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surgical treatment of upper gastrointestinal haemorrhage

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https://www.readbyqxmd.com/read/29920412/unusual-site-for-primary-arterio-enteric-fistula-resulting-in-massive-upper-gastrointestinal-bleeding-a-case-report-on-presentation-and-management
#1
Anthony Pio Dimech, Matthew Sammut, Kelvin Cortis, Nebosja Petrovic
INTRODUCTION: Communications between an artery and the bowel are termed arterio-enteric fistulae. These are uncommon and mainly involve the aorta and duodenum. They can cause fatal haemorrhage. A primary aorto-enteric fistula has several aetiologies, one of which is post-radiotherapy. CASE REPORT: 75-year old gentleman presented with acute upper gastrointestinal bleeding and haemorrhagic shock. He had a past history of right colonic cancer treated by resection and radiotherapy...
2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29894924/surgical-treatment-of-postoperative-laparostomy-and-pyloroduodenostomy-case-report
#2
António Bernardes, Catarina Melo, Sandra Ferraz
INTRODUCTION: Postoperative duodenal-cutaneous fistula represents a rare and very complex problem. In most cases operative management becomes necessary, but only after local and systemic stabilization and sepsis control. CASE PRESENTATION: A 39-year-old man was admitted for surgical management of laparostomy and pyloro-duodenostomy of the first (DI) and second (DII) duodenal segments with one year of evolution, as a complication of several surgical interventions...
2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27888865/advances-in-gastrointestinal-bleeding
#3
Ángel Lanas
The main innovations of the latest meeting of the Gastroenterological Association (2016) concerning upper gastrointestinal bleeding from the clinician's perspective can be summarised as follows: a) The Glasgow-Blatchford scale has the best accuracy in predicting the need for surgical intervention and hospital mortality; b) Prognostic scales for non-variceal upper gastrointestinal bleeding are also useful for lower gastrointestinal bleeding; c) Preliminary data suggest that treatment with hemospray does not seem to be superior to current standard treatment in controlling active peptic ulcer bleeding; d) Either famotidine or a proton pump inhibitor may be effective in preventing haemorrhagic recurrence in patients taking aspirin, but this finding needs to be confirmed in further studies; e) There was confirmation of the need to re-introduce antiplatelet therapy as early as possible in patients with antiplatelet-associated gastrointestinal bleeding in order to prevent cardiovascular mortality; f) Routine clinical practice suggests that gastrointestinal or cardiovascular complications with celecoxib or traditional NSAIDs are very low; g) Dabigatran is associated with an increased incidence of gastrointestinal bleeding compared with apixaban or warfarin...
September 2016: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/26592837/refractory-gastric-antral-vascular-ectasia-a-new-endoscopic-approach
#4
C Zulli, A Del Prete, M Romano, F Esposito, M R Amato, P Esposito
Gastric antral vascular ectasia (GAVE) is an uncommon disorder observed in patients with liver cirrhosis, causing upper gastro-intestinal haemorrhage. GAVE is diagnosed through esophagogastroduodenoscopy and is characterized by the presence of visible columns of red tortuous enlarged vessels along the longitudinal folds of the antrum (i.e., so-called watermelon stomach). Pharmacological, endoscopic and surgical approaches have been proposed for the treatment of GAVE. Endoscopy represents the gold standard for GAVE treatment...
November 2015: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/26291047/laparoscopic-management-of-a-cystic-artery-pseudoaneurysm-in-a-patient-with-calculus-cholecystitis
#5
Sofronis Loizides, Asad Ali, Richard Newton, Krishna Kumar Singh
INTRODUCTION: Pseudoaneurysm of the cystic artery is very rare. In the majority of cases it has been reported as a post-operative complication of laparoscopic cholecystectomy, however it has also been associated with the presence of acute cholecystitis or pancreatitis. When these pseudoaneurysms rupture they can lead to intraperitoneal bleeding, haemobilia and upper gastrointestinal haemorrhage. Radiological as well as open surgical approaches have been described for control of this rare pathology...
