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Lower gastrointestinal bleeding

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https://www.readbyqxmd.com/read/29334144/acute-gastrointestinal-bleeding-from-appendiceal-diverticulitis-diagnosed-preoperatively-by-combined-short-interval-computed-tomography-and-colonoscopy-a-case-report
#1
Yutaro Ogawa, Naoki Asayama, Shinji Nagata
Colonic diverticular bleeding is the most common cause of lower gastrointestinal bleeding1,2 . Appendiceal diverticulosis is an uncommon clinical entity, with an incidence of 0.004%-2% in surgical pathologic specimens3,4 . Appendiceal diverticulitis in symptomatic patients should be treated with early resection, because of the risk of perforation and peritonitis; the rate of perforation is higher in appendicitis (27%) with diverticulosis than in appendicitis alone (6.6%)5 . Untreated appendiceal diverticulitis can also lead to massive gastrointestinal hemorrhage and abscess formation, and has a potential role in the development of pseudomyxoma peritonei...
January 15, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29333014/is-colorectal-cancer-in-young-40-years-different-from-those-in-the-elderly-40-years-experience-from-a-regional-care-center
#2
Rudresha A Haleshappa, Suparna Ajit Rao, Sunny Garg, C Lakshmaiah Kuntegowdanahalli, Govinda Babu Kanakasetty, Lokanatha Dasappa
Background: Colorectal cancer (CRC) is considered a disease of elderly. There has been a steady decrease in the incidence in those aged >50 years, with an alarming increase noted in adults aged <50 years. Subjects and Methods: We retrospectively analyzed 89 patients diagnosed with CRC aged <40 years between the years 2010 and 2014. Their clinical profile, treatment, and outcomes were studied. Results: The median age was 33 years with a male preponderance (56...
October 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/29317943/acute-lower-gastrointestinal-bleeding-characteristics-and-clinical-outcome-of-patients-treated-with-an-intensive-protocol
#3
Georgia Diamantopoulou, Christos Konstantakis, Anastasia Kottorοu, Georgios Skroubis, Georgios Theocharis, Vasileios Theopistos, Christos Triantos, Vasiliki Nikolopoulou, Konstantinos Thomopoulos
Background: In recent years major advances have been made in the management of patients with acute lower gastrointestinal bleeding. The aim of this study was to investigate the characteristics and clinical outcome of patients with acute lower gastrointestinal bleeding (ALGIB) treated with an intensive protocol. Methods: We analyzed the medical records of 528 patients with ALGIB. All patients after hemodynamic stabilization underwent colonoscopy during the first 24 h of hospitalization and capsule enteroscopy when needed...
December 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/29317941/rockall-score-larger-than-7-as-a-reliable-criterion-for-the-selection-of-indications-for-preventive-transarterial-embolization-in-a-subgroup-of-high-risk-elderly-patients-after-primary-endoscopic-hemostasis-for-non-variceal-upper-gastrointestinal-bleeding
#4
Aleksejs Kaminskis, Patricija Ivanova, Sanita Ponomarjova, Maksims Mukans, Viesturs Boka, Guntars Pupelis
Background: Transarterial embolization (TAE) is an alternative procedure to repeat endoscopy or surgical intervention in the case of re-bleeding after primary endoscopic treatment. The aim of the study was to assess the Rockall score as a criterion for TAE in the case of re-bleeding after endoscopic treatment of non-variceal upper gastrointestinal bleeding (NVUGIB). Methods: Out of the 673 patients who underwent emergent endoscopic hemostasis due to NVUGIB, 111 had a high risk of re-bleeding having a Forrest I-IIb ulcer and the Rockall score ≥ 5...
