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)

The authors dealt with 37 patients suffering from advanced liver cirrhosis with ascites. Eighteen patients out of them underwent Denver peritoneum-jugular shunt as a first choice procedure, the other 19 patients underwent lymphovenous anastomosis. The extremely advanced hepatic damage and the general conditions of these patients discouraged us to perform a portocaval shunt. In the 19 patients who underwent lymphovenous anastomosis we had no mortality rate. Two patients showed post-operative complications: 1 patient complained which hoarseness regressed in 5 months and the other patient suffered from a spleno-mesenteric-portal thrombosis with digestive hemorrhage from gastro-esophageal varices. In 6 patients out of 19 who underwent lymphovenous anastomosis, we did not obtain any immediate positive effects on ascites. In 4 patients, after 3 months, the ascites came back ingravescent and in the other 9 patients the positive effects on ascites were still evident after 1 year. Despite failure to obtain very comforting results, they suggest to employ this technique at any rate, as the first procedure, to make ascites more "manageable", because of its safety.
 ...
PMID:[Lymphovenous anastomosis in severe ascites]. 262 51

Renal vein thrombosis in early infancy is a complication of dehydration and prolonged hypotension. The onset is usually acute and the most common clinical signs are uni- or bilateral frank masses, hematuria, proteinuria and thrombocytopenia. In most cases, with conservative management, the late outcome is favorable. In the adult, renal vein thrombosis is often a silent complication of the nephrotic syndrome, the hypercoagulability of which may be an important factor in the pathogenesis of the thrombosis. Clinically, the presentation of a sudden complete occlusion is that of severe abdominal and lumbar pain with hematuria and loss of function of the kidney that suffers hemorrhagic infarction. Physical examination often reveals an enlarged kidney. With gradual occlusion, renal function is preserved. The initial diagnostic approach is with ultrasound studies and computed tomography; definitive diagnosis is established by renal venography or by selective renal arteriography. In general, a conservative approach including the use of anticoagulant treatment is preferred to surgical intervention. Priapism is a persistent painful penile erection due to ischemic or non-ischemic causes; therapeutic intracavernosal injection of papaverine is becoming the most common cause. In early and mild stages, aspiration of blood from the corpora cavernosa supplemented with intracavernosal irrigation with alpha-stimulating agents is the procedure of first choice; in late and severe ischemia, a shunt procedure may become necessary. Hepatic vein thrombosis occurs in association with a number of conditions considered predisposing factors including the use of oral contraceptives. The clinical picture may be that of an acute illness with abdominal pain, hepatomegaly, ascites and hepatic failure as well as early death. More often, the onset is insidious with slowly developing ascites and wasting. For the diagnosis, hepatic scintigraphy may be helpful but, at present, ultrasonography, computed tomography and magnetic resonance scanning are procedures of choice. There is, as yet, no adequate treatment. A fatal outcome may be prevented by surgical decompression of the congested liver and, in recent years, liver transplantation has been employed. Portal vein thrombosis, in children, is usually considered a complication of umbilical sepsis or a result of a congenital abnormality of the portal vein. In adults, the most frequent causes are hepatic cirrhosis and neoplasia. Clinically, there may be a sudden appearance of ascites with resolution in a symptom-free interval until the onset of other features of portal hypertension occur. Currently, ultrasound real-time imaging supplemented with Doppler capability, computed tomography and magnetic resonance scanning provide the necessary diagnostic information. Variceal hemorrhage is often the first major complication requiring treatment.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Thrombosis in particular organ veins. 268 Aug 53

Major hepatic resection was carried out on 23 adult patients with hepatocellular carcinoma (HCC) and underlying cirrhosis of the liver (macronodular in six cases, micronodular in 11 and mixed type cirrhosis in six). Pre-operative liver functional state was Child's class A in 19, class B in three, and class C in one. The operations performed were extended right lobectomy in four patients, right lobectomy in 10, left found in 10 patients, five of whom had duplicated complications and finally died of liver failure 15-65 days after operation. In three of those five patients, other complications (hemorrhagic shock in two and portal thrombosis in one) had preceded liver failure. Eighteen patients tolerated the resection and were discharged from hospital. However, among 13 noncirrhotic patients with HCC who had undergone major hepatic resection during the same period of time, only two had postoperative complications and all patients were discharged from hospital. The 1-, 2- and 3-year survival rates in the 23 cirrhotics were 60.9%, 37.5% and 24.9% respectively, whereas the 1-5-year survival rates were all 61.5% in the 13 noncirrhotics. Thus, major hepatic resection may be indicated in selected patients with HCC and associated cirrhosis, but meticulous managements during and after operation are mandatory to prevent fatal postoperative liver failure.
 ...
PMID:Morbidity and mortality after major hepatic resection in cirrhotic patients with hepatocellular carcinoma. 285 32

