exudates and Esophageal-and-Gastric-Varices

Approximately one-third of patients with esophageal varices will develop bleeding which is a major cause of morbidity and mortality in patients with liver cirrhosis. Currently, the two most widely used modalities to prevent variceal bleeding are pharmacologic and oendoscopic variceal band ligation (EVL). However, EVL has been associated with significant complications. Hence we aim to evaluate and to identify the epidemiology, demography, and complications of EVL at our local Malaysian tertiary hospital.. This is a retrospective study of all the patients that had undergone endoscopic variceal surveillance at the Gastroenterology endoscopy unit, Serdang Hospital from 1st January 2015 to 31st March 2017. Patients' demography, aetiologies of liver cirrhosis, platelet level and international normalised ratio (INR) prior banding procedure, and the post EVL complications were recorded and further analysed with SPSS version 16.. In this study, 105 patients were screened for varices. Fifty-five of them had undergone EVL, with a quarter of the patients requiring repeated ligation. There was a male preponderance with 76.4%. 56.4% of patients were in age from 40-59 years. The majority of our patients were of the Malay ethnicity. The major aetiology for liver cirrhosis in our patients was viral hepatitis with Hepatitis C (31.0%), and Hepatitis B (20.0%). Most of our patients had platelet count >50,000 and INR <1.5 prior to EVL. There was no major complication in all of our subjects.. EVL is relatively safe and feasible treatment for prevention of oesophageal variceal bleeds with a low complication rate.

Topics: Adult; Esophageal and Gastric Varices; Esophagoscopy; Female; Gastrointestinal Hemorrhage; Humans; Ligation; Malaysia; Male; Middle Aged; Retrospective Studies; Tertiary Care Centers; Young Adult

To examine the medical status of children with biliary atresia (BA) surviving with native livers.. In this cross-sectional review, data collected included complications of chronic liver disease (CLD) (cholangitis in the preceding 12 mo, portal hypertension, variceal bleeding, fractures, hepatopulmonary syndrome, portopulmonary hypertension) and laboratory indices (white cell and platelet counts, total bilirubin, albumin, international normalized ratio, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase). Ideal medical outcome was defined as absence of clinical evidence of CLD or abnormal laboratory indices.. Fifty-two children [females = 32, 62%; median age 7.4 years,. Clinical or laboratory evidence of CLD are present in 98% of children with BA living with native livers after hepatoportoenterostomy. Portal hypertension and variceal bleeding may be seen in children younger than 5 years of age, underscoring the importance of medical surveillance for complications of BA starting at a young age.

Topics: Adolescent; Biliary Atresia; Child; Child, Preschool; Cholangitis; Chronic Disease; Cross-Sectional Studies; Esophageal and Gastric Varices; Female; Follow-Up Studies; Fractures, Bone; Gastrointestinal Hemorrhage; Hepatopulmonary Syndrome; Humans; Hypertension, Portal; Liver; Liver Function Tests; Malaysia; Male; Portoenterostomy, Hepatic

Bleeding gastroesophageal varices is associated with a high morbidity and mortality. Forty-four cases of bleeding gastroesophageal varices were treated at the Department of Surgery, Universiti Kebangsaan Malaysia, General Hospital, Kuala Lumpur over four and a half years. Thirty-two of them had liver cirrhosis. Hepatitis B infection was noted in 13 and alcoholic abuse was present in 14 patients. Five patients had associated hepatoma. Thirty-four percent had gastric fundal varices and a third of these bled from them. A total of 179 endoscopic injection sclerotherapy sessions were performed averaging 4 per person. Rebleeding rate was 4% and mortality was high (50%) in these cases. It was concluded that injection sclerotherapy is a safe and effective means of controlling bleeding oesophageal varices. Operative surgery was employed in those who rebled after injection and would be considered in those in Child's A.

Topics: Adolescent; Adult; Aged; Child; Esophageal and Gastric Varices; Female; Gastrointestinal Hemorrhage; Humans; Malaysia; Male; Middle Aged; Pregnancy; Recurrence; Retrospective Studies; Sclerotherapy

A review of 352 patients with primary liver cell carcinoma treated by the author is presented. The poor rate of resectability (7 per cent) has necessitated various forms of treatment over the years. These are described in detail. Based on this experience, the current form of treatment for nonresectable carcinoma is summarized. Although it is too early to assess this form of treatment, initial results appear to be promising. A second report in the near future is planned.

Topics: Age Factors; Alcoholism; alpha-Fetoproteins; Blood Donors; Carcinoma, Hepatocellular; Developing Countries; Esophageal and Gastric Varices; Female; Gastrointestinal Hemorrhage; Hepatectomy; Hepatic Artery; Hepatitis B Antigens; Humans; Liver Cirrhosis; Liver Neoplasms; Malaysia; Male; Mycotoxins; Nutrition Disorders; Prognosis; Racial Groups

Topics: Adolescent; Adult; Aged; Esophageal and Gastric Varices; Esophageal Neoplasms; Esophageal Stenosis; Esophagoplasty; Female; Gastrointestinal Hemorrhage; Humans; Malaysia; Male; Middle Aged; Mouth Neoplasms; Pharyngeal Neoplasms; Surgical Procedures, Operative