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https://www.readbyqxmd.com/read/28397065/referral-patterns-and-factors-influencing-age-at-admission-of-infants-with-cholestasis-in-india
#1
Gopinathan Mathiyazhagan, Barath Jagadisan
OBJECTIVES: To define the recognition, age at admission, referral time and referral pattern of neonatal cholestasis in India. METHODS: This prospective, observational study was conducted from February 2015 through March 2016 in the Pediatric gastroenterology unit of JIPMER, Pondicherry in infants with cholestasis < 6 mo of age. RESULTS: Among 64 infants, median age of admission was 52 d (IQR 28-63 d). Fifty of sixty four infants (78.1%) came with parent-reported cholestasis-related symptoms of either jaundice alone (57...
April 11, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28396724/complementary-roles-of-interventional-radiology-and-therapeutic-endoscopy-in-gastroenterology
#2
REVIEW
David M Ray, Indu Srinivasan, Shou-Jiang Tang, Andreas S Vilmann, Peter Vilmann, Timothy C McCowan, Akash M Patel
Acute upper and lower gastrointestinal bleeding, enteral feeding, cecostomy tubes and luminal strictures are some of the common reasons for gastroenterology service. While surgery was initially considered the main treatment modality, the advent of both therapeutic endoscopy and interventional radiology have resulted in the paradigm shift in the management of these conditions. In this paper, we discuss the patient's work up, indications, and complementary roles of endoscopic and angiographic management in the settings of gastrointestinal bleeding, enteral feeding, cecostomy tube placement and luminal strictures...
March 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28388751/-unclear-abdominal-pain-not-always-a-gastroenterological-emergency
#3
Anna Teresa Aschoff, Maciej Pech, Frank Fischbach, Jens Ricke, Blerim Luani, Rüdiger Christian Braun-Dullaeus, Jörg Herold
History and admission findings An 84-year old patient with persistent atrial fibrillation and chronic renal failure received a subcutaneous injection with low molecular weight heparin (LMWH) during a hospital stay. Over the course of her hospitalization, the patient developed abdominal pain. There was a marked hematoma at the injection site. A large tumor was palpable in the right abdominal quadrant. Examinations Due to the significant reduction in hemoglobin, we performed a CT-angiogram of the abdomen...
April 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28370422/clinical-practice-guideline-for-enteroscopy
#4
REVIEW
Hironori Yamamoto, Haruhiko Ogata, Takayuki Matsumoto, Naoki Ohmiya, Kazuo Ohtsuka, Kenji Watanabe, Tomonori Yano, Toshiyuki Matsui, Kazuhide Higuchi, Tetsuya Nakamura, Kazuma Fujimoto
The management of small bowel diseases has evolved since the advent of capsule endoscopy (CE) and balloon-assisted enteroscopy (BAE). One of the most common indications of enteroscopy is obscure gastrointestinal bleeding (OGIB), and followed by small bowel stenosis, tumors, and inflammatory bowel diseases. Although these enteroscopes have been regarded as useful tools, a proper guideline is urged to ensure that we manipulate these enteroscopes safely and efficiently in clinical practice. Herein, the Japanese Gastroenterological Endoscopy Society (JGES) has developed "Clinical Practice Guideline for Enteroscopy" in collaboration with the Japanese Society of Gastroenterology, the Japanese Gastroenterological Association, and the Japanese Association for Capsule Endoscopy...
March 31, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28348475/giant-intrahepatic-portal-vein-aneurysm-leave-it-or-treat-it
#5
Amit Shrivastava, Jagdeesh S Rampal, D Nageshwar Reddy
Portal vein aneurysm (PVA) is a rare vascular dilatation of the portal vein. It is a rare vascular anomaly representing less than 3% of all visceral aneurysms and is not well understood. Usually, PVA are incidental findings, are asymptomatic, and clinical symptoms are proportionally related to size. Patients present with nonspecific epigastric pain or gastrointestinal bleeding with underlying portal hypertension. PVA may be associated with various complications such as biliary tract compression, portal vein thrombosis/rupture, duodenal compression, gastrointestinal bleeding, and inferior vena cava obstruction...
