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

Thirty children, aged 7 months to 13 years, with bleeding esophageal varices were managed by endoscopic sclerotherapy (EST). Of these children, 73.3% had extrahepatic portal vein obstruction (EHPVO), 16.6% had cirrhosis of the liver, and 10% had noncirrhotic portal fibrosis. EST was done with fiberoptic pediatric upper gastrointestinal endoscopes and a flexible sclerotherapy needle under sedation with intravenous diazepam and pentazocine. The sclerosants used were ethoxysclerol 1% and absolute alcohol. Ten injections were given to control active variceal bleeding, and 145 injections were given on planned basis at 2-3-week interval. An average of five injections was required to obliterate the esophageal varices. In 90% of cases, an avariceal state was achieved; 10% had decreased size and number of varices. Emergency EST was effective to control bleeding in all sessions. Complications, including retrosternal discomfort, esophageal ulceration, stricture formation, and aspiration pneumonia, occurred in 60, 20, 20, and 6.6% of cases, respectively; complications were managed conservatively. Strictures were dilated with Eder-Puestow's olive dilators. Recurrence of esophageal varices, gastric varices, and rebleeding was seen in 13.3, 13.3, and 10% of cases, respectively. Shunt surgery was performed in 13.3% cases, who had developed gastric varices and were having EHPVO.
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PMID:Endoscopic sclerotherapy of esophageal varices in infants and children. 235 74

Portal Hypertension (PH) is the commonest cause of upper gastrointestinal bleeding in children. Most Indian studies have highlighted extrahepatic portal venous obstruction (EHPVO) as the major cause of PH in children. As there is paucity of data from the eastern part of the country we decided to study the major causes of PH in children in this region and to ascertain the efficacy of sclerotherapy for its management. Fifty children aged 14 months to 10 years with PH were studied from April 1990 to April 1995. Thorough examination and relevant investigations showed non-cirrhotic portal fibrosis (NCPF) in 24 (48%), EHPVO in 18 (36%) and cirrhosis of liver in 8 (16%) children. Forty six children had hematemesis and melaena of whom endoscopic sclerotherapy (EST) was done in 45 cases. One child having type 2 gastric varices was referred for surgery. Following eradication of varices the patients were followed-up at 3 monthly intervals. Number of sittings of sclerotherapy required for obliteration of varices was 5.9 +/- 1.6. A variceal state was achieved in 35 (78%) cases and varices were reduced to Grade I in 6 cases (13%). Two cases underwent surgery for EST failure. One patient of cirrhosis died within two weeks of bleeding episode due to hepatic encephalpathy. Rebleeding (13%) and recurrences (13%) were noted during the follow-up period. Retrosternal discomfort (22%), dysphagia (22%), stricture (13%), oesophageal ulceration (13%) and fever (11%) were the complications noted but these could be managed conservatively. The present study highlights that NCPF is an important cause of PH in eastern India. EST is useful in controlling variceal bleeding in children irrespective of their aetiology.
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PMID:Study of portal hypertension in children with special reference to sclerotherapy. 938 57

In the last two decades sclerotherapy has became one of the most widespread procedures in the palliative therapy of esophageal varicosity and rupture. Beside many of its advantages, there are high numbers of local and general complications. The new ligation method is very effective, but less invasive and free from side effects. The single shot method in spite of using overtube is slower, unpleasant and not free from risks. The new six shooter system, which uses 6 rubber-bands eliminates these disadvantages. This technique was introduced the first time in Hungary by the authors. They performed ligations between June 1997 and June 1999 on 39 random patients, 55 times. 41 times due to rupture of varices, 8 times in no-bleeding periods for eradication of varices, 6 times for prophylaxis. The average age was 51 (27-75), 32 men and 7 women participating. The cause of esophageal varicosity was thrombosis of vena portae in 1 patient and cirrhosis in others. The background of the cirrhosis was alcohol in all cases except for one which was due to alcohol and hepatitis C in addition. Altogether 346 rubber-bands were applied. The average ligation was 6.3 (3-17) per patient and 4.5 (3-6) per session. The 41 ruptures of the 32 patients were treated with 80 units of blood, not including one patient given 29 units of blood who had mortal haemorrhage. It means 2.5 units of blood per patient and 2 units per varix rupture. After ligation patients had no complaints except for retrosternal discomfort in some patients. There were no complications observed. The mortality rate was 5 out of 32 one patient died due to bleeding. The follow up of the ligation was carried out by endoscopy and in the 4 dead patients by pathological procedures. The ligation method which was applied by the authors is effective, faster and has less complications in varix irradications than sclerotherapy. The prophylactic therapy of high risk patients and other therapeutic indications can contribute to its wider utilization.
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PMID:[The role of endoscopic ligation in the management of esophageal varices and rupture]. 1057 88

Esophageal variceal bleeding is a common lethal complication of cirrhosis. Endoscopic injection sclerotherapy (EIS) is one of the major endoscopic approaches for treating esophageal variceal bleeding. However, complications may occur after EIS, which mainly include retrosternal discomfort/pain, dysphagia, re-bleeding, esophageal ulcer, esophageal strictures, and esophageal perforation, etc. In this article, we reported a 36-year-old male who developed esophageal ulcer related bleeding after EIS. Currently, there is no consensus on the treatment strategy for esophageal ulcer-related bleeding after EIS. In the present case, the following treatment strategy may be effective for ulcer related bleeding. The first step is to inhibit gastric acid secretion and reduce portal pressure by intravenous infusion of esomeprazole and somatostatin, respectively. The second is local hemostasis by oral norepinephrine and lyophilizing thrombin powder. The third is to protect digestive tract mucosa by oral Kangfuxin Ye and aluminum phosphate.
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PMID:Successful treatment of repeated hematemesis secondary to postsclerotherapy esophageal ulcer in a cirrhotic patient: A case report. 3046 64