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https://www.readbyqxmd.com/read/27908516/small-bowel-bleeding-updated-algorithm-and-outcomes
#1
REVIEW
Lauren B Gerson
Patients previously classified with "obscure gastrointestinal hemorrhage" should now be classified as "suspected small bowel bleeding" according to the 2015 American College of Gastroenterology guidelines. This article provides algorithms for how to manage patients with suspected small bowel bleeding, including utilization of second-look endoscopy and/or colonoscopy, video capsule endoscopy, computed tomographic enterography, magnetic resonance enterography, angiography, and deep enteroscopy.
January 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/27888865/advances-in-gastrointestinal-bleeding
#2
Ángel Lanas
The main innovations of the latest meeting of the Gastroenterological Association (2016) concerning upper gastrointestinal bleeding from the clinician's perspective can be summarised as follows: a) The Glasgow-Blatchford scale has the best accuracy in predicting the need for surgical intervention and hospital mortality; b) Prognostic scales for non-variceal upper gastrointestinal bleeding are also useful for lower gastrointestinal bleeding; c) Preliminary data suggest that treatment with hemospray does not seem to be superior to current standard treatment in controlling active peptic ulcer bleeding; d) Either famotidine or a proton pump inhibitor may be effective in preventing haemorrhagic recurrence in patients taking aspirin, but this finding needs to be confirmed in further studies; e) There was confirmation of the need to re-introduce antiplatelet therapy as early as possible in patients with antiplatelet-associated gastrointestinal bleeding in order to prevent cardiovascular mortality; f) Routine clinical practice suggests that gastrointestinal or cardiovascular complications with celecoxib or traditional NSAIDs are very low; g) Dabigatran is associated with an increased incidence of gastrointestinal bleeding compared with apixaban or warfarin...
September 2016: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/27811622/therapeutic-endoscopy-for-the-control-of-non-variceal-upper-gastrointestinal-bleeding-in-children-a-case-series
#3
Anna M Banc-Husu, Nuzhat A Ahmad, Vinay Chadrasekhara, Gregory G Ginsberg, David L Jaffe, Michael L Kochman, Michael Rajala, Petar Mamula
INTRODUCTION: Gastrointestinal bleeding is one of the most common indications for urgent endoscopy in the pediatric setting. The majority of these procedures are performed for control of variceal bleeding, with very few performed for non-variceal upper gastrointestinal (NVUGI) bleeding. The data on therapeutic endoscopy for NVUGI are very sparse. The aims of our study were to review our experience with NVUGI bleeding, describe technical aspects and outcomes of therapeutic endoscopy, and determine gastroenterology fellows' training opportunities according to the national training guidelines...
November 2, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27809364/continuation-of-anti-thrombotic-therapy-may-be-associated-with-a-high-incidence-of-colonic-post-polypectomy-bleeding
#4
Tomoyoshi Shibuya, Osamu Nomura, Tomohiro Kodani, Takashi Murakami, Hirofumi Fukushima, Yuzuru Tajima, Kohei Matsumoto, Hideaki Ritsuno, Hiroya Ueyama, Yoshihiro Inami, Dai Ishikawa, Kenshi Matsumoto, Naoto Sakamoto, Taro Osada, Akihito Nagahara, Tatsuo Ogihara, Sumio Watanabe
OBJECTIVES: Post-polypectomy bleeding (PPB) is the most common complication of endoscopic procedures. To reduce the risk of thromboembolic incidents, Japanese guidelines for gastroenterological endoscopy were revised to indicate that antithrombotic agents were not to be discontinued for endoscopic treatment. However, performing endoscopic procedures under antithrombotic medication potentially increases the incidence of hemorrhagic complications. This study investigated the impact of the revised guidelines on the frequency of complications after colonoscopic procedures...
November 3, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/27782961/using-the-objective-structured-clinical-exam-osce-to-assess-acgme-competencies-in-pediatric-gastroenterology-fellows
#5
Aliza B Solomon, Rachel Reed, Keith Benkov, Joseph Kingsbery, Sarah S Lusman, Lisa B Malter, Jeremiah Levine, Simon Rabinowitz, Martin Wolff, Sondra Zabar, Elizabeth Weinshel
BACKGROUND: The Accreditation Council for Graduate Medical Education (ACGME) has described six core competencies with which trainees should demonstrate proficiency. Using the Objective Structured Clinical Exam (OSCE), we aimed to assess four of these competencies among Pediatric GI fellows (PG). METHODS: Eight first-year PG's from six medical centers in the New York area participated in a four-station OSCE with trained standardized patient (SP) actors. The cases included an "ED Consult" for lower GI bleeding; "Breaking Bad News" focusing on CF nutritional complications; "Second Opinion" for abdominal pain; "Transition of Care" for inflammatory bowel disease...
