A 60-year-old man presented with hematemesis. He had been diagnosed with pancreatic tail cancer and gastric varices due to sinistral portal hypertension, which had been observed on computed tomography (CT). An upper gastrointestinal endoscopy was undertaken to assess the gastric varices, and a recent gastric variceal bleed was suggested (Figure 1). Although splenectomy was a definitive therapy,...

The bleeding of peristomal varices due to a portosystemic shunt is rare but potentially life-threatening in cirrhotic patients with portal hypertension. The scarce case reports in the literature recommend transjugular intrahepatic portosystemic shunt (TIPS) to prevent further bleeding. We report on a 72-year-old man who was referred to our hospital because of life-threatening bleeding from peri...

Bleeding gastroesophageal varices is associated with a high morbidity and mortality. Forty-four cases of bleeding gastroesophageal varices were treated at the Department of Surgery, Universiti Kebangsaan Malaysia, General Hospital, Kuala Lumpur over four and a half years. Thirty-two of them had liver cirrhosis. Hepatitis B infection was noted in 13 and alcoholic abuse was present in 14 patients...

Gastric variceal bleeding is a major complication of portal hypertension and is associated with high morbidity and mortality. While esophageal varices are more common, gastric varices are often more challenging to treat. Balloon-Occluded Retrograde Transvenous Obliteration is an interventional procedure whereby the portosystemic gastrorenal shunt is accessed via the left renal vein and the gast...

Bleeding from oesophageal varices, oesophageal ulcers or oesophagitis is occasionally massive and difficult to control. Octreotide, a synthetic analogue of somatostin lowers portal pressure and collateral blood flow including that through varices, increases lower oesophageal sphincter pressure, and inhibits the gastric secretion of acid as well as pepsin. Our current experience suggests it is e...

OBJECTIVE To evaluate platelet count/ splenic size ratio as a non-invasive parameter to predict the presence and absence of esophageal varices in patients with cirrhosis of liver. DESIGN An observational, cross- sectional study. PLACE AND DURATION OF STUDY The medical units of the Civil Hospital, Karachi, between October 2003 and October 2004. PATIENTS AND METHODS During one year of study...

OBJECTIVES/HYPOTHESIS To establish risk of hemorrhage in patients with varices compared to those without, determine additional risk factors, and make evidence-based treatment recommendations. STUDY DESIGN Retrospective cohort study. METHODS Patients who were vocal performers presenting for care during a 24-month period were analyzed to determine incidence of hemorrhage. Patients with varice...

BACKGROUND The transjugular intrahepatic portosystemic stent shunt (TIPSS) is effective in the management of both oesophageal and gastric variceal bleeding. Although it has been reported that gastric varices can bleed at pressures of < or = 12 mm Hg, this phenomenon has been little studied in the clinical setting. AIMS To assess the efficacy of TIPSS on rebleeding and mortality following gast...

AIM To investigate the association between plasma concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and formation of esophageal varices. METHODS Thirty-five patients with alcoholic cirrhosis were divided into three groups according to the Child-Pugh classification: grade A (n=11, 32%), B (n=12, 34%), and C (n=12, 34%). System hemodynamic parameters were measured using sp...