| Revista: | Annals of hepatology |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000411791 |
| ISSN: | 1665-2681 |
| Autors: | Copelan, Alexander1 Chehab, Monzer1 Dixit, Purushottam1 Cappell, Mitchell S2 |
| Institucions: | 1William Beaumont Hospital, Department of Radiology, Royal Oak, Michigan. Estados Unidos de América 2Oakland University, William Beaumont School of Medicine, Royal Oak, Michigan. Estados Unidos de América |
| Any: | 2015 |
| Període: | May-Jun |
| Volum: | 14 |
| Número: | 3 |
| Paginació: | 369-379 |
| País: | México |
| Idioma: | Inglés |
| Tipo de documento: | Artículo |
| Enfoque: | Analítico, descriptivo |
| Resumen en inglés | Analyze safety and efficacy of angiographic-occlusion-with-sclerotherapy/ embolotherapy-without-transjugular-intrahepatic-portosystemic-shunt (TIPS) for duodenal varices. Although TIPS is considered the best intermediate-to-long term therapy after failed endoscopic therapy for bleeding varices, the options are not well-defined when TIPS is relatively contraindicated, with scant data on alternative therapies due to relative rarity of duodenal varices. Prior cases were identified by computerized literature search, supplemented by one illustrative case. Favorable clinical outcome after angiography defined as no rebleeding during follow-up, without major procedural complications. Results. Thirty-two cases of duodenal varices treated by angiographic-occlusion-with-sclerotherapy/embolotherapy-without-TIPS were analyzed. Patients averaged 59.5 ± 12.2 years old (female = 59%). Patients presented with melena-16, hematemesis & melena-5, large varices-5, growing varices-2, ruptured varices-1, and other3. Twenty-nine patients had cirrhosis; etiologies included: alcoholism-11, hepatitis C-11, primary biliary cirrhosis-3, hepatitis B-2, Budd-Chiari-1, and idiopathic-1. Three patients did not have cirrhosis, including hepatic metastases from rectal cancer-1, Wilson’s disease-1, and chronic liver dysfunction-1. Thirty-one patients underwent esophagogastroduodenoscopy before therapeutic angiography, including fifteen undergoing endoscopic variceal therapy. Therapeutic angiographic techniques included balloon-occludedretrograde-transvenous-obliteration (BRTO) with sclerotherapy and/or embolization-21, DBOE (double-balloon-occluded-embolotherapy)-5, and other-6. Twenty-eight patients (87.5%; 95%-confidence interval: 69-100%) had favorable clinical outcomes after therapeutic angiography. Three patients were therapeutic failures: rebleeding at 0, 5, or 10 days after therapy. One major complication (Enterobacter sepsis) and one minor |
| Disciplines | Medicina |
| Paraules clau: | Cirugía, Gastroenterología, Sistema cardiovascular, Hipertensión portal, Cirrosis, Hemostasis, Derivación intrahepática portosistémica transyugular, Obliteración transvenosa retrógrada ocluida con balón |
| Keyword: | Medicine, Cardiovascular system, Gastroenterology, Surgery, Portal hypertension, Cirrhosis, Hemostasis, Transjugular intrahepatic portosystemic shunt, Balloon-occluded retrograde transvenous obliteration |
| Text complet: | Texto completo (Ver PDF) |
