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Variceal bleeding upper gastrointestinal

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https://www.readbyqxmd.com/read/29317941/rockall-score-larger-than-7-as-a-reliable-criterion-for-the-selection-of-indications-for-preventive-transarterial-embolization-in-a-subgroup-of-high-risk-elderly-patients-after-primary-endoscopic-hemostasis-for-non-variceal-upper-gastrointestinal-bleeding
#1
Aleksejs Kaminskis, Patricija Ivanova, Sanita Ponomarjova, Maksims Mukans, Viesturs Boka, Guntars Pupelis
Background: Transarterial embolization (TAE) is an alternative procedure to repeat endoscopy or surgical intervention in the case of re-bleeding after primary endoscopic treatment. The aim of the study was to assess the Rockall score as a criterion for TAE in the case of re-bleeding after endoscopic treatment of non-variceal upper gastrointestinal bleeding (NVUGIB). Methods: Out of the 673 patients who underwent emergent endoscopic hemostasis due to NVUGIB, 111 had a high risk of re-bleeding having a Forrest I-IIb ulcer and the Rockall score ≥ 5...
December 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/29315156/bleeding-risk-of-variceal-band-ligation-in-extrahepatic-portal-vein-obstruction-is-not-increased-by-oral-anticoagulation
#2
Maeva Guillaume, Camille Christol, Aurélie Plessier, Michèle Corbic, Jean-Marie Péron, Agnès Sommet, Pierre-Emmanuel Rautou, Yann Consigny, Jean-Pierre Vinel, Charles-Dominique Valla, Christophe Bureau
BACKGROUND AND OBJECTIVES: Noncirrhotic nontumoral extrahepatic portal vein obstruction (EHPVO) is the second leading cause of portal hypertension (PHT) and is mainly related to prothrombotic disorders. Patients with EHPVO often require prolonged oral anticoagulation therapy (OAT) together with variceal band ligation (VBL) to prevent thrombosis recurrence and PHT-related bleeding, respectively. The benefit-risk balance of VBL in this context remains unknown. We aimed to assess upper gastrointestinal bleeding (UGB) risk and variceal eradication efficacy in EHPVO patients undergoing a VBL program without stopping OAT...
January 8, 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29314627/etiology-of-gastrointestinal-bleeding-in-patients-on-dual-antiplatelet-therapy
#3
Arslan Shaukat, Salman Waheed, Ethan Alexander, Daniel Washko, Buddhadeb Dawn, Mojtaba Olyaee, Kamal Gupta
BACKGROUND: Dual antiplatelet therapy (DAPT) is associated with an increased risk of gastrointestinal bleeding (GIB). Traditionally thought to cause mostly upper GIB (UGIB), some recent reports suggest that incidence of lower GIB (LGIB) may be increasing. We conducted a study to assess the endoscopic findings and etiology of GIB in patients who presented with GIB on DAPT compared to those not on DAPT. METHODS: This is a retrospective, single center, case control study...
January 4, 2018: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/29287004/non-invasive-markers-of-portal-hypertension-appraisal-of-adult-experience-and-potential-utilisation-in-children
#4
Harry Sutton, Anil Dhawan, Tassos Grammatikopoulos
Portal Hypertension (PHT) is a significant cause of morbidity and mortality in children with chronic liver disease (CLD) and portal vein obstruction. Increased portal pressure results in variceal formation along the gastrointestinal (GI) tract resulting in major bleeding. Identifying children with significant PHT who are more likely to suffer GI bleeding has been challenging and the role of surveillance upper GI endoscopy has been debated. This review analyses research done on serum biomarkers and imaging techniques as possible predictors of significant PHT...
