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Duodenal bleeding

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https://www.readbyqxmd.com/read/28814595/bleeding-ectopic-duodenal-varix-use-of-a-new-microvascular-plug-mvp-device-along-with-transjugular-intrahepatic-portosystemic-shunt-tipss
#1
Richa Bhardwaj, Gaurav Bhardwaj, Erik Bee, Raffi Karagozian
Ectopic varices (ECV) occur along the gastrointestinal (GI) tract outside the common variceal sites and represent 2%-5% of all GI variceal bleeds with mortality rates up to 40%. Management is challenging because of inaccessibility and increased risk of rebleeding. We report what is to our knowledge the first clinical use of a new microvascular plug (MVP) with transjugular intrahepatic portosystemic shunt (TIPSS) for a bleeding duodenal varix (DV). A 68-year-old man presented with melena. Endoscopy demonstrated a grade II varix in the second part of the duodenum with red wale sign...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28807040/management-of-upper-gastrointestinal-bleeding-in-emergency-departments-from-bleeding-symptoms-to-diagnosis-a-prospective-multicenter-observational-study
#2
Pierre-Clément Thiebaud, Youri Yordanov, Jacques-Emmanuel Galimard, Pierre-Alexis Raynal, Sébastien Beaune, Laurent Jacquin, François-Xavier Ageron, Dominique Pateron
BACKGROUND: Upper gastrointestinal bleeding (UGB) is common in emergency departments (EDs) and can be caused by many eso-gastro-duodenal lesions. Most available epidemiological data and data on the management of UGB comes from specialized departments (intensive care units or gastroenterology departments), but little is known from the ED perspective. We aimed to determine the distribution of symptoms revealing UGB in EDs and the hemorrhagic lesions identified by endoscopy. We also describe the characteristics of patients consulting for UGB, UGB management in the ED and patients outcomes...
August 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28806622/case-report-on-the-non-operative-management-of-a-retrievable-inferior-vena-cava-filter-perforating-the-duodenum
#3
Joseph S Fernandez-Moure, Keemberly Kim, M Haseeb Zubair, Wade R Rosenberg
INTRODUCTION: Deep vein thrombosis (DVT) continues to be a significant source of morbidity for surgical patients. Placement of a retrievable inferior vena cava (IVC) filter is used when patients have contraindications to anticoagulation or recurrent pulmonary embolism despite therapeutic anticoagulation. Although retrievable IVC filters are often used, they carry a unique set of risks. PRESENTATION OF CASE: A 67-year-old man presents to the Emergency Room (ER) following large volume melena and complaining of syncope...
July 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28776354/multidisciplinary-approach-to-refractory-upper-gastrointestinal-bleeding-case-series-of-angiographic-embolization
#4
Ko Eun Lee, Ki Nam Shim, Chung Hyun Tae, Min Sun Ryu, Sun Young Choi, Chang Mo Moon, Seong Eun Kim, Hey Kyung Jung, Sung Ae Jung
Although medical and endoscopic hemostasis is now considered as the first-line therapy for nonvariceal upper gastrointestinal (UGI) bleeding, refractory bleeding still occurs in 5%-10% of the patients. In these patients, transcatheter arterial embolization (TAE) or surgery is required, but research on embolization for unmanageable UGI bleeding in Korea is scanty. We reviewed the medical records of 518 patients who underwent endoscopic hemostasis during 4 years. Among these subjects, 8 patients who required embolization due to failure of endoscopic hemostasis were enrolled...
September 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28763306/efficacy-and-safety-of-proton-pump-inhibitors-in-the-long-term-aspirin-users-a-meta-analysis-of-randomized-controlled-trials
#5
Khagendra Dahal, Sharan P Sharma, Jaspreet Kaur, Billie J Anderson, Gurpinder Singh
BACKGROUND: Long-term aspirin use in cardiovascular disease prevention may result in gastrointestinal bleeding. Although proton pump inhibitors (PPI) have been shown to reduce the risks of peptic ulcers and dyspeptic symptoms in long-term aspirin users in the randomized controlled trials, there are safety concerns about the long-term use of PPI. STUDY QUESTION: What is the safety and efficacy of PPI in patients using aspirin in long term for prevention of cardiovascular diseases and stroke? METHODS: We searched MEDLINE, EMBASE, CENTRAL, CINAHL, ProQuest, and relevant references from inception through February 2015, and used random-effects model for meta-analysis...
July 26, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28758246/endoscopic-hemostasis-for-spurting-duodenal-bleeding-using-dual-red-imaging
#6
Hidenori Tanaka, Shiro Oka, Shinji Tanaka
Endoscopic hemostasis for spurting gastrointestinal bleeding is sometimes difficult to achieve, because a precise bleeding point is often indistinguishable due to persistent hemorrhage. Dual red imaging (DRI) is a novel image enhancement technology that uses 3 wavelengths: 540 nm, 600 nm, and 630 nm. It was reported that DRI improves the visibility of deeper submucosal blood vessels and the bleeding point because 600 nm and 630 nm lights can penetrate deep into the tissue.(1-4) We describe an educational case of spurting duodenal bleeding in which DRI was used to achieve endoscopic hemostasis This article is protected by copyright...
