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Acta Radiol 2022 May 20:2841851221101356. Epub 2022 May 20.

Department of Interventional Oncology, Renji Hospital, 71140Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.

Background: Iodine concentrations measured using dual-energy spectral CT (DESCT) have been recently proposed as providing good performance for examining tissues hemodynamics.

Purpose: To evaluate the diagnostic efficacy of DESCT-derived parameters in evaluating portal venous pressure in patients with liver cirrhosis.

Material And Methods: A total of 71 patients with liver cirrhosis who underwent percutaneous transhepatic portal vein puncture procedures were included in this study. Read More

Dis Markers 2022 6;2022:2940578. Epub 2022 May 6.

Department of Vascular Surgery, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, China.

Esophagogastric variceal bleeding (EGVB) is one of the main complications of portal hypertension, especially in patients with liver cirrhosis, and has a very high fatality rate. At present, the treatment methods for rupture and bleeding of gastroesophageal varices (GV) include drug therapy, compression hemostasis with three-lumen and two-balloon tube, endoscopic therapy, and interventional and surgical operations. Endoscopy and intervention or their combined application is the mainstream treatment modes in clinical practice, especially their combined application has been increasingly recognized by front-line clinicians. Read More

BMC Gastroenterol 2022 May 15;22(1):245. Epub 2022 May 15.

Department of Medical Imaging Center, Renmin Hospital, Hubei University of Medicine, No. 39 Chaoyang Middle Road, Shiyan, 442000, Hubei, China.

Background: Calcification of abdominal lymph node is a common clinical phenomenon, but it is extremely rare to cause serious adverse clinical outcomes. In the present case, the ruptured hemorrhage of the oesophagogastric fundic varices occurred as a result of portal hypertension due to compression of the portal vein by calcified lymph nodes. The patient was treated with medication, interventional therapy, endoscopic therapy, and surgery, respectively and the four different treatment options for the bleeding are worth summarizing. Read More

BMC Med Imaging 2022 May 12;22(1):85. Epub 2022 May 12.

Department of Ultrasound Diagnosis, Tangdu Hospital, The Fourth Military Medical University, Xin Si Road, Ba Qiao District, Xi'an, China.

Background: Acoustic structure quantification (ASQ) has been applied to evaluate liver histologic changes by analyzing the speckle pattern seen on B-mode ultrasound. We aimed to assess the severity of portal hypertension (PHT) through hepatic ultrasonography.

Methods: Sixty patients diagnosed with PHT and underwent surgical treatment with portosystemic shunts were enrolled. Read More

Diagn Interv Radiol 2022 Mar;28(2):138-148

Department of Gastroenterology, Zhuji People's Hospital of Zhejiang Province, Zhuji Affiliated Hospital of Shaoxing University, Zhejiang, China.

PURPOSE The aim of this meta-analysis is to summarize the diagnostic accuracies of point shear wave elas- tography (pSWE) and two-dimensional (2D) SWE for esophageal varices (EV) and varices needing treatment (VNT). METHODS We conducted a systematic review and meta-analysis of diagnostic accuracy studies. We searched for studies reporting the EV and VNT diagnostic accuracy of pSWE and 2D SWE using PubMed Cen- tral, SCOPUS, MEDLINE, Embase, and Cochrane databases. Read More

J Coll Physicians Surg Pak 2022 May;32(5):586-590

Department of Digestive Internal Medicine, Funan County People's Hospital, Anhui, China.

Objective: To establish and verify a nomogram for individualized prediction of patients with oesophageal and gastric variceal rupture and haemorrhage in cirrhosis.

Study Design: Descriptive study.

Place And Duration Of Study: Department of Digestive Internal Medicine, Funan County People's Hospital, Anhui, China, from June 2017 to June 2020. Read More

Zhonghua Gan Zang Bing Za Zhi 2022 Apr;30(4):407-412

Liver Cirrhosis Diagnosis and Treatment Center, Fifth Medical Center of Chinese PLA General Hospital of China, Beijing 100039, China.

