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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors report here a case of antral hemorrhagic gastritis without ulceration nor erosion, but with intravascular coagulation within the chorionic layer, which had a prolonged course in a patient with non-alcoholic cirrhosis, and which continued in spite of surgical cure of portal hypertension. The authors discuss various theories which might explain this hemorrhage and the development of localised intravascular coagulation, together with its relationship with the cirrhosis.
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PMID:[Hemorrhagic gastritis caused by localised intravascular coagulation during the course of cryptogenic inflammatory cirrhosis]. 17 74

Forty-three patients with cirrhosis and ascites, 21 with normal renal function, 10 with a progressive functional renal failure (FRF), and 12 with a steady FRF, were investigated for the presence of endotoxaemia by the Limulus lysate test. Endotoxaemia was found in nine patients with FRF and in none of the 21 with normal renal function (P less than 0-01). A positive Limulus test was almost exclusively associated with a progressive FRF (eight of 10 patients) and all but one of them died. Renal function improved as endotoxaemia disappeared in the survivor. Endotoxaemia was also associated with haemorrhage due to acute erosions of the gastric mucosa, being present in six of the seven patients who had this complication. Intravascular coagulation was not found in any patient. The Limulus test was positive in the ascitic fluid in 18 of 21 patients tested, although only two of them had peritonitis. These results suggest that endotoxaemia may play a critical role in the development of progressive renal failure and haemorrhagic gastritis in cirrhosis, and emphasise the potential risk of procedures involving reinfusion of ascitic fluid.
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PMID:Functional renal failure and haemorrhagic gastritis associated with endotoxaemia in cirrhosis. 30 85

It is generally accepted that the bile acids are responsible for pathologies as a result of deficiency or by toxic action. Quantitative deficiency is difficult to evaluate but the normal pool of bile acids is generally considered to be between 2 and4 grams. Daily loss and replacement by synthesis is thought to be between 500 and 700 mg. There is experimental evidence to demonstrate the toxic action of certain bile acids on metabolic structures and processes. There is no doubt that alterations in the metabolism of bile acids give rise to certain pathologic aspects in some diseases of the gastrointestinal tract or the hepatobiliary system. There are other conditions, on the other hand, in which the study of these acids may reveal significant physiopathologic implications. The first group includes terminal ileopathy, blind loop syndrome, gastric ulcer, gastritis, cholestasis, cirrhosis of the liver, and cholelithiasis. In the second group are such diverse conditions as acute pancreatitis, cancer of the colon, endocrine disturbances, some hyperlipidemias, and others. Much of the present day understanding of the physiopathology of the bile acids will probably have to be revised in the nex few years, in view of the rapid advances being made in this field.
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PMID:[Bile acids II. Physiopathologic and clinical aspects (author's transl)]. 47 Apr 97

Eight cases of phlegmonous enterocolitis which involved the small intestine exclusively in 5 patients, colon exclusively in 2, and both small intestine and colon in one are reported. Seven of the cases were studied at autopsy. The intestinal lesion was clearly the cause of death in 3 patients and was probably a secondary finding in 4 others. In one case, the cecum was involved and this segment was surgically resected. Five of the patients gave a history of alcoholism. The livers of the 7 patients studied at autopsy were all abnormal; cirrhosis was present in 4, severe fatty metamorphosis in 2, and moderate fatty metamorphosis in 1. The clinical, morphological, and bacteriological aspects of phlegmonous gastritis and phlegmonous enterocolitis are similar, and these two conditions are thought to represent the same infectious disease involving different levels of the gastrointestinal tract. In most patients the factor(s) predisposing to infection of the gastric and intestinal wall are unknown. In some patients mucosal injury of varied type and septicemia appear to have been the forerunners of the phlegmonous lesion. The possible relationships of ischemic bowel injury, alcoholism, and liver disease to phlegmonous inflammation of the gastrointestinal tract are discussed.
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PMID:Phlegmonous enterocolitis. 66 13

The net ionic flux through the gastric wall was determined in eleven patients with hepatic cirrhosis and five normal controls. The back-diffusion of C1- and H+ was significantly increased in the cirrhotic group. In nine patients of this group the H+ loss was above the upper limits of normal. The Na+ flux was positive in both the control and the cirrhotic group. The Na+ flux towards the gastric cavity in the cirrhotic patients was not proportional to the loss of H+. Vasodilatation and edema of the lamina propria was always present as judged by gastric biopsy; in five cases mucosal hemorrhage was observed, in three superficial epithelial desquamation and in one melaena due to hemorrhagic gastritis. One the basis of the increase in H+ loss and the histological findings, we suspect an alteration in the gastric mucosal barrier in the patients with hepatic cirrhosis.
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PMID:Functional study of the gastric mucosal barrier in hepatic cirrhosis. 98 63

