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Utility of endoscopic ultrasound in patients with portal hypertension.
World J Gastroenterol. 2014 Oct 21; 20(39):14230-6.WJ

Abstract

Endoscopic ultrasound (EUS) has revolutionized the diagnostic and therapeutic approach to patients with gastrointestinal disorders. Its application in patients with liver disease and portal hypertension is increasing. Patients with chronic liver disease are at risk for development of portal hypertension sequale such as ascites, spontaneous bacterial peritonitis and gastroesophageal varices. Bleeding esophageal and gastric varices are among the most common causes of mortality in patients with cirrhosis. Thus, early detection and treatment improve the outcome in this population. EUS can improve the detection and diagnosis of gastroesophageal varices and collateral veins and can provide endoscopic therapy of gastroesophageal varices such as EUS-guided sclerotherapy of esophageal collateral vessels and EUS-guided cynoacrylate (Glue) injection of gastric varices. EUS can also provide knowledge on the efficacy of pharmacotherapy of portal hypertension. Furthermore, EUS can provide assessment and prediction of variceal recurrence after endoscopic therapy and assessment of portal hemodynamics such as E-Flow and Doppler study of the azygous and portal veins. Moreover, EUS-guided fine needle aspiration may provide cytologic diagnosis of focal hepatic tumors and analysis of free abdominal fluid. Using specialized EUS-guided needle biopsy, a sample of liver tissue can be obtained to diagnose and evaluate for chronic liver disease. EUS-guided fine needle injection can be used to study portal vein pressure and hemodynamics, and potentially could be used to assist in exact measurement of portal vein pressure and placement of intrahepatic portosystemic shunt.

Authors+Show Affiliations

Ghassan M Hammoud, Jamal A Ibdah, Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, Columbia, MO 65212, United States.Ghassan M Hammoud, Jamal A Ibdah, Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, Columbia, MO 65212, United States.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

25339809

Citation

Hammoud, Ghassan M., and Jamal A. Ibdah. "Utility of Endoscopic Ultrasound in Patients With Portal Hypertension." World Journal of Gastroenterology, vol. 20, no. 39, 2014, pp. 14230-6.
Hammoud GM, Ibdah JA. Utility of endoscopic ultrasound in patients with portal hypertension. World J Gastroenterol. 2014;20(39):14230-6.
Hammoud, G. M., & Ibdah, J. A. (2014). Utility of endoscopic ultrasound in patients with portal hypertension. World Journal of Gastroenterology, 20(39), 14230-6. https://doi.org/10.3748/wjg.v20.i39.14230
Hammoud GM, Ibdah JA. Utility of Endoscopic Ultrasound in Patients With Portal Hypertension. World J Gastroenterol. 2014 Oct 21;20(39):14230-6. PubMed PMID: 25339809.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Utility of endoscopic ultrasound in patients with portal hypertension. AU - Hammoud,Ghassan M, AU - Ibdah,Jamal A, PY - 2013/11/28/received PY - 2014/03/22/revised PY - 2014/06/14/accepted PY - 2014/10/24/entrez PY - 2014/10/24/pubmed PY - 2015/6/25/medline KW - Cirrhosis KW - Cyanoacrylate KW - Endoscopic ultrasound KW - Fine needle aspiration KW - Gastroesophageal varices KW - Hepatocellular carcinoma KW - Portal hypertension SP - 14230 EP - 6 JF - World journal of gastroenterology JO - World J Gastroenterol VL - 20 IS - 39 N2 - Endoscopic ultrasound (EUS) has revolutionized the diagnostic and therapeutic approach to patients with gastrointestinal disorders. Its application in patients with liver disease and portal hypertension is increasing. Patients with chronic liver disease are at risk for development of portal hypertension sequale such as ascites, spontaneous bacterial peritonitis and gastroesophageal varices. Bleeding esophageal and gastric varices are among the most common causes of mortality in patients with cirrhosis. Thus, early detection and treatment improve the outcome in this population. EUS can improve the detection and diagnosis of gastroesophageal varices and collateral veins and can provide endoscopic therapy of gastroesophageal varices such as EUS-guided sclerotherapy of esophageal collateral vessels and EUS-guided cynoacrylate (Glue) injection of gastric varices. EUS can also provide knowledge on the efficacy of pharmacotherapy of portal hypertension. Furthermore, EUS can provide assessment and prediction of variceal recurrence after endoscopic therapy and assessment of portal hemodynamics such as E-Flow and Doppler study of the azygous and portal veins. Moreover, EUS-guided fine needle aspiration may provide cytologic diagnosis of focal hepatic tumors and analysis of free abdominal fluid. Using specialized EUS-guided needle biopsy, a sample of liver tissue can be obtained to diagnose and evaluate for chronic liver disease. EUS-guided fine needle injection can be used to study portal vein pressure and hemodynamics, and potentially could be used to assist in exact measurement of portal vein pressure and placement of intrahepatic portosystemic shunt. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/25339809/Utility_of_endoscopic_ultrasound_in_patients_with_portal_hypertension_ L2 - https://www.wjgnet.com/1007-9327/full/v20/i39/14230.htm DB - PRIME DP - Unbound Medicine ER -