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Duodenal bleeding

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https://www.readbyqxmd.com/read/28440524/-clinical-epidemiological-characteristics-and-change-trend-of-upper-gastrointestinal-bleeding-over-the-past-15-years
#1
Jinping Wang, Yi Cui, Jinhui Wang, Baili Chen, Yao He, Minhu Chen
OBJECTIVE: To investigate the clinical epidemiology change trend of upper gastrointestinal bleeding (UGIB) over the past 15 years. METHODS: Consecutive patients who was diagnosed as continuous UGIB in the endoscopy center of The First Affiliated Hospital of Sun-Yat University during the period from 1 January 1997 to 31 December 1998 and the period from 1 January 2012 to 31 December 2013 were enrolled in this study. Their gender, age, etiology, ulcer classification, endoscopic treatment and hospitalization mortality were compared between two periods...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28410791/gastrointestinal-safety-of-celecoxib-versus-naproxen-in-patients-with-cardiothrombotic-diseases-and-arthritis-after-upper-gastrointestinal-bleeding-concern-an-industry-independent-double-blind-double-dummy-randomised-trial
#2
Francis K L Chan, Jessica Y L Ching, Yee Kit Tse, Kelvin Lam, Grace L H Wong, Siew C Ng, Vivian Lee, Kim W L Au, Pui Kuan Cheong, Bing Y Suen, Heyson Chan, Ka Man Kee, Angeline Lo, Vincent W S Wong, Justin C Y Wu, Moe H Kyaw
BACKGROUND: Present guidelines are conflicting for patients at high risk of both cardiovascular and gastrointestinal events who continue to require non-steroidal anti-inflammatory drugs (NSAIDs). We hypothesised that a cyclooxygenase-2-selective NSAID plus proton-pump inhibitor is superior to a non-selective NSAID plus proton-pump inhibitor for prevention of recurrent ulcer bleeding in concomitant users of aspirin with previous ulcer bleeding. METHODS: For this industry-independent, double-blind, double-dummy, randomised trial done in one academic hospital in Hong Kong, we screened patients with arthritis and cardiothrombotic diseases who were presenting with upper gastrointestinal bleeding, were on NSAIDs, and require concomitant aspirin...
April 11, 2017: Lancet
https://www.readbyqxmd.com/read/28408987/saving-from-unnecessary-pancreaticoduodenectomy-brunner-s-gland-hamartoma-case-report-on-a-rare-duodenal-lesion-and-exhaustive-literature-review
#3
Andrea Peloso, Jacopo Viganò, Alessandro Vanoli, Tommaso Dominioni, Sandro Zonta, Dario Bugada, Carlo Maria Bianchi, Francesco Calabrese, Ilaria Benzoni, Marcello Maestri, Paolo Dionigi, Lorenzo Cobianchi
INTRODUCTION: Brunner's gland hamartoma (BGH) is an infrequently encountered, benign, polypoid proliferation of Brunner's glands. Usually these lesions are asymptomatic, just only occasionally presenting with duodenal obstruction or bleeding signs and mimicking a tumoral lesion. CASE PRESENTATION: A 72-year-old male, referred for recurrent vomiting and epigastralgia, was investigated and all preoperative findings were suggestive of a tumour of the duodenum. During the scheduled pancreaticoduodenectomy a mass, resultant to a polyp, was palpatory felt inside the duodenum and then successfully and completely resected through a duodenotomy avoiding surgical overtreatment and connected postoperative morbidities...
