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Upper digestive bleeding

Mircea Beuran, Ionut Negoi, Ruxandra Irina Negoi, Sorin Hostiuc, Sorin Paun
A 59 year-old patient was admitted with upper gastrointestinal bleeding. The clinical exam showed mild hypotension and blood samples revealed acute anemia (hemoglobin = 7.5 g/dl). Emergency computed tomography showed an infrarenal abdominal aortic aneurysm and extravasation of the arterial contrast material toward the digestive tract. The patient was transported to the operating room for emergency laparotomy, which showed an aortoduodenal fistula. After proximal and distal aortic vascular control, the two anatomical structures were dissected with duodenorrhaphy, patch repair of the aortic tear and omentum interposition...
May 2016: Brazilian Journal of Cardiovascular Surgery
Beatriz Deoti E Silva Rodrigues, Raniere Dos Santos, Magda Maria Profeta da Luz, Flávia Chaves E Silva, Igor Guedes Nogueira Reis
Acute esophageal necrosis (AEN) or "black esophagus" is a rare condition presented by patients with critical state of health and characterized by a darkened esophagus, usually the distal third, in upper digestive endoscopy. The main clinical manifestation is upper gastrointestinal bleeding and there may be abdominal pain, dysphagia, nausea, vomiting, fever and syncope associated. The diagnosis depends on clinical suspicion and performing endoscopy, the biopsy not being required. In this article we present a case of a patient who had lots of comorbidities and developed AEN during a post-operative period, and discuss the importance of AEN in an increasingly ageing population...
October 11, 2016: Clinical Journal of Gastroenterology
E Ray-Offor, S N Elenwo, P O Igwe, C Ngeribara
BACKGROUND: The cystic dilatation of the biliary tract is an uncommon anomaly. Choledochocele, a cystic dilatation of the distal common bile duct, rarely presents clinically as massive gastrointestinal bleeding. AIM: This is to report a very rare disease condition and highlight minimal access options in surgical care. CASE SUMMARY: A 13 year-old boy was referred with a day history of sudden onset of passage of bright red blood per rectum with a fainting episode...
September 13, 2016: International Journal of Surgery Case Reports
Luis Vásquez, Julissa Guevara, Victor Aguilar, Monica Menéndez, Eduar Bravo, Patricia Guzman Rojas, Catherina Pichilingue, Arturo Zegarra, Jorge Huerta-Mercado, José Pinto, Ricardo Prochazka, Vanessa Valenzuela, Alejandro Bussalleu
Chronic actinic enteritis is a malfunction of the small bowel, occurring in the 6 months post-radiotherapy, and it can be manifestated as malabsortion, stenosis, fistula formation, local abscesses, perforation and bleeding, We report a case of an elderly patient who presents an episode of obscure gastrointestinal bleeding (OGIB) secondary to actinic enteritis. She is a 64-year- old female patient with the past medical history of cervical cancer who received radiotherapy and brachytherapy. One year after the treatment, the patient presents a chronic episode of melena and symptomatic anemia and 1 week before the admission she had hematochezia...
April 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Julien Souvignet, Hadyl Asfari, Jérémy Lardon, Emilie Del Tedesco, Gunnar Declerck, Cédric Bousquet
OBJECTIVE: To propose a method to build customized sets of MedDRA terms for the description of a medical condition. We illustrate this method with upper gastrointestinal bleedings (UGIB). RESEARCH DESIGN AND METHODS: We created a broad list of MedDRA terms related to UGIB and defined a gold standard with the help of experts. MedDRA terms were formally described in a semantic resource named OntoADR. We report the use of two semantic queries that automatically select candidate terms for UGIB...
September 2016: Expert Opinion on Drug Safety
Takahiro Sato, Katsu Yamazaki, Jouji Toyota, Yoshiyasu Karino, Takumi Ohmura, Jun Akaike, Yasuaki Kuwata, Toshihiro Suga
We treated a 74-year-old woman who complained of tarry stool. Neither endoscopic examination of the upper gastrointestinal tract nor colonoscopy revealed any finding indicative of bleeding, and (99m)Tc-HSA-D pool scintigraphic imaging showed no accumulation of blood in the digestive tract. Small tortuous collateral veins were observed on computed tomography (CT) in the distal third portion of the duodenum. Color Doppler ultrasonography obtained color flow images of varices in the distal third portion of the duodenum indicating turbulent flow, and color flow imaging showed the outflow vessel from duodenal varices...
