Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Some complications of liver transplantation appear as aspecific clinical and blood test abnormalities; others--e.g., hepatic artery thrombosis in the immediate postoperative period and stenosis of the biliary anastomosis before T-tube removal--require early diagnosis. These considerations justify the need of frequent radiologic examination in both the complicated course and the follow-up. The authors report their experience in 59 adult patients submitted to liver transplantation for irreversible liver disease in advanced stage (49 with cirrhosis, 10 with HCC; 5 with cholestatic hepatopathy; 3 with fulminant hepatitis; 1 with Budd-Chiari syndrome; 1 with metastatic APUDoma). Two hundred and sixty-three radiological examinations were performed (Doppler US, CT, angiography and cholangiography) which showed numerous early and delayed complications: 13 of them were treated with interventional radiology maneuvers (US-or CT-guided percutaneous drainage of fluid collections, biliary drainage, bilioplasty, arterial transcatheter embolization). Our results demonstrate that diagnostic and operative radiology are essential for the success of liver transplantation; integrated imaging is particularly important in the diagnosis of complications, while interventional radiology techniques can be usefully employed in their treatment.
 ...
PMID:[Liver transplantation: role of the radiologic methods in the postoperative period]. 145 22

A total of 508 patients had an non-decompression surgery for esophago-gastric varices in our department, from September 1979 to December 1991. These patients consisted of 387 cases of transthoracic esophageal transection with para-esophagogastric devascularization, 40 cases of transabdominal esophageal transection, and 81 cases of Hassab procedure. The original diseases were cirrhosis in 432 patients, IPH in 35, extrahepatic-portal occlusion in 24, primary biliary cirrhosis in 6, Budd-Chiari syndrome in 4, and others in 7. Operative mortality rate was 5.3%. By thoracic approach, esophageal varices completely disappeared. Postoperative cumulative variceal recurrence and bleeding rates at 10 years were 12% and 7%, although recurrence occurred more often than not in cases with hepatocellular carcinoma (HCC). Cumulative survival rates at 5, 10 years were 69%, 46% in liver cirrhosis without HCC. Present study confirmed that our non-decompression surgery is effective in controlling esophagogastric varices in long term of periods.
 ...
PMID:[Results of non-decompression surgery for esophago-gastric varices--postoperative disappearance, recurrence, rebleeding rate of varices, and cumulative survival rate]. 147 Jan 35

Portal hypertensive gastropathy (PGP) is an important cause of bleeding in portal hypertension patients. Although hyperdynamic congestion seems to be the underlying mechanism, the factors that influence the development of PGP are not understood. To investigate these, 107 patients [cirrhosis, 35; noncirrhotic portal fibrosis (NCPF), 24; extrahepatic portal vein obstruction (EHPVO), 46; Budd-Chiari syndrome, 2] were prospectively studied. Eighty-three patients had Child's A, 17 had Child's B, and 7 had Child's C liver disease. Before sclerotherapy, although intravariceal pressure was similar, 4 cirrhosis patients (3.7%) but no NCPF or EHPVO patients had PGP. After sclerotherapy, 21 additional patients (20.3%) developed PGP during a follow-up of 23.2 +/- 3.4 months (range, 1-52). The incidence of PGP was higher in cirrhotic patients (37.1%) than in NCPF (16.7%; P less than 0.05) or EHPVO (8.7%; P less than 0.01) patients. The probability of developing PGP among all patients at the end of 52 months of follow-up was 30%, more in cirrhosis than in EHPVO (55% vs. 15%; P less than 0.005). Only 2 patients bled from PGP during follow-up. Development of PGP correlated with severity of liver disease, being more common in Child's C than Child's A patients (87% vs. 13%; P less than 0.001). PGP was seen more often in patients with gastroesophageal varices than in patients with esophageal varices alone (42% vs. 11%; P less than 0.01). In conclusion, the results show that development of PGP is significantly influenced by sclerotherapy, severity of liver disease, etiology of portal hypertension, coexisting gastric varices and is not directly correlated with intravariceal pressure.
 ...
PMID:Factors influencing development of portal hypertensive gastropathy in patients with portal hypertension. 145 93