May 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28392713/a-case-report-on-the-treatment-of-complex-chronic-pain-and-opioid-dependence-by-a-multidisciplinary-transitional-pain-service-using-the-act-matrix-and-buprenorphine-naloxone
#4
Aliza Z Weinrib, Lindsay C Burns, Alex Mu, Muhammad Abid Azam, Salima Sj Ladak, Karen McRae, Rita Katznelson, Saam Azargive, Cieran Tran, Joel Katz, Hance Clarke
In an era of growing concern about opioid prescribing, the postsurgical period remains a critical window with the risk of significant opioid dose escalation, particularly in patients with a history of chronic pain and presurgical opioid use. The purpose of this case report is to describe the multidisciplinary care of a complex, postsurgical pain patient by an innovative transitional pain service (TPS). A 59-year-old male with complex chronic pain, as well as escalating long-term opioid use, presented with a bleeding duodenal ulcer requiring emergency surgery...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28381781/a-case-report-of-duodenal-obstruction-due-to-retroperitoneal-bleeding-after-the-rupture-of-a-lower-pancreaticoduodenal-artery-aneurysm
#5
Nobuhiro Takeuchi, Kazumasa Emori, Yusuke Nomura
We report a case of a patient with duodenal obstruction due to retroperitoneal bleeding after the rupture of a lower pancreaticoduodenal artery aneurysm. An 80-year-old female was admitted to our hospital because of nausea and vomiting. During hospitalization, she developed hemorrhagic shock. Enhanced computed tomography revealed retroperitoneal bleeding. Abdominal angiography revealed an 8-mm aneurysm of the lower pancreaticoduodenal artery, stenosis at the trunk of the celiac artery, and increased blood flow through the pancreaticoduodenal arcades from the superior mesenteric artery...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28372451/effectiveness-of-arterial-embolization-in-recurrent-bleeding-due-to-duodenal-ulcer-during-postoperative-cardiac-surgery
#6
Caridad Marín Hernández, Pablo Ramírez Romero, Rubén Jara, Daniel Carbonell, Pascual Parrilla
Upper gastrointestinal bleeding is one of the most frequent complications after cardiac surgery and endoscopic treatment (ET) is often the first-choice procedure. When it fails, surgery can be an option but has significant mortality and morbidity. We propose arterial embolization (TAE: transcatheter arterial embolization) as an alternative treatment in selected cases.
April 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28367340/postural-syncope-and-constipation-an-unusual-presentation-of-a-duodenal-dieulafoy-s-lesion
#7
Ahmed Dirweesh, Alvarez Chikezie, Muhammad Yasir Khan, Sana Zia, Muhammad Tahir
Dieulafoy lesions are a rare etiology of gastrointestinal bleeding from a large caliber-persistent tortuous submucosal artery. They account for 1-2% of all causes of acute gastrointestinal hemorrhage with 80%-95% of these lesions located in the stomach along the lesser curvature. One-third of these lesions present at an extragastric location, with the proximal duodenum accounting for 15% of them. We present a 21-year-old male with no significant past medical history or risk factors, who presented with repeated syncopal episodes followed by hematemesis, found to have a Dieulafoy lesion located at the duodenal bulb...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28348475/giant-intrahepatic-portal-vein-aneurysm-leave-it-or-treat-it
#8
Amit Shrivastava, Jagdeesh S Rampal, D Nageshwar Reddy
Portal vein aneurysm (PVA) is a rare vascular dilatation of the portal vein. It is a rare vascular anomaly representing less than 3% of all visceral aneurysms and is not well understood. Usually, PVA are incidental findings, are asymptomatic, and clinical symptoms are proportionally related to size. Patients present with nonspecific epigastric pain or gastrointestinal bleeding with underlying portal hypertension. PVA may be associated with various complications such as biliary tract compression, portal vein thrombosis/rupture, duodenal compression, gastrointestinal bleeding, and inferior vena cava obstruction...
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28338158/-diagnosis-and-treatment-of-duodenal-injury-and-fistula
#9
Kunmei Gong, Shikui Guo, Kunhua Wang
Duodenal injury is a serious abdominal organ injury. Duodenal fistula is one of the most serious complications in gastrointestinal surgery, which is concerned for its critical status, difficulty in treatment and high mortality. Thoracic and abdominal compound closed injury and a small part of open injury are common causes of duodenal injury. Iatrogenic or traumatic injury, malnutrition, cancer, tuberculosis, Crohn's disease etc. are common causes of duodenal fistula, however, there has been still lacking of ideal diagnosis and treatment by now...