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28293079/pediatric-gastrointestinal-bleeding-perspectives-from-the-italian-society-of-pediatric-gastroenterology
#6
REVIEW
Claudio Romano, Salvatore Oliva, Stefano Martellossi, Erasmo Miele, Serena Arrigo, Maria Giovanna Graziani, Sabrina Cardile, Federica Gaiani, Gian Luigi de'Angelis, Filippo Torroni
There are many causes of gastrointestinal bleeding (GIB) in children, and this condition is not rare, having a reported incidence of 6.4%. Causes vary with age, but show considerable overlap; moreover, while many of the causes in the pediatric population are similar to those in adults, some lesions are unique to children. The diagnostic approach for pediatric GIB includes definition of the etiology, localization of the bleeding site and determination of the severity of bleeding; timely and accurate diagnosis is necessary to reduce morbidity and mortality...
February 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28257716/the-risks-and-benefits-of-long-term-use-of-proton-pump-inhibitors-expert-review-and-best-practice-advice-from-the-american-gastroenterological-association
#7
REVIEW
Daniel E Freedberg, Lawrence S Kim, Yu-Xiao Yang
BACKGROUND & AIMS: The purpose of this review is to evaluate the risks associated with long-term use of proton pump inhibitors (PPIs), focusing on long-term use of PPIs for three common indications: gastroesophageal reflux disease (GERD), Barrett's esophagus (BE), and non-steroidal anti-inflammatory drug (NSAID) bleeding prophylaxis. METHODS: The recommendations outlined in this review are based on expert opinion and on relevant publications from PubMed, EMbase, and the Cochrane library (through July 2016)...
March 2017: Gastroenterology
https://www.readbyqxmd.com/read/28238693/digital-rectal-examination-reduces-hospital-admissions-endoscopies-and-medical-therapy-in-patients-with-acute-gastrointestinal-bleeding
#8
Manish P Shrestha, Mark Borgstrom, Eugene Trowers
BACKGROUND: Although digital rectal examination is an established part of physical examinations in patients with acute gastrointestinal bleeding, clinicians are reluctant to perform a rectal examination. We intended to assess whether rectal examination affects the clinical management decision in these patients. METHODS: We performed a single-center, retrospective, cross-sectional study using data from electronic health records of patients aged ≥18 years presenting to the emergency department with acute gastrointestinal bleeding...
February 24, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28109636/management-of-non-variceal-upper-gastrointestinal-bleeding-position-statement-of-the-catalan-society-of-gastroenterology
#9
Pilar García-Iglesias, Josep-Maria Botargues, Faust Feu Caballé, Càndid Villanueva Sánchez, Xavier Calvet Calvo, Enric Brullet Benedi, Gabriel Cánovas Moreno, Esther Fort Martorell, Marta Gallach Montero, Emili Gené Tous, José-Manuel Hidalgo Rosas, Amelia Lago Macía, Ana Nieto Rodríguez, Michel Papo Berger, Montserrat Planella de Rubinat, Joan Saló Rich, Rafel Campo Fernández de Los Ríos
In recent years there have been advances in the management of non-variceal upper gastrointestinal bleeding that have helped reduce rebleeding and mortality. This document positioning of the Catalan Society of Digestologia is an update of evidence-based recommendations on management of gastrointestinal bleeding peptic ulcer.
January 18, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28050786/multicenter-prospective-study-on-the-safety-of-upper-gastrointestinal-endoscopic-procedures-in-antithrombotic-drug-users
#10
Yoshiyasu Kono, Minoru Matsubara, Tatsuya Toyokawa, Ryuta Takenaka, Seiyu Suzuki, Junichirou Nasu, Masao Yoshioka, Masahiro Nakagawa, Motowo Mizuno, Hiroyuki Sakae, Makoto Abe, Tatsuhiro Gotoda, Ko Miura, Hiromitsu Kanzaki, Masaya Iwamuro, Keisuke Hori, Takao Tsuzuki, Masahide Kita, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada
BACKGROUND: The Japan Gastroenterological Endoscopy Society updated its guidelines for gastroenterological endoscopy in patients undergoing antithrombotic treatment in July 2012. However, the safety of endoscopic procedures in antithrombotic drug users has not been fully investigated. AIMS: To evaluate the safety of upper gastrointestinal endoscopic procedures in antithrombotic drug users. METHODS: From September 2013 to September 2015, patients who were taking antithrombotic drugs and who underwent upper gastrointestinal endoscopic procedures were prospectively enrolled at five hospitals...
