Balloon-occluded retrograde transvenous obliteration (BRTO) is widely used to treat isolated gastric varices (IGVs) in Japan. However, BRTO is difficult to perform for IGVs with many small collateral veins, and no secondary treatment has been established. We herein report a rare case of IGVs refractory to BRTO successfully treated by shunt-occluded endoscopic injection sclerotherapy (SO-EIS), which is a combination therapy of major shunt occlusion by a balloon catheter and endoscopic injection sclerotherapy. Since SO-EIS can be performed regardless of the IGVs' anatomical configuration, it may be a promising alternative treatment for IGVs refractory to BRTO.
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http://dx.doi.org/10.2169/internalmedicine.56.7761 | DOI Listing |
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.
Iowa Orthop J
January 2025
Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Background: The use of intraoperative intra-articular morphine has been suggested to lower postoperative pain scores and opioid use. We sought to evaluate the effectiveness of intra-articular morphine with 0.75% ropivacaine when compared to the use of ropivacaine alone.
View Article and Find Full Text PDFBMC Pregnancy Childbirth
January 2025
Department of Gynecology, Shenyang Women's and Children's Hospital, No. 87 Renao Road, Shenyang, Liaoning Province, 110011, China.
Background: This study aimed to investigate the risk factors related to the failure of initial combined local methotrexate (MTX) treatment and minimally invasive surgery for late cesarean scar pregnancy (CSP).
Methods: This retrospective case-control study was conducted between January 2016 and December 2023, involving patients with late CSP (≥ 8 weeks) who received local MTX injection combined with either hysteroscopic or laparoscopic surgery. Cesarean scar pregnancy was classified as type I, II, or III based on the direction of growth of the gestational sac and the residual myometrial thickness as assessed by ultrasound.
Endoscopic injection sclerotherapy (EIS) is a useful prophylactic hemostatic procedure for esophageal varices. However, injecting sclerosing agents into blood vessels is technically challenging and often ineffective. Gel-immersion EIS (GI-EIS) may facilitate easier intravascular sclerosing agent injection by dilating the varices and enhancing scope stability by maintaining low intra-gastrointestinal pressure.
View Article and Find Full Text PDFPrz Gastroenterol
March 2024
Department of Hepato-gastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
Introduction: Stasis of bile flow can result in microbial colonization of the biliary tree. Cholangitis is a common adverse event linked to endoscopic retrograde cholangiopancreatography (ERCP).
Aim: To establish the bacterial profiles isolated from the bile sample and to evaluate the pre-ERCP risk factors predicting the microbial growth and development of post-ERCP cholangitis (PEC).
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