A prothrombin complex concentrate was used in attempts to control life-threatening hemorrhage in 4 patients with chronic liver disease. The population manifested profuse bleeding from varices and/or hemorrhagic gastritis; 3 had Laennec's cirrhosis and 1 had postnecrotic cirrhosis from childhood hepatitis. In all patients the complex was given in amounts needed to raise the prothrombin (factor II) level to approximately 100% of normal. In all 4 cases the prothrombin time and prothrombin complex factors approached normal within 1-2 hr after beginning the infusion. In all patients bleeding ceased with correction of the clotting status. One patient rebled several hours after completing the infusion. In several patients, increases in factors V and VIII were noted following infusion of the concentrate. A further unexpected finding was a spontaneous increase in factors II and IX at 3 days postinfusion. Prothrombin complex concentrate appears to be useful in controlling the hemorrhage of chronic liver disease when used alone or in combination with other modalities to correct specific hemostatic defects; however, patients may be expected to rebleed when the effect of the concentrate wears off. Its use, therefore, should probably be restricted to those patients who are to undergo corrective surgery of the bleeding point once hemostasis is achieved.
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PMID:Prothrombin complex concentrate: use in controlling the hemorrhagic diathesis of chronic liver disease. 108 Mar 55

Upper gastrointestinal bleeding from isolated duodenal varices is a rare occurrence. We report the case of a patient with idiopathic duodenal varices in whom the diagnosis was established preoperatively by endoscopy. The patient did not have esophageal varices or portal hypertension, and he was treated by exicising the varix with a full thickness of duodenal wall. Bleeding has not recurred. Duodenal varices as well as duodenal ulcer and gastritis must be considered in evaluating a patient with cirrhosis and upper gastrointestinal bleeding.
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PMID:Duodenal varices. 125 52

Phlegmonous inflammation of the digestive tract is a rare lesion related in the majority of the previously described cases to systemic infections and chronic hepatic diseases. Both process may promote gastric and intestinal loss of the mucosal local defenses mechanisms against bacterial invasion. The term phlegmonous enterocolitis or gastritis defines an acute inflammatory process with purulent or nonpurulent character, that selectively damages the gastric, small and large intestines submucosal layer. The intestinal lesions are more frequently located in the small portion, followed by the colonic involvement. In the present paper we describe the postmortem findings and clinical course of a case with phlegmonous colitis in a 53 years old woman with cirrhosis and S pneumoniae septicemia.
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PMID:[Phlegmonous colitis]. 130 6

We endoscopically investigated gastric microcirculation using a laser-Doppler flowmeter and acute gastric mucosal lesions (AGML) during a 3-year follow-up period in patients with hepatic cirrhosis. Gastric microcirculation tends to decrease in patients with hepatic cirrhosis, especially when gastric mucosal hemorrhage or mucosal petechiae are observed endoscopically. Total gastric resection was performed for gastric hemorrhage due to AGML in three patients, two of whom had good liver function--Child's grade A--and survived more than 5 years with a good quality of life, but one patient with Child's grade C experienced poor quality of life and died within 2 years after surgery. We conclude that decreased gastric microcirculation plays a role in the occurrence of AGML in patients with hepatic cirrhosis. Total gastric resection should be carefully considered for hemorrhagic gastritis in patients with Child's grade C hepatic cirrhosis.
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PMID:Gastric microcirculation and acute gastric mucosal lesions in patients with hepatic cirrhosis. 150 96

Antral vascular ectasia (watermelon stomach) is an uncommon localised vascular abnormality which may cause occult gastrointestinal blood loss and iron deficiency anaemia. The endoscopic appearances are characteristic with well demarcated, often raised or nodular bright red streaks radiating from the pylorus back along the antrum. Endoscopic biopsies can be taken without risk of haemorrhage and may help distinguish this condition from gastritis. The aetiology remains obscure, but there is an association with achlorhydria, hypergastrinaemia, and cirrhosis of the liver. Four patients are described; two had antrectomy with long term control of their anaemia, and two were treated conservatively. The lesion may be diagnosed more frequently with more widespread recognition of the condition.
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PMID:Antral vascular ectasia: the watermelon stomach. 150 52


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