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https://www.readbyqxmd.com/read/28807040/management-of-upper-gastrointestinal-bleeding-in-emergency-departments-from-bleeding-symptoms-to-diagnosis-a-prospective-multicenter-observational-study
#1
Pierre-Clément Thiebaud, Youri Yordanov, Jacques-Emmanuel Galimard, Pierre-Alexis Raynal, Sébastien Beaune, Laurent Jacquin, François-Xavier Ageron, Dominique Pateron
BACKGROUND: Upper gastrointestinal bleeding (UGB) is common in emergency departments (EDs) and can be caused by many eso-gastro-duodenal lesions. Most available epidemiological data and data on the management of UGB comes from specialized departments (intensive care units or gastroenterology departments), but little is known from the ED perspective. We aimed to determine the distribution of symptoms revealing UGB in EDs and the hemorrhagic lesions identified by endoscopy. We also describe the characteristics of patients consulting for UGB, UGB management in the ED and patients outcomes...
August 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28806622/case-report-on-the-non-operative-management-of-a-retrievable-inferior-vena-cava-filter-perforating-the-duodenum
#2
Joseph S Fernandez-Moure, Keemberly Kim, M Haseeb Zubair, Wade R Rosenberg
INTRODUCTION: Deep vein thrombosis (DVT) continues to be a significant source of morbidity for surgical patients. Placement of a retrievable inferior vena cava (IVC) filter is used when patients have contraindications to anticoagulation or recurrent pulmonary embolism despite therapeutic anticoagulation. Although retrievable IVC filters are often used, they carry a unique set of risks. PRESENTATION OF CASE: A 67-year-old man presents to the Emergency Room (ER) following large volume melena and complaining of syncope...
July 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28806254/rare-ileal-ewing-sarcoma-primitive-neuroectodermal-tumor-on-18f-fdg-pet-ct
#3
Pan Yu, Fei Xiaochun, Lv Jing, Zhang Yifan
A 24-year-old woman who had melena, dizziness, and fatigue and looked pale for 2 months was confirmed to have a microcytic hypochromic anemia in the local hospital. It was further revealed that the patient had splenomegaly and a small intestinal lump, and she was then referred to our hospital. The enhanced CT showed an ileal lesion with enhancement, which showed an increased F-FDG activity in further PET/CT scanning. Lymphoma was therefore suspected, and an uncomplicated surgical resection of the ileal lesion was then performed...
August 12, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28799152/-gastric-schwannoma-rare-differenzial-diagnosis-of-acute-upper-gastrointestinal-gi-bleeding
#4
Orestis Lyros, Stephan Schickel, Katrin Schierle, Albrecht Hoffmeister, Ines Gockel
Schwannomas are benign tumors derived from Schwann cells and their typical site of origin is the subcutaneous tissue of the extremities. Gastrointestinal localization of Schwannomas is extremely rare and the stomach is the prevalent site. Gastric schwannomas primarily occur in the gastric submucosa and are usually asymptomatic.We present a rare case of a solitary gastric schwannoma in a 51-year old male, which initially manifested with hematemesis by acute upper gastrointestinal (GI) bleeding. The upper GI-Endoscopy revealed a gastric submucosal tumor, 7 cm in size, located in the proximal corpus and fundus...
August 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28796938/effect-of-intrapancreatic-fat-on-diabetes-outcomes-after-total-pancreatectomy-with-islet-autotransplantation
#5
Muhammed Kizilgul, Joshua J Wilhelm, Gregory J Beilman, Srinath Chinnakotla, Ty B Dunn, Timothy L Pruett, Muhamad Abdulla, David Heller, Martin L Freeman, Sarah J Schwarzenberg, Bernhard J Hering, Melena D Bellin
BACKGROUND: Pancreatic fat might adversely affect beta-cell mass and function, possibly via the local release of non-esterified fatty acids (NE-FAs) and pro-inflammatory and vasoactive factors released by adipose tissue, however, the impact of intrapancreatic fat has never been studied in patients with pancreatitis undergoing total pancreatectomy with islet autotransplantation (TPIAT). We aimed to test whether pancreatic fatty infiltration has a negative effect on metabolic outcomes following TPIAT METHODS: We studied the association between pancreatic fatty infiltration and diabetes outcomes in 79 patients undergoing TPIAT with low (LPF; n = 53) or high (HPF; n = 26) pancreatic fat content...
