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https://www.readbyqxmd.com/read/29671413/non-variceal-upper-gastrointestinal-bleeding
#1
REVIEW
Angel Lanas, Jean-Marc Dumonceau, Richard H Hunt, Mitsuhiro Fujishiro, James M Scheiman, Ian M Gralnek, Helen E Campbell, Alaa Rostom, Càndid Villanueva, Joseph J Y Sung
Non-variceal upper gastrointestinal bleeding (NVUGIB) is bleeding that develops in the oesophagus, stomach or proximal duodenum. Peptic ulcers, caused by Helicobacter pylori infection or use of NSAIDs and low-dose aspirin (LDA), are the most common cause. Although the incidence and mortality associated with NVUGIB have been decreasing owing to considerable advances in the prevention and management of NVUGIB over the past 20 years, it remains a common clinical problem with an annual incidence of ∼67 per 100,000 individuals in the United States in 2012...
April 19, 2018: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29626014/glasgow-blatchford-score-and-risk-stratifications-in-acute-upper-gastrointestinal-bleed-can-we-extend-this-to-2-for-urgent-outpatient-management
#2
Kelly Chatten, Huw Purssell, Ashwini Kumar Banerjee, Stephanie Soteriadou, Yeng Ang
Upper gastrointestinal (GI) bleeds are a common presentation to emergency departments in the UK. The Glasgow Blatchford score (GBS) predicts the outcome of patients at presentation. Current UK and European guidelines recommend outpatient management for a GBS of 0. In the current study, our aim was to assess whether extending the GBS allows for early discharge while maintaining patient safety. We also analysed whether pathologies could be missed by discharging patients too early. Data were retrospectively collected on patients admitted with symptoms of an upper GI bleed between 1 October 2013 and 10 June 2016...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29610020/pharmacological-treatment-of-gastrointestinal-bleeding-due-to-angiodysplasias-a-position-paper-of-the-italian-society-of-gastroenterology-sige
#3
REVIEW
Gerardo Nardone, Debora Compare, Alberto Martino, Alba Rocco
Angioectasias (AD) belong to benign vascular malformations of the gastrointestinal tract and are responsible for about 4-7% of upper non variceal bleeding, 30-40% of small bowel occult bleeding and 3-40% of colonic bleeding episodes. Gastrointestinal haemorrhage secondary to AD represents an important diagnostic and therapeutic problem that negatively impacts on the quality of life of patients and heath care costs. Endoscopic interventions are the mainstay in both diagnosis and treatment of vascular malformations...
February 15, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29601829/thirty-day-readmission-among-patients-with-non-variceal-upper-gastrointestinal-hemorrhage-and-effects-on-outcomes
#4
Marwan S Abougergi, Heather Peluso, John R Saltzan
BACKGROUND & AIMS: We aimed to determine the rate of hospital readmission within 30 days of non-variceal upper gastrointestinal hemorrhage (NVUGIH) and its impact on mortality, morbidity and healthcare utilization in the United States. METHODS: We performed a retrospective study using the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project Nationwide Readmission Database for the year 2014 (data on 14.9 million hospital stays at 2048 hospitals in 22 states)...
March 27, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29601652/comparison-of-clinical-outcomes-between-variceal-and-non-variceal-gastrointestinal-bleeding-in-patients-with-cirrhosis
#5
Parul Tandon, Kirles Bishay, Stacey Fisher, Dominique Yelle, Ian Carrigan, Krista Wooller, Erin Kelly
BACKGROUND AND AIM: Acute upper gastrointestinal bleeding (UGIB) in cirrhosis is associated with significant morbidity and mortality and can be classified as acute variceal bleeding (AVB) or non-variceal bleeding (NVB). Differences in mortality, hospital length of stay (LOS) and 30-day readmission have yet to be determined. As such, we aimed to evaluate differences in these clinical outcomes in cirrhotic patients admitted with UGIB. METHODS: This retrospective study included all cirrhotic patients hospitalized for UGIB who underwent upper endoscopy from July 2014 to July 2016...
