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https://www.readbyqxmd.com/read/28218383/stereotactic-ablative-radiation-therapy-as-a-potential-curative-treatment-in-duodenal-adenocarcinoma-a-case-report
#1
Francesco Maria Aquilanti, Maria Cristina Barba, Federico Bianciardi, Barbara Tolu, Barbara Nardiello, Giorgio Hamid Raza, Randa El Gawhary, Chiara D'Ambrosio, PierCarlo Gentile
PURPOSE: One of the rarest gastrointestinal neoplasm is small bowel cancer. Experience with its treatment modalities is limited. Stereotactic ablative radiation therapy (SABR) has improved, with image-guided radiation therapy becoming a curative option in many tumors. Especially when surgery cannot be performed due to comorbidities, SABR provides a good toxicity profile and an excellent tumor control rate owing to its specific schedule: high dose on a limited and well-defined area. METHODS: An 83-year-old man had arterial hypertension and congestive cardiomyopathy, with recent history of upper abdominal pain, weight loss over 10 kg, and progressive severe fatigue...
February 11, 2017: Tumori
https://www.readbyqxmd.com/read/28211282/signet-ring-cell-carcinoma-of-the-jejunum-an-uncommon-finding-within-the-reach-of-capsule-endoscopy
#2
José Francisco Juanmartiñena, Marta Montes, Ignacio Fernández-Urién
An 80 year-old female presented with ductal breast carcinoma (stage II) three years ago, complained of asthenia and iron-deficiency anemia. No diagnosis was obtained after conventional endoscopy and iron supplements were indicated. Ten months later visible digestive hemorrhage was presented. Upper and lower endoscopy was repeated but non-diagnosis was obtained. Thus, video capsule endoscopy was indicated identifying a stenotic lesion arising in the mucosa of distal jejunum. Histopathological examination revealed a poorly mucinous differentiated signet-ring cell adenocarcinoma with an intense peri-tumoral lymphoid (Crohn´s-like lymphoid reaction) and lympho-vascular infiltration with no nodal metastases (pT3N0;7ª edition TNM classification)...
February 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28210867/management-and-outcome-of-gastrointestinal-bleeding-in-patients-taking-oral-anticoagulants-or-antiplatelet-drugs
#3
Sven Pannach, Julia Goetze, Sandra Marten, Thomas Schreier, Luise Tittl, Jan Beyer-Westendorf
BACKGROUND: Non-vitamin K dependent oral anticoagulants (NOACs) significantly decrease overall major bleeding rates compared with vitamin K antagonists (VKAs) but there is conflicting evidence regarding the relative risk of gastrointestinal bleeding. Since data regarding the types, the management, and the outcome of NOAC-associated gastrointestinal bleeding are scarce, we aimed to fill this gap by comparing cases of gastrointestinal bleeding associated with NOAC, VKA, or antiplatelet therapy...
February 16, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28205386/nonvariceal-upper-gastrointestinal-bleeding-in-the-elderly-clinical-outcomes-and-prognostic-factors
#4
Josè Alberto González-González, Roberto Monreal-Robles, Diego García-Compean, Jonathan Paz-Delgadillo, Martín Wah-Suárez, Héctor Jesús Maldonado-Garza
AIM: To analyze the clinical characteristics, outcomes and prognostic factors in elderly patients with acute nonvariceal upper gastrointestinal bleeding (UGIB). METHODS: From a database prospectively collected from 2006 to 2013, the clinical characteristics and outcomes of patients aged 75 years or older consecutively admitted with acute nonvariceal UGIB undergoing upper gastrointestinal endoscopy were compared with those younger than 75 years. RESULTS: There were1136 patients included in the study; 276 (24...