We have analyzed the indications and results of shunt operation versus orthotopic liver transplantation (OLT) in 22 patients with Budd-Chiari syndrome (BCS). The underlying cause of the syndrome was similar between the two groups and was related to myeloproliferative disorders or the use of birth control pills in 18 of 22 patients. The results of biopsies of the liver showed centrilobular congestion and necrosis in all candidates who underwent shunting and the presence of fibrosis and cirrhosis in the OLT candidates. The indications for shunts included symptoms related to portal hypertension only and well-preserved synthetic hepatic function. Ten patients were treated with 12 shunt procedures, including mesoatrial (eight patients) and side to side portacaval shunt (four patients). Significant complications after shunt procedure included fulminant (one of ten patients) and progressive (one of ten patients) hepatic failure requiring urgent OLT; one death occurred because of pulmonary sepsis. Indications for OLT were signs of end stage liver expressed by severe portal hypertension and variceal bleeding (four of 14 patients), progressive encephalopathy (seven of 14 patients) and poor synthetic function (bilirubin greater than 3 milligrams per deciliter in eight of 14 patients and albumin less than 3.0 grams per liter, or both, in ten of 14 patients). Fourteen patients were treated with 16 OLT, three patients had retransplantation for primary nonfunction graft (two of 14 patients) or chronic rejection (one of 14 patients). There were two early deaths in the group. With a follow-up period between two months to five years, 12 of 14 patients undergoing OLT are alive, fully functional and have normal liver function tests. Seven of ten patients who had shunts are alive, six are able to maintain normal activity and one has progressive end stage hepatic disease and is not a candidate for OLT. However, the hepatic function continues progressively to be abnormal. Various options are available for the treatment of the syndrome. Portosystemic decompression is effective and should be considered at the early stage of the disease, prior to the development of significant hepatic failure. However, few of the patients will continue to have slow, but progressive hepatic failure and may require OLT. The only effective treatment for end stage hepatic disease secondary to the BCS is OLT.
 ...
PMID:Portosystemic shunt versus orthotopic liver transplantation for the Budd-Chiari syndrome. 159 20

Budd-Chiari syndrome is an unusual form of portal hypertension caused by liver cirrhosis. Its mortality rate exceeds 50% within 2 years. Surgical therapy provides superior survival rates than conservative medical management. During 1984-1989, 58 cases of Budd-Chiari syndrome were treated at PUMC hospital. The age of these patients ranged from 16 to 62. There were 39 males and 19 females. Diagnosis was mostly made by simultaneous inferior and superior Vena Cavography and one case was diagnosed by liver biopsy. Intraluminal pressure measurement of IVC and diameter measurement of IVC by Doppler ultrasound method were used for diagnosis. Preoperative intraluminal mean pressure of IVC in 26 cases was 3.2 +/- 0.6 kPa and it decreased to 1.9 +/- 0.6 kPa postoperatively. (P less than 0.01) Digital membranotomy through right atrium was done in 34 cases, percutaneous balloon catheter dilatation in 7 cases and Meso-atrial shunt, inferior Vena Cava Atrial shunt were performed in 20 cases. Postoperative improvement was found in 85% of the patients during the follow-up period (from 2-60 months).
 ...
PMID:[A report on 53 cases of Budd-Chiari syndrome]. 164 26

There are three types of disorders which may produce jaundice during pregnancy: 1) acute or chronic coexistent or pre-existent liver disease (acute and chronic hepatitis, liver cirrhosis etc.), 2) acute and chronic hemolytic disorders, 3) jaundice directly or indirectly related to pregnancy. Among the later group, intrahepatic cholostasis, gravidic hyperemesis with jaundice represent exacerbations of physiologic gravidic cholostasis. Hepatic steatoses of pregnancy are the result of toxic metabolites or drugs on the liver parenchyma. Severe forms of eclampsia may induce jaundice of hemolytic and parenchymal origin. Hypercoagulability may also induce, in the first post-partum days Budd-Chiari's syndrome with accompanying jaundice.
 ...
PMID:[Jaundices in pregnancy]. 179 74