December 28, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29282637/changing-epidemiology-of-upper-gastrointestinal-hemorrhage-in-the-last-decade-a-nationwide-analysis
#5
Brandon A Wuerth, Don C Rockey
BACKGROUND: Upper gastrointestinal hemorrhage (UGIH) is common and carries substantial mortality requiring frequent hospitalizations. AIM: To investigate trends in etiology and outcome of UGIH in hospitalized patients in the USA. METHODS: Retrospective, observational cohort study of the Nationwide Inpatient Sample from 2002 to 2012 was carried out. UGIH was identified in hospitalizations with a principle ICD-9-CM diagnosis of UGIH or secondary diagnosis of UGIH with a principal diagnosis of hematemesis, blood in stool, or gastrointestinal bleeding...
December 27, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29260002/profile-of-extrahepatic-portal-venous-obstruction-among-children-in-central-india
#6
Mayank Jain, Jenisha Jain, Gauri Rao Passi, Kamna Jain, Shikhar Jain
Introduction: There is a paucity of data regarding the clinical profile of children with extrahepatic portal venous obstruction (EHPVO) from Central India. Material and methods: Retrospective analysis of 30 children with EHPVO treated between 2002 and 2012. Results: The median age of presentation was 12.5 years (range 5-14 years) and median duration of symptoms was 3.2 years (range 0.3-10 years). Home delivery was noted in 30 cases (100%), umbilical sepsis in 8 (27%) and history of cow dung application over the umbilical cord in 2 cases (6...
December 2017: Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29234547/testicular-cancer-presenting-as-gastric-variceal-hemorrhage
#7
Carlos Eduardo Salazar-Mejía, David Hernández-Barajas, Edio Llerena-Hernández, José Luis González-Vela, María Inés Contreras-Salcido, Adriana González-Gutiérrez, Omar David Borjas-Almaguer, Luis Alberto Pérez-Arredondo, Blanca Otilia Wimer-Castillo
Testicular cancer is the most common solid malignancy affecting males between the ages of 15 and 35. The symptomatology caused by this tumor varies according to the site of metastasis. We present the case of a 26-year-old male who arrived to the emergency department with hematemesis. He had no previous medical history. On arrival, we noted enlargement of the left scrotal sac. There was also a mass in the left scrotum which provoked displacement of the penis and right testis. The serum alpha-fetoprotein level was 17,090 ng/mL, lactate dehydrogenase was 1480 U/L, and human chorionic gonadotropin was 287...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29224657/cta-as-an-adjuvant-tool-for-acute-intra-abdominal-or-gastrointestinal-bleeding
#8
REVIEW
Mitchell Storace, Jonathan G Martin, Jay Shah, Zachary Bercu
Hematemesis and acute postsurgical upper gastrointestinal hemorrhage are common emergent on-call consultations for the interventional radiologist. Upper GI bleleding (UGIB) is a relatively frequent problem. The incidence and mortality vary among patient populations, but studies have shown an overall incidence ranging from 36-172 cases per 100,000 adults per year, with a mortality rate of 5%-14%. The incidence is significantly higher in men. Peptic ulcer disease is the predominant etiology, responsible for 28%-59% of UGIB...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29201796/hepatic-venous-pressure-gradient-measurement-in-bangladeshi-cirrhotic-patients-a-correlation-with-child-s-status-variceal-size-and-bleeding
#9
Mamun Al Mahtab, Sheikh M Noor E Alam, Mohammad A Rahim, Mohammad A Alam, Faiz A Khondaker, Ahmed L Moben, Masuda Mohsena, Sheikh Mohammad Fazle Akbar
Background: Hepatic venous pressure gradient (HVPG) reflects the portal pressure in patients with cirrhotic portal hypertension. The aim of the study was to assess the relation of HVPG to variceal size, Child-Pugh status, and variceal bleeding. Materials and methods: A total of 96 patients with cirrhosis of liver were enrolled prospectively and each patient's HVPG level was measured via the transfemoral route. Clinical and biochemical evaluation and upper gastrointestinal (GI) endoscopy were done in each subject...
