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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/27908516/small-bowel-bleeding-updated-algorithm-and-outcomes
#2
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/27908515/intraoperative-enteroscopy-is-there-still-a-role
#3
REVIEW
Thibault Voron, Gabriel Rahmi, Stephane Bonnet, Georgia Malamut, Philippe Wind, Christophe Cellier, Anne Berger, Richard Douard
Intraoperative enteroscopy (IOE) to explore obscure gastrointestinal bleeding is now rarely indicated. IOE allows complete small bowel exploration in 57% to 100% of cases, finds a bleeding source in 80% of cases, allows the recurrence-free management of gastrointestinal bleeding in 76% of cases, but carries a high morbidity and mortality. IOE only remains indicated to guide the intraoperative treatment of preoperatively identified small bowel lesions when nonoperative treatments are unavailable and/or when intraoperative localization by external examination is impossible...
January 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/27908513/small-bowel-imaging-computed-tomography-enterography-magnetic-resonance-enterography-angiography-and-nuclear-medicine
#4
REVIEW
Jeff L Fidler, Ajit H Goenka, Chad J Fleming, James C Andrews
Radiology examinations play a major role in the diagnosis, management, and surveillance of small bowel diseases and are complementary to endoscopic techniques. Computed tomography enterography and magnetic resonance enterography are the cross-sectional imaging studies of choice for many small bowel diseases. Angiography still plays an important role for catheter-directed therapies. With the emergence of hybrid imaging techniques, radionuclide imaging has shown promise for the evaluation of small bowel bleeding and Crohn disease and may play a larger role in the future...
January 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/27906869/early-and-sustained-vasopressin-infusion-augments-the-hemodynamic-efficacy-of-restrictive-fluid-resuscitation-and-improves-survival-in-a-liver-laceration-model-of-hemorrhagic-shock
#5
Raúl J Gazmuri, Kasen Whitehouse, Kruti Shah, Karla Whittinghill, Alvin Baetiong, Jeejabai Radhakrishnan
BACKGROUND: Current management of hemorrhagic shock favors restrictive fluid resuscitation before control of the bleeding source. We investigated the additional effects of early and sustained vasopressin infusion in a swine model of hemorrhagic shock produced by liver laceration. METHODS: Forty male domestic pigs (32 to 40 kg) had a liver laceration inflicted with an X-shaped blade clamp, 32 received a second laceration at minute 7.5, and 24 received two additional lacerations at minute 15...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27906109/primary-melanoma-of-the-small-bowel-revealed-by-gastrointestinal-bleeding-a-case-report
#6
B Ait Idir, A Riany, A Jahid, B Chad
BACKGROUND: Primary melanoma of the small bowel is extremely rare. Only a limited number of cases have been described in the literature. Mostly, the small intestine is affected by metastatic tumors of other primary lesions, especially cutaneous. CASE PRESENTATION: We report the case of a 75-year-old North African woman with a small bowel melanoma. The diagnosis was made by histological examination and immunohistochemical profile matching after a segmental small bowel resection...
December 1, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27895862/cutaneous-angiosarcoma-metastatic-to-small-bowel-with-nodal-involvement
#7
Vidya A Fleetwood, Jamie C Harris, Minh B Luu
A 77-year-old male with a history of metastatic scalp angiosarcoma presented with intractable gastrointestinal bleeding from a jejunal mass detected on capsule endoscopy. He underwent laparoscopic-assisted resection of the mass. Intraoperatively, an isolated small bowel mass with bulky lymphadenopathy was seen and resected en bloc. Pathology showed a 6.8cm high-grade metastatic angiosarcoma with nodal involvement and negative margins. Angiosarcoma is a sarcoma with a grim prognosis. The incidence is 2% of all soft tissue sarcomas; cutaneous lesions comprise 27% of manifestations and usually appear on head and neck...
2016: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/27881035/the-dangers-of-the-bread-clip-ct-imaging-and-management-a-case-report
#8
J M Bakia, S Ovaere, F P Dijkman, E E Schipper
Most ingested foreign objects pass the gastrointestinal tract without serious consequences. A particular foreign object has been described related to serious adverse events such as gastrointestinal bleeding and small bowel obstruction: a plastic bread clip. During the diagnostic phase the morphology of this item is not always recognized during ultrasonography or CT imaging. In this case report we describe the diagnosis and management of a patient with a small bowel perforation caused by ingestion of a bread clip...
November 24, 2016: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/27878130/an-unusual-case-of-transorificial-abdomino-thoracic-impalement-injury-in-a-child
#9
Hemanshi Shah, Charu Tiwari, Shalika Jayaswal, Keshav Murthy
Impalement injuries are rare in the paediatric age group. Still rarer are injuries which traverse multiple body cavities. Such injuries require multispecialty management at a tertiary care centre. We describe a case of an accidental impalement injury in a 12-year-old boy after a fall from height. The rod was seen passing through the right lung in the paracardiac region, piercing the diaphragm and segment IV of the liver and then coursing anterior to the inferior vena cava in the midline. It was seen passing through the small bowel at multiple places and then coursing behind the bladder, entering the rectum and anal canal...