The usefulness of Doppler blood flow ultrasonography in diagnosis of some liver diseases was investigated. Normal subjects and patients with AH and CPH had no blood flow signal on their abdominal wall and their femoral veins were normal. One (5%) of 20 patients with CAH was found to have blood flow signals on abdominal wall and the direction of the flow was normal, suggesting that collateral circulation has been established due to portal hypertension as a result of liver cirrhosis. 12 out of 20 cases of liver cirrhosis with no varices on abdominal wall had blood flow signals on their abdominal wall and the direction of the flow was normal. One case of Budd-Chiari syndrome with occlusion of hepatic vein and inferior vena cava showed blood flow signal on his abdominal wall and the direction of the flow was abnormal. One case of constrictive pericarditis showed abnormal blood flow in the femoral veins. In conclusion, this method is highly useful for the diagnosis and differential diagnosis of portal hypertension of cirrhosis and Budd-Chiari syndrome. It is also of help for the diagnosis of pericarditis and some other vascular deformity.
 ...
PMID:[Usefulness of Doppler blood flow ultrasonography in diagnosis of liver diseases]. 183 17

A case of the Budd-Chiari syndrome due to a web of the hepatic inferior vena cava (IVC) is reported. A 54-year-old male with mild liver dysfunction was suspected with IVC obstruction from the screening CT which revealed liver cirrhosis with marked caudate lobe enlargement and dilatation of azygous and hemiazygous vein. Subsequent radionuclide cavography with 99mTc-HSA clearly demonstrated IVC obstruction, but failed to clarify the site or type of the obstruction. Finally contrast cavography diagnosed a web of the hepatic IVC, which was treated by percutaneous transluminal angioplasty (PTA). During two-year follow-up after PTA none of the radionuclide cavographies showed reocclusion of the IVC and as a result contrast cavography was avoided. Radionuclide cavography, therefore, was a useful method for evaluating IVC obstruction before and after PTA for the Budd-Chiari web.
 ...
PMID:[Radionuclide cavography before and after percutaneous transluminal angioplasty in Budd-Chiari web: case report]. 189 61

Over 12 years, 22 patients with the Budd-Chiari syndrome were treated surgically. Eighteen underwent a mesenterico-caval shunt (MCS); two, a side-to-side portacaval shunt; one, a mesenterico-atrial shunt (MAS); and one, a liver transplantation (OLT). One patient died after operation from the precipitating condition, and two MCS grafts that thrombosed were restored. All 21 surviving patients remain well, free from ascites, and all shunts are patent after a mean follow-up of 5.6 +/- 1 years, five patients with more than 10 years' follow-up. This long-term survival achieved by portasystemic shunts suggests that they have a major role in the treatment of the Budd-Chiari syndrome. The authors prefer the mesenterico-caval shunt using a jugular graft. This ensures a total portasystemic shunt, avoids subhepatic surgery, and reduces the long-term risk of prosthetic graft thrombosis. The MAS was reserved for cases with complete caval thrombosis. Patients with significant degrees of caval compression were satisfactorily decompressed by MCS. In patients not promptly treated, the disease progresses to cirrhosis, and such patients must be evaluated for transplantation similarly to those with other hepatopathies.
 ...
PMID:Portasystemic shunting versus liver transplantation for the Budd-Chiari syndrome. 195 11

The sex-specific and age-specific incidence rates of the major parenchymal liver diseases in a North European population were estimated using a computerized registry of all admissions to somatic hospitals in Denmark. The incidence was calculated by counting all incident cases of these diseases reported to the registry in the 5-yr period 1981 to 1985 and dividing the number of cases by the number of person-years at risk in this period. The incidence rates (per million person-years) were for men and women, respectively: infectious hepatitis, 109 and 71; toxic hepatitis, 19 and 22; chronic hepatitis, 27 and 29; alcoholic cirrhosis, 190 and 85; nonalcoholic nonbiliary cirrhosis, 110 and 82; primary biliary cirrhosis, 4 and 14. The pattern of the age-specific incidence rates was similar in men and women in infectious hepatitis, alcoholic cirrhosis, nonalcoholic nonbiliary cirrhosis and primary biliary cirrhosis. Toxic and chronic hepatitis had a higher incidence in women than in men only in older age groups. The incidence of idiopathic hemochromatosis, Wilson's disease, secondary biliary cirrhosis, portal vein thrombosis and Budd-Chiari's syndrome were less than four in both sexes.
 ...
PMID:Incidence of parenchymal liver diseases in Denmark, 1981 to 1985: analysis of hospitalization registry data. The Danish Association for the Study of the Liver. 201 Jan 59


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>