The American journal of gastroenterology
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Am. J. Gastroenterol. · Sep 1997
Outcome of 100 patients after transjugular intrahepatic portosystemic shunt for variceal hemorrhage.
One hundred consecutive patients with recurrent or refractory acute variceal hemorrhage treated with a transjugular intrahepatic portosystemic shunt (TIPS) from June 1990 to June 1993 at Oregon Health Sciences University or the Portland Veterans Affairs Medical Center were evaluated to assess shunt patency and clinical outcome, including complications of TIPS, rebleeding, and survival. ⋯ TIPS is effective in lowering elevated portal pressures in patients with refractory variceal hemorrhage, has acceptable postprocedure complication and mortality rates, ameliorates ascites, and in, a minority of patients, worsens encephalopathy. Shunt stenosis occurs in the majority of patients but can be effectively treated by interventional techniques to maintain patency. The incidence of recurrent variceal hemorrhage is low and is associated with shunt stenosis or occlusion.
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Am. J. Gastroenterol. · Sep 1997
Review Case ReportsPerforated diverticulum of the transverse colon.
We report a case of perforated diverticulitis of the transverse colon. The preoperative diagnosis of perforated appendicitis was made on the basis of findings of both ultrasonography and CT. ⋯ Diverticulitis of the transverse colon is rare, and there have been few reports in the English-language medical literature. This report describes a true diverticulum of the transverse colon that presented as acute diverticulitis.
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Am. J. Gastroenterol. · Sep 1997
Randomized Controlled Trial Clinical TrialBismuth subsalicylate instead of metronidazole with lansoprazole and clarithromycin for Helicobacter pylori infection: a randomized trial.
We evaluated the efficacy of lansoprazole, clarithromycin, and metronidazole (LCM) administered twice daily for 7 days. Because there is growing concern about the development of metronidazole-resistant H. pylori (HP) strains, we also tested a novel regimen consisting of lansoprazole, clarithromycin, and bismuth subsalicylate (LCB). ⋯ LCB for 7 days was as effective in eradicating HP infection as a 7-day course of LCM. Further studies evaluating the role of bismuth compounds in proton-pump inhibitor based triple therapy are warranted. Such therapy may have particular importance in areas where high metronidazole resistance is a concern.