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Ulcer Bleed

Anis Hasnaoui, Raja Jouini, Dhafer Haddad, Haithem Zaafouri, Ahmed Bouhafa, Anis Ben Maamer, Ehsen Ben Brahim
BACKGROUND: Since the advent of immunohistochemistry for the diagnosis of stromal tumours, the incidence of leiomyosarcomas has significantly decreased. Nowadays, gastric leiomyosarcoma is an exceptionally rare tumour. We report the second case in the English literature of gastric leiomyosarcoma revealed with massive bleeding and hemodynamic instability and diagnostic pitfalls that we encountered. CASE PRESENTATION: A 63-year-old woman, with 2 years' history of dizziness and weakness probably related to an anaemic syndrome, presented to the emergency room with hematemesis, melena and hemodynamic instability...
August 17, 2018: BMC Surgery
Vijay Gayam, Amrendra Kumar Mandal, Mazin Khalid, Jaspreet Kaler, Shivani Thapa, Pavani Garlapati, Arshpal Gill, Ragin Alex, Binav Shrestha
Systemic lupus erythematosus (SLE) is a chronic inflammatory disease which can manifest in many different organ systems. Gastrointestinal (GI) involvement is common in SLE, but the symptoms are usually mild. More severe GI complications including acute pancreatitis and peptic ulcer bleeding are rare but represent a significant risk of morbidity and mortality. We present a case of a 25-year-old Hispanic female with a severe SLE flare. The initial presentation included symptoms of hematemesis and epigastric abdominal pain secondary to both gastric ulceration and acute pancreatitis, an atypical presentation of an SLE flare...
August 2018: Gastroenterology Research
S A Sovtsov
AIM: To improve immediate results in patients with acute ulcerative gastroduodenal bleeding. MATERIAL AND METHODS: The study enrolled 91 patients with ulcerative gastroduodenal bleeding. RESULTS: Diagnostic and curative procedures should be related to hospital's equipment, specialists' qualification and comprehensive development and application of accepted tactical approaches. 20-year development of this protocol which includes original low-temperature irrigator of stomach and duodenal mucous membranes, objective choice of endoscopic hemostasis technique depending on bleeding source in gastroduodenal wall, early administration of proton pump inhibitors significantly increases efficacy and reliability of endoscopic hemostasis...
2018: Khirurgiia
Jamil M Shah, Abul B Shahidullah
Gastrostomy tube placement is a well-known procedure for obtaining permanent enteral access and providing long-term nutritional support. Although it is usually well tolerated, a diverse array of complications can occur. A rare, and often unrecognized, complication of gastrostomy tube placement is upper gastrointestinal bleeding secondary to a gastric ulcer caused by pressure from a gastrostomy tube bumper or balloon. Here, we present a case of an elderly woman who experienced hematemesis and bleeding around the gastrostomy site...
June 11, 2018: Curēus
F A Offner, C Langner
Heterotopia of the gastrointestinal tract is a common finding. This is due to the complex embryogenesis and the relative ease to detect heterotopic tissue during endoscopy. The reason for biopsy is mostly to rule out neoplasms or to define specific causes of inflammation. Heterotopic tissue can occur in any location of the gastrointestinal tract. The most frequent are gastric heterotopia, pancreatic heterotopia, and heterotopia of Brunner's gland. On rare occasions, heterotopic tissue of salivary gland type as well as heterotopias of apocrine glands, thyroid, and prostatic tissue have been described...
August 13, 2018: Der Pathologe
Henry H Nguyen, Robert Bechara, William G Paterson, Lawrence C Hookey
Background and aims:  Rectal bleeding affects ~15 % of the general population and is a common reason for referral to gastroenterologists by primary care physicians. Direct to procedure flexible sigmoidoscopy is an appealing modality to investigate rectal bleeding due its diagnostic yield, safety profile, and accessibility. Patients referred on a routine basis for direct to procedure clinic by primary care physicians with the sole complaint of rectal bleeding have not previously been studied...
August 2018: Endoscopy International Open
Paul M Reynolds, Rob MacLaren
STUDY OBJECTIVE: As recent studies have challenged the efficacy of stress ulcer prophylaxis (SUP) in the critically ill patient, the objective of this study was to evaluate the efficacy of SUP with proton pump inhibitors (PPIs) or histamine2 receptor antagonists (H2 RAs) against placebo, control, no therapy, or enteral nutrition alone in critically ill adults. DESIGN: Meta-analysis with trial sequential analysis (TSA) of 34 randomized controlled trials. PATIENTS: A total of 3220 critically ill adults who received PPIs or H2 RAs versus placebo, control, no therapy, or enteral nutrition...
