Gastrointestinal bleeding related to portal hypertension is a serious complication in patients with liver cirrhosis. Most patients bleed from esophageal or gastric varices, but bleeding from ectopic varices or portal hypertensive gastropathy is also possible. The management of acute bleeding has changed over the last years. Patients are managed with a combination of endoscopic and pharmacologic...

After an episode of acute bleeding from esophageal varices, patients are at a high risk for recurrent bleeding and death. However, there are few reports regarding the long-term results of secondary prophylaxis using endoscopic variceal ligation (EVL) against variceal rebleeding in pediatrics. Thirty-seven, who were followed for over 3 yr post-eradication, were included in the study. The mean du...

Budd-Chiari syndrome is characterized by hepatic venous outflow obstruction. We describe a patient with a huge caudate lobe of the liver due to Budd-Chiari syndrome. A 49-year-old woman was referred to Nippon Medical School Hospital to receive treatment for enlarged gastric varices. She had been followed up for idiopathic portal hypertension with deformity of the liver for 7 years and had under...

Gastric varices (GV) are less prevalent than esophageal ones. It has been estimated that GV are present in 8-15% of patients with cirrhosis and portal hypertension. However, the prevalence of GV, in those patients with non-cirrhotic portal hypertension, has been estimated to be around 20%. GV should also be investigated in patients who present with splenic vein thrombosis (segmentary portal hyp...

AIM To determine whether diameters of the left gastric vein (LGV) and its originating vein are associated with endoscopic grades of esophageal varices. METHODS Ninety-eight liver cirrhotic patients with hepatitis B undergoing magnetic resonance (MR) portography, and upper gastrointestinal endoscopy for grading esophageal varices were enrolled. Diameters of the LGV and its originating vein - t...

Observations: Subsurface microstructure and microcirculation images of normal and pathologic GI tissues, including Barrett’s esophagus, esophageal varices, portal hypertensive gastropathy, gastric antral vascular ectasia, gastric lymphoma, and duodenal adenocarcinoma, were obtained from 72 individual sites in vivo. Differences in vessel diameter, distribution, density, and blood-flow velocity w...

A 61-year-old man was referred to our hospital to treat extrahepatic portal venous obstruction. Endoscopic injection sclerotherapy (EIS) was performed for the esophageal varices; however, the patient returned with massive hematemesis from gastric varices 6 months after treatment. Although the varices were treated with EIS, gastric devascularization and splenectomy concomitant with shunt surgery...

Esophageal varices are present in 50% of cirrhotic patients. Th eir presence is correlated with the severity of the liver disease. While only 40 % of Child A cirrhosis patients have varices, 85% of patients with Child C cirrhosis have esophageal varices at the time of diagnosis (1). Prospective studies show that cirrhotic patients without esophageal varices develop them at an 8% annual rate and...

Catastrophic bleeding from gastric varices rupture is a life-threatening emergency. In many instances a SengstakenBlakemore balloon tube cannot stop the bleeding and this area is also beyond the field of sclerotherapy. Surgery seems the only definite therapy, which may offer chances for survival, no recurrent bleeding and no hepatic encephalopathy [1]. Herein we present a 67-year-old patient wi...

Transesophageal echocardiography (TEE) has proved invaluable in the evaluation of a number of conditions, including stroke, endocarditis, prosthetic valves, and acute aortic syndromes, as well as in the preoperative and perioperative evaluation of valvular heart disease. The value of TEE must of course be balanced against the risk of performing the procedure. The insertion and manipulation of a...