Sclerotherapy Using Aluminum Potassium Sulfate and Tannic Acid (ALTA) for Haemorrhoids in Patients With Liver Cirrhosis

Background Symptomatic haemorrhoids in liver cirrhosis are difficult to handle due to rich collateral circulation and possible concomitant coagulo-therapy. Objectives The purpose of this study was to investigate the efficacy and safety of ALTA sclerotherapy in treating symptomatic haemorrhoids...

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Autores principales:	Hidenori Miyamoto, Tateo Nakagawa, Hideyuki Miyamoto, Atsushi Takata
Formato:	article
Lenguaje:	EN
Publicado:	Shiraz University of Medical Sciences 2015
Materias:	haemorrhoids liver cirrhosis alta transanal ultrasonography Medicine R
Acceso en línea:	https://doaj.org/article/c71ce82f82eb4f998a5241b9885fa903
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spelling	oai:doaj.org-article:c71ce82f82eb4f998a5241b9885fa9032021-11-15T09:41:07ZSclerotherapy Using Aluminum Potassium Sulfate and Tannic Acid (ALTA) for Haemorrhoids in Patients With Liver Cirrhosis2783-243010.17795/acr-32980https://doaj.org/article/c71ce82f82eb4f998a5241b9885fa9032015-12-01T00:00:00Zhttps://colorectalresearch.sums.ac.ir/article_45502_8c08e68d1c3488cb5fb571aaefe843dd.pdfhttps://doaj.org/toc/2783-2430Background Symptomatic haemorrhoids in liver cirrhosis are difficult to handle due to rich collateral circulation and possible concomitant coagulo-therapy. Objectives The purpose of this study was to investigate the efficacy and safety of ALTA sclerotherapy in treating symptomatic haemorrhoids in patients with liver cirrhosis and to demonstrate the differences of blood flow in hemorrhoidal tissue in patients with liver cirrhosis in vivo, using transanal ultrasonography. Patients and Methods Eleven patients with liver cirrhosis and haemorrhoidal disease were included in this study. The blood flow in the haemorrhoids was identified using three-dimensional power Doppler angiography (3D-PDA). All patients performed ALTA sclerotherapy. Results All patients’ symptoms (prolapse and/or bleeding) improved. However, two cases re-prolapsed during five years. Although two patients experienced slight bleeding after treatment and three patients experienced retention of ascites, there were no serious complications. 3D-PDA showed higher or lower vascularization in haemorrhoidal tissue in patients with liver cirrhosis. The prevalence of anorectal varices and haemorrhoids in cirrhotic patients had no association to Child-Pugh’s grading. Two patients with hyper-vascularity in haemorrhoidal tissue experienced slight bleeding after treatment. Conclusions ALTA sclerotherapy could bring an acceptable outcome for haemorrhoidal patients concurrent with liver cirrhosis. Using transanal ultrasonography, we could visualize the difference of blood flow in the haemorrhoid plexus and anorectal varices in vivo. This might be useful for treatment of haemorrhoids for patients with liver cirrhosis. We confirmed the efficacy and safety of ALTA sclerotherapy for haemorrhoidal patients with liver cirrhosis. Using 3D-PDA, we could visualize three-dimensionally the hemorrhoid plexus in patients with liver cirrhosis.Hidenori MiyamotoTateo NakagawaHideyuki MiyamotoAtsushi TakataShiraz University of Medical Sciencesarticlehaemorrhoidsliver cirrhosisaltatransanal ultrasonographyMedicineRENIranian Journal of Colorectal Research, Vol 3, Iss 4, Pp 0-0 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	haemorrhoids liver cirrhosis alta transanal ultrasonography Medicine R
spellingShingle	haemorrhoids liver cirrhosis alta transanal ultrasonography Medicine R Hidenori Miyamoto Tateo Nakagawa Hideyuki Miyamoto Atsushi Takata Sclerotherapy Using Aluminum Potassium Sulfate and Tannic Acid (ALTA) for Haemorrhoids in Patients With Liver Cirrhosis
