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https://www.readbyqxmd.com/read/27908518/gastrointestinal-angiodysplasia-diagnosis-and-management
#1
REVIEW
Christian S Jackson, Richard Strong
Gastrointestinal angiodysplasia (GIAD) are red flat arborized lesions that are found throughout the entire gastrointestinal tract. GIAD can vary in size and have a range of presentation from occult to life-threatening bleeding. The typical presentation is intermittent bleeding in the setting of iron deficiency anemia. Endoscopy is the primary means of diagnosis and endoscopic therapy is noted to be initially effective. However, rebleeding can be as high as 40% to 50% in patients with small bowel GIAD. This review describes the pathophysiology for the development of GIAD and the current roles of endoscopic, medical, and surgical therapy in its treatment...
January 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/27894604/evaluation-of-the-efficacy-of-therapeutic-endoscopy-in-gastrointestinal-bleeding-secondary-to-angiodysplasias
#2
J Arribas Anta, C Zaera de la Fuente, R Martín Mateos, J A González Martín, A Cañete Ruiz, D Boixeda de Miquel, A Albillos Martínez
INTRODUCTION: Gastrointestinal angiodysplasias are defined as vascular dilations that communicate capillaries and veins in the walls of the digestive tract. The clinical presentation of these lesions varies from chronic occult bleeding to severe gastrointestinal hemorrhage. AIM: The primary aim of our study was to analyze lesion location, the efficacy of therapeutic endoscopy with argon plasma coagulation, and the factors associated with rebleeding in patients with gastrointestinal angiodysplasias...
November 25, 2016: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/27864873/hereditary-haemorrhagic-telangiectasia-to-transplant-or-not-to-transplant-is-there-a-right-time-for-liver-transplantation
#3
Yannick D Muller, Roland Oppliger, Romain Breguet, Philippe Meyer, Laura Rubbia-Brandt, Pierre-Auguste Petignat, Thomas Harr, Eric Dayer, Jörg D Seebach
BACKGROUND & AIMS: Hereditary haemorrhagic telangiectasia is characterized by arterio-venous malformations (AVM). It frequently involves the liver without clinical symptoms, but may lead to biliary ischaemia, portal hypertension, or fatal high-output heart failure. The indication of liver transplantation is controversial. METHODS: Herein, we report the case of a 65-year-old female patient with a 'double Osler syndrome' consisting of hereditary haemorrhagic telangiectasia (HHT) and type I hereditary angioedema diagnosed at the age of 25 and 22 years respectively...
December 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27858326/left-ventricular-assist-devices-impact-hospital-resource-utilization-without-affecting-patient-mortality-in-gastrointestinal-bleeding
#4
Feng Li, Alice Hinton, Alan Chen, Nishaki K Mehta, Samer Eldika, Cheng Zhang, Hisham Hussan, Darwin L Conwell, Somashekar G Krishna
BACKGROUND: Left ventricular assist devices (LVADs) are being utilized for management of end-stage heart failure and require systemic anticoagulation. Gastrointestinal bleeding (GIB) is one of the most common adverse events following LVAD implantation. AIM: To investigate the impact of continuous-flow (CF) LVAD implants on outcomes of patients admitted with GIB. METHODS: This is a cross-sectional study utilizing the Nationwide Inpatient Sample in the CF-LVAD era from 2010 to 2012...
November 17, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27826976/patients-with-klippel-trenaunay-syndrome
#5
M Zavacka, J Pobehova, K Gibarti, M Frankovicova
Klippel-Trenaunay syndrome is the most frequent systemic venous angiodysplasia. It is characterized by cutaneous capillary malformations - naevus flammeus, excessive growth of soft and bone tissue, venous and lymphatic malformations. Investigative methods include: clinical examinations, venography as the evidence of dysplastic changes of superficial and / or deep venous system, the Moyne obstruction and venous insufficiency perforator. Treatment is conservative, related to that of chronic venous disease. The surgery is aimed at removing the varices and insufficient perforators (Fig...