February 16, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28203131/brunner-s-gland-adenoma-a-rare-cause-of-gastrointestinal-bleeding-case-report-and-systematic-review
#5
Michele Sorleto, Annette Timmer-Stranghöner, Helge Wuttig, Oliver Engelhard, Carsten Gartung
Brunner's gland adenoma is an extremely rare benign small bowel neoplasm, often discovered incidentally during upper gastrointestinal endoscopy or radiological diagnostics. In few cases, it tends to cause gastrointestinal hemorrhage or intestinal obstruction. We report here our experience with a 47-year-old woman with a Brunner's gland adenoma of more than 6 cm in size, located in the first part of the duodenum and causing gastrointestinal bleeding. Initially, we performed a partial endoscopic resection using endoloop and snare alternatively to prevent severe bleeding...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28191810/gist-institutional-experience-at-srms-ims-india
#6
Shubhanshu Gupta, Keshri Amit, Ashish Gupta, Tanu Argawal
Gastro-Intestinal Stromal Tumors (GIST) is a malignant, non-epithelial, mesenchymal tumor of the digestive tract that is not uncommon in clinical practice nowadays; diagnosis being based upon immuno-histo-chemical analysis of the resected or biopsied (FNAC) specimen. Abdominal lump with or without intra-luminal bleed is a common mode of presentation. Early diagnosis and appropriate management with surgery and/or Imatinib therapy improves recurrence free survival and may impact overall survival. We present here our institutional experience of four patients, admitted in Onco-Surgery Dept...
September 2016: Gulf Journal of Oncology
https://www.readbyqxmd.com/read/28184273/hemoptysis-during-general-anesthesia-in-a-diabetic-patient-with-healed-tuberculosis-a-case-report
#7
Mee Young Chung, Hyeon-Do Jeong, Seul-Gi Kim, Chang Jae Kim
Hemoptysis is a common complication of pulmonary tuberculosis. Most of the cases of hemoptysis originate from hypertrophied bronchial arteries. Also, diabetes induces pulmonary vascular abnormalities such as endothelial dysfunction, inflammatory infiltration and pulmonary vascular remodeling. A 27-year-old male, with diabetes and a history of tuberculosis, underwent the procedure of pars plana vitrectomy under general anesthesia. After an uneventful intra-operative period, he had hemoptysis prior to extubation...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28184053/gastrointestinal-diseases-and-their-oro-dental-manifestations-part-4-peutz-jeghers-syndrome
#8
S E Korsse, M E van Leerdam, E Dekker
Peutz-Jeghers syndrome (PJS) is a rare, autosomal dominant inherited disorder, caused by germline mutations in the LKB1 tumour suppressor gene. It is clinically characterised by distinct perioral mucocutaneous pigmentations, gastrointestinal polyposis and an increased cancer risk in adult life. Hamartomatous polyps can develop already in the first decade of life and may cause various complications, including abdominal pain, bleeding, anaemia, and acute intestinal obstruction. Furthermore, patients have an increased risk for developing cancer, both in the gastrointestinal tract as in other organs...
February 10, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28174978/p130-ingestion-of-100ml-and-300ml-blood-mimicking-upper-gi-bleeding-leads-to-significant-calprotectin-elevation-in-healthy-volunteers-results-from-the-vampire-study
#9
S Vavricka, H Heinrich, B Misselwitz, S Buetikofer, E Burri, G Rogler, F Breitenmoser, X Schneider, J Zeitz, L Biedermann, M Sauter
No abstract text is available yet for this article.
February 1, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28168570/early-enteral-nutrition-in-critically-ill-patients-esicm-clinical-practice-guidelines
#10
REVIEW
Annika Reintam Blaser, Joel Starkopf, Waleed Alhazzani, Mette M Berger, Michael P Casaer, Adam M Deane, Sonja Fruhwald, Michael Hiesmayr, Carole Ichai, Stephan M Jakob, Cecilia I Loudet, Manu L N G Malbrain, Juan C Montejo González, Catherine Paugam-Burtz, Martijn Poeze, Jean-Charles Preiser, Pierre Singer, Arthur R H van Zanten, Jan De Waele, Julia Wendon, Jan Wernerman, Tony Whitehouse, Alexander Wilmer, Heleen M Oudemans-van Straaten
PURPOSE: To provide evidence-based guidelines for early enteral nutrition (EEN) during critical illness. METHODS: We aimed to compare EEN vs. early parenteral nutrition (PN) and vs. delayed EN. We defined "early" EN as EN started within 48 h independent of type or amount. We listed, a priori, conditions in which EN is often delayed, and performed systematic reviews in 24 such subtopics. If sufficient evidence was available, we performed meta-analyses; if not, we qualitatively summarized the evidence and based our recommendations on expert opinion...
