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variceal gastrointestinal bleeding

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https://www.readbyqxmd.com/read/28167214/doppler-endoscopic-probe-monitoring-of-blood-flow-improves-risk-stratification-and-outcomes-of-patients-with-severe-non-variceal-upper-gastrointestinal-hemorrhage
#1
Dennis M Jensen, Thomas Og Kovacs, Gordon V Ohning, Kevin Ghassemi, Gustavo A Machicado, Gareth S Dulai, Alireza Sedarat, Rome Jutabha, Jeffrey Gornbein
BACKGROUND & AIMS: For 4 decades, stigmata of recent hemorrhages in patients with non-variceal lesions have been used for risk stratification and endoscopic hemostasis. The arterial blood flow that underlies the stigmata is rarely monitored, but can be used to determine risk for rebleeding. We performed a randomized controlled trial to determine whether Doppler endoscopic probe monitoring of blood flow improves risk stratification and outcomes in patients with severe non-variceal upper gastrointestinal hemorrhage...
February 3, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28147475/over-the-scope-clip-in-the-management-of-gastrointestinal-defect-and-intractable-non-variceal-bleeding
#2
Hyungkil Kim
No abstract text is available yet for this article.
January 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28109636/management-of-non-variceal-upper-gastrointestinal-bleeding-position-statement-of-the-catalan-society-of-gastroenterology
#3
Pilar García-Iglesias, Josep-Maria Botargues, Faust Feu Caballé, Càndid Villanueva Sánchez, Xavier Calvet Calvo, Enric Brullet Benedi, Gabriel Cánovas Moreno, Esther Fort Martorell, Marta Gallach Montero, Emili Gené Tous, José-Manuel Hidalgo Rosas, Amelia Lago Macía, Ana Nieto Rodríguez, Michel Papo Berger, Montserrat Planella de Rubinat, Joan Saló Rich, Rafel Campo Fernández de Los Ríos
In recent years there have been advances in the management of non-variceal upper gastrointestinal bleeding that have helped reduce rebleeding and mortality. This document positioning of the Catalan Society of Digestologia is an update of evidence-based recommendations on management of gastrointestinal bleeding peptic ulcer.
January 18, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28101125/preventive-transarterial-embolization-in-upper-nonvariceal-gastrointestinal-bleeding
#4
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/28099341/laparoscopic-distal-splenoadrenal-shunt-for-the-treatment-of-portal-hypertension-in-children-with-congenital-hepatic-fibrosis-a-case-report
#5
Jin-Shan Zhang, Wei Cheng, Long Li
BACKGROUND: The distal splenorenal shunt is an effective procedure for the treatment of portal hypertension in children. However, there has been no report about laparoscopic distal splenorenal shunt in the treatment of portal hypertension in children. METHODS: From December 2015 to August 2016, 4 children with upper gastrointestinal bleeding underwent laparoscopic distal splenoadrenal shunt. Portal hypertension and splenomegaly were demonstrated on the preoperative computed tomography (CT) and sonography...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28091770/relevance-of-surgery-in-patients-with-non-variceal-upper-gastrointestinal-bleeding
#6
S Dango, T Beißbarth, E Weiss, A Seif Amir Hosseini, D Raddatz, V Ellenrieder, J Lotz, B M Ghadimi, A Beham
INTRODUCTION: Upper GI bleeding remains one of the most common emergencies with a substantial overall mortality rate of up to 30%. In severe ill patients, death does not occur due to failure of hemostasis, either medical or surgical, but mainly from comorbidities, treatment complications, and decreased tolerated blood loss. Management strategies have changed dramatically over the last two decades and include primarily endoscopic intervention in combination with acid-suppressive therapy and decrease in surgical intervention...
January 14, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28089365/gastric-bleeding-risk-following-spleen-preserving-distal-pancreatectomy-with-excision-of-the-splenic-vessels-a%C3%A2-long-term-follow-up
#7
D Louis, A Alassiri, S Kirzin, S Blaye-Felice, M Chalret du Rieu, C H Julio, E Bloom, L Ghouti, B Pradère, G Portier, N Carrère
BACKGROUND: Spleen-preserving distal pancreatectomy with resection of the splenic vessels (VR-SPDP) is an effective procedure. However, hemodynamic changes in splenogastric circulation may lead to the development of gastric varices (GV) with a risk of gastrointestinal (GI) bleeding. This retrospective study aimed to assess the long-term postoperative clinical follow-up of patients and review the late postoperative abdominal computed tomography (CT) or endoscopic examination. METHODS: From 1988 to 2015, 48 consecutive VR-SPDP for benign or low-grade malignant disease were included...
