Search Our Scientific Publications & Authors

J Pediatr Surg 2019 Feb 2. Epub 2019 Feb 2.

Division of Transplant Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. Electronic address:

Background: The management of portal hypertension (PHT) in children with well compensated cirrhosis and cystic fibrosis (CF) is controversial. We present our experience with distal splenorenal shunting (DSRS) for the treatment of PHT as an alternative to liver transplantation (LT).

Methods: Between 2008 and 2017, 5 CF children underwent a DSRS at a pediatric hepatobiliary and transplantation referral center. Read More

J Gastrointest Surg 2019 Feb 21. Epub 2019 Feb 21.

Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, No.37 Guoxue Alley, Wuhou District, Chengdu, 610041, Sichuan Province, China.

Background: Uncontrolled variceal bleeding (VB) remains a great challenge for clinical treatment. Emergency transjugular intrahepatic portosystemic shunt (TIPS) is a salvage procedure, but unsatisfactory clinical outcomes and a high incidence of complications have been reported. This study aimed to investigate the effect and safety of emergency TIPS performed in our institution during recent years. Read More

Emerg Infect Dis 2019 Mar;25(3):425-433

Hepatitis E virus (HEV) genotype 4 (HEV-4) is an emerging cause of acute hepatitis in China. Less is known about the clinical characteristics and natural history of HEV-4 than HEV genotype 3 infections in immunocompromised patients. We report transmission of HEV-4 from a deceased organ donor to 5 transplant recipients. Read More

Arq Gastroenterol 2018 Oct-Dec;55(4):324-328

Nossa Senhora das Graças Hospital, Unidade de Gastroenterologia, Hepatologia e Transplante de Fígado, Curitiba, PR, Brasil.

The disease and the case reported here are relevant especially because of their varied clinical presentation, possibility of being associated with other disorders affecting several organs and possible differential diagnoses. Congenital Hepatic Fibrosis is an autosomal recessive disease due to mutation in the PKHD1 gene, which encodes the fibrocystin/polyductine protein. It is a cholangiopathy, characterized by varying degrees of periportal fibrosis and irregular proliferation of bile ducts. Read More

Sci Rep 2019 Feb 19;9(1):2256. Epub 2019 Feb 19.

Department of Internal Medicine I, University of Bonn, Bonn, Germany.

Rho-kinase (ROCK) activation in hepatic stellate cells (HSC) is a key mechanism promoting liver fibrosis and portal hypertension (PTH). Specific delivery of ROCK-inhibitor Y-27632 (Y27) to HSC targeting mannose-6-phosphate-receptors reduces portal pressure and fibrogenesis. In decompensated cirrhosis, presence of ascites is associated with reduced renal perfusion. Read More

Asian J Surg 2019 Feb 16. Epub 2019 Feb 16.

Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address:

Background: Portal hypertension (PH), which is closely associated with the severity of liver cirrhosis, has been suggested as a contraindication of liver resection for hepatocellular carcinoma (HCC). We aimed to explore the role of a potential player, histologic severity of liver cirrhosis, in affecting surgical outcomes of the patients with both HCC and PH.

Methods: A total of 374 HCC patients with PH underwent resection for HCC were retrospectively reviewed. Read More

BMC Gastroenterol 2019 Feb 19;19(1):32. Epub 2019 Feb 19.

Department of Gastroenterology and Hepatology, Beijing You An Hospital affiliated to the Capital Medical University, 8 Xi Tou Tiao, Youanmen wai, Beijing, 100069, China.

Background: The recurrence of esophageal varices remains high in patients with hepatic portal hypertension after the endoscopic esophageal variceal eradication therapies, including endoscopic variceal band ligation (EVL), injection sclerotherapy (EIS) or EVL plus EIS. The aim of this study was to evaluate the endoscopic ultrasound probe examinations (EUP) findings in the prediction of recurrence following esophageal variceal eradication in a prospective cohort.

Methods: A total of 206 cirrhotic portal hypertension patients with esophageal variceal eradication, who underwent endoscopic variceal therapy (EVL or EIS or EVL plus EIS) were initially enrolled. Read More

Surg Case Rep 2019 Feb 18;5(1):25. Epub 2019 Feb 18.

Department of Surgery, Osaka Rosai Hospital, 1179-3 Nagasonecho, Kita-ku, Sakai, 591-8025, Japan.

Background: A case of a short circuit (Retzius shunt) from the inferior mesenteric vein (IMV) to the inferior vena cava (IVC) without accompanying portal hypertension due to liver cirrhosis is rare.

