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https://www.readbyqxmd.com/read/28994309/overview-of-small-bowel-angioectasias-clinical-presentation-and-treatment-options
#1
Stefania Chetcuti Zammit, Anastasios Koulaouzidis, David S Sanders, Mark E McAlindon, Emanuele Rondonotti, Diana E Yung, Reena Sidhu
Elderly patients with multiple co-morbidities are at an increased risk of developing small bowel angioectasias. Treating these lesions can be both challenging and costly with patients requiring extensive investigations and recurrent admissions for iron infusions and blood transfusions as well as invasive procedures. This review presents treatment options and describes in detail drugs that should be considered whilst taking into account their effectiveness and their safety profile. Areas covered: A PubMed search was carried out using the following keywords: small bowel angiodysplasias, small bowel angioectasias, small bowel bleeding and obscure gastrointestinal bleeding to assess existing evidence...
October 10, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28978901/aortic-valve-replacement-for-the-management-of-heyde-syndrome-a-case-report
#2
Akihiko Shibamoto, Hideto Kawaratani, Takuya Kubo, Norihisa Nishimura, Shinya Sato, Kenichiro Seki, Yasuhiko Sawada, Hiroaki Takaya, Yasushi Okura, Kousuke Takeda, Masakazu Uejima, Tadashi Namisaki, Kei Moriya, Akira Mitoro, Junichi Yamao, Hitoshi Yoshiji
Heyde syndrome describes the triad of aortic stenosis, acquired coagulopathy, and anemia due to bleeding from intestinal angiodysplasia. An 87-year-old man with iron deficiency anemia due to melena was admitted to our hospital. On examination, a systolic murmur was heard and echocardiography confirmed the presence of aortic stenosis. Esophagogastroduodenoscopy and colonoscopy were unremarkable. Capsule endoscopy and double balloon endoscopy revealed angiodysplasia throughout the small intestine. Laboratory investigations were significant for reduced plasma levels of high molecular weight von Willebrand factor multimers...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/28892784/ileal-angiodysplasia-presentation-as-a-bowel-obstruction-a-case-report
#3
Ons Ghdes, Ali Gaja, Ahlem Blel, Hichem Jarraya, Najla Mnif
INTRODUCTION: Angiodysplasia is a common vascular abnormality of the gastrointestinal tract, found in the elderly and most frequently revealed by gastrointestinal bleeding. We report an original case of ileal angiodysplasia in an 83-year-old woman presenting as a bowel obstruction. CASE PRESENTATION: An 83-year-old woman with a medical history of chronic untreated anemia, presented with cardinal symptoms of bowel obstruction. Computed tomography revealed diffuse ileal wall thickening with multiple zones of stenosis, which were aggravated by an ileal perforation and associated with vascular abnormalities compatible with angiodysplasia...
July 24, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28868182/assessment-of-serum-angiogenic-factors-as-a-diagnostic-aid-for-small-bowel-angiodysplasia-in-patients-with-obscure-gastrointestinal-bleeding-and-anaemia
#4
Grainne Holleran, Mary Hussey, Sinead Smith, Deirdre McNamara
AIM: To assess the use of serum levels of angiopoietin-1 (Ang1), Ang2 and tumor necrosis factor-α (TNFα) as predictive factors for small bowel angiodysplasia (SBA). METHODS: Serum samples were collected from patients undergoing capsule endoscopy for any cause of obscure gastrointestinal bleeding (OGIB) or anaemia. Based on small bowel findings patients were divided into 3 groups: (1) SBA; (2) other bleeding causes; and (3) normal, according to diagnosis. Using ELISA technique we measured serum levels of Ang1, Ang2 and TNFα and compared mean and median levels between the groups based on small bowel diagnosis...
