Endoscopic Ultrasound Evaluation of Portal Pressure.

Portal hypertension is a complex syndrome with multiple clinical manifestations that develop in a variety of conditions and diseases. The spectrum of portal hypertension manifestations is wide and dependent on the physiologic site of increased portal resistance (pre-, post-, and sinusoidal or intrahepatic), as well as the presence of hepatocellular dysfunction.

Early Detection of Pancreatic Cancer: Risk Factors and the Current State of Screening Modalities.

Pancreatic cancer (PC) is expected to become the second leading cause of cancer-related mortality in the United States within the next decade. Patients often present at late stages of the disease, when they become symptomatic; in many cases, these patients have unresectable disease that is associated with a poor prognosis. Considering the low incidence of PC in the general population, routine screening of average-risk individuals is not feasible and not recommended.

Endoscopic Management of Primary Sclerosing Cholangitis.

Primary sclerosing cholangitis (PSC) remains a rare but potentially devastating chronic, cholestatic liver disease. PSC causes obstruction of intra- and/or extra-hepatic bile ducts by inflammation and fibrosis, leading to biliary obstruction, cirrhosis and portal hypertension with all associated sequelae. The most dreaded consequence of PSC is cholangiocarcinoma, occurring in 10-20% of patients with PSC, and with population-based estimates of a 398-fold increased risk of cholangiocarcinoma in patients with PSC compared to the general population.

Clinical distinctions and pathogenic implications of type 1 autoimmune hepatitis in Brazil and the United States.

Background/aims: Type 1 autoimmune hepatitis has a strong genetic predisposition that varies among different ethnic groups. Our aims were to determine if the clinical manifestations differed between patients with type 1 autoimmune hepatitis from Brazil and the United States and if classical disease could be associated with region-specific susceptibility markers.

Methods: The clinical manifestations and genetic risk factors of 161 patients from the United States were compared to those of 115 patients from Brazil.

Small adenocarcinomas of the esophagogastric junction: association with intestinal metaplasia and dysplasia.

Objectives: Intestinal metaplasia in Barrett's esophagus predisposes to esophageal adenocarcinoma. Intestinal metaplasia of the cardia is a common finding in persons without cancer. Many adenocarcinomas of the esophagogastric junction are large enough to obliterate any underlying intestinal metaplasia.