P ORTAL-SYSTEMIC SHUNTS HAVE LONG been considered the operation of choice for bleeding from esophageal varices associated with portal hypertension, although impossible or inadvisable in many patients. It may be impossible because there is no suitable patent vein in the portal circulation to anastomose to a systemic vein, or inadvisable because the liver function is too seriously impaired for th...

Achalasia is characterized by incomplete lower esophageal sphincter (LES) relaxation and aperistalsis of the esophagus. It is manifested by regurgitation, dysphagia and weight loss. Treatment options include addition of pharmacotherapy, endoscopic dilatation, botulinum toxin injection (BTI) and surgical myotomy. The presence of esophageal varices makes endoscopic treatment difficult and therefo...

BACKGROUND This study assessed the risk of recurrence of esophageal varices by evaluating the severity of cardia vascular structures in patients with portal hypertension by EUS with a catheter US probe before endoscopic variceal ligation. METHODS Thirty consecutive patients with esophageal varices at high risk for bleeding were studied. Simultaneous conventional endoscopy and EUS with a 20 MH...

Portal hypertension is the leading cause of morbidity and mortality in liver cirrhosis. Complications of portal hypertension in cirrhotic patients include esophageal and gastric varices, portal hypertensive gastropathy, ascites, hepatorenal syndrome, hepatopulmonary syndrome and portopulmonary hypertension. The hepatic venous pressure gradient should be at least 10 mmHg for esophageal varices t...

Gastric varices represent an inhomogeneous entity morphologically, topographically and hemodynamically. Hence proper classification is mandatory not only to prognosticate but also to determine optimal therapeutic option. Although a number of classifications based on variceal location, morphology and color have been proposed, the one proposed by Sarin et al2 is most widely used and has been reco...

Background: To evaluate the value of shear wave elastic imaging (SWE) in classification esophageal varices (EV) and detection rupture hemorrhage.

133 While the safety of endoscopic banding liga-tion is largely undisputed, there is one major risk of this technique: esophageal perforation during insertion of the overtube. Perforation of the esophagus often occurs as a result of inability to relax the pharyngeal muscle by the patient and forceful insertion of the tube by the endoscopist. The development of multiple banding ligators (Speedba...

OBJECTIVE To evaluate platelet count/ splenic size ratio as a non-invasive parameter to predict the presence and absence of esophageal varices in patients with cirrhosis of liver. DESIGN An observational, cross- sectional study. PLACE AND DURATION OF STUDY The medical units of the Civil Hospital, Karachi, between October 2003 and October 2004. PATIENTS AND METHODS During one year of study...

BACKGROUND AND OBJECTIVES Endoscopic procedures are the gold standard for the diagnosis of esophageal varices but these invasive methods are complex to perform in hemophilic patients co-infected with hepatitis C virus/human immunodeficiency virus (HCV/HIV). Real-time ultrasonography has been reported to be an effective, non-invasive procedure able to monitor patients with chronic liver disease ...

BACKGROUND - Variceal bleeding has a high mortality among cirrhotics, and screening with endoscopy is indicated at the diagnosis of cirrhosis. Screening with endoscopy implies discomfort, risks and considerable costs. OBJECTIVE - To evaluate platelet count squared/spleen diameter-aspartate aminotransferase ratio (PS/SA), as a non-invasive predictor of esophageal varices in cirrhotics. METHO...