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https://www.readbyqxmd.com/read/28091770/relevance-of-surgery-in-patients-with-non-variceal-upper-gastrointestinal-bleeding
#1
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/28081590/emergency-endoscopic-variceal-ligation-in-cirrhotic-patients-with-blood-clots-in-the-stomach-but-no-active-bleeding-or-stigmata-increases-the-risk-of-rebleeding
#2
Su Jin Kim, Cheol Woong Choi, Dae Hwan Kang, Hyung Wook Kim, Su Bum Park, Young Mi Hong, Ki Tae Yoon, Mong Cho, Hyung Seok Nam, Sm Bakhtiar Ui Islam
BACKGROUND/AIMS: This study aimed to evaluate the efficacy and safety of emergency variceal ligation for the prevention of rebleeding in cirrhotic patients who are found on initial endoscopy to have blood clots in the stomach but no actively bleeding esophageal and gastric varices or stigmata. METHODS: This study included 28 cirrhotic patients who underwent emergency prophylactic EVL and 41 who underwent an elective intervention between January 2009 and June 2014...
December 2016: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28076941/double-balloon-endoscopy-in-overt-and-occult-small-bowel-bleeding-results-complications-and-correlation-with-prior-videocapsule-endoscopy-in-a-tertiary-referral-center
#3
Carlijn Hermans, Arnold Stronkhorst, Annemarie Tjhie-Wensing, Jan Kamphuis, Bas van Balkom, Rob Dahlmans, Lennard Gilissen
Background/Aims: Videocapsule endoscopy (VCE) and double-balloon endoscopy (DBE) allow deep exploration in patients with suspected small bowel pathology. VCE is often performed as an initial small bowel examination to explore whether an intervention by DBE is indicated and to determine insertion route. The study aim was to evaluate the correlation between DBE and VCE in patients with obscure or overt bleeding or anemia, as well as intervention frequency, and complications. Methods: Retrospective observational study...
January 12, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28075104/esophageal-cancer
#4
Matthew W Short, Kristina G Burgers, Vincent T Fry
Esophageal cancer has a poor prognosis and high mortality rate, with an estimated 16,910 new cases and 15,910 deaths projected in 2016 in the United States. Squamous cell carcinoma and adenocarcinoma account for more than 95% of esophageal cancers. Squamous cell carcinoma is more common in nonindustrialized countries, and important risk factors include smoking, alcohol use, and achalasia. Adenocarcinoma is the predominant esophageal cancer in developed nations, and important risk factors include chronic gastroesophageal reflux disease, obesity, and smoking...
January 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28072751/duodenal-plexiform-fibromyxoma-as-a-cause-of-obscure-upper-gastrointestinal-bleeding-a-case-report
#5
Demetrios Moris, Evangelia Spanou, Stavros Sougioultzis, Nikolaos Dimitrokallis, Polyxeni Kalisperati, Ioanna Delladetsima, Evangelos Felekouras
RATIONALE: We are reporting the first-to our knowledge-case of duodenal Plexiform Fibromyxoma causing obscure upper gastrointestinal bleeding. PATIENT CONCERNS: Plexiform fibromyxoma triggered recurrent upper gastrointestinal bleeding episodes in a 63-year-old man who remained undiagnosed, despite multiple hospitalizations, extensive diagnostic workups and surgical interventions (including gastrectomies), for almost 17 years. DIAGNOSES-INTERVENTIONS: During hospitalization for the last bleeding episode, an upper gastrointestinal endoscopy revealed an intestinal hemorrhagic nodule...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28070213/lower-gastrointestinal-bleeding-computed-tomographic-angiography-colonoscopy-or-both
#6
Daniel Clerc, Fabian Grass, Markus Schäfer, Alban Denys, Nicolas Demartines, Martin Hübner
BACKGROUND: Lower endoscopy (LE) is the standard diagnostic modality for lower gastrointestinal bleeding (LGIB). Conversely, computed tomographic angiography (CTA) offers an immediate non-invasive diagnosis visualizing the entire gastrointestinal tract. The aim of this study was to compare these 2 modalities with regards to diagnostic value and bleeding control. METHODS: Tertiary center retrospective analysis of consecutive patients admitted for LGIB between 2006 and 2012...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28069269/clinical-considerations-for-blunt-laryngotracheal-trauma-in-children
#7
REVIEW
Jeffrey Cheng, Matthew Cooper, Elisabeth Tracy
OBJECTIVE: Systematic review of blunt pediatric laryngeal and tracheal trauma and development of proposed evaluation and management strategy. STUDY DESIGN: Systematic review and proposed clinical consideration algorithm. DATA SOURCES: PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. REVIEW METHODS: A medical librarian was utilized. RESULTS: 329 titles and abstracts were identified, and 50 reports were included...