January 12, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28079234/evaluation-of-endoscopic-secondary-prophylaxis-in-children-and-adolescents-with-esophageal-varices
#8
Júlio Rocha Pimenta, Alexandre Rodrigues Ferreira, Eleonora Druve Tavares Fagundes, Paulo Fernando Souto Bittencourt, Alice Mendes Moura, Simone Diniz Carvalho
BACKGROUND: - Bleeding of esophageal varices is the main cause of morbidity and mortality in children and adults with portal hypertension and there are few studies involving secondary prophylaxis in children and adolescents. OBJECTIVE: - To evaluate the efficacy of endoscopic secondary prophylaxis in prevention of upper gastrointestinal bleeding in children and adolescents with esophageal varices. METHODS: - This is a prospective analysis of 85 patients less than 18 years of age with or without cirrhosis, with portal hypertension...
January 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28074870/microrna-155-is-upregulated-in-ascites-in-patients-with-spontaneous-bacterial-peritonitis
#9
Philipp Lutz, Mohamed M Haimid, Alessandra Pohlmann, Jennifer Lehmann, Christian Jansen, Robert Schierwagen, Sabine Klein, Christian P Strassburg, Ulrich Spengler, Jonel Trebicka
MircoRNA's (miR) have been recognised as important modulators of gene expression and potential biomarkers. However, they have been rarely investigated in bio fluids apart from blood. We investigated the association of miR-125b and miR-155 with complications of cirrhosis. Ascites was prospectively collected from patients with cirrhosis undergoing paracentesis at our department. miR's were determined in the supernatant using qPCR and normalized by SV-40. Clinical parameters were assessed at paracentesis and during follow-up...
January 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28072750/upper-gastrointestinal-ectopic-variceal-bleeding-treated-with-various-endoscopic-modalities-case-reports-and-literature-review
#10
Sang Woo Park, Eunae Cho, Chung Hwan Jun, Sung Kyu Choi, Hyun Soo Kim, Chang Hwan Park, Jong Sun Rew, Sung Bum Cho, Hee Joon Kim, Mingui Han, Kyu Man Cho
RATIONALE: Ectopic variceal bleeding is a rare (2-5%) but fatal gastrointestinal bleed in patients with portal hypertension. Patients with ectopic variceal bleeding manifest melena, hematochezia, or hematemesis, which require urgent managements. Definitive therapeutic modalities of ectopic varices are not yet standardized because of low incidence. Various therapeutic modalities have been applied on the basis of the experiences of experts or availability of facilities, with varying results...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28066855/spectrum-of-small-bowel-mucosal-abnormalities-identified-by-capsule-endoscopy-in-patients-with-portal-hypertension-of-varied-etiology
#11
T S Chandrasekar, Gokul Bollu Janakan, Viveksandeep Thoguluva Chandrasekar, Raja Yogesh Kalamegam, Sathiamoorthy Suriyanarayanan, Prasad Menta Sanjeevaraya
BACKGROUND: Bleeding from small intestinal ectopic varices and persistent anemia caused by portal hypertensive enteropathy (PHE) can be very challenging. Capsule endoscopy (CE) is one of the best noninvasive modalities in identifying such lesions. AIM: The aims of this study are to study the prevalence of small-bowel changes related to portal hypertension (PHT) and to correlate them with the observations related to the effects of portal hypertension in the esophagus, stomach, and colon...
January 9, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28065374/predictive-value-of-ct-for-first-esophageal-variceal-bleeding-in-patients-with-cirrhosis-value-of-para-umbilical-vein-patency
#12
Paul Calame, Maxime Ronot, Sébastien Bouveresse, Jean-Paul Cervoni, Valérie Vilgrain, Éric Delabrousse
PURPOSE: To evaluate if the presence/size of a para-umbilical vein (PUV) on computed tomography (CT) are associated with a first esophageal variceal hemorrhage (EVH) in patients with cirrhosis and whether imaging features can help identify patients at increased risk of EVH. MATERIALS AND METHODS: From January 2010 to June 2012 patients with cirrhosis who underwent CT and upper gastrointestinal endoscopy within six months were included. The presence/size of PUV was noted...
February 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28064299/idiopathic-duodenal-varix-presenting-as-a-massive-upper-gastrointestinal-bleeding-a-case-report
#13
N H Zubaidah, J H Asraf, L Lee, T Gee
Ectopic variceal bleeding is both a diagnostic dilemma and a therapeutic challenge, especially when it is located in the third part of the duodenum. Varix is rare in the absence of cirrhosis or portal hypertension. Because the diagnosis of this condition is usually delayed, treatment is administered late resulting in high morbidity and mortality rate. We report a case of a 61-year-old lady with an idiopathic duodenal varix presenting as an upper gastrointestinal bleeding.
