This is an interim report of a prospective controlled study to evaluate prophylactic surgery in 112 patients with portal hypertension and esophageal varices treated since 1980. Methods of operation were confined to those with the least influence on portal circulation, namely selective shunts and nonshunting direct interruption procedures. The bleeding rates were 19.2% in the medical group and none in the surgical group (p less than 0.01). The mortality in the medical group in case of first bleeding was 50%. Operative mortality was 3.3%. There was no difference in the survival rate between the two groups at the time of 2 years follow-up. Prophylactic surgery led to a prevention of esophageal bleeding without any increase in the mortality rates.
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http://dx.doi.org/10.1097/00000658-198407000-00010 | DOI Listing |
J Med Case Rep
January 2025
Department of Hepatic Biliary Pancreatic Medicine, First Hospital of Jilin University, 1 Xinmin Avenue, Changchun, 130021, China.
Background: Dyskeratosis congenita is a rare genetic disease due to telomere biology disorder and characterized by heterogeneous clinical manifestations and severe complications. "Porto-sinusoidal vascular disease" has been recently proposed, according to new diagnostic criteria, to replace the term "idiopathic non-cirrhotic portal hypertension." TERT plays an important role in telomeric DNA repair and replication.
View Article and Find Full Text PDFMinerva Anestesiol
January 2025
Transplant Anesthesia and Critical Care, Pisa NHS and University Hospitals, Pisa, Italy -
Intraoperative hemodynamic monitoring is crucial for managing patients with end-stage liver disease (ESLD) undergoing orthotopic liver transplantation (OLT) due to their complex cardiovascular and pulmonary abnormalities. Traditionally, pulmonary artery catheterization (PAC) has been the standard for hemodynamic monitoring during OLT. However, the use of transesophageal echocardiography (TEE) has increased due to its real-time visualization of cardiac and vascular structures, which aids in managing hemodynamic instability during the three surgical phases of OLT: pre-anhepatic, anhepatic, and neo-hepatic.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Pulmonary and Critical Care, University of Florida College of Medicine, Jacksonville, Florida, USA.
Gastric varices (GVs) are dilated veins in the stomach submucosa, typically caused by portal hypertension. A prompt diagnosis is needed, given the significant risk of bleeding and mortality. Endoscopic cyanoacrylate injections are widely adopted for treating GV due to their efficacy in preventing rebleeding with lower complication rates.
View Article and Find Full Text PDFBMC Pediatr
January 2025
Liver Transplantation & Hepatopancreatobiliary Surgery Unit, Department of General Surgery, Istanbul Faculty of Medicine, Istanbul, Türkiye.
Background: Gastro-esophageal variceal hemorrhage (GEVH) is one of the major causes of life-threatening gastrointestinal bleeding in children. Medical, endoscopic, angiographic, and surgical interventions can be utilized in treatment. In this case report, we describe partial splenic artery embolization for refractory GEVH due to portal vein thrombosis.
View Article and Find Full Text PDFFront Immunol
January 2025
Department of Rheumatology and Immunology, the Second Affiliated Hospital of Xiamen Medical College, Xiamen, China.
Introduction: Systemic lupus erythematosus (SLE) complicated by thrombotic microangiopathy (TMA) and non-cirrhotic portal hypertension (NCPH) is rare. We present a case of a female patient with SLE who developed TMA and NCPH and responded positively to rituximab and plasma exchange treatment.
Case Description: A 53-year-old woman was admitted with 6 h of confusion.
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