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避免陷阱:肝移植内镜医师应了解的知识——第二部分。

Avoiding pitfalls: what an endoscopist should know in liver transplantation--part II.

作者信息

Sharma Sharad, Gurakar Ahmet, Camci Cemalettin, Jabbour Nicolas

机构信息

Nazih Zuhdi Transplant Institute, 3300 North West Expressway, Oklahoma City, OK 73112, USA.

出版信息

Dig Dis Sci. 2009 Jul;54(7):1386-402. doi: 10.1007/s10620-008-0520-7. Epub 2008 Dec 17.

Abstract

Over the last decade the number of patients undergoing transplantation has increased. At the same time, effective peri- and postoperative care and better surgical techniques have resulted in greater numbers of recipients achieving long-term survival. Identification and effective management in the form of adequate treatment is essential, since any delay in diagnosis or treatment may result in graft loss or serious threat to patient's life. Various aspects of endoscopic findings that can be commonly encountered among liver transplant recipients are discussed herein. Topics include: persistent and/or recurrent esophageal varices, reflux, Candida or cytomegalovirus (CMV) esophagitis, esophageal neoplasms, posttransplant peptic ulcer, biliary complications, posttransplant lymphoproliferative disorder (PTLD), Kaposi's sarcoma, CMV colitis and inflammatory bowel disease, colonic neoplasms, Clostridium difficile infection, and graft versus host disease (GVHD).

摘要

在过去十年中,接受移植手术的患者数量有所增加。与此同时,有效的围手术期和术后护理以及更好的手术技术使得更多的受者实现了长期存活。以适当治疗形式进行的识别和有效管理至关重要,因为诊断或治疗的任何延迟都可能导致移植物丢失或对患者生命造成严重威胁。本文讨论了肝移植受者中常见的内镜检查结果的各个方面。主题包括:持续性和/或复发性食管静脉曲张、反流、念珠菌或巨细胞病毒(CMV)食管炎、食管肿瘤、移植后消化性溃疡、胆道并发症、移植后淋巴细胞增生性疾病(PTLD)、卡波西肉瘤、CMV结肠炎和炎症性肠病、结肠肿瘤、艰难梭菌感染以及移植物抗宿主病(GVHD)。

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