August 15, 2017: World Journal of Gastrointestinal Pathophysiology
https://www.readbyqxmd.com/read/28833332/pharmacotherapeutic-management-of-gastrointestinal-bleeding-in-patients-with-continuous-flow-left-ventricular-assist-devices
#5
Adam Sieg, Jeremy D Moretz, Edward Horn, Douglas L Jennings
Continuous-flow left ventricular assist devices (CF-LVADs) have become an integral component of the management in patients with advanced heart failure, serving as destination therapy or as a bridge to heart transplantation. Despite significant advances in the design and longevity of the device, the ongoing risk for bleeding remains a significant concern. The genesis of gastrointestinal bleeding (GIB) in patients with CF-LVADs is likely multifactorial and may include components of acquired von Willebrand disease, angiodysplasia, and gastrointestinal arteriovenous malformations, as well as additional risk factors such as history of GIB and increased age...
August 22, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28789675/life-threatening-subdural-hematoma-after-aortic-valve-replacement-in-a-patient-with-heyde-syndrome-a-case-report
#6
Tetsuro Uchida, Azumi Hamasaki, Eiichi Ohba, Atsushi Yamashita, Jun Hayashi, Mitsuaki Sadahiro
BACKGROUND: Heyde syndrome is known as a triad of calcific aortic stenosis, anemia due to gastrointestinal bleeding from angiodysplasia, and acquired type 2A von Willebrand disease. This acquired hemorrhagic disorder is characterized by the loss of the large von Willebrand factor multimers due to the shear stress across the diseased aortic valve. The most frequently observed type of bleeding in these patients is mucosal or skin bleeding, such as epistaxis, followed by gastrointestinal bleeding...
August 8, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28729354/continuous-flow-lvad-support-causes-a-distinct-form-of-intestinal-angiodysplasia
#7
Jooeun Kang, Samson Hennessy-Strahs, Pawel Kwiatkowski, Christian A Bermudez, Michael A Acker, Pavan Atluri, Patrick I McConnell, Carlo R Bartoli
RATIONALE: The objective of this autopsy study was to determine whether gastrointestinal angiodysplasia develops during continuous-flow left ventricular assist device (LVAD) support. OBJECTIVE: LVAD support causes pathologic degradation of von Willebrand factor (vWF) and bleeding from gastrointestinal angiodysplasia at an alarming rate. It has been speculated that LVAD support itself may cause angiodysplasia. The relationship to abnormal vWF metabolism is unknown...
September 29, 2017: Circulation Research
https://www.readbyqxmd.com/read/28670610/in-vivo-characterization-of-abnormalities-in-small-bowel-diseases-using-probe-based-confocal-laser-endomicroscopy
#8
Naoki Ohmiya, Noriyuki Horiguchi, Tomomitsu Tahara, Mitsuo Nagasaka, Yoshihito Nakagawa, Tomoyuki Shibata, Tetsuya Tsukamoto, Makoto Kuroda
BACKGROUND AND STUDY AIMS:  Probe-based confocal laser endomicroscopy (pCLE) enables real-time optical biopsy. Little is known about pCLE imaging deep inside the small bowel, therefore the aim of this study was to determine its usefulness. PATIENTS AND METHODS:  Between April 2014 and January 2016, we performed 38 pCLE examinations during double-balloon enteroscopy with intravenous fluorescein in 37 patients with: tumors (n = 10), vascular disorders (n = 6), inflammatory diseases and drug injuries (n = 13), other disorders (n = 4), and normal findings (n = 4)...
July 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28670597/solitary-polypoid-angiodysplastic-lesion-mimicking-a-tumor-in-the-jejunum
#9
Abhishek D Polavarapu, Mayurathan Kesavan, Vivek V Gumaste, Monika Wrzolek, Elias Purow
Small bowel bleeding should be considered in patients with overt or occult gastrointestinal hemorrhage after normal upper and lower endoscopic examination. Angiodysplasia appearing as multiple flat vascular tufts is the most common cause of small bowel bleeding in patients over 40 years old. Polypoid angiodysplasia, however, is extremely rare. This report illustrates a unique case of solitary polypoid angiodysplasia in the jejunum of an adult with chronic kidney disease, who presented with an occult gastrointestinal bleed...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28670433/thalidomide-for-the-treatment-of-gastrointestinal-bleeding-due-to-angiodysplasia-in-a-patient-with-glanzmann-s-thrombasthenia
#10
Bruno K L Duarte, Sílvia M de Souza, Carolina Costa-Lima, Samuel S Medina, Margareth C Ozelo
Angiodysplasia is a frequent cause of persistent gastrointestinal (GI) hemorrhage in elderly patients. Although GI bleeding isn't the most common manifestation in patients with bleeding disorders, when present, it represents a challenging complication. We describe a 62-year-old patient with Glanzmann's thrombasthenia, who used thalidomide for severe and recurrent GI bleeding. For 6 months, the patient experienced temporary control of GI bleeding with thalidomide in a daily oral dose of 100 mg. The anti-angiogenic effects of thalidomide have recently been explored by several groups, particularly in the management of bleeding from angiodysplasia, including cases with von Willebrand disease...
