Portal hypertension and emergency care.

OBJECTIVE: Aim: To evaluate the peculiarities of the course of complications and the provision of care for portal hypertension associated with the development of diureticresistant ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, and variceal bleeding. PATIENTS AND METHODS: Materials and Methods: This research is based on a review of the literature in PubMed, CrossRef, Google Scholar sources on complicated portal hypertension. Such complications of portal hypertension as spontaneous bacterial peritonitis, ascites, hepatorenal sуndrome, variceal bleeding caused by sinistral portal hypertension are considered. The effectiveness of interventional treatment methods and laparoscopic surgical interventions has been demonstrated. CONCLUSION: Conclusions: Diagnosis and treatment of patients with complicated portal hypertension requires a multidisciplinary approach, which is due to the diverse pathophysiological process of portal hypertension. The possibilities of providing emergency care to this category of patients depend on the level of medical training of the staff, the possibilities of medical and technical support in the provision of interventional care, the ineffectiveness of which necessitates surgical treatment using minimally invasive technologies.

Three cases of fatal postoperative thromboembolic complications in patients with liver cirrhosis and bleeding from esophageal varicose veins after COVID-19.

Coronavirus disease (COVID-19), which broke out in China and caused a devastating pandemic worldwide, is associated with a significantly increased risk of thrombotic complications, especially pulmonary embolism. During the COVID-19 pandemic, investigations have reported a high incidence of venous thromboembolic (VTE) events in hospitalized patients with COVID-19, often despite thromboprophylaxis. Current recommendations for thromboprophylaxis are based on randomized clinical trials, which usually exclude patients at а potentially high risk of hemorrhagic complications. This category includes patients with liver cirrhosis complicated by variceal bleeding, thrombocytopenia, and coagulopathy. We present three patients who suffered severe covid pneumonia and were hospitalized with acute variceal bleeding, who developed fatal thromboembolic complications in the postoperative period.