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Nonvariceal upper gastrointestinal bleeding

Praneet Wander, Daniel Castaneda, Lionel D'Souza, Simi Singh, Sam Serouya, Ana I Velazquez, Rifat Mamun, Rebecca Voaklander, Petros Benias, David L Carr-Locke
BACKGROUND: To assess the safety and efficacy of the Instinct clip in the acute endoscopic treatment of upper gastrointestinal bleeding (UGIB). MATERIALS AND METHODS: This is the first large series reporting this clip in achieving hemostasis. A retrospective descriptive chart review was performed on patients presenting with recent overt GI bleeding treated with endoclip therapy at Mount Sinai Beth Israel Medical Center between May 2013 and January 2016. Results are expressed in absolute numbers, percentages, and trends...
April 2018: Journal of Clinical Gastroenterology
Sergi Juanpere, Laia Valls, Isabel Serra, Margarita Osorio, Arantxa Gelabert, Albert Maroto, Salvador Pedraza
A wide spectrum of abnormalities can affect the duodenum, ranging from congenital anomalies to traumatic and inflammatory entities. The location of the duodenum and its close relationship with other organs make it easy to miss or misinterpret duodenal abnormalities on cross-sectional imaging. Endoscopy has largely supplanted fluoroscopy for the assessment of the duodenal lumen. Cross-sectional imaging modalities, especially multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI), enable comprehensive assessment of the duodenum and surrounding viscera...
January 31, 2018: Insights Into Imaging
Nauman S Siddiqui, Suman Paul, Zubair Khan, Toseef Javaid, Syed S Hasan, Zarmina Khan, Jamal Saleh, Douglas J Federman, Sadik Khuder, Ali Nawras
OBJECTIVE: Limited information is available based on single-center studies on trends of incidence and outcomes in gastrointestinal (GI) bleed with shock. METHODS: We analyzed data from 2002 to 2013 National Inpatient Sample. Using ICD-9 codes we identified 6.4 million hospital discharges of GI bleed from National Inpatient Sample database. Events were analyzed based on type of GI bleed, in-hospital mortality, hemodynamic status, and use of blood products. RESULTS: GI bleed with shock results in higher hospital mortality (20...
January 23, 2018: Journal of Clinical Gastroenterology
Audrius Širvinskas, Edgaras Smolskas, Kipras Mikelis, Vilma Brimienė, Gintautas Brimas
Introduction: Transcatheter arterial embolization is a possible treatment for patients with recurrent bleeding from the upper gastrointestinal tract after failed endoscopic management and is also an alternative to surgical treatment. Aim: To analyze the outcomes of transcatheter arterial embolization and identify the clinical and technical factors that influenced the rates of morbidity and mortality. Material and methods: A retrospective analysis was carried out, based on the data of 36 patients who underwent transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding in 2013 to 2015 in our center...
December 2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Wei Ming Chua, Nanda Venkatanarasimha, Karthikeyan Damodharan
Empirical embolization of the gastroduodenal artery (GDA) is accepted as a safe and effective treatment option for endoscopy-refractory nonvariceal upper gastrointestinal bleeding (UGIB) in patients with high surgical risk. Nontarget embolization is a recognized complication of transarterial embolization, however, symptomatic pancreatic injury is extremely rare. We report a patient who developed acute ischemic pancreatitis immediately after embolization of the GDA, which was confirmed intraoperatively. Interventionists as well as referring clinicians need to be aware of this rare but life threatening complication...
July 2017: Indian Journal of Radiology & Imaging
Seung Hoon Lee, Yang Won Min, Joohwan Bae, Hyuk Lee, Byung Hoon Min, Jun Haeng Lee, Poong Lyul Rhee, Jae J Kim
The predictive role of lactate in patients with nonvariceal upper gastrointestinal bleeding (NVUGIB) has been suggested. This study evaluated several lactate parameters in terms of predicting outcomes of bleeding patients and sought to establish a new scoring model by combining lactate parameters and the AIMS65 score. A total of 114 patients with NVUGIB who underwent serum lactate level testing at least twice and endoscopic hemostasis within 24 hours after admission were retrospectively analyzed. The associations between five lactate parameters and clinical outcomes were evaluated and the predictive power of lactate parameter combined AIMS65s (L-AIMS65s) and AIMS56 scoring was compared...
November 2017: Journal of Korean Medical Science
Yong Hwan Kwon
No abstract text is available yet for this article.