December 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/29317374/acute-lower-gastrointestinal-bleeding-predictive-factors-and-clinical-outcome-for-the-patients-who-needed-first-time-mesenteric-conventional-angiography
#5
Onur Sıldıroğlu, Jamil Muasher, Tara A Bloom, İrem Kapucu, Bülent Arslan, John F Angle, Alan H Matsumoto, Ülkü Cenk Turba
PURPOSE: We aimed to investigate patients with lower gastrointestinal bleeding who presented to the emergency department requiring initial conventional angiography. We report risk-stratified and mesenteric conventional angiography outcomes. METHODS: We retrospectively reviewed patients with lower gastrointestinal bleeding between 2001 and 2012. We included all consecutive patients with clinical lower gastrointestinal bleeding with a requirement of further angiography and possible embolization...
January 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/29314627/etiology-of-gastrointestinal-bleeding-in-patients-on-dual-antiplatelet-therapy
#6
Arslan Shaukat, Salman Waheed, Ethan Alexander, Daniel Washko, Buddhadeb Dawn, Mojtaba Olyaee, Kamal Gupta
BACKGROUND: Dual antiplatelet therapy (DAPT) is associated with an increased risk of gastrointestinal bleeding (GIB). Traditionally thought to cause mostly upper GIB (UGIB), some recent reports suggest that incidence of lower GIB (LGIB) may be increasing. We conducted a study to assess the endoscopic findings and etiology of GIB in patients who presented with GIB on DAPT compared to those not on DAPT. METHODS: This is a retrospective, single center, case control study...
January 4, 2018: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/29305021/risk-factors-associated-with-clinically-significant-gastrointestinal-bleeding-in-pediatric-emergency-department
#7
Ayse Gultekingil, Ozlem Teksam, Hayriye Hızarcıoğlu Gulsen, Burcu Berberoğlu Ates, İnci Nur Saltık-Temizel, Hülya Demir
INTRODUCTION: Gastrointestinal bleeding is a common problem in pediatric emergency department (PED). Some of these patients can lose significant amount of blood which may lead to shock. The aim of this study is to determine the risk factors predicting clinically significant gastrointestinal (GIS) bleeding in patients presenting to PED. METHODS: This study was performed prospectively from January 1st 2013 to December 31th 2013 in patients with upper or lower GIS bleeding...
December 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29304527/is-there-a-preferred-stroke-prevention-strategy-for-diabetic-patients-with-non-valvular-atrial-fibrillation-comparing-warfarin-dabigatran-and-rivaroxaban
#8
Chih-Cheng Hsu, Pai-Feng Hsu, Shih-Hsien Sung, Shih-Te Tu, Ben-Hui Yu, Chi-Jung Huang, Hao-Min Cheng
BACKGROUND:  The prevalence of diabetes is growing, and diabetes is an independent risk factor for both atrial fibrillation (AF) and stroke. However, the relative effectiveness and safety of different oral anticoagulants for diabetic patients with non-valvular AF remain unclear. We aimed to compare thromboembolic events, bleeding and mortality in diabetic AF patients treated with rivaroxaban, dabigatran and warfarin. METHODS AND RESULTS:  Diabetic AF patients taking dabigatran (n = 322), rivaroxaban (n = 320) or warfarin (n = 1,899) were identified from the nationwide diabetes pay-for-performance program (n = 814,465) in Taiwan...
January 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29301795/recurrent-cytomegalovirus-colitis-a-rare-case-of-immune-reconstitution-inflammatory-syndrome
#9
Joseph Alukal, Mohammed Asif, Rachana Mundada, William B McNamee
Cytomegalovirus (CMV) colitis usually occurs in patients with advanced immunosuppression when the CD4 count is <50 cells/μL. We reported a case of recurrent CMV colitis in a patient with HIV who presented with profuse lower gastrointestinal bleed. This was a case of immune reconstitution inflammatory syndrome (IRIS) manifesting as CMV colitis and has been reported only once in the literature previously. This patient had a CD4 count of 157 cells/μL and undetectable viral load after being on antiretroviral therapy (ART) for 5 months, which was consistent with IRIS...