February 6, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28167214/doppler-endoscopic-probe-monitoring-of-blood-flow-improves-risk-stratification-and-outcomes-of-patients-with-severe-non-variceal-upper-gastrointestinal-hemorrhage
#11
Dennis M Jensen, Thomas Og Kovacs, Gordon V Ohning, Kevin Ghassemi, Gustavo A Machicado, Gareth S Dulai, Alireza Sedarat, Rome Jutabha, Jeffrey Gornbein
BACKGROUND & AIMS: For 4 decades, stigmata of recent hemorrhages in patients with non-variceal lesions have been used for risk stratification and endoscopic hemostasis. The arterial blood flow that underlies the stigmata is rarely monitored, but can be used to determine risk for rebleeding. We performed a randomized controlled trial to determine whether Doppler endoscopic probe monitoring of blood flow improves risk stratification and outcomes in patients with severe non-variceal upper gastrointestinal hemorrhage...
February 3, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28154918/accessory-splenic-artery-a-rare-cause-of-upper%C3%A2-gastrointestinal-bleeding
#12
Shreyas R Patel, Stephen Lowe
Variations in the origin and branching pattern of splenic artery are relatively common and asymptomatic, but the presence of an accessory splenic artery, that too symptomatic, is quite rare. This report describes a 67-year-old male, with no history of liver disease, who presented with recurrent upper gastrointestinal bleeding and was found to have an accessory splenic artery arising from the left gastric artery with submucosal intragastric course and supplying the upper pole of the spleen.
February 2, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28141549/glomus-tumor-of-the-stomach-a-case-report-and-a-literature-review
#13
Mariusz Chabowski, Adam Paszkowski, Jerzy Skotarczak, Tadeusz Dorobisz, Michał Leśniak, Dawid Janczak, Dariusz Janczak
The study presented a case of a patient with a glomus tumor of the stomach, a mesenchymal neoplasm manifesting with upper gastrointestinal bleeding (Forrest IB). The patient was operated twice. First, he underwent elective laparotomy, during which Billroth I (Rydygier's method) gastric resection was performed. This his was followed by Billroth II resection with Braun's anastomosis. Histopathological examination revealed glomus tumor tissue. Literature data on the glomus tumor of the stomach are presented.
December 1, 2016: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28133153/-a-case-of-gist-in-the-small-intestine-diagnosed-via-ct-after-repeated-melena-and-removed-by-laparoscopy-assisted-surgery
#14
Hiroyuki Notani, Daisuke Asano, Naoto Fujiwara, Toru Kawamura, Yasushi Sato, Akira Nakashima
A 63-year-old man visited an emergency outpatient unit with the chief complaints of melena and lightheadedness. At the time of the visit, blood tests showed Hb of 4.3 g/dL, suggesting severe anemia, and he exhibited repeated melena, even after hospitalization. Small intestinal bleeding was suspected during endoscopic examination of the lower gastrointestinal tract, and abdominalCT examination suggested a 3.5 cm tumor-like lesion in the jejunum. He was diagnosed as having bleeding of a tumor in the small intestine and consequently underwent laparoscopic surgery...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28127205/factors-associated-with-complicated-erosive-esophagitis-a-japanese-multicenter-prospective-cross-sectional-study
#15
Masahiro Sakaguchi, Noriaki Manabe, Nobuo Ueki, Jun Miwa, Tomoki Inaba, Norimasa Yoshida, Kouichi Sakurai, Masahiro Nakagawa, Hajime Yamada, Michiya Saito, Koji Nakada, Katsuhiko Iwakiri, Takashi Joh, Ken Haruma
AIM: To assess the clinical characteristics of patients with complicated erosive esophagitis (EE) and their associated factors. METHODS: This prospective, cross-sectional study included patients diagnosed with EE by upper gastrointestinal endoscopy between October 2014 and March 2015 at 106 Japanese hospitals. Data on medical history, general condition, gastrointestinal symptoms, lifestyle habits, comorbidities, and endoscopic findings were collected using a standard form to create a dedicated database...