To investigate the effects of primary preventive treatment under endoscope for esophageal and gastric varices on bleeding rate and its relevant factors. 127 cases with liver cirrhosis accompanied with esophageal and gastric varices without bleeding history were included in the endoscopic and non-endoscopic treatment group, respectively. Informed consent was obtained from both groups. Read More

Case Rep Gastroenterol 2022 Jan-Apr;16(1):179-185. Epub 2022 Mar 28.

Hepatobiliary Division Endoscopy Unit, Dr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, Jakarta, Indonesia.

Bleeding esophageal varices (EV) have the highest mortality rate from all complications of liver cirrhosis (LC). Several Doppler ultrasound (DUS) studies have been done on the splenic or portal vein (PV) to evaluate the hemodynamic of the esophageal vein. Our study focused on finding a better index using the ratio from two parameters correlated with EV, splenic vein flow volume (SFV), and PV flow velocity. Read More

Arab J Gastroenterol 2022 May 4. Epub 2022 May 4.

Division of Gastroenterology, Bezmialem Vakif University, Istanbul, Turkey. Electronic address:

Background And Study Aims: Gastric variceal bleeding is more severe than esophageal variceal bleeding, and is associated with higher rebleeding and mortality rates. The benefits of endoscopic ultrasound-guided coil deployment alone for treating gastric varices, compared with concomitant cyanoacrylate injection, remain unclear. Therefore, this study aimed to compare the outcomes of both modalities. Read More

Rev Gastroenterol Mex (Engl Ed) 2022 May 3. Epub 2022 May 3.

Servicio de Gastroenterología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.

Introduction And Aim: Chronic hepatitis C is one of the main causes of cirrhosis of the liver. Treatment with direct-acting antivirals (DAAs) improves survival. There is controversy as to whether AADs create an increased risk for the development of hepatocellular carcinoma (HCC). Read More

Endoscopy 2022 May 6. Epub 2022 May 6.

Department of Radiology and Hepatogastroenterology, Edouard Herriot Hospital, Lyon, France.

J Gastroenterol Hepatol 2022 May 5. Epub 2022 May 5.

H. H. Chao Comprehensive Digestive Disease Center, University of California, Los Angeles, California, USA.

Background And Aim: The portal pressure gradient (PPG) is a useful predictor of portal hypertension (PH) related complications. We previously showed the feasibility and safety of endoscopic ultrasound guided PPG measurement (EUS-PPG). Now EUS-guided liver biopsy (EUS-bx) has been shown to be a safe and effective alternative to percutaneous or Interventional Radiology-guided liver biopsy for the diagnosis of chronic liver disease (CLD). Read More

Cureus 2022 Apr 3;14(4):e23774. Epub 2022 Apr 3.

Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, New York, USA.

Ischemic colitis is one of the most common ischemic pathologies of the gastrointestinal system and can be divided into non-gangrenous and gangrenous forms. The pathophysiology involves restricted blood supply to the colonic mucosa. Several risk factors have been implicated in the development of ischemic colitis. Read More

J Chin Med Assoc 2022 May 4. Epub 2022 May 4.

Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.

Background: Esophageal varices (EV) is common and is a poor prognostic factor for patients with hepatocellular carcinoma (HCC). However, the outcomes between cirrhotic and non-cirrhotic HCC patients with EV is not well studied. The present study aimed to investigate the clinical manifestations and prognoses of HCC patients after surgical resection stratified by the cirrhosis status. Read More

BMC Gastroenterol 2022 May 2;22(1):213. Epub 2022 May 2.

Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School, 321#, Zhongshan Road, Nanjing, 210008, Jiangsu, China.

Background And Aims: Risk stratification to identify patients with high risk of variceal rebleeding is particularly important in patients with decompensated cirrhosis. In clinical practice, eliminating gastroesphageal varices thoroughly after sequential endoscopic treatment reduces the rebleeding rate, however, no simple method has been build to predict high risk of variceal rebleeding. We conducted this study to explore the value of the number of endoscopic sessions required to eradicate gastroesphageal varices in identifying high risk of rebleeding. Read More

Eur J Radiol 2022 Apr 20;152:110326. Epub 2022 Apr 20.

Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China. Electronic address:

Purpose: To assess the value of splenic hemodynamic parameters measured using low-dose perfusion CT in the noninvasive evaluation of esophageal varices (EV) in patients with liver cirrhosis.

Methods: We retrospectively studied 43 cirrhotic patients with EV, which were divided into mild (EV1), moderate (EV2) and severe (EV3) groups. 14 patients with normal liver function and no EV were selected as the control group. Read More

GE Port J Gastroenterol 2022 Mar 27;29(2):82-95. Epub 2021 Jul 27.

Department of Internal Medicine (Hepatology Division), Faculty of Medicine, Alexandria University, Alexandria, Egypt.

Introduction: Activation of hepatic macrophages in liver disease is pathogenically related to portal hypertension (PH). Soluble CD163 (sCD163) is shed in blood by activated macrophages and may predict PH progression noninvasively. This study was designed to investigate the relation of serum sCD163 to the grade and bleeding risk of esophageal varices (EV) and its role for prediction of variceal hemorrhage (VH). Read More

JHEP Rep 2022 May 31;4(5):100476. Epub 2022 Mar 31.

Ciber de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain.

[This corrects the article DOI: 10.1016/j.jhepr. Read More

Zhonghua Nei Ke Za Zhi 2022 May;61(5):496-506

The consensus proposes the emergency treatment process of portal hypertension bleeding. The first aid, medical treatment, interventional treatment, and surgical treatment of portal hypertension bleeding are described. The indications and contraindications, operating norms, precautions, and prevention of complications regarding the recommended diagnostic methods and treatment are summarized to optimize the first aid process. Read More

Dig Endosc 2022 Apr 29. Epub 2022 Apr 29.

Department of Gastroenterology, Sherbrooke University Hospital, Quebec, Canada.

Objectives: Objective assessments of esophageal varices (EVs) are inadequate. The recurrence of variceal bleeding after endoscopic variceal ligation (EVL) is associated with residual blood flow underlying EVL or incomplete treatment of a perforating vein by EVL. We aimed to assess our novel endoscopic through-the-scope Doppler probe method (DOP) for the evaluation and management of EVs. Read More

Cir Pediatr 2022 Apr 1;35(2):57-62. Epub 2022 Apr 1.

La Fe University and Polytechnic Hospital. Valencia (Spain).

Introduction: Transjugular intrahepatic portosystemic shunt (TIPS) was designed to treat complications of portal hypertension (PH). The objective of this study was to analyze the results of the TIPS performed in pediatric patients in our institution as a previous step to liver transplantation (LT).

Material And Methods: A retrospective, descriptive study of pediatric patients with liver cirrhosis undergoing TIPS prior to LT from 2015 to 2020 was carried out. Read More

Sci Rep 2022 Apr 27;12(1):6833. Epub 2022 Apr 27.

Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.

The optimal timing of endoscopy in patients with acute upper gastrointestinal bleeding (UGIB) remains controversial. In this study, we investigated the clinical outcomes of urgent endoscopy in patients with UGIB compared with elective endoscopy. From January 2016 to December 2018, consecutive patients who visited the emergency department and underwent endoscopy for clinical manifestations of acute UGIB, including variceal bleeding, were eligible. Read More

Arab J Gastroenterol 2022 Apr 23. Epub 2022 Apr 23.

National Committee for Control of Viral Hepatitis, Egypt; Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Background And Study Aims: In resource-limited countries, non-invasive tests for assessing liver fibrosis are a potential alternative to costly endoscopic screening for esophageal varices. We aimed to validate several non-invasive parameters for predicting the presence of varices.

Patients And Methods: Between September 2006 and August 2017, a total of 46,014 patients who underwent upper gastrointestinal endoscopy as one of the perquisites for receiving hepatitis C virus (HCV) therapy were enrolled and divided into group I (without varices) and group II (with varices). Read More

Clin Res Hepatol Gastroenterol 2022 Apr 22:101925. Epub 2022 Apr 22.