July 2017: Euroasian Journal of Hepato-Gastroenterology
https://www.readbyqxmd.com/read/29099778/upper-gastrointestinal-bleeding-in-children-a-tertiary-united-kingdom-children-s-hospital-experience
#10
Omar Nasher, David Devadason, Richard J Stewart
The aim of this study was to review the aetiology, presentation and management of these patients with upper gastrointestinal bleeding (UGIB) at a tertiary children's unit in the United Kingdom. This was a retrospective single-institution study on children (<16 years) who presented with acute UGIB over a period of 5 years using known International Classification of Diseases (ICD) codes. A total of 32 children (17 males, 15 females) were identified with a total median age at presentation of 5.5 years. The majority (24/32) of patients presented as an emergency...
November 3, 2017: Children
https://www.readbyqxmd.com/read/29063774/-massive-bleeding-in-portal-hypertension-endoscopic-surgical-or-endovascular-management
#11
J Tornikidis, J Hoch, R Pádr, R Keil
Upper gastrointestinal bleeding is a serious and potentially life-threatening abdominal emergency. An important diagnostic goal is to determine the cause and localize the bleeding site(s), which is crucial for choosing an appropriate therapy and consequently also for the long-term result. Our case report presents a patient with recurrent upper gastrointestinal bleeding where even repeated endoscopic, surgical and endovascular interventions were not sufficient to determinate the cause of bleeding and to save the patient´s life...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28983161/etiological-and-endoscopic-profile-of-middle-aged-and-elderly-patients-with-upper-gastrointestinal-bleeding-in-a-tertiary-care-hospital-in-north-india-a-retrospective-analysis
#12
Pranav Mahajan, Vijant Singh Chandail
BACKGROUND: Upper gastrointestinal (GI) bleeding is a common medical emergency associated with significant morbidity and mortality. The clinical presentation depends on the amount and location of hemorrhage and the endoscopic profile varies according to different etiology. At present, there are limited epidemiological data on upper GI bleed and associated mortality from India, especially in the middle and elderly age group, which has a higher incidence and mortality from this disease...
July 2017: Journal of Mid-life Health
https://www.readbyqxmd.com/read/28971259/efficacy-and-safety-of-superselective-trans-catheter-arterial-embolization-of-upper-and-lower-gastrointestinal-bleeding-using-n-butyl-2-cyanoacrylate
#13
Jae Hyun Kwon, Yoon Hee Han
PURPOSE: To evaluate the efficacy and safety of superselective trans-catheter arterial embolization (TAE) with N-butyl-2-cyanoacrylate (NBCA) for patients with acute non-variceal upper and lower gastrointestinal (GI) bleeding. METHODS: TAE using NBCA was performed in 21 patients (13 males, 8 females, mean age 60.9 years) with acute non-variceal upper (n = 15) and lower (n = 6) GI bleeding. TAE using other embolic agents was performed in 25 patients (13 males, 12 females, mean age 69...
October 2, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28924594/can-we-now-recommend-otsc-as-first-line-therapy-in-case-of-non-variceal-upper-gastrointestinal-bleeding
#14
EDITORIAL
Shannon Melissa Chan, James Yw Lau
No abstract text is available yet for this article.
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28924593/use-of-the-over-the-scope-clip-otsc-in-non-variceal-upper-gastrointestinal-bleeding-in-patients-with-severe-cardiovascular-comorbidities-a-retrospective-study
#15
Edris Wedi, Daniel von Renteln, Susana Gonzalez, Olena Tkachenko, Carlo Jung, Sinan Orkut, Victor Roth, Selin Tumay, Juergen Hochberger
INTRODUCTION:  The over-the-scope-clip (OTSC) can potentially overcome limitations of standard clips and achieve more efficient and reliable hemostasis. Data on OTSC use for non-variceal upper gastrointestinal bleeding (NVUGIB) in patients with cardiovascular comorbidities are currently limited. PATIENTS AND METHODS:  We prospectively collected and retrospectively analyzed our database from February 2009 to September 2015 from all patients who underwent emergency endoscopy for high-risk NVUGIB in 2 academic centers and were treated with OTSC as first-line (n = 81) or second-line therapy (n = 19)...
