Essay On Esophageal Varices

When the central scar is large the conspicuity of the lesion increases (34). In some cases, a halo might be present around the lesion. It is thought that this halo represents compressed hepatic parenchyma or vessels and is more prominent when the lesion is located within a liver with steatosis. Contrast-enhanced US has been reported more accurate in detecting FNH. With using contrast materials an enhancement is possible and prominent feeding vessels may be seen in the arterial phase (34). In the portal venous phase, in contrast to hemangioma and hepatocellular adenoma, a centrifugal filling is seen and the enhancement is sustained in the portal venous phase (opposite to hepatocellular adenoma)

Although, LB is still considered the gold standard procedure to measure the severity and nature of liver diseases 7,8. It can assess the response of the treatment in chronic hepatitis , and specific for grading (necroinflammatory activity) and staging (fibrosis) in most patients, also for evaluating steatosis which facilitate the accurate diagnosis and the therapeutic outcome 9. Advantage and disadvantage of liver biopsy depend on the type of LB technique. There are different methods to obtain the tissue. Among them, percutaneous biopsy is the most commonly used. Others, such as transjugular biopsy and laparoscopic biopsy, are only used in specific situations 7,8. A study done in Calgary estimated the rate of using LB to be 4275 liver biopsies from 1994 to 2002, among a total of 3627 patients. The study found that the annual rate was 54.8 per 100,000 population. 0.75 % of the patients had complications related to biopsy (1994–1997 vs. 1998–2002: 1.28 vs. 0.44%; P = 0.003). The most significant complications identified by this study were pain, bleeding, hypotension, fever and death due to prolonged bleeding

As population is aging, liver cirrhosis is progressively predominant, and more elderly population with already diagnosed liver disease will be seen by geriatricians. It very useful to understand predictive factors for survival in cirrhotic patients in order to help with therapeutic decision-making, including allocation for liver transplantation (Fox et al., 2011).

Extra-hepatic portal vein obstruction (EHPVO), i.e., in the absence of liver cirrhosis or abdominal cancer, is a rare manifestation of venous thrombosis that often leads to portal hypertension1.After prothrombin, factor V, next most common cause of thrombophilia is high plasma levels of coagulation factor VIII, which are present in approximately 20% of patients with deep vein thrombosis (DVT) of the lower limbs and increase the risk of the disease in a dose-dependent manner 2. Like fibrinogen, factor VIII is an acute phase reactant whose concentration rises in plasma in the presence of inflammation. However, high factor VIII levels are associated with an increased risk of DVT independently of the acute phase reaction3.

Chronic liver diseases and liver biopsy. Chronic liver diseases encompass many different causes, including viral infections, nonalcoholic fatty liver disease (NAFLD), alcohol abuse, primary sclerosing cholangitis, primary hemochromatosis, and autoimmune disease. All of these precipitate chronic damage to the liver via necroinflammation and subsequent cellular injury and accumulation of extracellular matrix (ECM) proteins distorting the hepatic architecture by forming hepatic fibrosis with abnormal collagen deposition. Without treatment, the eventual development of cirrhosis (the end stage of fibrosis) can accelerate to hepatocellular dysfunction, hepatic insufficiency, portal hypertension, and hepatocellular carcinoma (HCC), thus

Initial liver biopsy is recommended for assessment of the inflammatory activity and the severity of fibrosis, which is useful for making therapeutic decision. The work-up shows that interface and zone 1 lobular hepatitis is the hallmark with the characteristic lymphoplasmacytic infiltrate, typically prominent portal and periportal (in case of bridging necrosis or cirrhosis) inflammation which generally spares the bile ducts, and acinar transformation of hepatocytes (rosettes formation). Plasma cells may not be dominant but prominent inflammatory cells only at the interface. The non-specificity of histological findings to autoimmune hepatitis should always be remembered, and the absence of plasma cells does not preclude the diagnosis. Meanwhile,

Define the stage of the disease is very important for diagnosis, treatment, and follow-up . There are many ways for assessing the degree of liver fibrosis. Liver biopsy was the gold standard for assessing liver fibrosis, but now it is of limited value because it is so invasive, its high cost, poor acceptance, risk of complications, and intra/inter-observer variability (Poynard et al.,2007). During the different stages of fibrosis , there are excessive amounts of extracellular matrix of various biomarkers changed and new biomarkers appeared in the serum (Jarcuska et al.,2010 and Baranova et al. 2011).

