Search

Researchers at the Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital conducted a study on varicose veins, specifically focusing on the validation of spleen stiffness measurement (SSM) for screening high-risk esophageal varices among cirrhotic patients in Indonesia. The study, a single-center cross-sectional analysis, found that SSM is useful for identifying high-risk esophageal varices, with specific cutoff values providing high sensitivity and specificity. This research contributes to the understanding of non-invasive methods for predicting clinically significant portal hypertension and esophageal varices in patients with liver cirrhosis. [Extracted from the article]

The article discusses a clinical trial, NCT06664307, focusing on the evaluation of the efficacy and safety of Portal Pressure Gradient (PPG) measurement guided by Endoscopic Ultrasound (EUS) in patients with liver cirrhosis. The trial aims to assess the acute hemodynamic response through EUS-derived GPP to intravenous propranolol administration to determine patients who would benefit from Non-selective beta-blocker (NSBB) treatment. The study addresses the need for a less invasive technique to predict chronic hemodynamic response and guide personalized therapy for patients with liver cirrhosis. [Extracted from the article]

A recent study conducted at the Second Affiliated Hospital of Air Force Medical University focused on the independent prognostic value of perioperative hepatic venous pressure gradient measurements in patients with portal hypertension who underwent laparoscopic splenectomy plus esophagogastric devascularization (LSED). The research found that LSED led to a significant decrease in hepatic venous pressure gradient, with patients experiencing a postoperative decrease of more than 20% showing better survival benefits. This study sheds light on the potential prognostic value of hepatic venous pressure gradient measurements in patients undergoing surgery for portal hypertension. [Extracted from the article]

A study conducted at Sun Yat-sen University in Guangdong, China, compared the outcomes of partial hepatectomy and interventional treatment for patients with Hepatitis B Virus-related Hepatocellular Carcinoma and clinically significant portal hypertension. The research found that while partial hepatectomy did not significantly improve overall survival or recurrence-free survival compared to interventional treatment, it is still considered a safe procedure and a viable treatment option. The study highlights the importance of considering different treatment options for patients with HBV-related HCC within the Milan criteria and clinically significant PHT. [Extracted from the article]

Researchers from the Catholic University of the Sacred Heart in Rome, Italy, conducted a study on noninvasive methods for evaluating portal hypertension in patients with liver cirrhosis. The study focused on the use of dynamic contrast-enhanced ultrasound (D-CEUS) and liver stiffness (LS) measurements as alternatives to the gold standard hepatic venous pressure gradient (HVPG) assessment. The results showed a positive correlation between LS and HVPG, with D-CEUS features proving to be reliable predictors of clinically significant portal hypertension (CSPH) and severe portal hypertension (SPH). This research offers a potential alternative to HVPG for assessing portal hypertension in patients with liver cirrhosis. [Extracted from the article]

The article discusses a clinical trial, NCT06632457, focusing on the use of survodutide to help individuals with liver diseases like NASH/MASH who have cirrhosis. Participants are randomly assigned to receive either survodutide or a placebo, with the aim of improving liver function. The study involves regular injections, dietary counseling, and exercise recommendations over a period of up to 4.5 years, with health monitoring and data collection to assess the treatment's effectiveness. [Extracted from the article]

Researchers from Universitat de Barcelona conducted a study on varicose veins in patients with cirrhosis, focusing on the accuracy of hepatic venous pressure gradient (HVPG) in reflecting portal pressure. The study found that despite HVPG dropping below 10 mmHg after etiologic factor removal, varices persisted in some patients. The research highlights the importance of HVPG in assessing portal hypertension post-treatment and calls for further studies to validate these findings and guide clinical management. The study was published in JHEP Reports and was supported by various institutions. [Extracted from the article]

A study conducted at Massachusetts General Hospital in Boston, Massachusetts, explored the use of proximal splenic artery embolization (PSAE) as a treatment for refractory ascites in patients with portal hypertension. The research found that PSAE reduced the need for paracentesis sessions and drained ascitic fluid volume over a 12-month follow-up period, with six out of ten patients becoming independent of large-volume paracentesis. The study concluded that PSAE could be a safe and effective alternative to transjugular intrahepatic portosystemic shunt (TIPS) for managing refractory ascites in certain patients. [Extracted from the article]

A recent study conducted by researchers at Southeast University in Nanjing, China, explored the use of liver biopsy for diagnosing unexplained portal hypertension. The study analyzed data from 188 patients with unexplained portal hypertension who underwent liver biopsy. The results showed that liver biopsy was valuable for determining the cause of portal hypertension, with cirrhosis being the most common cause. The study also highlighted the importance of considering porto-sinusoidal vascular disease as a potential cause of portal hypertension. The researchers concluded that while clinical features can provide some insight, pathological examination is essential for accurate diagnosis and assessment of disease progression. [Extracted from the article]