2015: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/26011833/can-the-principles-of-oncological-surgery-be-complied-with-in-haemorrhagic-gastric-cancer
#6
COMPARATIVE STUDY
X Pucheanu, M Beuran
AIM: To discover if in the case of bleeding gastric cancer the principles of oncological surgery could be applied to gastric cancer. METHODS: We studied two groups of patients, one with haemorrhagic gastric cancer and the second with uncomplicated gastric cancer. We took into account gender, age, number of days from admission to surgery, tumour location, type of intervention,haemoglobin on admission, haemorrhage externalization pathway, comorbidities, intervention type, extension of lymphadenectomy, stage, tumour type degree of differentiation there of, number of excised lymph nodes, perineural and vascular invasion, preoperative transfusion, postoperative complications, deaths...
March 2015: Chirurgia
https://www.readbyqxmd.com/read/25177367/management-of-variceal-and-nonvariceal-upper-gastrointestinal-bleeding-in-patients-with-cirrhosis
#7
REVIEW
Isabelle Cremers, Suzane Ribeiro
Acute upper gastrointestinal haemorrhage remains the most common medical emergency managed by gastroenterologists. Causes of upper gastrointestinal bleeding (UGIB) in patients with liver cirrhosis can be grouped into two categories: the first includes lesions that arise by virtue of portal hypertension, namely gastroesophageal varices and portal hypertensive gastropathy; and the second includes lesions seen in the general population (peptic ulcer, erosive gastritis, reflux esophagitis, Mallory-Weiss syndrome, tumors, etc...
September 2014: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/24960815/selective-embolization-for-massive-upper-gastrointestinal-bleeding-deriving-from-gastric-angiodysplasia
#8
G Vrakas, M-G Pramateftakis, D Raptis, D Kanellos, I Kanellos
Transcatheter arterial embolization is a valuable, minimally invasive method, used as treatment for upper gastrointestinal bleeding, after failed primary endoscopic approach. It is a safe and effective procedure, but it's use is limited because of relatively high rates of rebleeding and mortality. The aim of this paper is to present a case of severe, massive upper gastrointestinal bleeding deriving from gastric angiodysplasia, which was treated successfully with superselective embolization. The patient recovered from the haemorrhagic shock and avoided emergency surgical intervention...
2012: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/24824909/-upper-gastrointestinal-bleeding-and-haemorrhagic-shock-at-the-end-of-the-holidays-pre-hospital-and-in-hospital-management-of-a-gastrointestinal-emergency
#9
M Nguyen-Tat, A Hoffman, J U Marquardt, H Buggenhagen, T Münzel, W Kneist, P R Galle, R Kiesslich, J W Rey
Upon returning from holidays, a 55-year-old patient presenting with melena and haemorrhagic shock was admitted to a University hospital after receiving first emergency medical care in a German InterCity train. In an interdisciplinary effort, haemodynamics were stabilised and the airway and respiratory function were secured. Under emergency care conditions the patient then underwent an emergency upper GI endoscopy where a spurting arterial upper gastrointestinal bleeding (Forrest 1a) was found. While the bleeding could not be controlled with endoscopic techniques, definitive haemostasis was achieved with a surgical laparotomy...
May 2014: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/24478930/gastric-antral-vascular-ectasia-gave-in-two-non-cirrhotic-patients-involved-large-area-of-stomach-case-report-and-literature-review
#10
Fengli Liu, Feng Ji, Xi Jin, Yechun Du
Gastric antral vascular ectasia (GAVE) is a rare clinical disease which can cause recurrent upper gastrointestinal (GI) tract bleeding. It is responsible for about 4% of non-variceal upper GI haemorrhages. GAVE was also named as watermelon stomach (WS) for its characteristic endoscopic performance. Though the etiology of GAVE is unknown, it received several presumptions according to its histopathological features. Treatments of GAVE can be separated into three categories: pharmacologic, endoluminal, and surgical approaches...