December 30, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28066947/training-in-eus-an-asian-perspective
#8
REVIEW
J Y Y Wong, P Kongkam, K Y Ho
Training of endoscopic ultrasound (EUS) in Asia faces two major challenges: (i) the ever-increasing demand for skills to handle a growing range of interventional EUS procedures; and (ii) a continual shortage of EUS training programs. As the therapeutic application of EUS continues to expand,(1, 2) the need to train more new endosonographers and upgrade skills of existing ones has become more critical than ever before. A formal fellowship to acquire EUS knowledge and skills in an advanced endoscopy centre has always been perceived as the best way of training novices, but such opportunities remain limited in most Asian countries...
January 9, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28064286/rockall-risk-score-in-predicting-30-days-non-variceal-upper-gastrointestinal-rebleeding-in-a-malaysian-population
#9
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/28063840/efficacy-and-safety-of-eus-guided-biliary-drainage-in-comparison-with-percutaneous-biliary-drainage-when-ercp-fails-a-systematic-review-and-meta-analysis
#10
REVIEW
Reem Z Sharaiha, Muhammad Ali Khan, Faisal Kamal, Amy Tyberg, Claudio R Tombazzi, Bilal Ali, Claudio Tombazzi, Michel Kahaleh
BACKGROUND AND AIMS: Endoscopic ultrasound-guided biliary drainage (EUS-BD) is being increasingly used as an alternate therapeutic modality to percutaneous transhepatic biliary drainage (PTBD) for biliary obstruction in patients who fail ERCP. We conducted a systematic review and meta-analysis to compare the efficacy and safety of these 2 procedures. METHODS: We searched several databases from inception to September 4, 2016, to identify comparative studies evaluating the efficacy and safety of EUS-BD and PTBD...
January 4, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28062437/dieulafoy-s-lesion-of-the-oesophagus-a-case-series-and-literature-review
#11
Faisal Inayat, Waqas Ullah, Qulsoom Hussain, Abu Hurairah
Dieulafoy's lesion is a vascular abnormality consisting of a tortuous, dilated aberrant submucosal vessel that erodes the overlying mucosal layer without ulceration. The oesophagus is a very rare location for the lesion. Herein, we report a case series of 3 patients who presented with upper gastrointestinal bleeding. Endoscopy was performed, which showed a large calibre-persistent tortuous submucosal artery protruding into the oesophageal lumen. All the patients were successfully managed with endoscopic intervention using epinephrine injection around the lesion followed by hemoclip application...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28058546/is-chemical-pyloroplasty-necessary-for-minimally-invasive-esophagectomy
#12
Camille L Stewart, Lauren Wilson, Aidan Hamm, Christan Bartsch, Megan Boniface, Ana Gleisner, John D Mitchell, Michael J Weyant, Robert Meguid, Csaba Gajdos, Barish H Edil, Martin McCarter
BACKGROUND: Many centers use botulinum toxin for chemical pyloroplasty in minimally invasive esophagectomies as prophylaxis against delayed gastric emptying. No previous studies have compared botulinum toxin injection with no pyloric intervention for patients treated with a combined laparoscopic and thoracoscopic approach. The authors hypothesized that chemical pyloroplasty does not improve outcomes for these patients. METHODS: The study investigated patients undergoing minimally invasive esophagectomies from September 2009 to June 2015...
