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Gastrointestinal bleeding

Wen-Guo Chen, Guo-Dong Shan, Hong Zhang, Ming Yang, Lin L, Min Yue, Guang-Wu Chen, Qing Gu, Hua-Tuo Zhu, Guo-Qiang Xu, Li-Hua Chen
The aim of the study was to evaluate the diagnostic and therapeutic value of double-balloon entoroscopy (DBE) in small bowel diseases (SBDs) in China.A retrospective review of 674 consecutive patients who underwent DBE between January 2007 and November 2015 was conducted. Patients were divided into 3 groups by age, young group (<45 years), middle-aged group (45-65 years), and elderly group (>65 years). Data were collected with regard to demographics, clinical, endoscopic findings, complications, diagnostic yield, and management...
October 2016: Medicine (Baltimore)
Yoo Jin Choi, Kyung Su Kim, Gil Joon Suh, Woon Yong Kwon
OBJECTIVE: This study compared the diagnostic accuracy of computed tomography (CT) angiography in patients with various severities of gastrointestinal hemorrhage (GIH). METHODS: We retrospectively enrolled adult patients (n=262) with GIH who had undergone CT angiography from January 2012 to December 2013. Age, sex, comorbidities, presenting symptoms, initial vital signs, laboratory results, transfusion volume, emergency department disposition, and hospital mortality were abstracted from patient records...
June 2016: Clin Exp Emerg Med
Jungyoup Lee, Kyuseok Kim, You Hwan Jo, Jae Hyuk Lee, Joonghee Kim, Heajin Chung, Ji Eun Hwang
Resuscitative endovascular balloon occlusion of the aorta (REBOA) was developed for controlling intra-abdominal arterial bleeding before definitive bleeding control, and is commonly used in patients with ruptured abdominal aortic aneurysms. Although there is limited evidence for other uses of REBOA, we used REBOA in a patient with massive gastrointestinal bleeding. A 53-year-old man with hematochezia was admitted to our emergency department with an initial systolic blood pressure (SBP) of 83 mmHg. His SBP decreased to 40 mmHg in 10 minutes despite rapid fluid infusion...
March 2016: Clin Exp Emerg Med
X R Feng, M L Liu, F Liu, Y Fan, Q P Tian
OBJECTIVE: To assess the consequences of switching aspirin dosage from 100 mg/d to 40 mg/d on cardiovascular benefit, bleeding risk and platelet aggregation in very elderly patients. METHODS: Arachidonic acid induced platelet aggregation(AA-Ag) was measured in 537 patients aged 80 or older treated with aspirin (100 mg/d). In the study, 100 patients with low on-treatment platelet aggregation and at high risk of bleeding and low risk of cardiovascular events, were switched to aspirin (40 mg/d) and their platelet aggregation was measured again 7 days later...
October 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Mohammad Minakari, Shervin Badihian, Pooyan Jalalpour, Vahid Sebghatollahi
BACKGROUND AND AIM: Upper gastrointestinal bleeding (UGIB) is a threatening condition leading to urgent hospitalization. This study aims to investigate etiology and outcome in UGIB patients in Iran. METHODS: Medical records of GIB patients admitted to Alzahra referral hospital (in Isfahan) during 2010-2015 were retrospectively reviewed for demographic data, comorbidities, history of smoking and taking non-steroidal anti-inflammatory drugs (NSAIDs), presenting symptoms, endoscopic findings, therapeutic endoscopy, blood products' infusion, surgical intervention and mortality...
October 17, 2016: Journal of Gastroenterology and Hepatology
Martin Strömdahl, Johan Helgeson, Evangelos Kalaitzakis
OBJECTIVE: To assess the occurrence, clinical predictors, and associated mortality of all-cause emergency readmissions after acute upper gastrointestinal bleeding (AUGIB). PATIENTS AND METHODS: All patients with AUGIB from an area of 600 000 inhabitants in Sweden admitted in a single institution in 2009-2011 were retrospectively identified. All medical records were scrutinized and relevant data (such as comorbid illness and medications, endoscopy, rebleeding, inhospital mortality, and 30-day emergency readmission) were extracted...
September 30, 2016: European Journal of Gastroenterology & Hepatology
Alan N Barkun, Viviane Adam, Yidan Lu, Yen-I Chen, Myriam Martel
GOALS: We compared the cost-effectiveness of traditional recommended endoscopic hemostatic therapies and Hemospray alone or in combination when treating nonvariceal upper gastrointestinal bleeding (NVUGIB). BACKGROUND: Hemospray (TC-325) is a novel endoscopic hemostatic powder, achieving hemostasis through adherence to actively bleeding biological surfaces. STUDY: A decision tree of patients with NVUGIB assessed 4 possible treatment strategies: traditional therapy alone (T), Hemospray alone (H), traditional therapy completed by Hemospray if needed (T+H), or Hemospray completed by traditional therapy if needed (H+T)...
