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upper gastrointestinal bleed

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https://www.readbyqxmd.com/read/28545503/time-to-endoscopic-intervention-in-patients-with-upper-gastrointestinal-patients-can-be-improved-with-pathway-provision
#1
R Singer, P Campbell, C Fernandes, P Statham, D Hochhauser, J Bridgewater
BACKGROUND: Patients with upper gastrointestinal malignancy often require admission to hospital with dysphagia or jaundice requiring therapeutic endoscopy. Endoscopic intervention is often effective permitting rapid discharge. An efficient service would permit rapid discharge for patients who are often at the end of life. We noted that a majority of patients in hospital under the gastroenterological oncology were admitted with symptoms requiring therapeutic endoscopy. METHODS: We conducted an audit cycle of the inpatient days before and after pathway implementation...
May 25, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28544091/a-new-predictive-model-for-acute-gastrointestinal-bleeding-in-patients-taking-oral-anticoagulants-a-cohort-study
#2
Akira Shimomura, Naoyoshi Nagata, Takuro Shimbo, Toshiyuki Sakurai, Shiori Moriyasu, Hidetaka Okubo, Kazuhiro Watanabe, Chizu Yokoi, Junichi Akiyama, Naomi Uemura
BACKGROUND: We developed a predictive model of long-term gastrointestinal (GI) bleeding risk in patients receiving oral anticoagulants and compared it with the HAS-BLED score. METHODS: We periodically followed a cohort of 508 patients taking oral anticoagulants (66 direct oral anticoagulants users and 442 warfarin users). Absence of GI bleeding at an initial examination, and any subsequent GI bleeding, were confirmed endoscopically. The bleeding model was developed by multivariate survival analysis and evaluated by Harrell's c-index...
May 19, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28543334/the-use-of-selective-serotonin-receptor-inhibitors-ssris-is-not-associated-with-increased-risk-of-endoscopy-refractory-bleeding-rebleeding-or-mortality-in-peptic-ulcer-bleeding
#3
S B Laursen, G I Leontiadis, A J Stanley, J Hallas, O B Schaffalitzky de Muckadell
BACKGROUND: Observational studies have consistently shown an increased risk of upper gastrointestinal bleeding in users of selective serotonin receptor inhibitors (SSRIs), probably explained by their inhibition of platelet aggregation. Therefore, treatment with SSRIs is often temporarily withheld in patients with peptic ulcer bleeding. However, abrupt discontinuation of SSRIs is associated with development of withdrawal symptoms in one-third of patients. Further data are needed to clarify whether treatment with SSRIs is associated with poor outcomes, which would support temporary discontinuation of treatment...
May 23, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28542116/prevalence-and-clinical-characteristics-of-spontaneous-splenorenal-shunt-in-liver-cirrhosis-a-retrospective-observational-study-based-on-contrast-enhanced-computed-tomography-ct-and-magnetic-resonance-imaging-mri-scans
#4
Xingshun Qi, Xiaolong Qi, Yongguo Zhang, Xiaodong Shao, Chunyan Wu, Yongji Wang, Ran Wang, Xintong Zhang, Han Deng, Feifei Hou, Jing Li, Xiaozhong Guo
BACKGROUND This is a retrospective observational study evaluating the prevalence and clinical characteristics of spontaneous splenorenal shunt in liver cirrhosis. MATERIAL AND METHODS We included a total of 105 cirrhotic patients who were admitted to our hospital between June 2012 and December 2013 and underwent contrast-enhanced CT and/or MRI scans at admissions. Spontaneous splenorenal shunt was identified. Clinical and laboratory data were compared between cirrhotic patients with and without spontaneous splenorenal shunt...
