Euroasian Journal of Hepato-Gastroenterology

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2017 | July-December | Volume 7 | Issue 2

ORIGINAL ARTICLE

Xia Chen, Ping Li, Fei Wang, Guozhong Ji, Lin Miao, Sihong You

Psychological Results of 438 Patients with persisting Gastroesophageal Reflux Disease Symptoms by Symptom Checklist 90-Revised Questionnaire

[Year:2017] [Month:July-December] [Volume:7] [Number:2] [Pages:5] [Pages No:117 - 121]

PDF  |  DOI: 10.5005/jp-journals-10018-1230  |  Open Access |  How to cite  | 

Abstract

Aims and objectives

Gastroesophageal reflux disease (GERD) affects mental state and social activities. On the contrary, mental disorders may also play a crucial role in GERD symptoms. The purpose of the study was to analyze the data of Symptom Checklist 90-Revised (SCL-90-R) questionnaire from patients with persisting GERD and to explore the impact of psychological factors on them.

Materials and methods

The patients accepted SCL-90-R questionnaire survey, following endoscopy, high-resolution manometry (HRM), and ambulatory impedance-pH monitoring. Based on these results, we divided patients into different groups. The result of SCL-90-R was also compared with degree of acid reflux, symptoms, symptom duration, and gender.

Results

The data from 438 patients were analyzed. All patients were divided into reflux esophagitis (RE; 63, 14.38%); nonerosive gastroesophageal reflux disease (NERD; 106, 24.20%); functional heartburn (FH; 123, 28.08%), hypersensitive esophagus (HE; 67, 15.29%), diffuse esophageal spasm (DES; 5: 1.14%), hypertensive (10, 3.42%); weak peristalsis (14, 3.20%); achalasia (50, 11.42%). There were significant differences between different groups regarding depression (DEP), anxiety (ANX), paranoid ideation (PAR), and psychoticism (PSY). The patients with ≥2 years with GERD presented with increased scores in DEP, ANX, and PSY. Women had dramatically higher scores than men in each domain (p < 0.05).

Conclusion

Data have shown that GERD patients exhibit differential levels of psychological symptoms. Long duration of GERD was related to typical plus atypical symptoms and females seem to be more prone to develop psychological disorders.

How to cite this article

Chen X, Li P, Wang F, Ji G, Miao L, You S. Psychological Results of 438 Patients with persisting Gastroesophageal Reflux Disease Symptoms by Symptom Checklist 90-Revised Questionnaire. Euroasian J Hepato-Gastroenterol 2017;7(2):117-121.

ORIGINAL ARTICLE

Melpakkam Srinivas, Piyush Bawane

Does Chicago Classification address Symptom Correlation with High-resolution Esophageal Manometry?

[Year:2017] [Month:July-December] [Volume:7] [Number:2] [Pages:4] [Pages No:122 - 125]

PDF  |  DOI: 10.5005/jp-journals-10018-1231  |  Open Access |  How to cite  | 

Abstract

Aim

To assess the correlation of symptoms with findings on esophageal high-resolution manometry (HRM) in Indian patients.

Materials and methods

Prospective data collection of all patients undergoing esophageal manometry was done at two centers in India—Indore and Chennai—over a period of 18 months. Symptom profile of the study group was divided into four: Motor dysphagia, noncardiac chest pain (NCCP), gastroesophageal reflux (GER), and esophageal belchers. The symptoms were correlated with manometric findings.

Results

Of the study group (154), 35.71% patients had a normal study, while major and minor peristaltic disorders were noted in 31.16 and 33.76% respectively. In patients with symptoms of dysphagia, achalasia cardia was the commonest cause (45.1%), followed by ineffective esophageal motility (IEM) (22.53%) and normal study (19.71%). In patients with NCCP, normal peristalsis (50%) and ineffective motility (31.25%) formed the major diagnosis. Of the 56 patients with GER symptoms, 26 (46.4%) had normal manometry. An equal number had ineffective motility. Of the 11 esophageal belchers, 7 (63.6%) of these had a normal study and 3 had major motility disorder. Dysphagia was the only symptom to have a high likelihood ratio and positive predictive value to pick up major motility disorder.

Conclusion

Dysphagia correlates with high chance to pick up a major peristaltic abnormality in motor dysphagia. The role of manometry in other symptoms in Indian setting needs to be ascertained by larger studies.