Case Presentation: An 83-year-old woman who was followed after surgery for thyroid and breast cancer was incidentally found to have rectal cancer on computed tomography (CT). Preoperative three-dimensional CT showed a venous malformation forming a short circuit (Retzius shunt) from the IMV to the IVC. Read More

Exp Clin Transplant 2019 Jan;17(Suppl 1):223-225

From the Division of General Surgery, Gazi University Faculty of Medicine, Ankara, Turkey.

Portal hypertensive biliopathy may occur in patients with noncirrhotic hepatic fibrosis. Portal hypertensive biliopathy treatment should be focused on management of portal hypertension and relief of biliary obstruction. In patients with noncirrhotic portal fibrosis and symptomatic portal hypertensive biliopathy, portal decompression surgery by proximal splenorenal shunt is one successful treatment option. Read More

J Surg Oncol 2019 Feb 18. Epub 2019 Feb 18.

Department of Liver Surgery & Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, China.

 This review aimed to evaluate the safety, feasibility, and effectiveness of synchronous hepatectomy and splenectomy for selected patients with hepatocellular carcinoma and clinically significant portal hypertension compared to hepatectomy alone. A systematic search in electronic databases was conducted. A total of 8 studies including 1445 patients were reviewed. Read More

Hepat Med 2019 25;11:23-34. Epub 2019 Jan 25.

The Liver Unit, Cochin Gastroenterology Group, Ernakulam Medical Centre, Cochin, Kerala, India,

Portosystemic shunt (PS) syndrome encompasses a spectrum of disease manifestations ranging from asymptomatic portal hypertension to recurrent and refractory hepatic encephalopathy, ultimately culminating in progressive hepatic failure in patients of cirrhosis and associated large PSs. PSs commonly seen in cirrhosis include splenorenal, gastrorenal, and dilated paraumbilical veins, all of which can present with recurrent or refractory hepatic encephalopathy. In this exhaustive review, we describe the anatomy of PSs, elucidate new theories on their pathophysiology, discuss the clinical implications of PSs in cirrhosis, provide details on different techniques (classical and novel) of shunt embolization, and explore all the pertinent current literature on shunt embolization for refractory and recurrent hepatic encephalopathy, all of which are enumerated with extensive images and illustrations. Read More

Ther Clin Risk Manag 2019 29;15:191-200. Epub 2019 Jan 29.

Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, People's Republic of China,

Objective: Variceal hemorrhage is the primary driver of mortality in patients with portal hypertension. Recent guidelines recommended that patients with esophageal varices should receive endoscopic band ligation (EBL) or carvedilol as prophylaxis of variceal bleeding. Several clinical trials have compared carvedilol use with EBL intervention, yielding controversial results. Read More

Diagn Interv Radiol 2019 Feb 18. Epub 2019 Feb 18.

Department of Interventional Radiology, Clínica Universidad de Navarra, Pamplona, Spain.

Aneurysms of the portal vein and its branches have been rarely described. Their natural history is unknown although large ones (>3cm in diameter) have been reported to cause rupture, thrombosis, duodenal or biliary obstruction, inferior vena cava compression and/or portal hypertension. We report the case of an incidentally diagnosed 4. Read More

J Vasc Interv Radiol 2019 Feb 14. Epub 2019 Feb 14.

Department of Interventional Radiology, Texas Children's Hospital, 6621 Fannin Street, Houston, TX, 77030. Electronic address:

Purpose: To evaluate technical and clinical success and report long-term outcomes of portal vein (PV) recanalization in pediatric orthotopic liver transplant (OLT) patients with chronic PV occlusion.

Materials And Methods: This is a retrospective review of 15 OLT patients (5 males) with chronic PV occlusion who underwent PV recanalization (33 procedures) between October 2011 and February 2018. Median age was 4. Read More

Clin Mol Hepatol 2019 Feb 18. Epub 2019 Feb 18.

Department of Gastroenterology, Chiba University Graduate School of Medicine, Chiba, Japan.

Chronic liver disease is a major disorder worldwide. A better understanding of anatomy, blood flow, and pathophysiology may be a key issue for their proper management. Ultrasound (US) is a simple and non-invasive diagnostic tool in the abdominal field. Read More

J Ethnopharmacol 2019 Feb 13. Epub 2019 Feb 13.