October 2016: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28064286/rockall-risk-score-in-predicting-30-days-non-variceal-upper-gastrointestinal-rebleeding-in-a-malaysian-population
#14
H T Lip, H T Heah, T J Huei, S Premaa, A Sarojah
OBJECTIVE: the aim of this study was to determine the usefulness of Rockall score in predicting outcomes of 30 days rebleeding, mortality and need for surgical intervention of bleeding gastric and duodenal ulcers. METHODS: this is a retrospective cohort study of all the emergency endoscopies performed in Hospital sultan Ismail from January 2009 to October 2014 for indications of upper gastrointestinal bleeding (UGIb). Data was extracted from hospital's electronic database and only non-variceal bleeds were included...
October 2016: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28045757/left-colonic-bleeding-secondary-to-inferior-mesenteric-vein-stenosis
#15
Thang Q Le, Donald Romanelli
Lower gastrointestinal bleeding is most commonly associated with diverticulosis, ischemic colitis, vascular ectasia, and anorectal disease and less commonly associated with colonic malignancy. Infrequently, it is associated with mesenteric varices, a rare etiology that is not well documented in the radiology literature. We present a case of a 50-year-old man diagnosed as having intermittent left colonic bleeding from mesenteric varices due to a critical stenosis at the portal vein-inferior mesenteric vein confluence...
January 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/28011279/association-of-prophylactic-endotracheal-intubation-in-critically-ill-patients-with-upper-gi-bleeding-and-cardiopulmonary-unplanned-events
#16
Umar Hayat, Peter J Lee, Hamid Ullah, Shashank Sarvepalli, Rocio Lopez, John J Vargo
BACKGROUND AND AIMS: Prophylactic endotracheal intubation (PEI) is often advocated to mitigate the risk of cardiopulmonary adverse events in patients presenting with brisk upper GI bleeding (UGIB). However, the benefit of such a measure remains controversial. Our study aimed to compare the incidence of cardiopulmonary unplanned events between critically ill patients with brisk UGIB who underwent endotracheal intubation versus those who did not. METHODS: Patients aged 18 years or older who presented at Cleveland Clinic between 2011 and 2014 with hematemesis and/or patients with melena with consequential hypovolemic shock were included...
December 21, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27935911/giant-left-atrium-a-rare-case-of-acute-upper-gastrointestinal-bleeding
#17
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/27922855/liver-stiffness-predicts-variceal-bleeding-in-hiv-hcv-coinfected-patients-with-compensated-cirrhosis
#18
Nicolás Merchante, Antonio Rivero-Juárez, Francisco Téllez, Dolores Merino, Maria José Ríos-Villegas, Guillermo Ojeda-Burgos, Mohamed Omar, Juan Macías, Antonio Rivero, Monserrat Pérez-Pérez, Miguel Raffo, Inmaculada López-Montesinos, Manuel Márquez-Solero, Maria Amparo Gómez-Vidal, Juan A Pineda
BACKGROUND: A liver stiffness below 21 kPa has a high negative predictive value to exclude the presence of esophageal varices at risk of bleeding in HIV/hepatitis C virus (HCV)-coinfected patients. Consequently, upper gastrointestinal endoscopy (UGE) for the screening of esophageal varices could be avoided in these patients. However, this strategy has not been widely accepted due to concerns about its safety. OBJECTIVE: To assess the ability of liver stiffness to predict the risk of portal hypertensive gastrointestinal bleeding (PHGB) in HIV/HCV-coinfected patients with compensated cirrhosis...
February 20, 2017: AIDS
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
#19
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/27888865/advances-in-gastrointestinal-bleeding
#20
Ángel Lanas
The main innovations of the latest meeting of the Gastroenterological Association (2016) concerning upper gastrointestinal bleeding from the clinician's perspective can be summarised as follows: a) The Glasgow-Blatchford scale has the best accuracy in predicting the need for surgical intervention and hospital mortality; b) Prognostic scales for non-variceal upper gastrointestinal bleeding are also useful for lower gastrointestinal bleeding; c) Preliminary data suggest that treatment with hemospray does not seem to be superior to current standard treatment in controlling active peptic ulcer bleeding; d) Either famotidine or a proton pump inhibitor may be effective in preventing haemorrhagic recurrence in patients taking aspirin, but this finding needs to be confirmed in further studies; e) There was confirmation of the need to re-introduce antiplatelet therapy as early as possible in patients with antiplatelet-associated gastrointestinal bleeding in order to prevent cardiovascular mortality; f) Routine clinical practice suggests that gastrointestinal or cardiovascular complications with celecoxib or traditional NSAIDs are very low; g) Dabigatran is associated with an increased incidence of gastrointestinal bleeding compared with apixaban or warfarin...
September 2016: Gastroenterología y Hepatología
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