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https://www.readbyqxmd.com/read/29671011/-rectal-bleeding-in-a-60-year-old-woman-under-anticoagulation-and-platelet-aggregation-inhibition
#1
J Pohlan, N Willamowski, C Jürgensen, E Zimmermann, M Möckel
CASE REPORT: We report on a woman with lower gastrointestinal bleeding under effective oral anticoagulation with both phenprocoumon and apixaban (with intention to switch to the latter) as well as the antiplatelet agent acetylsalicylic acid for aortic bifurcation kissing stents after stent thrombosis. Our patient presented with weakness and rectal bleeding. Upon examination, she looked anemic and had sinus tachycardia (104 beats per minute). The digital rectal examination revealed bright red blood mixed with clots...
April 18, 2018: Der Internist
https://www.readbyqxmd.com/read/29662934/bevacizumab-for-refractory-gastrointestinal-bleeding-in-rendu-osler-weber-disease
#2
Carlos Bernardes, Sara Santos, Rafaela Loureiro, Verónica Borges, Gonçalo Ramos
Rendu-Osler-Weber disease, also known as hereditary hemorrhagic telangiectasia, is a rare autosomal dominant disorder which is often characterized by recurrent epistaxis, mucocutaneous and gastrointestinal telangiectasias, and visceral arteriovenous malformations. Patients with gastrointestinal involvement can present with a wide spectrum of severity, which may vary from uncomplicated iron deficiency anemia to continuous and refractory bleeding. We present the case of a 62-year-old female, who was admitted with anemia following several episodes of melena, and whose endoscopic examination revealed multiple angiodysplasias in the stomach and small bowel...
March 2018: GE Portuguese Journal of Gastroenterology
https://www.readbyqxmd.com/read/29652031/association-between-patient-characteristics-and-magnetically-controlled-capsule-endoscopy-findings
#3
Huasheng Lai, Junsheng Huang, Yangzhi Xu, Jie Zhang, Zhenyu Chen, Fengcheng Xi, Aimin Li, Side Liu
Background/Aim: Magnetically-controlled capsule endoscopy (MCE) is a potential option for the evaluation of gastric diseases in cases that are unsuited for conventional endoscopy, avoiding discomfort, sedation, and related complications. This retrospective study investigated associations between MCE findings and patient gender, age, and inpatient/outpatient status. Patients and Methods: The data of 580 consecutive patients who underwent MCE from 2015 to 2016 were analyzed...
April 13, 2018: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/29610020/pharmacological-treatment-of-gastrointestinal-bleeding-due-to-angiodysplasias-a-position-paper-of-the-italian-society-of-gastroenterology-sige
#4
REVIEW
Gerardo Nardone, Debora Compare, Alberto Martino, Alba Rocco
Angioectasias (AD) belong to benign vascular malformations of the gastrointestinal tract and are responsible for about 4-7% of upper non variceal bleeding, 30-40% of small bowel occult bleeding and 3-40% of colonic bleeding episodes. Gastrointestinal haemorrhage secondary to AD represents an important diagnostic and therapeutic problem that negatively impacts on the quality of life of patients and heath care costs. Endoscopic interventions are the mainstay in both diagnosis and treatment of vascular malformations...
February 15, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29588836/emerging-role-of-thalidomide-in-the-treatment-of-gastrointestinal-bleeding
#5
REVIEW
Michael McFarlane, Lauren O'Flynn, Rachel Ventre, Benjamin R Disney
Thalidomide was initially synthesised in 1954 and marketed as a sedative and antiemetic for morning sickness. It was withdrawn in 1961 due to the realisation that it was teratogenic with over 10 000 children born with congenital abnormalities. Since then it has been used for treatment of dermatological and oncological conditions, including myeloma. In 1994, it was found to have a potent antiangiogenic effect via downregulation of vascular endothelial growth factor (VEGF). This has led to its use in gastrointestinal bleeding, as vascular abnormalities such as angiodysplasia have been found to have elevated VEGF levels...
