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Small bowel bleeding

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
Taina Nykänen, Erno Peltola, Leena Kylänpää, Marianne Udd
PURPOSE: To evaluate the safety, efficacy, and feasibility of transcatheter arterial embolization (TAE) in the treatment of lower gastrointestinal bleeding (LGIB). METHODS: Study group comprised all patients receiving angiography for LGIB in the Helsinki University Hospital during the period of 2004-2016. Hospital medical records provided the study data. Rebleeding, complication, and mortality rates (≤ 30 days) were the primary outcomes. Secondary outcomes included need for blood transfusions, durations of intensive care unit and hospital admissions, incidence of delayed rebleeding, and long-term complications, as well as overall survival...
March 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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
Emanuele Rondonotti, Cristiano Spada, Samuel Adler, Andrea May, Edward J Despott, Anastasios Koulaouzidis, Simon Panter, Dirk Domagk, Ignacio Fernandez-Urien, Gabriel Rahmi, Maria Elena Riccioni, Jeanin E van Hooft, Cesare Hassan, Marco Pennazio
SMALL-BOWEL CAPSULE ENDOSCOPY (SBCE): 1: ESGE recommends that prior to SBCE patients ingest a purgative (2 L of polyethylene glycol [PEG]) for better visualization.Strong recommendation, high quality evidence.However, the optimal timing for taking purgatives is yet to be established. 2: ESGE recommends that SBCE should be performed as an outpatient procedure if possible, since completion rates are higher in outpatients than in inpatients.Strong recommendation, moderate quality evidence...
March 14, 2018: Endoscopy
Yu Meng, FangGen Lu, Lin Shi, MeiChu Cheng, Jie Zhang
RATIONALE: The use of anticoagulants is a contributor to gastrointestinal (GI) bleeding. Most bleeding patients on anticoagulant therapy such as warfarin commonly have basic lesions existing in their GI mucosa. PATIENT CONCERNS: We report a case of major GI bleeding following the use of anticoagulants in a patient with hookworm infection. DIAGNOSES: The patient was diagnosed with nephrotic syndrome with pulmonary embolism. INTERVENTIONS: He was treated with anticoagulants and suffered from acute major GI bleeding during the treatment...
March 2018: Medicine (Baltimore)
Noriyuki Ogata, Kazuo Ohtsuka, Seiko Sasanuma, Masataka Ogawa, Yasuharu Maeda, Katsuro Ichimasa, Yuichi Mori, Masashi Misawa, Toyoki Kudo, Tomokazu Hisayuki, Takemasa Hayashi, Kunihiko Wakamura, Hideyuki Miyachi, Toshiyuki Baba, Fumio Ishida, Shin-Ei Kudo
Background and study aims:  Capsule endoscopy (CE) has become a routine means of diagnosing obscure gastrointestinal bleeding (OGIB) in the small intestine. Capsules using novel blue-enhanced white light-emitting diodes are expected to acquire clearer contrast images (CIs) of the small bowel vasculature. We conducted a pilot study to examine whether CIs facilitate visualization of small bowel erosions, ulcers, and areas of angioectasia compared with standard white light images (WLIs)...
March 2018: Endoscopy International Open
Stefania Chetcuti Zammit, Reena Sidhu
PURPOSE OF REVIEW: The objective is to provide an overview on the cause of small bowel bleeding. We discuss the role of small bowel endoscopy in the management of small bowel bleeding and provide an outline of pharmacotherapy that can be additionally beneficial. RECENT FINDINGS: Small bowel capsule endoscopy (SBCE) is the initial diagnostic investigation of choice in small bowel bleeding. Computed tomography (CT) can be helpful in the context of small bowel tumours...
March 7, 2018: Current Opinion in Gastroenterology
Ali Mohtashami, Andrew Kiat, Jane Cross, Robert Simon, Austin Curtin
INTRODUCTION: Abernethy malformations are extremely rare congenital anomalous portosystemic shunts. We report the case of a patient with a rare variant Abernethy malformation between the superior mesenteric vein and left renal vein, associated with a massive jejunal diverticulum. PRESENTATION OF CASE: A 37-year-old Caucasian female presented to our emergency department with severe abdominal pain and proceeded to laparotomy for a presumed small bowel obstruction...
