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Lower gi bleed

Konstantinos Triantafyllou, Paraskevas Gkolfakis, Nikos Viazis, Panagiotis Tsibouris, Athanasios Tsigaridas, Periklis Apostolopoulos, John Anastasiou, Eleni Hounda, Ioannis Skianis, Konstantina Katopodi, Xhoela Ndini, George Alexandrakis, Demetrios G Karamanolis
INTRODUCTION: Since its introduction, small bowel video capsule endoscopy (VCE) use has evolved considerably. AIM: Evaluation of the temporal changes of small bowel VCE utilization in three tertiary centers in Greece in Era 1 (2002-2009) and Era 2 (2010-2014) and the development a forecast model for future VCE use during 2015-2017. MATERIALS AND METHODS: Data from all small bowel VCE examinations were retrieved and analyzed in terms of the annual number of the performed examinations, their indications and the significance of their findings...
October 21, 2016: European Journal of Gastroenterology & Hepatology
Walter H Reinhart
The hematocrit (Hct) determines the oxygen carrying capacity of blood, but also increases blood viscosity and thus flow resistance. From this dual role the concept of an optimum Hct for tissue oxygenation has been derived. Viscometric studies using the ratio Hct/blood viscosity at high shear rate showed an optimum Hct of 50-60% for red blood cell (RBC) suspensions in plasma. For the perfusion of an artificial microvascular network with 5-70μm channels the optimum Hct was 60-70% for high driving pressures. With lower shear rates or driving pressures the optimum Hct shifted towards lower values...
October 21, 2016: Clinical Hemorheology and Microcirculation
Ju H Kim, Ramesh Singh, Francis D Pagani, Shashank S Desai, Nicholas A Haglund, Shannon M Dunlay, Simon Maltais, Keith D Aaronson, John M Stulak, Mary E Davis, Christopher T Salerno, Jennifer A Cowger, Palak Shah
BACKGROUND: Limited data exist on outcomes in patients greater than 70 years of age supported with continuous flow left ventricular assist devices (LVAD). METHODS: Data on 1,149 continuous-flow LVAD recipients was queried from the Mechanical Circulatory Support Research Network. Groups were assigned based on age: ≥70 years ("older patients") and <70 years. The primary outcome was survival at one-year based on age grouping. RESULTS: Compared with younger patients, (54...
October 17, 2016: Journal of Cardiac Failure
Ahmed Kamel Abdel-Aal, Nabila Dawoud, Amr Soliman Moustafa, Maysoon F Hamed, Souheil Saddekni
We report a case of 59-year-old female with non-alcoholic-steato-hepatitis (NASH) induced cirrhosis, who presented with hematochezia. The patient had a history of bleeding esophageal varices treated with endoscopic variceal ligation (EVL). Colonoscopy showed large rectal varices which were the source of her lower gastrointestinal bleeding (LGIB). Since endoscopic treatment for LGIB are limited, and because the patient had portal vein thrombosis which contraindicated transjugular intrahepatic portosystemic shunt (TIPS), we performed percutaneous transhepatic embolization of her rectal varices using a new mixture of embolic and sclerotic agents, followed by Amplatzer plug 2 (AVP 2)...
September 2016: Journal of Radiology Case Reports
Takaki Emura, Kenji Hosoda, Shota Harai, Noboru Oyachi, Takeyuki Suzuki, Ken Takada, Koji Kobayashi, Hisatake Ikeda
BACKGROUND: Massive gastrointestinal bleeding in children, mostly caused by esophageal varices secondary to chronic liver disease, is uncommon. Dieulafoy lesion in the gastrointestinal tract is a rare but important cause of gastrointestinal bleeding; massive bleeding from this lesion can be fatal unless adequate treatment is promptly initiated. We report a case of gastric Dieulafoy lesion in a 2-year old successfully treated with endoscopic hemoclipping. CASE PRESENTATION: A 2-year-old Japanese boy was admitted to our department with sudden massive hematemesis...
October 19, 2016: Journal of Medical Case Reports
ZhuYing Cai, Wei Yang, YingYing He, Qingge Chen, ShiQiang Wang, Xuming Luo, Xiongbiao Wang
An 87-year-old woman developed abdominal wall hematoma and upper gastrointestinal bleeding during treatment with cefoperazone/sulbactam for pneumonia. The woman received cefoperazone/sulbactam at 4.5 g twice daily for intravenous infusion. After 7 days, she developed sudden onset of left lower abdominal pain, associated with subcutaneous mass, and vomited a coffee-colored liquid. Investigations revealed a coagulation index abnormality and activated partial thromboplastin time and prothrombin time increased obviously...