Clinical significance

The present study highlights lack of symptom correlation with manometry findings in Indian patients.

How to cite this article

Jain M, Srinivas M, Bawane P, Venkataraman J. Does Chicago Classification address Symptom Correlation with High-resolution Esophageal Manometry? Euroasian J Hepato-Gastroenterol 2017;7(2):122-125.

ORIGINAL ARTICLE

Filiz F Bolukbas, Cengiz Bolukbas, Hatice Y Balaban, Cem Aygun, Seyda Ignak, Emine Ergul, Mehtap Yazicioglu, Suat S Ersahin

Intrahepatic Cholestasis of Pregnancy: Spontaneous vs in vitro Fertilization

[Year:2017] [Month:July-December] [Volume:7] [Number:2] [Pages:4] [Pages No:126 - 129]

PDF  |  DOI: 10.5005/jp-journals-10018-1232  |  Open Access |  How to cite  | 

Abstract

Aim

Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease in pregnancy. Although it was shown that multiple pregnancy and hormone therapies increase the risk of ICP, there is limited information that compared spontaneous fertilization and in vitro fertilization (IVF) from the aspect of developing ICP. In our study, we investigated the potential relationship between ICP and IVF/spontaneous pregnancy.

Materials and methods

We reviewed the records (between June 2007 and December 2014) of pregnancies with ICP who were referred to gastroenterology clinics in three different hospitals. Fifty-nine pregnancies (43 spontaneous fertilization, 16 IVF) with ICP were analyzed from the aspect of age, fertilization type, multiple/singleton pregnancy, delivery week, and biochemical results.

Results

We found that serum bile acid levels were higher in the IVF group than the spontaneous fertilization group (32.8 ± 20 vs 19.6 ± 19 μmol/L; p < 0.05). There was a significant inverse correlation between serum bile acid levels and gestational age (r = −0.42, p < 0.01) in the whole group. There was no difference between IVF and spontaneous fertilization groups in term of age, onset time of symptoms, serum alanine aminotransferase (ALT), alkaline phosphatase (ALP), total and direct bilirubin levels, prothrombin time (PT), international normalized ratio (INR), and platelet count.

Conclusion

Our results suggest that the serum bile acid levels are higher in IVF than in spontaneous pregnancies with ICP, but its clinical implications are not clear. Further prospective studies with large number of ICP cases are needed to clarify the effect of IVF on ICP.

How to cite this article

Bolukbas FF, Bolukbas C, Balaban HY, Aygun C, Ignak S, Ergul E, Yazicioglu M, Ersahin SS. Intrahepatic Cholestasis of Pregnancy: Spontaneous vs in vitro Fertilization. Euroasian J Hepato-Gastroenterol 2017;7(2):126-129.

ORIGINAL ARTICLE

Anurag S Lavekar, Dhananjay V Raje, Amarja A Lavekar

Role of Probiotics in the Treatment of Nonalcoholic Fatty Liver Disease: A Meta-analysis

[Year:2017] [Month:July-December] [Volume:7] [Number:2] [Pages:8] [Pages No:130 - 137]

PDF  |  DOI: 10.5005/jp-journals-10018-1233  |  Open Access |  How to cite  | 

Abstract

Aim

Despite extensive ongoing research, there is scarcity of widely accepted therapeutic options for the treatment of nonalcoholic fatty liver disease (NAFLD). Probiotics are a promising treatment option for treating NAFLD; however, their effectiveness needs to be established. Since any single randomized controlled trial (RCT) cannot establish the role of probiotics in the treatment of NAFLD, this study aims at meta-analysis of different RCTs.

Materials and methods

Extensive search was done by two independent observers for RCTs studying the role of probiotics in the treatment of NAFLD. The parameters under consideration were body mass index (BMI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), homeostatic model assessment of insulin resistance (HOMA-IR), serum triglycerides (TGs), and ultrasonographic grades of fatty liver. Jadad scale was used to select the articles for meta-analysis. Heterogeneity in the results was evaluated using chi-square test and I2. Significant heterogeneity in the results was decided based on p-value < 0.05 and the corresponding I2 close to 0%.

