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acute upper gastrointestinal bleeding

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https://www.readbyqxmd.com/read/28286937/early-versus-late-bedside-endoscopy-for-gastrointestinal-bleeding-in-critically-ill-patients
#1
Jee Hyun Kim, Ji Hye Kim, Jaeyoung Chun, Changhyun Lee, Jong Pil Im, Joo Sung Kim
Background/Aims: Gastrointestinal (GI) bleeding is a life-threatening complication in critically ill patients. The aim of this study was to determine the efficacy of bedside endoscopy in an intensive care unit (ICU) setting, and to compare the outcomes of early endoscopy (within 24 hours of detecting GI bleeding) with late endoscopy (after 24 hours). Methods: We retrospectively reviewed the medical records of patients who underwent bedside endoscopy for nonvariceal upper GI bleeding and lower GI bleeding that occurred after ICU admission at Seoul National University Hospital from January 2010 to May 2015...
March 15, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28286843/clinical-scoring-systems-in-predicting-the-outcome-of-acute-upper-gastrointestinal-bleeding-a-narrative-review
#2
REVIEW
Hanieh Ebrahimi Bakhtavar, Hamid Reza Morteza Bagi, Farzad Rahmani, Kavous Shahsavari Nia, Arezu Ettehadi
Prediction of the outcome and severity of acute upper gastrointestinal bleeding (UGIB) has significant importance in patient care, disposition, and determining the need for emergent endoscopy. Recent international recommendations endorse using scoring systems for management of non-variceal UGIB patients. To date, different scoring systems have been developed for predicting the risk of 30-day mortality and re-bleeding. We have discussed the screening performance characteristics of Baylor bleeding score, the Rockall risk scoring score, Cedars-Sinai Medical Center predictive index, Glasgow Blatchford score, T-score, and AIMS65 systems, in the present review...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28280628/multiple-angiodysplasia-diagnosed-by-capsule-endoscopy
#3
Giulia Diamantini, Giovanni Battista Levi Sandri, Fabio Procacciante
A 28-year-old Caucasian man was admitted in our unit for acute massive rectal bleeding. Past medical and family history was unremarkable. Hemoglobin was 7.6 g/dL. Blood transfusions were required. Computed tomography and gastrointestinal endoscopy were negative for active bleeding. When patient's hemoglobin was normalized and stable, a video capsule endoscopy was performed. Video relieved the presence of multiple digiunal and ileal angiodysplastic lesions. A double endoscopic argon plasma coagulation procedure was planned on general anaesthesia...
February 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28278445/no-catheter-angiography-is-needed-in-patients-with-an-obscure-acute-gastrointestinal-bleed-and-negative-cta
#4
Pratik A Shukla, Adam Zybulewski, Marcin K Kolber, Erik Berkowitz, James Silberzweig, Morris Hayim
PURPOSE: To evaluate the negative predictive power of computed tomography angiography (CTA) for the identification of obscure acute gastrointestinal (GI) bleeding (GI bleeding not visualized/treated by endoscopy) on subsequent mesenteric angiography (MA) with the intention to treat. MATERIALS AND METHODS: A retrospective chart review of patients was performed who underwent mesenteric angiography for the evaluation/treatment of acute GI bleeding between November 2012 and July 2016...
March 1, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28246528/clinical-performance-of-prediction-rules-and-nasogastric-lavage-for-the-evaluation-of-upper-gastrointestinal-bleeding-a-retrospective-observational-study
#5
Hassan K Dakik, F Douglas Srygley, Shih-Ting Chiu, Shein-Chung Chow, Deborah A Fisher
Introduction. The majority of patients with acute upper gastrointestinal bleeding (UGIB) are admitted for urgent endoscopy as it can be difficult to determine who can be safely managed as an outpatient. Our objective was to compare four clinical prediction scoring systems: Glasgow Blatchford Score (GBS) and Clinical Rockall, Adamopoulos, and Tammaro scores in a sample of patients presenting to the emergency department of a large US academic center. Methods. We performed a retrospective cohort study of patients during 2008-2010...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28238693/digital-rectal-examination-reduces-hospital-admissions-endoscopies-and-medical-therapy-in-patients-with-acute-gastrointestinal-bleeding
#6
Manish P Shrestha, Mark Borgstrom, Eugene Trowers
BACKGROUND: Although digital rectal examination is an established part of physical examination in patients with acute gastrointestinal bleeding, clinicians are reluctant to perform rectal examination. We intended to assess if rectal examination affects the clinical management decision in these patients. STUDY: We performed a single-center, retrospective, cross-sectional study using data from electronic health record of patients ≥18 years old presenting to emergency with acute gastrointestinal bleeding...