August 10, 2017: Journal of Diabetes
https://www.readbyqxmd.com/read/28790264/-a-case-of-lung-adenocarcinoma-presenting-with-leptomeningeal-carcinomatosis-successfully-treated-with-afatinib-after-erlotinib-induced-hepatotoxicity
#6
Hiroaki Tanaka, Minehiko Inomata, Ryuji Hayashi, Kazuki Shimokawa, Kotaro Tokui, Seisuke Okazawa, Kenta Kambara, Toru Yamada, Toshiro Miwa, Tatsuhiko Kashii, Hirofumi Konishi, Kazuyuki Tobe
A 65-year-old man was diagnosed with leptomeningeal carcinomatosis based on the findings of cerebrospinal fluid cytology and magnetic resonance imaging(MRI).Treatment with erlotinib and bevacizumab was initiated, and partial improvement in consciousness and MRI findings were obtained.However, it was difficult to continue the treatment because of elevation in levels of liver enzymes and melena.We switched the treatment to afatinib monotherapy, and his consciousness improved immediately.Progression -free survival and overall survival from the initiation of the treatment with afatinib were 7 and 9...
July 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28783927/a-case-of-primary-small-bowel-melanoma-diagnosed-by-single-balloon-enteroscopy
#7
Jun Young Shin, In Suh Park, Byoung Wook Bang, Hyung Kil Kim, Yong Woon Shin, Kye Sook Kwon
Although metastasis from cutaneous malignant melanoma to the small intestine is not uncommon, primary small bowel melanoma (SBM) is extremely rare. This case report describes a rare case of primary SBM, diagnosed by single-balloon enteroscopy. A 74-year-old man presented with recurrent melena. Upper endoscopy and colonoscopy were unremarkable. Abdominal computed tomography (CT) revealed an ileal mass with ileo-ileal intussusception. Subsequent single-balloon enteroscopy identified an ileal tumor, which was histologically diagnosed as melanoma...
July 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28783522/fatal-liver-gas-gangrene-after-biliary-surgery
#8
Yui Miyata, Hiroyuki Kashiwagi, Kazuya Koizumi, Jun Kawachi, Madoka Kudo, Shinichi Teshima, Naoko Isogai, Katsunori Miyake, Rai Shimoyama, Ryota Fukai, Hidemitsu Ogino
INTRODUCTION: Liver gas gangrene is a rare condition with a highly mortality rate. It is mostly associated with host factors, such as malignancy and immunosuppression. PRESENTATION OF CASE: A 57-year-old female was admitted to our hospital with abnormalities of her serum hepato-biliary enzymes. She had a history of hypertension, diabetes mellitus, cerebral infarction, and chronic renal failure. She was diagnosed with bile duct cancer of the liver hilum and a left hepatectomy was carried out, with extrahepatic bile duct resection...
July 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28781792/prostate-cancer-with-disseminated-carcinomatosis-of-the-bone-marrow-two-case-reports
#9
Tasuku Hiroshige, Yoshiro Eguchi
Disseminated carcinomatosis of the bone marrow (DCBM) is caused by cancer metastasis to the bone marrow and is often accompanied by disseminated intravascular coagulation (DIC), with rapid clinical progression. We herein report two cases receiving treatment with combined androgen blockade (CAB) and denosumab for prostate cancer with DCBM. The patient in case 1 was an 80-year-old man who was admitted with a 3-day history of melena and was diagnosed with prostate cancer with DCBM by bone marrow biopsy. Despite receiving therapy with CAB and denosumab, the patient developed castration-resistant prostate cancer (CRPC) with accompanying relapse of DIC and succumbed to the disease 7 months later...