H.E. J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Pakistan; Department of Biochemistry, Dr. Panjwani Center for Molecular Medicine and Drug Research (P.C.M.D.), International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Pakistan. Electronic address:

Ethnopharmacological Relevance: Tetrapleura tetrapteura Taub. is a leguminous multipurpose tree (Fabaceae) indigenous to tropical Africa. Fruits, seeds and stem bark infusions or decoctions of Tetrapleura tetrapteura Taub. Read More

Gastroenterology 2019 Feb 13. Epub 2019 Feb 13.

Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, and Fondazione Luigi Villa, Milano, Italy.

Portal vein thrombosis unrelated to solid malignancy is common in patients with cirrhosis but less frequently observed in patients without cirrhosis. Prompt diagnosis and management of acute symptomatic portal vein thrombosis are essential. Failure to detect and treat thromboses can result in mesenteric ischemia, chronic cavernous transformation, and complications of portal hypertension. Read More

Gastroenterology 2019 Feb 13. Epub 2019 Feb 13.

AP-HP, Hôpital Jean Verdier, Service d'Hépatologie, Bondy, Université Paris 13, Bobigny et INSERM U1162, Université Paris 5, Paris.

Background & Aims: Management of patients with cirrhosis includes endoscopic screening and surveillance to detect esophageal varices (EV) and prevent bleeding. However, the Baveno VI guidelines recommend avoiding endoscopies for patients with liver stiffness measurements below 20 kPa and platelet counts above 150,000 (favorable Baveno VI status) and endoscopic assessment of patients with higher levels of liver stiffness and platelet counts (unfavorable Baveno VI status). We aimed to validate the Baveno VI guidelines, evaluating outcomes of patients in the ANRS-CO12 CirVir cohort with compensated cirrhosis associated with hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, with or without a sustained response to antiviral therapy. Read More

Eur J Gastroenterol Hepatol 2019 Feb 12. Epub 2019 Feb 12.

Clinical Physiology, Center of Functional Imaging and Research, Faculty of Health Sciences, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.

Objectives: Portal hypertension in cirrhosis is associated with endothelial dysfunction, impaired wound healing, and decreased platelet count. Increased von Willebrand factor (VWF) formation has been suggested as a compensatory mechanism, but the role of VWF processing has not been directly assessed. The aim was to measure the processing of activated VWF (VWF-A) in addition to VWF release (VWF-N) to investigate the association of primary hemostasis with disease activity and portal hypertension in liver cirrhosis. Read More

Hepatol Commun 2019 Feb 10;3(2):207-212. Epub 2018 Dec 10.

Liver Unit Institute of Gastroenterology and Liver Diseases, Division of Internal Medicine Hebrew University-Hadassah Medical Organization Jerusalem Israel.

There are limited efficacious therapeutic options for management of gastric variceal bleeding. Treatment modalities include transjugular intrahepatic portosystemic shunt, surgical shunts, and endoscopic interventions, including the recent advancement of endoscopic ultrasound (EUS)-guided coiling. We present a case series of 10 patients with portal hypertension (7 with liver cirrhosis and 3 without cirrhosis), complicated by gastric varices (GV) with bleeding. Read More

Hepatol Commun 2019 Feb 13;3(2):180-192. Epub 2018 Dec 13.

Department of Surgery University of California San Diego La Jolla CA.

Hepatic fibrosis results from chronic injury and inflammation in the liver and leads to cirrhosis, liver failure, and portal hypertension. Understanding the molecular mechanisms underlying hepatic fibrosis has advanced the prospect of developing therapies for regression of the disease. Resolution of fibrosis requires a reduction of proinflammatory and fibrogenic cytokines, a decrease in extracellular matrix (ECM) protein production, an increase in collagenase activity, and finally, a disappearance of activated myofibroblasts. Read More

Lancet 2019 Feb 11. Epub 2019 Feb 11.

AP-HP, Hôpital Cochin, Unité d'Hépatologie, Paris, France; Université Paris Descartes, INSERM U1223 and USM-20, Institut Pasteur, Paris, France.

Background: Although direct-acting antivirals have been used extensively to treat patients with chronic hepatitis C virus (HCV) infection, their clinical effectiveness has not been well reported. We compared the incidence of death, hepatocellular carcinoma, and decompensated cirrhosis between patients treated with direct-acting antivirals and those untreated, in the French ANRS CO22 Hepather cohort.

Methods: We did a prospective study in adult patients with chronic HCV infection enrolled from 32 expert hepatology centres in France. Read More

Acta Oncol 2019 Feb 15:1-3. Epub 2019 Feb 15.

d Division of Translational Medicine and Human Genetics, Perelman School of Medicine , University of Pennsylvania , Philadelphia , USA.

