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acute upper gastrointestinal bleeding

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https://www.readbyqxmd.com/read/28634688/acute-variceal-bleeding-risk-stratification-and-management-including-tips
#1
REVIEW
Virginia Hernández-Gea, Claudia Berbel, Anna Baiges, Juan C García-Pagán
Acute variceal bleeding should be suspected in all patients with cirrhosis presenting with upper gastrointestinal bleeding. Vasoactive drugs and prophylactic antibiotics must be started as soon as possible, even before performing the diagnostic endoscopy. Once the patient is hemodynamically stable, upper gastrointestinal endoscopy should be performed in order to confirm the diagnosis and provide endoscopic therapy (preferably banding ligation). After this initial approach, the most appropriate therapy to prevent both early and late rebleeding must be instituted following a risk stratification strategy...
June 20, 2017: Hepatology International
https://www.readbyqxmd.com/read/28634135/outcomes-and-role-of-urgent-endoscopy-in-high-risk-patients-with-acute-nonvariceal-gastrointestinal-bleeding
#2
Soo-Han Cho, Yoon-Seon Lee, Youn-Jung Kim, Chang Hwan Sohn, Shin Ahn, Dong-Woo Seo, Won Young Kim, Jae Ho Lee, Kyoung Soo Lim
BACKGROUND & AIMS: We investigated clinical outcomes in high-risk patients with acute nonvariceal upper gastrointestinal bleeding (UGIB), and determined if urgent endoscopy is effective. METHODS: Consecutive patients with Glasgow-Blatchford score >7 who underwent endoscopy for acute nonvariceal UGIB at the emergency department from January 1, 2005, to December 31, 2014, were included. Urgent (<6 h) and elective (6-48 h) endoscopies were defined according to the time to endoscopy after the initial presentation...
June 17, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28626374/bochdalek-hernia-in-an-adult-with-upper-gastrointestinal-bleeding
#3
Mohammed Al-Dugdugi, Abdulhameed Alhazmi, Abdulhadi Khaliel, Luis Perez
Bochdalek hernia (BH) can be a life-threatening condition in infants. Approximately 85.3% of newborns with a BH are immediately at high risk and have a high mortality rate due to respiratory insufficiency [Kocakusak et al.: Hernia 2005;9: 284-287]. However, BH is almost asymptomatic in adults and discovered only incidentally [Wilkins et al.: Clin Imaging 1994;18: 224-229]. Complicated BH in adults might present with visceral incarceration and lethal complications. Upper gastrointestinal bleeding and acute pancreatitis are rarely reported in the literature as complications of BH in adults...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28616396/management-for-non-variceal-upper-gastrointestinal-bleeding-in-elderly-patients-the-experience-of-a-tertiary-university-hospital
#4
Koichiro Kawaguchi, Hiroki Kurumi, Yohei Takeda, Kazuo Yashima, Hajime Isomoto
BACKGROUND: Peptic ulcer bleeding (PUB) is the main cause of non-variceal upper gastrointestinal bleeding (UGIB). Endoscopic treatment and acid suppression with proton-pump inhibitors (PPIs) are most important in the management of PUB and these treatments have reduced mortality. However, elderly patients sometimes have a poor prognostic outcome due to severe comorbidities. METHODS: A retrospective study was performed on 504 cases with acute non-variceal UGIB who were examined in our hospital, in order to reveal the risk factor of a poor outcome in elderly patients...
April 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28569554/nsaid-related-upper-gastrointestinal-bleeding-types-of-drug-use-and-patient-profiles-in-real-clinical-practice
#5
Carlos Sostres, Patrica Carrera, Angel Lanas
BACKGROUND: The best available evidence regarding non-steroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) bleeding comes from randomized controlled trials including patients who use NSAIDs to manage chronic rheumatic diseases; however, patients with varying background profiles commonly take NSAIDs for many other reasons, often without prescription, and such usage has not been well studied. OBJECTIVES AND METHODS: To define the characteristics of patients hospitalized for upper GI bleeding in clinical practice, we conducted a case-control study among patients with endoscopy-proven major upper GI bleeding due to gastroduodenal peptic lesions and control subjects...
June 1, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28544091/a-new-predictive-model-for-acute-gastrointestinal-bleeding-in-patients-taking-oral-anticoagulants-a-cohort-study
#6
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/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
#7
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/28514389/-acute-bleeding-from-upper-gastrointestinal-tract-due-to-splenic-artery-pseudoaneurysm-in-a-cavity-of-pancreatic-pseudocyst
#8
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
#9
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
#10
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/28508032/what-is-the-ideal-timing-for-endoscopy-in-acute-upper-gastrointestinal-bleeding
#11
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
#12
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/28468689/a-splenic-artery-aneurysm-presenting-with-multiple-episodes-of-upper-gastrointestinal-bleeding-a-case-report
#13
W S L De Silva, D S Gamlaksha, D P Jayasekara, S D Rajamanthri
BACKGROUND: Splenic artery aneurysm is rare and its diagnosis is challenging due to the nonspecific nature of the clinical presentation. We report a case of a splenic artery aneurysm in which the patient presented with chronic dyspepsia and multiple episodes of minor intragastric bleeding. CASE PRESENTATION: A 60-year-old, previously healthy Sri Lankan man presented with four episodes of hematemesis and severe dyspeptic symptoms over a period of 6 months. The results of two initial upper gastrointestinal endoscopies and an abdominal ultrasound scan were unremarkable...
