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British Medical Journal Sep 1976
Topics: Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Humans; Liver Cirrhosis
PubMed: 1085648
DOI: No ID Found -
Pediatrics and Neonatology May 2021
Topics: Child; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Humans; Hypertension, Portal; Ligation; Liver Cirrhosis; Primary Prevention
PubMed: 33941345
DOI: 10.1016/j.pedneo.2021.04.005 -
The British Journal of Surgery Sep 2020In patients who undergo curative treatment for oesophageal cancer, risk estimates of venous thromboembolism (VTE), arterial thromboembolism and bleeding are needed to...
BACKGROUND
In patients who undergo curative treatment for oesophageal cancer, risk estimates of venous thromboembolism (VTE), arterial thromboembolism and bleeding are needed to guide decisions about thromboprophylaxis.
METHODS
This was a single-centre, retrospective cohort study of patients with stage I-III oesophageal cancer who received neoadjuvant chemoradiation followed by oesophagectomy. The outcomes VTE, arterial thromboembolism, major bleeding, clinically relevant non-major bleeding and mortality were analysed for four consecutive cancer treatment stages (from diagnosis to neoadjuvant chemoradiotherapy, during neoadjuvant treatment, 30-day postoperative period, and up to 6 months after postoperative period).
RESULTS
Some 511 patients were included. The 2-year survival rate was 67·3 (95 per cent c.i. 63·2 to 71·7) per cent. During the 2-year follow-up, 50 patients (9·8 per cent) developed VTE, 20 (3·9 per cent) arterial thromboembolism, 21 (4·1 per cent) major bleeding and 30 (5·9 per cent) clinically relevant non-major bleeding. The risk of these events was substantial at all treatment stages. Despite 30-day postoperative thromboprophylaxis, 17 patients (3·3 per cent) developed VTE after surgery. Patients with VTE had worse survival (time-varying hazard ratio 1·81, 95 per cent c.i. 1·25 to 2·64). Most bleeding events occurred around the time of medical intervention, and approximately one-half during concomitant use of prophylactic or therapeutic anticoagulation.
CONCLUSION
Patients with oesophageal cancer undergoing neoadjuvant chemoradiotherapy and surgery are at substantial risk of thromboembolic and bleeding events throughout all stages of treatment. Survival is worse in patients with thromboembolic events during follow-up.
Topics: Adenocarcinoma; Aged; Anticoagulants; Carcinoma, Squamous Cell; Chemoradiotherapy; Cohort Studies; Esophageal Neoplasms; Esophagectomy; Female; Follow-Up Studies; Hemorrhage; Humans; Male; Middle Aged; Nadroparin; Neoadjuvant Therapy; Retrospective Studies; Thromboembolism
PubMed: 32424862
DOI: 10.1002/bjs.11665 -
BMC Gastroenterology Oct 2022Portal hypertensive gastropathy (PHG) is often underestimated in clinical diagnosis. Gastrointestinal bleeding in cirrhosis of PHG accounts for approximately 10% of...
BACKGROUND
Portal hypertensive gastropathy (PHG) is often underestimated in clinical diagnosis. Gastrointestinal bleeding in cirrhosis of PHG accounts for approximately 10% of upper gastrointestinal bleeding. However, the relationship between PHG and gender, laboratory parameters, liver function and varices is still controversial. In the present study, we aimed to retrospectively evaluate the incidence of PHG and to explore the relationship between PHG and gender, laboratory parameters, liver function and varicose veins.
METHODS
A retrospective analysis of 325 patients with cirrhosis who underwent esophagogastroduodenoscopy (EGD) in the Department of Gastroenterology of the Second Hospital of Hebei Medical University from 1 January 2018 to 31 December 2020 was performed. The relationships among age, gender, laboratory parameters, Child-Pugh stage, oesophageal varices (EV), gastric varices (GV) and ascites with PHG were analysed with univariate and multivariate logistic regression.
RESULTS
The occurrence of PHG was significantly associated with gender, haemoglobin, platelet count, prothrombin time, albumin, Child-Pugh stage, EV, GV and ascites (P < 0.05). Furthermore, there was a positive correlation between the severity of PHG and the degree of EV, GV and ascites (P < 0.05). Multivariate logistic regression showed that albumin, EV and GV levels were independently associated with the occurrence of PHG.
CONCLUSION
The incidence of PHG in cirrhosis was 87.4% in this study. The occurrence of PHG was related to gender, haemoglobin, platelet count, prothrombin time, albumin, Child-Pugh stage, EV, GV and ascites. Albumin, the degree of EV and GV are independent risk factors for the occurrence of PHG.
Topics: Albumins; Ascites; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Humans; Hypertension, Portal; Liver Cirrhosis; Retrospective Studies; Risk Factors; Stomach Diseases
PubMed: 36241992
DOI: 10.1186/s12876-022-02468-7 -
The Yale Journal of Biology and Medicine 1984Gastrointestinal hemorrhage in infants and children is a catastrophic event but is not associated with significant mortality except in those with a severe primary... (Review)
Review
Gastrointestinal hemorrhage in infants and children is a catastrophic event but is not associated with significant mortality except in those with a severe primary illness. Upper gastrointestinal bleeding in infants and young children is most often associated with stress ulcers or erosions, but in older children it may also be caused by duodenal ulcer, esophagitis, and esophageal varices. Lower gastrointestinal bleeding may be caused by a variety of lesions among which are infectious colitides, Meckel's diverticulum, bleeding disorders, gastrointestinal allergy, and inflammatory bowel disease. Techniques of diagnosis and management are discussed.