January 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28122752/optimizing-proton-pump-inhibitor-therapy-for-treatment-of-nonvariceal-upper-gastrointestinal-bleeding
#16
REVIEW
Jarett C Worden, Kirollos S Hanna
PURPOSE: The pharmacology, rationale, and dosing optimization strategies of proton pump inhibitors (PPIs) for the treatment of upper gastrointestinal bleeding (UGIB) are discussed. SUMMARY: In combination with endoscopic therapy, PPIs are the treatment of choice for UGIB. While the advent of PPIs has improved patient outcomes, controversy still exists over optimal PPI therapy for UGIB. Pharmacologic treatment in combination with endoscopic therapy has demonstrated improved outcomes in patients with nonvariceal UGIB...
February 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28110901/-gastrointestinal-bleeding-and-delirium-challenges-in-the-diagnosis-of-gallstone-ileus-a-case-report-and-review-of-literature
#17
Francisco Aguilar-Espinosa, José Luis Gálvez-Romero, Jesús Falfán-Moreno, Gustavo Adolfo Guerrero-Martínez, Facundo Vargas-Solís
BACKGROUND: Gallstone ileus is a non-strangulated mechanical obstruction of the small bowel or colon as a result of the passage of gallstones through a biliary enteric fistula. It is a rare complication of cholelithiasis, affects patients over 65 years, and the disease occurs predominantly in females. Preoperative diagnosis is difficult due to the lack of specific signs and symptoms in elderly patients with multiple comorbidities. CLINICAL CASE: A 93-year-old female presenting with a one-week history of upper gastrointestinal bleeding, electrolyte imbalance and community- acquired pneumonia pneumonia...
January 19, 2017: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/28109636/management-of-non-variceal-upper-gastrointestinal-bleeding-position-statement-of-the-catalan-society-of-gastroenterology
#18
Pilar García-Iglesias, Josep-Maria Botargues, Faust Feu Caballé, Càndid Villanueva Sánchez, Xavier Calvet Calvo, Enric Brullet Benedi, Gabriel Cánovas Moreno, Esther Fort Martorell, Marta Gallach Montero, Emili Gené Tous, José-Manuel Hidalgo Rosas, Amelia Lago Macía, Ana Nieto Rodríguez, Michel Papo Berger, Montserrat Planella de Rubinat, Joan Saló Rich, Rafel Campo Fernández de Los Ríos
In recent years there have been advances in the management of non-variceal upper gastrointestinal bleeding that have helped reduce rebleeding and mortality. This document positioning of the Catalan Society of Digestologia is an update of evidence-based recommendations on management of gastrointestinal bleeding peptic ulcer.
January 18, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28108748/-acute-hemorrhage-in-the-upper-gastrointestinal-tract
#19
M Busch, A Schneider, T Lankisch, T von Hahn
Bleeding in the upper gastrointestinal (GI) tract is a frequent and complex emergency. There are guidelines for acute medical treatment, established endoscopic treatment as well as surgical and radiological rescue procedures. Nevertheless, the mortality of the upper GI tract bleeding is high, which is due to the fact that affected patients often have serious preexisting illnesses.
January 20, 2017: Der Internist
https://www.readbyqxmd.com/read/28107762/thulium-laser-in-interventional-endoscopy-animal-and-human-studies
#20
Gian E Tontini, Helmut Neumann, Luca Pastorelli, Luisa Spina, Flaminia Cavallaro, Paola Soriani, Alessandro Rimondi, Barbara Bruni, Claudio Clemente, Filippo Fagnani, Pavlos Lagoussis, Luca Carmignani, Maurizio Vecchi
Background and study aims The thulium laser system (TLS) is an emerging surgical tool. The 2-μm wavelength provides a confined coagulation depth (0.2 - 0.4 mm) to reduce the potential for inadvertent injuries. For the first time ever, we assessed TLS feasibility for endoscopic hemostasis ex vivo in pigs. In addition, we performed the first in vivo hemostatic treatments in humans. Patients and methods Tissue damage induced by TLS using different settings and optical fibers was compared to that from argon plasma coagulation (APC) in established ex vivo animal models...
January 20, 2017: Endoscopy
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