October 4, 2016: Journal of Clinical Gastroenterology
Peter Witters, Dominic Hughes, Palaniswamy Karthikeyan, Somashekara Ramakrishna, Mark Davenport, Anil Dhawan, Tassos Grammatikopoulos
BACKGROUND AND AIMS: Variceal haemorrhage can be a life-threatening complication of chronic liver disease in children. There is limited evidence about the optimal prophylactic management and selection criteria of children who will benefit from upper gastrointestinal endoscopy. METHODS: Children presenting in our centre with suspected portal hypertension or gastrointestinal bleeding and undergoing their first oesophagogastroduodenoscopy between 2005-2012 were included...
October 4, 2016: Journal of Pediatric Gastroenterology and Nutrition
Yuka Minami-Kobayashi, Atsuo Yamada, Hirotsugu Watabe, Hirobumi Suzuki, Yoshihiro Hirata, Yutaka Yamaji, Haruhiko Yoshida, Kazuhiko Koike
BACKGROUND/AIM: The efficacy of flexible spectral imaging color enhancement (FICE) ch. 1 (F1) for the detection of ulcerative lesions and angioectasias in the small intestine with capsule endoscopy (CE) has been reported. In the present study, we evaluated whether F1 could detect incremental findings in patients with no findings in a standard review mode. PATIENTS AND METHODS: In total, 52 patients (age: 60.1 ± 15.3 years; 30 males) with obscure gastrointestinal bleeding (OGIB) who underwent CE and in whom no lesion was detected in the small intestine in the standard mode (first review) were enrolled...
September 2016: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Andrew A M Ibey, Derek Andrews, Barb Ferreira
The authors present a case in which a physical anomaly with an infusion pump resulted in an unforeseen fault that the nurse's attempts to resolve unknowingly exacerbated. This case study presents the first report in the literature to detail the difficulty in recreating a patient safety event using smart pump logs, support server continuous quality improvement (CQI) data, and the drug order entry system to elucidate the clinical scenario. A 75-year-old male patient presented to a major teaching hospital and was admitted to the intensive care unit (ICU) with a massive gastrointestinal bleed and myocardial infarction, then stabilized...
December 2016: Drug Saf Case Rep
ZhuYing Cai, Wei Yang, YingYing He, Qingge Chen, ShiQiang Wang, Xuming Luo, Xiongbiao Wang
An 87-year-old woman developed abdominal wall hematoma and upper gastrointestinal bleeding during treatment with cefoperazone/sulbactam for pneumonia. The woman received cefoperazone/sulbactam at 4.5 g twice daily for intravenous infusion. After 7 days, she developed sudden onset of left lower abdominal pain, associated with subcutaneous mass, and vomited a coffee-colored liquid. Investigations revealed a coagulation index abnormality and activated partial thromboplastin time and prothrombin time increased obviously...
December 2016: Drug Saf Case Rep
Amr Shaaban Hanafy, Amr Talaat El Hawary
Objectives: Evaluation of the outcome and experience in 2 years of management of portal hypertensive gastropathy (PHG) by argon plasma coagulation (APC) in a cohort of Egyptian cirrhotic patients. Methods: This study was conducted over a 2-year period from January 2011 to February 2013. Upper gastrointestinal endoscopy was performed to evaluate the degree and site of PHG. APC was applied to areas with mucosal vascular lesions. Results: In total, 200 cirrhotic patients were enrolled; 12 patients were excluded due to death (n = 6) caused by hepatic encephalopathy (n = 3), hepatorenal syndrome (n = 2), or chronic lymphatic leukemia (n = 1), or did not complete the treatment sessions (n = 6), so 188 patients completed the study...
October 2016: Endoscopy International Open
Emmanuel Akintoye, Nitin Kumar, Hiroyuki Aihara, Hala Nas, Christopher C Thompson
Background and study aims: Endoscopic submucosal dissection (ESD) is an advanced endoscopic technique that allows en-bloc resection of gastrointestinal tumor. We systematically review the medical literature in order to evaluate the safety and efficacy of colorectal ESD. Patients and methods: We performed a comprehensive literature search of MEDLINE, EMBASE, Ovid, CINAHL, and Cochrane for studies reporting on the clinical efficacy and safety profile of colorectal ESD. Results: Included in this study were 13833 tumors in 13603 patients (42 % female) who underwent colorectal ESD between 1998 and 2014...