2016: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/27807584/hemobilia-from-biliary-angiodysplasia-diagnosed-with-cholangioscopy
#6
Kap Sum Foong, Ashley Lee, Shaismy Kudakachira, Hemchand Ramberan
Biliary angiodysplasia is extremely rare. Our background search revealed only a few case reports in the English literature. We present a case of angiodysplasia of the proximal common bile duct in a patient with subacute upper gastrointestinal bleeding and symptomatic anemia. A standard esophagogastroduodenoscopy with subsequent dedicated duodenoscopy revealed blood-stained bile draining from the major ampulla orifice. A contrast-enhanced magnetic resonance cholangiopancreatography was unrevealing for any pancreaticobiliary pathology...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27785314/safety-of-deep-enteroscopy-and-capsule-endoscopy-in-lvad-patients-case-report-and-literature-review
#7
Wilson Tak-Yu Kwong, Michelle Pearlman, Denise Kalmaz
Patients with a left ventricular assist device (LVAD) have increased risk of gastrointestinal (GI) bleeding. They are prone to develop angiodysplasia of the small intestine, and have a higher risk of bleeding as these patients are all required to be on permanent therapeutic anticoagulation. Here we report a case of a critically ill 55-year-old male on pressors and inotropes with an LVAD, who successfully underwent an antegrade double balloon enteroscopy (DBE).
December 2015: Gastroenterology Research
https://www.readbyqxmd.com/read/27755216/altered-prostasin-cap1-prss8-expression-favors-inflammation-and-tissue-remodeling-in-dss-induced-colitis
#8
Anna Keppner, Sumedha Malsure, Antoine Nobile, Muriel Auberson, Olivier Bonny, Edith Hummler
BACKGROUND: Inflammatory bowel diseases (IBD) including ulcerative colitis and Crohn's disease are diseases with impaired epithelial barrier function. We aimed to investigate whether mutated prostasin and thus, reduced colonic epithelial sodium channel activity predisposes to develop an experimentally dextran sodium sulfate (DSS)-induced colitis. METHODS: Wildtype, heterozygous (fr/+), and homozygous (fr/fr) prostasin-mutant rats were treated 7 days with DSS followed by 7 days of recovery and analyzed with respect to histology, clinicopathological parameters, inflammatory marker mRNA transcript expression, and sodium transporter protein expression...
October 12, 2016: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/27646132/a-rare-cause-of-persisting-anaemia-in-a-patient-with-a-failing-fontan-circulation
#9
Loes Lambrecht, Bjorn Cools, Peter Witters
This case report describes intestinal angiodysplasias as a cause of persisting anaemia in a 16-year-old girl with a failing Fontan circulation. Although this is a very rare cause of anaemia, we highlight the importance of video capsule endoscopy in such patients to initiate a life-saving treatment.
September 20, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27619827/multicentre-open-label-randomised-parallel-group-superiority-study-to-compare-the-efficacy-of-octreotide-therapy-40%C3%A2-mg-monthly-versus-standard-of-care-in-patients-with-refractory-anaemia-due-to-gastrointestinal-bleeding-from-small-bowel-angiodysplasias-a-protocol
#10
K V Grooteman, E J M van Geenen, J P H Drenth
INTRODUCTION: Gastrointestinal angiodysplasias are an important cause of difficult-to-manage bleeding, especially in older patients. Endoscopic coagulation of angiodysplasias is the mainstay of treatment, but may be difficult for small bowel angiodysplasias because of the inability to reach them for endoscopic intervention. Some patients are red blood cell (RBC) transfusion dependent due to frequent rebleeding despite endoscopic treatment. In small cohort studies, octreotide appears to decrease the number of bleeding episodes in patients with RBC transfusion dependency due to gastrointestinal angiodysplasias...
