‘De novo’ development of esophageal varices in patients with a recent histologic diagnosis of liver cirrhosis

Primignani, Massimo; Albè, R.; Preatoni, Paoletta; Carnevale, Paolo; Bianchi, M.; Parravicini, M. L.; Ninno, E. Del; Franchis, R. De

doi:10.1016/s0016-5085(98)85374-2

Cited by 15 publications

(6 citation statements)

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“…Approximately 30% of the patients with compensated cirrhosis and 60% of those with decompensated cirrhosis have varices at endoscopy (42,43,117) . One study from Italy involving 111 subjects with cirrhosis revealed a cumulative incidence of varices of 5% and 20% in 2 and 5 years, respectively (117) .…”

Section: ) Screening Of Varices In Patients With Portal Hypertensionmentioning

confidence: 99%

“…One study from Italy involving 111 subjects with cirrhosis revealed a cumulative incidence of varices of 5% and 20% in 2 and 5 years, respectively (117) . Merli et al (100) evaluated 206 cirrhotics with annual endoscopy and disclosed the appearance of varices in 5% and 28% of the subjects at 1 and 3 years of follow-up, respectively.…”

Section: ) Screening Of Varices In Patients With Portal Hypertensionmentioning

confidence: 99%

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Variceal bleeding: consensus meeting report from the Brazilian Society of Hepatology

Bittencourt

Farias

Strauss

et al. 2010

Arq. Gastroenterol.

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-In the last decades, several improvements in the management of variceal bleeding have resulted in a significant decrease in morbidity and mortality of patients with cirrhosis and bleeding varices. Progress in the multidisciplinary approach to these patients has led to a better management of this disease by critical care physicians, hepatologists, gastroenterologists, endoscopists, radiologists and surgeons. In this respect, the Brazilian Society of Hepatology has, recently, sponsored a consensus meeting in order to draw evidence-based recommendations on the management of these difficult-to-treat subjects. An organizing committee comprised of four people was elected by the Governing Board and was responsible to invite 27 researchers from distinct regions of the country to make a systematic review of the subject and to present topics related to variceal bleeding, including prevention, diagnosis, management and treatment, according to evidence-based medicine. After the meeting, all participants met together for discussion of the topics and the elaboration of the aforementioned recommendations. The organizing committee was responsible for writing the final document. The meeting was held at Salvador, May 6th, 2009 and the present manuscript is the summary of the systematic review that was presented during the meeting, organized in topics, followed by the recommendations of the Brazilian Society of Hepatology.

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Section: ) Screening Of Varices In Patients With Portal Hypertensionmentioning

confidence: 99%

Section: ) Screening Of Varices In Patients With Portal Hypertensionmentioning

confidence: 99%

Variceal bleeding: consensus meeting report from the Brazilian Society of Hepatology

Bittencourt

Farias

Strauss

et al. 2010

Arq. Gastroenterol.

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“…Once established, varices can remain indolent or grow in size, and also cause lifethreatening haemorrhage. When the portal pressure is above 10 mmHg, the median time for the development of varices is 4 years [21] while some studies show a de novo formation rate of 4-6% per year [22,23].…”