March 30, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29570557/the-use-and-safety-of-a-novel-haemostatic-spray-in-the-endoscopic-management-of-acute-non-variceal-upper-gastrointestinal-bleeding-in-children
#6
Mike Thomson, Arun Urs, Priya Narula, Prithviraj Rao, Dalia Belsha
AIMS AND BACKGROUND: Advanced endo-haemostatic technique performance and experience is extremely variable in distribution amongst pediatric endoscopists. Haemostatic spray (Hemospray®), a novel endo-haemostatic topically applied powder has the advantage of extreme ease of use and; hence may lower the threshold of competency required by the endoscopist thereby potentially reducing mortality. The aim of the study is to prospectively evaluate the efficacy and the safety of haemostatic spray in paediatric patients with AUGIB...
March 22, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29525375/evaluation-and-management-of-gastrointestinal-bleeding
#7
REVIEW
Ronald Samuel, Mohammad Bilal, Obada Tayyem, Praveen Guturu
Non-variceal upper gastrointestinal bleeding continues to be an important cause of morbidity and mortality. The most common causes include peptic ulcer disease, Mallory-Weiss syndrome, erosive gastritis, duodenitis, esophagitis, malignancy, angiodysplasias and Dieulafoy's lesion. Initial assessment and early aggressive resuscitation significantly improves outcomes. Upper gastrointestinal endoscopy continues to be the gold standard for diagnosis and treatment. We present a comprehensive review of literature for the evaluation and management of non-variceal upper gastrointestinal bleeding...
March 7, 2018: Disease-a-month: DM
https://www.readbyqxmd.com/read/29488575/-fundal-variceal-bleeding-treated-with-balloon-occluded-endoscopic-inyection-sclerotherapy-report-of-two-cases
#8
Daniel da Costa, Cristián Montenegro, Patricio Palavecino, Germán Lobos, Tomás Cermenati, Jaime Poniachik
Management of gastrointestinal bleeding caused by fundal varices is particularly difficult to manage. The options are: transjugular intrahepatic portosystemic shunt (TIPS), endoscopic injection of cyanoacrylate or balloon-occluded retrograde transvenous obliteration (BRTO). We report a 63 year-old male with a cirrhosis caused by hepatitis C and a 66 year-old female with a cirrhosis caused by a non-alcoholic steatohepatitis. Both patients had a gastrointestinal bleeding caused by fundal varices and were treated with sclerotherapy with cyanoacrylate assisted with BRTO...
October 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/29469515/-application-of-degree-of-portal-systemic-shunting-in-assessing-upper-gastrointestinal-bleeding-in-patients-with-schistosomiasis-cirrhosis
#9
Ju Shuai, Li Ying, Ji Chang-Xue, Zhang Biao
OBJECTIVE: To discuss the application of the degree of portal systemic shunting in assessing the upper gastrointestinal bleeding in patients with hepatic schistosomiasis. METHODS: Thirty-three patients with upper gastrointestinal bleeding caused by hepatic schistosomiasis (a bleeding group) and 29 schistosomiasis cirrhosis patients without bleeding (a non-bleeding group) were enrolled as investigation subjects in Jinshan Hospital. The subjects were scanned by the 128 abdominal slice spiral CT...
March 27, 2017: Zhongguo Xue Xi Chong Bing Fang Zhi za Zhi, Chinese Journal of Schistosomiasis Control
https://www.readbyqxmd.com/read/29467124/gastric-and-duodenal-ischaemia-after-transarterial-chemoembolisation-for-hepatocellular-carcinoma-an-unexpected-but-significant-complication
#10
Sai Pavan Chintalapati, Arpan Patel, Hari Conjeevaram
Transarterial chemoembolisation (TACE) is commonly used for unresectable intermediate-stage hepatocellular carcinoma (HCC). TACE is usually well-tolerated. We report a case of a patient who presented with a gastrointestinal bleed from TACE. A 64-year-old man presented with chronic hepatitis C cirrhosis and multifocal bilobar HCC. He had previously undergone multiple TACE sessions, radiofrequency ablation and stereotactic body radiation therapy. In the evening of his TACE procedure, he developed abdominal pain and haematemesis...
