简介：AIM:ToevaluatetheefficacyandsafetyofN-butyl-2-cyanoacrylateintreatingacutebleedingofgastricvaricesinchildren.METHODS:Theretrospectivestudyincluded21childrenwith47episodesofactivegastricvaricealbleedingwhoweretreatedbyendoscopicinjectionofN-butyl-2-cyanoacrylateatAsanMedicalCenterChildren’sHospitalbetweenAugust2004andDecember2011.Toreducetheriskofembolism,eachinjectionconsistedof0.1-0.5mLof0.5mLN-butyl-2-cyanoacrylatedilutedwith0.5or0.8mLLipiodol.Theprimaryoutcomewasincidenceofhemostasisaftervaricealobliterationandthesecondaryoutcomewascomplicationoftheprocedure.RESULTS:The21patientsexperienced47episodesofactivegastricvaricealbleeding,includingrebleeding,forwhichtheyreceivedatotalof52cyanoacrylateinjections.Following42bleedingepisodes,hemostasiswasachievedafteroneinjectionandfollowingfivebleedingepisodesitwasachievedaftertwoinjections.Themeanvolumeofeachsinglealiquotofcyanoacrylateinjectedwas0.3±0.1mL(range:0.1-0.5mL).Injectionachievedhemostasisin45of47(95.7%)episodesofacutegastricvaricealbleeding.Elevenpatients(52.4%)developedrebleedingevents,withthemeandurationofhemostasisbeing11.1±11.6mo(range:1.0-39.2mo).Notreatment-relatedcomplicationssuchasdistalembolismwerenotedwiththeexceptionofabdominalpaininonepatient(4.8%).Amongfourmortalities,onepatientdiedofvaricealrebleeding.CONCLUSION:Endoscopicvaricealobliterationusingasmallvolumeofaliquotswithrepeatedcyanoacrylateinjectionwasaneffectiveandsafeoptionforthetreatmentofgastricvaricesinchildren.

简介：AIM:Todeterminethecorrelationbetweenthehepaticvenouspressuregradientandtheendoscopicgradeofesophagealvarices.METHODS:FromSeptember2009toMarch2013,atotalof176measurementsofhepaticvenouspressuregradient(HVPG)weredonein146patients.EachtransjugularHVPGwasmeasuredtwice,firstusinganendwholecatheter(EH-HVPG),andthenusingaballooncatheter(B-HVPG).TheHVPGwascomparedwiththeendoscopicgradeofesophagealvarices(accordingtothegeneralrulesforrecordingendoscopicfindingsofesophagogastricvarices),whichwasrecordedwithinamonthofthemeasurementofHVPG.RESULTS:Thestudyincluded110menand36women,withameanageof56.1years(range,43-76years).Thetechnicalsuccessrateofthepressuremeasurementswas100%andtherewerenocomplicationrelatedtotheprocedures.MeanHVPGwas15.3mmHgasmeasuredusingtheendholecathetermethodand16.5mmHgasmeasuredusingtheballooncathetermethod.MeanHVPG(bothEHHVPGandB-HVPG)wasnotsignificantlydifferentamongpatientswithdifferentcharacteristics,includingsexandcomorbidfactors,exceptforcaseswithhepatocellularcarcinoma(B-HVPG,P=0.01;EH-HVPG,P=0.02).Portalhypertension(>12mmHgHVPG)occurredin66%ofpatientsaccordingtoEH-HVPGand83%ofpatientsaccordingtoB-HVGP,andsignificantlycorrelatedwithChild’sstatus(B-HVPG,P<0.000;EHHVGP,P<0.000)andesophagealvariesobserveduponendoscopy(EH-HVGP,P=0.003;B-HVGP,P=0.006).Onehundredandthirty-fiveendoscopieswereperformed,ofwhich15showednormalfindings,27showedgrade1endoscopicesophagealvarices,49showedgrade2varices,and44showedgrade3varices.WhencomparingendoscopicesophagealvaricealgradesandHVPGusingunivariateanalysis,thePvaluewas0.004forEH-HVPGand0.002forB-HVPG.CONCLUSION:BothEH-HVPGandB-HVPGshowedapositivecorrelationwiththeendoscopicgradeofesophagealvarices,withB-HVPGshowingastrongercorrelationthanEH-HVPG.

简介：结肠的静脉曲张是更低的胃肠的流血的一个很稀罕的原因。少数在英语文学比自发的结肠的静脉曲张(ICV)的结肠的静脉曲张，和30个案例的100个案例被报导了。在ICV的这30个案例之中，19个案例被血管造影术诊断，并且7个操作案例以后作为回盲肠静脉赤字被诊断，缝血管瘤，并且在1自发，1，5个案例分别地。我们报导受不了在11年岁时改变学位的便血的多重事件的一个24岁的人的案例。他与21g/L的血红素有严重贫血症。在结肠镜检查上，曲折地扩大了特别在书籍的右页sigmoid区域被黑暗坏死的纸巾盖住的粘膜下层静脉和脆的溃疡从直肠被看见直到远侧的下降结肠。它开始看起来是有静脉曲张的癌。肠系膜angiographic学习建议了一个结肠的缝血管瘤。低前面的切除术由于难处理的医学上和周期性的便血被做。另外的肠和mes伤寒脉管的结构显得正常。没有代表新容器生长，显微镜检查在整个粘膜下层和浆膜与扩大静脉揭示了正常结肠的粘膜。一起这些调查结果拿所有，病人作为ICV被诊断。他的手术后的功课是平静的。