January 4, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29282382/massive-upper-and-lower-gi-bleed-from-simultaneous-primary-al-amyloidosis-of-the-stomach-and-transverse-colon-in-a-patient-with-multiple-myeloma
#10
Zubair Khan, Umar Darr, Anas Renno, Abhinav Tiwari, Aijaz Sofi, Ali Nawras
Symptomatic primary (amyloid light-chain or AL) amyloidosis of the gastrointestinal (GI) tract is very rare. Most of the patients with symptomatic involvement of the GI tract present with altered motility, malabsorption, or bleeding. We report a case of gastric and colonic amyloidosis on anticoagulation presenting with massive upper and lower GI bleeding. A 67-year-old lady known to have multiple myeloma and AL amyloidosis on rivaroxaban presented with massive upper GI bleeding. Esophagogastroduodenoscopy showed a mass lesion (3 × 7 cm) located along the greater curvature in the body/antrum with active bleeding...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29278001/spontaneous-intramural-intestinal-hemorrhage-due-to-anticoagulation-therapy
#11
Helena Ribeiro, Richard Azevedo, Eduardo Pereira, António Banhudo
An 84-years old woman, medicated with acenocumarol, was admitted to the Emergency Room with lower abdominal pain and nauseas and no history of trauma. She was medicated with acenocumarol and had a non-measurable international normalized ratio. The findings of the bowel ultrasound, ileocolonoscopy and biopsies specimens were suggestive of intramural bleeding of the ileum, ileocecal valve and cecum. Spontaneous intramural bleeding of the gastrointestinal wall associated with oral anticoagulation is rare.
December 26, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29277620/re-bleeding-and-mortality-after-lower-gastrointestinal-bleeding-in-patients-taking-anti-platelets-or-anti-coagulants
#12
Kathryn Oakland, Michael J Desborough, Mike F Murphy, Mike Schachter, Vipul Jairath
BACKGROUND & AIMS: Patients who develop lower gastrointestinal bleeding (LGIB) while receiving anti-coagulants or anti-platelets have increased severity of bleeding and risk of re-bleeding. We compared outcomes of patients receiving anti-platelets, anti-coagulants, or direct oral anti-coagulants (DOACs) who develop LGIB, as well as the effects of withholding these drugs on their course of bleeding. METHODS: We performed a retrospective study of 2528 consecutive adult patients with LGIB at 143 hospitals in the United Kingdom, from September through December 2015; 917 were taking anti-coagulant or anti-platelet drugs and 1218 were taking neither (unexposed)...
December 22, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29273940/investigation-of-clostridium-difficile-ribotypes-in-symptomatic-patients-of-a-german-pediatric-oncology-center
#13
Arne Simon, Markus Mock, Norbert Graf, Lutz von Müller
In a German pediatric oncology unit, the attending physicians diagnosed 27 cases of Clostridium difficile-associated disease (CDI) from January 01, 2010 to October 31, 2013. This refers to a CDI incidence density of 2.0/1000 inpatient days. According to the hospital hygiene standard, symptomatic patients with CDI were kept in contact isolation. Most patients (median age 8.2 years) suffered from acute lymphoblastic leukemia; 88.9% were treated with broad-spectrum antibiotics during the preceding 4 weeks. 29...
December 22, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29250278/the-nonvitamin-k-antagonist-oral-anticoagulants-and-atrial-fibrillation-challenges-and-considerations
#14
REVIEW
Anna Plitt, Sameer Bansilal
The nonvitamin K antagonist oral anticoagulants (NOACs) dabigatran, rivaroxaban, apixaban, and edoxaban are used for the reduction of the risk of stroke or systemic embolism (SEE) in patients with nonvalvular atrial fibrillation (NVAF). The purpose of this review is to highlight the safety and efficacy results of the pivotal NOAC clinical trials for use in NVAF, discuss some of the unique management challenges in the use of NOACs in special populations, summarize data on emerging and novel indications, and address potential future directions...