April 2018: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29582237/locations-and-mucosal-lesions-responsible-for-major-gastrointestinal-bleeding-in-patients-on-warfarin-or-dabigatran
#6
Jennifer M Kolb, Kathryn Friedman Flack, Prapti Chatterjee-Murphy, Jay Desai, Lars C Wallentin, Michael Ezekowitz, Stuart Connolly, Paul Reilly, Martina Brueckmann, John Ilgenfritz, James Aisenberg
BACKGROUND AND AIM: Different oral anticoagulants may be associated with gastrointestinal bleeding (GIB) from different locations or mucosal lesions. We aimed to test this hypothesis. METHODS: Two blinded gastroenterologists independently analyzed source documents from the randomized evaluation of long-term anticoagulant therapy (RE-LY) trial of dabigatran 150 mg BID (D150), dabigatran 110 mg BID (D110) versus warfarin in non-valvular atrial fibrillation (NVAF)...
March 27, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29545870/diagnostic-value-of-omom-capsule-endoscopy-for-small-bowel-diseases-in-adults
#7
Lili Zhang, Junsong Shen, Linchun Guo, Fenggan Cheng, Qi Fan, Keqian Ni, Shujing Xia, Detong Zhou
The present study aimed to determine the diagnostic yield of OMOM capsule endoscopy for small bowel diseases in adults. A total of 89 patients, including 45 cases of obscure abdominal pain, 22 of chronic diarrhea, 18 of obscure gastrointestinal bleeding and 4 of obscure anemia were enrolled in the present study. The transit time of the endoscopy capsule in the digestive tract was recorded and the testing results were analyzed. All detections were completed except for four capsule retentions and the completion rate was 95...
April 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29525375/evaluation-and-management-of-gastrointestinal-bleeding
#8
REVIEW
Ronald Samuel, Mohammad Bilal, Obada Tayyem, Praveen Guturu
Non-variceal upper gastrointestinal bleeding continues to be an important cause of morbidity and mortality. The most common causes include peptic ulcer disease, Mallory-Weiss syndrome, erosive gastritis, duodenitis, esophagitis, malignancy, angiodysplasias and Dieulafoy's lesion. Initial assessment and early aggressive resuscitation significantly improves outcomes. Upper gastrointestinal endoscopy continues to be the gold standard for diagnosis and treatment. We present a comprehensive review of literature for the evaluation and management of non-variceal upper gastrointestinal bleeding...
March 7, 2018: Disease-a-month: DM
https://www.readbyqxmd.com/read/29525374/evaluation-and-management-of-lower-gastrointestinal-bleeding
#9
REVIEW
Aun Raza Shah, Vikram Jala, Hammad Arshad, Mohammad Bilal
Lower gastrointestinal bleeding (LGIB) is a common cause of presentation to the emergency department and hospital admissions. The incidence of LGIB increases with age and the most common etiologies are diverticulosis, angiodysplasia, malignancy and anorectal diseases. Foremost modality for evaluation and treatment of LGIB is colonosopy. Other diagnostic tools such as nuclear scintigraphy, computed tomography, angiography and capsule endoscopy are also frequently used in the workup of LGIB. Choice of treatment modality depends on the hemodynamic status of the patient, rate of bleeding, expertise and available resources...
March 7, 2018: Disease-a-month: DM
https://www.readbyqxmd.com/read/29487685/management-of-stroke-risk-in-atrial-fibrillation-patients-with-bleeding-on-oral-anticoagulation-therapy-role-of-left-atrial-appendage-closure-octreotide-and-more
#10
REVIEW
Tawseef Dar, Bharat Yarlagadda, James Vacek, Buddhadeb Dawn, Dhanunjaya Lakkireddy
Background: Bleeding complications especially gastrointestinal bleeding remains a major challenge associated with oral anticoagulation therapy (OAT) and often leads clinicians to withdraw oral anticoagulation therapy (OAT) . This exposes patients to risk of stroke and systemic thromboembolism (STE). Novel oral anticoagulants (NOACs) have proved no better when it comes to bleeding events and in fact studies have shown that overall NOACs are associated with higher incidence of gastrointestinal (GI) bleeding compared to warfarin ...