March 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28314316/non-whipple-operations-in-the-management-of-benign-premalignant-and-early-cancerous-duodenal-lesions
#10
Alexandros Papalampros, Demetrios Moris, Athanasios Petrou, Nikolaos Dimitrokallis, Ioannis Karavokyros, Dimitrios Schizas, Ioanna Delladetsima, Theodore N Pappas, Evangelos Felekouras
AIM: We reviewed our 20-year experience with non-Whipple operations (pancreas-preserving duodenectomy and transduodenal ampullectomy) for the treatment of benign, premalignant or early-stage malignant duodenal lesions. PATIENTS AND METHODS: Twenty-four patients who underwent non-Whipple operations between January 1996 and December 2015 were identified from an institutional database and retrospectively analyzed. RESULTS: Between 1996 and 2015, 10 patients underwent pancreas-preserving duodenectomy and 14 patients underwent transduodenal ampullectomy...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28302230/distal-duodenal-varices-first-presentation-of-upper-gastrointestinal-bleeding
#11
Inam -Ul- Haq, Amir Ali Shah, S Chandramohan
Varices are abnormal dilated veins which result from increased pressure in the portal circulation. Although the oesophagus and stomach are the most common sites for varices to develop, they may also occur as ectopic varices in the duodenum, rectum, and retroperitoneal areas. Isolated duodenal varices involving distal duodenum, particularly the fourth part of the duodenum, are extremely rare. However, such ectopic varices are associated with an increased risk of bleeding and mortality. Not only are they a diagnostic challenge, particularly if they present as a first manifestation of portal hypertension, they are also very difficult to treat due to their location...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28295649/duodenal-endoscopic-submucosal-dissection-with-traction-method-using-the-s-o-clip
#12
Rintaro Hashimoto, Dai Hirasawa
Use of endoscopic submucosal dissection (ESD) technique has been widespread. However, ESD of lesions in the duodenum is technically more challenging than ESD in other parts of the GI tract because it is difficult to keep the submucosal layer lifted. Therefore, the procedure is associated with severe complications, such as delayed bleeding and perforation. [1] We present a case of duodenal ESD in which traction method was used with an S-O clip (Zeon Medical Co., Ltd., Tokyo, Japan) (Figure 1) [2] to visualize the submucosal layer clearly...
March 10, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28292662/cytomegalovirus-duodenitis-associated-with-life-threatening-duodenal-hemorrhage-in-an-immunocompetent-patient-a-case-report
#13
Lucy Shen, David Youssef, Suzan Abu-Abed, Sangita K Malhotra, Kenneth Atkinson, Elena Vikis, George Melich, Shawn MacKenzie
INTRODUCTION: Cytomegalovirus (CMV) is known to be opportunistic in immunocompromised patients. However, there have been emerging cases of severe CMV infections found in immunocompetent patients. Gastrointestinal (GI) CMV disease is the most common manifestation affecting immunocompetent patients, with duodenal involvement being exceedingly rare. Presented is a case of an immunocompetent patient with life-threatening bleeding caused by CMV duodenitis, requiring surgical intervention. PRESENTATION OF CASE: A 60-year-old male with history of disseminated Methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia and aortic valve infective endocarditis, presented with life-threatening upper GI hemorrhage...
February 21, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28283237/duodenal-ulcers-are-a-major-cause-of-gastrointestinal-bleeding-after-cardiac-surgery
#14
Frances Krawiec, Andrew Maitland, Qiuli Duan, Peter Faris, Paul J Belletrutti, William D T Kent
OBJECTIVE: To determine the incidence of gastrointestinal (GI) bleeding in patients after cardiac surgery, assess the perioperative risk factors, and determine the type of GI tract pathology associated with bleeding events. METHODS: At a tertiary referral hospital, all cardiac surgery patients having a postoperative GI bleed from April 2002 to March 2012 were identified. To determine bleeding etiology, only patients requiring endoscopy were included in the analysis...
February 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28281485/laparoscopic-resection-of-duodenal-gastrointestinal-stromal-tumour
#15
Tammy Zioni, Vitaliy Dizengof, Boris Kirshtein
Only a few studies have revealed using laparoscopic technique with limited resection of gastrointestinal stromal tumour (GIST) of the duodenum. A 68-year-old man was admitted to the hospital due to upper gastrointestinal (GI) bleeding. Evaluation revealed an ulcerated, bleeding GI tumour in the second part of the duodenum. After control of bleeding during gastroduodenoscopy, he underwent a laparoscopic wedge resection of the area. During 1.5 years of follow-up, the patient is disease free, eats drinks well, and has regained weight...
