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Small bowel bleeding

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https://www.readbyqxmd.com/read/29786046/effect-of-double-balloon-enteroscopy-on-diagnosis-and-treatment-of-small-bowel-diseases
#1
Li Tang, Liu-Ye Huang, Jun Cui, Cheng-Rong Wu
Background: The diagnosis and treatment of small-bowel diseases is clinically difficult. The purpose of this study was to evaluate the diagnostic and therapeutic value of double-balloon enteroscopy in small-bowel diseases. Methods: The history and outcomes of 2806 patients who underwent double-balloon enteroscopy from July 2004 to April 2017 were reviewed, which included 562 patients with obscure digestive tract bleeding, 457 patients with obscure diarrhea, 930 patients with obscure abdominal pain, 795 patients with obscure weight loss, and 62 patients with obscure intestinal obstruction...
June 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29777456/distal-bowel-re-feeding-in-patients-with-proximal-jejunostomy
#2
Anand Nagar, Siddharth Mehrotra, Amitabh Yadav, Vivek Mangla, Shailendra Lalwani, Naimish Mehta, Samiran Nundy
BACKGROUND: Patients who have a proximal jejunostomy are difficult to manage because of their high stoma output which results in fluid and electrolyte imbalance with repeated hospital admissions and the necessity for expensive parenteral nutrition (PN). There are few reports on the use of re-feeding of the proximal effluents in this situation. METHODS: We here relate our experience with this manoeuvre in 35 patients between Jan 2010 and Feb 2016 who had stomas less than 120 cm away from the duodenojejunal flexure...
May 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29767393/small-bowel-capsule-endoscopy-in-clinical-practice-has-anything-changed-over-13-years
#3
Marco Soncini, Carlo Maria Girelli, Roberto de Franchis, Emanuele Rondonotti
BACKGROUND: In Lombardia, one of the 20 Italian administrative Regions, small-bowel capsule endoscopy (SBCE) was introduced in 2001. In January 2011, the Regional Health Authorities established a reimbursement for outpatient SBCE. AIM: To prospectively record data on SBCE between 2011-2013 and compare them to similar data retrospectively collected from the same geographical area (covering the period 2001-2008) and published in 2008. METHODS: Consecutive SBCEs performed between January 2011 and December 2013 in Lombardia were prospectively collected...
May 16, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29756020/multicenter-prospective-evaluation-of-the-express-view-reading-mode-for-small-bowel-capsule-endoscopy-studies
#4
Jean-Christophe Saurin, Philippe Jacob, Laurent Heyries, Christian Pesanti, Franck Cholet, Isaac Fassler, James Boulant, Slim Bramli, Antoin De Leusse, Gabriel Rahmi
Background:  Reducing the reading time of capsule endoscopy films is of high priority for gastroenterologists. We report a prospective multicenter evaluation of an "express view" reading mode (Intromedic capsule system). Methods:  Eighty-three patients with obscure gastrointestinal bleeding were prospectively included in 10 centers. All patients underwent small-bowel capsule endoscopy (Intromedic, Seoul, Republic of Korea). Films were read in standard mode, then a second reading was performed in express view mode at a second center...
May 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29754836/misoprostol-for-small-bowel-ulcers-in-patients-with-obscure-bleeding-taking-aspirin-and-non-steroidal-anti-inflammatory-drugs-masters-a-randomised-double-blind-placebo-controlled-phase-3-trial
#5
Ali S Taha, Caroline McCloskey, Paula McSkimming, Alex McConnachie
BACKGROUND: The incidence of obscure gastrointestinal bleeding, which originates from the small bowel and is mainly associated with the use of aspirin and non-steroidal anti-inflammatory drugs (NSAIDs), is rising. We assessed the efficacy and safety of misoprostol for the treatment of small bowel ulcers and erosions in patients taking low-dose aspirin or NSAIDs with obscure gastrointestinal bleeding. METHODS: In this randomised, double-blind, placebo-controlled, phase 3 trial, we recruited patients (aged ≥18 years) with small bowel ulcers who were taking low-dose aspirin, NSAIDs, or both for a minimum of 4 weeks, at University Hospital Crosshouse (Kilmarnock, UK)...
May 10, 2018: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29730513/intraluminal-migration-of-gossypibioma
#6
Vamsi Krishna, D Bharathkumar
BACKGROUND: Surgical sponge retained in the abdominal cavity following surgery, is a serious but avoidable complication. Common symptoms and signs of transmural migration of gossypibioma may include abdominal pain, vomiting, and bleeding. Transmural migration of surgical swab is a very rare phenomenon. CASE SERIES: We report a series of three such cases which presented to us with small bowel obstruction and laparotomy with extraction of gossypibioma was performed...