December 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29484051/colonic-angiodysplasia-on-ct-colonography-case-report-and-characteristic-imaging-findings
#11
Laura Filograna, Enrica Filograna, Adolfo D'Onofrio, Nicola Flor, Yusef Haddad, Roberto Floris
Gastrointestinal angiodysplasia represents the cause of 6% of lower gastrointestinal tract bleeding, particularly in the elderly. Because of the common presentation and age range of affected patients, often patients with occult or massive gastrointestinal bleedings are investigated with colonoscopy, in the suspect of colonic cancer. Other methods are capsule enteroscopy, angiography, double-contrast barium enema, computed tomography angiography, and radionuclide scanning. In this contribution, we describe a case of colonic angiodysplasia first suspected during computed tomography colonography performed after an incomplete colonoscopy in a patient with recent anemization...
December 2017: Radiology Case Reports
https://www.readbyqxmd.com/read/29479375/efficacy-and-safety-of-pasireotide-lar-for-the-treatment-of-refractory-bleeding-due-to-gastrointestinal-angiodysplasias-results-of-the-angiopas-multicenter-phase-ii-noncomparative-prospective-double-blinded-randomized-study
#12
Robert Benamouzig, Mourad Benallaoua, Jean-Christophe Saurin, Marouane Boubaya, Christophe Cellier, René Laugier, Magalie Vincent, Christian Boustière, Rodica Gincul, Elia Samaha, Philippe Grandval, Thomas Aparicio, Gheorghe Airinei, Bakhtiar Bejou, Cyriaque Bon, Jean-Jacques Raynaud, Vincent Levy, Denis Sautereau
Background: Gastrointestinal angiodysplasias (GIADs) could be responsible for recurrent bleeding and severe anemia. Somatostatin analogs could reduce transfusion requirements in these patients but no randomized controlled study is available. The main objective of the ANGIOPAS phase II double-blinded randomized, noncomparative study was to assess the effectiveness of pasireotide-LAR in reducing transfusion requirements in patients with refractory GIADs bleeding. Methods: A total of 22 patients with transfusion requirements ⩾6 units of packed red blood cells (pRBCs) during the 6 months prior to inclusion were randomized to receive pasireotide-LAR 60 mg ( n = 10) or placebo ( n = 12) every 28 days for 6 months...
2018: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29451965/pazopanib-effective-for-bevacizumab-unresponsive-epistaxis-in-hereditary-hemorrhagic-telangiectasia
#13
Joseph G Parambil, Troy D Woodard, Omer N Koc
Hereditary hemorrhagic telangiectasia (HHT) most commonly manifests with nasal mucosal telangiectasias, and vascular endothelial growth factor (VEGF) plays a significant role in this angiodysplasia. We describe a patient with HHT with epistaxis recalcitrant to several endonasal procedures and six cycles of intravenous bevacizumab, for which he was dependent on iron infusions and packed red blood cells transfusions. He then started pazopanib at 100 mg with dramatic improvements in epistaxis and normalization of hemoglobin and iron levels, without replenishment needs for 12 months...
February 16, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29446520/lenalidomide-as-a-novel-therapy-for-gastrointestinal-angiodysplasia-in-von-willebrand-disease
#14
N V Khatri, B Patel, D R Kohli, S S Solomon, K Bull-Henry, C M Kessler
INTRODUCTION: Lenalidomide is a thalidomide analog with anti-angiogenic properties. Previous case reports suggest its efficacy in preventing gastrointestinal bleeding (GIB) secondary to angiodysplasia (AD) in hereditary haemorrhagic telangiectasia and potentially in reversing AD. We present the first case series to explore lenalidomide as a treatment for AD-related GIB in patients with von Willebrand disease (VWD). METHODS: A retrospective chart review was conducted to include patients with VWD, who were evaluated from 2010 to 2013 and who had received lenalidomide to treat recurrent GIB secondary to AD...