February 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29240068/-treatment-of-a-woman-with-phlegmasia-cerulea-dolens-complicated-by-massive-pulmonary-thromboembolism-and-intestinal-haemorrhage
#15
E Iu Belousov, V V Soroka, K N Fomin
Acute thrombosis of the lower limb deep veins remains one of the most common vascular diseases. It is characterised by formation of thrombotic masses in the system of the deep veins of the lower extremities. A serious complication associated with deep vein thrombosis is pulmonary embolism. In rare cases, under certain conditions a massive and disseminated blockade of the venous outflow with thrombotic masses may lead to ischaemia of the extremity with the formation of superficial and deep necroses and later on to gangrene...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29238577/lower-gastrointestinal-bleeding-due-to-rectal-dieulafoy-s-lesion
#16
Omar N Nadhem, Omar A Salh, Omar H Bazzaz
Dieulafoy's lesion is a relatively rare but serious cause of gastrointestinal bleeding. It usually involves the upper gastrointestinal tract. However, it has recently been reported in different regions of the gastrointestinal tract, including the rectum. Here, we report the case of a female patient who presented with fresh bleeding per rectum for 1 day with low hemoglobin level. Colonoscopy revealed an actively bleeding rectal Dieulafoy's lesion which was successfully treated with a clip. To our knowledge, there have been few reported cases of lower gastrointestinal bleeding caused by Dieulafoy's lesion in the rectum...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29231993/etiology-and-long-term-rebleeding-of-endoscopic-ulcerative-lesions-in-the-small-bowel-in-patients-with-obscure-gastrointestinal-bleeding-a-multicenter-cohort-study
#17
Tomonori Aoki, Atsuo Yamada, Yoshihiro Hirata, Hirohumi Suzuki, Ayako Nakada, Ryota Niikura, Motoko Seto, Makoto Okamoto, Kazuhiko Koike
BACKGROUND: Among patients with obscure gastrointestinal bleeding (OGIB), endoscopic ulcerative lesions in the small bowel have diverse etiologies and often cause rebleeding. Certain characteristics of patients or ulcerations may be reasonable indications for diagnostic balloon-assisted endoscopy (BAE) to assess etiology and may be risks of rebleeding; however, these characteristics are unclear. We aimed to elucidate appropriate indications for diagnostic BAE and predictors of long-term rebleeding in patients with small-bowel ulcerative lesions...
December 12, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29228736/bleeding-risk-with-dabigatran-rivaroxaban-warfarin-and-antiplatelet-agent-in-asians-with-non-valvular-atrial-fibrillation
#18
Yi-Hsin Chan, Yung-Hsin Yeh, Hui-Tzu Tu, Chi-Tai Kuo, Shang-Hung Chang, Lung-Sheng Wu, Hsin-Fu Lee, Lai-Chu See
It is not understood if dabigatran or rivaroxaban are superior to antiplatelet agents (AA) for safety outcomes in Asians with non-valvular atrial fibrillation (NVAF). In this study we evaluated the bleeding risk of dabigatran, rivaroxaban, warfarin and AA in Asians with NVAF. This national retrospective cohort study analyzed 6,600, 3,167, 5,338 and 8,238 consecutive NVAF patients taking dabigatran, rivaroxaban, warfarin or AAs (including aspirin, clopidogrel or ticlopidine), respectively, from June 1, 2012 to December 31, 2013...
November 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/29228500/cyclical-haematochezia-an-uncommon-cause-of-lower-gastrointestinal-bleeding
#19
Frederick Hong Xiang Koh, Yoke-Fai Fong, Ju-Ee Seet, Ker-Kan Tan
No abstract text is available yet for this article.
December 11, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29224658/management-of-acute-lower-gastrointestinal-bleeding
#20
REVIEW
Ethan J Speir, R Mitchell Ermentrout, Jonathan G Martin
Acute lower gastrointestinal bleeding (LGIB), defined as hemorrhage into the gastrointestinal tract distal to the ligament of Treitz, is a major cause of morbidity and mortality among adults. Overall, mortality rates are estimated between 2.4% and 3.9%. The most common etiology for LGIB is diverticulosis, implicated in approximately 30% of cases, with other causes including hemorrhoids, ischemic colitis, and postpolypectomy bleeding. Transcatheter visceral angiography has begun to play an increasingly important role in both the diagnosis and treatment of LGIB...
December 2017: Techniques in Vascular and Interventional Radiology
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