I understand that you are going through a series of frequent and agonizing heartburns. The heartburn you are encountering is from eating substantial dinners during the evening. The physician examined you with an endoscope, which is a thin and flexible tube equipped with an optical device (DeBruyne and Pinnap, 2014, p.494). The results of the examination indicates evidence of a medical complication of reflux esophagitis and esophageal stricture. According to DeBruyne and Pinna (2014) , the term reflux esophagitis is inflammation in the esophagus related to the reflux acid stomach contents (p.493). Due to the inflammation in the esophagus, it begins to narrow and tighten, which is what we call esophageal stricture.

Sampling: Under complete aseptic conditions, 8 ml of venous blood were collected .Each blood sample was divided and divided as follows: Tube A :4 ml were collected in plain tube, left to clot at 37ºC ,then centrifuged ,clear sera were separated and divided into 3 aliquots; the first one was used to determine liver function tests(total &direct bilirubin, AST, ALT, GGT,ALP, total protein and albumin) by using AU640 autoanalyzer. The second was used for measurement of alpha feto- protein by enzyme-linked immunosorbent assay using Human AFP ELISA kits supplied by Glory Science(Immunospec Corporation, 7018 Owensmouth Ave. Suite 103 Canoga Park, CA, 91303) and the third one used for detection of hepatitis markers antibodies (HBsAg, and HCV antibody) by direct sandwich assay using the ELISA Kit supplied by Adltis, Germany. The specimens were kept frozen at -20 ˚C until the time of assay, Tube B: 2 ml were collected in a sterile sodium citrate vacutainer tubes for immediate assay of prothrombin time, concentration and INR and Tube C: 2ml were collected in sterile vacutainer tubes containing EDTA for DNA extraction.

What is Barrett’s esophagus? It is a metaplasia of the glandular changes in the lower distal esophagus. This diagnosis is related to a high incidence of esophageal adenocarcinoma. Therefore for surveillance and screening a 4 quadrant biopsy is obtained. Furthermore, this relates in the ability to focus subsequent biopsies on

Intervention for the problem is adoption of statin therapy as the remedy to help in the reduction of cardiovascular disease related mortality rates. The management of the disease is highly beneficial to the people most vulnerable to developing the disease. The efficient monitoring of the liver function tests among the patients is highly recommended to ensure the proper management among the patients experiencing the liver disease (Shehata et al, 2015).

Esophageal cancer is a malignant tumor that develops in the esophagus. Although it is not clear as of what causes esophageal cancer. The major cause is DNA mutation of the cells in the esophagus that makes them grow rapidly and divide without inhibition. If not detected in the early stages these cells spread to the adjacent tissues and eventually spread throughout the body.

Esophageal varices are abnormal, enlarged veins in the lower part of the esophagus. Esophageal varices develop when normal blood flow to the liver is obstructed by scar tissue in the liver or a clot. Seeking a way around the blockages, blood flows into smaller blood vessels that are not designed to carry large volumes of blood. The vessels may leak blood or even rupture, causing life-threatening bleeding.

Varicose veins are a common occurrence in the legs due to the distance of the legs from the heart and lungs, the centre of the circulatory and respiratory systems. The blood is pumped into the legs by arteries. The veins then have to carry the blood back up towards the heart. This is done against gravity and, due to distance, without the strong pumping action of the heart. Veins move blood by using surrounding muscles and one way valves that prevent backflow of the blood. The weight of the column of blood in the legs when standing still, can cause the valves to fail and the blood can then slow down and pool. This causes the veins to

All ERCP procedures were performed by experienced endoscopists using the Pentax lateral view endoscope ED-3440T and ED-3485T. Patients were placed in prone position and sedated with midazolam and propofol in conjunction with a topical anesthetic applied to the posterior oropharynx under the supervision of an anesthesiologist. EPLBD was done with a balloon dilator (controlled radial expansion [CRE] dilation balloon; maximum diameter 15 or 18 mm; length 5 cm; Microvasive, Boston Scientific Corp., Ireland) between 10 and 16 mm in diameter without preceding ES. After diagnostic cholangiography, a guidewire (0.025_0.035inch, Boston Scientific Corp., Natick, MA, USA) was passed through the diagnostic cannula into the bile duct. The balloon dilator