August 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28764229/upper-gastrointestinal-bleed-as-a-manifestation-of-poorly-differentiated-metastatic-squamous-cell-carcinoma-of-the-lung
#10
Richa Bhardwaj, Gaurav Bhardwaj, Arun Gautam, Raffi Karagozian
Gastrointestinal (GI) metastasis from primary lung cancer is a rare clinical finding. Lung cancer most often metastasizes to the brain, bone, liver, and adrenal glands; with gastrointestinal involvement being very rare. We report a case of a 39-year-old female with a diagnosis of poorly differentiated Squamous Cell Carcinoma (SCC) of the lung presenting with dizziness and melena. Esophagogastroduodenoscopy (EGD) showed a bleeding mass in the stomach. Final biopsy report and Immunohistochemistry (IHC) of the specimen were consistent with SCC lung metastasis...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28761039/atrio-esophageal-fistula-a-case-series-and-literature-review
#11
Craig A Schuring, Luke J Mountjoy, Ashley B Priaulx, Robert J Schneider, Hayden L Smith, Geoffrey C Wall, Dipen Kadaria, Amik Sodhi
BACKGROUND Percutaneous catheter radiofrequency ablation (RFA) and cryoablation of the left atrium and pulmonary vein ostia have become successful therapeutic modalities in the management of atrial fibrillation. Atrio-esophageal fistula is a rare complication. Awareness of complication risk is imperative because without prompt diagnosis and urgent surgical intervention, the outcome is often fatal. We present 3 cases of atrio-esophageal fistula following percutaneous catheter radiofrequency ablation (RFA). CASE REPORT Case 1: A 72-year old white male presented 27 days after percutaneous RFA for atrial fibrillation with fever, altered mental status, and melena...
August 1, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28746317/acute-upper-gastrointestinal-bleeding-in-a-tertiary-care-centre-of-nepal
#12
M S Paudel, S Kc, A K Mandal, N S Poudyal, R Shrestha, B N Paudel, S Chaudhary
INTRODUCTION: AUGIB is characterized by hematemesis or melena or both. Peptic ulcers and variceal bleed account for majority of cases. Use of proton pump inhibitors in current era is associated with a gradual reduction in burden of peptic ulcer disease. We conducted this study to look into the cause of AUGIB in our community. METHODS: We studied 100 patients in one year period who presented to us with hematemesis or melena. The study was conducted in department of Gastroenterology, Bir hospital, Kathmandu...
April 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28746201/a-rare-case-of-iron-pill-induced-gastritis-in-a-female-teenager-a-case-report-and-a-review-of-the-literature
#13
REVIEW
Lorena Elena Meliţ, Cristina Oana Mărginean, Simona Mocanu, Maria Oana Mărginean
RATIONALE: The treatment of iron-deficiency anemia with oral iron supplements can present side-effects on the GI tract mucosa including necrosis, ulceration, or ischemia. The particular endoscopic findings and the histopathological exam will establish the diagnosis of erosive gastritis with iron deposits in the gastric mucosa. PATIENT CONCERNS: We present the case of a 14-year-old female admitted in our clinic for upper digestive hemorrhage, nausea, melena, and abdominal pain...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28741615/patient-and-disease-characteristics-associated-with-the-presence-of-diabetes-mellitus-in-adults-with-chronic-pancreatitis-in-the-united-states
#14
Melena D Bellin, David C Whitcomb, Judah Abberbock, Stuart Sherman, Bimaljit S Sandhu, Timothy B Gardner, Michelle A Anderson, Michele D Lewis, Samer Alkaade, Vikesh K Singh, John Baillie, Peter A Banks, Darwin Conwell, Gregory A Cote, Nalini M Guda, Thiruvengadam Muniraj, Gong Tang, Randall E Brand, Andres Gelrud, Stephen T Amann, Christopher E Forsmark, C Mel Wilcox, Adam Slivka, Dhiraj Yadav
OBJECTIVES: Diabetes mellitus (DM) is a common complication of chronic pancreatitis (CP). Past studies for DM risk factors in CP have been limited to single centers or highly focused on a single etiology such as alcoholic or hereditary disease. We studied risk factors for DM in a large population of patients with CP of all etiologies enrolled in the North American Pancreatitis 2 studies. METHODS: Participants (1,171) with CP (n=383 with DM, n=788 without DM) were enrolled prospectively from 26 participating centers...
July 25, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28740840/bicytopenia-and-leukoerythroblastosis-a-rare-initial-presentation-of-signet-ring-cell-gastric-adenocarcinoma
#15
REVIEW
Vilma Takayasu, Edna Harumi Goto, Mayra Zanon Casagrande, Paulo Guilherme de Arruda Miranda, Gabriela Bezerra de Freitas Diniz, Micaela Frasson Monteiro, Aloisio Felipe-Silva
Gastric adenocarcinoma is a common neoplasia and is responsible for up to 30% of the overall deaths due to cancer. Advanced disease is mostly characterized by peritoneum, liver, and lung involvement. The spread of the disease to the bone is rare, and bone marrow dissemination is even rarer. In this setting, leukoerythroblastosis may be the initial manifestation of the disease. The authors report the case of a 64-year-old Caucasian man who sought medical care complaining of back pain, weakness, and weight loss...