August 13, 2018: Pharmacotherapy
Polychronis Gatos-Gatopoulos, Georgios Tziatzios, Paraskevas Gkolfakis, Konstantinos Triantafyllou
Endoscopic placement of self-expandable metal stent (SEMS) is an efficient method for the palliative decompression of malignant gastro duodenal obstruction. However, its role in treating benign obstructive conditions is controversial. We herein present an unusual case of recurrent upper gastrointestinal (GI) bleeding episodes due to ischemic lesions induced by an uncovered SEMS placed several years before to treat post peptic ulcer pyloric obstruction. Patient's advanced age precluded any attempt for endoscopic or surgical removal of the stent and the patient was successfully treated only with proton pump inhibitors, remaining uneventful on the long term...
July 2018: Annals of Translational Medicine
Leon M T Dicks, Lasse S Mikkelsen, Erik Brandsborg, Harold Marcotte
Clostridium difficile is normally present in low numbers in a healthy adult gastro-intestinal tract (GIT). Drastic changes in the microbial population, e.g., dysbiosis caused by extensive treatment with antibiotics, stimulates the growth of resistant strains and the onset of C. difficile infection (CDI). Symptoms of infection varies from mild diarrhea to colitis (associated with dehydration and bleeding), pseudomembranous colitis with yellow ulcerations in the mucosa of the colon, to fulminant colitis (perforation of the gut membrane), and multiple organ failure...
August 6, 2018: Current Microbiology
Shahrad Hakimian, Salmaan Jawaid, Yurima Guilarte-Walker, Jomol Mathew, David Cave
Background and study aims:  Video capsule endoscopy (VCE) is a minimally invasive tool that helps visualize the gastrointestinal tract from the esophagus to the right colon without the need for sedation or preparation. VCE is safe with very few contraindications. However, its role and safety profile in the intensive care unit (ICU) population have not been reported. The aim of this study is to evaluate the safety, efficacy, and feasibility of VCE use in ICU patients. Patients and methods:  We conducted a single-center retrospective observational study of patients who underwent VCE for evaluation of obscure overt gastrointestinal bleeding in the ICU between 2008 and 2016...
August 2018: Endoscopy International Open
Masayasu Horibe, Yuki Ogura, Juntaro Matsuzaki, Tetsuji Kaneko, Takuya Yokota, Osamu Okawa, Yukihiro Nakatani, Eisuke Iwasaki, Toshihiro Nishizawa, Naoki Hosoe, Tatsuhiro Masaoka, Naohisa Yahagi, Shin Namiki, Takanori Kanai
Background: The need for a blood transfusion, defined as hemoglobin < 70 g/L, is the measure for assessing the risk levels in patients with upper gastrointestinal bleeding (UGIB). However, not all patients with a low hemoglobin level have a poor prognosis. Objective: We assessed the clinical predictive factors associated with poor short-term prognosis in patients with a low hemoglobin level. Methods: In this prospective cohort study, all consecutive patients with suspected acute UGIB at Tokyo Metropolitan Tama Medical Center were enrolled between 2008 and 2015...
June 2018: United European Gastroenterology Journal
Mitsuru Esaki, Sho Suzuki, Yasuyo Hayashi, Azusa Yokoyama, Shuichi Abe, Taizo Hosokawa, Shinichi Tsuruta, Yosuke Minoda, Yoshitaka Hata, Haruei Ogino, Hirotada Akiho, Eikichi Ihara, Yoshihiro Ogawa
BACKGROUND: Endoscopic submucosal dissection (ESD) of the postoperative stomach (ESD-P) for early gastric cancer (EGC) is considered a technically difficult procedure. However, it is difficult to compare the outcomes of ESD-P and ESD of the non-operative stomach (ESD-N) because their baseline characteristics are different. Therefore, we aimed to compare the technical outcomes of ESD-P with those of ESD-N using a propensity score-matching analysis to compensate for the differences. METHODS: The chart records of 1046 patients with EGC who were treated with ESD between January 2004 and July 2016 at Kitakyushu Municipal Medical Center in Japan were reviewed in this retrospective study...
August 6, 2018: BMC Gastroenterology
Hitomi Takechi, Nobuaki Fujikuni, Yuki Takemoto, Kazuaki Tanabe, Hironobu Amano, Toshio Noriyuki, Masahiro Nakahara
INTRODUCTION: Laparoscopic and endoscopic cooperative surgery (LECS) is a minimally invasive hybrid procedure that facilitates the precise dissection of gastrointestinal malignancies. We report the use of LECS as palliative treatment for a patient with advanced gastric cancer at a high risk due to comorbidities. PRESENTATION OF CASE: A 68-year-old woman with general malaise was admitted to the hospital and received multiple transfusions for anemia. Endoscopy examination detected an ulcerative lesion in the stomach...
July 21, 2018: International Journal of Surgery Case Reports
David Itskoviz, Ben Ben Avraham, Hagar Banai, Irit Avni, Tuvia Ben Gal, Iris Dotan, Eyal Gal
INTRODUCTION: Suspected small bowel bleeding is frequently encountered in left ventricular assist device recipients and the identification of the culprit lesion may be challenging. Data regarding the safety and yield of small bowel capsule in the investigation of suspected small bowel bleeding are limited. We aimed to evaluate the safety and efficacy of small bowel video capsule endoscopy for the investigation of suspected small bowel bleeding among left ventricular assist device recipients...