Results

Seven studies qualified for meta-analysis. Use of probiotics significantly caused reduction in BMI (p < 0.0001), ALT (p < 0.0001), AST (< 0.0001), HOMA-IR (p = 0.006), and ultrasonographic grade of fatty liver (p = 0.0051). Heterogeneity in other parameters was contributed mainly by couple of previous studies.

Conclusion

Meta-analysis shows that variety of parameters has significant improvement after probiotic treatment in different RCTs. However, the magnitude of improvement is not uniform across studies due to varying strains, dose patterns, and treatment duration. In future, probiotics remain a promising option for treating NAFLD.

How to cite this article

Lavekar AS, Raje DV, Manohar T, Lavekar AA. Role of Probiotics in the Treatment of Nonalcoholic Fatty Liver Disease: A Meta-analysis. Euroasian J Hepato-Gastroenterol 2017;7(2):130-137.

ORIGINAL ARTICLE

Sudhir J Gupta, Nitin R Gaikwad, Amol R Samarth, Sonal R Gattewar

Pneumatic Balloon Dilatation for Achalasia Cardia: Outcome, Complications, Success, and Long-term Follow-up

[Year:2017] [Month:July-December] [Volume:7] [Number:2] [Pages:4] [Pages No:138 - 141]

PDF  |  DOI: 10.5005/jp-journals-10018-1234  |  Open Access |  How to cite  | 

Abstract

Background

Achalasia is a chronic disease that can be managed with effective endoscopic modalities.

Aim

To evaluate the effectiveness of single setting of pneumatic balloon dilatation for achalasia and assess the long-term success and outcomes.

Materials and methods

This is a retrospective study of all achalasia patients who underwent pneumatic balloon dilatation at our institute. Patients who could be contacted were inquired regarding their symptoms and dysphagia-free interval after dilatation.

Results

A total of 72 patients were enrolled. Out of this, 14 patients lost to follow-up. Mean age of 58 patients was 45.02 ± 16.51 years. Male:female ratio was 13:16. Mean predilatation Eckardt score was 7.16 ± 0.834. Type I achalasia was present in 10 (17.2%), type II in 44 (75.9%), type III in 4 (6.9%). Predilatation basal integrated relaxation pressure (IRP) was 28.14 ± 14.76 mm Hg. Postdilatation Eckardt score was 2.40 ± 1.67. Postdilatation dysphagia-free interval was 17.28 ± 6.70 months. A total of 9 patients (15.51%) failed to respond to first dilatation and 49 (84.48%) patients benefited from single setting of pneumatic dilatation. Esophageal perforation occurred in 2/58 (3.44%). We did not find any significant difference in gender distribution, age of presentation, duration of symptom, pre- and postdilatation Eckardt score, type of achalasia, and basal IRP on manometry between type of achalasia. Postdilatation dysphagia-free interval in type II achalasia (18.09 ± 5.976 months) was more than types I and III achalasia cardia (p = 0.066), which showed trend toward significance.

Conclusion

Pneumatic balloon dilatation of achalasia cardia is a highly effective endoscopic procedure with minimal complications and mortality. Even the single setting of dilatation can have long-lasting dysphagia-free interval.

How to cite this article

Gupta SJ, Gaikwad NR, Samarth AR, Gattewar SR. Pneumatic Balloon Dilatation for Achalasia Cardia: Outcome, Complications, Success, and Long-term Follow-up. Euroasian J Hepato-Gastroenterol 2017;7(2):138-141.

ORIGINAL ARTICLE

Ahmed L Moben, Mohammad A Alam, Sheikh M Noor E Alam, Faiz A Khondaker, Masuda Mohsena

Hepatic Venous Pressure Gradient Measurement in Bangladeshi Cirrhotic Patients: A Correlation with Child's Status, Variceal Size, and Bleeding

[Year:2017] [Month:July-December] [Volume:7] [Number:2] [Pages:4] [Pages No:142 - 145]

PDF  |  DOI: 10.5005/jp-journals-10018-1235  |  Open Access |  How to cite  | 

Abstract

Background

Hepatic venous pressure gradient (HVPG) reflects the portal pressure in patients with cirrhotic portal hypertension. The aim of the study was to assess the relation of HVPG to variceal size, Child—Pugh status, and variceal bleeding.

Materials and methods

A total of 96 patients with cirrhosis of liver were enrolled prospectively and each patient's HVPG level was measured via the transfemoral route. Clinical and biochemical evaluation and upper gastrointestinal (GI) endoscopy were done in each subject. Severity of cirrhosis was assessed by Child's status.