October 25, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27782896/variceal-bleeding-in-cirrhotic-patients-what-is-the-best-prognostic-score
#6
Asmaa N Mohammad, Khairy H Morsy, Moustafa A Ali
BACKGROUND/AIMS: To find the most accurate, suitable, and applicable scoring system for the prediction of outcome in cirrhotic patients with bleeding varices. MATERIALS AND METHODS: A prospective study was conducted comprising 120 cirrhotic patients with acute variceal bleeding who were admitted to Tropical Medicine and Gastroenterology Department in Sohag University Hospital, over a 1-year period (1/2015 to 1/2016). The clinical, laboratory, and endoscopic parameters were studied...
September 2016: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/27779592/improved-outcomes-following-implementation-of-an-acute-gastrointestinal-bleeding-multidisciplinary-protocol
#7
Tyler J Loftus, Kristina L Go, Steven J Hughes, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Scott C Brakenridge, Alicia M Mohr, Janeen R Jordan
BACKGROUND: Effective multidisciplinary management of gastrointestinal bleeding (GIB) requires effective communication. We instituted a protocol to standardize communication practices with the hypothesis that outcomes would improve following protocol initiation. METHODS: We performed a retrospective cohort analysis of 442 patients who required procedural management of acute GIB at our institution during a 50 month period spanning 25 months before and 25 months after implementation of a multidisciplinary communication protocol...
October 25, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27672577/retained-wireless-capsule-endoscope-in-a-girl-with-suspected-crohn-s-disease
#8
Koushik Herle, Susan Jehangir
Wireless capsule endoscopy (WCE) is one of the great milestones in the field of gastroenterology. It is versatile in image acquisition, painless and can reach parts of the small bowel not amenable to conventional endoscopy. The commonest complication with WCE is retention of the capsule. We report a case of retained capsule in a child who was being investigated for obscure gastrointestinal bleeding (OGIB). Operative intervention was required for its retrieval after two weeks of expectant management.
September 2016: APSP Journal of Case Reports
https://www.readbyqxmd.com/read/27662496/acute-gastrointestinal-bleeding-cases-presenting-to-the-emergency-department-are-associated-with-age-sex-and-seasonal-and-circadian-factors
#9
Henrike Lenzen, Eliane Musmann, Martina Kottas, Bastian Schönemeier, Thomas Köhnlein, Michael P Manns, Tim O Lankisch
BACKGROUND: Gastrointestinal bleeding (GIB) is one of the most common emergencies in gastroenterology. The aim of this study was to investigate the association between the incidence of GIB and seasonal, circadian and meteorological patterns in the emergency department (ED) of a tertiary hospital. PATIENTS AND METHODS: From January 2007 until December 2012, we retrospectively evaluated patients presenting to the ED with respect to the number and location of GIB, season, time of day and weather...
January 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27643628/downhill-varices-an-uncommon-cause-of-upper-gastrointestinal-bleeding
#10
Guillermo Ontanilla Clavijo, Claudio Trigo Salado, Norberto Rojas Mercedes, Juan Antonio Caballero Gómez, Adalberto Rincón Gatica, Juan Manuel Alcívar-Vasquez, José Luis Márquez Galán
BACKGROUND: Upper gastrointestinal bleeding (UGIB) is a common condition in gastroenterology, but "Downhill Varices" (DHV) or varices of the upper oesophagus are an uncommon cause of UGIB, with different aetiology from lower third oesophageal varices and different therapeutic implications. CASE REPORT: A 28-year-old male patient, with a history of chronic kidney failure secondary undergoing haemodialysis and superior vena cava syndrome (SCVS) due to multiple catheter replacements, was admitted to the Emergency Department with haematemesis secondary to a varicose vein rupture in the proximal third of oesophagus, treated initially with ethanolamine...