Using an ultrasonic Doppler duplex system, we investigated the portal hemodynamics of two patients with portal thrombosis after splenectomy and esophageal transection for portal hypertension accompanied by liver cirrhosis. In both cases, the preoperative blood flow volumes of the splenic and portal veins were especially high, but were markedly lower--even than normal--after the operation. However, the results of pre- and postoperative peripheral platelet counts and coagulation function tests did not differ remarkably. The dramatic change in portal hemodynamics caused by the splenectomy was thought to be the main factor in the formation of the portal thrombi.
 ...
PMID:Hemodynamic analysis of postsplenectomy portal thrombosis using ultrasonic Doppler duplex system. 331 87

Of 60 patients suffering from various stages of esophageal varices with no previously recorded bleeding, 30 underwent combined peri- and intravascular fiberscopic sclerotherapy in a prospective controlled study. Each of the two groups consisted of 22 men and 8 women with an average age of 49 years. The cause of portal hypertension in 58 patients was a morphologically proven cirrhosis of the liver, due mainly to alcoholism. Portal vein thrombosis was present in two patients. The severity of the liver disease was first evaluated in accordance with the PUGH modification of the CHILD classification. 53% of the patients in the control, and 56% in the treatment, group belonged to the prognostically favourable CHILD A category. The period of observation was at least 26 months, with a mean of 36 months. Sclerotherapy lowered the risk of bleeding to 13.3%; in the control group it was 30%. The mortality rate during the overall observation period was lowered significantly (p less than 0.05) by sclerotherapy to 5.9% in the CHILD A group as compared with 25% in the control group. The mortality rate of CHILD B and C patients was over 40% in the control group and an unequally large 70% in the treatment group. The most frequent cause of death was bleeding from esophageal varices in the control group and liver failure in the treatment group. Complications were seen in 20% and paralleled the severity of the esophageal varices. All complications responded to conservative treatment and no fatality was seen.
 ...
PMID:Prophylactic sclerosing of esophageal varices--results of a prospective controlled study. 348 21

The authors report 6 cases of portal hypertension with gastrorenal shunt. This shunt did not arise from the left gastric vein, but from the splenic vein. Portal hypertension was related to alcoholic cirrhosis in 3 cases, to extensive portal thrombosis in 2 cases, and to nodular regenerative hyperplasia of the liver in one case. A gastrointestinal hemorrhage revealed portal hypertension and the liver disease in the 3 cases of alcoholic cirrhosis and complicated the course of the disease in the other cases. Hemorrhage was either massive and life-threatening or often recurred. It was related to a rupture of fundic varices in all cases. The fundic varices were not associated with esophageal varices in the 3 cases of cirrhosis. The degree of portal hypertension was above 20 mm Hg, as assessed by the portohepatic gradient (one case), or the pressure gradient between a tributary portal system vein and the inferior vena cava during laparotomy (5 cases). Definitive control of hemorrhage could not be achieved by endoscopic variceal sclerotherapy (2 cases) or percutaneous transhepatic embolization (one case). Portacaval shunt or splenectomy was performed in 5 cases. These findings suggest that spontaneous splenogastrorenal shunt is a clinical and hemodynamic entity which requires specific treatment when associated with gastric variceal bleeding.
 ...
PMID:[Splenogastrorenal shunt in portal hypertension: a little known entity. Study of 6 cases and review of the literature]. 349 66

