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Introduction: Esophageal variceal bleeding (EVB) is a common complication of portal hypertension. Guidelines recommend initiation of vasoactive agents in combination with antimicrobial therapy prior to endoscopic variceal ligation. In cases of refractory EVB, trans-jugular intrahepatic portosystemic shunt (TIPSS) is recommended; however, it is contraindicated in up to 35% of cases.
Case Presentation: We report a case of a 61-year-old male newly diagnosed with hepatocellular carcinoma and extensive portal vein thrombosis. The patient developed a refractory EVB failing medical and endoscopic therapies which was successfully treated with transcutaneous left gastric vein embolization (LGVE).
Conclusion: LGVE could be contemplated in instances where anatomical complexities or contraindications to TIPSS arise.
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http://dx.doi.org/10.1159/000543537 | DOI Listing |
JGH Open
September 2025
Department of Genomic Medicine, Division of Biochemistry, Molecular Biology, and Nutrition University Hospital of Nancy Nancy France.
Introduction: Cirrhosis progresses from compensated to decompensated phases, often marked by portal hypertension and complications like ascites, variceal hemorrhage, and hepatic encephalopathy. The ammonia-to-urea (A-to-U) ratio, reflecting urea cycle efficiency, may offer superior diagnostic performance compared to plasma ammonia levels alone. This study compared the diagnostic accuracy of the A-to-U ratio and plasma ammonia levels for identifying portal hypertension.
View Article and Find Full Text PDFJHEP Rep
October 2025
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
Background & Aims: Conflicting evidence exists on hepatocellular carcinoma (HCC) risk in patients with chronic hepatitis B (CHB) receiving tenofovir entecavir. We assessed the impacts of the two drugs on the clinical trajectory of CHB at a population level.
Methods: We conducted a retrospective nationwide cohort study using data from Taiwan's National Health Insurance Research Database, including 55,885 patients with CHB who were treatment-naïve aged 30-75 years receiving tenofovir (n = 17,137) or entecavir (n = 38,748) monotherapy for ≥3 months between November 2009 and December 2020, and followed until December 2022.
Gastrointest Endosc
September 2025
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern, Memorial Hospital, New Taipei City, Taiwan; Taiwan Association for the Study of Intestinal Diseases (TASID), Taoyuan City, Taiwan; College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
World J Hepatol
August 2025
Division of Digestive Diseases and Nutrition, Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, KY 40536, United States.
Background: There is increasing incidence of alcohol-associated liver disease in females. Despite this recent increased incidence, there is a paucity of research on the clinical course and outcomes of alcohol-associated hepatitis (AH) in females compared to males.
Aim: To assess if there may be sex differences in severity, outcomes, and healthcare utilization for patients hospitalized for AH.
World J Methodol
December 2025
Department of Clinical Sciences, Lund University, Malmo 22100, Sweden.
Portal hypertension (PH) is a major complication of chronic liver disease, often leading to serious clinical consequences such as variceal bleeding, ascites, and splenomegaly. The current gold standard for PH diagnosis, namely, hepatic venous pressure gradient measurement, is invasive and not widely available. Transient elastography has emerged as a non-invasive alternative for assessing liver stiffness (LS), and recent studies have highlighted the potential role of splenic stiffness (SS) in evaluating PH severity.
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