May 25, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28533916/pediatric-intensive-care-stress-ulcer-prevention-pic-up-a-protocol-for-a-pilot-randomized-trial
#5
Mark Duffett, Karen Choong, Jennifer Foster, Elaine Gilfoyle, Jacques Lacroix, Nikhil Pai, Lehana Thabane, Deborah J Cook
BACKGROUND: Despite sparse pediatric data on effectiveness, the majority of critically ill children receive medications to prevent gastrointestinal (GI) bleeding. Stress ulcer prophylaxis may have unintended consequences-increasing the risk of nosocomial infections-which may be more serious and common than the bleeding which these drugs are prescribed to prevent. Randomized controlled trials (RCTs) in pediatric critical care are exceptionally challenging to complete, thus a rigorous pilot RCT is crucial...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28524623/upper-gastrointestinal-complications-following-ablation-therapy-for-atrial-fibrillation
#6
S-Y Park, M Camilleri, D Packer, K Monahan
BACKGROUND: Following ablation therapy for cardiac arrhythmias, patients may develop upper gastrointestinal (UGI) symptoms. The vagus nerve is close to the atria and may be affected by ablating energy. AIM: To identify structural or functional complications in UGI tract following ablation for atrial fibrillation (AF) and clinical outcomes and association with vagal dysfunction. METHODS: Using natural language processing of electronic medical records and an AF ablation database of 5380 patients treated during 17 years, we identified 40 patients with UGI complications...
May 19, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28523485/report-of-mesocaval-shunt-in-the-management-of-variceal-hemorrhage-following-gastric-bypass-surgery
#7
Anurag Shrimal, Ranjan Sudan, Gaurav Chaubal, Ahmad Zaaroura, Kitza Williams, Kadiyala Ravindra
Gastrointestinal bleeding following Roux-en- Y gastric bypass (RYGB) is rare. We report an unusual cause of upper gastrointestinal bleeding following RYGB that was complicated by porto- splenic vein thrombosis. A 35- year- old woman was successfully treated by mesocaval surgical shunt for recurrent variceal hemorrhage in the excluded stomach following RYGB.
May 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28523328/duodenal-gastrointestinal-stromal-tumor-presenting-as-pancreatic-head-mass-a-case-report
#8
DănuŢ Vasile, George Iancu, Raluca Claudia Iancu, George Simion, Radu Constantin Ciuluvică
Duodenal gastrointestinal stromal tumors (GISTs) are uncommon. Tumors arising from the first and the second part of the duodenum (DI and DII, respectively) can be wrongly diagnosed as pancreatic mass. We present a case of a 59-year-old woman who came with abdominal pain and severe upper gastrointestinal bleeding (hemoglobin 3.5 g÷dL). A solid, heterogeneously enhancing neoplasm in the head of the pancreas was revealed preoperatively by an abdominal computed tomography scan. A diagnosis of GIST was suggested...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28520574/orthotopic-liver-transplantation-changes-the-course-of-gastric-antral-vascular-ectasia-a-case-series-from-a-transplant-center
#9
Chaitanya Allamneni, Basem Alkurdi, Rehan Naseemuddin, Brendan M McGuire, Mohamed G Shoreibah, Devin E Eckhoff, Shajan Peter
BACKGROUND AND AIM: Gastric antral vascular ectasia (GAVE) is an important cause of upper gastrointestinal bleeding and anemia in patients with cirrhosis. The aim of our study was to evaluate the effect of orthotopic liver transplantation (OLT) on GAVE and associated anemia. PATIENTS AND METHODS: We performed a chart review and identified all cirrhotic patients with GAVE who underwent OLT at the University Of Alabama at Birmingham between 2005 and 2013. Population's demographics, etiology of cirrhosis, comorbidities, presentation and treatment modalities of GAVE, endoscopic and histopathologic reports, hemoglobin values before and after transplant, and immunosuppressive regimens were collected...
May 17, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28514389/-acute-bleeding-from-upper-gastrointestinal-tract-due-to-splenic-artery-pseudoaneurysm-in-a-cavity-of-pancreatic-pseudocyst
#10
I G Repin, K A Savostiyanov, S P Mizin, A A Stolyarov, D I Repin
No abstract text is available yet for this article.