description	Background Symptomatic haemorrhoids in liver cirrhosis are difficult to handle due to rich collateral circulation and possible concomitant coagulo-therapy. Objectives The purpose of this study was to investigate the efficacy and safety of ALTA sclerotherapy in treating symptomatic haemorrhoids in patients with liver cirrhosis and to demonstrate the differences of blood flow in hemorrhoidal tissue in patients with liver cirrhosis in vivo, using transanal ultrasonography. Patients and Methods Eleven patients with liver cirrhosis and haemorrhoidal disease were included in this study. The blood flow in the haemorrhoids was identified using three-dimensional power Doppler angiography (3D-PDA). All patients performed ALTA sclerotherapy. Results All patients’ symptoms (prolapse and/or bleeding) improved. However, two cases re-prolapsed during five years. Although two patients experienced slight bleeding after treatment and three patients experienced retention of ascites, there were no serious complications. 3D-PDA showed higher or lower vascularization in haemorrhoidal tissue in patients with liver cirrhosis. The prevalence of anorectal varices and haemorrhoids in cirrhotic patients had no association to Child-Pugh’s grading. Two patients with hyper-vascularity in haemorrhoidal tissue experienced slight bleeding after treatment. Conclusions ALTA sclerotherapy could bring an acceptable outcome for haemorrhoidal patients concurrent with liver cirrhosis. Using transanal ultrasonography, we could visualize the difference of blood flow in the haemorrhoid plexus and anorectal varices in vivo. This might be useful for treatment of haemorrhoids for patients with liver cirrhosis. We confirmed the efficacy and safety of ALTA sclerotherapy for haemorrhoidal patients with liver cirrhosis. Using 3D-PDA, we could visualize three-dimensionally the hemorrhoid plexus in patients with liver cirrhosis.
format	article
author	Hidenori Miyamoto Tateo Nakagawa Hideyuki Miyamoto Atsushi Takata
author_facet	Hidenori Miyamoto Tateo Nakagawa Hideyuki Miyamoto Atsushi Takata
author_sort	Hidenori Miyamoto
title	Sclerotherapy Using Aluminum Potassium Sulfate and Tannic Acid (ALTA) for Haemorrhoids in Patients With Liver Cirrhosis
title_short	Sclerotherapy Using Aluminum Potassium Sulfate and Tannic Acid (ALTA) for Haemorrhoids in Patients With Liver Cirrhosis
title_full	Sclerotherapy Using Aluminum Potassium Sulfate and Tannic Acid (ALTA) for Haemorrhoids in Patients With Liver Cirrhosis
title_fullStr	Sclerotherapy Using Aluminum Potassium Sulfate and Tannic Acid (ALTA) for Haemorrhoids in Patients With Liver Cirrhosis
title_full_unstemmed	Sclerotherapy Using Aluminum Potassium Sulfate and Tannic Acid (ALTA) for Haemorrhoids in Patients With Liver Cirrhosis
title_sort	sclerotherapy using aluminum potassium sulfate and tannic acid (alta) for haemorrhoids in patients with liver cirrhosis
publisher	Shiraz University of Medical Sciences
publishDate	2015
url	https://doaj.org/article/c71ce82f82eb4f998a5241b9885fa903
work_keys_str_mv	AT hidenorimiyamoto sclerotherapyusingaluminumpotassiumsulfateandtannicacidaltaforhaemorrhoidsinpatientswithlivercirrhosis AT tateonakagawa sclerotherapyusingaluminumpotassiumsulfateandtannicacidaltaforhaemorrhoidsinpatientswithlivercirrhosis AT hideyukimiyamoto sclerotherapyusingaluminumpotassiumsulfateandtannicacidaltaforhaemorrhoidsinpatientswithlivercirrhosis AT atsushitakata sclerotherapyusingaluminumpotassiumsulfateandtannicacidaltaforhaemorrhoidsinpatientswithlivercirrhosis
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Sclerotherapy Using Aluminum Potassium Sulfate and Tannic Acid (ALTA) for Haemorrhoids in Patients With Liver Cirrhosis

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