Results

The mean HVPG was higher in patients with Child's B and C (14.10 ± 7.56 and 13.64 ± 7.17 mm Hg respectively) compared with those of Child's A (10.15 ± 5.63 mm Hg). The levels of HVPG differed significantly between Child's classes A and B (p = 0.011) and Child's A and C (p = 0.041). The mean HVPG was also higher in bleeders compared with nonbleeders with large varices (17.7 ± 5.5 vs 14.9 ± 4.7 mmHg respectively; p = 0.006).

Conclusion

Hepatic venous pressure gradient seems to be important to assess the severity of liver cirrhosis.

How to cite this article

Al Mahtab M, Noor E Alam SM, Rahim MA, Alam MA, Khondaker FA, Moben AL, Mohsena M, Akbar SMF. Hepatic Venous Pressure Gradient Measurement in Bangladeshi Cirrhotic Patients: A Correlation with Child's Status, Variceal Size, and Bleeding. Euroasian J Hepato-Gastroenterol 2017;7(2):142-145.

ORIGINAL ARTICLE

Orhan Sezgin, Serkan Yaras, Fehmi Ates, Engin Altintas, Bunyamin Saritas

Effectiveness of Sedoanalgesia in Percutaneous Liver Biopsy Premedication

[Year:2017] [Month:July-December] [Volume:7] [Number:2] [Pages:4] [Pages No:146 - 149]

PDF  |  DOI: 10.5005/jp-journals-10018-1236  |  Open Access |  How to cite  | 

Abstract

Aim

Percutaneous needle liver biopsy (PLB) is frequently associated with pain and anxiety. This may discourage the patients for biopsy, and rebiopsies, if needed. We planned a study to investigate the efficacy of additional analgesia or sedation for PLB.

Materials and methods

The study has been designed as a single-center, prospective study. The PLB was planned for 18- to 65-year-old consecutive patients who were included in the study. The patients were divided into three premedication groups as control, Meperidine, and Midazolam. Hospital Anxiety and Depression Scale (HADS) was used to measure each subject's anxiety level. Fifteen minutes before the biopsy, 1 mL 0.9% NaCl subcutaneously (sc), 1 mg/kg (max 100 mg) Meperidine sc, or 0.1 mg/kg (max 5 mg) Midazolam intravenously was administered to patients respectively. Then PLB was done with 16 G Menghini needle. The day after, the patients were asked about feelings regarding biopsy.

Results

Groups were similar by gender and age. The HADS scores prior to PLB and on visual analog scale (VAS, 1—10 points) score during PLB were similar. In the three groups, 7, 12, and 7 patients, respectively, experienced no pain. Other patients explained pain as mild or moderate or severe. The number of patients who agreed for possible rebiopsy was higher in Meperidine and Midazolam groups than in the control group.

Conclusion

Premedication with Meperidine or Midazolam in PLB would improve patients' tolerance, comfort, and attitude against a possible repeat PLB.

How to cite this article

Sezgin O, Yaras S, Ates F, Altintas E, Saritas B. Effectiveness of Sedoanalgesia in Percutaneous Liver Biopsy Premedication. Euroasian J Hepato-Gastroenterol 2017;7(2):146-149.

RESEARCH ARTICLE

Hali Rakici

Adrenal Insufficiency in Cirrhosis Patients: Evaluation of 108 Case Series

[Year:2017] [Month:July-December] [Volume:7] [Number:2] [Pages:4] [Pages No:150 - 153]

PDF  |  DOI: 10.5005/jp-journals-10018-1237  |  Open Access |  How to cite  | 

Abstract

Aim

Adrenal insufficiency (AI) in cirrhosis is an issue that has recently gained momentum. It can be seen in both stable and critically ill (sepsis, septic shock, and gastrointestinal system bleeding) cirrhotic patients. Its prevalence exists in a wide range since standardization of diagnostic methods is lacking. We aimed to scrutinize this issue in a 108 case series.

Materials and methods

We studied the presence of AI and its stage in patients with cirrhosis and its complications by using cross-sectional study. Standard-dose short synacthen test (SD-SST) was performed in 108 patients that had Child C decompensated cirrhosis without critical illness and it was aimed to determine the prevalence of AI based on basal cortisol, peak cortisol, and delta cortisol (basal total cortisol minus peak cortisol after stimulation) levels.

