1.Assessment and Current Treatment of Portal Hypertension.
The Korean Journal of Hepatology 2005;11(3):211-217
No abstract available.
Humans
;
*Hypertension, Portal/diagnosis/therapy
3.Clinical analysis of childhood cavernous transformation of the portal vein.
Ying LI ; Yue-Hua LI ; Li-Juan ZHANG ; Heng-Ming PAN
Chinese Journal of Contemporary Pediatrics 2006;8(1):75-76
Child
;
Child, Preschool
;
Female
;
Humans
;
Hypertension, Portal
;
diagnosis
;
etiology
;
therapy
;
Infant
;
Male
;
Portal Vein
;
pathology
;
Venous Thrombosis
;
diagnosis
;
etiology
;
therapy
5.Ascites, Hepatorenal Syndrome and Spontaneous Bacterial Peritonitis in Patients with Portal Hypertension.
The Korean Journal of Gastroenterology 2010;56(3):168-185
Ascites, hepatic encephalopathy and variceal hemorrhage are three major complications of portal hypertension. The diagnostic evaluation of ascites involves an assessment of its etiology by determining the serum-ascites albumin gradient and the exclusion of spontaneous bacterial peritonitis. Ascites is primarily related to an inability to excrete an adequate amount of sodium into urine, leading to a positive sodium balance. Sodium restriction and diuretic therapy are keys of ascites control. But, with the case of refractory ascites, large volume paracentesis and transjugular portosystemic shunts are required. In hepatorenal syndrome, splanchnic vasodilatation with reduction in effective arterial volume causes intense renal vasoconstriction. Splanchnic and/or peripheral vasoconstrictors with albumin infusion, and renal replacement therapy are only bridging therapy. Liver transplantation is the only definitive modality of improving the long term prognosis.
Anti-Bacterial Agents/therapeutic use
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Ascites/complications/*diagnosis/therapy
;
Bacterial Infections/*diagnosis
;
Hepatic Encephalopathy/complications
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Hepatorenal Syndrome/complications/*diagnosis/therapy
;
Humans
;
Hypertension, Portal/*complications
;
Liver Transplantation
;
Peritonitis/*diagnosis/drug therapy/etiology
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Serum Albumin/administration & dosage
6.Pharmacological Therapy of Portal Hypertension: Focused on Korean Data.
The Korean Journal of Gastroenterology 2005;45(6):381-386
Portal hypertension as a consequence of liver cirrhosis is responsible for serious complications such as variceal bleeding, ascites and hepatic encephalopathy. Successful pharmacological treatment of portal hypertension can prevent the risk of the variceal bleeding, and contribute to reduce the morbidity and mortality in patients with liver cirrhosis. To identify the effect of drugs on portal hypertension, portal pressure was evaluated accurately before and after the drug administration. The hepatic venous pressure gradient has been accepted as the gold-standard method for assessing the severity of portal hypertension and the response to drug treatment. The mean hepatic venous pressure gradient was 15.1+/-5.4 mmHg in Korean cirrhotic patients who had experienced variceal bleeding. Non-selective beta blockers are the treatment of choice for primary and secondary prevention of variceal bleeding. The dose of propranolol should be subsequently adjusted until the resting heart rate had been reduced by 25% or less than 55 beats per minute. It has been reported that the optimal dose of propranolol is variable due to racial differences in cardiovascular receptor sensitivity. In Korean patients with portal hypertension and liver cirrhosis, the mean required dose of propranolol to reach target heart rate was 165 mg (range; 80-280 mg). This review covers mainly the results of the pharmacological therapy of portal hypertension in Korean cirrhotic patients.
Adrenergic beta-Antagonists/administration & dosage
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Hepatic Veins
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Humans
;
Hypertension, Portal/diagnosis/*drug therapy/physiopathology
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Korea
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Liver Cirrhosis/complications/physiopathology
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Propranolol/administration & dosage
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Venous Pressure/drug effects
7.Progress in the diagnosis and treatment of hepatic hydrothorax.
Hong-cui LI ; Xiao LI ; Cheng-wei TANG
Chinese Journal of Hepatology 2009;17(12):958-960
Ascites
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diagnosis
;
etiology
;
therapy
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Diagnostic Imaging
;
methods
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Humans
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Hydrothorax
;
diagnosis
;
etiology
;
therapy
;
Hypertension, Portal
;
complications
;
Liver Cirrhosis
;
complications
;
Liver Transplantation
;
Pleural Effusion
;
diagnosis
;
etiology
;
therapy
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Portasystemic Shunt, Transjugular Intrahepatic
8.Diagnosis and treatment of mesenteric venous thrombosis: analysis of eleven cases.
Bao LIU ; Yong-jun LI ; Yue-hong ZHENG ; Chang-wei LIU ; Xiao-dong HE ; Chao-ji ZHENG ; Yu-pei ZHAO ; Heng GUAN
Acta Academiae Medicinae Sinicae 2003;25(2):190-192
OBJECTIVETo evaluate the diagnosis and treatment of mesenteric venous thrombosis.