June 1, 2017: Hematology Reports
https://www.readbyqxmd.com/read/28652649/bleeding-with-the-artificial-heart-gastrointestinal-hemorrhage-in-cf-lvad-patients
#11
EDITORIAL
Grigoriy E Gurvits, Elena Fradkov
Continuous-flow left ventricular assist devices (CF-LVADs) have significantly improved outcomes for patients with end-stage heart failure when used as a bridge to cardiac transplantation or, more recently, as destination therapy. However, its implantations carries a risk of complications including infection, device malfunction, arrhythmias, right ventricular failure, thromboembolic disease, postoperative and nonsurgical bleeding. A significant number of left ventricular assist devices (LVAD) recipients may experience recurrent gastrointestinal hemorrhage, mainly due to combination of antiplatelet and vitamin K antagonist therapy, activation of fibrinolytic pathway, acquired von Willebrand factor deficiency, and tendency to develop small intestinal angiodysplasias due to increased rotary speed of the pump...
June 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28651907/tumor-necrosis-factor-%C3%AE-levels-and-non-surgical-bleeding-in-continuous-flow-left-ventricular-assist-devices
#12
Corey E Tabit, Mitchell J Coplan, Phetcharat Chen, Valluvan Jeevanandam, Nir Uriel, James K Liao
BACKGROUND: Non-surgical bleeding (NSB) due to angiodysplasia is common in left ventricular assist device (LVAD) patients. Thrombin-induced angiopoietin-2 (Ang-2) expression in LVAD patients leads to altered angiogenesis and is associated with lower angiopoietin-1 (Ang-1) and increased NSB. However, the mechanism for decreased Ang-1, made by pericytes, is unknown and the origin of thrombin in LVAD patients is unclear. We hypothesized that high tumor necrosis factor-α (TNF-α) levels in LVAD patients induce pericyte apoptosis, tissue factor (TF) expression and vascular instability...
June 8, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28617760/nonisolated-small-bowel-gastrointestinal-angiodysplasias-are-associated-with-higher-rebleeding-rates-when-compared-with-isolated-small-bowel-gastrointestinal-angiodysplasia-on-video-capsule-endoscopy
#13
Stephanie H Mai, Daniel C Chao, Shu-Yi Liao, Christian S Jackson
BACKGROUND: Gastrointestinal angiodysplasias (GIAD) are commonly diagnosed in the small bowel but can be located in other areas of the gastrointestinal tract. About half of patients diagnosed with GIAD have more than 1 lesion and 20% of patients have GIAD in both the small bowel and a source outside of the small bowel (nonisolated to small bowel GIAD or NISGIAD). The remaining patients with GIAD have lesions isolated to the small bowel (ISGIAD). Complications including rebleeding, hospitalization and mortality rates have not been previously analyzed between these 2 groups...
June 14, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28614113/role-of-octreotide-in-pediatric-gastrointestinal-bleeding-secondary-to-angiodysplasia-in-children-with-right-heart-failure
#14
Kanika Puri, Robert Caldwell, Jean P Molleston
OBJECTIVES: Angiodysplasia is a relatively uncommon cause of GI bleeding in children and may be seen in right heart failure. Octreotide has been used successfully in adult patients with gastrointestinal bleeding due to angiodysplasias. METHODS: We describe two patients who had congenital heart disease with right heart failure and gastrointestinal bleeding from angiodysplasia. RESULTS: Angiodysplasia lesions were documented on traditional endoscopy and capsule endoscopy...