April 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28275018/brunner-s-gland-hamartoma-a-rare-cause-of-iron-deficiency-anaemia-and-report-of-an-adapted-colonic-polyp-resection-technique
#16
Stephanie Judd, Suhag Patel, Edi Levi, Fadi Antaki
A man aged 65 years presented with symptomatic anaemia without overt gastrointestinal bleeding. An oesophagogastroduodenoscopy (EGD) was performed and he was found to have a large ulcerated pedunculated Brunner's gland hamartoma in the duodenal bulb. The polyp was resected using snare cautery in forward and retroflexed positions. Colonoscopy was also performed and a few diminutive polyps were resected. A year later, the patient returned for a surveillance EGD, and no residual polyp was noted. Haemoglobin and iron studies normalised within a few months after polypectomy, with resolution of symptoms...
March 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28270041/bleeding-gastric-and-duodenal-ulcers-case-control-study-comparing-angioembolization-and-surgery
#17
Taina Nykänen, Erno Peltola, Leena Kylänpää, Marianne Udd
OBJECTIVES: To compare the safety, efficacy and feasibility of transcatheter arterial embolization (TAE) and surgery in the treatment of bleeding gastric and duodenal ulcers (BGDUs). MATERIALS AND METHODS: The study group comprised patients receiving TAE or surgery for BGDUs after failed endoscopic hemostasis in Helsinki University Hospital (HUH) during 2000-2015. Hospital medical records provided study data. 30-d mortality and rebleeding rates were the primary outcomes...
May 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28266293/emergency-pancreatico-duodenectomy-with-superior-mesenteric-and-portal-vein-resection-and-reconstruction-using-a-gore-tex-vascular-graft
#18
Mihai Adrian Eftimie, Vasile Lungu, Marian Tudoroiu, Genady Vatachki, Severina Batca, Leonard David
Emergency pancreatico-duodenectomy(EPD) is a very rare procedure and few reports are present in medical literature. It is an uncommon approach, usually used for emergency surgical treatment of abdominal trauma that involves the head of the pancreas or the duodenum, but it is also a surgical tool for the treatment of ruptured aneurysms, bleeding pseudocysts, duodenal perforations, uncontrollable hemorrhage from ulcers and tumors, severe infectious complications of acute pancreatitis or endoscopic retrograde cholangiopancreatography related complications (1,2)...
January 2017: Chirurgia
https://www.readbyqxmd.com/read/28263162/-duodenal-lipoma-is-a-rare-cause-of-gastrointestinal-bleeding
#19
Kimie Ødorf, Svend Knuthsen
Lipomas of the gastrointestinal tract are extremely rare, slow-growing and most often asymptomatic tumours. They are composed of highly differentiated fat cells surrounded by a fibrous capsule. Tumours larger than 2 cm can produce symptoms of abdominal pain and discomfort or cause anaemia due to ulceration and bleeding, or intestinal obstruction due to intussusception. This is a case report of a 73-year-old man with a bleeding duodenal lipoma situated at the papilla duodeni major which caused difficulty in the diagnostic process, and the endoscopic visualization raised suspicion of cancer of the papilla...
March 6, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28262530/comparison-of-heater-probe-coagulation-and-argon-plasma-coagulation-in-the-management-of-mallory-weiss-tears-and-high-risk-ulcer-bleeding
#20
Mete Akin, Erhan Alkan, Yasar Tuna, Tolga Yalcinkaya, Bulent Yildirim
BACKGROUND AND STUDY AIMS: Upper gastrointestinal (GI) bleeding is a common medical emergency. Endoscopic treatments often lead to better therapeutic outcomes than conventional conservative treatments. This study aimed to investigate and compare the use of heater probe coagulation (HPC) and argon plasma coagulation (APC) together with epinephrine injection for the treatment of Mallory-Weiss tears and high-risk ulcer bleeding. PATIENTS AND METHODS: A total of 97 patients (54 in the HPC group and 43 in the APC group) who were diagnosed with upper GI bleeding secondary to a Mallory-Weiss tear or high-risk gastric or duodenal ulcers were included in the study...
March 2017: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
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