METHODSThe clinical data of 11 cases diagnosed as mesenteric venous thrombosis between 1992 and 2001 in PUMC Hospital were analyzed retrospectively.
RESULTSPostoperative state(27.3%), especially cirrhosis and portal hypertension, and other history of thrombosis (27.3%) were the most common causes. Thrombolysis was performed successfully in two of the eleven cases. The rest of them were misdiagnosed in other hospitals and operated. No patient died after operation, and one (11.1%) recurrence was found.
CONCLUSIONSEarly application of anticoagulant is necessary for patients with thrombosis risks. For suspected patients, early computed tomography (CT) and DSA examination should be performed, and prompt thrombolysis and anticoagulation therapy can be performed to avoid the bowel resection after definite diagnosis. To reduce the recurrence, anticoagulant should be maintained for a proper time.
Adult ; Aged ; Diagnostic Errors ; Female ; Humans ; Hypertension, Portal ; surgery ; Male ; Mesenteric Veins ; Middle Aged ; Postoperative Complications ; diagnosis ; drug therapy ; Retrospective Studies ; Thrombolytic Therapy ; Urokinase-Type Plasminogen Activator ; therapeutic use ; Venous Thrombosis ; diagnosis ; drug therapy
9.Portal Hypertensive Gastropathy and Gastric Antral Vascular Ectasia.
The Korean Journal of Gastroenterology 2010;56(3):186-191
Portal hypertensive gastropathy (PHG) is a term used to define the endoscopic findings of gastric mucosa with a characteristic mosaic-like pattern with or without red spots, and a common finding in patients with portal hypertension. These endoscopic findings correspond to dilated mucosal capillaries without inflammation. The pathogenesis of PHG in not well known, but portal hypertension and some humoral factors seem to be crucial factors for its development. Pharmacological (e.g. propranolol), or interventional radiological (such as transjugular intrahepatic portosystemic shunt) procedures may be useful in preventing re-bleeding from PHG. The classic features of gastric antral vascular ectasia (GAVE) syndrome include red, often haemorrhagic lesions predominantly located in the gastric antrum which can result in significant blood loss. Although the pathogenesis of GAVE is not clearly defined, it seems to be a separate disease entity from PHG, because GAVE generally does not respond to a reduction of portal pressures. Endoscopic ablation (such as argon plasma coagulation) is the first-line treatment of choice. This review will focus on the incidence, clinical importance, etiology, pathophysiology, and treatment of PHG and GAVE syndrome in the setting of portal hypertension.
Esophageal and Gastric Varices/*diagnosis/etiology/therapy
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Gastric Antral Vascular Ectasia/*diagnosis/etiology/therapy
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Gastric Mucosa/metabolism/pathology
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Humans
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Hypertension, Portal/*complications
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Portasystemic Shunt, Transjugular Intrahepatic
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Vasodilator Agents/therapeutic use
10.A case of variceal bleeding from the jejunum in liver cirrhosis.
Chan Woong PARK ; Sae Hee KIM ; Hyeon Woong YANG ; Yun Jung LEE ; Sung Hee JUNG ; Ho Sup SONG ; Sang Ok LEE ; Anna KIM ; Sang Woo CHA
Clinical and Molecular Hepatology 2013;19(1):78-81
While esophagogastric varices are common manifestations of portal hypertension, variceal bleeding from the jejunum is a rare complication of liver cirrhosis. In addition, ectopic variceal bleeding occurs in the duodenum and at sites of previous bowel surgery in most cases, including of stomas. We report a case of obscure overt gastrointestinal bleeding from jejunal varices in a 55-year-old woman who had not previously undergone abdominal surgery, who had liver cirrhosis induced by the hepatitis C virus. Emergency endoscopy revealed the presence of esophageal varices without stigmata of recent bleeding, and no bleeding focus was found at colonoscopy. She continued to produce recurrent melena with hematochezia and received up to 21 units of packed red blood cells. CT angiography revealed the presence of jejunal varices, but no active bleeding was found. Capsule endoscopy revealed fresh blood in the jejunum. The patient submitted to embolization of the jejunal varices via the portal vein, after which she had a stable hemoglobin level and no recurrence of the melena. This is a case of variceal bleeding from the jejunum in a liver cirrhosis patient without a prior history of abdominal surgery.
Angiography
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Capsule Endoscopy
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Embolization, Therapeutic
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Esophageal and Gastric Varices/complications/diagnosis
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Female
;
*Gastrointestinal Hemorrhage
;
Humans
;
Hypertension, Portal
;
Jejunal Diseases/*diagnosis/therapy
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Liver Cirrhosis/*diagnosis
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Melena/complications
;
Middle Aged
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Tomography, X-Ray Computed