Variceal Hemorrhage

This book discusses the management of variceal bleeding in liver cirrhosis, covering a wide range of topics, including epidemiology, mechanism, diagnosis and monitoring, prophylaxis, treatment, and prognostic assessment. It also presents the latest research in the field, such as non-invasive approaches, self-expanding metal stents, hemostatic powder, and early TIPS. The book is a valuable resource for physicians wanting to establish standard treatment strategies, researchers launching innovative clinical and experimental studies, and also for patients and their relatives wishing to gain a better understanding of this disease.

Variceal Hemorrhage provides an update of the evidence concerning several aspects of variceal hemorrhage. The book features new information on natural history, diagnosis of esophageal varices, assessment of the risk of bleeding and identification of high risk groups and patients who may benefit or be harmed from different treatments. The volume also presents a critical analysis of the different steps in the management of acute variceal bleeding. Authored by the most prominent world experts in their areas of expertise, Variceal Hemorrhage serves as a very useful reference for gastroenterologists, GI surgeons, residents in internal medicine and physicians dealing with and interested in the different aspects of this severe medical emergency.

The reference text for all those practicing diagnostic and therapeutic pediatric endoscopy – trainees, trainers, specialist endoscopists, gastroenterologists and hepatologists alike. Practical Pediatric Gastrointestinal Endoscopy, 3rd Edition provides a comprehensive and up-to-date exploration for the performance of endoscopy in infants, children and young adults. Written in the form of a complete "how to" manual and filled with step-by-step instructions, this book seeks to bring newcomers to the field of pediatric gastrointestinal endoscopy quickly up to speed. The book is also highly useful for experienced specialist endoscopists and gastroenterologists to brush up on best practice in standard techniques and explore advanced topics in the field. Practical Pediatric Gastrointestinal Endoscopy highlights the substantial and important differences between performing an endoscopy on a mature adult and performing one in a pediatric patient. The differences discussed include: GI pathology Subtleties of diagnostic technique specific to children Application of therapeutic endoscopy to specifically pediatric scenarios Anesthesia and sedation Training and skill maintenance Sophisticated endoscopic techniques adapted from adult endoscopy to children and those techniques specifically orientated to problems and diseases mainly encountered in childhood. This guide is becoming an essential companion for those of us providing diagnostic and therapeutic endoscopy for children in the world today and opens the door to future possibilities in this ever-evolving field.

This issue of Gastroenterology Clinics of North America is all about acute upper GI bleeding and is divided into two distinct sections: section I is devoted to nonvariceal upper GI bleeding and section II is devoted to variceal upper GI bleeding. Acute nonvariceal upper GI bleeding may originate from the esophagus, stomach, or duodenum, essentially anywhere proximal to the Ligament of Treitz. In Section I, Dr Gianluca Rotondano, Hospital Maresca, Torre del Greco, Italy, begins with a review of the epidemiology and diagnosis of acute nonvariceal upper GI bleeding. We then turn to patient presentation, risk stratification, and how to initially medically manage these bleeding patients. I am pleased to have one of our emergency medicine colleagues, Dr Andrew Meltzer, Department of Emergency Medicine, George Washington University, contribute this important article and provide a unique viewpoint from the emergency department where most of these patients initially present. As we all know, endoscopic hemostasis is the accepted standard of care for patients with acute nonvariceal upper GI bleeding. Moreover, peptic ulcer bleeding is the most common nonvariceal cause of acute upper GI bleeding; thus, Drs Yidan Lu, Yen-I Chen, and Alan Barkun from McGill University, Montreal, Canada, provide an in-depth review of the endoscopic management of peptic ulcer bleeding. Drs Eric Tjwa, I. Lisanne Holster, and Ernst Kuipers from the Erasmus Medical Center University Hospital, Rotterdam, The Netherlands, review the endoscopic management of all other causes of acute nonvariceal upper GI bleeding, and in addition, Drs Louis Wong Kee Song and Michael Levy from the Mayo Clinic, Rochester, Minnesota discuss emerging endoscopic hemostasis treatments, such as topical sprays and over-the-scope clipping devices. Although endoscopic hemostasis is very highly effective, there are unfortunately cases where bleeding is unable to be controlled or when significant rebleeding occurs that is not amenable to endoscopic therapy. Therefore, I have included two articles that provide insight into the question...what if endoscopic hemostasis fails? The first article, written by Drs Philip Wai Yan Chiu and James Yun Wong Lau, from Prince of Wales Hospital, The Chinese University of Hong Kong, focuses on tried and true surgical treatment options. The second article, by Dr Sujal Nanavati, University of California at San Francisco, Department of Radiology and Biomedical Imaging, addresses the alternative treatment strategy of angiographic embolization, which has now emerged as the often preferred salvage treatment strategy.

Ideally suited for students in critical care rotations and residents, this concise, practical handbook presents the essentials of medical and surgical critical care in an easy-to-read format. The authors succinctly explain the pathophysiology underlying clinical disorders and the key principles of diagnosis and patient management, emphasizing cost-effective approaches. The Fourth Edition includes Controversies in Critical Care boxes in many chapters, which briefly summarize opposing arguments on controversial points. Other highlights include enhanced discussion of CT for abdominal disorders, new ACLS guidelines, and new material on removable IVC filters, interventional radiologic techniques for GI bleeding, and use of vascular ultrasound.

This atlas is designed to provide an all-inclusive resource that describes step by step how to perform the essential bedside procedures required to provide optimal care to the critically ill patient. Detailed descriptions of these procedures, with sequential photographs depicting each critical step, provide an in depth understanding of the anatomy, critical technical steps and common pitfalls to both military and civilian trainees. For the advanced professional operator, this atlas will provide a rapid refresher of the critical steps and is an excellent teaching resource, based on the decades of collective experience accumulated by the authors. The top quality photographs of perfused and ventilated cadavers makes this atlas a standard reference for surgeons, critical care physicians, nurses and all critical care professionals.