September 12, 2016: BMJ Open
https://www.readbyqxmd.com/read/27596107/risk-factors-for-active-bleeding-from-colonic-angiodysplasia-confirmed-by-colonoscopic-observation
#11
Naoyuki Nishimura, Motowo Mizuno, Yuichi Shimodate, Akira Doi, Hirokazu Mouri, Kazuhiro Matsueda, Hiroshi Yamamoto
PURPOSE: Colonic angiodysplasia is an important cause of lower gastrointestinal bleeding in the elderly. Here, we investigated the risk factors for bleeding from colonic angiodysplasia seen at endoscopy. METHODS: We conducted a retrospective case-control study by reviewing records of 435 patients with angiodysplasia at colonoscopy from November 2006 to November 2015 in our hospital. To identify risk factors for active bleeding, the following were analyzed: age, sex, comorbidities, use of antithrombotic drugs and non-steroidal anti-inflammatory drugs, and the size and location of the lesions...
December 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27595456/gastrointestinal-bleeding-from-vascular-malformations-is-octreotide-effective-to-rescue-difficult-to-treat-patients
#12
Andrea Iannone, Mariabeatrice Principi, Michele Barone, Giuseppe Losurdo, Enzo Ierardi, Alfredo Di Leo
Gastrointestinal vascular malformations are responsible for 2-8% of all cases of bleeding and 30-40% of all obscure hemorrhages, being the most frequent cause of occult bleeding in older people. The aim of this review was to provide an up-to-date report about the use of octreotide in bleeding from both hereditary and acquired vascular malformations of the gastrointestinal tract. A systematic literature search was performed, using the keywords "gastrointestinal vascular malformation", "octreotide", "angiodysplasia", "portal hypertensive gastropathy", "gastric antral vascular ectasia", and "hereditary vascular malformations"...
September 2016: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/27548727/a-prospective-blinded-comparison-of-video-capsule-endoscopy-versus-computed-tomography-enterography-in-potential-small-bowel-bleeding-clinical-utility-of-computed-tomography-enterography
#13
Julajak Limsrivilai, Sitthipong Srisajjakul, Supot Pongprasobchai, Somchai Leelakusolvong, Tawesak Tanwandee
GOALS: To compare the efficacy of video capsule endoscopy (VCE) with computed tomography enterography (CTE) in potential small bowel (SB) bleeding, and to identify factors predictive of a high diagnostic yield for CTE. BACKGROUND: In potential SB bleeding, CTE potentially detects some lesions missed by VCE, but few data have determined its clinical utility. STUDY: Consecutive patients with potential SB bleeding were prospectively enrolled...
August 19, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27548619/outcome-and-safety-of-anterograde-and-retrograde-single-balloon-enteroscopy-clinical-experience-at-a-tertiary-medical-center-in-taiwan
#14
Meng-Chiung Lin, Peng-Jen Chen, Yu-Lueng Shih, Hsin-Hung Huang, Wei-Kuo Chang, Tsai-Yuan Hsieh, Tien-Yu Huang
Single-balloon enteroscopy (SBE) is designed for identifying possible small bowel lesions with balloon-assisted enteroscopy that allows deep intubation of the intestine. However, data regarding the outcome and safety of SBE remain limited. We conducted this study to evaluate the outcome and safety of anterograde and retrograde SBE approaches. This retrospective review from a tertiary medical center in Taiwan included endoscopic reports and chart data from 128 patients with 200 anterograde and retrograde procedures from September 2009 to November 2014...
2016: PloS One
https://www.readbyqxmd.com/read/27528867/evaluation-of-superselective-transcatheter-arterial-embolization-with-n-butyl-cyanoacrylate-in-treating-lower-gastrointestinal-bleeding-a-retrospective-study-on-seven-cases
#15
Yuan Zhao, Gang Li, Xiang Yu, Ping Xie
Background. To investigate the safety and efficacy of superselective transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA) in treating lower gastrointestinal bleeding caused by angiodysplasia. Methods. A retrospective study was performed to evaluate the clinical data of the patients with lower gastrointestinal bleeding caused by angiodysplasia. The patients were treated with superselective TAE with NBCA between September 2013 and March 2015. Angiography was performed after the embolization...