Department of Gastroenterology and Hepatology, PROMISE, University of Palermo, Palermo, Italy. Electronic address:

Background And Aims: We aimed to improve non-invasive screening of varices needing treatment (VNT) and compare different screening strategies.

Methods: 2,290 patients with chronic liver disease were included in a retrospective study. Etiologies were: virus: 50. Read More

Cureus 2022 Mar 11;14(3):e23064. Epub 2022 Mar 11.

Department of Internal Medicine, Division of Gastroenterology and Hepatology, Addis Ababa University, Addis Ababa, ETH.

Acquired hepatocerebral degeneration (AHD) is a neurologic syndrome caused by liver dysfunction and long-standing portosystemic shunting. The pathogenesis of the condition is predominantly considered to be related to the deposition of manganese in parts of the brain due to shunting. We report a case of a 25-year-old male who underwent splenectomy and splenorenal shunt for recurrent upper GI bleeding (UGIB) due to esophageal varices caused by non-cirrhotic portal hypertension (NCPH). Read More

Cells 2022 Apr 14;11(8). Epub 2022 Apr 14.

Division of Gastroenterology and Liver Unit, University of Alberta, Edmonton, AB T6G 2X8, Canada.

Myosteatosis (pathological fat accumulation in muscle) is defined by lower mean skeletal muscle radiodensity in CT. We aimed to determine the optimal cut-offs for myosteatosis in a cohort of 855 patients with cirrhosis. CT images were used to determine the skeletal muscle radiodensity expressed as Hounsfield Unit (HU). Read More

Medicina (Kaunas) 2022 Apr 12;58(4). Epub 2022 Apr 12.

Department of Anaesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan.

: Although complications after liver resection for hepatic cancer are common, the long-term impact of these complications on oncological outcomes remains unclear. This study aimed to investigate the potential effect of high-grade postoperative complications on long-term mortality and cancer recurrence after surgical resection of hepatocellular carcinoma. : In a retrospective cohort study, patients undergoing curative liver resection for primary hepatocellular carcinoma between 2005 and 2016 were evaluated. Read More

Sci Rep 2022 Apr 21;12(1):6554. Epub 2022 Apr 21.

Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.

In this study the diagnostic capability and additional value of sequential CT arterioportography-arteriosplenography (CT AP-AS) in comparison to standard cross-sectional imaging and upper gastrointestinal endoscopy (UGE) in pediatric portal hypertension (PH) was analyzed. Patients with clinical signs of PH who underwent CT AP-AS in combination with additional contrast-enhanced magnetic resonance imaging (CE-MR) and/or contrast-enhanced computed tomography (CE-CT) were included. Two radiologists reviewed independently imaging regarding the capability to prove patency of (1) extrahepatic and intrahepatic main stem portal vein (PV), (2) intrahepatic PV system and (3) splenomesenteric venous axis. Read More

Medicine (Baltimore) 2022 Apr 8;101(14):e29128. Epub 2022 Apr 8.

Department of Internal Medicine, Chosun University Hospital, Gwang-Ju, Korea.

Abstract: Acute variceal bleeding, a crucial complication of liver cirrhosis requires high energy expenditures but gastrointestinal bleeding limits enteral feeding in the acute stage. We investigated the safety and efficacy of ω-3 fatty acid-enriched parenteral nutrition in acute variceal bleeding patients.In this retrospective study, a total of 208 cirrhotic patients with acute variceal bleeding who underwent parenteral nutrition in the absence of enteral nutrition were enrolled. Read More

Surg Case Rep 2022 Apr 21;8(1):73. Epub 2022 Apr 21.

Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.

The patient was a 61-year-old woman with a history of diabetes mellitus who had undergone ileocecal resection for ascending colon carcinoma 5 years earlier, followed by a postoperative adjuvant chemotherapy with XELOX (capecitabine + oxaliplatin). During follow-up, the liver gradually atrophied, and radiological imaging showed suspicious findings of 20 × 14 mm hepatocellular carcinoma (HCC) in the right lobe of the liver. The patient also underwent endoscopic variceal ligation for the esophageal varices. Read More