May 3, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28460805/outcomes-in-variceal-hemorrhage-following-the-use-of-a-balloon-tamponade-device
#14
Jonathan Nadler, Nikola Stankovic, Amy Uber, Mathias J Holmberg, Leon D Sanchez, Richard E Wolfe, Maureen Chase, Michael W Donnino, Michael N Cocchi
BACKGROUND: Variceal hemorrhage is associated with high morbidity and mortality. A balloon tamponade device (BTD), such as the Sengstaken-Blakemore or Minnesota tube, may be used in cases of variceal hemorrhage. While these devices may be effective at controlling acute bleeding, the effect on patient outcomes remains less clear. We sought to describe the number of patients with variceal hemorrhage and a BTD who survive to discharge, survive to one-year, and develop complications related to a BTD...
April 20, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28459708/withholding-pantoprazole-for-stress-ulcer-prophylaxis-in-critically-ill-patients-a-pilot-randomized-clinical-trial-and-meta-analysis
#15
Waleed Alhazzani, Gordon Guyatt, Mohammed Alshahrani, Adam M Deane, John C Marshall, Richard Hall, John Muscedere, Shane W English, François Lauzier, Lehana Thabane, Yaseen M Arabi, Tim Karachi, Bram Rochwerg, Simon Finfer, Nick Daneman, Fayez Alshamsi, Nicole Zytaruk, Diane Heel-Ansdell, Deborah Cook
INTRODUCTION: A decreased frequency of upper gastrointestinal bleeding and a possible association of proton pump inhibitor use with Clostridium difficile and ventilator-associated pneumonia have raised concerns recently. The Reevaluating the Inhibition of Stress Erosions Pilot Trial determined the feasibility of undertaking a larger trial investigating the efficacy and safety of withholding proton pump inhibitors in critically ill patients. METHODS: In 10 ICUs, we randomized adult ICU patients anticipated to be mechanically ventilated for greater than or equal to 48 hours to receive 40 mg of IV pantoprazole daily or placebo...
July 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28433982/acute-on-chronic-gastrointestinal-bleeding-a-unique-clinical-entity
#16
Don C Rockey, Adam C Hafemeister, Joan S Reisch
Gastrointestinal bleeding is defined in temporal-spatial terms-as acute or chronic, and/or by its location in the gastrointestinal tract. Here, we define a distinct type of bleeding, which we have coined 'acute on chronic' gastrointestinal bleeding. We prospectively identified all patients who underwent endoscopic evaluation for any form of gastrointestinal bleeding at a University Hospital. Acute on chronic bleeding was defined as the presence of new symptoms or signs of acute bleeding in the setting of chronic bleeding, documented as iron deficiency anemia...
April 21, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28414670/diulafoy-s-lesion-an-uncanny-etiology-of-gastrointestinal-bleed
#17
V Gasia, O Lamendola
INTRODUCTION: Dieulafoy's lesion is a relatively rare, but potentially life-threatening, condition. It accounts for 1-2 percent of acute gastrointestinal (GI); bleeding. CASE: A 99-year-old woman was initially admitted due to left lower extremity cellulitis related to chronic venous stasis ulcer and was receiving broad-spectrum IV antibiotics. Upon admission to the medical floor, she had an episode of hematemesis and multiple bowel movements with black-tarry stools...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28397699/restrictive-versus-liberal-blood-transfusion-for-gastrointestinal-bleeding-a-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#18
Ayodele Odutayo, Michael J R Desborough, Marialena Trivella, Adrian J Stanley, Carolyn Dorée, Gary S Collins, Sally Hopewell, Susan J Brunskill, Brennan C Kahan, Richard F A Logan, Alan N Barkun, Michael F Murphy, Vipul Jairath
BACKGROUND: Acute upper gastrointestinal bleeding is a leading indication for red blood cell (RBC) transfusion worldwide, although optimal thresholds for transfusion are debated. METHODS: We searched MEDLINE, Embase, CENTRAL, CINAHL, and the Transfusion Evidence Library from inception to Oct 20, 2016, for randomised controlled trials comparing restrictive and liberal RBC transfusion strategies for acute upper gastrointestinal bleeding. Main outcomes were mortality, rebleeding, ischaemic events, and mean RBC transfusion...
May 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28396724/complementary-roles-of-interventional-radiology-and-therapeutic-endoscopy-in-gastroenterology
#19
REVIEW
David M Ray, Indu Srinivasan, Shou-Jiang Tang, Andreas S Vilmann, Peter Vilmann, Timothy C McCowan, Akash M Patel
Acute upper and lower gastrointestinal bleeding, enteral feeding, cecostomy tubes and luminal strictures are some of the common reasons for gastroenterology service. While surgery was initially considered the main treatment modality, the advent of both therapeutic endoscopy and interventional radiology have resulted in the paradigm shift in the management of these conditions. In this paper, we discuss the patient's work up, indications, and complementary roles of endoscopic and angiographic management in the settings of gastrointestinal bleeding, enteral feeding, cecostomy tube placement and luminal strictures...
March 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28377105/association-between-an-increase-in-blood-urea-nitrogen-at-24-hours-and-worse-outcomes-in-acute-nonvariceal-upper-gi-bleeding
#20
Navin L Kumar, Brian L Claggett, Aaron J Cohen, Jennifer Nayor, John R Saltzman
BACKGROUND AND AIMS: An increase in blood urea nitrogen (BUN) at 24 hours is a solitary and significant predictor of mortality in patients with acute pancreatitis, which may predict worse outcomes in the similarly resuscitation-requiring condition of acute nonvariceal upper gastrointestinal bleeding (UGIB). The aim of our study is to assess if an increase in BUN at 24 hours is predictive of worse clinical outcomes in acute nonvariceal UGIB. METHODS: A retrospective cohort study was conducted of patients admitted to an academic hospital from 2004 to 2014...
April 1, 2017: Gastrointestinal Endoscopy
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