Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
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Clin. Gastroenterol. Hepatol. · Sep 2008
Screening and surveillance colonoscopy in chronic Crohn's colitis: results of a surveillance program spanning 25 years.
Since 1980, we have followed 259 patients with chronic Crohn's colitis in a prospective colonoscopic surveillance program. Our initial results through August 1998 showed a 22% chance of developing definite dysplasia or cancer by the fourth surveillance examination. We now update the results of all examinations since September 1998 until April 2005. ⋯ Periodic surveillance colonoscopy should be part of the routine management of chronic extensive Crohn's colitis.
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Clin. Gastroenterol. Hepatol. · Sep 2008
Case ReportsCerebral edema and hyperammonemia after transjugular intrahepatic portosystemic shunt placement in a cirrhotic patient.
Transjugular intrahepatic portosystemic shunt (TIPS) placement has been widely performed for nearly two decades and has been shown to alleviate refractory ascites in patients with cirrhosis. Hepatic encephalopathy after TIPS is rarely severe; however, a risk of cerebral edema resulting from hyperammonemia after TIPS does exist. Here we describe a case demonstrating the development of severe hepatic encephalopathy with cerebral edema caused by hyperammonemia as a complication of TIPS in a patient with chronic liver disease with relatively preserved liver function.