August 3, 2018: International Journal of Artificial Organs
Patrick D Melmer, Trenton Banks, Sharon Holmes, Jason D Sciarretta, John Mihran Davis
The number of patients being treated surgically for gastroduodenal disease has decreased over the past five decades as a result of focus on medical treatment. However, perforated and bleeding peptic ulcer disease (PUD) continues to represent a significant percentage of patients who require emergency surgery. The aim of this study was to characterize these critically ill surgical patients treated for gastroduodenal disease in our hospital. A retrospective, single-center, consecutive cohort study of all patients identified from the hospital National Surgical Quality Improvement Program database who were admitted to our institution requiring emergent surgical intervention over the past two years was conducted...
July 1, 2018: American Surgeon
E Alnuaimi, M Al Halabi, A Khamis, M Kowash
AIM: The aim of this study was to estimate the prevalence of oral health problems in leukaemic paediatric patients in the United Arab Emirates (UAE) and correlate it to the phase of chemotherapy. MATERIALS AND METHODS: Medical records of 120 paediatric leukaemic patients (age below 15 years) in the UAE were reviewed for the occurrence of oral health problems. Records from the three main hospitals that provide cancer therapy were accessed after obtaining the required permissions...
September 2018: European Journal of Paediatric Dentistry: Official Journal of European Academy of Paediatric Dentistry
Ujjal Poddar
BACKGROUND: There is a lack of clarity about the approach to and management of upper gastrointestinal (UGI) bleeding in children. AIM: To examine the recent literature on UGI bleeding in children in order to outline the diagnostic approach and management. METHODS: The English language literature was searched for articles on UGI bleeding in children. Special attention was paid to its prevalence, risk factors, clinical approach and management...
July 30, 2018: Paediatrics and International Child Health
Haruhisa Suzuki, Kohei Takizawa, Toshiaki Hirasawa, Yoji Takeuchi, Kenji Ishido, Shu Hoteya, Tomonori Yano, Shinji Tanaka, Masaki Endo, Masahiro Nakagawa, Takashi Toyonaga, Hisashi Doyama, Kingo Hirasawa, Mitsuru Matsuda, Hironori Yamamoto, Mitsuhiro Fujishiro, Satoru Hashimoto, Yuki Maeda, Tsuneo Oyama, Ryuta Takenaka, Yoshinobu Yamamoto, Yuji Naito, Tomoki Michida, Nozomu Kobayashi, Yoshiro Kawahara, Masaaki Hirano, Mario Jin, Shinichiro Hori, Yasumasa Niwa, Takuto Hikichi, Taichi Shimazu, Hiroyuki Ono, Satoshi Tanabe, Hitoshi Kondo, Hiroyasu Iishi, Motoki Ninomiya, Ichiro Oda
OBJECTIVES: A Japanese multicenter prospective cohort study examining endoscopic resection (ER) for early gastric cancer (EGC) has been conducted using a Web registry developed to determine the short-term and long-term outcomes based on absolute and expanded indications. We hereby present the short-term outcomes of this study. METHODS: All consecutive patients with EGC or suspected EGC undergoing ER at 41 participating institutions between July 2010 and June 2012 were enrolled and prospectively registered in the Web registry...
July 30, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Byoung Wook Bang, Don Haeng Lee, Hyung Kil Kim, Kye Sook Kwon, Yong Woon Shin, Su Jin Hong, Jong Ho Moon
BACKGROUND: Endoscopically applicable hemostatic agents have been demonstrated to have high initial hemostasis rates in cases of upper gastrointestinal bleeding (UGIB). AIMS: The authors developed a new hemostatic powder (CEGP-003) and evaluated its hemostatic and ulcer healing effects in UGIB. METHODS: Patients with peptic ulcer or post-endoscopic resection bleeding were randomly assigned to be treated by epinephrine injection or CEGP-003 spray...
July 27, 2018: Digestive Diseases and Sciences
Christophoros S Kosmidis, Georgios D Koimtzis, Georgios Anthimidis, Nikolaos Varsamis, Stefanos Atmatzidis, Ioannis S Koskinas, Triantafyllia Koletsa, Katerina Zarampouka, Eleni Georgakoudi, Sofia Baka, Christophoros Efthimiadis, Maria S Kosmidou, Georgios Kouklakis
BACKGROUND The first gastric resection for stomach cancer was performed in 1879, and the first gastric resection for gastric ulcer disease was performed in 1882. During the 1990s, the first laparoscopic gastrostomies were reported. During the past decade, laparoscopic techniques have developed rapidly, gaining wide clinical acceptance. Minimally invasive surgery is now shifting the balance away from traditional open methods. We report 2 cases of endoscopically assisted laparoscopic local gastric resections for both gastric cancer and gastric ulcer disease...
July 28, 2018: American Journal of Case Reports
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