2017: Khirurgiia
https://www.readbyqxmd.com/read/28512772/subspecialty-approach-for-the-management-of-acute-cholecystitis-an-alternative-to-acute-surgical-unit-model-of-care
#11
Sonia Tran, Vincent Choi, Kirsten Hepburn, Nathan Hewitt, Joel Zhou, Daniel L Chan, Michael L Talbot
BACKGROUND: Acute cholecystitis is a common condition. Recent studies have shown an association between creation of an acute surgical unit (ASU) and improved outcomes. This study aimed to evaluate the outcomes of a subspecialty based approach to the management of acute cholecystitis as an alternative to the traditional 'generalist' general surgery approach or the ASU model. METHOD: A 6-year retrospective analysis of outcomes in patients admitted under a dedicated upper gastrointestinal service for acute cholecystitis undergoing emergency laparoscopic cholecystectomy...
May 16, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28512647/early-esophagogastroduodenoscopy-is-associated-with-better-outcomes-in-upper-gastrointestinal-bleeding-a-nationwide-study
#12
Sushil K Garg, Chimaobi Anugwom, James Campbell, Vaibhav Wadhwa, Nancy Gupta, Rocio Lopez, Sukhman Shergill, Madhusudhan R Sanaka
Background and study aims We analyzed NIS (National Inpatient Sample) database from 2007 - 2013 to determine if early esophagogastroduodenoscopy (EGD) (24 hours) for upper gastrointestinal bleeding improved the outcomes in terms of mortality, length of stay and costs. Patients and methods Patients were classified as having upper gastrointestinal hemorrhage by querying all diagnostic codes for the ICD-9-CM codes corresponding to upper gastrointestinal bleeding. For these patients, performance of EGD during admission was determined by querying all procedural codes for the ICD-9-CM codes corresponding to EGD; early EGD was defined as having EGD performed within 24 hours of admission and late EGD was defined as having EGD performed after 24 hours of admission...
May 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28511235/direct-peroral-cholangioscopy-with-a-new-anchoring-technique-using-the-guide-probe-of-kautz-first-clinical-experiences
#13
Frank Lenze, Tobias M Nowacki, Torsten Beyna, Hansjoerg Ullerich
Background and study aims We present the first clinical results of a new tandem technique for direct peroral cholangioscopy using a standard ultraslim upper gastrointestinal endoscope and a guide probe that was originally developed for the non-transendoscopic placement of biliary endoprostheses (guide probe of Kautz; MTW, Wesel, Germany). Patients and methods Twenty direct peroral cholangioscopy procedures were performed with the new anchor-assisted method using the guide probe of Kautz in a single center and were retrospectively analyzed...
May 16, 2017: Endoscopy
https://www.readbyqxmd.com/read/28508032/what-is-the-ideal-timing-for-endoscopy-in-acute-upper-gastrointestinal-bleeding
#14
EDITORIAL
Alan Barkun
No abstract text is available yet for this article.
May 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28507835/endoscopic-view-of-gastroduodenal-artery-coils-at-the-base-of-duodenal-ulcer-in-case-of-recurrent-massive-upper-gastrointestinal-bleed
#15
Rawaa Ebrahem, Salam Kadhem, John W Frey, William Salyers
Helicobacter pylori (H. pylori) infection is one of the major causes of bleeding peptic ulcer disease, which is associated with serious complications; therefore, the eradication of H. pylori is essential to prevent these devastating complications. Post-treatment follow-up is crucial to guarantee the eradication of the organism and may be conducted via the urea breath test, the stool antigen test, or a gastric biopsy. Acute massive upper gastrointestinal (UGI) bleeding is one of the most common complications of peptic ulcer disease...