Pediatr Surg Int 2019 Feb 14. Epub 2019 Feb 14.

Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan.

Purpose: Portal hypertension in patients with biliary atresia (BA) is generally thought to result from portal vein (PV) narrowing secondary to hepatic fibrosis. To test the hypothesis, we morphometrically analyzed the PVs and hepatic arteries (HAs).

Methods: Morphometrical analyses of 25 BA and 26 non-BA liver biopsy specimens from patients treated from 2000 to 2014. Read More

Korean J Intern Med 2019 Feb 18. Epub 2019 Feb 18.

Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

Background/aims: Non-selective β-blockers (NSBBs) are used for primary prevention of esophageal variceal hemorrhage (VH) in patients with portal hypertension, but a significant number of patients develop VH while on NSBB therapy. In this study, we sought to determine whether liver volume can predict the risk of primary prophylaxis failure in cirrhotic patients on NSBB therapy.

Methods: A retrospective cohort of 309 patients on prophylactic propranolol was analyzed. Read More

Chirurg 2019 Feb 13. Epub 2019 Feb 13.

Klinik für Allgemein‑, Viszeral- und Gefäßchirurgie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.

Chirurg 2019 Feb 13. Epub 2019 Feb 13.

Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland.

Eur J Case Rep Intern Med 2018 26;5(6):000868. Epub 2018 Jun 26.

Department of Otorhinolaryngology, Hospital General Universitario Reina Sofía, Murcia, Spain.

We describe the incidental finding of an aneurysm of the left branch of the portal vein in a patient without liver pathology. The diagnosis was confirmed by Doppler ultrasound.

Learning Points: Portal vein aneurysms are rare but have been described in patients with cirrhosis and portal hypertension. Read More

BMC Pediatr 2019 Feb 11;19(1):55. Epub 2019 Feb 11.

Department of Cardiology, Shanghai Children's Hospital, Shanghai Jiaotong University, No. 355 Luding Road, Shanghai, 200062, China.

Background: Abernethy malformation is an extremely rare congenital malformation characterised by an extrahepatic portosystemic shunt. Children with Abernathy malformation can develop hepatopulmonary syndrome (HPS) with pulmonary arteriovenous fistulas (PAVF) or pulmonary hypertension. PAVF manifests as central cyanosis with effort intolerance. Read More

J Clin Gastroenterol 2019 Mar;53(3):e126-e127

Departments of Hepatology.

Genet Med 2019 Feb 11. Epub 2019 Feb 11.

Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, CRSA, Paris, France.

Purpose: The SERPINA1 Z allele is associated with cystic fibrosis (CF)-related liver disease (CFLD), a common manifestation in patients with CF. We estimated CFLD incidence based on the SERPINA1 genotype in 3328 CF patients with CFLD-phenotype information.

Methods: The associations of SERPINA1 Z (rs28929474) and S (rs17580) alleles with age at CFLD onset and the development of CFLD-related complications (severe liver disease with cirrhosis, portal hypertension, esophageal varices) were analyzed. Read More

Lancet 2019 Feb 6. Epub 2019 Feb 6.

Department of Cardiovascular Sciences, University of Leicester, Leicester, UK; NIHR Leicester Biomedical Research Centre, The Glenfield Hospital, Leicester, UK.

Background: Systolic blood pressure of more than 185 mm Hg is a contraindication to thrombolytic treatment with intravenous alteplase in patients with acute ischaemic stroke, but the target systolic blood pressure for optimal outcome is uncertain. We assessed intensive blood pressure lowering compared with guideline-recommended blood pressure lowering in patients treated with alteplase for acute ischaemic stroke.

Methods: We did an international, partial-factorial, open-label, blinded-endpoint trial of thrombolysis-eligible patients (age ≥18 years) with acute ischaemic stroke and systolic blood pressure 150 mm Hg or more, who were screened at 110 sites in 15 countries. Read More

Liver Int 2019 Feb 9. Epub 2019 Feb 9.

Department of Medicine I, University of Bonn, Bonn, Germany.

Background: Remodeling of extracellular matrix (ECM) is crucial in progressive liver fibrosis. Collagen type III desposition has been shown in acute decompensation. ECM is compiled of deposition of various components. Read More

J Infect Chemother 2019 Feb 6. Epub 2019 Feb 6.

Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan.