January 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28055990/dilation-of-pediatric-eosinophilic-esophagitis-adverse-events-and-short-term-outcomes
#13
Calies Menard-Katcher, Glenn T Furuta, Robert E Kramer
OBJECTIVES: Although several studies report the experience with adult eosinophilic esophagitis (EoE) related stricture, outcomes for pediatric patients with EoE associated fibrostenosis and stricture is even more limited. To address this, we aim to identify the adverse event rate and short-term outcomes of the largest reported cohort of children with EoE to undergo esophageal dilation for management of symptomatic esophageal narrowing. METHODS: A retrospective assessment of all children, 18 years and younger, who underwent esophageal dilation at an academic children's hospital over a 5-year period was conducted...
July 18, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28053181/comparison-of-risk-scoring-systems-for-patients-presenting-with-upper-gastrointestinal-bleeding-international-multicentre-prospective-study
#14
Adrian J Stanley, Loren Laine, Harry R Dalton, Jing H Ngu, Michael Schultz, Roseta Abazi, Liam Zakko, Susan Thornton, Kelly Wilkinson, Cristopher J L Khor, Iain A Murray, Stig B Laursen
OBJECTIVE:  To compare the predictive accuracy and clinical utility of five risk scoring systems in the assessment of patients with upper gastrointestinal bleeding. DESIGN:  International multicentre prospective study. SETTING:  Six large hospitals in Europe, North America, Asia, and Oceania. PARTICIPANTS:  3012 consecutive patients presenting over 12 months with upper gastrointestinal bleeding. MAIN OUTCOME MEASURES:  Comparison of pre-endoscopy scores (admission Rockall, AIMS65, and Glasgow Blatchford) and post-endoscopy scores (full Rockall and PNED) for their ability to predict predefined clinical endpoints: a composite endpoint (transfusion, endoscopic treatment, interventional radiology, surgery, or 30 day mortality), endoscopic treatment, 30 day mortality, rebleeding, and length of hospital stay...
January 4, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28052886/intestinal-rehabilitation-for-children-with-intestinal-failure-is-cost-effective-a-simulation-study
#15
Henk Groen, Esther G Neelis, Marten J Poley, Joanne F Olieman, René Scheenstra, Paul Fm Krabbe, Gerard Dijkstra, Edmond Hhm Rings
BACKGROUND: Children with intestinal failure (IF) depend on parenteral nutrition (PN). The goal in the treatment of IF is to wean children off PN through intestinal rehabilitation (IR). Although the healthcare burden of IF is enormous, to our knowledge there has been no previous cost-effectiveness analysis in pediatric IF including IR. OBJECTIVE: We sought to determine the cost-effectiveness of IR in terms of costs and life-years. DESIGN: We simulated the treatment of IF in children in a discrete-event model...
January 4, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28044954/haemobilia-a-rare-cause-of-upper-gastro-intestinal-bleeding
#16
Daniel Ion, Carmen Iuliana Mavrodin, Mihai Bogdan Șerban, Tudor Marinescu, Dan Nicolae Păduraru
Haemobilia is a rare cause of upper gastrointestinal bleeding that consists of haemorrhage within the biliary tree. Most cases of haemobilia are due to iatrogenic cause, laparoscopic or open cholecystectomy, abdominal trauma, gallstones, hepatic tumours, vascular aneurism. We present the case of a male patient admitted in the surgery department for epigastric and right hypochondria pain, nausea and vomiting. Open cholecystectomy was performed with a trans-cystic tube drainage. Postoperative outcome was favourable but with a continuous decrease in haemoglobin level...