July 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27622898/pediatric-gastrointestinal-endoscopy-european-society-of-pediatric-gastroenterology-hepatology-and-nutrition-espghan-and-european-society-of-gastrointestinal-endoscopy-esge-guidelines
#11
Mike Thomson, Andrea Tringali, Rosario Landi, Jean-Marc Dumonceau, Marta Tavares, Jorge Amil-Dias, Marc Benninga, Merit M Tabbers, Raoul Furlano, Manon Spaander, Cesare Hassan, Christos Tzvinikos, Hanneke Ijsselstijn, Jérôme Viala, Luigi Dall'Oglio, Rok Orel, Yvan Vandenplas, Radan Keil, Štěpán Hlava, Claudio Romano, Eva Brownstone, Patrick Gerner, Werner Dolak, Wolf Dietrich Huber, Simon Everett, Andreas Vecsei, Lars Aabakken, Alessandro Zambelli
This Guideline refers to infants, children and adolescents aged 0-18 years. The areas covered include: indications for diagnostic and therapeutic esophagogastroduodenoscopy and ileo-colonoscopy; endoscopy for foreign body ingestion; corrosive ingestion and stricture/stenosis endoscopic management; upper and lower gastrointestinal bleeding; endoscopic retrograde cholangio-pancreatography and endoscopic ultrasonography. Percutaneous endoscopic gastrostomy and endoscopy specific to inflammatory bowel disease (IBD) has been dealt with in other Guidelines [1-3] and are therefore not mentioned in this Guideline...
September 12, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27617420/pediatric-gastrointestinal-endoscopy-european-society-of-gastrointestinal-endoscopy-esge-and-european-society-for-paediatric-gastroenterology-hepatology-and-nutrition-espghan-guideline-executive-summary
#12
Andrea Tringali, Mike Thomson, Jean-Marc Dumonceau, Marta Tavares, Merit M Tabbers, Raoul Furlano, Manon Spaander, Cesare Hassan, Christos Tzvinikos, Hanneke Ijsselstijn, Jérôme Viala, Luigi Dall'Oglio, Marc Benninga, Rok Orel, Yvan Vandenplas, Radan Keil, Claudio Romano, Eva Brownstone, Štěpán Hlava, Patrick Gerner, Werner Dolak, Rosario Landi, Wolf Dietrich Huber, Simon Everett, Andreas Vecsei, Lars Aabakken, Jorge Amil-Dias, Alessandro Zambelli
This Executive summary of the Guideline on pediatric gastrointestinal endoscopy from the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) refers to infants, children, and adolescents aged 0 - 18 years. The areas covered include: indications for diagnostic and therapeutic esophagogastroduodenoscopy and ileocolonoscopy; endoscopy for foreign body ingestion; endoscopic management of corrosive ingestion and stricture/stenosis; upper and lower gastrointestinal bleeding; endoscopic retrograde cholangiopancreatography, and endoscopic ultrasonography...
September 12, 2016: Endoscopy
https://www.readbyqxmd.com/read/27588296/the-role-of-the-endoscopist-in-the-stroke-unit
#13
REVIEW
Thomas Frieling
BACKGROUND: Acute cerebral stroke is a common problem that is frequently associated with dysphagia resulting in an increased risk of aspiration pneumonia, complication, and mortality. METHODS: A literature review was carried out using the search terms 'stroke unit and endoscopy', 'stroke unit and dysphagia', and 'stroke unit and gastroenterology'. RESULTS: Only few papers focus on the role of endoscopy in stroke units. One major role is the early detection of dysphagia by flexible endoscopic evaluation of swallowing (FEES)...
February 2016: Visceral Medicine
https://www.readbyqxmd.com/read/27509702/solitary-rectal-ulcer-syndrome-clinical-endoscopic-histological-and-anorectal-manometry-findings-in-north-indian-patients
#14
M K Behera, V K Dixit, S K Shukla, J K Ghosh, V B Abhilash, P K Asati, A K Jain
BACKGROUND: Solitary rectal ulcer syndrome (SRUS) is a chronic, benign defecation disorder often related to excessive straining. SRUS is diagnosed on the basis of clinical symptoms, endoscopic and histological findings. METHODS: All patients diagnosed with SRUS by colonoscopy and confirmed by histopathology from October 2012 to August 2014 in the Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, India, were included in the study...
October 2015: Tropical Gastroenterology: Official Journal of the Digestive Diseases Foundation
https://www.readbyqxmd.com/read/27491671/study-protocol-first-nationwide-comparative-audit-of-acute-lower-gastrointestinal-bleeding-in-the-uk
#15
Kathryn Oakland, Richard Guy, Raman Uberoi, Frances Seeney, Gary Collins, John Grant-Casey, Neil Mortensen, Mike Murphy, Vipul Jairath
INTRODUCTION: Acute lower gastrointestinal bleeding (LGIB) is a common indication for emergency hospitalisation worldwide. In contrast to upper GIB, patient characteristics, modes of investigation, transfusion, treatment and outcomes are poorly described. There are minimal clinical guidelines to inform care pathways and the use of endoscopy, including (diagnostic and therapeutic yields), interventional radiology and surgery are poorly defined. As a result, there is potential for wide variation in practice and clinical outcomes...
