Liaoning Score for Prediction of Esophageal Varices in Cirrhotic Patients Who Had Never Undergone Endoscopy: A Multicenter Cross-Sectional Study in Liaoning Province, China

AbstractBackground and AimsEndoscopy is necessary for assessment of esophageal varices (EVs) in cirrhotic patients, but its use is limited because of the poor compliance of patients and shortage of public health resources at primary hospitals or rural areas, especially in less well developed countries. A multicenter cross-sectional study aimed to establish a novel non-invasive score for prediction of EVs in cirrhotic patients who had never undergone endoscopy.MethodsPatients with liver cirrhosis regardless of acute upper gastrointestinal bleeding (AUGIB) who underwent the first-time upper gastrointestinal endoscopy at 11 hospitals in Liaoning Province, China were considered. Independent predictors for EVs were identified by multivariate logistic regression analysis and then combined into an equation. The diagnostic performance with area under curve (AUC) was further evaluated by receiver operating characteristic curve analysis.ResultsOverall, 363 patients were included, of whom 260 had EVs and 180 presented with AUGIB. In all patients, AUGIB, ascites, and platelets were the independent predictors for EVs. The equation (i.e., Liaoning score) was 0.466  + 1.088 × AUGIB (1 = yes; 0 = no) + 1.147 × ascites (1 = yes; 0 = no) − 0.012 × platelets, which had an AUC of 0.807 (p 
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research

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dquo; Study Group Investigators Abstract BACKGROUND: Current guidelines do not address the post-sustained virological response management of patients with baseline hepatitis C virus (HCV) cirrhosis and oesophageal varices taking betablockers as primary or secondary prophylaxis of variceal bleeding. We hypothesized that in some of these patients portal hypertension drops below the bleeding threshold after sustained virological response, making definitive discontinuation of the betablockers a safe option. AIM: To assess the evolution of portal hypertension, associated factors, non-invasive assessment, and risk ...
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
We present the case of a patient with diabetes showing minimal perturbations of liver function tests, but for whom a simple blood fibrosis test suggested the presence of advanced liver fibrosis. The patient was referred to a hepatologist who confirmed the diagnosis using a specialized blood test and transient elastography. Thereafter, a liver biopsy was performed and pathology was positive for cirrhosis. An upper gastrointestinal endoscopy showed no gastrointestinal varices. Simple blood fibrosis tests are very attractive for the first-line evaluation of liver fibrosis by non-specialists in the large populations of NAFLD a...
Source: Clinics and Research in Hepatology and Gastroenterology - Category: Gastroenterology Source Type: research
Conclusion and Relevance: Our study observed no difference in clinical end points. This suggests that octreotide provides no additional major clinical benefit in NVUGIB, and PPI therapy alone may be sufficient. PMID: 30803243 [PubMed - as supplied by publisher]
Source: The Annals of Pharmacotherapy - Category: Drugs & Pharmacology Authors: Tags: Ann Pharmacother Source Type: research
Background Noninvasive methods have been established to detect clinically significant portal hypertension in liver cirrhosis with variable limitations. The von Willebrand factor (vEF) has been found to increase in liver cirrhosis. Aim The aim of this study was to explore the vEF and VITRO (von Willebrand factor antigen/platelet ratio) score in the prediction of variceal bleeding in patients with portal hypertension. Materials and methods Fifty patients with hepatitis C-related liver cirrhosis (25 patients with variceal bleeding and 25 without variceal bleeding) as well as 80 healthy controls were included. Laborato...
Source: European Journal of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research
Abstract BACKGROUND/AIMS: The development of esophageal varices (EV) and resultant bleeding are the most critical complications of portal hypertension. Upper gastrointestinal endoscopy is the gold standard for diagnosis of EV. To find a non-invasive method for diagnosis of EV and to predict the bleeding risk is appealing and would decrease the cost and discomfort of upper endoscopy. The aim of our study was to evaluate the blood ammonia level as a predictor of the presence of EV and of a high risk of bleeding. MATERIALS AND METHODS: In this cross-sectional study, a total of 359 patients with cirrhosis were ex...
Source: The Turkish Journal of Gastroenterology - Category: Gastroenterology Authors: Tags: Turk J Gastroenterol Source Type: research
​BY GREGORY TAYLOR, DO, &SHERIF EL-ALAYLI, DOA 60-year-old man with a significant history of alcohol abuse, metastatic hepatocellular carcinoma, and cirrhosis presented to the emergency department complaining of vomiting up bright red blood. The patient was reportedly supposed to have an esophagogastroduodenoscopy (EGD) six months earlier but failed to follow up.He had two episodes of melena the night before and two episodes of hematemesis that morning. He was also experiencing fatigue, weakness, and abdominal pain, which he described as achy and localized to the epigastric region. He had refused treatment for his he...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
CONCLUSION: The SS measured by 2D-SWE is not an accurate predictor of variceal grade and thus bleeding in patients of EHPVO. Advances in knowledge: EHPVO is a vascular pathology with most patients showing splenomegaly and preserved liver function. Although, elastography of spleen has been shown to be useful in patients with cirrhosis for predicting portal hypertension, it does not seem to be helpful in patients with EHPVO. PMID: 30226081 [PubMed - as supplied by publisher]
Source: The British Journal of Radiology - Category: Radiology Authors: Tags: Br J Radiol Source Type: research
A 49 year-old man with alcoholic cirrhosis presented with upper gastrointestinal bleeding and ascites. Endoscopy showed grade 2 esophageal varices with innumerable sessile polyps of the stomach and duodenum with diffuse hemorrhage (Figures A and B), which were treated with epinephrine injection and hemostatic clips. Over the following months, the patient had frequent hospitalizations for recurrent bleeding from the polyps and refractory ascites. Endoscopic biopsy of the polyps showed hyperplastic duodenal mucosa with vascular ectasia (Figure C, arrows) and patchy erosion (Figure C, arrowheads).
Source: Clinical Gastroenterology and Hepatology - Category: Gastroenterology Authors: Tags: Electronic Image of the Month Source Type: research
A 49 year-old man with alcoholic cirrhosis presented with upper gastrointestinal bleeding and ascites. Endoscopy showed grade 2 esophageal varices with innumerable sessile polyps of the stomach and duodenum with diffuse hemorrhage (Figures A and B), which were treated with epinephrine injection and hemostatic clips. Over the following months, the patient had frequent hospitalizations for recurrent bleeding from the polyps and refractory ascites. Endoscopic biopsy of the polyps showed hyperplastic duodenal mucosa with vascular ectasia (Figure C, arrows) and patchy erosion (Figure C, arrowheads).
Source: Clinical Gastroenterology and Hepatology - Category: Gastroenterology Authors: Tags: Electronic image of the month Source Type: research
We report a case of bleeding ileal varices associated with intra-abdominal adhesions after colectomy which was successfully diagnosed using capsule endoscopy. A 77-year-old woman visited the emergency department for several episodes of melena. She had a medical history of neoadjuvant chemo-radiation therapy and subsequent surgery for rectal cancer 6 years previously. Conventional diagnostic examinations including upper endoscopy, colonoscopy, and abdominal computed tomography could not detect any bleeding focus, however, following capsule endoscopy revealed venous dilatations with some fresh blood in the distal ileum, indi...
Source: Korean J Gastroenter... - Category: Gastroenterology Authors: Tags: Korean J Gastroenterol Source Type: research
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