October 2016: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/27852679/acquired-haemophilia-a-an-unusual-postoperative-complication
#10
Sumant Arora, Gaurav Goyal, Rehan Sarmad, Kenneth J Wool
An African-American man aged 65 years with multiple malignancies in remission was admitted for small bowel obstruction. He was treated with laparotomy following failure of conservative management. Postoperatively, he developed intra-abdominal bleed, which persisted, despite surgical haematoma evacuation. Further haematological workup revealed isolated prolongation of activated partial thromboplastin time (aPTT) with reduced factor VIII (FVIII) activity and raised FVIII inhibitor titre. Assuming acquired haemophilia A (AHA), FVIII inhibitor bypassing activity and corticosteroids were started with subsequent resolution of the bleeding from the surgical site...
November 16, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27847791/major-pelvic-bleeding-following-a-stapled-transanal-rectal-resection-use-of-laparoscopy-as-a-diagnostic-tool
#11
Giovanni Domenico Tebala, Abdul Qayyum Khan, Sean Keane
Stapled transanal rectal resection (STARR) and stapled hemorrhoidopexy (SH) are well-established techniques for treating rectal prolapse and obstructed defecation syndrome (ODS). Occasionally, they can be associated with severe complications. We describe the case of a 59-year-old woman who underwent STARR for ODS and developed a postoperative pelvic hemorrhage. A computed tomography (CT) scan revealed a vast pelvic, retroperitoneal hematoma and free gas in the abdomen. Laparoscopy ruled out any bowel lesions, but identified a hematoma of the pelvis...
October 2016: Annals of Coloproctology
https://www.readbyqxmd.com/read/27833380/indications-and-surgical-options-for-small-bowel-large-bowel-and-perianal-crohn-s-disease
#12
REVIEW
James Wt Toh, Peter Stewart, Matthew Jfx Rickard, Rupert Leong, Nelson Wang, Christopher J Young
Despite advancements in medical therapy of Crohn's disease (CD), majority of patients with CD will eventually require surgical intervention, with at least a third of patients requiring multiple surgeries. It is important to understand the role and timing of surgery, with the goals of therapy to reduce the need for surgery without increasing the odds of emergency surgery and its associated morbidity, as well as to limit surgical recurrence and avoid intestinal failure. The profile of CD patients requiring surgical intervention has changed over the decades with improvements in medical therapy with immunomodulators and biological agents...
October 28, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27830096/hemorrhage-from-extra-antral-gastric-antral-vascular-ectasia-in-a-patient-with-duodenal-heterotopic-gastric-mucosa
#13
John Gubatan, Nathan Raines, Hasan Khosravi, Tracy L Challies, Tyler M Berzin
Gastric antral vascular ectasias (GAVE) have been increasingly recognized as an uncommon cause of chronic gastrointestinal bleeding and anemia, although their underlying pathogenesis is not completely well understood. Heterotopic gastric mucosa (HGM) has been reported to occur at various sites along the gastrointestinal tract and although relatively common, it is often asymptomatic. We report a case of a 60-year-old woman with a prior history of GAVE who developed melena and symptomatic anemia during her hospitalization following cardiac catheterization...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27821032/small-bowel-capsule-endoscopy-for-the-investigation-of-obscure-gastrointestinal-bleeding-when-we-should-do-it-and-what-should-we-expect
#14
REVIEW
N Viazis, J Anastasiou, D G Karamanolis
Obscure gastrointestinal bleeding is defined as bleeding of unknown origin that persists or recurs (i.e. recurrent or persistent iron deficiency anemia, fecal occult blood test positivity or visible bleeding) after a negative initial workout that necessarily includes gastroscopy and colonoscopy. In clinical practice, small bowel capsule endoscopy is recommended as a third stage examination in these patients, since it is a simple, safe, non-invasive and reliable test. To date there are three available small bowel capsule systems that have gained FDA approval and their diagnostic yield has shown to be superior to other diagnostic modalities for the investigation of the small bowel in patients with obscure gastrointestinal bleeding...