Results

The prevalence of AI in cirrhosis was found to be 25% based on basal cortisol level of <140 nmol/L, 22.2% based on delta cortisol level of <250 nmol/L, and 29.6% based on peak cortisol level of <500 nmol/L.

Conclusion

Prevalence of AI shows variation in decompensated cirrhosis without critical illness depending on different measures used. More definite results can be obtained when more standardized criteria are widely put into use.

How to cite this article

Rakici H. Adrenal Insufficiency in Cirrhosis Patients: Evaluation of 108 Case Series. Euroasian J Hepato-Gastroenterol 2017;7(2):150-153.

RESEARCH ARTICLE

Mai I Mehrez, Dina SA Fattah, Naglaa AA Azeem, Mohamed A Saleh, Khadiga M Mostafa

Hemochromatosis Gene Polymorphism as a Predictor of Sustained Virological Response to Antiviral Treatment in Egyptian Chronic Hepatitis C Patients

[Year:2017] [Month:July-December] [Volume:7] [Number:2] [Pages:4] [Pages No:154 - 157]

PDF  |  DOI: 10.5005/jp-journals-10018-1238  |  Open Access |  How to cite  | 

Abstract

Aim

The aim of this article is to assess HFE C282Y gene mutations as a predictor of sustained virological response (SVR) to anti-hepatitis C virus (HCV) treatment in Egyptian patients.

Materials and methods

One hundred and forty chronic hepatitis C (CHC) patients were divided into two groups: 70 patients achieved SVR and 70 patients were nonresponders (NRs). All patients were subjected to quantitative polymerase chain reaction (PCR) at baseline, 12 and 24 weeks after therapy commencement. Deoxyribonucleic acid (DNA) sequencing for HFE (C282Y) was done by restriction fragment length polymorphism PCR.

Results

Sixty five patients did not have mutation and 5 patients had C282Y mutation (GA) with SVR. While 45 NRs had heterozygous C282Y mutation (GA), 4 patients (5.7%) had homozygous mutation (AA) and 21 patients (30%) had no mutation (GG). The parameters of elevated iron [transferrin saturation (TS; p < 0.001), S iron (p < 0.02), total iron binding capacity (TIBC; p < 0.001), transferrin (p < 0.016), and soluble transferrin receptor (sTfR; p-value, 0.001)] were significantly associated with C282Y mutation. However, there was no significant difference regarding ferritin values and C282Y mutation in NR patients.

Conclusion

Iron overload was frequently detected in CHC patients and associated with C282Y mutation, while biochemical markers of iron overload and C282Y HFE mutation were negative prognostic factor.

How to cite this article

Mehrez MI, Fattah DSA, Azeem NAA, Saleh MA, Mostafa KM. Hemochromatosis Gene Polymorphism as a Predictor of Sustained Virological Response to Antiviral Treatment in Egyptian Chronic Hepatitis C Patients. Euroasian J Hepato-Gastroenterol 2017;7(2):154-157.

RESEARCH ARTICLE

Perihan Ekmekçi, Gulbanu Erkan, Hakan Yilmaz, Baturay K Kazbek, Ulku C Köksoy, Güler Doganay, Filiz Tüzüner

Effect of Different Sedation Regimes on Cognitive Functions in Colonoscopy

[Year:2017] [Month:July-December] [Volume:7] [Number:2] [Pages:5] [Pages No:158 - 162]

PDF  |  DOI: 10.5005/jp-journals-10018-1239  |  Open Access |  How to cite  | 

Abstract

Aim

To compare the effects of propofol/remifentanil and meperidine/midazolam on postprocedure cognitive function.

Materials and methods

A total of 100 American Society of Anesthesiologists (ASA) score I to III patients undergoing elective colonoscopy were taken into the study and divided into two groups. Exclusion criteria were patient refusal, mini mental test (MMT) <26, The Amsterdam Preoperative Anxiety and Information Scale (APAIS) >10, advanced cardiopulmonary or psychiatric disease, chronic alcohol abuse, morbid obesity, and known allergy to study drugs. In group MM, 2 mg midazolam and 20 mg meperidine was given intravenously and additional 1 to 2 mg midazolam and 20 mg meperidine (with a maximum total of 5 mg midazolam and 50 mg meperidine) was given when bispectral index (BIS) was >80. In group RP, 100 μg/kg/minute propofol infusion and 1 μg/kg remifentanil bolus was administered and additional 0.5 μg/kg remifentanil bolus was given when BIS was >80. Observer's Assessment of Alertness/Sedation scale (OAA/S) and Facial Pain Score (FPS) values were recorded. Cognitive function was measured by Trieger Dot Test (TDT) and Digit Symbol Substitution Test (DSST).