March 2007: Journal of Medical Ultrasonics
Cong Xu, Lingchao Ji, Jingjie Jia, Xin Qiu, Zhaolei Luan, Yin Bai, Jing Zhang, Hongtian Wang
OBJECTIVE: To analyze the causes of misdiagnosis in patients with familial nasal bleeding and to improve the level of diagnosis and treatment. METHOD: The clinical characteristics of 7 families with nose blood were analyzed retrospectively and 2 typical cases were reported, including their treatment and misdiagnosis in consulting, out-patient and in-patient. RESULT: Typical case 1 was misdiagnosed and mistreated for 42 years, misdiagnosed as blood disease so that the patient was biopsied in bone marrow, misdiagnosed as endometriosis so that the patient was performed uterus resection...
December 2015: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Razvan Iacob, Anca Dimitriu, Oana Stanciulea, Vlad Herlea, Irinel Popescu, Cristian Gheorghe
We present the case of a 63-year-old man that was admitted for melena and severe anemia. Upper GI endoscopy and colonoscopy failed to identify the lesion responsible for bleeding, and enteroCT scan was also non-contributive to the diagnosis. Capsule endoscopy indicated possible jejunal bleeding but could not indicate the source of bleeding, recommending anterograde enteroscopy. Single balloon enteroscopy identified a 2 cm submucosal tumour in the distal part of the jejunum, with a macroscopic appearance suggesting a gastrointestinal stromal tumour (GIST)...
March 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
Mingliang Lu, Gang Sun, Xiu-li Zhang, Xiao-mei Zhang, Qing-sen Liu, Qi-yang Huang, James W Y Lau, Yun-sheng Yang
BACKGROUND/AIMS: To determine risk factors associated with mortality and increased drug costs in patients with nonvariceal upper gastrointestinal bleeding. METHODOLOGY: We retrospectively analyzed data from patients hospitalized with nonvariceal upper gastrointestinal bleeding between January 2001-December 2011. Demographic and clinical characteristics and drug costs were documented. Univariate analysis determined possible risk factors for mortality. Statistically significant variables were analyzed using a logistic regression model...
June 2015: Hepato-gastroenterology
Yu Bai, Zhao Shen Li
Acute non-variceal upper gastrointestinal bleeding (ANVUGIB) is one of the most common medical emergencies in China and worldwide. In 2009, we published the "Guidelines for the diagnosis and treatment of acute non-variceal upper gastrointestinal bleeding" for the patients in China; however, during the past years numerous studies on the diagnosis and treatment of ANVUGIB have been conducted, and the management of ANVUGIB needs to be updated. The guidelines were updated after the databases including PubMed, Embase and CNKI were searched to retrieve the clinical trials on the management of ANVUGIB...
February 2016: Journal of Digestive Diseases
Matteo Fornai, Luca Antonioli, Carolina Pellegrini, Rocchina Colucci, Deborah Sacco, Erika Tirotta, Gianfranco Natale, Alessia Bartalucci, Marina Flaibani, Cecilia Renzulli, Emilia Ghelardi, Corrado Blandizzi, Carmelo Scarpignato
Nonsteroidal anti-inflammatory drugs, besides exerting detrimental effects on the upper digestive tract, can also damage the small and large intestine. Although the underlying mechanisms remain unclear, there is evidence that enteric bacteria play a pivotal role. The present study examined the enteroprotective effects of a delayed-release formulation of rifaximin-EIR (R-EIR, 50mg/kg BID, i.g.), a poorly absorbed antibiotic with a broad spectrum of antibacterial activity, in a rat model of enteropathy induced by indomethacin (IND, 1...
February 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Shadi Hamdeh, Toufik Mahfood Haddad, Amjad Kabach
No abstract text is available yet for this article.
December 2015: American Journal of Gastroenterology
Gonzalo Latorre S, Jorge Álvarez O, Danisa Ivanovic-Zuvic S, Gonzalo Valdivia C, Paula Margozzini M, José Chianale B, Juan Francisco Miquel P
BACKGROUND: In Chile, gastric cancer (GC) is a major cause of cancer related deaths. The current screening strategy consists of an upper gastrointestinal endoscopy (UGE) for people aged 40 years or more with epigastric pain. AIM: To evaluate the diagnostic coverage of the use of UGE for early detection of GC in Chile. MATERIAL AND METHODS: As part of the digestive module of the 2009-10 National Health Survey, 5293 adults over 15 years were asked about the presence of epigastric pain, possible upper gastrointestinal bleeding (PUGB), use of proton pump inhibitors (PPIs) or histamine H2-receptor antagonists (H2RAs), family history of GC and having performed an UGE...