February 27, 2018: International Journal of Surgery Case Reports
Praneet Wander, Daniel Castaneda, Lionel D'Souza, Simi Singh, Sam Serouya, Ana I Velazquez, Rifat Mamun, Rebecca Voaklander, Petros Benias, David L Carr-Locke
BACKGROUND: To assess the safety and efficacy of the Instinct clip in the acute endoscopic treatment of upper gastrointestinal bleeding (UGIB). MATERIALS AND METHODS: This is the first large series reporting this clip in achieving hemostasis. A retrospective descriptive chart review was performed on patients presenting with recent overt GI bleeding treated with endoclip therapy at Mount Sinai Beth Israel Medical Center between May 2013 and January 2016. Results are expressed in absolute numbers, percentages, and trends...
April 2018: Journal of Clinical Gastroenterology
Cedric Van de Bruaene, Pieter Hindryckx, Laurens Van de Bruaene, Danny De Looze
PURPOSE OF REVIEW: Gastrointestinal bleeding originating from the small bowel (SB) poses a challenge to the treating gastroenterologist. Once diagnosed, management is not a walk in the park either. This review intends to summarize the current state-of-the-art evidence in a complete way with special attention for vascular and ulcerative lesions, to provide the reader with a clinical guide and flow chart towards SB bleeding. RECENT FINDINGS: Absence of SB bleeding lesions on CE does not directly yield better prognosis; although having a lower rebleeding rate the first 2 years, rebleeding in the long term is high...
March 7, 2018: Current Gastroenterology Reports
Rhona H Hurley, Michael McCormick, Mohamad Elhassan, Gary Nicholson
Gastrointestinal stromal tumours (GIST) are rare tumours of mesenchymal origin. These can be associated with neurofibromatosis type 1 (NF1), which is an autosomal dominant disorder. The prevalence of GIST in NF1 is estimated at 3.9-25%. This paper describes the presentation of a GIST arising from the jejenum in a 75-year-old lady with NF1, who presented with gastrointestinal bleeding. This was diagnosed by CT angiography. She was managed with laparotomy, with resection of small bowel, and an ischaemic segment of large bowel with two primary anastomoses...
February 2018: Journal of Surgical Case Reports
Ian C Glenn, Ibrahim Abd El-Shafy, Nicholas E Bruns, E Pete Muenks, Yara K Duran, Joshua A Hill, Shawn D St Peter, Jose M Prince, Aaron M Lipskar, Todd A Ponsky
PURPOSE: It is unclear whether simple diverticulectomy, rather than segmental bowel resection (SBR), is adequate treatment for gastrointestinal bleeding (GIB) secondary to Meckel diverticulum (MD). There is concern that ulcers in the adjacent bowel may continue to bleed if only the diverticulum is removed. This study seeks to determine if diverticulectomy is satisfactory treatment for bleeding MD. METHODS: A multi-institution, retrospective review was performed for patients with a diagnosis of MD and GIB who underwent simple diverticulectomy or small bowel resection...
February 19, 2018: Pediatric Surgery International
Yi-An Tu, Yu-Li Chen, Ming-Chieh Lin, Chi-An Chen, Wen-Fang Cheng
OBJECTIVE: To report a case and review published cases of large cell neuroendocrine carcinoma (LCNEC) of the endometrium. CASE REPORT: A 51-year-old female presented with postmenopausal bleeding and a palpable pelvic mass. An endometrial biopsy showed a malignant mixed Mullerian tumor (MMMT). Suboptimal debulking surgery was performed. The final pathology revealed stage IVB endometrial LCNEC. Post-operative adjuvant chemotherapy with cisplatin and etoposide was administered...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
E Pérez-Cuadrado-Robles, L E Zamora-Nava, V A Jiménez-García, E Pérez-Cuadrado-Martínez
INTRODUCTION AND AIMS: The growing elderly population and wide use of capsule endoscopy have led to a higher number of procedures in those patients. The aim of the present study was to assess the usefulness of capsule endoscopy in older patients. MATERIALS AND METHODS: All consecutive patients undergoing capsule endoscopy at our center within the time frame of 2004-2016 were classified as older (≥75 years of age) and younger. Findings and diagnostic yield were comparatively assessed...