Results

The study was concluded with 100 patients. Heart rate was slower and BIS values were lower in group RP throughout the procedure. Blood pressure was lower in group RP without clinical significance. There was no difference concerning recovery time and visual analog scores (VASs). In group MM, TDT scores were higher and DSST scores were lower. Satisfaction was higher in group RP.

Conclusion

Propofol/remifentanil combination is better than meperidine/midazolam combination concerning cognitive function in sedation for colonoscopy.

Clinical significance

The addition of BIS monitorization to evaluate the depth of sedation and the negative effects of midazolam meperidine combination on postprocedural cognitive function.

How to cite this article

Ekmekçi P, Erkan G, Yilmaz H, Kazbek BK, Köksoy UC, Doganay G, Tüzüner F. Effect of Different Sedation Regimes on Cognitive Functions in Colonoscopy. Euroasian J Hepato-Gastroenterol 2017;7(2):158-162.

REVIEW ARTICLE

Stella C Pak, Yaseen Alastal, Zubair Khan, Umar Darr

Viral Hepatitis in South Korea

[Year:2017] [Month:July-December] [Volume:7] [Number:2] [Pages:3] [Pages No:163 - 165]

PDF  |  DOI: 10.5005/jp-journals-10018-1240  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Pak SC, Alastal Y, Khan Z, Darr U. Viral Hepatitis in South Korea. Euroasian J Hepato-Gastroenterol 2017;7(2):163-165.

REVIEW ARTICLE

Alan I Valderrama-Treviño, Baltazar Barrera-Mera, Jesús C Ceballos-Villalva, Eduardo E Montalvo-Javé

Hepatic Metastasis from Colorectal Cancer

[Year:2017] [Month:July-December] [Volume:7] [Number:2] [Pages:10] [Pages No:166 - 175]

PDF  |  DOI: 10.5005/jp-journals-10018-1241  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Valderrama-Treviño AI, Barrera-Mera B, Ceballos-Villalva JC, Montalvo-Javé EE. Hepatic Metastasis from Colorectal Cancer. Euroasian J Hepato-Gastroenterol 2017;7(2):166-175.

CASE REPORT

Apoorv Goel, Roli Bansal

Massive Lower Gastrointestinal Bleed caused by Typhoid Ulcer: Conservative Management

[Year:2017] [Month:July-December] [Volume:7] [Number:2] [Pages:2] [Pages No:176 - 177]

PDF  |  DOI: 10.5005/jp-journals-10018-1242  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Goel A, Bansal R. Massive Lower Gastrointestinal Bleed caused by Typhoid Ulcer: Conservative Management. Euroasian J Hepato-Gastroenterol 2017;7(2):176-177.

CASE REPORT

Sila Ulus, Gulhan Ertan Akan, Cengiz Erol

Aneurysm of Portosystemic Fistula: A Case Report and Review of Literature

[Year:2017] [Month:July-December] [Volume:7] [Number:2] [Pages:3] [Pages No:178 - 180]

PDF  |  DOI: 10.5005/jp-journals-10018-1243  |  Open Access |  How to cite  | 

Abstract

Aim

A case of asymptomatic aneurysm of spontaneous portosystemic venous fistula (SPVF) with the radiologic findings is described.

Background

Although advances and more widespread use of ultrasound (US) and computed tomography angiography (CTA) have enabled more detection of SPVF in the liver, it is a rare entity.

Case report

A 49-year-old male was referred to our hospital's nephrology outpatient clinic due to hypertension. Abdominal sonography examination detected a well-defined cystic lesion adjacent to the middle hepatic vein in the liver. The lesion showed venous flow in the color Doppler US examination. Computed tomography angiography examination revealed an aneurysm of the fistula.

Conclusion

Radiologists should be aware of this vascular anomaly and cyst-like lesions in the liver should be examined with color Doppler ultrasonography for possible vascularization, and be differentiated with CTA if necessary.