July 2016: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/27815920/intestinal-hemorrhage-caused-by-meckel-s-diverticulum-with-ectopic-gastric-mucosa-on-polypoid-lesion-a-case-report
#15
Toshiyuki Irie, Seiichi Shinji, Hiroki Arai, Hayato Kan, Takeshi Yamada, Michihiro Koizumi, Yasuyuki Yokoyama, Goro Takahashi, Takuma Iwai, Mikihiro Okusa, Keiichiro Ohta, Eiji Uchida
Meckel's diverticulum may sometimes present as an intraluminal polypoid mass causing small bowel obstruction; however, gastrointestinal bleeding due to Meckel's diverticulum with a polypoid lesion is rare. A 14-year-old girl presented with tarry stool and syncope in our hospital. Laboratory examination showed iron-deficiency anemia with a low hemoglobin level of 5.8 g/dl. The bleeding site was detected by neither upper gastrointestinal endoscopy nor colonoscopy. Transanal double-balloon enteroscopy showed a diverticulum with an ulceration at a site approximately 50 cm from the ileocecal valve and a polypoid lesion inside of the diverticulum...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27802212/contrast-enhanced-ultrasound-to-evaluate-organ-microvascularization-after-operative-versus-endovascular-treatment-of-visceral-artery-aneurysms
#16
Karin Pfister, Piotr M Kasprzak, Ernst M Jung, René Müller-Wille, Walter Wohlgemuth, Reinhard Kopp, Wilma Schierling
PURPOSE: To evaluate the organ microvascularization after operative versus endovascular treatment of visceral artery aneurysms (VAAs) by contrast-enhanced ultrasound (CEUS) and colour-coded duplex sonography (CCDS). METHOD AND MATERIALS: Between April 1995 to January 2016, 168 patients (78 males, 90 females; median age: 62 years) were diagnosed with VAAs at our hospital site. 60/168 patients (36%) fulfilled treatment criteria and had either open (29/60, 48%) or endovascular (31/60, 52%) aneurysm repair...
October 12, 2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27799890/sclerosing-encapsulating-peritonitis-in-a-long-term-propranolol-user
#17
Se Hui Noh, Byong Duk Ye, Hoonsub So, Yu Seok Kim, Dong Jin Suh, Sang Nam Yoon
Sclerosing encapsulating peritonitis (SEP) is a rare cause of bowel obstruction that is characterized by the encasement of the small bowel by a thick, whitish, and fibrous membrane. The pathophysiology of SEP is poorly understood and preoperative diagnosis is difficult. Previous reports suggest that SEP may be linked to the chronic use of β-adrenergic blockers. A 46-year-old man with liver cirrhosis and end-stage renal disease on hemodialysis presented with recurrent abdominal pain and borborygmi. He had been taking propranolol to prevent bleeding from gastroesophageal varices for the past 15 years...
October 2016: Intestinal Research
https://www.readbyqxmd.com/read/27797847/amyloidosis-an-unusual-cause-of-upper-gastrointestinal-bleeding
#18
Keith Siau, Amera Elzubeir, Sheldon C Cooper, Tariq Iqbal
We report a rare case of upper gastrointestinal bleeding in a 55-year-old man with monoclonal gammopathy of unknown significance presenting with abdominal pain, weight loss and melaena. Gastroscopy was unremarkable, but melaena persisted, with the development of symptomatic anaemia. While colonoscopy excluded a lower gastrointestinal aetiology, CT revealed jejunitis, confirmed at capsule endoscopy. Histopathological examination of specimens obtained at single balloon enteroscopy revealed an unusual aetiology: small bowel AL-amyloidosis...
October 26, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27775952/a-13-year-time-trend-analysis-of-3724-small-bowel-video-capsule-endoscopies-and-a-forecast-model-during-the-financial-crisis-in-greece
#19
Konstantinos Triantafyllou, Paraskevas Gkolfakis, Nikos Viazis, Panagiotis Tsibouris, Athanasios Tsigaridas, Periklis Apostolopoulos, John Anastasiou, Eleni Hounda, Ioannis Skianis, Konstantina Katopodi, Xhoela Ndini, George Alexandrakis, Demetrios G Karamanolis
INTRODUCTION: Since its introduction, small bowel video capsule endoscopy (VCE) use has evolved considerably. AIM: Evaluation of the temporal changes of small bowel VCE utilization in three tertiary centers in Greece in Era 1 (2002-2009) and Era 2 (2010-2014) and the development a forecast model for future VCE use during 2015-2017. MATERIALS AND METHODS: Data from all small bowel VCE examinations were retrieved and analyzed in terms of the annual number of the performed examinations, their indications and the significance of their findings...
October 21, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27771813/a-case-of-multiple-gastrointestinal-stromal-tumors-caused-by-a-germline-kit-gene-mutation-p-leu576pro
#20
Rita Vale Rodrigues, Filipa Santos, João Pereira da Silva, Inês Francisco, Isabel Claro, Cristina Albuquerque, Maria Manuel Lemos, Manuel Limbert, António Dias Pereira
Multiple gastrointestinal stromal tumors (GISTs) caused by germline KIT gene mutations are an extremely rare autosomal dominant disorder. We report a case of a 21-year-old woman who presented to the emergency department with a 2-week history of asthenia, palpitations and upper gastrointestinal bleeding. After further clinical evaluation one gastric and two small bowel GISTs were diagnosed, which were surgically resected after neoadjuvant therapy with Imatinib. Diffuse hyperplasia of the interstitial cells of Cajal was also seen in the background gastric and small intestinal walls...
October 22, 2016: Familial Cancer
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