Bacterial peritonitis, an infection of the ascitic fluid, can be classified etiologically as spontaneous or secondary bacterial peritonitis. The former is mainly caused by portal hypertension and its subsequent effects, whereas the latter is caused by the direct dissemination of bacteria into the peritoneal cavity. Previous reports have described some distinguishing features of these two entities. Read More

Transpl Int 2019 Feb 8. Epub 2019 Feb 8.

Departments of Thoracic Surgery University Hospitals Leuven, Leuven, Belgium.

Background: Transplant type for end-stage pulmonary vascular disease remains debatable. We compared recipient outcome after heart-lung(HLT) versus double-lung(DLT) transplantation.

Methods: Single-center analysis (38HLT-30DLT; 1991-2014] for different causes of pre-capillary pulmonary hypertension(PH): idiopathic(22); heritable(2); drug-induced(9); hepato-portal(1); connective tissue disease(4); congenital heart disease(CHD)(24); chronic thromboembolic PH(6). Read More

J Hepatol 2019 Feb 4. Epub 2019 Feb 4.

Department of Obstetric Medicine, Mater Health, Australia. Electronic address:

J Hepatol 2019 Feb 4. Epub 2019 Feb 4.

Service d'Hépatologie, DHU Unity, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, Clichy, France; INSERM, U970, Paris Cardiovascular Research Center - PARCC, Paris, France; Université Denis Diderot-Paris 7, Sorbonne Paris Cité, 75018 Paris, France. Electronic address:

BMC Womens Health 2019 Feb 7;19(1):31. Epub 2019 Feb 7.

The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiaotong University, 145, Guang-yuan Road, Xuhui District, Shanghai, 200030, China.

Background: Post-menopause vaginal haemorrhage is typically related to gynaecological malignancies. Bleeding from vaginal varices rarely occurs, especially in nonpregnant women. Moreover, nonpregnancy-related causes of vaginal varicosities include portal hypertension, especially that caused by liver cirrhosis, pelvic congestion syndrome and Klippel-Trenaunay syndrome or Parkes-Weber syndrome. Read More

Niger J Clin Pract 2019 Feb;22(2):265-269

Department of General Surgery - Organ Transplantation Center, Istanbul Medipol University, Istanbul, Turkey.

Background: Patients with end-stage liver disease are prone to hemodynamic disturbances which may be aggravated with liver transplantation. Blood pooling in splanchnic area and portal hypertension cause reduction in central blood volume. Terlipressin reduces mesenteric and hepatic blood flow, causing vasoconstriction in the smooth muscles of the arteries in the splanchnic region. Read More

Dig Dis Sci 2019 Feb 6. Epub 2019 Feb 6.

Section of Gastroenterology, Evans Department of Medicine, Boston University School of Medicine, Suite 7717, 85 E Concord St, Boston, MA, 02118, USA.

Primary sclerosing cholangitis is a rare, chronic cholestatic liver disease characterized by progressive idiopathic stricturing of the biliary system, typically leading to cirrhosis, end-stage liver disease, and colonic or hepatobiliary malignancy. Its presentation is often that of asymptomatic alkaline phosphatase elevation. When symptoms are present, they typically include fatigue, pruritus, or jaundice. Read More

Liver Int 2019 Feb 5. Epub 2019 Feb 5.

Inserm, U1016,Institut Cochin, Paris, 75014, France.

Background/aims: Loss of hepatocyte nuclear factor-4α (HNF4α), a critical factor driving liver development and differentiation, is frequently associated with hepatocellular carcinoma (HCC). Our recent data revealed that HNF4α level was decreased in mouse and human HCCs with activated β-catenin signaling. In addition, increasing HNF4α level by miR-34a inhibition slowed tumor progression of β-catenin activated HCC in mice. Read More

J Mol Med (Berl) 2019 Feb 5. Epub 2019 Feb 5.

Storr Liver Unit, Westmead Millennium Institute and Westmead Hospital, University of Sydney, Westmead, NSW, 2145, Australia.

Recent studies have indicated that the Adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK) pathway is closely involved in liver fibrosis and other fibrotic diseases. However, whether targeting the AMPK pathway can rescue liver fibrosis and its complications, such as portal hypertension, is unknown. This study aimed to explore the therapeutic value of AICAR (5-aminoimidazole-4-carboxyamide ribonucleoside), an agonist of the AMPK pathway, on liver fibrosis and portal hypertension in bile duct ligation (BDL) rats. Read More

J Clin Gastroenterol 2019 Feb 1. Epub 2019 Feb 1.

