Endoscopic variceal ligation as primary prophylaxis for upper GI bleeding in children

Variceal hemorrhage can be a life-threatening adverse event of chronic liver disease. In contrast to the well described guidelines for the management of portal hypertension (PH) in adults, there is limited evidence about the optimal prophylactic management of variceal bleeding in children. The study was carried out to assess the efficacy of endoscopic variceal ligation (EVL) as primary prophylaxis to prevent upper GI bleeding in children with PH.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: 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
Acute variceal bleeding (AVB) is a common medical emergency in patients with portal hypertension and carries a published inpatient mortality risk of 11-43%. It remains unclear whether measures of liver disease severity (liver risk) or upper gastrointestinal bleeding (UGIB) risk stratification scores offer the best predictive power in patients with AVB. AIMS65 is a risk stratification score validated to predict inpatient mortality. The AIMS65 score assigns 1 point for each of the following: albumin level 1.5, altered mental status, systolic blood pressure 65 years.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Saturday abstract Source Type: research
ConclusionsContinuous infusion of terlipressin may be more effective than intermittent infusion to prevent treatment failure in patients with variceal bleeding. There is significant relationship between MELD-Na score [Odd ratio = 1.37  (95% CI-1.16 - 1.62),p-value
Source: Indian Journal of Gastroenterology - Category: Gastroenterology Source Type: research
Portal hypertension (PHT) is a significant cause of morbidity and mortality in children with chronic liver disease and portal vein obstruction. Increased portal pressure results in variceal formation along the gastrointestinal (GI) tract resulting in major bleeding. Identifying children with significant PHT who are more likely to suffer GI bleeding has been challenging and the role of surveillance upper GI endoscopy has been debated. This review analyses research done on serum biomarkers and imaging techniques as possible predictors of significant PHT. We evaluated the research performed on adult population, as well as the...
Source: Journal of Pediatric Gastroenterology and Nutrition - Category: Gastroenterology Tags: Reviews Source Type: research
es JG Abstract A major complication of portal hypertension in patients with cirrhosis is the development of esophageal varices with the associated risk of variceal bleeding. Hence, the Baveno consensus on portal hypertension in its first five editions had recommended surveillance with periodic upper endoscopies in these patients to identify in a timely fashion the development of esophageal varices and initiate a primary prophylaxis strategy in those at a high risk of bleeding. For the first time, the Sixth Baveno Consensus on Portal Hypertension (Baveno VI) recommended using non-invasive tools to rule out the pres...
Source: The Turkish Journal of Gastroenterology - Category: Gastroenterology Authors: Tags: Turk J Gastroenterol Source Type: research
Acute variceal bleeding (AVB) is a common emergency in patients with portal hypertension with a published inpatient mortality risk of 14-43%. It remains unclear whether measures of liver disease severity (liver risk) or upper gastrointestinal bleeding (UGIB) risk stratification scores offer the best predictive power in patients presenting with AVB. AIMS65 is a new risk stratification score validated to predict inpatient mortality. The AIMS65 score assigns 1 point for each of the following: albumin level 1.5, altered mental status, systolic blood pressure 65 years.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Oral abstract Source Type: research
Conclusions: Our new prediction score may be a useful tool in the selection of children with clinically significant varices eligible for a screening endoscopy.
Source: Journal of Pediatric Gastroenterology and Nutrition - Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research
Authors: Campos S, Agostinho C, Cipriano MA Abstract A 48-year old female patient was admitted to the emergency department with upper gastrointestinal bleeding. Endoscopy showed large esophageal varices that were treated with band ligation. She had been treated with cyclophosphamide, melphalan, lenalidomide and corticosteroids for POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy or edema, M protein, skin changes). She had no other risk factors for chronic liver disease. Laboratory and radiological examinations could not confirm the etiology of portal hypertension. The liver biopsy suggested hepatoportal...
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
Abstract The development of liver cirrhosis and portal hypertension (PH), one of its major complications, are structural and functional alterations of the liver, occurring in many patients with chronic liver diseases (CLD). Actually the progressive deposition of hepatic fibrosis has a key role in the prognosis of CLD patients. The subsequent development of PH leads to its major complications, such as ascites, hepatic encephalopathy, variceal bleeding and decompensation. Liver biopsy is still considered the reference standard for the assessment of hepatic fibrosis, whereas the measurement of hepatic vein pressure g...
Source: World Journal of Gastroenterology - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
CONCLUSION: Nonvariceal upper GI bleeding in patients with aALD has clinically important differences from that in the general population without aALD, including: more frequent and more severe bleeding from PUD, DL, or MWS. PMID: 26755890 [PubMed - in process]
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
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