| Bleeding ectopic varices in cirrhosis: the role of TIPSS. | |
| | |
MedLine Citation:
|
PMID: 18419756 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
Introduction: Bleeding from ectopic varices is uncommon but can be difficult to manage. We report here, our experience of use of transjugular intrahepatic portosystemic shunts (TIPSS) in management of uncontrolled bleeding from ectopic varices. Methods: A retrospective study of patients who had TIPSS for bleeding ectopic varices. Patients were selected from a dedicated data base. Results: Over 14 years, of 750 TIPSS insertions, 28 patients had TIPSS for bleeding ectopic varices. (C-P score:8.8+/-1.8). Varices were rectal (12), stomal (8), duodenal (4) and at other sites (4). Concomitant variceal embolisation was performed in 5. Portal pressure gradient fell from 18.2+/-6.4 to 7.2+/-3.5 mmHg. TIPSS achieved haemostasis in 6 of 9 patients who presented with active bleeding. Five patients rebled from ectopic varices. This was related to shunt dysfunction in two and responded to shunt interventions. Three patients rebled despite a functional shunt. Of these, thrombin controlled bleeding in one. Eight patients developed hepatic encephalopathy post-TIPSS. Conclusions: TIPSS is a safe and effective treatment for bleeding ectopic varices. Rebleeding from ectopic varices related to shunt dysfunction responds to shunt intervention. A significant proportion of patients have rebleeding despite a patent shunt where other adjunctive measures like thrombin injection may be tried. |
| | |
Authors:
|
N Kochar; D Tripathi; N C McAvoy; H Ireland; D N Redhead; P C Hayes |
Related Documents
:
|
9367696 - A retrospective review of paclitaxel-associated gastrointestinal necrosis in patients w... 7647446 - Catheter tract hemorrhage during percutaneous biliary intervention: management with use... 19172516 - Glanzmann's thrombasthenia in north indians: sub classification and carrier detection b... 3663506 - Response to therapy in 37 patients with hiv-related thrombocytopenic purpura. 21135546 - Fibroblast growth factor 23 in chronic kidney disease: bridging the gap between bone mi... 20122556 - Heart failure with preserved versus reduced left ventricular systolic function: a prosp... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2008-4-18 |
Journal Detail:
|
Title: Alimentary pharmacology & therapeutics Volume: - ISSN: 1365-2036 ISO Abbreviation: Aliment. Pharmacol. Ther. Publication Date: 2008 Apr |
Date Detail:
|
Created Date: 2008-4-18 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8707234 Medline TA: Aliment Pharmacol Ther Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
Dept of Hepatology, Royal Infirmary of Edinburgh, UK. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: A direct role for phosphatidylinositol-4,5-bisphosphate in unconventional secretion of fibroblast gr...
Next Document: Hepatitis C patients' self-reported adherence to pegylated interferon and ribavirin.