April 2017: Autopsy & case reports
https://www.readbyqxmd.com/read/28740566/salvage-embolization-and-histologic-analysis-of-gastric-cancer-with-hemorrhagic-shock-using-spherical-embolic-material
#16
Norifumi Kennoki, Toru Saguchi, Jun Otaka, Yosuke Makuuchi, Takafumi Watanabe, So Katayanagi, Hiromi Serizawa, Kiyoshi Koizumi, Koichi Tokuuye
BACKGROUND: In a recent study, it was reported that transcatheter arterial embolization with spherical embolic material for life-threatening hemorrhages in various cancer patients was safe and effective. Calibrated microspheres are able to access distal regions of the target arteries, which results in the disappearance of tumor staining. However, there are few reports on the pathological behavior of EmboSpheres in gastric cancer specimens. In this case, we succeeded in salvage embolization for advanced gastric cancer with hemorrhagic shock using spherical embolic material...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28736359/-small-intestinal-cavernous-hemangioma-causing-chronic-hemorrhage-a-case-report
#17
Geng-Yuan Zhang, Chang-Jiang Luo, Bin Zhao, Hao Zhan, Bo Long, Ling-Yun Guo, Hui-Nian Zhou, Zuo-Yi Jiao
Small intestinal hemangioma is a rare condition that can be divided histologically into capillary, cavernous or mixed types, among which the cavernous type is the most common. Here we report a case of small intestinal cavernous hemangioma with chronic hemorrhage in 44-year-old man. The patient complained of weakness and dizziness for 2 years that aggravated 1 month before admission accompanied by intermittent melena. Laboratory tests suggest severe anemia, and computed tomography, gastroscopy and colonoscopy all revealed signs of anemia...
July 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28732002/-gastrointestinal-stromal-tumor-in-young-pregnant-woman-case-report
#18
Walker Del Cid Jove Oblitas, Miguel Joseph Abril Barreda
Female patient, 28 years old, with a gestation of 14 weeks, natural and from Ilo-Moquegua. Came with a time of disease 4 days with hematemesis, melena, epigastric pain and syncope. Background of colonic resection for peritonitis due to trauma 20 years ago; upper gastrointestinal bleeding three years ago; paternal grandparents died of gastric cancer; chronic gastritis diagnosed from 19 year old. In laboratory studies hemoglobin of 9.2. In the upper gastrointestinal endoscopy was found absence of active upper gastrointestinal bleeding, a large tumor in proximal body toward greater curvature and posterior wall, 8 cm in diameter approximately, lobed appearance, with most of the mucosal surface unscathed is evidence, areas of ulceration of 2-3 mm covered with fibrin (biopsies taken), hard consistency, tent sign (positive) and cushionsign (negative)...
April 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28721343/upper-gastrointestinal-bleeding-in-patients-with-end-stage-renal-disease-causes-characteristics-and-factors-associated-with-need-for-endoscopic-therapeutic-intervention
#19
Syed Mudassir Laeeq, Abbas Ali Tasneem, Farina M Hanif, Nasir Hassan Luck, Rajesh Mandhwani, Rajesh Wadhva
BACKGROUND AND OBJECTIVES: The risk of upper gastrointestinal bleeding (UGIB) is increased among the end-stage renal disease (ESRD) patients. The aim of the current study was to describe the causes and characteristics of UGIB in ESRD patients at our center and to assess the need for endoscopic therapeutic intervention (ETI) using Rockall (RS) and Glasgow Blatchford scores (GBS). MATERIAL AND METHODS: All patients with ESRD and UGIB with age ≥14 years were included...
June 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28721327/two-catastrophes-in-one-patient-drug-reaction-with-eosinophilia-and-systemic-symptoms-and-toxic-shock-syndrome
#20
Moayed Ibrahim, Diana L Nunley
A 70-year-old, immunocompromised patient presented to the emergency room (ER) five weeks after she was started on clopidogrel. She complained of skin eruption, mouth ulcers, fatigue, and myalgia over the past two weeks. Labs showed severe hyponatremia, acute kidney injury, rhabdomyolysis, hyperkalemia, and elevated liver enzymes. She was treated with steroids and discharged after her condition improved. However, a month later, she returned to the ER, complaining of nausea, vomiting, diarrhea, dizziness, chills, and shortness of breath over the past two days...
June 15, 2017: Curēus
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