July 31, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28756909/gastroduodenal-artery-coiling-to-curb-upper-gastrointestinal-bleeding
#7
Krishnamurti A Rao, Ramsey Al-Hakim, Thomas Scagnelli, George Sanchez, William Munios, Erick Hernandez, Juan E Sola, Holly Neville, Anthony Hogan, Eduardo A Perez
BACKGROUND: Peptic ulcers in pediatric populations are uncommon and can present with upper gastrointestinal bleeding and shock on presentation. An endoscopy is done initially to identify bleeding source. However, definitive treatment is achieved with angiography. The use of coiling is effective in achieving hemorrhagic control in duodenal ulcers or gastric ulcers, particularly in adults. However, the use in pediatric populations is unknown. We present a case of peptic ulcer disease treated with a gastroduodenal artery coil in a pediatric patient that has never been reported in the literature...
July 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28746317/acute-upper-gastrointestinal-bleeding-in-a-tertiary-care-centre-of-nepal
#8
M S Paudel, S Kc, A K Mandal, N S Poudyal, R Shrestha, B N Paudel, S Chaudhary
INTRODUCTION: AUGIB is characterized by hematemesis or melena or both. Peptic ulcers and variceal bleed account for majority of cases. Use of proton pump inhibitors in current era is associated with a gradual reduction in burden of peptic ulcer disease. We conducted this study to look into the cause of AUGIB in our community. METHODS: We studied 100 patients in one year period who presented to us with hematemesis or melena. The study was conducted in department of Gastroenterology, Bir hospital, Kathmandu...
April 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28731954/laparoscopic-pancreaticoduodenectomy-a-single-team-preliminary-experience
#9
Xiaohui Duan, Bo Jiang, Lixue Zhou, Jianhui Yang, Bingzhang Tian, Huiming Wen, Xianhai Mao
OBJECTIVE: The present study aimed to describe the authors' experience and the perioperative outcome for laparoscopic pancreaticoduodenectomy (LPD). MATERIALS AND METHODS: Perioperative clinical data of 57 consecutive pancreaticoduodenectomy (PD) procedures performed from January 2014 to May 2016 in the Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital were retrospectively analyzed. RESULTS: The median of operative time was 315 minutes (range, 220 to 575 min) and the median of intraoperative estimated blood loss was 200 mL (range, 100 to 550 mL)...
July 20, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28718261/modern-management-of-duodenal-variceal-bleeding
#10
Amer Rehman Farooqi, Lawrence Sunderraj
Duodenal variceal bleeding is an uncommon cause of gastrointestinal bleeding. Treatment strategies are reliant on case reports and case series with new developments in interventional treatment modalities including endoscopic therapy, radiological intervention, and surgery. Endoscopic treatment includes injection sclerotherapy using various agents, banding of varices and clipping of varices. Interventional radiological procedures include Transjugular Intrahepatic porto-systemic shunt (TIPSS), and Balloon- Occluded Retrograde Transvenous Obliteration (BRTO)...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28694665/pancreas-preserving-distal-duodenectomy-a-versatile-operation-for-a-range-of-infra-papillary-pathologies
#11
W Kyle Mitchell, Pradeep F Thomas, Abed M Zaitoun, Adam J Brooks, Dileep N Lobo
AIM: To investigate the range of pathologies treated by pancreas preserving distal duodenectomy (PPDD) and present the outcome of follow-up. METHODS: Neoplastic lesions of the duodenum are treated conventionally by pancreaticoduodenectomy. Lesions distal to the major papilla may be suitable for a pancreas-preserving distal duodenectomy, potentially reducing morbidity and mortality. We present our experience with this procedure. Selective intraoperative duodenoscopy assessed the relationship of the papilla to the lesion...
June 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28689427/duodenal-hematoma-caused-by-endoscopic-hemostatic-procedures-sclerotherapy
#12
Rebeca Irisarri Garde, Juan José Vila Costas
Endoscopic hemostatic procedures such as local injection of epinephrine are commonly used for the treatment of bleeding ulcers. Although the risks are usually considered to be minimal, there are reports describing that duodenal intramural hematomas may develop as a complication after endoscopy especially in patients susceptible to hemorrhage such as those with anticoagulants therapy or blood dyscrasia.
July 10, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28685135/duodenal-gangliocytic-paraganglioma-with-lymph-node-metastases-a-case-report-and-comparative-review-of-31-cases
#13
Sahara J Cathcart, Aaron R Sasson, Jessica A Kozel, Jennifer M Oliveto, Quan P Ly
Gangliocytic paraganglioma (GP) is a rare tumor of uncertain origin most often located in the second portion of the duodenum. It is composed of three cellular components: Epithelioid endocrine cells, spindle-like/sustentacular cells, and ganglion-like cells. While this tumor most often behaves in a benign manner, cases with metastasis are reported. We describe the case of a 62-year-old male with a periampullary GP with metastases to two regional lymph nodes who was successfully treated with pancreaticoduodenectomy...