Esophagogastrectomy for carcinoma of the esophagus or cardia has been performed in 23 patients with histologically proven hepatic cirrhosis. All but two patients were classified as Child's class A and all but three had a prothrombin time over 60% of normal values. Twenty-two esophagogastrostomies were performed through a separate abdominal and right thoracic approach in 15 patients, a left thoracoabdominal approach in five patients, and without thoracotomy in two patients. One patient had a colon interposition. Six patients died after operation (26%) as a result of anastomotic leakage in two patients, hepatorenal in three patients and portal thrombosis in one patient. The type of procedure did not influence mortality. The most common postoperative complication was the development of ascites (65%), and when associated with hepatorenal syndrome there was a significant mortality (p less than 0.05). Sepsis was present in the terminal stages of all nonsurvivors. A prothrombin time less than or equal to 60% of normal values was the only significant preoperative predictive factor of mortality, with none of the three patients surviving below this level (p less than 0.05). It is concluded that the presence of cirrhosis is not a contraindication to esophagogastrectomy for carcinoma when curative resection can be undertaken. Hepatic reserve is the determinant factor of operative prognosis. Operative risk is acceptable if patients are classified as Child's class A and prothrombin time is over 60% of normal values. Operation should be delayed when acute alcoholic hepatitis is present. Intraoperative discovery of cirrhosis is not a contraindication to resection where the above criteria are met. This strict selection allows one to anticipate a lower mortality rate.
 ...
PMID:Results of esophagogastrectomy for carcinoma in cirrhotic patients. A series of 23 consecutive patients. 360 34

Portal vein thrombosis was thought to be a common complication of liver cirrhosis in the past. The incidence of angiographically demonstrable portal vein thrombosis was studied in 708 consecutive patients with unequivocal cirrhosis seen in the past 10 yr in whom either transhepatic portography or superior mesenteric arterial portography clearly delineated the major portal vein system. Excluding 2 cases that were thought to be associated with past splenectomy, there were 4 cases of portal vein thrombosis related to cirrhosis, all in a decompensated stage. The calculated incidence of portal vein thrombosis was 0.573% of all cirrhotic patients without splenectomy in the past. They constituted 23.5% of the 17 cases of extrahepatic portal vein obstruction encountered during the same period. There were 78 cases of idiopathic portal hypertension similarly studied angiographically, and the incidence of portal vein thrombosis unrelated to splenectomy was 2.86%. A statistical survey based on 247,728 necropsies recorded in the Japan Autopsy Registries of 1975-1982 showed a 0.05489% incidence of portal vein thrombosis and a 6.58857% incidence of cirrhosis of all types among them, suggesting that portal vein thrombosis is not a common complication of cirrhosis in Japan in recent years.
 ...
PMID:Incidence of portal vein thrombosis in liver cirrhosis. An angiographic study in 708 patients. 400 19

An autopsy case of pulmonary hypertension in a 29-year-old Japanese female with macronodular, posthepatic liver cirrhosis and hepatitis-B antigenemia was presented. No recognizable known cardio-pulmonary disease or portal thrombosis was obtained. Hepatitis-B antigen was demonstrated in the cirrhotic hepatocytes by a specific peroxidase antiperoxidase method. Characteristic pulmonary arterial changes including plexiform lesions with varying developmental stages were widely observed throughout the lungs. Complication of these two distinct disease processes seems to be rarely encountered in the literature. Discussion was focused on the possible interrelationship between the liver cirrhosis with hepatitis-B antigenemia and pulmonary hypertension. Proposed were presumptive underlying humoral, particularly immunological, abnormalities common to these diseases rather than mere incidental complications.
 ...
PMID:Pulmonary hypertension associated with liver cirrhosis and hepatitis-B antigenemia. 634 Feb 45

The effects of 30-minute intravenous and superior mesenteric artery (SMA) infusions of vasopressin in dosages of 2.75 mU and 14 mU per min per kg were compared in five dogs that had cirrhosis and portal hypertension induced by fractionated intraportal polyvinyl alcohol injections. A reduction in portal pressure of approximately 35% was found with both SMA doses and the larger intravenous vasopressin dose, while the smaller intravenous dose reduced portal pressure only 18%. A significantly larger decrease in portal blood flow was found with SMA than intravenous vasopressin administration. Cardiovascular side effects were dose-dependent but independent of the administration mode. Liver enzymes were not affected. Portal vein thrombosis occurred in one dog after the larger SMA dose.
 ...
PMID:Intravenous versus superior mesenteric artery vasopressin infusions for the treatment of variceal bleeding. 697 90


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