ***:The instantaneous hemostatic rate was 96.2%.Early re-bleeding after injection in 9 cases(6.2%) was estimated from rejection of *** re-bleeding occurred in 12 patients(8.1%) at 2-18 *** glue cast was extruded into the lumen within one month in 86.1% of patients and eliminated within one *** erosion was seen at the injection position and mucosa edema in the second *** glue casts were extruded in 18 patients(12.1%) after one week and in 64 patients(42.8%) after two *** kinds of glue clumping shapes and colors on endoscopic examination were observed in 127 patients(86.1%) within one month,including punctiform,globular,pillar and *** one patients(27.9%) had glue extrusion after 3 mo and 28 patients(28.9%) after six *** extrusion time was not related to the injection volume of *** was seen in 70.2%(104 cases) *** main complication was re-bleeding resulting from *** prognosis of the patients depended on the severity of the underlying liver ***:Endoscopic injection of cyanoacrylate is highly effective for gastric varices *** glue clump

关键词： gastric variceal bleeding Glue extruded N-butyl-2-cyanoacrylate Portal hypertension

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Efficacy and safety of combined endoscopic cyanoacrylate injection and balloon-occluded retrograde transvenous occlusion(BRTOcc)of gastrorenal shunts in patients with bleeding gastric fundal varices

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Gastroenterology Report 2021年第3期9卷 212-218,I0001,I0002页

作者： Fateh Bazerbachi Akira Dobashi Swarup Kumar Sanjay Misra Navtej S.Buttar Louis M.Wong Kee Song Division of Gastroenterology Interventional Endoscopy ProgramMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA Division of Gastroenterology and Hepatology Mayo ClinicRochesterMNUSA Vascular and Interventional Radiology Mayo ClinicRochesterMNUSA

Background:Endoscopic cyanoacrylate(glue)injection of fundal varices may result in life-threatening embolic adverse events through spontaneous gastrorenal shunts(GRSs).Balloon-occluded retrograde transvenous occlusion(BRTOcc)of GRSs during cyanoacrylate injection may prevent serious systemic glue embolization through the *** study aimed to evaluate the efficacy and safety of a combined endoscopic–interventional radiologic(BRTOcc)approach for the treatment of bleeding fundal ***:We retrospectively analysed the data of patients who underwent the combined procedure for acutely bleeding fundal varices between January 2010 and April *** were extracted for patient demographics,clinical and endoscopic findings,technical details,and adverse events of the endoscopic–BRTOcc approach and patient ***:We identified 30 patients(13[43.3%]women;median age 58[range,25–92]years)with gastroesophageal varices type 2(53.3%,16/30)and isolated gastric varices type 1(46.7%,14/30)per Sarin classification,and median clinical and endoscopic follow-up of 151(range,4–2,513)days and 98(range,3–2,373)days,*** median volume of octylcyanoacrylate:Lipiodol injected was 7(range,4–22)***-related adverse events occurred in three(10.0%)patients,including transient fever,non-life-threatening pulmonary glue embolism,and an injection-site ulcer *** gastric variceal obturation was achieved in 18 of 21 patients(85.7%)at endoscopic *** variceal rebleeding was confirmed in one patient(3.3%)and suspected in two patients(6.7%).Although no procedure-related deaths occurred,the overall mortality rate was 46.7%,primarily from liver-disease progression and ***:The combined endoscopic–BRTOcc procedure is a relatively safe and effective technique for bleeding fundal varices,with a high rate of variceal obturation and a low rate of serious adverse events.

关键词： balloon-occluded retrograde transvenous occlusion cyanoacrylate injection gastric varices gastric variceal bleeding gastrorenal shunt

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Torsion of spleen and portal hypertension: Pathophysiology and clinical implications

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World Journal of Hepatology 2021年第7期13卷 774-780页

作者： Ashish Kumar Jha Sameer Bhagwat Vishwa Mohan Dayal Arya Suchismita Department of Gastroenterology Indira Gandhi Institute of Medical SciencesPatna 800014India Department of Paediatric Hepatology Institute of Liver and Biliary SciencesDelhi 110070India

The displacement of spleen from its normal location to other places is known as wandering spleen(WS)and is a rare *** repeated torsion of WS is due to the presence of long pedicle and absence/laxity of anchoring ligaments.A WS is an extremely rare cause of left-sided portal hypertension(PHT)and severe gastric variceal ***-sided PHT usually occurs as a result of splenic vein occlusion caused by splenic torsion,extrinsic compression of the splenic pedicle by enlarged spleen,and splenic vein *** is a paucity of data on WSrelated PHT,and these data are mostly in the form of case *** this review,we have analyzed the data of 20 reported cases of WS-related *** mechanisms of pathogenesis,clinico-demographic profile,and clinical implications are described in this *** majority of patients were diagnosed in the second to third decade of life(mean age:26 years),with a strong female preponderance(M:F=1:9).Eleven of the 20 WS patients with left-sided PHT presented with abdominal pain and *** 6 of the 11 patients,varices were detected incidentally on preoperative imaging studies or discovered ***,pre-operative search for varices is required in patients with splenic torsion.

关键词： Wandering spleen Splenic torsion Left-sided portal hypertension gastric variceal bleeding Splenectomy

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Coil-assisted retrograde transvenous obliteration for gastric varices in a Chinese case

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Journal of Interventional Medicine 2021年第2期4卷 94-96页

作者： Pengxu Ding Chao Liu Xinwei Han Edward Wolfgang Lee Department of Intervention The First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina Division of Interventional Radiology Department of RadiologyUCLA Medical CenterDavid Geffen School of Medicine at UCLALos AngelesCAUSA

gastric varices are a major complication of portal hypertension in patients with liver cirrhosis and are associated with more massive bleeding events and higher mortality *** intrahepatic portosystemic shunt(TIPS)and balloon-occluded retrograde transvenous obliteration(BRTO)have been well documented as effective therapies for portal hypertensive gastric variceal *** China,TIPS are well accepted but BRTO is not well recieved due to the increase risk of complications associated with traditional ***,modified-BRTO,known as coil-assisted and plug-assisted retrograde transvenous obliteration(CARTO and PARTO,respectively),is receiving increased attention due to devoid of BRTO’s *** CARTO case from China has been reported in literature thus ***,we present a Chinese case of CARTO to treat gastric varices bleeding.

关键词： gastric varices gastric variceal bleeding Coil assisted retrograde transvenous obliteration

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