October 2016: Endoscopy International Open
Jun Yamanouchi, Takaaki Hato, Sanshiro Shiraishi, Kazuto Takeuchi, Yoshihiro Yakushijin, Masaki Yasukawa
Vancomycin-induced thrombocytopenia is a rare adverse reaction that may be overlooked because no specific diagnostic test is currently available. We herein report a patient with vancomycin-induced immune thrombocytopenia who was diagnosed by the detection of vancomycin-dependent anti-platelet antibody with flow cytometry. An IgG antibody in the patient's serum reacted with platelets only in the presence of vancomycin. Severe thrombocytopenia gave rise to life-threatening gastrointestinal bleeding, which was quickly resolved after effective platelet transfusion following the cessation of vancomycin administration...
2016: Internal Medicine
Ari Garber, Sunguk Jang
Non-variceal upper gastrointestinal bleeding, the most common etiology of which is peptic ulcer disease, remains a persistent challenge despite a reduction in both its incidence and mortality. Both pharmacologic and endoscopic techniques have been developed to achieve hemostasis, with varying degrees of success. Among the pharmacologic therapies, proton pump inhibitors remain the mainstay of treatment, as they reduce the risk of rebleeding and requirement for recurrent endoscopic evaluation. Tranexamic acid, a derivative of the amino acid lysine, is an antifibrinolytic agent whose role requires further investigation before application...
September 2016: Clinical Endoscopy
André Gonçalves, Marinho Almeida, Luís Malheiro, J Costa-Maia
INTRODUCTION: Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. The perforation of a Meckel's diverticulum by a foreign body is a very rare complication. CASE PRESENTATION: A 61-year-old male presented to the Emergency Department with complaints with abdominal pain and fever, and abdominal rebound tenderness on physical examination. An intestinal perforation by a foreign body was diagnosed by CT scan. The patient was submitted to a diagnostic laparoscopy and a perforation of a Meckel's diverticulum by a foreign body was identified...
September 7, 2016: International Journal of Surgery Case Reports
Snehal R Patel, Shivank Madan, Omar Saeed, Mohammed Algodi, Anne Luke, Marc Gibber, Daniel J Goldstein, Ulrich P Jorde
OBJECTIVES: This study sought to determine whether the nasal mucosa can serve as a surrogate for evaluating arteriovenous malformations (AVMs) related gastrointestinal (GI) bleeding in patients supported by continuous flow left ventricular assist devices (CF LVADs). BACKGROUND: Bleeding from the mucosal surfaces of GI tract, particularly AVMs, is the most common complication of CF LVAD support. The pathophysiology of AVM formation during CF LVAD support is of critical interest yet poorly understood; in large part because of the length and accessibility of the GI tract...
September 29, 2016: JACC. Heart Failure
Mehmet Bosnak, Seher Erdogan, E Habibe Aktekin, Ali Bay
We report two children who were diagnosed as having primary hemophagocytic syndrome and who successfully underwent therapeutic plasma exchange (TPE). The first patient was a 6-month-old girl diagnosed with HLH who was admitted to the pediatric intensive care unit. The patient's clinical condition worsened on the 9th day of the HLH-2004 treatment protocol. Her ferritin level was found 50.000 ng/mL, and TPE was performed for 9 sessions, after which her clinical condition and laboratory findings improved. The patient is still on the HLH-2004 protocol and waits for a suitable stem cell transplantation donor...
September 28, 2016: Transfusion and Apheresis Science
Simardeep Gill, Min Jun, Pietro Ravani
The prevalence of atrial fibrillation and the risk of stroke display an age-related increase in the chronic kidney disease (CKD) population. Evidence from large randomized controlled trials conducted in the general population supports the use of anticoagulation to reduce the risk of stroke in the setting of non-valvular atrial fibrillation. However, data in the non-dialysis-dependent and dialysis-dependent CKD populations are limited largely to observational studies, which demonstrate conflicting results regarding the risk-benefit profile of anticoagulation...
October 14, 2016: Nephrology, Dialysis, Transplantation
Sagar Pandey, Miao Fan, Zhe Xu, Chaogui Yan, Junfeng Zhu, Xiuhong Li
INTRODUCTION: Meckel diverticulum (MD) is the most common congenital abnormality of gastrointestinal tract. Tough believed to occur in 2% of population, most of them remain veiled because majority are clinically asymptomatic and remain obscure in radiological examination. CLINICAL FINDINGS AND DIAGNOSIS: A 26-year-old male with episodic black colored stool since last 10 years. Tough symptomatic, diagnosis of pathological lesion, and the bleeding site could not be established with any of the sophisticated diagnostic technique...
October 2016: Medicine (Baltimore)
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