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Peptic ulcer bleeding

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
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
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
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
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
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
S Di Saverio, E Segalini, A Birindelli, S Todero, M Podda, A Rizzuto, G Tugnoli, A Biondi
BACKGROUND: Ideal surgical treatment for acute duodenal injuries should offer a definitive treatment, with low morbidity and mortality. It should be simple and easily reproducible by acute care surgeons in an emergency. Duodenal injury, due to major perforated or bleeding peptic ulcers or iatrogenic/traumatic perforation, represents a surgical challenge, with high morbidity and mortality. The aim was to review definitive surgery with pancreas-sparing, ampulla-preserving duodenectomy for these patients...
July 19, 2018: British Journal of Surgery
Yutaka Kondo, Waku Hatta, Tomoyuki Koike, Yasushi Takahashi, Masahiro Saito, Takeshi Kanno, Kiyotaka Asanuma, Naoki Asano, Akira Imatani, Atsushi Masamune
BACKGROUND: Previous studies have shown that several factors such as hemodynamic instability at admission are risk factors for rebleeding of peptic ulcer bleeding. However, whether steroid use increases the risk of rebleeding remains elusive. AIMS: This study aimed to clarify the risk factors for rebleeding after endoscopic hemostasis for peptic ulcer bleeding. METHODS: A total of 185 patients who underwent endoscopic hemostasis for peptic ulcer bleeding at our institution between 2005 and 2017 were retrospectively analyzed...
July 19, 2018: Digestive Diseases and Sciences
Romaric Loffroy, Marc Bardou
No abstract text is available yet for this article.
July 11, 2018: Gut
Jacky Shui Ho Chan, Amelia Chien Wei Chao, Vincent Chi Ho Cheung, Sophia Sau Kuen Wong, Whitney Tang, Justin Che Yuen Wu, Henry Lik Yuen Chan, Francis Ka Leung Chan, Joseph Jao Yiu Sung, Siew Chien Ng
BACKGROUND AND AIM: Gastrointestinal (GI) diseases account for substantial morbidity, mortality, and health care utilization. This public hospital-based study assessed the incidence and time trend of hospitalization and mortality of major GI diseases over one decade. METHODS: We conducted an observational study using population-wide database managed by the Hong Kong Hospital Authority with a principal diagnosis of GI diseases defined by International Classification of Disease, 9th Revision, Clinical Modification coding...
July 11, 2018: Journal of Gastroenterology and Hepatology
Mohammed Safwan Ali Khan, Syeda Umme Kulsoom Khundmiri, Syeda Rukhaiya Khundmiri, Mohammad M Al-Sanea, Pooi Ling Mok
Ulceration in the stomach develops in peptic ulcer disease when there is a loss of protective mucosal layers, particularly in Helicobacter pylori infection. Antibiotic therapy has failed to eradicate and impede the colonization of H. pylori . Despite given treatment, recurrent bleeding can occur and lead to death in the affected individual. The disease progression is also related to the non-steroidal inflammatory drug and stress. There are extensive research efforts to identify the gastroprotective property from various alkaloids, flavonoids, and tannins compounds from plants and marine...
2018: Frontiers in Pharmacology
Nobuyuki Sugisaki, Ryuichi Iwakiri, Nanae Tsuruoka, Yasuhisa Sakata, Ryo Shimoda, Shun Fujimoto, Yuichiro Eguchi, Kazuma Fujimoto
BACKGROUND: We aimed to identify the adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDs) and antithrombotics on the upper gastrointestinal (GI) mucosa in a clinical setting as a case-control study using a large-scale medical database in Japan. METHODS: We evaluated the risk of upper GI mucosal injuries in patients receiving NSAIDs and antithrombotics using the Japan Medical Data Center claims database with data for 13 million accumulated patients, from January 2009 to December 2014...
June 12, 2018: Journal of Gastroenterology
Gokhan Tumgor, Mehmet Agin, Figen Doran, Salih Cetiner
AIM: The aim of the present study is to investigate the frequency of celiac disease in children with peptic ulcers and to compare it with that of non-celiac peptic ulcers in terms of clinical and laboratory values. METHODS: Upper gastrointestinal endoscopy was performed in 1769 patients at the Department of Pediatric Gastroenterology, The Faculty of Medicine, Cukurova University, Turkey, between January 2012 and January 2017. These cases consisted of subjects presenting with various GIS symptoms and indicated for endoscopy (with chronic diarrhea, delayed growth and development, abdominal pains, GIS bleeding, etc...