November 2017: Journal of Korean Medical Science
Lauren R Klein, Joel Money, Kaveesh Maharaj, Aaron Robinson, Tarissa Lai, Brian E Driver
BACKGROUND: Assessing the likelihood of a variceal versus nonvariceal source of upper gastrointestinal bleeding (UGIB) guides therapy, but can be difficult to determine on clinical grounds. The objective of this study was to determine if there are easily ascertainable clinical and laboratory findings that can identify a patient as low risk for a variceal source of hemorrhage. METHODS: This was a retrospective cohort study of adult ED patients with UGIB between January 2008 and December 2014 who had upper endoscopy performed during hospitalization...
November 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Jung Wan Choe, Seung Young Kim, Jong Jin Hyun, Sung Woo Jung, Young Kul Jung, Ja Seol Koo, Hyung Joon Yim, Sang Woo Lee
Background/Aims: Various clinical scoring systems, including the Glasgow-Blatchford score (GBS), Rockall risk score (RS), and AIMS65 score (AIMS65), have been validated to predict the clinical outcomes in patients with upper gastrointestinal bleeding (UGIB). We compared the performance of these three scoring systems in predicting clinical outcomes in patients with UGIB in Korea. Methods: We retrospectively evaluated 286 patients with UGIB who visited emergency department...
November 15, 2017: Gut and Liver
Ko Eun Lee, Ki Nam Shim, Chung Hyun Tae, Min Sun Ryu, Sun Young Choi, Chang Mo Moon, Seong Eun Kim, Hey Kyung Jung, Sung Ae Jung
Although medical and endoscopic hemostasis is now considered as the first-line therapy for nonvariceal upper gastrointestinal (UGI) bleeding, refractory bleeding still occurs in 5%-10% of the patients. In these patients, transcatheter arterial embolization (TAE) or surgery is required, but research on embolization for unmanageable UGI bleeding in Korea is scanty. We reviewed the medical records of 518 patients who underwent endoscopic hemostasis during 4 years. Among these subjects, 8 patients who required embolization due to failure of endoscopic hemostasis were enrolled...
September 2017: Journal of Korean Medical Science
Soo-Han Cho, Yoon-Seon Lee, Youn-Jung Kim, Chang Hwan Sohn, Shin Ahn, Dong-Woo Seo, Won Young Kim, Jae Ho Lee, Kyoung Soo Lim
BACKGROUND & AIMS: We investigated clinical outcomes in high-risk patients with acute nonvariceal upper gastrointestinal bleeding (UGIB), and determined if urgent endoscopy is effective. METHODS: Consecutive patients with a Glasgow-Blatchford score greater than 7 who underwent endoscopy for acute nonvariceal UGIB at the emergency department from January 1, 2005, to December 31, 2014, were included. Urgent (<6 h) and elective (6-48 h) endoscopies were defined according to the time to endoscopy after the initial presentation...
March 2018: Clinical Gastroenterology and Hepatology
Ji Hyung Nam, Tae Joo Jeon, Jae Hee Cho, Jae Hak Kim
BACKGROUND/AIMS: Despite of successful endoscopic hemostasis of nonvariceal upper gastrointestinal bleeding (NGIB), rebleeding rate has not decreased. The aim of this study was to identify risk factors for rebleeding after endoscopic hemostasis in patients with NGIB according to bleeding patterns. MATERIALS AND METHODS: A retrospective analysis was performed on the consecutive patients with NGIB in whom successful primary endoscopic hemostasis had been achieved at three university hospitals in Korea...
June 7, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Rawaa Ebrahem, Salam Kadhem, John W Frey, William Salyers
Helicobacter pylori (H. pylori) infection is one of the major causes of bleeding peptic ulcer disease, which is associated with serious complications; therefore, the eradication of H. pylori is essential to prevent these devastating complications. Post-treatment follow-up is crucial to guarantee the eradication of the organism and may be conducted via the urea breath test, the stool antigen test, or a gastric biopsy. Acute massive upper gastrointestinal (UGI) bleeding is one of the most common complications of peptic ulcer disease...