February 21, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29465096/management-of-acute-upper-gastrointestinal-bleeding-an-update-for-the-general-physician
#11
K Siau, W Chapman, N Sharma, D Tripathi, T Iqbal, N Bhala
Acute upper gastrointestinal bleed (AUGIB) is one of the most common medical emergencies in the UK, with roughly one presentation every 6 min. Despite advances in therapeutics and endoscopy provision, mortality following AUGIB over the last two decades has remained high, with over 9,000 deaths annually in the UK; consequently, several national bodies have published UK-relevant guidelines. Despite this, the 2015 UK National Confidential Enquiry into Patient Outcome and Death in AUGIB highlighted variations in practice, raised concerns regarding suboptimal patient care and released a series of recommendations...
September 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/29428942/outcomes-of-patients-undergoing-endoscopic-hemostasis-for-the-upper-gastrointestinal-bleeding-were-not-influenced-by-the-timing-of-hospital-emergency-visits-a-situation-prevailing-in-japan
#12
Satoko Matsuura, Yasuhisa Sakata, Nanae Tsuruoka, Koichi Miyahara, Megumi Hara, Yoichiro Ito, Kenichiro Nakayama, Takuya Shimamura, Takahiro Noda, Takahiro Yukimoto, Ryo Shimoda, Ryuichi Iwakiri, Kazuma Fujimoto
BACKGROUND: The aim of the present study was to determine differences in the prognosis of patients in Japan who underwent emergency endoscopic hemostasis (i) during regular hours versus off hours and (ii) as outpatients versus hospitalized patients. METHODS: The present retrospective study included 443 patients who underwent emergency endoscopic hemostasis for non-variceal upper gastrointestinal bleeding from January 2008 to December 2014. These patients were classified into 2 groups: hospitalized patients and outpatients...
February 9, 2018: Digestion
https://www.readbyqxmd.com/read/29415371/effectiveness-of-the-polysaccharide-hemostatic-powder-in-non-variceal-upper-gastrointestinal-bleeding-using-propensity-score-matching
#13
Jun Chul Park, Yeong Jin Kim, Eun Hye Kim, Jinae Lee, Hyun Su Yang, Eun Hwa Kim, Kyu Yeon Hahn, Sung Kwan Shin, Sang Kil Lee, Yong Chan Lee
BACKGROUND AND AIM: Recently, the application of hemostatic powder to the bleeding site has been used to treat active upper gastrointestinal bleeding (UGIB). We aimed to assess the effectiveness of the polysaccharide hemostatic powder (PHP) in patients with non-variceal UGIB. METHODS: We reviewed prospectively collected 40 patients with UGIB treated with PHP therapy between April 2016 and January 2017 (PHP group) and 303 patients with UGIB treated with conventional therapy between April 2012 and October 2014 (conventional therapy group)...
February 7, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29340282/should-vasoconstrictors-be-considered-in-a-cirrhotic-patient-with-acute-non-variceal-upper-gastrointestinal-bleeding
#14
Xingshun Qi, Hongyu Li, Xiaodong Shao, Zhendong Liang, Xia Zhang, Ji Feng, Hao Lin, Xiaozhong Guo
Varices manifest as a major etiology of upper gastrointestinal bleeding in patients with chronic liver diseases, such as liver cirrhosis and hepatocellular carcinoma. By contrast, non-variceal upper gastrointestinal bleeding is rare. Pharmacological treatment differs between patients with variceal and non-variceal bleeding. Vasoconstrictors are recommended for the treatment of variceal bleeding, rather than non-variceal bleeding. In contrast, pump proton inhibitors are recommended for the treatment of non-variceal bleeding, rather than variceal bleeding...