June 13, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28554655/hemorrhagic-angiodysplasia-of-the-digestive-tract-pathogenesis-diagnosis-and-management
#15
REVIEW
Aymeric Becq, Gabriel Rahmi, Guillaume Perrod, Christophe Cellier
No abstract text is available yet for this article.
May 26, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28552982/decreased-health-related-quality-of-life-in-angiodysplasia-patients-a-cross-sectional-cohort
#16
Karina V Grooteman, Mijntje Matheeuwsen, Erwin J M van Geenen, Joost P H Drenth
Gastrointestinal angiodysplasias may cause anemia. Quality of life (QoL) is a valid patient reported outcome and improvement of QoL represents an important treatment goal. There is a paucity of data on the effect of angiodysplasias on QoL. Therefore, we aim to evaluate QoL and fatigue in angiodysplasia patients. We performed a cross-sectional patient-reported outcome study. We included patients with endoscopy proven angiodysplasias and measured QoL with Short Form-36 and level of fatigue using Multi Fatigue Inventory-20...
2017: PloS One
https://www.readbyqxmd.com/read/28503284/arteriovenous-malformations-of-the-colon-a-report-of-two-cases-and-review-of-the-literature
#17
Ghodratollah Maddah, Abbas Abdollahi, Omid Rouhbakhshfar, Shirin Taraz Jamshidi, Masoumeh Hassanpour
BACKGROUND: Arteriovenous malformations are one of the most common vascular disorders of the colon. Vascular disorders present as painless, high-volume rectal bleeding. CASE PRESENTATION: This study elucidates two rare cases of vascular disorders that are diagnosed as angiodysplasia of the left colon and cavernous hemangioma of the colon and rectum. The chief complaint in two patients was rectorrhagia. The patients who were diagnosed of ulcerative colitis were treated with sulfadiazine and prednisone...
2017: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/28489838/-diagnostic-and-therapeutic-approach-to-small-bowel-disorders-through-capsule-endoscopy-and-double-balloon-endoscopy
#18
Federico De Simone, Pablo Machado, Edson Guzmán Calderon
Many small bowel disorders represent a great challenge for gastroenterologists and endoscopists due to the very low rates of success showed by the different agnosis techniques. The advent of the capsule endoscopy and double-balloon endoscopy has allowed a total, secure and efficient examination of the small bowel, which represents a real impact in diagnosis, treatment, and prognosis of our patients. The capsule endoscopy is a safe, minimally invasive procedure, which does not need sedation, does not cause pain, and allows the observation of the totality of the small bowel...
January 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28476066/angiodysplasia-in-von-willebrand-disease-understanding-the-clinical-and-basic-science
#19
Soundarya Selvam, Paula James
Severe and intractable gastrointestinal bleeding caused by angiodysplasia is a debilitating problem for up to 20% of patients with von Willebrand disease (VWD). Currently, the lack of an optimal treatment for this recurrent problem presents an ongoing challenge for many physicians in their management of affected patients. Over the past few years, studies have pointed to a regulatory role for the hemostatic protein, von Willebrand factor (VWF), in angiogenesis, providing a novel target for the modulation of vessel development...
September 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28467190/risk-of-gastrointestinal-bleeding-during-anticoagulant-treatment
#20
REVIEW
Aitor Lanas-Gimeno, Angel Lanas
Gastrointestinal bleeding (GIB) is a major problem in patients on oral anticoagulation therapy. This issue has become even more pressing since the introduction of direct oral anticoagulants (DOACs) in 2009. Areas covered: Here we review current evidence related to GIB associated with oral anticoagulants, focusing on randomized controlled trials, meta-analyses, and post-marketing observational studies. Dabigatran 150 mg twice daily and rivaroxaban 20 mg once daily increase the risk of GIB compared to warfarin...
June 2017: Expert Opinion on Drug Safety
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