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acute upper gastrointestinal bleeding

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https://www.readbyqxmd.com/read/28101125/preventive-transarterial-embolization-in-upper-nonvariceal-gastrointestinal-bleeding
#1
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
#2
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
#3
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
#4
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)...
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/27906917/efficacy-and-safety-of-tc-325-hemospraytm-for-non-variceal-upper-gastrointestinal-bleeding-at-middlemore-hospital-the-early-new-zealand-experience
#10
Hannah Giles, Dinesh Lal, Stephen Gerred, Paul Casey, Alasdair Patrick, Derek Luo, Ravinder Ogra
AIMS: A case series to review early experiences with HemosprayTM for a variety of non-variceal upper gastrointestinal bleeding (UGIB) at Middlemore Hospital. METHODS: HemosprayTM was administered therapeutically as first line or rescue at the discretion of the endoscopist. All cases of UGIB requiring HemosprayTM at Middlemore Hospital were identified to the investigator who undertook analysis of electronic and hard copy notes. RESULTS: Between October 2013 and July 2016, 36 patients were treated endoscopically with HemosprayTM...
December 2, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27807586/a-rare-case-of-hepatitis-c-associated-cryoglobulinemic-duodenal-vasculitis
#11
Shivali R Berera, Alexandra Gomez, Kevin Dholaria, Leopoldo R Arosemena, Marco A Ladino-Avellaneda, Laura Barisoni, Kalyan R Bhamidimarri
Intestinal involvement of cryoglobulinemia is an uncommon manifestation and marker of severe vasculitis. We describe the case of a woman admitted to our service for management of acute renal failure and progressive gastrointestinal symptoms after initiating hepatitis C virus treatment with ribavirin and sofosbuvir 4 weeks prior. With an undetectable hepatitis C viral load and persistent symptoms despite hepatitis C virus therapy cessation, an upper endoscopy revealed duodenal sloughing, erythema, and bleeding, sparking suspicion for recurrence of cryoglobulinemic vasculitis...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27793353/cost-effectiveness-of-low-dose-submicron-diclofenac-compared-with-generic-diclofenac
#12
Deirdre Mladsi, Naoko Ronquest, Dawn Odom, LaStella Miles, Kenneth Saag
PURPOSE: NSAIDs are commonly prescribed for the treatment of pain and inflammation. Despite the effectiveness of NSAIDs, concerns exist regarding their tolerability. Worldwide health authorities, including the European Medicines Agency, Health Canada, and the US Food and Drug Administration, have advised that NSAIDs be prescribed at the lowest effective dosage and for the shortest duration. Effective lowering of NSAID dosage without compromising pain relief has been demonstrated in randomized, controlled trials of the recently approved NSAID lower-dose submicron diclofenac...
October 25, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27789550/obscure-upper-gastrointestinal-haemorrhage-haemosuccus-pancreaticus
#13
Prateush Singh, Asim Khan, Manuel Jasper, Javaid Subhani
A Caucasian man aged 28 years with a history of pancreatitis presented with fatigue, intermittent melaena and severe anaemia. Symptomatic treatment for anaemia was coupled with thorough investigation to localise the source of gastrointestinal haemorrhage. Two oesophagogastroduodenoscopies and colonoscopies failed to identify a cause. CT abdomen revealed splenomegaly secondary to splenic vein thrombosis with evidence of portal hypertension and small collateral vessels. A CT mesenteric angiogram revealed a splenic artery pseudoaneurysm as the likely source of bleeding...
October 27, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27788611/helicobacter-pylori-liver-cirrhosis-and-portal-hypertension-an-updated-appraisal
#14
Raffaele Licinio, Giuseppe Losurdo, Sonia Carparelli, Andrea Iannone, Floriana Giorgio, Michele Barone, Mariabeatrice Principi, Enzo Ierardi, Alfredo Di Leo
OBJECTIVE: Helicobacter pylori (H. pylori) is the most common cause of gastritis and peptic ulcer. However, H. pylori is even involved in extragastric diseases, and it has been hypothesized that H. pylori could be a risk factor for several hepatic diseases. For instance, a direct involvement of H. pylori in the development of portal hypertension (PH) in cirrhotic patients has been postulated. METHODS: We performed a literature search in major databases to elucidate the relationship between H...