December 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/29340247/weekend-effect-in-upper-gastrointestinal-bleeding-a-systematic-review-and-meta-analysis
#15
Pei-Ching Shih, Shu-Jung Liu, Sung-Tse Li, Ai-Chen Chiu, Po-Chuan Wang, Lawrence Yu-Min Liu
Aim: To perform a systematic review and meta-analysis of the weekend effect on the mortality of patients with upper gastrointestinal bleeding(UGIB). Methods: The review protocol has been registered in the PROSPERO International Prospective Register of Systematic Reviews (registration number: CRD42017073313) and was written according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We conducted a search of the PUBMED, COCHRANE, EMBASE and CINAHL databases from inception to August 2017...
2018: PeerJ
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
#16
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/29316579/-management-of-compensated-liver-cirrhosis-2018-evidence-based-prophylactic-measures
#17
Kathrin Karkmann, Felix Piecha, Anna Caterina Rünzi, Lisa Schulz, Moritz von Wulffen, Daniel Benten, Johannes Kluwe, Henning Wege
In 2015, more than 13 000 people died due to the consequences of liver cirrhosis in Germany. Frequently, relevant liver fibrosis is diagnosed by non-invasive methods (e. g., ultrasound-based measurement of liver stiffness) already in the compensated stage. Following diagnosis of liver fibrosis, a thorough investigation of the underlying chronic liver disease and effective treatment are important to prevent progression to decompensated cirrhosis. Since morbidity and mortality dramatically increase in the decompensated stage (patients may present with jaundice, ascites, hepatic encephalopathy, gastrointestinal bleeding) with an upsurge in 1-year-mortality from 1 - 3...
January 2018: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29287004/non-invasive-markers-of-portal-hypertension-appraisal-of-adult-experience-and-potential-utilisation-in-children
#18
Harry Sutton, Anil Dhawan, Tassos Grammatikopoulos
Portal hypertension (PHT) is a significant cause of morbidity and mortality in children with chronic liver disease and portal vein obstruction. Increased portal pressure results in variceal formation along the gastrointestinal (GI) tract resulting in major bleeding. Identifying children with significant PHT who are more likely to suffer GI bleeding has been challenging and the role of surveillance upper GI endoscopy has been debated. This review analyses research done on serum biomarkers and imaging techniques as possible predictors of significant PHT...
April 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29110990/transjugular-intrahepatic-portosystemic-shunt-as-a-bridge-to-non-hepatic-surgery-in-cirrhotic-patients-with-severe-portal-hypertension-a-systematic-review
#19
REVIEW
Eylon Lahat, Chetana Lim, Prashant Bhangui, Liliana Fuentes, Michael Osseis, Toufic Moussallem, Chady Salloum, Daniel Azoulay
BACKGROUND: Portal hypertension (PHTN) increases the risk of non-hepatic surgery in cirrhotic patients. This first systematic review analyzes the place of transjugular intrahepatic portosystemic shunt (TIPS) in preparation for non-hepatic surgery in such patients. METHODS: Medline, EMBASE, and Scopus databases were searched from 1990 to 2017 to identify reports on outcomes of non-hepatic surgery in cirrhotic patients with PHTN prepared by TIPS. Feasibility of TIPS and the planned surgery, and the short- and long-term outcomes of the latter were assessed...
February 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28971259/efficacy-and-safety-of-superselective-trans-catheter-arterial-embolization-of-upper-and-lower-gastrointestinal-bleeding-using-n-butyl-2-cyanoacrylate
#20
Jae Hyun Kwon, Yoon Hee Han
PURPOSE: To evaluate the efficacy and safety of superselective trans-catheter arterial embolization (TAE) with N-butyl-2-cyanoacrylate (NBCA) for patients with acute non-variceal upper and lower gastrointestinal (GI) bleeding. METHODS: TAE using NBCA was performed in 21 patients (13 males, 8 females, mean age 60.9 years) with acute non-variceal upper (n = 15) and lower (n = 6) GI bleeding. TAE using other embolic agents was performed in 25 patients (13 males, 12 females, mean age 69...
October 2, 2017: Emergency Radiology
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