Department of Oncology Interventional Therapy, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Pudong, Shanghai, China.

Background: Early diagnosis of portal hypertension is imperative for timely treatment to reduce the mortality rate. However, there is still no adequate method to noninvasively and accurately assess the portal hypertension in routine clinical practice.

Purpose: We aimed to evaluate the accuracy of parameters measured using dual energy spectral computed tomography (LightSpeed CT750 HD) in assessing portal venous pressure in patients with liver cirrhosis. Read More

Can J Gastroenterol Hepatol 2019 2;2019:1673197. Epub 2019 Jan 2.

Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Italy.

Aims: Budd-Chiari Syndrome (BCS) is a rare vascular disease of the liver caused by the obstruction of the hepatic venous outflow located from the small hepatic venules up to the entrance of the inferior vena cava (IVC) into the right atrium. Current prognostic indexes are suboptimal for an individual prognostic assessment and subsequent management of patients with BCS. Liver (LSM) and spleen (SSM) stiffness measurements are widely validated prognostic tools in hepatology, but the evidence in patients with BCS is limited. Read More

J Vasc Interv Radiol 2019 Feb;30(2):187-194

Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Virginia Health System, 1215 Lee Street, Charlottesville, VA 22903. Electronic address:

Purpose: To assess short- and long-term mortality and rebleeding with endoscopic cyanoacrylate (EC) versus balloon-occluded retrograde transvenous obliteration (BRTO).

Materials And Methods: A retrospective cohort comparison was conducted of 90 EC patients and 71 BRTO patients from 1997 through 2015 with portal hypertension who presented due to endoscopically confirmed bleeding cardiofundal gastric varices. Patients underwent either endoscopic intra-varix injection of 4-carbon-n-butyl-2-cyanoacrylate or sclerosis with sodium tetradecyl sulfate with balloon occlusion for primary variceal treatment. Read More

Diagn Interv Imaging 2019 Jan 30. Epub 2019 Jan 30.

Department of Radiology, centre hospitalier universitaire de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France.

Purpose: The purpose of our study was to retrospectively assess the safety and efficacy of percutaneous real-time ultrasound guidance for portal vein puncture during transjugular intrahepatic portosystemic shunt (TIPS) placement.

Materials And Methods: Between January 2011 and November 2018, procedure details and outcome were retrospectively analyzed for 224 patients who underwent TIPS placement using real-time ultrasound guidance for portal vein puncture. There were 175 men and 49 women with a mean age of 52. Read More

BMJ Case Rep 2019 Jan 31;12(1). Epub 2019 Jan 31.

Intensive Care Medicine, Ente Ospedaliero Cantonale, Ospedale Regionale di Mendrisio, Mendrisio, Switzerland.

A middle-aged woman previously in good health arrived to hospital with severe haemorrhagic shock. An abdominal and pelvic CT scan showed hepatomegaly, fluid in the sigmoid colon, perigastric and right sided pelvic varices without a clear source of bleeding. Urgent esophagogastroduodenoscopy excluded gastric varices and active upper gastrointestinal bleeding and the colonoscopy was inconclusive due to haemodynamic instability and massive bleeding which made it impossible to proceed with a full colonoscopy. Read More

J Gastroenterol 2019 Feb 1. Epub 2019 Feb 1.

Department of Gastroenterology, Kanazawa University Graduate School of Medical Science, 13-1 Takara-Machi, Kanazawa, Ishikawa, 920-8641, Japan.

Background: Nonalcoholic steatohepatitis (NASH) is associated with liver inflammation in patients with nonalcoholic fatty liver disease, and it can progress to liver fibrosis at an advanced stage, as well as hepatocellular carcinoma (HCC) and portal hypertension. Although liver fibrosis is accurately diagnosed via biopsy, noninvasive methods are preferable. Aldo-keto reductase family 1 member B10 (AKR1B10) is associated with HCC and is secreted into the blood by liver cells via a lysosome-mediated nonclassical pathway. Read More

Pediatrics 2019 Jan 31. Epub 2019 Jan 31.

Departments of Pediatrics, Gastroenterology, and Hepatology and

Pediatric intractable autoimmune hepatitis is rare and may be responsible for acute liver failure. Mutations in the itchy E3 ubiquitin protein ligase () gene (located on chromosome 20q11.22) can lead to a deficiency of the encoded protein, resulting in increased T-cell activity with lack of immune tolerance and manifestation of a complex systemic autoimmune disease. Read More