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MFE cu varice Lupii Daciei | Pagina

Bleeding esophageal and gastric varices constitute MFE cu varice serious complication in liver cirrhosis. Previous studies have shown that endoscopic ultrasonography EUS can be used to predict early esophageal variceal bleeding in liver cirrhosis. We report MFE cu varice case of a year-old man with hepatitis B liver cirrhosis CTP score, 5; Child—Pugh class, A who was admitted to our hospital due to a decreased appetite lasting 1 week.

He was initially diagnosed with decompensated hepatitis B cirrhosis; an abdominal computed tomography CT scan indicated a diagnosis of liver cirrhosis and portal hypertension PHT.

Common endoscopic examination showed no evidence of gastroesophageal varices; EUS revealed distinct varices of the esophageal and gastric veins. Six months after discharge, the patient was rehospitalized because of upper gastrointestinal bleeding. Endoscopic ligation was implemented as well as esophageal varices loop ligature EVL. We should strongly recommend that patients with liver cirrhosis undergo EUS in addition to a routine endoscopic examination. EUS can play an important role in evaluating the risk for bleeding in PHT and can be used to assess the efficacy of EVL.

Guoliang Zhang, Digestive Department, Tianjin First Center Hospital, No. The authors wish to thank the Science and Technology Fund of Tianjin City Health and Family Planning Committee KY The study was approved by our institutional review board and written informed consent was obtained from all subjects.

MFE cu varice is an open access article distributed under the Creative Commons Attribution License 4. Bleeding esophageal and gastric varices constitute a digestive emergency with poor MFE cu varice response, numerous complications, and a high death rate. Moreover, bleeding for the first time is one of the most serious complications in patients with hepatic cirrhosis.

Previous research has shown that portal hypertension PHT can cause the occurrence of collateral and perforator veins, as well as varicose veins in the esophagus. After endoscopic treatment, patients with collateral and perforator veins are more likely to experience the recurrence of varicose veins. Since Dimagno, an American physician, first reported on the application of endoscopic ultrasonography EUS for examination of the digestive tract inthe technology has greatly improved.

EUS has mainly been used to determine the origin and nature of submucosal tumors in the digestive tract, determine tumor depth, diagnose pancreatic tumors accurately, and clearly observe the presence of MFE cu varice lesions.

While EUS has been greatly developed in the above areas, the application of EUS in the evaluation of PHT has gradually progressed. Given that EUS can MFE cu varice reveal the esophageal branches and perforating veins, [3] it has been employed by some researchers to predict bleeding and recurrence of varicose veins.

The following case study shows that EUS can be used to predict the risk of esophageal—gastro varicosity. A year-old man with hepatitis B liver cirrhosis CTP score, 5; Child—Pugh class, A was admitted to our hospital due to a decreased appetite lasting a week.

The patient MFE cu varice a family history of liver diseases: Thus, the preliminary diagnosis was decompensated hepatitis B cirrhosis. Inspections after hospitalization had similar results. In addition, an abdominal computed tomography CT varicelor pe forum Tratamentul indicated a diagnosis of liver cirrhosis and PHT.

Common endoscopic examination showed no MFE cu varice of gastroesophageal varices Figs. The patient was discharged after liver-protecting and antiviral treatments. However, 6 months later, the patient was rehospitalized because of upper gastrointestinal bleeding. Emergent endoscopy was performed and revealed bleeding from the rupture of the esophageal varices.

Endoscopic ligation was implemented to prevent active hemorrhage. Fifteen days later, the patient received esophageal varices loop ligature EVL for secondary prevention. After the second treatment, the varicose veins had nearly disappeared. To evaluate the therapeutic effect, we recommended EUS after the treatment; however, the patient refused. The patient was reexamined 6 months later and, as expected, esophageal varices had recurred; EUS showed obvious collateral and perforator veins.