February 23, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28229613/hemobilia-related-to-cystic-artery-pseudoaneurysm-as-a-cause-of-acute-pancreatitis
#7
Patricia Lozano-Cruz, Percy Arenas, Ignacio Moral
Hemobilia is a rare cause of upper gastrointestinal bleeding (UGIB). It is commonly iatrogenic, and is more rarely caused by tumors, lithiasis, and inflammatory or vascular disease. We describe a case of cystic artery pseudoaneurysm, which caused acute pancreatitis as an unusual complication.
February 23, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28205386/nonvariceal-upper-gastrointestinal-bleeding-in-the-elderly-clinical-outcomes-and-prognostic-factors
#8
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/28184053/gastrointestinal-diseases-and-their-oro-dental-manifestations-part-4-peutz-jeghers-syndrome
#9
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/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...
March 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28108748/-acute-hemorrhage-in-the-upper-gastrointestinal-tract
#11
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/28101125/preventive-transarterial-embolization-in-upper-nonvariceal-gastrointestinal-bleeding
#12
Aleksejs Kaminskis, Aina Kratovska, Sanita Ponomarjova, Anna Tolstova, Maksims Mukans, Solvita Stabiņa, Raivis Gailums, Andrejs Bernšteins, Patricija Ivanova, Viesturs Boka, Guntars Pupelis
BACKGROUND: Transarterial embolization (TAE) is a therapeutic option for patients with a high risk of recurrent bleeding after endoscopic haemostasis. The aim of our prospective study was a preliminary assessment of the safety, efficacy, and clinical outcomes following preventive TAE in patients with non-variceal acute upper gastrointestinal bleeding (NVUGIB) with a high risk of recurrent bleeding after endoscopic haemostasis. METHODS: Preventive visceral angiography and TAE were performed after endoscopic haemostasis on patients with NVUGIB who were at a high risk of recurrent bleeding (PE+ group)...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28100060/boerhaave-s-syndrome-diagnostic-gastroscopy
#13
Rocío Ferreiro-Iglesias, Manuel Narciso Blanco Freire, Manuel Paz Novo, J Enrique Domínguez Muñoz
A 47-year-old man was attended at the emergency room for severe chest pain after eating sausage with subsequent vomiting and mild upper gastrointestinal bleeding. In the chest radiography we could not see abnormalities. He referred previous episodes of choking without consulting. The urgent gastroscopy detected tertiary contractile activity (nutcracker esophagus) and a foreign body in the lower third of the esophagus. After removing the food bolus, we observed a 4 cm longitudinal tear compatible with esophageal rupture or Boerhaave's syndrome in the right posterior wall of the lower esophagus, proximal to the gastroesophageal junction...
January 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28088773/epidemiology-and-outcome-of-acute-pancreatitis-in-end-stage-renal-disease-dialysis-patients-a-10-year-national-cohort-study
#14
Hung-Jui Chen, Jhi-Joung Wang, Wen-Ing Tsay, Shwu-Huey Her, Cheng-Heng Lin, Chih-Chiang Chien
BACKGROUND: The objective of this study is to determine the incidence and severity of acute pancreatitis (AP) in patients with end-stage renal disease (ESRD) on dialysis and whether the dialysis modality [hemodialysis (HD) versus peritoneal dialysis (PD)] confers a higher risk for AP as well as complications or mortality related to AP. METHODS: We analyzed national health insurance claims data of 67 078 ESRD patients initiating dialysis between 1999 and 2007 in Taiwan...
January 14, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28069629/randomized-pragmatic-trial-of-nasogastric-tube-placement-in-patients-with-upper-gastrointestinal-tract-bleeding
#15
Don C Rockey, Chul Ahn, Silvio W de Melo
The value of nasogastric (NG) tube placement in patients with upper gastrointestinal tract bleeding (UGIB) is unclear. We therefore aimed to determine the usefulness of NG tube placement in patients with UGIB. The study was a single-blind, randomized, prospective, non-inferiority study comparing NG placement (with aspiration and lavage) to no NG placement (control). The primary outcome was the probability that physicians could predict the presence of a high-risk lesion (ie, requiring endoscopic therapy). 140 patients in each arm were included; baseline clinical features were similar in each group...