Clinical significance

This condition is usually encountered incidentally and patients usually have no symptoms. However, severe complications, such as hepatopulmonary syndrome, liver tumors, encephalopathy, and heart failure can be seen.

How to cite this article

Ulus S, Akan GE, Erol C. Aneurysm of Portosystemic Fistula: A Case Report and Review of Literature. Euroasian J Hepato-Gastroenterol 2017;7(2):178-180.

CASE REPORT

Apoorv Goel, Shalabh Gupta, Ayush Agarwal, Tripta S Bhagat, Atul K Gupta

Porcelain Gallbladder

[Year:2017] [Month:July-December] [Volume:7] [Number:2] [Pages:2] [Pages No:181 - 182]

PDF  |  DOI: 10.5005/jp-journals-10018-1244  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Goel A, Agarwal A, Gupta S, Bhagat TS, Kumar G, Gupta AK. Porcelain Gallbladder. Euroasian J Hepato-Gastroenterol 2017;7(2):181-182.

CASE REPORT

Subhajeet Dey, Malwinder Singh, Ankit Kaura, Gaurav Diwakar

A Rare Case of Complete Agenesis of Dorsal Pancreas

[Year:2017] [Month:July-December] [Volume:7] [Number:2] [Pages:2] [Pages No:183 - 184]

PDF  |  DOI: 10.5005/jp-journals-10018-1245  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Jain A, Singh M, Dey S, Kaura A, Diwakar G. A Rare Case of Complete Agenesis of Dorsal Pancreas. Euroasian J Hepato-Gastroenterol 2017;7(2):183-184.

CASE REPORT

Farhanul Huda, Manisha Naithani, Sudhir K Singh, Sarama Saha

Ascitic Fluid/Serum Bilirubin Ratio as an aid in Preoperative Diagnosis of Choleperitoneum in a Neglected Case of Spontaneous Common Bile Duct Perforation

[Year:2017] [Month:July-December] [Volume:7] [Number:2] [Pages:2] [Pages No:185 - 186]

PDF  |  DOI: 10.5005/jp-journals-10018-1246  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Huda F, Naithani M, Singh SK, Saha S. Ascitic Fluid/Serum Bilirubin Ratio as an aid in Preoperative Diagnosis of Choleperitoneum in a Neglected Case of Spontaneous Common Bile Duct Perforation. Euroasian J Hepato-Gastroenterol 2017;7(2):185-187.

CASE REPORT

Pankaj Dwivedi, Mukta Waghmare, Hemanshi Shah, Charu Tiwari, Kiran Khedkar

Management of Traumatic Liver and Bile Duct Laceration

[Year:2017] [Month:July-December] [Volume:7] [Number:2] [Pages:3] [Pages No:188 - 190]

PDF  |  DOI: 10.5005/jp-journals-10018-1247  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Tiwari C, Shah H, Waghmare M, Khedkar K, Dwivedi P. Management of Traumatic Liver and Bile Duct Laceration. Euroasian J Hepato-Gastroenterol 2017;7(2):188-190.

CASE REPORT

Stella C Pak, Yaseen Alastal, Umar Darr, Youngsook Yoon

Long Esophageal Stricture in a Brittle Diabetic

[Year:2017] [Month:July-December] [Volume:7] [Number:2] [Pages:2] [Pages No:191 - 192]

PDF  |  DOI: 10.5005/jp-journals-10018-1248  |  Open Access |  How to cite  | 

Abstract

Aim

We report a case of atypical esophageal stricture in a young diabetic woman.

Background

Diabetes mellitus and gastroesophageal reflux disease (GERD) are two common disorders in modern society.

Case report

A young diabetic woman developed a 6-cm-long esophageal stricture. This stricture was refractory to multiple esophageal dilation procedures. She underwent subtotal esophagectomy and had excellent treatment outcome.

Conclusion

Gastroesophageal reflux disease can cause severe long esophageal stricture in a brittle diabetic.

Clinical significance

Improving the awareness of their association between diabetes and GERD would greatly benefit the day-to-day practice of medicine.

How to cite this article

Pak SC, Darr U, Alastal Y, Yoon Y. Long Esophageal Stricture in a Brittle Diabetic. Euroasian J Hepato-Gastroenterol 2017;7(2):191-192.

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