July 2013: Journal of Interventional Gastroenterology
https://www.readbyqxmd.com/read/24394852/a-rare-cause-of-upper-gastrointestinal-haemorrhage-ruptured-cystic-artery-pseudoaneurysm-with-concurrent-cholecystojejunal-fistula
#11
Michael A Glaysher, David Cruttenden-Wood, Karoly Szentpali
INTRODUCTION Cystic artery pseudoaneurysms and cholecystoenteric fistulae represent two rare complications of gallstone disease. PRESENTATION OF CASE An 86 year old male presented to the emergency department with obstructive jaundice, RUQ pain and subsequent upper gastrointestinal bleeding. Upper GI endoscopy revealed bleeding from the medial wall of the second part of the duodenum and a contrast-enhanced computed tomography scan revealed a cystic artery pseudoaneurysm, concurrent cholecystojejunal fistula and gallstone ileus...
2014: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/24363942/gastric-lipoma-presenting-with-massive-upper-gastrointestinal-bleeding
#12
Michael J Ramdass, Sanjana Mathur, Panduranga Seetahal-Maraj, Shaheeba Barrow
A case of massive upper gastrointestinal bleeding in a 37-year-old female is presented showing a submucosal mass in the gastric body. At laparotomy a pedunculated submucosal mass was found located on the posterior wall at the junction of the body and antrum of the stomach, 8 cm from the pylorus. Pathology confirmed that it was a 4 cm benign gastric lipoma with a bleeding central ulcer. Gastric lipomas are rare, benign, typically submucosal tumors occurring in the gastric antrum. They are usually asymptomatic but can become symptomatic depending on size, location, and if there is ulceration of the lesion...
2013: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/23944102/-embolization-procedures-in-acute-haemorrhage-from-upper-gastrointestinal-tract
#13
Tadeusz J Popiela, Paweł Brzegowy, Anna Paciorek
Perioperative mortality in the pa tients with acute haemorrhage from upper gastrointestinal tract undergo ng unsuccessful routine endoscopic procedures is relatively high. The study evaluates the effective ness of upper gastrointestinal tract arterial vessels embolization as the alternative procedure to surgery. The analyses was conducted in 48 patients who underwent unsuccessful endoscopic procedures. All patients were subjected to diagnostic angiogra phy, which allowed to localize or con firm the haemorrhage site in 37 (77%) cases...
2013: Przegla̧d Lekarski
https://www.readbyqxmd.com/read/23916664/does-concentration-of-surgical-expertise-improve-outcomes-for-laparoscopic-cholecystectomy-9-year-audit-cycle
#14
S Andrews
BACKGROUND: Evidence from surgery shows that high volume is often associated with better outcomes. The aim of this study was to investigate this principle related to elective laparoscopic cholecystectomy practice. METHODS: A retrospective analysis of all conversions and complications for patients undergoing elective laparoscopic cholecystectomy was performed. Data was collected and then repeated after restrictions were implemented to concentrate practice. Hospital databases and patient notes were used to collect data...
December 2013: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/23856254/upper-gastrointestinal-bleeding-a-rare-complication-of-acute-cholecystitis
#15
Gael R Nana, Matthew Gibson, Archie Speirs, James R Ramus
INTRODUCTION: Haemobilia is a rare complication of acute cholecystitis and may present as upper gastrointestinal bleeding. PRESENTATION OF CASE: We describe two patients with acute cholecystitis presenting with upper gastrointestinal bleeding due to haemobilia. Bleeding from the duodenal papilla was seen at endoscopy in one case but none in the other. CT demonstrated acute cholecystitis with a pseudoaneurysm of the cystic artery in both cases. Definitive control of intracholecystic bleeding was achieved in both cases by embolisation of the cystic artery...