Section: Growth Classification and Location Of Varicesmentioning

confidence: 99%

Endoscopic Management of Oesophageal and Gastric Varices

Rajoriya¹,

Gorard²

2013

Endoscopy of GI Tract

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Chronic liver disease of any aetiology can result in portal hypertension. Portal hypertension leads to the formation of porto-systemic collaterals including gastro-oesophageal varices. The development of portal hypertension can also herald the development of other complications of liver cirrhosis such as ascites formation, hepatic encephalopathy and when varices occur, their bleeding. However it should be noted that portal hypertension also occurs in non-cirrhotic conditions, such as "udd-Chiari, myeloproliferative diseases and extra-hepatic portal vein obstruction.Variceal haemorrhage is a serious life-threatening complication of portal hypertension, with overall mortality rates historically reported as -% [ ]. "lthough mortality can be up to % at weeks, it can be up to % at year [ ]. With the generally improved management of the critically ill cirrhotic patient, together with vasoactive therapy and new endoscopic techniques for managing variceal haemorrhage, overall mortality has reduced, with one centre in Europe showing a reduction from % in to % in [ ]. The treatment of gastric varices has also evolved over recent years with the introduction of adhesive compounds such as N-butyl--cyanoacrylate and thrombin, and the increased use of Transjugular Intrahepatic Portosystemic Shunts TIPS in variceal bleeding and early in rebleeding. New self-expanding oesophageal stents have been developed for oesophageal haemorrhage in the ever expanding endoscopic armamentarium against variceal bleeding. Earlier emergency access to endoscopy performed by skilled endoscopists has coincided with the decline in use of tamponade equipment such as Sengstaken-"lakemore tubes, and the virtual extinction of emergency surgical procedures of oesophageal transection or porto-caval shunt formation.© 2013 Rajoriya and Gorard; licensee InTech. This is an open access ar"icle dis"rib""ed "nder "he "erms of "he Crea"ive Commons A""rib""ion License (h""p://crea"ivecommons.org/licenses/by/3.0), which permi"s "nres"ric"ed "se, dis"rib""ion, and reprod"c"ion in any medi"m, provided "he original work is properly ci"ed.This chapter addresses the aetiology and pathogenesis of oesophageal and gastric varices, the strategy of primary prophylaxis against variceal bleeding, and reviews the medical and endoscopic treatment of variceal haemorrhage and rebleeding thereafter. . Portal hypertension and the development of varicesPortal hypertension is a key factor in the development of oesophageal or gastric varices. The endoscopic appearances of oesophageal and gastric varices can be seen in Figures and respectively. Gas"ric varix seen on re"roflexion of "he endoscope in f"nd"s of "he s"omach wi"h "he classical hanging grapes appearance (co"r"esy of Dr Branislav K"nčak, Universi"y of Trnava and Nové Zámky Hospi"al, Nové Zámky, Slovakia a" www.Endoa"las.sk) Endoscopy of GI Trac" 100The portal pressure is the pressure in the portal vein and portal vein tributaries. Normal portal pressure is -mmHg. When the portal pressure gradient difference in pressure betwee...

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“…Portal hypertension is a serious complication of chronic liver disease. Varices are the most common clinical manifestations though their prevalence is extremely variable, ranging from 24% to 80% [1,2]. This wide range seems to be related to the degree of liver dysfunction: compensated patients show a lower prevalence than decompensated ones.…”

Section: Introductionmentioning

confidence: 99%

Fatal hemorrhage from a periumbilical wound: Stabbing or hemorrhage from a caput medusae?

Frigiolini

Pinto

Caputo

et al. 2020

Journal of Forensic Sciences

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Portal hypertension is a serious complication of chronic liver disease. Varices are the most common clinical manifestations though their prevalence is extremely variable, ranging from 24% to 80% [1,2]. This wide range seems to be related to the degree of liver dysfunction: compensated patients show a lower prevalence than decompensated ones. Bleeding from ruptured varices is the predominant cause of mortality in patients with portal hypertension, and they represent the cause of death in about one third of cirrhotic subjects [3,4]. The most common site of varices is the lower esophagus, but they may occur at any location where there are portosystemic anastomoses [5,6], like the rectum, the peritoneum, the right diaphragm, the falciform and splenic ligaments, and the umbilicus. Any nongastroesophageal site is referred to as an "ectopic varix" [7,8]. Periumbilical varices are known as "caput medusae." Bleeding from ectopic varices represents only 1-5% of all variceal bleeding [9,10]: more specifically, exsanguination from caput medusae is

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‘De novo’ development of esophageal varices in patients with a recent histologic diagnosis of liver cirrhosis

Cited by 15 publications

References 0 publications

Variceal bleeding: consensus meeting report from the Brazilian Society of Hepatology

Variceal bleeding: consensus meeting report from the Brazilian Society of Hepatology

Endoscopic Management of Oesophageal and Gastric Varices

Fatal hemorrhage from a periumbilical wound: Stabbing or hemorrhage from a caput medusae?

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