Prevalence, nature, and predictors of colonic changes in children with extrahepatic portal vein obstruction
Medical literature on colonic changes in children with extrahepatic portal venous obstruction (EHPVO) is limited. We evaluated EHPVO children for prevalence, nature, and relation of colonic changes with disease duration, extent of splenoportal axis (SPA) thrombosis, portal hypertensive gastropathy (PHG), and esophageal varices (EVs). The correlation between histological and endoscopic changes was studied.
In the aging society, the use of antithrombotic therapy (ATT) has been increasing in patients who are required for the prevention of thromboembolic diseases. Severe acute cholecystitis often requires the urgent drainage. Therefore, in these patients, ATT discontinuation to safely perform gallbladder drainage is often impossible since there is no time to discontinue ATT for the recommended period. In addition, the discontinuation ATT increases a risk of thromboembolism. An increased risk of bleeding complications during surgery and percutaneous drainage is also found in patients with acute cholecystitis receiving ATT.
Endoscopic treatment for common bile duct (CBD) stone using endoscopic sphincterotomy (EST) or endoscopic papillary large balloon dilation (EPLBD) is an established therapeutic procedure during endoscopic retrograde cholangiopancreatography (ERCP); however, all these pose a high risk for hemorrhage. Recently, antithrombotic agents, including antiplatelet agents and anticoagulants, have been widely used to reduce the risk of thromboembolic events in patients with certain cardiovascular conditions, cerebrovascular disease, and deep venous thrombosis.
Inflammatory bowel disease (IBD) exacerbation increases the risk of venous thromboembolism (VTE), and current guidelines recommend pharmacologic VTE prophylaxis (PVTEP) during hospitalization. Compliance with these guidelines is poor, in part due to the physician and patient concerns that PVTEP may worsen anemia and/or bleeding. This risk in the IBD population is poorly defined.
Conclusions: We argue global FDG-PET/CT will be the gold standard moving forward for the diagnosis and clinical management of IBD. This molecular imaging technique has demonstrated superiority over purely structural imaging modalities. Therefore, future studies should further explore the role of FDG-PET/CT in IBD, as well as compare results to other imaging modalities.
yas-Plass M Abstract BACKGROUND AND OBJECTIVE: The spread of an infection from the paranasal sinuses is rare but severe. Between 4% and 20% of all rhinosinusitis can become complicated, orbital involvement being the most frequent (60-75%). Orbital complications are more common in children but more severe in adults. We aim to analyse the epidemiological characteristics of these patients and to propose a management algorithm. MATERIALS AND METHODS: We carried out a retrospective review of 21 patients with orbital complications of acute rhinosinusitis diagnosed in the same institution from 2005 to 2018. The diag...
We reported a case of intermittent massive upper gastrointestinal bleeding in a 33-year-old man with cholangiocarcinoma who underwent surgical resection followed by chemoradiation. A portoduodenal fistula due to chronic duodenal ulceration was identified. The bleeding was successfully controlled by endoscopic ultrasound-guided coil placement through the duodenal bulb using the anchoring technique. Follow-up endoscopy and computed tomography scan showed multiple coil placements between a part of the portal vein and the duodenal bulb without any evidence of portal vein thrombosis. There were no complications, and bleeding di...
Conclusion In this small group of patients under anticoagulation therapy undergoing variceal band ligation, only a minority presented postendoscopic bleeding of minor importance. Nevertheless, particular attention should be paid to patients with previous decompensation of cirrhosis.
CONCLUSION: Today IPAA is the gold standard. The IRA is indicated in selected patients where they meet the following requirements: normal sphincter tone, absence of severe perineal disease, rectum does not actively involved by the disease, absence of dysplasia or cancer. It is also indicated in patients who refuse an ileostomy and it can be proposed as a possible interim procedure in young women, because it does not need a pelvic dissection and because the risk of infertility is minimal or absent when compared to IPAA. Because the risk of cancer is higher, patients undergoing IRA must be adequately informed about the risk,...
ConclusionsOur case suggests that gallbladder hemorrhage needs to be considered a possible complication for patients on direct oral anticoagulants.
Conclusion: Molecular-weight heparin and intraoperative intermittent pneumatic compression controls the hypercoagulation effect more efficiently when it is administered 1 hour before surgery: it causes significant reduction of F1+2, TAT, and MP-TF indexes and significant increases of fTFPI levels during and after laparoscopic fundoplication.