November 2016: Chirurgia
https://www.readbyqxmd.com/read/28043931/similar-efficacies-of-endoscopic-ultrasound-gallbladder-drainage-with-a-lumen-apposing-metal-stent-vs-percutaneous-transhepatic-gallbladder-drainage-for-acute-cholecystitis
#17
Shayan Irani, Saowanee Ngamruengphong, Anthony Teoh, Uwe Will, Jose Nieto, Barham K Abu Dayyeh, S Ian Gan, Michael Larsen, Hon Chi Yip, Mark D Topazian, Michael J Levy, Christopher C Thompson, Andrew C Storm, Gulara Hajiyeva, Amr Ismail, Yen-I Chen, Majidah Bukhari, Yamile Haito Chavez, Vivek Kumbhari, Mouen A Khashab
BACKGROUND & AIMS: Acute cholecystitis in patients who are not candidates for surgery is often managed with percutaneous transhepatic gallbladder drainage (PT-GBD). Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) with a lumen-apposing metal stent (LAMS) is an effective alternative to PT-GBD. We compared the technical success of EUS-GBD vs PT-GBD, as well as patient outcomes, numbers of adverse events (AEs), length of hospital stay, pain scores, and repeat interventions. METHODS: We performed a retrospective study to compare EUS-GBD vs PT-GBD at 7 centers (5 in the United States, 1 in Europe, and 1 in Asia), from 2013 through 2015, in management of acute cholecystitis in patients who are not candidates for surgery...
December 30, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28042391/identification-of-factors-associated-with-sedation-tolerance-in-5000-patients-undergoing-outpatient-colonoscopy-canadian-tertiary-center-experience
#18
Alexandra Shingina, George Ou, Oliver Takach, Sigrid Svarta, Ricky Kwok, Jessica Tong, Kieran Donaldson, Eric Lam, Robert Enns
AIM: To develop a prediction model aimed at identifying patients that may require higher than usual sedation doses during colonoscopy. METHODS: A retrospective chart review on 5000 patients who underwent an outpatient colonoscopy at St. Paul's Hospital from 2009 to 2010 was conducted in order to develop a model for identifying patients who will require increased doses of sedatives. Potential predictor variables including age, gender, endoscopy indication, high sedation requirements during previous endoscopies, difficulty of the procedure, bowel preparation quality, interventions, findings as well as current use of benzodiazepines, opioids and alcohol were analyzed...
December 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28040528/role-of-diagnostic-endoscopy-in-posterior-segment-evaluation-for-definitive-prognostication-in-eyes-with-corneal-opacification
#19
Rajeev R Reddy Pappuru, Mudit Tyagi, Remya M Paulose, Vivek P Dave, Taraprasad Das, Jay Chhablani, Raja Narayanan, Rushil K Saxena, Divya Balakrishnan, Sayan Basu, Virender S Sangwan
PURPOSE: Direct visualization of the posterior segment is not possible with conventional imaging techniques in eyes with corneal opacification. This study evaluated the efficacy of video-endoscopy in visualising and hence prognosticating the visual outcomes in such eyes . DESIGN: Prospective non-comparative consecutive interventional case series. METHODS: This study included 64 eyes of 64 patients with corneal opacification who underwent diagnostic ophthalmic endoscopy procedure from March 2014 to May 2016...
December 28, 2016: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/28035550/bleeding-after-endoscopic-procedures-in-patients-with-chronic-hematologic-thrombocytopenia
#20
Hyun Jin Oh, Jae Myung Park, Seung Bae Yoon, Han Hee Lee, Chul-Hyun Lim, Jin Su Kim, Yu Kyung Cho, Bo-In Lee, Young-Seok Cho, Myung-Gyu Choi
BACKGROUND: Procedure-induced bleeding is a major complication after endoscopic intervention. AIMS: The aim of this study was to investigate the risk of endoscopy-related bleeding in patients with chronic hematologic thrombocytopenia. METHODS: We investigated endoscopy-related bleeding in 175 procedures performed on 108 patients with immune thrombocytopenic purpura or aplastic anemia. The outcomes were compared with those of 350 procedures on age-, sex-, and procedure-matched control subjects...
December 29, 2016: Digestive Diseases and Sciences
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