September 2015: Revista Médica de Chile
Anca Alexandra Romcea, Marcel Tanţău, Andrada Seicean, Oliviu Pascu
AIMS: To investigate the etiology of upper digestive hemorrhage in cirrhotic patients. PATIENTS AND METHODS: From November 2004 to December 2006, we performed a prospective study at the Regional Institute of Gastroenterology and Hepatology "O. Fodor" Cluj-Napoca. The study was performed on 1,284 patients with esophageal varices from the endoscopy records, diagnosed with liver cirrhosis based on clinical, biochemical and endoscopic information, documented from the observation sheet...
2013: Clujul Medical (1957)
Ángel Lanas
In the Digestive Disease Week in 2015 there have been some new contributions in the field of gastrointestinal bleeding that deserve to be highlighted. Treatment of celecoxib with a proton pump inhibitor is safer than treatment with nonselective NSAID and a proton pump inhibitor in high risk gastrointestinal and cardiovascular patients who mostly also take acetylsalicylic acid. Several studies confirm the need to restart the antiplatelet or anticoagulant therapy at an early stage after a gastrointestinal hemorrhage...
September 2015: Gastroenterología y Hepatología
Ahmed El Ray, Mohamed Mohamed Azab, Ibrahim Mohamed Abd El-Aziz, Ahmed Abd El-Aleem, Mohamed Darwish El-Talkawy, Mohamed Abd El-Hameed Abd El-Badea, Mahmoud El Ansary, Abdelaziz Ali Safeem, Tarek Mahmoud Diab
Variceal bleeding is the last step of a chain of events initiatedby an increase in portal pressure, followed by the development and progressive dilation ofvarices until these finally rupture and bleed. The ideal method to diagnose portal hypertension should be accurate, noninvasive, objective, and reproducible. The study evaluated the predictive value of two non-invasive parameters for the diagnosis of esophageal varices (EV): 1-Right liver lobe diameter/serum albumin ratios (RLLD/S. albumin), and 2-Platelet count/splenic bipolar diameter ratios (Platelets count/SBPD)...
August 2015: Journal of the Egyptian Society of Parasitology
(no author information available yet)
BACKGROUND: Obscure gastrointestinal bleeding (OGIB) is defined as persistent or recurrent bleeding associated with negative findings on upper and lower gastrointestinal (GI) endoscopic evaluations. The diagnosis and management of patients with OGIB is particularly challenging because of the length and complex loops of the small intestine. Capsule endoscopy (CE) is 1 diagnostic modality that is used to determine the etiology of bleeding. OBJECTIVES: The objective of this analysis was to review the diagnostic accuracy, safety, and impact on health outcomes of CE in patients with OGIB in comparison with other diagnostic modalities...
2015: Ontario Health Technology Assessment Series
Mahdi Haghighatafshar, Farshid Gheisari, Tahereh Ghaedian
We presented a pediatric case with a history of intermittent melena for 3 years because of angiodyplasia of small intestine. The results of frequent upper gastrointestinal endoscopies and colonoscopies as well as both Tc-red blood cell (RBC) and Meckel's scintigraphies for several times were negative in detection of bleeding site. However, Tc-RBC scintigraphy with single-photon emission computed tomography (SPECT)/computed tomography (CT) after heparin augmentation detected a site of bleeding in the distal ileum which later was confirmed during surgery with final diagnosis of angiodysplasia...
August 2015: Medicine (Baltimore)
Ramiro Gálvez-Valdovinos, Ernesto Marín-Santillán, Juan Francisco Funes-Rodríguez, Gustavo López-Ambriz
BACKGROUND: Acute gastric volvulus is a rare, but potentially life-threatening, cause of upper gastrointestinal obstruction. CLINICAL CASE: Male of 60 years old with severe epigastric pain and abdominal distension with haematemesis on two occasions. The patient was haemodynamically stable, with abdominal distension and palpable epigastric fullness. Hematic cytology showed: haemoglobin 8.2g/dl and haematocrit 27%. Abdominal X-ray showed an elevation of left diaphragm with a hugely dilated stomach...
March 2016: Cirugia y Cirujanos
A-V Schettini, R S Pinheiro, P Pescatore, J Lerut
A case of a 36 years old man presenting massive upper GI bleeding due to oesophageal varices developed in the context of an idiopathic portal cavernoma and extensive porto-splenic thrombosis is discussed. He underwent a successful modified Sugiura operation (oesophago-gastric devascularisation and splenectomy [OGDS]) completed with interventional endoscopic treatment of residual oesophageal varices. The benefit of the modified Sugiura procedure proposed for the treatment of upper GI variceal bleeding developed in the context of splanchnic venous thrombosis is discussed...
May 2015: Acta Chirurgica Belgica
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