December 2016: Drug Saf Case Rep
Simardeep Gill, Min Jun, Pietro Ravani
The prevalence of atrial fibrillation and the risk of stroke display an age-related increase in the chronic kidney disease (CKD) population. Evidence from large randomized controlled trials conducted in the general population supports the use of anticoagulation to reduce the risk of stroke in the setting of non-valvular atrial fibrillation. However, data in the non-dialysis-dependent and dialysis-dependent CKD populations are limited largely to observational studies, which demonstrate conflicting results regarding the risk-benefit profile of anticoagulation...
October 14, 2016: Nephrology, Dialysis, Transplantation
Omar D Borjas-Almaguer, Carlos A Cortez-Hernández, Emmanuel I González-Moreno, Francisco J Bosques-Padilla, José A González-González, Aldo A Garza, Juan A Martínez-Segura, Diego García-Compean, Juan V Alejandre-Loya, Jesús García-García, Guillermo Delgado-García, Héctor J Maldonado-Garza
:  Background & Aims. It is unclear whether portal vein thrombosis (PVT) unrelated to malignancy is associated with reduced survival or it is an epiphenomenon of advanced cirrhosis. The objective of this study was to assess clinical outcome in cirrhotic patients with PVT not associated with malignancy and determine its prevalence. MATERIAL AND METHODS: Retrospective search in one center from June 2011 to December 2014. RESULTS: 169 patients, 55 women and 114 men, median age 54 (19-90) years...
November 2016: Annals of Hepatology
K K Rawal
Ectopic varices are an unusual cause of gastrointestinal bleeding accounting for upto 5% of all variceal bleeds. Colorectal variceal bleeding is even rare. As the bleed is massive and has a poor prognosis, one must be aware of this condition in a patient of portal hypertension with life-threatening lower gastrointestinal bleeding. Two cases of colorectal variceal bleeding in cirrhotic patients treated successfully by endoscopic therapy are reported here.
June 2016: Journal of the Association of Physicians of India
Davide Capodanno, Dominick J Angiolillo
Daily administration of low-dose of aspirin has proven to be beneficial in preventing recurrent cardiovascular events. However, the role of aspirin for primary prevention in patients with no overt cardiovascular disease is more controversial. In fact, in lower risk patients, the modest benefit in reducing serious vascular events can be offset by the increased risk of bleeding, including intracranial and gastrointestinal hemorrhage. Diabetes mellitus (DM) has been associated with a substantially increased risk of both first and recurrent atherothrombotic events, which makes aspirin therapy of potential value in these subjects...
October 11, 2016: Circulation
Waseem Raja Dar, Imtiyaz Dar, Waseem Raja, Mushtaq Ahmad Khan, Najeebullah Sofi
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Kegan Jessamy, Fidelis O Ojevwe, Ezinnaya Ubagharaji, Anuj Sharma, Obiajulu Anozie, Christy Ann Gilman, Sekou Rawlins
Clostridium septicum is a highly virulent pathogen which is associated with colorectal malignancy, hematological malignancy, immunosuppression, diabetes mellitus and cyclical neutropenia. Presentation may include disseminated clostridial infection in the form of septicemia, gas gangrene, and mycotic aortic aneurysms. We report the case of a 62-year-old female presenting with necrotizing fasciitis of her left thigh and subsequently developing rectal bleeding. While she was being treated with empiric antibiotics, her blood culture was found to be positive for C...
May 2016: Case Reports in Gastroenterology
Ken Okumura, Masatsugu Hori, Norio Tanahashi, A John Camm
Nonvalvular atrial fibrillation (AF) is a risk factor for stroke in elderly patients. Although warfarin has been used to prevent AF-associated stroke for more than 50 years, non-vitamin K antagonist oral anticoagulants (NOACs) including dabigatran, rivaroxaban, apixaban, and edoxaban recently have been developed to overcome the disadvantages of warfarin. Based on the results of NOAC clinical trials, Savelieva and Camm made recommendations regarding selection of NOACs in patients with nonvalvular AF. Recent accumulating evidence indicates that NOACs work differently in Asian and non-Asian individuals...
