Bleeding from esophageal varices is a major cause of mortality in patients with advanced liver disease. Although standard treatment and secondary prophylaxis are effective, in some patients sustained hemostasis cannot be achieved. We report the case of a woman with alcoholic liver disease in whom pharmacological, endoscopic, and intravascular therapies failed to control variceal bleeding. Only a combination of (repeated) band ligation, insertion of a self-expanding metal stent, TIPS implantation and redilatation, transjugular variceal embolization, and finally implantation of a portocaval shunt proved to be successful. We discuss the stepwise approach to this situation and the challenges encountered in the process.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1055/s-0042-117227 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The learning curve for laparoscopic-assisted single-port mediastinoscopic esophagectomy: an analysis of proficiency.
BMC Surg
January 2025
Department of Cardiothoracic Surgery, Fifth Affiliated Hospital of Sun Yat-Sen University, No.52 East Meihua Road, Zhuhai, Guangdong Province, 519000, China.
Background: Laparoscopic-assisted single-port mediastinoscopic esophagectomy is a safe and effective emerging minimally invasive esophagectomy, but little has been reported about the learning curve for this technology. The goal of the study was to determine the number of procedures to achieve different levels of proficiency on the learning curve.
Methods: This study retrospectively analyzed data from consecutive surgeries performed by the same surgeon at the same center from 2016 to 2021.
Management of Vascular Complications from Button Battery Ingestions.
Curr Gastroenterol Rep
January 2025
Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and New York- Presbyterian Morgan Stanley Children's Hospital, 630 West 168Th Street, New York, NY, PH17-105H10032, USA.
Purpose: To propose a gastrointestinal bleeding management algorithm that incorporates an endoscopic and imaging scoring system and specifies management of vascular complication from button battery ingestion.
Recent Findings: Button batteries (BB) are found in many electronic devices and ingestions are associated with serious complications especially in cases of unwitnessed ingestions, prolonged impaction, and in children less than 5 years of age. Gastrointestinal bleeding from BB related vascular injury is rare but often rapidly fatal, with a mortality rate as high as 81%.
Black Esophagus: A Life-Threatening Consequence of Hypoperfusion.
Cureus
December 2024
Gastroenterology II, Mohammed V Military Teaching Hospital, Rabat, MAR.
Acute esophageal necrosis (AEN) is an uncommon endoscopic finding characterized by a patchy or diffuse circumferential black pigmentation of the esophageal mucosa, corresponding to ischemic necrosis. It usually presents with upper gastrointestinal bleeding and is thought to be caused by a systemic low blood flow in patients with predisposing risk factors, like advanced age and cardiovascular comorbidities. After initial hemodynamic stabilization, diagnosis is established by esophagogastroduodenoscopy (EGD) with careful biopsies and histological evaluation.
View Article and Find Full Text PDFClinical and radiological features of gastric and small intestinal anisakiasis: comparison with gastric ulcers and crohn's disease.
Jpn J Radiol
January 2025
Department of Radiology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.
Purpose: To compare the clinical and radiological features of gastric and small intestinal anisakiasis with those of gastric ulcers and Crohn's disease.
Materials And Methods: In this retrospective cohort study, 205 cases of anisakiasis (148 gastric; 53 small intestinal) were identified between July 2003 and February 2022. The control groups included 130 and 31 patients with gastric ulcers and Crohn's disease, respectively.
Diagnosis and Treatment Options for Cirrhosis With Unexplained Upper Gastrointestinal Bleeding: An Observational Study Based on Endoscopic Ultrasonography.
Surg Laparosc Endosc Percutan Tech
January 2025
Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Key Laboratory of Digestive Diseases of Anhui Province, Hefei, Anhui, China.
Objective: To investigate the role of endoscopic ultrasonography (EUS) in the diagnosis and treatment of upper gastrointestinal bleeding of unknown origin in liver cirrhosis, focusing on patients with recurrent treatment of esophageal and gastric varices who failed to identify the bleeding site under direct endoscopy.
Background: Esophagogastric variceal bleeding is one of the severe complications of decompensated liver cirrhosis, and serial endoscopic therapy can improve the long-term quality of life of patients. Most acute bleeding can be detected under direct endoscopy with thrombus or active bleeding, but there are still some patients with recurrent bleeding after repeated treatments, and it is difficult to find the bleeding site, especially in gastric variceal bleeding.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!