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

Circulating insulin was determined by radioimmunoassay in ten children with cirrhosis of the liver and in 6 age-matched controls. They were found to be elevated in cirrhotics during fasting as well as at 1/2, 1, 1 1/2 and 2 h during the oral glucose tolerance test. These determinations were also carried out in two children with extrahepatic portal hypertension to show the possible role of portal systemic shunts for the elevated serum insulin levels. We believe that the hyperinsulinemia of these patients was related to decreased insulin degradation by the liver as well as to portal-systemic shunting.
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PMID:Hyperinsulinemia in childhood cirrhosis. 73 3

Meso-renal shunt (MRS) has been designed for patients with biliary cirrhosis and portal hypertension, in whom the derivation of the portal flow must be done prior to the biliary surgery. We performed the MRS in five patients. In three due to secondary biliary cirrhosis, one case due to criptogenic cirrhosis and the last presenting cavernomatous degeneration of the portal vein. After the MRS one patient died 33 days later due to acute liver failure and hepatorenal syndrome. Of the survivors three are enjoying normal lifestyle, one of them was underwent colecistectomy and coledocostomy without any surgical problems. One patient was lost to follow up out presenting at that time chronic porta-systemic encephalopathy. When necessary the MRS may offer a satisfactory choice, since can be performed far from the subhepatic area, thus allowing to perform further biliary surgery.
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PMID:[Meso-renal derivation. A surgical alternative in the treatment of portal hypertension]. 74 Nov 43

A new operation for the treatment of cirrhosis and portal hypertension has recently been described involving arterialization of the portal vein in combination with an end-to-side portacaval shunt. We present, for the first time, the appearances at wedge hepatic venography. No significant change is seen in the wedge hapatic pressure as a result of this technique, and the sinusoidal pattern is preserved. Filling of the portosplanchnic collaterals is not as frequent as after end-to-side shunts alone, and the appearances seem to reflect improved sinusoidal perfusion. The clinical results have been encouraging.
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PMID:Arterialization of the portal vein in cirrhosis: the findings at wedge hepatic venography. 74 21

The value of emergency upper gastrointestinal fibre-endoscopy, followed where required by the use of a modified Sengstaken tube, was studied during 84 episodes of acute bleeding in 75 patients who had evidence of portal hypertension with varices. The portal hypertension was due to alcoholic cirrhosis in 80% and to cryptogenic cirrhosis in 9% of the patients. By definition, varices were present in all patients, but in only 66% of episodes were the varices the cause of the bleed. The correct diagnosis of the source of bleeding was made at endoscopy in 89%. A Boyce modification of the Sengstaken-Blakemore tube was passed in 73% of the episodes of variceal bleeding. It effectively stopped the bleeding primarily in 85% of patients but was successful as a final definitive measure only in 46%. Furthermore, only 40% of the patients in whom the tube was passed, survived. Mortality rate could be related to the severity of the bleed and to hepatocellular dysfunction. Survival increased from 23% in those patients with jaundice, ascites, and encephalopathy on admission to 92% in those without these manifestations. The in-hospital survival rate was 52% in patients bleeding from varices and 64% in those bleeding from other causes, with an overall survival rate of 56%, indicating the poor prognosis in cirrhotic patients with gastrointestinal bleeding, irrespective of the cause.
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PMID:Fibreoptic endoscopy and the use of the Sengstaken tube in acute gastrointestinal haemorrhage in patients with portal hypertension and varices. 77 87

Oral glucose tolerance tests (100 g glucose) and the intravenous tolbutamide test were carried out. The glucose tolerance was seen to be disordered even in acute infectious hepatitis, but returning to normal when cured. If chronic hepatitis develops, however, the proportion of manifest diabetes increases to 7.2% in chronic persistent hepatitis and to 16.3% in chronic progressive hepatitis, while 30% each have latent diabetes. The glucose tolerance is most impaired in fatty liver (stage III) and in active cirrhosis of the liver with portal hypertension, where more than half of all patients present manifest or latent diabetes. Conversely, glucose tolerance improves even in chronic hepatitis and in cirrhosis of the liver as the inflammatory activity subsides. The main cause for the development of "liver diabetes" is therefore likely to be the activity of the inflammatory process, the extent of portal hypertension, disorders of glucose regulation in the liver and the increased insulin inactivation in the cirrhotic liver.
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PMID:[Disorders of glucose tolerance in 2600 histologically confirmed acute and chronic liver patients (author's transl)]. 81 Jun 95

A case is presented which, 9 years after surgical removal of a scirrhous breast cancer, exhibited morphologically atypical metastasis in the liver with fibrosis and reduction of liver parenchyma, as well as typical features of cirrhosis including portal hypertension and esophageal varices. Problems posed by the differential diagnosis and pathogenesis of this rare type of metastasis (known in the literature as metastatic carcinomatous cirrhosis) are briefly discussed.
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PMID:[Liver cirrhosis due to a breast neoplasm metastasis. So-called metastatic-carcinomatous cirrhosis]. 83 63

In 15 patients with cirrhosis of the liver, the pressures in a systemic artery, in the inferior vena cava and the portal vein, flows in the portal vein and the hepatic artery, and oxygen content and acid-base balance in the arterial, portal and hepatic venous blood were studied during operation before and after the construction of an end-to-side portacaval shunt. Portal pressure decreased from 23 to 13 millimeters of mercury. Portal flow increased from 660 mililiters per minute to the liver to 1,300 milliliters per minute through the shunt. Hepatic arterial flow increased from 230 to 480 milliliters per minute, but this did not fully compensate for the loss of portal blood flow to the liver. Accordingly, total hepatic blood flow was reduced. There was also a decrease in the oxygen transport to the liver, but in spite of this, there was no change in the oxygen content in the hepatic vein nor any production of acid metabolites. Possible implications of these findings on the preoperative investigation of patients with portal hypertension are discussed.
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PMID:Immediate changes in blood flow and oxygen metabolism of the cirrhotic liver following portacaval shunt operations. 84 2

Bleeding esophageal varices and severe portal hypertension developed in a patient with capillary hemangiomatosis of the spleen. No signs of cirrhosis were found at postmortem examination, and preoperative celiac angiography suggested an intrasplenic shunt as the cause of the high portal pressure. Although a very rare condition, this possibility should be considered in the differential diagnosis of esophageal varices.
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PMID:Portal hypertension and esophageal varices in hemangiomatosis of the spleen. 84 25

Cases of portal hypertension, other than those caused by cirrhosis, are uncommon. We report a rare disorder of the liver parenchyma causing portal hypertension, which can be difficult to diagnosis ante mortem, even with a full liver work-up including biopsy.
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PMID:Nodular transformation of the liver: report of a case. 85 69

This review deals with the clinically important aspects of etiology and symptoms of cirrhosis. Apart from alcohol and hepatitis, which are the most frequent etiological factors, also rare causes of cirrhosis are described, because their knowledge is important for the differential diagnosis of cryptogenic cirrhosis. Portal hypertension is the root of most symptoms and complications in cirrhosis. Therefore, a description of the haemodynamic changes precedes the extrahepatic syndromes, of which renal failures, ascites and portal encephalopathy are discussed more in detail.
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PMID:[Etiology and clinical aspects of liver cirrhosis]. 85 88


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