February 15, 2018: Revista de Gastroenterología de México
Foong Way David Tai, Mark E McAlindon
PURPOSE OF REVIEW: The review describes the effects of NSAID gastrointestinal toxicity on the small bowel, wherein injury is as prevalent as in the gastroduodenum. This is well documented by capsule endoscopy, which also provides an endoscopic endpoint for novel treatment strategies. RECENT FINDINGS: Appreciation of the prevalence of NSAID enteropathy has grown with capsule endoscopy and the use of composite end points that include obscure haemoglobin decreases in clinical studies...
February 12, 2018: Current Opinion in Gastroenterology
Zhiqiang Li, Inamul Kabir, Gladys Tietelman, Chongmin Huan, Jianglin Fan, Tilla Worgall, Xian-Cheng Jiang
Serine palmitoyltransferase (SPT) is the rate-limiting enzyme for sphingolipid biosynthesis. SPT has two major subunits, SPTLC1 and SPTLC2. We previously found that liver Sptlc2 deficiency in early life impairs the development of adherens junctions. Here, we investigated the role of Sptlc2 deficiency in intestine. We treated Sptlc2-Flox/villin-Cre-ERT2 mice with tamoxifen (days 1, 2, and 3) to ablate Sptlc2 specifically in the intestine. At day 6 after tamoxifen treatment, Sptlc2-deficient mice had significantly decreased body weight with concurrent diarrhea and rectal bleeding...
February 7, 2018: Cell Death & Disease
Youngjin Han, Tae-Won Kwon, Sang Jun Park, Min-Jae Jeong, Kyunghak Choi, Gi-Young Ko, Sang-Oh Lee, Yong-Pil Cho
BACKGROUND: Infected aortic disease is a serious clinical condition associated with significant morbidity and mortality. This study reviewed the outcomes of in situ aortic replacement with a prosthetic graft for infected aortic disease, including primary infected abdominal aortic aneurysms (PIAAA), infected aortic prosthetic grafts (IAPG), and infected aortic stent grafts (IASG). METHODS: Twenty-eight consecutive patients who underwent in situ aortic replacement with a prosthetic graft for PIAAA, IAPG, and IASG at a single center from January 2001 to December 2015 were retrospectively analyzed...
February 6, 2018: World Journal of Surgery
Jordan E Axelrad, Alberto Pinsino, Pauline N Trinh, Anusorn Thanataveerat, Christian Brooks, Ryan T Demmer, Lisa Effner, Grant Parkis, Barbara Cagliostro, Jiho Han, A Reshad Garan, Veli Topkara, Koji Takeda, Hiroo Takayama, Yoshifumi Naka, Ivonne Ramirez, Reuben Garcia-Carrasquillo, Paolo C Colombo, Tamas Gonda, Melana Yuzefpolskaya
BACKGROUND: Gastrointestinal bleeding (GIB) is a frequent cause of re-admission in patients with continuous-flow left ventricular assist devices (CF-LVADs) and is associated with multiple endoscopic procedures and high resource utilization. Our aim was to determine the diagnostic and therapeutic yield of endoscopy and to develop a more cost-effective approach for the management of GIB in CF-LVAD recipients. METHODS: We retrospectively reviewed 428 patients implanted with a CF-LVAD between 2009 and 2016 at the Columbia University Medical Center and identified those hospitalized for GIB...
December 20, 2017: Journal of Heart and Lung Transplantation
Hiroki Kobayashi, Shoji Hirajima, Tsuyoshi Takagi, Kanehisa Fukumoto
A 44-years-old man presented to our hospital with bloody stool. CT of the abdomen revealed a 90mm mass adjacent to small intestine and high density ascites in lower abdomen. On the day of the admission, he lapsed into hemorrhagic shock caused by gastrointestinal bleedings. So emergency operation was performed. Operative findings showed a solid tumor of small intestine that were 95mm in diameter and a small amount of bloody ascites(100mL). Another tumor was also found in analis small intestine from primary lesion...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Kamal Seyed-Forootan, Hamid Karimi, Nazilla-Sadat Seyed-Forootan
BACKGROUND: Plastic surgeons have used several methods for the construction of neo-vaginas, including the utilization of penile skin, free skin grafts, small bowel or recto-sigmoid grafts, an amnion graft, and cultured cells. PURPOSE: The aim of this study is to compare the results of amnion grafts with amnion seeded with autograft fibroblasts. MATERIALS AND METHODS: Over 8 years, we compared the results of 24 male-to-female transsexual patients retrospectively based on their complications and levels of satisfaction...
January 30, 2018: Aesthetic Plastic Surgery
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