2016: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/27514597/hereditary-hemorrhagic-telangiectasia
#16
REVIEW
Joseph G Parambil
Hereditary hemorrhagic telangiectasia (HHT) is an underrecognized and underdiagnosed autosomal-dominant angiodysplasia that has an estimated prevalence of 1 in 5000 individuals, with variable clinical presentations even within family members with identical mutations. The most common manifestations are telangiectasias of the skin and nasal mucosa. However, HHT can often be complicated by the presence of arteriovenous malformations and telangiectasias in the lungs, brain, gastrointestinal tract, and liver that are often silent and can lead to life-threatening complications of stroke and hemorrhage...
September 2016: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/27462834/multimodal-assessment-reveals-late-onset-hemispheric-shift-of-language-in-a-child-with-meningocerebral-dysplasia
#17
Anna Lorenzen, Marko Wilke, Michael Alber, Monika Milian, Antje Bornemann, Ulrike Ernemann, Sabine Rona
We report on a girl with progressive left frontal tissue destruction starting at the age of almost 8 years. She manifested acutely with epileptic seizures accompanied by Broca aphasia as well as transient right hemiparesis. Due to refractory epilepsy developing over the next years, which originated from the left frontal lobe, the decision was made to proceed to epilepsy surgery. By then, her language functions had recovered despite progressive left frontal tissue-destruction, raising the possibility of a hemispheric shift of language...
October 2016: Neuropediatrics
https://www.readbyqxmd.com/read/27437891/von-willebrand-factor-abnormalities-and-heyde-syndrome-in-dysfunctional-heart-valve-prostheses
#18
Joseph L Blackshear, Chad W McRee, Robert E Safford, Peter M Pollak, Mark E Stark, Colleen S Thomas, Candido E Rivera, Ewa M Wysokinska, Dong Chen
IMPORTANCE: Limited data suggest that von Willebrand factor (VWF) abnormalities may accompany the high-shear state associated with prosthetic valve dysfunction. If true, laboratory testing could add value in quantifying prosthesis dysfunction and could suggest a pathophysiological explanation for acquired bleeding in some patients. OBJECTIVES: To determine whether dysfunctional valve prostheses are associated with VWF abnormalities compared with normally functioning valve prostheses, to identify the severity of the VWF abnormality relative to other conditions, and to describe associated bleeding and the occurrence of gastrointestinal angiodysplasia...
May 1, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27437394/hematochezia-due-to-angiodysplasia-of-the-appendix
#19
Je-Min Choi, Seung-Hun Lee, Seung-Hyun Lee, Byung-Kwon Ahn, Sung-Uhn Baek
Common causes of lower gastrointestinal bleeding include diverticular disease, vascular disease, inflammatory bowel disease, neoplasms, and hemorrhoids. Lower gastrointestinal bleeding of appendiceal origin is extremely rare. We report a case of lower gastrointestinal bleeding due to angiodysplasia of the appendix. A 72-year-old man presented with hematochezia. Colonoscopy showed active bleeding from the orifice of the appendix. We performed a laparoscopic appendectomy. Microscopically, dilated veins were found at the submucosal layer of the appendix...
June 2016: Annals of Coloproctology
https://www.readbyqxmd.com/read/27426957/evaluation-of-iron-deficiency-anaemia-for-gastrointestinal-causes-in-patients-without-gi-symptoms-in-high-prevalent-gi-malignancy-zones
#20
Showkat A Kadla, Nisar A Shah, Muzafar A Bindroo, Bilal A Khan, Adil Farooq, Wajeed Yousf, Bilal A Wani
BACKGROUND AND STUDY AIMS: Gastric cancer is highly prevalent in Kashmir, as are lower gastrointestinal (LGI) malignancies. Colonic cancer, gastric cancer, and coeliac disease are the most important gastrointestinal (GI) causes of iron deficiency anaemia (IDA) worldwide. Approximately 9% of patients with IDA present with a suspicious lesion in the GI tract upon examination. However, the absence of GI symptoms and a possible lesion accounting for blood loss in IDA have not been studied in this zone with a high prevalence of GI malignancy...
June 2016: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
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