August 4, 2016: BMJ Open
https://www.readbyqxmd.com/read/27464285/-bleeding-in-patients-receiving-dual-antiplatelet-therapy-after-acute-coronary-syndrome-significance-prevention-and-interdisciplinary-management
#16
U Zeymer, J Koscielny, C von Heymann, M Spannagl, J Labenz, J Cremer, E Giannitsis, H Darius, F Goss
For secondary prevention of acute coronary syndrome, guidelines recommend dual antiplatelet therapy with acetylsalicylic acid and a P2Y12 receptor antagonist such as clopidogrel, prasugrel or ticagrelor for a period of 12 months. Premature discontinuation of dual antiplatelet therapy is associated with an increased risk of ischaemic events. However, antiplatelet therapy is also associated with an increased risk of bleeding that should not be under- or overestimated. To ensure an optimal care of patients receiving dual antiplatelet therapy after an acute coronary syndrome, an interdisciplinary group of experienced experts in the fields of cardiology, cardiac surgery, gastroenterology, anaesthesiology, intensive care and haemostaseology gathered bleeding-related information and developed recommendations relevant to daily clinical practice...
July 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27446832/canadian-association-of-gastroenterology-indicators-of-safety-compromise-following-colonoscopy-in-clinical-practice
#17
Mark R Borgaonkar, David Pace, Muna Lougheed, Curtis Marcoux, Bradley Evans, Nikita Hickey, Meghan O'Leary, Jerry McGrath
In 2012 the Canadian Association of Gastroenterology published 19 indicators of safety compromise. We studied the incidence of these indicators by reviewing all colonoscopies performed in St. John's, NL, between January 1, 2012, and June 30, 2012. Results. A total of 3235 colonoscopies were included. Adverse events are as follows. Medication-related includes use of reversal agents 0.1%, hypoxia 9.9%, hypotension 15.4%, and hypertension 0.9%. No patients required CPR or experienced allergic reactions or laryngospasm/bronchospasm...
2016: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27442656/well-differentiated-neuroendocrine-tumor-of-the-stomach-a-rare-case-at-an-uncommon-site
#18
Burak Gumuscu, Kevin Norwood, George A Parker, C Lee Bridges, Carl B Rountree
INTRODUCTION: A 13-year-old African-American female presented to her primary care physician's office with fatigue, syncope, and hematemesis. After initial evaluation, the patient was referred to pediatric gastroenterology clinic for further evaluation. MAIN CONCERNS, IMPORTANT FINDINGS: An upper gastrointestinal endoscopy was performed to evaluate the source of her bleeding. Endoscopy revealed a 3-cm mass in the lesser curvature of the stomach, and a biopsy of the mass revealed a concern for carcinoid (neuroendocrine) features...
July 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27409086/-rol-of-double-balloon-enteroscopy-in-the-management-of-small-intestine-diseases-experience-in-the-national-hospital-guillermo-almenara-irigoyen-lima-peru
#19
Juan Paredes Méndez, Luis Lazo Molina, Bruno Molina Martos
OBJECTIVE: Evaluate the diagnostic and therapeutic utility, safeness, efficacy and complications of double-balloon enteroscopy (DBE). MATERIAL AND METHODS: This prospective, descriptive study of DBE took place between July 2010 and June 2015 at the service of Gastroenterology of Hospital Nacional Guillermo Almenara Irigoyen- Lima Peru. 129 DBE were performed in 121 patients with the Fujinon EN-450T5 double balloon enteroscope, with conscious sedation and with previous bowel preparation...
April 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/27395835/peptic-ulcers-and-erosions-in-children-at-a-pediatric-unit-in-turkey
#20
Tugba Koca, Filiz Serdaroglu, Selim Dereci, Mustafa Akcam
OBJECTIVE: To study the characteristics of peptic ulcer and erosion in pediatric patients. METHODS: Over a period of seven years, 1,026 children underwent upper gastrointestinal endoscopy in our pediatric gastroenterology unit. RESULTS: Peptic ulcers and erosions were found in 59 (7.2%) patients [ulcers in 42 (5.1%)and erosions in 17 (2.1%)]. Thirty (50.9%) children presented with acute upper gastrointestinal bleeding. Helicobacter pylori positivity was found in 27 patients (45...
August 8, 2016: Indian Pediatrics
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