April 25, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29707077/suspected-blood-indicator-to-identify-active-gastrointestinal-bleeding-a-prospective-validation
#7
Samuel Han, Julien Fahed, David R Cave
Background: The suspected blood indicator (SBI) function in the RAPID Reader v8.3 program was designed to quickly identify the presence of blood in video capsule endoscopy. While previous retrospective studies have shown that the SBI function was accurate in detecting the presence of active bleeding in the small bowel, its specificity and sensitivity were poor. Methods: An initial retrospective review (phase 1) compared 115 patients with active gastrointestinal bleeding seen on video capsule endoscopy (VCE) to 115 patients with no active bleeding seen on VCE to produce a highly accurate algorithm...
April 2018: Gastroenterology Research
https://www.readbyqxmd.com/read/29704683/rates-of-hospital-readmission-among-medicare-beneficiaries-with-gastrointestinal-bleeding-vary-based-on-etiology-and-comorbidities
#8
Shazia Mehmood Siddique, Shivan J Mehta, James Lewis, Mark D Neuman, Rachel M Werner
BACKGROUND & AIMS: Gastrointestinal bleeding results in significant morbidity, mortality, and healthcare costs in the United States. The Center for Medicare and Medicaid Services' payment reform programs assess quality and value based on rates of hospital readmission for patients with gastrointestinal bleeding, but they identify these patients using Medicare Severity Diagnosis Related Groups (MS-DRGs), which include many types of gastrointestinal bleeding and do not account for the clinical heterogeneity among these patients...
April 25, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29701506/outcomes-of-laparoscopic-subtotal-colectomy-with-cecorectal-anastomosis-for-slow-transit-constipation-a-single-center-retrospective-study
#9
Dong Yang, Liang He, Tong-Rong Su, Yan Chen, Quan Wang
PURPOSE: To study the safety and efficacy of laparoscopic subtotal colectomy (LASC) with cecorectal anastomosis for slow-transit constipation (STC). METHODS: This study was a retrospective review of all patients undergoing LASC with cecorectal anastomosis for STC between March 2010 and May 2017. The main variables included the operative time, blood loss, length of postoperative hospital stay, complications, and long-term outcomes. RESULTS: In this analysis, 56 patients were included...
April 27, 2018: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/29698967/motorized-spiral-enteroscopy-for-occult-bleeding
#10
Laura Mans, Marianna Arvanitakis, Horst Neuhaus, Jacques Devière
Small-bowel disorders remain a diagnostic and therapeutic challenge due to intestinal length. Their management was revolutionized by the emergence of deep enteroscopy. In comparison with video capsule endoscopy, deep enteroscopy allows diagnostic and therapeutic interventions. Spiral enteroscopy (Spirus Medical Endo-Ease Overtube) achieves progression by gentle push and manual clockwise rotation inducing pleating of the small bowel on the endoscope. It has the advantage of shorter examination time and more stability during withdrawal but requires two operators...
April 26, 2018: Digestive Diseases
https://www.readbyqxmd.com/read/29686835/atypical-presentation-of-meckel-s-diverticulum-in-a-hispanic-man-a-case-report
#11
Yohanis O'Neill, Hiram M Soler
The incidence of Meckel's diverticulum is 2% in the general population. Although most commonly found in children as painless rectal bleeding, in adults, obstruction, inflammation, and perforation are the usual manifestations. We present the case of a 32 year old man who arrived at our institution with hematochezia and symptomatic anemia. A large Meckel's diverticulum was encountered during work-up and treated by segmental small bowel resection. A literature review, including disease presentation, pathology findings, and treatment options is discussed...
April 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29686230/nomogram-based-prediction-of-rebleeding-in-small-bowel-bleeding-patients-the-prsbb-score
#12
Genta Uchida, Yoshiki Hirooka, Masanao Nakamura, Osamu Watanabe, Takeshi Yamamura, Masanobu Matsushita, Hiroki Suhara, Takuya Ishikawa, Kazuhiro Furukawa, Kohei Funasaka, Eizaburo Ohno, Hiroki Kawashima, Ryoji Miyahara, Hidemi Goto
Small bowel capsule endoscopy (SBCE) and balloon-assisted endoscopy (BAE) have revolutionized the diagnosis and treatment of small bowel bleeding (SBB), allowing access to the small bowel and identification of specific bleeding lesions. However, some patients experience rebleeding after small bowel investigation, and there are no definitive algorithms for determining the most appropriate follow-up strategy in SBB patients. We developed and validated a nomogram that can predict rebleeding risk and be used to develop a risk-stratified follow-up strategy in SBB patients...
April 23, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29672294/endoscopic-ultrasound-guided-choledocho-enterostomy-by-using-lumen-apposing-metal-stent-in-patients-with-failed-endoscopic-retrograde-cholangiopancreatography-a-literature-review
#13
Deepanshu Jain, Manan Shah, Upen Patel, Abhinav Sharma, Shashideep Singhal
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) has been the cornerstone in the management of malignant jaundice to provide symptomatic relief and/or to allow chemotherapy. Difficult biliary cannulation or the presence of concomitant duodenal obstruction may lead to its failure. METHOD: An extensive English literature search was done via PubMed and Google Scholar to identify 13 peer-reviewed original articles. RESULTS: Of 92 patients, 98...