A recent study conducted by researchers at Army Medical University in Chongqing, China aimed to develop a prognostic score for predicting the outcomes of transjugular intrahepatic portosystemic shunt (TIPS) placement in patients with viral hepatitis cirrhosis-related portal hypertension. The study included 925 patients and developed a novel Viral-associated Index of Post-TIPS score (VIPs) model, which was compared to five previous models. The VIPs model demonstrated good predictive efficiency in both short-term and long-term prognoses. This study provides valuable insights for predicting outcomes after TIPS in patients with viral hepatitis cirrhosis-related portal hypertension. [Extracted from the article]

A recent study conducted by researchers at the Faculty of Medicine in Cluj Napoca, Romania, explores the potential applications of artificial intelligence (AI) in the management of esophageal varices. Esophageal varices are dilated submucosal veins in the lower esophagus that are commonly associated with portal hypertension, particularly due to liver cirrhosis. The study highlights the limitations of traditional diagnostic methods and discusses how AI algorithms, particularly machine learning and deep learning, have shown promise in improving risk stratification and diagnosis of esophageal varices. However, the researchers emphasize that AI should complement rather than replace traditional methods, and further research is needed to validate the efficacy of these technologies in clinical practice. [Extracted from the article]

Cirrhosis is a leading cause of mortality, and complications such as hepatorenal syndrome (HRS) and hepatopulmonary syndrome (HPS) can significantly impair renal and pulmonary functions. The transjugular intrahepatic portosystemic shunt (TIPS) procedure, which diverts blood from the portal to systemic circulation, has shown efficacy in treating complications of cirrhosis. TIPS generally improves renal function in patients with portal hypertension, but its benefits for HRS and HPS are limited and require further investigation. TIPS has inconsistent effects on pulmonary function, and while it may temporarily improve oxygenation in HPS, these benefits are not long-lasting. Further research is needed to establish the safety and efficacy of TIPS in these conditions. [Extracted from the article]

A recent report from Maharashtra, India discusses the topic of portal hypertension, specifically focusing on autoimmune hepatitis (AIH) and its progression to liver cirrhosis. The research highlights the chronic liver injury caused by autoimmune liver disease, leading to inflammation, cell proliferation, and the formation of extracellular matrix proteins. The study emphasizes the increased risk of morbidity and mortality in cirrhotic patients, particularly due to complications such as portal hypertension. Additionally, the report presents a case study of a 53-year-old female with chronic liver disease, later diagnosed with cirrhosis of autoimmune origin. [Extracted from the article]

The article explores the clinical features and treatments of sinistral portal hypertension (SPH), a condition linked to pancreatic diseases that can lead to varicose veins and upper gastrointestinal bleeding. Topics include the prevalence of SPH, its common causes and manifestations, and recommended treatment approaches.

The article discusses research by Andy Petroianu and colleagues, reported in the "Revista da Associacao Medica Brasileira" issue on August 19, 2024. Topics include the incidence of portal vein thrombosis after surgical treatment for schistosomal portal hypertension, the comparison of different surgical methods, and the lack of association between thrombosis and patient characteristics or laboratory tests.

The article offers information on a case of inadvertent splenic vein occlusion resulting in sinistral portal hypertension and massive gastric variceal hemorrhage. Topics discussed include the patient's initial direct intrahepatic portocaval shunt (DIPS) procedure; the discovery of splenic vein occlusion; and the subsequent treatment that resolved the gastrointestinal hemorrhage.

A recent study conducted at Kanazawa University Hospital in Japan has reported a rare case of idiopathic portal hypertension (IPH)-like disease that developed after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The patient, a 53-year-old woman who underwent allo-HSCT for acute myeloid leukemia, showed portal hypertension with radiological and histopathological findings consistent with IPH. This case highlights the importance of considering IPH-like disease as a potential cause of portal hypertension after allo-HSCT. The researchers suggest that awareness of this complication can aid in the early diagnosis and appropriate management of patients post allo-HSCT. [Extracted from the article]

A new report from the Memorial Sloan-Kettering Cancer Center provides insights into varicose veins, specifically focusing on a rare cause of gastric variceal bleeding called sinistral portal hypertension. The research discusses a case study of a patient with distal pancreatic cancer who experienced gastric variceal bleeding. After failed attempts at conservative management and transvenous intervention, a percutaneous trans-splenic approach using ultrasound guidance was successful in accessing the intraparenchymal vein feeding the gastric varices. Glue embolization was then performed with positive results. This research contributes to the understanding and potential treatment options for varicose veins in the context of sinistral portal hypertension. [Extracted from the article]