Topics: Adolescent; Child; Child, Preschool; Colitis; Colonic Neoplasms; Duodenitis; Esophageal and Gastric Varices; Esophagitis; Gastrointestinal Hemorrhage; Humans; Infant; Infant, Newborn; Intestinal Polyps; Intussusception; Meckel Diverticulum; Peptic Ulcer; Peptic Ulcer Hemorrhage; Rectum; Stress, Physiological
PubMed: 6382833
DOI: No ID Found -
The Korean Journal of Gastroenterology... Sep 2021Varices are a frequent complication of liver cirrhosis and a major cause of mortality in patients with liver cirrhosis. Patients with decompensated cirrhosis... (Review)
Review
Varices are a frequent complication of liver cirrhosis and a major cause of mortality in patients with liver cirrhosis. Patients with decompensated cirrhosis complications have a poor prognosis and require careful management. Portal hypertension is the most common complication of liver cirrhosis, which is the key determinant for varices development. Increased intrahepatic vascular resistance to portal flow leads to the development of portal hypertension. Collateral vessels develop at the communication site between the systemic and portal circulation with the progression of portal hypertension. Varices are the representative collaterals, develop gradually with the progression of portal hypertension and may eventually rupture. Variceal bleeding is a major consequence of portal hypertension and causes the death of cirrhotic patients. The present paper reviews the latest knowledge regarding the diagnosis and management of esophageal and gastric variceal bleeding.
Topics: Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Humans; Hypertension, Portal; Liver Cirrhosis
PubMed: 34565784
DOI: 10.4166/kjg.2021.113 -
World Journal of Gastroenterology Mar 2012Portal hypertension can be caused by a wide variety of conditions. It frequently presents with bleeding from esophageal varices. The approach to acute variceal... (Review)
Review
Portal hypertension can be caused by a wide variety of conditions. It frequently presents with bleeding from esophageal varices. The approach to acute variceal hemorrhage in children is a stepwise progression from least invasive to most invasive. Management of acute variceal bleeding is straightforward. But data on primary prophylaxis and long term management prevention of recurrent variceal bleeding in children is scarce, therefore prospective multicenter trials are needed to establish best practices.
Topics: Child; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Hemodynamics; Humans; Hypertension, Portal; Splenomegaly
PubMed: 22468080
DOI: 10.3748/wjg.v18.i11.1176 -
The Western Journal of Medicine Oct 1986Endoscopic sclerotherapy remains an uncertain therapy for bleeding esophageal varices. Several recently reported randomized trials address the efficacy of immediate,... (Clinical Trial)
Clinical Trial Review
Endoscopic sclerotherapy remains an uncertain therapy for bleeding esophageal varices. Several recently reported randomized trials address the efficacy of immediate, long-term and prophylactic sclerotherapy. Analysis of these studies suggests that sclerotherapy may stop acute bleeding but has little impact on survival of an acute bleeding episode. Ongoing sclerosis reduces the incidence of rebleeding episodes and improves survival for those patients fortunate enough to survive the acute bleeding episode. Prophylactic therapy is an exciting concept limited by difficulty in identifying "high-risk" patients and by the high rate of complications associated with sclerotherapy.
Topics: Clinical Trials as Topic; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Humans; Random Allocation; Sclerosing Solutions
PubMed: 3538660
DOI: No ID Found -
Postgraduate Medical Journal Jun 1981This report of oesophageal peptic ulceration communicating with the thoracic aorta, successfully treated, illustrates the importance of prompt recognition of major...
This report of oesophageal peptic ulceration communicating with the thoracic aorta, successfully treated, illustrates the importance of prompt recognition of major bleeding and early repair.
Topics: Adult; Aorta, Thoracic; Aortic Diseases; Esophageal Fistula; Fistula; Humans; Male; Peptic Ulcer Hemorrhage
PubMed: 7301685
DOI: 10.1136/pgmj.57.668.380 -
Postgraduate Medical Journal Jan 2002A variety of endoscopic haemostatic techniques have enabled major advances in the management of not only bleeding peptic ulcers and bleeding varices, but also in a... (Review)
Review
A variety of endoscopic haemostatic techniques have enabled major advances in the management of not only bleeding peptic ulcers and bleeding varices, but also in a variety of bleeding lesions in the small intestine and in the colon. Indeed, the development and widespread implementation of endoscopic haemostasis has been one of the most important developments in clinical gastroenterology in the past two decades. An increasingly ageing cohort of patients with multiple co-morbidity are being treated and therefore improving the outcome of gastrointestinal bleeding continues to pose major challenges.
Topics: Acute Disease; Algorithms; Chronic Disease; Colonic Diseases; Endoscopy, Gastrointestinal; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Humans; Intestine, Small; Peptic Ulcer Hemorrhage; Prognosis; Recurrence; Resuscitation
PubMed: 11796865
DOI: 10.1136/pmj.78.915.4