February 15, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29413215/management-of-acute-gastrointestinal-bleed
#15
REVIEW
Francisca Cisneros Farrar
Acute gastrointestinal bleeding is a common problem found in critically ill patients that can range from self-limited bleeding to a hemorrhaging emergency. Patients can quickly develop shock and altered mental status when they develop hemodynamic instability. Therefore, it is essential that the frontline critical care nurse develop self-efficacy for management of these disorders. This article overviews standards of practice for the management of upper and lower acute gastrointestinal bleeding. Common bleeding disorders are reviewed with expanded focus on peptic ulcer, acute variceal hemorrhage, colonic diverticular bleeding, and angiodysplasias, which are commonly found in the critical care setting...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29398197/clinical-presentation-and-treatment-paradigms-in-patients-with-hereditary-hemorrhagic-telangiectasia-and-spinal-vascular-malformations
#16
Ilyas Eli, Nicholas T Gamboa, Evan J Joyce, Min S Park, Philipp Taussky, Richard H Schmidt, William T Couldwell, Jamie McDonald, Kevin J Whitehead, M Yashar S Kalani
Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder that causes angiodysplasia and results in mucocutaneous telangiectasias and arteriovenous malformations of organs. Although central nervous system vascular malformations can occur anywhere along the neuraxis, spinal vascular malformations are rare. We present our experience with the presentation and management of spinal vascular malformations in patients with HHT. Of the more than 800 patients with the diagnosis of HHT screened at our institution from 1995 through 2017, four patients with spinal vascular malformations (age range 1 month-77 years; 2 male, 2 female) were identified, three of whom came to clinical attention after significant neurological deterioration from previously unknown malformations...
February 2, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29397472/gastrointestinal-bleeding-in-native-and-prosthetic-valve-disease
#17
REVIEW
Joseph L Blackshear
Gastrointestinal bleeding with severe aortic stenosis was originally described in the 1950s by Heyde, although for years, the association was debated. Further discovery of mechanisms and the ubiquity and severity of acquired von Willebrand syndrome in the left ventricular assist device therapy have removed any doubts. At this time, gastrointestinal bleeding from intestinal angiodysplasia in patients with turbulence-related proteolysis of the highest molecular weight multimers of von Willebrand factor is now known to occur in patients with aortic stenosis, and also subaortic obstruction and associated mitral insufficiency in hypertrophic cardiomyopathy, isolated mitral and aortic insufficiency, endocarditis, and in patients with prosthetic valve dysfunction, either from stenosis or insufficiency...
February 3, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29384923/emergency-transcatheter-arterial-embolization-for-massive-gastrointestinal-arterial-hemorrhage
#18
Zhong Xing Shi, Jing Yang, Hong Wei Liang, Zhen Hua Cai, Bin Bai
To evaluate the different arteriographic manifestations of acute arterial massive hemorrhage of the gastrointestinal (GI) tract and the efficacy of emergency transcatheter arterial embolization (ETAE).A total of 88 patients with acute massive GI bleeding who experienced failure of initial endoscopy and/or conservative treatment were referred to our interventional department for acute GI arteriography from January 2007 to June 2015. After locating the source of bleeding, appropriate embolic agents, such as spring coil, hydroxyl methyl acrylic acid gelatin microspheres, polyvinyl alcohol (PVA) particles, etc...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29336404/role-of-transesophageal-echocardiography-during-left-atrial-appendage-occlusion-device-closure-in-a-patient-with-non-valvular-atrial-fibrillation-and-angiodysplasia-of-the-colon
#19
Dinesh Kumar, Sunil Kumar, Nagraj Desai
Atrial fibrillation is the most common arrhythmia associated with significant mortality and morbidity secondary to thrombo-embolism. To prevent this thrombo-embolism oral anticoagulation therapy is the recommended treatment. In patients with contraindications to oral anticoagulation therapy, percutaneous left atrial appendage occlusion device is indicated. TEE is essential to guide in all the stages of LAA device deployment. Right from pre-procedure screening, to guiding during deployment, to rule out any complications and post-procedure surveillance and monitoring long term outcomes...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29282637/changing-epidemiology-of-upper-gastrointestinal-hemorrhage-in-the-last-decade-a-nationwide-analysis
#20
Brandon A Wuerth, Don C Rockey
BACKGROUND: Upper gastrointestinal hemorrhage (UGIH) is common and carries substantial mortality requiring frequent hospitalizations. AIM: To investigate trends in etiology and outcome of UGIH in hospitalized patients in the USA. METHODS: Retrospective, observational cohort study of the Nationwide Inpatient Sample from 2002 to 2012 was carried out. UGIH was identified in hospitalizations with a principle ICD-9-CM diagnosis of UGIH or secondary diagnosis of UGIH with a principal diagnosis of hematemesis, blood in stool, or gastrointestinal bleeding...
December 27, 2017: Digestive Diseases and Sciences
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