March 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28044953/a-rare-case-of-upper-digestive-hemorrhage-due-to-bleeding-duodenal-tumor
#11
Claudiu Turculeţ, Dragoş Ene, Teodor Florin Georgescu, E Ciucă, A Vlădăşcău, Florin Iordache, Mircea Beuran
We present the case of a 48-year-old patient with no medical history, who presents himself to the emergency room with melena, asthenia and dizziness. The blood tests revealed a severe anemia (Hb = 4,8 g/dL). He is admitted in the Gastroenterology ward, where a first superior digestive endoscopy is performed which shows a duodenal bleeding tumor (second duodenum) of 7 cm in length. After the administration of red blood cell mass, plasma and haemostatic agents the level of the hemoglobin increases. The abdominal CT scan reveals a 3/5 tumor localized in the second and third duodenum...
November 2016: Chirurgia
https://www.readbyqxmd.com/read/27984401/who-orders-a-head-ct-perceptions-of-the-cirrhotic-bleeding-risk-in-an-international-multispecialty-survey-study
#12
Laura M Mazer, Marie Méan, Elliot B Tapper
OBJECTIVE: Traditional coagulopathic indices, including elevated international normalized ratio, do not correlate with bleeding risk in patients with cirrhosis. For this reason, head computed tomography (CT) has a low yield in cirrhotic patients with altered mental status and no trauma history. The initial diagnostic evaluation, however, is often made by nongastroenterologists influenced by the so-called "coagulopathy of cirrhosis." We sought to examine the prevalence, impact, and malleability of this perception in an international, multispecialty cohort...
December 14, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27957300/efficacy-of-egg-yolk-and-nitroglycerin-ointment-as-treatments-for-acute-anal-fissures-a-randomized-clinical-trial-study
#13
Masoumeh Salari, Roshanak Salari, Maliheh Dadgarmoghadam, Majid Khadem-Rezaiyan, Mousalreza Hosseini
BACKGROUND: Acute anal fissure as a common disease in society has several etiologies and manifestations such as severe anal pain and bleeding. Nitroglycerin ointment 0.2% is the most common topical treatment used. The most common side effect of nitroglycerin is headache, which is annoying for patients and often leads to discontinuation of the drug. OBJECTIVE: Comparison of egg yolk as a natural substance with analgesic and anti-inflammatory properties and minimal side effects with nitroglycerin ointment in the treatment of acute anal fissure...
October 2016: Electronic Physician
https://www.readbyqxmd.com/read/27908516/small-bowel-bleeding-updated-algorithm-and-outcomes
#14
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
#15
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-nonvariceal-upper-gastrointestinal-bleeding-in-children-a-case-series
#16
Anna M Banc-Husu, Nuzhat A Ahmad, Vinay Chandrasekhara, Gregory G Ginsberg, David L Jaffe, Michael L Kochman, Michael W Rajala, Petar Mamula
OBJECTIVES: 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 few performed for nonvariceal upper gastrointestinal (NVUGI) bleeding. The data on therapeutic endoscopy for NVUGI are 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...
April 2017: 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
#17
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-examination-to-assess-acgme-competencies-in-pediatric-gastroenterology-fellows
#18
Aliza B Solomon, Rachel Reed, Keith Benkov, Joseph Kingsbery, Sarah S Lusman, Lisa B Malter, Jeremiah Levine, Simon S Rabinowitz, Martin Wolff, Sondra Zabar, Elizabeth Weinshel
BACKGROUND: The Accreditation Council for Graduate Medical Education has described 6 core competencies with which trainees should demonstrate proficiency. Using the Objective Structured Clinical Examination (OSCE), we aimed to assess 4 of these competencies among Pediatric Gastrointestinal (GI) fellows (PGs). METHODS: Eight first-year PGs from 6 medical centers in the New York area participated in a 4-station OSCE with trained standardized patient (SP) actors. The cases included an emergency department (ED) consult, or "ED Consult" for lower gastrointestinal bleeding; "Breaking Bad News" focusing on CF nutritional complications; "Second Opinion" for abdominal pain; "Transition of Care" for inflammatory bowel disease...
April 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27782896/variceal-bleeding-in-cirrhotic-patients-what-is-the-best-prognostic-score
#19
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
#20
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
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