A recent study conducted at Zhongshan Hospital Fudan University examined the effectiveness of carvedilol therapy in preventing rebleeding in patients with esophageal and gastric varices (EGV) caused by liver cirrhosis. The study found that ascites, a condition characterized by the accumulation of fluid in the abdomen, may affect the efficacy of carvedilol in preventing EGV rebleeding. The researchers analyzed data from 286 patients with EGV bleeding and found that those with ascites had a higher rebleeding rate compared to those without ascites. The study concluded that ascites is a risk factor for EGV rebleeding in patients undergoing carvedilol therapy. [Extracted from the article]

A study conducted by the University of Hong Kong examined the development of portal hypertension (PHT) in native liver survivors (NLS) of biliary atresia (BA) after Kasai portoenterostomy (KPE). The study found that early KPE performed before day 41 of life protected against the development of PHT among NLSs. Patients with persistent cholestasis at one year after KPE were at a higher risk of developing PHT. The study suggests that these patients should receive more vigilant follow-up. [Extracted from the article]

A study conducted at the First Affiliated Hospital of Harbin Medical University investigated the clinical value of combining the AIMS65 score and Glasgow-Blatchford score with red blood cell distribution width (RDW) in predicting in-hospital death in patients with esophageal and gastric variceal bleeding (EGVB) in cirrhosis. The study included 396 patients with cirrhotic EGVB and found that hepatic encephalopathy, RDW>14.50%, GBS score>10.65 points, and AIMS65 score>3.35 points were independent risk factors for in-hospital death. The combination of the AIMS65 score and elevated RDW had a high clinical value in predicting the risk of in-hospital all-cause death in cirrhotic patients with EGVB. [Extracted from the article]

A team of experts in China has developed a comprehensive and practical expert consensus specifically for the diagnosis and treatment of advanced primary liver cancer. The consensus takes into account various factors such as tumor characteristics, liver function status, and hepatitis B virus replication status. The recommendations provide detailed and individualized diagnosis and treatment strategies for clinicians. The consensus also includes recommendations for surgical resection, radiotherapy, systemic anti-tumor drug therapy, and antiviral management for patients with virus-associated liver cancer. Additionally, the consensus addresses the management of advanced liver cancer complicated with portal hypertension. [Extracted from the article]

A recent study conducted in Milan, Italy, explores the use of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of complications related to portal hypertension (PH), specifically non-neoplastic portal vein thrombosis (PVT). The study aims to establish selection criteria for TIPS in PVT cases. The researchers found that screening for patent foramen ovale (PFO) and subsequent treatment may be feasible for patients with splanchnic vein thrombosis (SVT) who undergo TIPS placement. The study suggests that PFO screening and closure could be considered as part of the management of SVT patients undergoing TIPS. [Extracted from the article]

A recent study conducted at Liaquat National Hospital and Medical College in Karachi, Pakistan, aimed to determine the frequency of gastric variceal bleeding in patients with chronic liver disease. The study included 135 patients with a history of melena, hematemesis, and a diagnosis of chronic liver disease for more than six months. The researchers found that gastric variceal bleeding occurred in 13.3% of the patients who underwent endoscopy. The study concluded that gastric variceal bleeding is a rare but potentially lethal complication of chronic liver disease, particularly in patients under 50 years old, female patients, those with hypertension, and those with a duration of chronic liver disease less than five years. [Extracted from the article]

A recent report highlights the clinical implications and management strategies for spontaneous portosystemic shunts (SPSS) in liver cirrhosis. SPSS are collateral blood vessels that form due to portal hypertension from chronic liver disease. The size and location of these shunts can affect clinical outcomes and increase the risk of complications such as variceal bleeding, hepatic encephalopathy, portopulmonary hypertension, and portal vein thrombosis. The detection and assessment of SPSS rely on computed tomography (CT) and magnetic resonance imaging, and management strategies include interventional radiology techniques and liver transplantation. Surgical options are considered when other methods fail, and intraoperative SPSS ligation may be recommended for high-risk patients. [Extracted from the article]

A study conducted by Chongqing Medical University in China explored the feasibility of laparoscopic liver resection (LLR) for patients with hepatocellular carcinoma (HCC) complicated with significant portal hypertension (SPH). The study found that LLR for HCC patients with SPH is feasible, although it may result in longer operative time and more blood loss. The survival rates and overall outcomes were not significantly different between patients with SPH and those without SPH. Prognostic factors for worse overall survival included high alpha-fetoprotein levels, ascites, higher American Society of Anesthesiologists classification, and tumor diameter greater than 5 cm. [Extracted from the article]