April 13, 2017: Curēus
Nimarta Singh-Bhinder, David H Kim, Brian P Holly, Pamela T Johnson, Michael Hanley, Laura R Carucci, Brooks D Cash, Ankur Chandra, Kenneth L Gage, Drew L Lambert, Angela D Levy, Isabel B Oliva, Christine M Peterson, Richard Strax, Frank J Rybicki, Karin E Dill
Upper gastrointestinal bleeding (UGIB) remains a significant cause of morbidity and mortality with mortality rates as high as 14%. This document addresses the indications for imaging UGIB that is nonvariceal and unrelated to portal hypertension. The four variants are derived with respect to upper endoscopy. For the first three, it is presumed that upper endoscopy has been performed, with three potential initial outcomes: endoscopy reveals arterial bleeding source, endoscopy confirms UGIB without a clear source, and negative endoscopy...
May 2017: Journal of the American College of Radiology: JACR
Navin L Kumar, Brian L Claggett, Aaron J Cohen, Jennifer Nayor, John R Saltzman
BACKGROUND AND AIMS: An increase in blood urea nitrogen (BUN) at 24 hours is a solitary and significant predictor of mortality in patients with acute pancreatitis, which may predict worse outcomes in the similarly resuscitation-requiring condition of acute nonvariceal upper GI bleeding (UGIB). The aim of our study was to assess whether an increase in BUN at 24 hours is predictive of worse clinical outcomes in acute nonvariceal UGIB. METHODS: A retrospective cohort study including patients admitted to an academic hospital from 2004 to 2014 was conducted...
April 2, 2017: Gastrointestinal Endoscopy
Hee Kyong Na, Hwoon-Yong Jung, Dong Woo Seo, Hyun Lim, Ji Yong Ahn, Jeong Hoon Lee, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Jin-Ho Kim
BACKGROUND/AIMS: The aim of this study was to compare the effects of erythromycin infusion and gastric lavage in order to improve the quality of visualization during emergency upper endoscopy. METHODS: We performed a prospective randomized pilot study. Patients presented with hematemesis or melena within 12 hours and were randomly assigned to the erythromycin group (intravenous infusion of erythromycin), gastric lavage group (nasogastric tube placement with gastric lavage), or erythromycin + gastric lavage group (both erythromycin infusion and gastric lavage)...
November 2017: Korean Journal of Internal Medicine
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
R Contreras-Omaña, J A Alfaro-Reynoso, C E Cruz-Chávez, A Velarde-Ruiz Velasco, D I Flores-Ramírez, I Romero-Hernández, I Donato-Olguín, X García-Samper, A Bautista-Santos, M Reyes-Bastidas, E Millán-Marín
BACKGROUND: The predictive scale for mortality risk in patients with nonvariceal upper gastrointestinal bleeding (NVUGIB) proposed by Italy's PNED (Progetto Nazionale Emorragia Digestiva) group has not been validated in Latin America since its original publication. AIM: To compare the PNED system and the Rockall score as mortality predictors in patients hospitalized for NVUGIB. MATERIAL AND METHODS: A multicenter, prospective, cross-sectional, analytic study was conducted that recruited patients diagnosed with nonvariceal upper gastrointestinal bleeding within the time frame of 2011 to 2015...
April 2017: Revista de Gastroenterología de México
Pyeong Hwa Kim, Jiaywei Tsauo, Ji Hoon Shin, Sung-Cheol Yun
PURPOSE: To evaluate the safety and efficacy of transcatheter arterial embolization with N-butyl cyanoacrylate (NBCA) for the treatment of gastrointestinal (GI) bleeding via a meta-analysis of published studies. MATERIALS AND METHODS: The MEDLINE/PubMed and EMBASE databases were searched for English-language studies from January 1990 to March 2016 that included patients with nonvariceal GI bleeding treated with transcatheter arterial embolization with NBCA with or without other embolic agents...
April 2017: Journal of Vascular and Interventional Radiology: JVIR
José A González-González, Roberto Monreal-Robles, Diego García-Compean, Jonathan Paz-Delgadillo, Martín Wah-Suárez, Héctor J Maldonado-Garza
OBJECTIVE: To analyze the clinical characteristics, outcomes and prognostic factors in elderly patients (aged 75 years and elder) with acute nonvariceal upper gastrointestinal bleeding (UGIB). METHODS: Consecutive patients admitted with acute nonvariceal UGIB who underwent upper gastrointestinal endoscopy were prospectively recruited and subdivided into two age-based groups, elderly (aged ≥75 years) and younger patients (<75 years). The patients' characteristics and outcomes were recorded...
April 2017: Journal of Digestive Diseases
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