2013: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/23770528/varices-of-the-descending-duodenum-explored-during-emergency-gastro-duodenal-resection-for-upper-gastrointestinal-haemorrhage-case-report
#16
Sławomir Rudzki, Tadeusz Dryka, Piotr Wilczyński, Paweł Bernat, Jacek Bicki, Jacek Furmaga, Jacek Piłat
Upper gastrointestinal haemorrhage is a major medical emergency and accounts for approximately 7,000 admissions to hospitals in Scotland each year. Over the last 10 years there has been a number of improvements in diagnosis and conservative management of the condition, which significantly reduced the ratio of life-threatening cases requiring an emergency surgery. Despite these achievements surgical intervention or, if accessible, endovascular procedures must be undertaken as emergency actions, should conservative management fail...
May 2013: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/23452779/emergency-cholecystectomy-and-hepatic-arterial-repair-in-a-patient-presenting-with-haemobilia-and-massive-gastrointestinal-haemorrhage-due-to-a-spontaneous-cystic-artery-gallbladder-fistula-masquerading-as-a-pseudoaneurysm
#17
Hazrah Priya, Gupta Anshul, Tiwari Alok, Kale Saurabh, Nath Ranjit, Lal Romesh, Sharma Deborshi
BACKGROUND: Haemobilia usually occurs secondary to accidental or iatrogenic hepatobiliary trauma. It can occasionally present with cataclysmal upper gastrointestinal haemorrhage posing as a life threatening emergency. Haemobilia can very rarely be a complication of acute cholecystitis. Here we report a case of haemobilia manifesting as massive gastrointestinal haemorrhage in a patient without any prior history of biliary surgery or intervention and present a brief review of literature...
March 3, 2013: BMC Gastroenterology
https://www.readbyqxmd.com/read/23343578/gastroduodenal-major-haemorrhages-in-critical-patients-an-original-surgical-technique
#18
Francesco Cortese, Sara Colozzi, Roberto Marcello, Irnerio Angelo Muttillo, Francesco Giacovazzo, Matteo Nardi, Alessandro Mero
AIM: Upper gastrointestinal bleeding represents today a serious pathology with two important problems: mortality and correct management. Our study is a review of recent and past licterature about causes, diagnosis and treatment of upper gastrointestinal bleeding. PERSONAL EXPERIENCE: The Authors describe an original surgical technique in treating patients with gastroduodenal haemorrhages and critical circulatory-coagulative conditions. Any surgical resective procedure could be absolutely inacceptable for the rates in morbility and mortality in these absolutely instable patients...
November 2013: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/23330048/diagnosis-and-management-of-gastric-antral-vascular-ectasia
#19
Lorenzo Fuccio, Alessandro Mussetto, Liboria Laterza, Leonardo Henry Eusebi, Franco Bazzoli
Gastric antral vascular ectasia (GAVE) is an uncommon but often severe cause of upper gastrointestinal (GI) bleeding, responsible of about 4% of non-variceal upper GI haemorrhage. The diagnosis is mainly based on endoscopic pattern and, for uncertain cases, on histology. GAVE is characterized by a pathognomonic endoscopic pattern, mainly represented by red spots either organized in stripes radially departing from pylorus, defined as watermelon stomach, or arranged in a diffused-way, the so called honeycomb stomach...
January 16, 2013: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/22262326/choledocho-duodenal-fistula-encountered-during-emergency-laparotomy-for-upper-gastro-intestinal-haemorrhage-what-should-be-the-surgical-strategy
#20
N Periselneris, J J Bong
Surgery remains the gold standard for the treatment of bleeding peptic ulcer after failed endoscopic therapy. It is unusual to encounter a bilio-enteric fistula complicating peptic ulcer disease during the emergency surgery for bleeding. We report a case of a 67-year-old man who presented with haemetemesis and hypotension. After failed endoscopy, a laparotomy was performed. A choledocho-duodenal fistula and a Forrest IIA ulcer was encountered. The bleeding ulcer was underrun and a subtotal cholecystectomy was performed...
2011: La Clinica Terapeutica
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