When banding fails; investigation hails

Clinical presentation A 67-year-old man presented to our centre 5 years ago with a short history of jaundice and weight loss. A diagnosis of autoimmune hepatitis was made following laboratory investigations, imaging and a trans-jugular liver (TJ) biopsy. He was treated with prednisolone and azathioprine, which resulted in normalisation of his transaminases and bilirubin. Four years later, he was diagnosed with cirrhosis (Childs class A) based on clinical, biochemical and radiological parameters. He underwent a screening endoscopy, which revealed grade III oesophageal varices with multiple red signs and was started on propranolol as primary prophylaxis. He was unable to tolerate β blockers and oesophageal endoscopic band ligation (EBL) was subsequently undertaken. He underwent six further upper GI endoscopies with repeated EBL of his oesophageal varices; however, the grade III varices with red signs persisted. Contrast-enhanced arterial phase imaging was performed and the reason for him failing to respond to...
Source: Gut - Category: Gastroenterology Authors: Tags: GUT Snapshot Editor ' s quiz: GI snapshot Source Type: research

Related Links:

Alcohol Damage to the Liver – What Happens? Alcohol use disorder and heavy drinking present many harmful health risks. They can include everything from high blood pressure to fatal seizures. One of the most well-known health risks that come along with prolonged heavy drinking is liver damage. How does alcohol impact the liver, and what types of alcohol damage to the liver are there? In order to better understand alcohol damage to the liver, it is important to learn how the liver processes alcohol. According to MyDr, there are 2 ways that alcohol can be processed by your liver: Most alcohol is broken down, or metabol...
Source: Cliffside Malibu - Category: Addiction Authors: Tags: Alcohol Alcohol Rehab Information Alcoholism Detox Resources for Alcohol and Drugs/Opiates alcohol abuse alcohol dependence alcohol detox alcohol treatment alcohol treatment center alcohol treatment facility Source Type: blogs
ConclusionBBD can prevent and cure hepatic encephalopathy (HE) derived from both chronic and acute liver diseases. BBD can reduce hyperammonemia as well as the systematic and neurological inflammation. Inflammation is likely an important target of BBD to treat HE. The anti-inflammatory role of BBD may lie in its regulation of the TLR4/MyD88/NF-κ B pathways.Graphical abstract
Source: Journal of Ethnopharmacology - Category: Drugs & Pharmacology Source Type: research
Rationale: Despite vast improvements in technique, several complications still challenge surgeons and medical practitioners alike, including biliary and vascular complications, acute and chronic rejection, and disease recurrence. Patient concerns: A 59-year-old man was admitted to hospital on July, 2016. He had hepatitis B cirrhosis related recurrent hepatocellular carcinoma and underwent living donor liver transplantation in our hospital. Diagnosis: At the time of admission, the patient's spirit, diet, sleep, normal urine and stool, and weight did not change significantly. The test indicators are as follows: total...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Autoimmune hepatitis (AIH) is an acute or chronic liver disease that causes significant inflammation at a cellular level and leads to cirrhosis if left untreated. The basis of diagnosis is increased liver enzymes and immunoglobulins with positive autoantibodies and necroinflammatory changes on liver biopsy. Clinical presentations can vary. Asymptomatic patients may only have raised liver enzymes detected on routine testing, the other extreme of presentation being represented by fatigue, jaundice and liver failure.
Source: Medicine - Category: Internal Medicine Authors: Tags: Autoimmune liver disease Source Type: research
Rationale: Fusidic acid (FA) is an active agent against gram-positive bacteria such as Staphylococcus, it is generally well tolerated and the major adverse effects are mild gastrointestinal discomfort, diarrhea, and headache. However, some rare side effects such as granulocytopenia and thrombocytopenia have also been reported. Here we report a case of FA-induced hepatotoxicity and hematologic toxicity. Patient concerns: A 54-year-old woman with hepatitis B cirrhosis was referred to us because of fever, Staphylococcus aureus was identified in the twice blood culture, and intravenous FA was given (0.5 g, q8 hours). ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Asymptomatic abnormal liver function tests (LFTs) are common, affecting 8% of the population. They are mainly caused by alcoholic liver disease and non-alcoholic fatty liver disease, whereas jaundice is most commonly caused by extrahepatic biliary obstruction, followed by alcoholic liver disease and acute liver injury from drugs or viruses. A careful history helps to exclude non-hepatic causes of abnormal LFTs, as well as indicating a potential hepatic cause. Cirrhosis can present with ascites or jaundice, the latter being common in alcoholic liver disease as a result of added injury from alcoholic hepatitis.
Source: Medicine - Category: Internal Medicine Authors: Tags: Assessment of liver disease Source Type: research
We report what is likely the first known case of severe jaundice after medication with glecaprevir/pibrentasvir in a patient with compensated liver cirrhosis. Clinicians should bear potential hyperbilirubinemia in mind when treating chronic hepatitis C with this regimen and should monitor the patient closely during follow-up laboratory exams, especially in elderly cirrhotic patients.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
A 45-year-old woman presented to the emergency department with nausea and vomiting. Her symptoms had started seven days earlier and steadily worsened. She reported generalized abdominal pain and distention and that her eyes appeared yellow.The patient had no past medical history, took no medications, and said she did not drink or use drugs. Her history showed that she had been drinking an herbal preparation every day for the past five months to ameliorate her heavy menstrual periods.The patient had mild right upper quadrant tenderness but no distention, rebound, or guarding. Her lungs were clear, and her heart rate and rhy...
Source: The Tox Cave - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
CONCLUSION: Hepatitis B vaccine is the mainstay of hepatitis B prevention. Safe injection practices, blood safety and promoting wider access to monitoring and screening, care and treatment services for hepatitis B are the best guarantees to prevent and control this disease. PMID: 31060884 [PubMed - as supplied by publisher]
Source: Revue d Epidemiologie et de Sante Publique - Category: Epidemiology Tags: Rev Epidemiol Sante Publique Source Type: research
Authors: Arab JP, Roblero JP, Altamirano J, Bessone F, Chaves Araujo R, Higuera-De la Tijera F, Restrepo JC, Torre A, Urzua A, Simonetto DA, Abraldes JG, Méndez-Sánchez N, Contreras F, Lucey MR, Shah VH, Cortez-Pinto H, Bataller R Abstract Alcohol-related liver disease (ALD) is a major cause of advanced chronic liver disease in Latin-America, although data on prevalence is limited. Public health policies aimed at reducing the alarming prevalence of alcohol use disorder in Latin-America should be implemented. ALD comprises a clinical-pathological spectrum that ranges from steatosis, steatohepatitis to ...
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
More News: Beta-Blockers | Bilirubin | Cirrhosis | Endoscopy | Hepatitis | Inderal | Jaundice | Laboratory Medicine | Liver | Prednisolone | Upper Endoscopy | Urology & Nephrology | Weight Loss