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28839866/antithrombotic-drugs-and-non-variceal-bleeding-outcomes-and-risk-scoring-systems-comparison-of-glasgow-blatchford-rockall-and-charlson-scores
#16
Ali S Taha, Caroline McCloskey, Theresa Craigen, Wilson J Angerson
OBJECTIVES: Antithrombotic drugs (ATDs) cause non-variceal upper gastrointestinal bleeding (NVUGIB). Risk scoring systems have not been validated in ATD users. We compared Blatchford, Rockall and Charlson scores in predicting outcomes of NVUGIB in ATD users and controls. METHODS: A total of 2071 patients with NVUGIB were grouped into ATD users (n=851) and controls (n=1220) in a single-centre retrospective analysis. Outcomes included duration of hospital admission, the need for blood transfusion, rebleeding requiring surgery and 30-day mortality...
October 2016: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28833912/identifying-emergency-department-patients-at-low-risk-for-a-variceal-source-of-upper-gastrointestinal-hemorrhage
#17
Lauren R Klein, Joel Money, Kaveesh Maharaj, Aaron Robinson, Tarissa Lai, Brian E Driver
BACKGROUND: Assessing the likelihood of a variceal versus nonvariceal source of upper gastrointestinal bleeding (UGIB) guides therapy, but can be difficult to determine on clinical grounds. The objective of this study was to determine if there are easily ascertainable clinical and laboratory findings that can identify a patient as low risk for a variceal source of hemorrhage. METHODS: This was a retrospective cohort study of adult ED patients with UGIB between January 2008 and December 2014 who had upper endoscopy performed during hospitalization...
November 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28798285/is-the-aims-65-score-useful-in-prepdicting-clinical-outcomes-in-korean-patients-with-variceal-and-nonvariceal-upper-gastrointestinal-bleeding
#18
Jung Wan Choe, Seung Young Kim, Jong Jin Hyun, Sung Woo Jung, Young Kul Jung, Ja Seol Koo, Hyung Joon Yim, Sang Woo Lee
Background/Aims: Various clinical scoring systems, including the Glasgow-Blatchford score (GBS), Rockall risk score (RS), and AIMS65 score (AIMS65), have been validated to predict the clinical outcomes in patients with upper gastrointestinal bleeding (UGIB). We compared the performance of these three scoring systems in predicting clinical outcomes in patients with UGIB in Korea. Methods: We retrospectively evaluated 286 patients with UGIB who visited emergency department...
November 15, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28746317/acute-upper-gastrointestinal-bleeding-in-a-tertiary-care-centre-of-nepal
#19
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/28726433/gastric-antral-vascular-ectasia-and-solitary-rectal-ulcer-syndrome-two-rare-diagnoses-as-the-cause-of-anemia-in-a%C3%A2-single-patient-case-report
#20
Lumír Kunovský, Milan Dastych, Radek Kroupa, Beata Hemmelova, Katarina Muckova, Miroslava Chovancova, Lenka Kucerova, Jiri Dolina
Gastric antral vascular ectasia (GAVE) and solitary rectal ulcer syndrome (SRUS) are both mentioned in the literature as rare causes of iron deficiency anemia and gastrointestinal (GI) bleeding. GAVE accounts for up to 4 % of upper non-variceal GI bleeding; SRUS is a rare benign disorder that presents with rectal bleeding. We present the case of a 75-year-old patient who was admitted to our facility with anemia. In the same patient, we encountered chronic bleeding from GAVE and SRUS. Both diagnoses were treated endoscopically: GAVE by argon plasma coagulation and a subsequent treatment with proton pump inhibitors and SRUS by adrenaline injection and clipping, consecutively treated with mesalazine enemas...
2017: Vnitr̆ní Lékar̆ství
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