Hematuria in an orthotopic neobladder is a difficult entity to manage due to its' unique anatomic and physiologic features. Infection, stone disease, primary bowel mass, and recurrent urothelial cell cancer are among the causes to consider. Here, we report a case of a 61 year old male who developed hematuria secondary to neobladder varices which was managed with TIPS (Transjugular Intrahepatic ...

Transjugular intrahepatic portosystemic shunt (TIPS) is an attractive therapeutic option in cirrhotic patients with recurrent variceal bleeding refractory to medical and endoscopic therapy. There is little known about the use of TIPS in patients with left ventricular assist devices (LVAD). We describe a patient with a durable continuous-flow LVAD and concurrent decompensated cardiac cirrhosis w...

OBJECTIVE To review the management of acute gastrointestinal bleeding in the critically ill patient in a two part presentation. DATA SOURCES Articles and a review of studies reported from 1991 to 2001 and identified through a MEDLINE search of the English language literature on acute gastrointestinal bleeding. SUMMARY OF REVIEW Oesophageal varices are a common source of upper gastrointestin...

OBJECTIVE Reports of fatality following carbon dioxide digital subtraction angiography (CO2-DSA) have raised concerns regarding its safety. This study reviews the safety of CO2-DSA. DESIGN Single-institution retrospective review. SETTING Tertiary care teaching hospital in Los Angeles, California. PATIENTS A total of 951 patients who underwent 1007 CO2-DSA procedures during a 21-year perio...

Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 862 Hepatopulmonary syndrome . . . . . . . . . . . . . . . . . . 862 Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 862 Staging of severity . . . . . . . . . . . . . . . . . . . . . . . 863 Natural history and outcome . . . . . . . . . . . . . . . . 863 Pathophysiology . . . . . . . . . . . . . . . . . . ...

Purpose. We report a novel technique which aided recanalization of an occluded portal vein for transjugular intrahepatic portosystemic shunt (TIPS) creation in a patient with symptomatic portal vein thrombosis with cavernous transformation. Some have previously considered cavernous transformation a contraindication to TIPS. Case Presentation. 62-year-old man with chronic pancreatitis, portal ve...

Background and Aims EUS-guided portal pressure gradient (EUS-PPG) measurement is a novel method to evaluate hypertension severity. In this study, we determined the consistency between EUS-PPG hepatic venous (HVPG) measurements in patients with acute or subacute hypertension. Methods Twelve were prospectively enrolled. performed using 22-gauge FNA needle central monitor. The HVPG transjugular ap...