EUS can clearly show each layer of the digestive tract and can detect the remodeling of gastric esophageal varices after PHT. A previous study reported a fold increase per year in MFE cu varice risk of future variceal bleeding for each cubic centimeter increase in the sum of the cross-sectional surface area of all varices in the distal MFE cu varice. Thus, MFE cu varice can play an important role in evaluating the risk for bleeding in PHT.

In addition, EUS can be used to assess the efficacy of EVL. Residual veins in the esophagus wall have been reported to be associated with a high risk of the reoccurrence of varices. In consideration of the high risk of article source, he underwent endoscopy 6 months later, and the recurrence of esophageal varices was observed. The 2 factors leading to the recurrence of esophageal varices are the regeneration of veins within the esophageal mucosa and the repatency of varicose veins.

Although a simple ligation surgery can close varicose veins in the lumen, a quandary exists for the submucosal blood vessels. In addition, the failed previous treatments in the present case suggest that simple ligation does not work very well. It occurred to us that we could have performed sclerosis therapy under ultrasound guidance after MFE cu varice ligation surgery, targetedly and accurately blocking the submucosal vessels and improving the curative effect.

The application of EUS, especially with a high frequency miniature probe, for the accurate detection of the perforating branches and other abnormal blood vessels after the injection of a sclerosing agent has been reported to have a good effect with nu varicele care dar apar advantages over an ordinary endoscope.

However, a study by MFE cu varice et al [11] suggests that Doppler ultrasound of the blood flow is MFE cu varice necessary in treatments involving a penetrating branch MFE cu varice. In addition, fan-shaped scanning EUS has advantages over linear-array endoscopic Doppler ultrasonography.

More small perforating arteries are observed with higher frequency and a wider promotion of sector scanning exists. There are some related statements in the Baveno VI Guideline. While endoscopic surgery requires experienced endoscopists and specialized equipment, EUS has a higher MFE cu varice for the operator. Endoscopic skills, as well as the ability to judge the accuracy of the ultrasound imaging are necessary.

In MFE cu varice, Japan MFE cu varice a standard EUS training program. Although there is no authoritative training program in other locations, many EUS-related articles are published each year.

Because of the high requirements and difficulty in image interpretation, mastering EUS takes time. Some Japanese scholars believe that EUS training for the digestive tract cavity requires 6 months, while that for the gallbladder and pancreatic require one year.

In addition, anesthesia must be administered intravenously as too much water in the esophagus creates difficulties for endoscopic surgery. In selecting the ultrasonic endoscope, a microprobe is more sensitive for the diagnosis of submucosal, perforator, and esophageal varices; fan-shaped scanning endoscopic ultrasound has a lower detection rate.

Esophageal collateral and perforating veins are mainly viewed using an ultrasonic probe. The sensitivity, specificity, and positive and negative predictive values of EUS in the diagnosis of PHT are A disadvantage of EUS is that the more info is not flexible and cannot be combined with see more at the same time.

Furthermore, EUS may cause iatrogenic upper digestive tract hemorrhage in severe esophageal varices. Multislice spiral CT portography MSCTP provides accurate data with fast 3-dimensional reconstruction and a wide range of image acquisition modalities.

MSCTP has a more complete and accurate display of the portal vein and its tributaries for classification than EUS, and can display the spatial relationships with multiangle 3-dimensional levels. MSCTP can be used to detect stenosis, dilation, and filling defects. In addition, MSCTP can be used to measure the diameters of the main portal vein and its branches to effectively predict the upper digestive tract hemorrhage rate. Furthermore, MSCTP can reveal rare collateral circulation, such as a shunt between the spleen and the kidney.

A disadvantage of MSCTP is that the detection of smaller diameter veins is not ideal. MFE cu varice addition, MFE cu varice cannot clearly display the communicating branches between adjacent esophageal and peripheral veins with esophageal varices, and cannot determine the direction of blood flow.

We recommend that patients with early liver cirrhosis undergo EUS, the popularity of which should be strengthened, in addition to a routine endoscopic examination. First, it should be determined whether esophageal and gastric varices are accompanied by the formation of perforating or nonperforating branches. Additional treatments are required for patients with perforating branches as well as for the following cases: With the development of EUS and the wide application of ultrasound probes, our understanding of the pathophysiology of gastroesophageal varices has deepened.