A recent study conducted at Rostov State Medical University focused on improving the treatment outcomes for patients with complicated intrahepatic portal hypertension caused by liver cirrhosis. The study examined and treated 82 patients with clinically significant portal hypertension and developed optimal surgical treatment tactics along with drug correction to prevent thrombotic venous complications. The results showed that personalized drug correction regimens were effective in preventing complications, and the combination of transjugular intrahepatic portosystemic stent bypass surgery and selective embolization of gastric veins yielded comparable results. The study emphasizes the importance of individualized approaches and risk stratification in the treatment of liver cirrhosis. [Extracted from the article]

A recent report from Hangzhou Xixi Hospital - Zhejiang Chinese Medical University in China discusses the case of a 31-year-old male patient with congenital hepatic fibrosis (CHF) and negative endoscopic evaluation of esophageal and gastric varices. CHF is a rare genetic disease that often presents with portal hypertension-related symptoms and signs, as well as normal or mildly abnormal liver function. The patient received various treatments for liver protection, and his condition stabilized. The report emphasizes the importance of performing ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) examinations in patients with negative endoscopic evaluation to determine the presence of portal hypertension. When patients with normal or mildly abnormal liver function have unexplained liver cirrhosis complicated with portal hypertension, the possibility of CHF should be considered. [Extracted from the article]

A report from Tanta University in Egypt discusses research on portal hypertension, specifically focusing on the correlation between gallbladder wall thickness (GBWT) and portal hemodynamic changes in cirrhotic patients. The study involved 80 patients, including cirrhotic patients with and without esophageal varices (EV), as well as noncirrhotic individuals. The researchers found that GBWT was significantly increased in cirrhotic patients with EV compared to those without EV and noncirrhotic individuals. They concluded that GBWT could be a simple noninvasive predictor of portal hypertension and EV, as it was positively correlated with portal hemodynamic changes in cirrhotic patients. [Extracted from the article]

A recent study from Hospital das Forcas Armadas has revealed new findings on liver abscesses, specifically focusing on pylephlebitis, a rare condition associated with Gram-negative bacteria. The study highlights the importance of early diagnosis and treatment, as delayed intervention can lead to increased morbidity and mortality. The research emphasizes the need for immediate antibiotic therapy and the potential use of anticoagulation in certain cases. The authors also discuss several case studies that illustrate the challenging nature of pylephlebitis and the role of imaging studies in confirming the diagnosis. Overall, the study aims to increase awareness among healthcare workers and improve the early detection of this potentially serious condition. [Extracted from the article]

A study conducted at Liaquat National Hospital in Karachi aimed to determine the frequency of gastro-esophageal varices in cirrhotic patients with splenomegaly. The researchers collected data from 257 cirrhosis patients with splenomegaly and found that 62.65% of them had gastro-esophageal varices. The study concluded that variceal bleeding in cirrhotic individuals can be predicted by various clinical and physiological parameters. The research provides valuable information on the prevalence of varicose veins in this specific patient population. [Extracted from the article]

A recent study conducted at the Government Medical College and Hospital in Chandigarh, India, aimed to determine the correlation between portal vein diameter (PVD) and clinical prognostic scores in patients with liver cirrhosis. The study included 97 patients with cirrhosis and found that there was a weak positive correlation between PVD and spleen size. However, PVD cannot be used as a substitute for the clinical grading and staging of cirrhosis. The study highlights the limitations of using ultrasonographically measured PVD as an indicator of portal hypertension in patients with liver cirrhosis. [Extracted from the article]

A recent study from Northwestern University Feinberg School of Medicine provides new insights into portal hypertension, a condition characterized by high blood pressure in the liver. The study emphasizes the importance of noninvasive tests for assessing liver fibrosis, which is a key indicator of ongoing liver injury and disease. Noninvasive blood tests, such as APRI and FIB-4, are recommended as the initial choice for assessing the severity of liver fibrosis and portal hypertension. Imaging tests, particularly liver stiffness measurement (LSM), are also effective in predicting fibrosis severity and assessing portal hypertension. In cases of diagnostic uncertainty, liver biopsy may be considered. [Extracted from the article]

A recent study conducted by researchers at Nara Medical University in Japan has found that the drug tofogliflozin may delay the progression of portal hypertension (PH) and hepatic fibrosis in rats with liver cirrhosis. Portal hypertension is a condition that occurs as a result of liver cirrhosis and is characterized by the capillarization of liver sinusoidal endothelial cells (LSECs). Tofogliflozin, an antidiabetic agent, was found to prevent PH and liver fibrosis in the rat model by reducing vasoconstriction and sinusoidal capillarization. The drug also suppressed inflammation and fibrogenesis in the liver. These findings suggest that tofogliflozin may be a potential treatment option for liver cirrhosis-related PH. [Extracted from the article]