[Endovascular embolization of the gastric veins in portal hypertension complicated by esophagogastric hemorrhages]. / Endovaskuliarnaia émbolizatsiia ven zheludka pri portal'noi gipertenzii, oslozhnennoi ézofagogastral'nymi krovotecheniiami.

Through a period from 1981 to 1996 127 roentgen-endovascular embolization of gastric veins were carried out in 95 patients for portal hypertension complicated by esophagogastric bleeding or in its threatening relapse. Group 1 consisted of 73 patients, to whom endovascular treatment was carried out urgently at the background of continuing hemorrhage, in 52 patients--it was delayed and in 21 patients in the nearest posthemorrhagic period. In 73 patients bleeding resulting from embolization was stopped. In the earliest postembolization period recurrence of hemorrhage developed in 6 patients, thus initial hemostatic effect of embolization made up 91.8%, and survival rate--74% (54 from 73 patients of the 1-st group were discharged from the clinic). Group 2 consisted of 22 patients to whom embolization of gastric veins was carried out as an elective procedure. There were bleedings in the anamnesis in the patients of the latter group, and varicose veins of the esophagus with trophic disturbances in esophageal mucosa manifested real treat of the hemorrhage. The survival rate in this group of patients made up 95.5%. The analysis of the results of elective endovascular embolization of gastric veins revealed more favourable results in the nearest postembolization period, than in urgent procedures. Far off results of embolization of gastric veins were followed up in 61 patients (43 patients of the 1st group and 18 patients of the 2nd group). Index of survival up to 6 months made up 87.8%, up to 12 months--80.5%, up to 3 years--57.5% and up to 6 years--19.6%. Hemostatic effect up to 6 months made up 100%, to 12 months--84.6%, to 3 years--54.9%, to 6 years--15.6%.

[Enteral detoxication in patients with liver cirrhosis and bleeding from the esophageal and gastric varices ]. / Enteral'naia detoksikatsiia u bol'nykh tsirrozom pecheni i krovotecheniem iz varikozno-rasshirennykh ven pishchevoda i zheludka.

A new method of enteral detoxication with the use of both well-known medicines ("Normase", "Sorbit") and new medicine-"Rafinosa" is described. Clinical effectiveness (normalization of neurological status) of these medicines correlates with normalization of blood amino acids unbalance, decrease of the catabolic processes and accumulation of toxic products of nitrogenous metabolism. All the above medicines (Italian made "Normase", "Sorbit" and Russian made "Rafinosa") are equally important for clinical practice. Enternal detoxication may be effective only in case of preventing relapsing bleeding by all possible measures from endoscopic thrombosing and endovascular embolisation of varicose veins to direct surgical operation on the esophageal and cardial veins.

[Several factors in the pathogenesis of hepatic failure in patients with liver cirrhosis and bleeding from esophageal and gastric varicose veins]. / Izuchenie nekotorykh faktorov patogeneza pechenochnoi nedostatochnosti u bol'nykh tsirrozom pecheni i krovotecheniem iz varikozno-rasshirennykh ven pishchevoda i zheludka.

Bleeding in patients with liver cirrhosis leads to the activation of catabolic processes, accumulation of end products of nitrogen metabolism and pronounced imbalance of blood plasma amino acids. There is a correlation between the changes observed and disorders in neurological status. The authors hold that increased catabolism, pronounced imbalance of blood plasma amino acids and elevated blood ammonia level are the leading factors affecting the onset of hepatic encephalopathy.