April 19, 2018: Digestion
https://www.readbyqxmd.com/read/29662934/bevacizumab-for-refractory-gastrointestinal-bleeding-in-rendu-osler-weber-disease
#14
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/29622900/unsuspected-small-bowel-crohn-s-disease-in-elderly-patients-diagnosed-by-video-capsule-endoscopy
#15
Che-Yung Chao, Carl Frederic Duchatellier, Ernest G Seidman
Background: Video capsule endoscopy (VCE) is increasingly performed among the elderly for obscure bleeding. Our aim was to report on the utility of VCE to uncover unsuspected Crohn's disease (CD) in elderly patients. Methods: Retrospective review of VCE performed in elderly patients (≥70 y) at a tertiary hospital (2010-2015). All underwent prior negative bidirectional endoscopies. CD diagnosis was based on consistent endoscopic findings, exclusion of other causes, and a Lewis endoscopic score (LS) > 790 (moderate-to-severe inflammation)...
2018: Diagnostic and Therapeutic Endoscopy
https://www.readbyqxmd.com/read/29620627/small-bowel-capsule-endoscopy-indications-results-and-clinical-benefit-in-a-university-environment
#16
Juliane Flemming, Silke Cameron
Capsule endoscopy (CE) opened a new method for visualization of the small intestine. We here further explore its clinical implications.We retrospectively analyzed the clinical benefit of CE in view of medical history, diagnostics, and therapy. Our patient collective consisted of 203 patients. CE was investigated in the context of bleeding, anemia, abdominal pain, diarrhea, Crohn's disease, and suspected tumors.The study collective consisted of 118 male and 85 female patients with a mean age of 58 years (range 8-90 years)...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29610020/pharmacological-treatment-of-gastrointestinal-bleeding-due-to-angiodysplasias-a-position-paper-of-the-italian-society-of-gastroenterology-sige
#17
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/29607390/duplication-cyst-of-the-ileum-presenting-with-severe-anemia-detected-by-double-balloon-endoscopy
#18
Yumi Takegawa, Katsushi Hiramatsu, Yosuke Murata, Yu Akazawa, Yasushi Saito, Yoshihiko Ozaki, Kazuto Takahashi, Tatsushi Naito, Kazuya Ofuji, Hidetaka Matsuda, Masahiro Ohtani, Tomoyuki Nemoto, Hiroyuki Suto, Takanori Goi, Yoshiaki Imamura, Yasunari Nakamoto
Background and study aims  Duplication cysts of the ileum are rare and present with non-specific clinical manifestations such as abdominal pain, vomiting, melena, and intussusception. Therefore, preoperative diagnosis is difficult. Here, we report a case of duplication cyst of the small intestine that was diagnosed preoperatively using double-balloon enteroscopy. A 19-year-old man presented with severe iron deficiency anemia, abdominal pain, and exertional dyspnea. Gastroscopy and colonoscopy revealed no remarkable findings...
April 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29577056/an-overt-obscure-gastrointestinal-bleed-caused-by-a-primary-small-bowel-fibroblastic-reticular-cell-sarcoma
#19
Stephanie L Gold, Shirley Cohen-Mekelburg, Russell Rosenblatt, Jose Jessurun, Reem Sharaiha, Karim Halazun, David Wan
Small bowel bleeding should be considered in patients who continue to bleed despite a negative upper endoscopy and colonoscopy. The differential diagnosis of small bowel bleeding can include infection, inflammatory conditions, vascular malformations, and, rarely, malignancy. This report demonstrates a rare, primary, small bowel, reticular cell sarcoma presenting as an overt gastrointestinal bleed. These tumors are difficult to diagnose because they are rarely seen on traditional cross-sectional imaging and can present with multiple synchronous lesions throughout the intestinal tract...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29560646/esophageal-lesions-detected-during-small-bowel-capsule-endoscopy-incidence-diagnostic-and-therapeutic-impact
#20
J F Juanmartiñena Fernández, I Fernández-Urién Sainz, C Saldaña Dueñas, A Elosua González, M Montañés Guimera, B Zabalza Ollo, S Pardo González, J J Vila Costas
BACKGROUND: Nowadays, capsule endoscopy is the first-line procedure for the visualization of the small bowel. Although it was primarily designed with this goal, it may also identify other segments of the gastrointestinal tract. The aim of the current study is to evaluate the incidence of esophageal abnormalities detected in patients undergoing small bowel capsule endoscopy and its impact on patient management. PATIENTS AND METHODS: This study is a retrospective analysis of data from 2217 consecutive capsule endoscopy procedures performed at a single tertiary-care centre between January 2008 and February 2016...
October 2017: Acta Gastro-enterologica Belgica
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