January 9, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28065526/hemospray-for-treatment-of-acute-bleeding-due-to-upper-gastrointestinal-tumours
#16
Monica Arena, Enzo Masci, Leonardo Henry Eusebi, Giuseppe Iabichino, Benedetto Mangiavillano, Paolo Viaggi, Elisabetta Morandi, Lorella Fanti, Antonino Granata, Mario Traina, Pier Alberto Testoni, Enrico Opocher, Carmelo Luigiano
BACKGROUND: Hemospray is a new endoscopic haemostatic powder that can be used in the management of upper gastrointestinal bleedings. AIMS: To assess the efficacy and safety of Hemospray as monotherapy for the treatment of acute upper gastrointestinal bleeding due to cancer. METHODS: The endoscopy databases of 3 Italian Endoscopic Units were reviewed retrospectively and 15 patients (8 males; mean age 74 years) were included in this study. RESULTS: Immediate haemostasis was achieved in 93% of cases...
December 21, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28008413/gastrointestinal-symptoms-from-left-ventricular-assist-device-external-compression-of-the-gastric-lumen
#17
Jorge Suarez, Dennis Yang
A 74-year-old man with a left-ventricular assist device (LVAD) as destination therapy for end-stage ischemic cardiomyopathy presented with acute upper gastrointestinal bleeding. Other symptoms included chronic early satiety, intermittent nausea, and non-specific abdominal discomfort since LVAD implantation 3 years ago. An actively bleeding duodenal arteriovenous malformation was successfully treated with endoscopic coagulation. There was also evidence of moderate external compression of the anterior gastric wall from the LVAD pump with luminal narrowing in the antrum...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27935911/giant-left-atrium-a-rare-case-of-acute-upper-gastrointestinal-bleeding
#18
K R Dewan, B S Patowary, S Bhattarai
Acute upper GI bleeding is a common medical emergency with a hospital mortality of approximately 10%. Non variceal UGI bleeding is the most common cause followed by oesophageal varices. Various rare causes have been described in the literature but there are very few cases of giant left atrium leading to oesophageal erosion and causing upper GI bleeding. We are presenting a case of rheumatic valvular heart disease with giant left atrium who presented in our department with acute upper GI bleeding.
January 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/27930875/comparison-of-three-scoring-systems-in-predicting-clinical-outcomes-in-patients-with-acute-upper-gastrointestinal-bleeding-a-prospective-observational-study
#19
Min Zhong, Wan Jun Chen, Xiao Ye Lu, Jie Qian, Chang Qing Zhu
OBJECTIVE: To compare the performance of the Glasgow-Blatchford score (GBS), modified GBS (mGBS), and AIMS65 in predicting clinical outcomes in patients with acute upper gastrointestinal bleeding (AUGIB). METHODS: This study enrolled 320 consecutive patients with AUGIB. High-risk and low-risk patients were categorized according to the GBS, mGBS and AIMS65 scoring systems. The primary outcome was the occurrence of adverse events. Secondary outcomes were occurrences of rebleeding, in-hospital mortality, and need for clinical intervention...
December 8, 2016: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/27920416/re-evaluating-the-inhibition-of-stress-erosions-revise-a-protocol-for-pilot-randomized-controlled-trial
#20
RANDOMIZED CONTROLLED TRIAL
Waleed Alhazzani, Gordon Guyatt, John C Marshall, Richard Hall, John Muscedere, Francois Lauzier, Lehana Thabane, Mohammed Alshahrani, Shane W English, Yaseen M Arabi, Adam M Deane, Tim Karachi, Bram Rochwerg, Simon Finfer, Nick Daneman, Nicole Zytaruk, Diane Heel-Ansdell, Deborah Cook, On Behalf Of
INTRODUCTION: Clinicians routinely administer stress ulcer prophylaxis to mechanically ventilated patients in the intensive care unit (ICU), most commonly prescribing proton pump inhibitors (PPIs). However, the incidence of gastrointestinal (GI) bleeding from stress ulceration is low and recent observational studies suggest these agents may increase infections. Therefore, a large randomized clinical trial (RCT) is needed to inform modern practice. The aim of this multicenter pilot trial is to determine the feasibility of performing a large RCT to investigate the efficacy and safety of withholding intravenous pantoprazole...
November 2016: Annals of Saudi Medicine
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