June 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28666150/mesenteric-desmoid-tumour-presenting-with-recurrent-abdominal-abscess-and-duodenal-fistula-a-case-report-and-review-of-literature
#14
Kai Huang, Heather Stuart, Kirill Lyapichev, Andrew E Rosenberg, Alan S Livingstone
INTRODUCTION: Desmoid tumors are locally destructive but histologically benign. Their management involves close observation and surgical, medical, or hormonal treatment. PRESENTATION OF THE CASE: A 36-year-old male was admitted for abdominal pain and fever. A CT scan showed fluid collections and air within a mesenteric mass. Diagnostic laparotomy was performed with drainage of the abscess and biopsy of the mass. The pathology suggested a desmoid tumor. His fever and abdominal pain persisted...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28664427/safety-and-efficacy-of-the-endoscopic-duodenal-jejunal-bypass-liner-prototype-in-severe-or-morbidly-obese-subjects-implanted-for-up-to-3-years
#15
Nicolás Quezada, Rodrigo Muñoz, Carla Morelli, Dannae Turiel, Julián Hernández, Fernando Pimentel, Alex Escalona
BACKGROUND: The duodenal-jejunal bypass liner (DJBL) is an endoscopic device that mimics the duodenal-jejunal exclusion component of the Roux-en-Y gastric bypass. Previous studies assessing the efficacy of the DJBL have shown 10-40% excess weight loss (%EWL) and improvements in obesity-associated comorbidities. The aim of this study was to evaluate the safety and efficacy of a new DJBL prototype over a 3-year period. METHODS: Morbidly obese subjects were enrolled in a single-arm, open-label, prospective trial...
June 29, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28660836/superior-mesenteric-artery-syndrome-a-single-centre-experience-of-laparoscopic-duodenojejunostomy-as-the-operation-of-choice
#16
G C Kirby, E R Faulconer, S J Robinson, A Perry, R Downing
INTRODUCTION The superior mesenteric artery (SMA) syndrome, or Wilkie's syndrome, is a rare cause of postprandial epigastric pain, vomiting and weight loss caused by compression of the third part of the duodenum as it passes beneath the proximal superior mesenteric artery. The syndrome may be precipitated by sudden weight loss secondary to other pathologies, such as trauma, malignancy or eating disorders. Diagnosis is confirmed by angiography, which reveals a reduced aorto-SMA angle and distance, and contrast studies showing duodenal obstruction...
July 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28630246/ominous-triad-triggered-by-high-dose-glucocorticosteroid-therapy
#17
Sarah Bär, Fritz Daudel, Thomas Zueger
Glucocorticosteroids (CS) play a key role in the treatment of numerous diseases. Nonetheless, they can be accompanied by several adverse effects. We present the case of a 51-year-old woman who was treated with high-dose CS for a relapse of her multiple sclerosis. After 5 days of treatment, the patient developed severe diabetic ketoacidosis, hypertriglyceridemia and acute pancreatitis-a potentially life-threatening triad which has previously been described, in our case, however, for the first time as a complication of CS therapy...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28625069/a-rare-cause-of-intestinal-bleeding-duodenal-metastasis-from-endometrial-cancer
#18
Cátia Leitão, Ana Caldeira, António Banhudo
With this report we alert to an extremely rare case of duodenal metastases, from an endometrial adenocarcinoma by lymphatic spread and whose primary manifestation was with gastrointestinal bleeding. We think this is the first case reported of duodenal metastases from endometrial carcinoma and with this presentation.
June 19, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28621187/-gastrointestinal-lipomas-report-of-three-cases-and-a-short-review-of-the-literature
#19
Gergely Vertse, Tibor Vagács, András Iványi, Márton Szeleczky
Lipoma in the alimentary tract is a rare entity, it can usually be found in the subcutaneous tissue. Generally, lipomas are asymptomatic. Gastrointestinal lipoma must be removed only in case of bleeding or obstruction. We report 3 successfully operated cases of gastrointestinal lipomas: one duodenal (a 4 cm in diameter lipoma was enucleated from the bulb), one in the small bowel (ileal lipoma causing intususception; due to the unusual masroscopical appearance, segmental resection was performed), and one in the large bowel (colonic lipoma located at 47 cm from the anus, causing intermittent obstruction was remowed by colotomy)...
June 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28619193/protein-losing-enteropathy-in-patients-with-congenital-heart-disease
#20
Maxim Itkin, David A Piccoli, Gregory Nadolski, Jack Rychik, Aaron DeWitt, Erin Pinto, Jonathan Rome, Yoav Dori
BACKGROUND: Protein-losing enteropathy (PLE), characterized by loss of proteins in the intestine, is a devastating complication in patients with congenital heart disease. The cause of PLE is unknown, but lymphatic involvement has been suspected. OBJECTIVES: The authors evaluated the use of lymphangiographic imaging and liver lymphatic embolization as a treatment for PLE. METHODS: This was a single-center, retrospective review of imaging and interventions used in 8 consecutive patients with liver lymphatic embolization and congenital heart disease with elevated central venous pressure complicated by PLE...
June 20, 2017: Journal of the American College of Cardiology
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