The present study focused on the predictive role played by EUS for evaluating esophagogastric variceal bleeding in the early diagnosis and the recurrence of esophageal and gastric variceal bleeding începutul tratamentului varicelor EVL. Research suggests that EUS cannot only improve treatment check this out and safety, but can also reduce the treatment time and postoperative recurrence or rebleeding rate, thus reducing medical expenses.

In addition, we believe that with the continuous accumulation of technology MFE cu varice experience, EUS will be regarded as a potential method for the diagnosis and MFE cu varice of gastroesophageal varices.

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End Note Procite Reference Manager Save my selection. Endoscopic ultrasonography predicts early esophageal variceal bleeding in liver MFE cu varice April - Volume 96 - Issue 17 ciroza varice hepatica esofagiene in p e Six months see more, EUS MFE cu varice obvious collateral and perforator veins.

Digestive Department, MFE cu varice First Center Hospital, Tianjin, P. The patient has recently shared his experience. The authors have no conflicts of interest to disclose.

Abstract 1 Introduction 2 Case presentation 3 Discussion 4 Conclusion References. Back to Here Article Outline. Wollenman CS, Chason R, Reisch JS, et al. Impact of ethnicity in upper gastrointestinal haemorrhage. J Clin Gastroenterol ; View Full Text PubMed CrossRef. Masalaite L, Valantinas J, Stanaitis J. The role of collateral veins detected by endosonography in predicting the recurrence of esophageal varices after endoscopic treatment: Endoscopic ultrasound in the diagnosis and treatment of upper digestive bleeding: J Gastrointestin Liver Dis ; Miller L, Banson FL, Continue reading K, et al.

Risk of esophageal variceal bleeding based on endoscopic ultrasound evaluation of the sum of esophageal variceal cross sectional surface area. Am J Gastroenterol ; Sato T, Yamazaki K, Toyota J, et al. Endoscopic ultrasonographic evaluation of hemodynamics related to variceal relapse in esophageal variceal patients. Kume K, Yamasaki M, Watanabe T, et al. Mild Collateral varices and a fundic plexus without perforating veins on EUS predict endoscopic non-recurrence of esophageal varices after EVL.

Lahbabi M, Mellouki I, Aqodad N, et al. Esophageal variceal ligation in the secondary prevention of variceal bleeding: Pan Afr Med J ; Endoscopic ultrasound EUS for esophageal and gastric varices: J Clin Exp Hepatol ;2: Romero Castro R, Pellicer-Bautista F, Giovannini M, et al. Endoscopic ultrasound guided coil embolization therapy in gastric varices.

Lahoti S, Catalano MF, Alcocer E, et al. Obliteration of esophageal varices using EUS-guided sclerotherapy with color Doppler. Lee YT, Chen FK, Ching JY, et al. Diagnosis of gasrtoesophageal varices and portal MFE cu varice venous abnormalities by endosonography in cirrhotic patients. Expanding consensus in portal hypertension: Stratifying risk and individualizing care for portal hypertension. Wang AJ, Li BM, Zheng XL, et al. Utility of endoscopic ultrasound in the diagnosis and management of esophagogastric varices.

Endoscopic ultrasonographic signs of portal hypertension in cirrhosis. He W, Yu SX, He Q. Multi slice CT portal venography in diagnosing liver cirrhosis with portal hypertension.

Med Imaging Tech ; Kang HK, Jeong MFE cu varice, Choi JH, et al. Three-dimensional multi detector row CT portal venography in the evaluation of portal systemic collateral vessels in liver cirrhosis. Kim YJ, Raman SS, Yu NC, et al. Esophageal varices in cirrhotic patients: AJR Am J Roentgenol, Email to a Colleague. Separate multiple e-mails with a. Thought you might appreciate this item s I saw at Medicine.

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