October 7, 2016: Clinical Cardiology
Juan Paredes Méndez, Guillermo Otoya Moreno, Ana Lucía Mestanza Rivas Plata, Luis Lazo Molina, Katia Acuña Ordoñez, José Luis Arenas Gamio, Eduardo Huamán Egoavil, Fabián Juliao Baños
OBJECTIVE: To identify sociodemographic, clinical, and endoscopic characteristics in patients with inflammatory bowel disease (IBD). MATERIALS AND METHODS: The study period was from January 2004 to December 2014. The final diagnosis was determined by clinical gastroenterologists experienced in the diagnosis and management of IBD, based on internationally accepted diagnostic criteria. RESULTS: 105 patients with IBD were studied, 77% with ulcerative colitis (UC) and 23% with Crohn's disease (CD)...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Anette Bygum, Inmaculada Martinez-Saguer, Murat Bas, Jeffrey Rosch, Jonathan Edelman, Mikhail Rojavin, Debora Williams-Herman
BACKGROUND: Treatment of hereditary angioedema (HAE) in 'older adults' (those aged ≥65 years) has not been well studied. The international Berinert Patient Registry collected data on the use of intravenous plasma-derived, pasteurized, nanofiltered C1-inhibitor concentrate (pnfC1-INH; Berinert(®)/CSL Behring) in patients of any age, including many older adults. METHODS: This observational registry, conducted from 2010 to 2014 at 30 US and seven European sites, gathered prospective (post-enrollment) and retrospective (pre-enrollment) usage and adverse event (AE) data on subjects treated with pnfC1-INH...
October 4, 2016: Drugs & Aging
Hamid Tavakkoli, Mehdi Zobeiri, Mansour Salesi, Mohammad Hossein Sanei
Wegener's granulomatosis is an uncommon inflammatory disease that manifests as vasculitis, granulomatosis, and necrosis. It usually involves the upper and lower respiratory tracts and kidneys. Although it may essentially involve any organ, gastrointestinal (GI) involvement is notably uncommon. A 20-year-old male patient presented with epigastric pain, vomiting, hematemesis, and melena. On physical examination, he was pale. There was no abdominal tenderness or organomegaly. Upper GI endoscopy revealed dark blue-colored infiltrative lesions in prepyloric area...
July 2016: Middle East Journal of Digestive Diseases
Navin L Kumar, Aaron J Cohen, Jennifer Nayor, Brian L Claggett, John R Saltzman
BACKGROUND: Current guidelines advise that upper endoscopy be performed within 24 hours of presentation in patients with acute nonvariceal upper gastrointestinal bleeding (UGIB). However, the role of urgent endoscopy (< 12 hours) is controversial. AIM: Our aim was to assess whether patients admitted with acute nonvariceal UGIB with lower-risk versus high-risk bleeding have different outcomes with urgent compared with non-urgent endoscopy. METHODS: A retrospective cohort study was conducted of patients admitted to an academic hospital with nonvariceal UGIB...
September 29, 2016: Gastrointestinal Endoscopy
Sanne Jensen Dich, Alaa El-Hussuna
INTRODUCTION: We present a case of a presacral hematoma, which penetrated into the rectum resulting in rectal bleeding. This is an unusual presentation of a presacral hematoma. PRESENTATION OF THE CASE: A 76-year-old woman, using warfarin anticoagulant prophylaxis, presented with a rectal bleed two days after a fall. A sigmoidoscopy revealed that the source of bleeding was a presacral hematoma penetrating into the rectum. A Computed Tomography scan of the pelvis confirmed the presence of a hematoma measuring 10×9...
September 22, 2016: International Journal of Surgery Case Reports
Ralph Kamel, Talal Seoud, Teniola Oluwadamilola, Michael Karass, Emily Grossniklaus, Gabriela Oprea-Ilies, Daniel A Goldstein, Sanjay Jain
Choriocarcinoma, a nonseminomatous germ cell tumor, is a rare type of testicular malignancy that tends to occur in young males. It is, however, exceedingly rare for choriocarcinoma to involve the GI tract. In this article, we present a rare case of a 31-year-old male, diagnosed with choriocarcinoma of the left testes, along with several metastases to distant sites. The patient presented with headaches and severe lower GI bleeding due to metastases to the GI tract, which was eventually controlled with systemic chemotherapy, while requiring several units of packed RBCs during his admission to the hospital...
2016: Case Reports in Oncological Medicine
Gautam Ray
There is rising incidence and prevalence of inflammatory bowel disease (IBD) in India topping the Southeast Asian (SEA) countries. The common genes implicated in disease pathogenesis in the West are not causal in Indian patients and the role of "hygiene hypothesis" is unclear. There appears to be a North-South divide with more ulcerative colitis (UC) in north and Crohn's disease (CD) in south India. IBD in second generation Indian migrants to the West takes the early onset and more severe form of the West whereas it retains the nature of its country of origin in migrants to SEA countries...
September 28, 2016: World Journal of Gastroenterology: WJG
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