October 27, 2016: Immunopharmacology and Immunotoxicology
https://www.readbyqxmd.com/read/27786543/assessment-of-safety-of-performing-percutaneous-coronary-intervention-after-a-recent-episode-of-gastrointestinal-bleeding
#15
Saima Karim, Sweetheart T Ador-Dionisio, Munira Karim, Mohammad Karim, Sadaf S Khan, Ashish Atreja, Stephen Ellis
BACKGROUND: Little literature exists on the risk of performing coronary intervention (PCI) on patients who have had recent gastrointestinal bleeding (GIB), although bleeding after PCI has been identified as a risk factor for long-term mortality. METHODS: Patients within the Cleveland Clinic PCI database who had acute GIB within 30 days preceding PCI during the same hospitalization (n = 79) were retrospectively compared to those who had PCI without recent GIB (n = 10 979) for mortality and need for revascularization...
October 27, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27784430/-prognostic-value-of-a-logistic-regression-model-based-on-keratin-18-in-patients-with-hbv-related-liver-failure
#16
Q R Gan, X Y Jiang, X Zhang, M S Chen, C Pan
Objective: To investigate the association between serum keratin 18 (K18) level and prognosis in patients with HBV-related acute-on-chronic liver failure (ACLF). Methods: A total of 120 patients who visited Department of Hepatology in Fuzhou Infectious Disease Hospital and were diagnosed with HBV-related ACLF from December 2012 to March 2014 were enrolled and followed up for 3 months. The patients were divided into death group and survival group. The serum levels of K18 fragments (M30 and M65) were measured and related laboratory data were collected to analyze the differences in M30, M65, M30/M65, and other laboratory markers...
July 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/27776486/bleeding-downhill-esophageal-varices-associated-with-benign-superior-vena-cava-obstruction-case-report-and-literature-review
#17
Michael Loudin, Sharon Anderson, Barry Schlansky
BACKGROUND: Proximal or 'downhill' esophageal varices are a rare cause of upper gastrointestinal hemorrhage. Unlike the much more common distal esophageal varices, which are most commonly a result of portal hypertension, downhill esophageal varices result from vascular obstruction of the superior vena cava (SVC). While SVC obstruction is most commonly secondary to malignant causes, our review of the literature suggests that benign causes of SVC obstruction are the most common cause actual bleeding from downhill varices...
October 24, 2016: BMC Gastroenterology
https://www.readbyqxmd.com/read/27749768/emergency-readmission-following-acute-upper-gastrointestinal-bleeding
#18
Martin Strömdahl, Johan Helgeson, Evangelos Kalaitzakis
OBJECTIVE: To assess the occurrence, clinical predictors, and associated mortality of all-cause emergency readmissions after acute upper gastrointestinal bleeding (AUGIB). PATIENTS AND METHODS: All patients with AUGIB from an area of 600 000 inhabitants in Sweden admitted in a single institution in 2009-2011 were retrospectively identified. All medical records were scrutinized and relevant data (such as comorbid illness and medications, endoscopy, rebleeding, inhospital mortality, and 30-day emergency readmission) were extracted...
January 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27737411/primary-aortoduodenal-fistula-first-you-should-suspect-it
#19
Mircea Beuran, Ionut Negoi, Ruxandra Irina Negoi, Sorin Hostiuc, Sorin Paun
A 59 year-old patient was admitted with upper gastrointestinal bleeding. The clinical exam showed mild hypotension and blood samples revealed acute anemia (hemoglobin = 7.5 g/dl). Emergency computed tomography showed an infrarenal abdominal aortic aneurysm and extravasation of the arterial contrast material toward the digestive tract. The patient was transported to the operating room for emergency laparotomy, which showed an aortoduodenal fistula. After proximal and distal aortic vascular control, the two anatomical structures were dissected with duodenorrhaphy, patch repair of the aortic tear and omentum interposition...
May 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27730597/acute-esophageal-necrosis
#20
Beatriz Deoti E Silva Rodrigues, Raniere Dos Santos, Magda Maria Profeta da Luz, Flávia Chaves E Silva, Igor Guedes Nogueira Reis
Acute esophageal necrosis (AEN) or "black esophagus" is a rare condition presented by patients with critical state of health and characterized by a darkened esophagus, usually the distal third, in upper digestive endoscopy. The main clinical manifestation is upper gastrointestinal bleeding and there may be abdominal pain, dysphagia, nausea, vomiting, fever and syncope associated. The diagnosis depends on clinical suspicion and performing endoscopy, the biopsy not being required. In this article we present a case of a patient who had lots of comorbidities and developed AEN during a post-operative period, and discuss the importance of AEN in an increasingly ageing population...
December 2016: Clinical Journal of Gastroenterology
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