Chronic intestional pseudoobstruction syndrome is a rare clinical condition in which impaired intestinal peristalsis. Causes recurrent symptoms of bowel obstruction in the absence of a mechanical occlusion. This syndrome may involve variable segments of small or large bowel. And may be associated with urinary bladder retention. This study included 6 children(3 boys and 3 girls) of chronic intestinal obstruction. Four were symptomatic at birth and two were of the ages of one month and one year. All had abdominal distention and defication difficulty. Five had urinary bladder distention. Despite parenteral nutrition and surgical intervention(ileostomy or colostomy), bowel obstruction persisted and four patients expired from sepsis within one year. All had gaseous distention of small and large bowel on abdominal films. In small bowel series. Consistent findings were variable degree of dilatation. Decreased peristalsis(prolonged transit time) and microcolon or microrectum. This disease entity must be differentiated from congenital megacolon, ileal atresia and megacystis syndrome.
Dilatation ; Hirschsprung Disease ; Humans ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction* ; Parenteral Nutrition ; Parturition ; Peristalsis ; Sepsis ; Urinary Bladder

Liver cirrhosis results from chronic liver injury that leads to necroinflammation and fibrosis. The development of liver cirrhosis is significantly associated with increased morbidity and mortality. Liver biopsy has been considered to be the gold standard for the diagnosis of liver cirrhosis, which is characterized by diffuse fibrosis and the development of regenerating nodules. However, liver biopsy is invasive and has some drawbacks, such as sampling error and intraobserver and interobserver variability in the assessment of fibrosis stages. Recently, various non-invasive tests such as serum markers, radiologic tests, and elastography have been investigated to overcome the limitations of liver biopsy. This review will focus on the use of these non-invasive tests for diagnosing liver cirrhosis.
Biomarkers ; Biopsy ; Diagnosis* ; Elasticity Imaging Techniques ; Fibrosis ; Liver Cirrhosis* ; Liver* ; Mortality ; Observer Variation ; Selection Bias

One author's affiliation is misspelled in original article.

Because of the anatomical position and its unique vascular system, the liver is susceptible to the exposure to the microbial products from the gut. Although large amount of microbes colonize in the gut, translocation of the microbes or microbial products into the liver and systemic circulation is prevented by gut epithelial barrier function and cleansing and detoxifying functions of the liver in healthy subjects. However, when the intestinal barrier function is disrupted, large amount of bacterial products can enter into the liver and systemic circulation and induce inflammation through their receptors. Nowadays, there have been various reports suggesting the role of gut flora and bacterial translocation in the pathogenesis of chronic liver disease and portal hypertension. This review summarizes the current knowledge about bacterial translocation and its contribution to the pathogenesis of chronic liver diseases and portal hypertension.
Antigens, CD14/metabolism ; Bacterial Translocation ; Gastrointestinal Tract/*microbiology ; Humans ; Hypertension, Portal/metabolism/*pathology ; Liver/metabolism/*microbiology ; Liver Cirrhosis/metabolism/*pathology ; Receptors, Cytoplasmic and Nuclear/metabolism ; Toll-Like Receptors/metabolism

No abstract available.
Biopsy ; Elasticity ; *Elasticity Imaging Techniques ; Fatty Liver/complications ; Hepatitis B, Chronic/complications ; Hepatitis C, Chronic/complications ; Humans ; Inflammation/complications ; Liver Cirrhosis/etiology/pathology/*ultrasonography ; Risk Factors ; Severity of Illness Index

No abstract available.

Ascites is the most common complication of liver cirrhosis and the first presentation of hepatic decompensation in most of patients with liver cirrhosis. In addition, the development of ascites is the significant predictor for poor prognosis. The therapeutic modalities for the control of uncomplicated ascites include low sodium diet and diuretics. Spironolactone is the drug of choice for the control of cirrhotic ascites, while furosemide is generally used as an adjunct to spironolactone. In patients with refractory ascites, repeated large-volume paracentesis is the treatment choice. Spontaneous bacterial peritonitis (SBP) is the most common infection in patients with liver cirrhosis. Although inhospital mortality of patients with SBP have significantly reduced with the rapid diagnosis and choice of effective antibiotics, still 15~20% of patients died during hospitalization. Third-generation cephalosporin is the drug of choice for the treatment of SBP, which can cover about 95% of causative organisms. In patients with high-risk of SBP, prophylactic antibiotics should be considered.
Anti-Bacterial Agents ; Ascites ; Diet ; Diuretics ; Furosemide ; Hospital Mortality ; Hospitalization ; Humans ; Liver Cirrhosis ; Paracentesis ; Peritonitis ; Prognosis ; Sodium ; Spironolactone

Acute kidney injury (AKI) is common in patients with liver cirrhosis, occurring in 13-20% of patients hospitalized with decompensated cirrhosis, and is significantly associated with the prognosis. The development and progression of AKI is an independent predictive factor for mortality in these patients. If AKI develops, the renal function declines progressively even if AKI is improved later, the patients have a poorer prognosis compared to those who have not developed AKI. In addition, in patients without appropriate treatment or no improvement with the initial treatment, AKI often progress to hepatorenal syndrome (HRS), which is associated with significant morbidity and mortality. Therefore, early detection and appropriate management for the development of AKI is very important in these patients. Recently, there have been significant revisions in the diagnostic criteria and treatment of AKI and HRS; this manuscript reviews these changes.
Acute Kidney Injury* ; Fibrosis ; Hepatorenal Syndrome* ; Humans ; Liver Cirrhosis ; Mortality ; Prognosis

Ascites is a common complication in patients with liver cirrhosis and is the most common cause of hospitalization in these patients. The development of ascites is associated with a poor prognosis in patients with liver cirrhosis with a higher mortality rate than in those without ascites. Furthermore, the presence of cirrhotic ascites is related to the development of various serious complications, such as refractory ascites, spontaneous bacterial peritonitis, acute kidney injury, and hepatorenal syndrome. Therefore, early detection and appropriate management for the development of ascites and their complications is very important in these patients. Recently, there have been significant revisions in the diagnostic criteria and treatment of cirrhotic ascites and their complications. This manuscript reviews these revisions.
Acute Kidney Injury ; Ascites* ; Hepatorenal Syndrome ; Hospitalization ; Humans ; Hypertension, Portal ; Liver Cirrhosis ; Liver* ; Mortality ; Peritonitis ; Prognosis

Bleeding from gastroesophageal varices is a serious complication in patients with liver cirrhosis and portal hypertension. Although there has been significance improvement in the prognosis of variceal bleeding with advancement in diagnostic and therapeutic modalities for its management, mortality rate still remains high. Therefore, appropriate prevention and rapid, effective management of bleeding from gastroesophageal varices is very important. Recently, various studies about management of gastoesophageal varices, including prevention of development and aggravation of varices, prevention of first variceal bleeding, management of acute variceal bleeding, and prevention of variceal rebleeding, have been published. The present article reviews published articles and practice guidelines to present the most optimal management of patients with gastroesophageal varices.
Esophageal and Gastric Varices ; Fibrosis ; Hemorrhage ; Humans ; Hypertension, Portal ; Ligation ; Liver Cirrhosis ; Mortality ; Prognosis ; Varicose Veins*