April 13, 2017: Curēus
https://www.readbyqxmd.com/read/28507747/the-clinical-and-cost-implications-of-failed-endoscopic-hemostasis-in-gastroduodenal-ulcer-bleeding
#16
Ann Roy, Micheline Kim, Robert Hawes, Shyam Varadarajulu
AIM: The aim of this article is to evaluate the clinical and cost implications of failed endoscopic hemostasis in patients with gastroduodenal ulcer bleeding. METHODS: A retrospective claims analysis of the Medicare Provider Analysis and Review (MedPAR) file was conducted to identify all hospitalizations for gastroduodenal ulcer bleeding in the year 2012. The main outcome measures were to compare all-cause mortality, total length of hospital stay (LOS), hospital costs and payment between patients managed with one upper gastrointestinal (UGI) endoscopy versus more than one UGI endoscopy or requiring interventional radiology-guided hemostasis (IRH) or surgery after failed endoscopic attempt...
April 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28506073/duodenal-diverticular-bleeding-an-endoscopic-challenge
#17
Eduardo Valdivielso Cortázar, Lucía Madarnás Alonso, Susana Ortíz Marín, Ignacio Couto Worner, Pedro Alonso Aguirre
Duodenal diverticula are an uncommon cause of upper gastrointestinal bleeding. Until recently, it was primarily managed with surgery, but advances in the field of endoscopy have made management increasingly less invasive. We report a case of duodenal diverticular bleeding that was endoscopically managed, and review the literature about the various endoscopic therapies thus far described.
May 16, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28504002/development-and-evaluation-of-a-novel-score-for-prediction-of-large-oesophageal-varices-in-patients-with-hepatitis-c-virus-induced-liver-cirrhosis
#18
K Farid, M M Omran, R E Farag, M M Arafa, T M Emran
OBJECTIVE: Variceal bleeding is one of the most common life-threatening complications of liver cirrhosis. This study aimed to develop and evaluate a predictive score, named Platelet count, Alpha fetoprotein (AFP) and Prothrombin-INR (PAP) for the prediction of large oesophageal varices and to compare PAP score with eight common liver fibrosis scores (AAR, APRI, GUCI, BRC score, Fibro-Alfa, FIB4, Lok and Fibro-Q) in patients with hepatitis C virus (HCV) induced liver cirrhosis. METHODS: A total of 277 patients with HCV-induced liver cirrhosis were evaluated by upper gastrointestinal endoscopy for presence of varices...
May 15, 2017: British Journal of Biomedical Science
https://www.readbyqxmd.com/read/28501386/atrioesophageal-fistula-after-ablation-for-atrial-fibrillation
#19
Trisha Mackle, Kevin Pistawka
BACKGROUND: Atrioesophageal fistula (AEF) is a rare and highly fatal complication of ablation procedures for atrial fibrillation. We report a diagnostically challenging case of AEF that highlights the unfortunate outcome that can be expected when this condition is not promptly diagnosed and managed accordingly. The varied clinical presentations are reviewed and recommended diagnostic and management approaches are presented. CASE REPORT: A 79-year-old female who was 5 weeks post-ablation presented to a community emergency department with chest pain and a transient episode of left-arm weakness...
May 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28496533/the-diagnostic-value-of-alarm-features-for-identifying-types-and-stages-of-upper-gastrointestinal-malignancies
#20
Shou-Wu Lee, Chi-Sen Chang, Hong-Jeh Yeh, Han-Chung Lien, Teng-Yu Lee, Yen-Chun Peng
BACKGROUND: Upper gastrointestinal (GI) malignancies are an uncommon cause of dyspepsia but of great concern. The aim of this study was to determine the association between alarm features and each type and stage of upper GI malignancies. METHODS: Patients who underwent endoscopy for symptoms of dyspepsia between January 2008 and December 2009 were retrospectively collected. Alarm features studied in this study were dysplasia, body weight loss and GI bleeding. Patients were classified according to the findings of endoscopy and histological reports...
April 2017: Gastroenterology Research
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