Endoscopic control of bleeding gastric fundal varices by butyl cyanoacrylate

The present retrospective study aimed to determine the safety and efficacy of using butyl cyanoacrylate to control bleeding from gastric fundal varices. A total of 249 patients presented with bleeding from fundal varices underwent endoscopic injection of cyanoacrylate for hemostasis. Indications for treatment included chronic liver disease and portal hypertension, hematemesis and/or melena and gastric fundal varices at index endoscopy showing active bleeding or an overlying clot with no endoscopic evidences of bleeding from other sources. Injection therapy was administered as the first active measure. Cyanoacrylate was mixed with lipiodol [1:1] and injected strictly intravariceal through a Teflon injection device. The study concluded that cyanoacrylate injection to control gastric fundal variceal bleeding has been found to be remarkably safe and highly effective. An experienced team is always required

Immediate endoscopic injection therapy of bleeding oesophagea varices: a prospective comparative evaluation of injecting materials in egyptian patients with portal hypertension

This study was conducted to compare usual sclerosants [polidocanol 1%, ethanolamine oleate 5%] and the tissue adhesive [cyanoacrylate] in the control of esophageal variceal bleeding in Egyptian patients with portal hypertension in a prospective comparative trial. 60 patients with portal hypertension due to schistosomal hepatic fibrosis and/or post-hepatitic liver cirrhosis who had presented with acute esophageal variceal bleeding were enrolled. Patients received balloon tamponade prior to injection were excluded. Resuscitation had been done before or during emergency endoscopy. Emergency endoscopy was conducted within 2 hours from the onset of hematemesis. Patients were immediately randomized during emergency endoscopy to receive polidocanol 1%, ethanolamine oleate 5% or tissue adhesive. Variceal rebleeding was managed by reinjection. The 3 groups were comparable for age, sex, etiology of portal hypertension, Child-Pugh class and findings at emergency endoscopy. From the results obtained, it was concluded that polidocanol, ethanolamine and cyanoacrylate are equally safe and effective. For immediate endoscopic injection therapy, an experienced team must be available

Pattern and psycho-social, behavioral environmental risk factors for schistosomiasis infection among Egyptian school children

This article presented schistosomiasis infection pattern and described different infection/reinfection risk factors among a cohort of school children over a period of one year. Baseline data revealed a prevalence of 43.9% and a geometric mean egg count [GMEC] per gram stool among infected children of 319. Two months and one year later, the prevalence was 8.1% with GMEC of 54.5 and 15.9% with GMEC of 60.2, respectively, with 63.7% relative reduction in prevalence. Incidence rate was 12.9%, reinfection rate was 17.2% with GMEC of 74.2. Both infected boys and infected girls were more significantly involved with farming and irrigation with canal water during the growth of certain crops than were their uninfected counter-parts. Washing animals was also found to increase one's risk for schistosomiasis. Although most houses had access to tap water, the inconsistency of adequate water supply appears to be a common problem. Dirty floors that would become muddy with a good deal of washing was also a factor. The lack of alternative, affordable, competitive sports were identified as a reason why some boys choose to swim in the canals

Endoscopic control of gastric variceal bleeding with butyl cyanoacrylate in patients with schistosomiasis

100 patients with portal hypertension due to schistosomal hepatic fibrosis and/or post-hepatitic liver cirrhosis were included. All patients presented with bleeding from gastric varices, either fundal [80 patients] or inferior extension of esophageal varices [20 patients], were enrolled. Injection therapy was administered as the first active measure. No tamponade or drugs were used. Cyanoacrylate was mixed with lipid and injection through a hand-made probe. A mean of 3 [range 1 - 9] ampoules of cyanoacrylate were used per injection session. Bleeding stopped at the end of all sessions. Ten patients with fundal varices had rebleeding during the first 24 hours. Reinjection could control bleeding in 6 patients with a total success rate of 95%. Four patients were managed surgically. Fatal pulmonary embolism developed in one patient with fundal varix. Another five patients [6.25%] died from bleeding-related liver failure. In conclusion, injection of cyanoacrylate is highly satisfactory in controlling bleeding from both types of gastric varices

Helicobacter pylori among Egyptian patients with chronic liver, diseases a comparative study

80 patients subjected to upper gastrointestinal endoscopy were enrolled. They were divided according to their liver status into 2 groups. The 1st group included patients with liver cirrhosis and the 2nd group included patients who had no liver affection. Gallbladder diseases were excluded by abdominal ultrasound examinations. Endoscopic antral mucosal biopsies were used for H. Pylori screening by both culture and urease test, and for histopathological examinations. Both groups were matched as regards age, sex and socioeconomic conditions. Culture was positive in 42.2% and 40.7% of patients in both groups, respectively, [P >0.05]. Urease test showed positive results in 58% and 76.6% in both groups, respectively, [P >0.05]. H. pylori prevalence showed no significant differences between both studied groups as regards age, sex or type of gastric lesions. Furthermore, liver status in patients with chronic liver diseases does not play a role in the distribution of infection. The study showed the high prevalence of H. pylori among Egyptians and the absence of a relation between H. pylori and chronic liver diseases