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Bleeding Esophageal Varices in Patient With Liver Cirrhosis - Research Proposal Example

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This research proposal "Bleeding Esophageal Varices in Patient With Liver Cirrhosis" analyzes whether ultrasonic measurement of portal vein diameter and hemodynamics can be used as predictive tool for bleeding esophageal varices in a patient with liver cirrhosis. …
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Bleeding Esophageal Varices in Patient With Liver Cirrhosis
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Download file to see previous pages At one point in time, this fibrotic process becomes irreversible, and most clinical features or complications of cirrhosis of the liver can be correlated to the extent of the injury and subsequent histological changes, rather than to the causes of these changes per se. There are effects of loss of functional hepatocytes, but which is relevant to this proposal is fibrosis and distortion of intrahepatic micro and macrovascular architectures leading to portal hypertension and its effects, which include dilatation of veins at the gastroesophageal junction, termed as gastroesophageal varices and splenomegaly (Merkel et al., 2003).
The portal venous system anatomically is designed to carry 60 to 80% of the afferent blood to the liver. Unlike other venous systems in the body, there are no valves in the portal venous system. It is connected to the spleen, and at least one-fifth of the portal venous blood is contributed to by the spleen. The compression on the tiny portal venous radicles due to widespread parenchymal distortion and fibrous tissue overgrowth, the portal venous pressure increases. The hindrance of flow through the portal vein leads to extensive intrahepatic and selective extrahepatic communication between the systemic and portal venous systems (Choi et al., 2003). Out of these hepatofugal collateral pathways to channel blood from the obstructed portal systems into the systemic circulation, the connection between portal and short gastric veins in the esophagus appears to be the most significant since they can lead to life-threatening bleeding, which is difficult to control (Merkel et al., 1985). Preintervention investigations designed to gain information about these collateral and abnormal communications are important, not only to assess the extent of the disease (Poynard et al., 1987) but also to predict inadvertent injuries during intervention leading to significant and critical bleeding.  ...Download file to see next pagesRead More
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