June 26, 2018: Digestive Diseases and Sciences
Debbie Troland, Adrian Stanley
Peptic ulcer bleeding is common and associated with significant morbidity and mortality. We discuss the endoscopic assessment of peptic ulcers and the rationale for treatment. We also review the evidence for the available endoscopic therapies, both individually and in combination, to draw conclusions on the optimum endoscopic management of peptic ulcer bleeding.
July 2018: Gastrointestinal Endoscopy Clinics of North America
Igor Akushevich, Julia Kravchenko, Arseniy P Yashkin, Anatoliy I Yashin
Longer lifespan is accompanied by a larger number of chronic diseases among older adults. Because of a growing proportion of older adults in the U.S., this brings the problem of age-related morbidity to the forefront as a major contributor to rising medical expenditures. We evaluated 15-year time trends (from 1998 to 2013) in the prevalence of 48 acute and chronic non-cancer diseases and cancers in older U.S. adults aged 65+ and estimated the annual percentage changes of these prevalence trends using SEER-Medicare and HRS-Medicare data...
June 19, 2018: Experimental Gerontology
Fares Ayoub, Vikas Khullar, Debdeep Banerjee, Patrick Stoner, Tiffany Lambrou, Donevan R Westerveld, Wissam Hanayneh, Amir Y Kamel, David Estores
Background: After inpatient management of upper gastrointestinal bleeding (GIB) due to peptic ulcer disease (PUD), oral proton pump inhibitor (PPI) therapy is recommended at discharge to decrease rebleeding risk and improve ulcer healing. Our aim is to determine whether once-daily oral PPI dosing at hospital discharge is associated with inferior 30-day rebleeding outcomes as compared to twice-daily dosing. Methods: We retrospectively identified 233 patients admitted with signs and symptoms of upper GIB found to be due to PUD on upper endoscopy...
June 2018: Gastroenterology Research
Jessamine Liu, Rohit Gupta, Karen Hay, Chrys Pulle, Tony Rahman, Shaun Pandy
This study aimed to identify the incidence of perioperative acute upper gastrointestinal bleeding (UGIB) in our hip fracture patients; to evaluate the characteristics, management and clinical outcomes of these patients; and to explore risk factors and protective factors. Of the 1691 consecutive patients admitted for surgical management of hip fractures, 11 (0.65%) had UGIB and a further four patients for each case were selected as controls for evaluation of risk factors and protective factors. Pre-existing peptic ulcer disease was identified as a risk factor for acute UGIB (odds ratio 7...
June 2018: Internal Medicine Journal
M T Al-Qaisi, A Kahn, M D Crowell, G E Burdick, M F Vela, F C Ramirez
Proton pump inhibitors (PPI) are utilized for a variety of indications, including treatment of gastroesophageal reflux disease, peptic ulcer disease, and prevention of gastrointestinal (GI) bleeding. Several studies have documented an increasing prevalence of inappropriate PPI use. Furthermore, recent media reports have highlighted new research data suggesting a possible association between chronic PPI use and several adverse medical outcomes, leading to frequent patient inquiries about these associations. Thus, providers face the challenge of counseling patients about the balance of risks and benefits related to PPI use...
June 4, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Zahraa Abdul Sater, Smita Jha, Raven McGlotten, Iris Hartley, Mustapha El Lakis, Katherine A Araque, Lynnette K Nieman
Context: Patients taking exogenous glucocorticoids are at risk for gastrointestinal (GI) complications, including peptic ulcer disease with perforation and gastric bleeding. However, little is known about the GI comorbidity in patients with endogenous hypercortisolemia. Case Descriptions: We describe six patients with endogenous Cushing syndrome (CS) who developed sudden perforation of colonic diverticula necessitating urgent exploratory laparotomy. Most of these patients shared the following features of CS: skin thinning, severe hypercortisolemia (24-hour urinary free cortisol ≥10 times the upper limit of normal), ectopic secretion of ACTH, and severe hypokalemia...
August 1, 2018: Journal of Clinical Endocrinology and Metabolism
Arthur Schmidt, Stefan Gölder, Martin Goetz, Alexander Meining, James Lau, Stefan von Delius, Markus Escher, Arthur Hoffmann, Reiner Wiest, Helmut Messmann, Thomas Kratt, Benjamin Walter, Dominik Bettinger, Karel Caca
BACKGROUND & AIMS: Endoscopic hemostasis is effective in treatment of bleeding peptic ulcers. However, rebleeding is difficult to treat and associated with substantial morbidity and mortality. We performed a prospective randomized trial to determine whether over-the-scope clips (OTSCs) are more effective than standard treatment of severe recurrent upper gastrointestinal bleeding. METHODS: We performed our study at 9 academic referral centers (in Germany, Switzerland, and Hong Kong) from March 2013 through September 2016...
May 24, 2018: Gastroenterology
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