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Gastrointestinal bleeds

Alan N Barkun, Viviane Adam, Richard C K Wong
BACKGROUND & AIMS: Upper gastrointestinal bleeding is a common emergency and rebleeding is associated with an increased risk of death. Proper assessment of high-risk lesions and appropriate endoscopic hemostasis are required for the best outcomes. The endoscopic Doppler probe exam (DPE) allows for a more complete assessment of the stigmata of hemorrhage, providing better evaluation of the need for endoscopic hemostasis and determination of its completeness. We aimed to evaluate whether use of the DPE provides an additional advantage in cost and effectiveness compared with traditional endoscopic visual assessment (TEA) of high-risk stigmata in patients with non-variceal upper gastrointestinal bleeding...
February 14, 2019: Clinical Gastroenterology and Hepatology
Wen-Chi Chen, I-Fang Hsin, Ping-Hsien Chen, Ping-I Hsu, Yen-Po Wang, Jin-Shiung Cheng, Huey-Shyan Lin, Ming-Chih Hou, Fa-Yauh Lee
BACKGROUND & AIMS: Gastric variceal bleeding (GVB) frequently recurs after hemostasis by gastric variceal obturation (GVO). We performed a multicenter, randomized controlled trial to determine the efficacy of carvedilol plus GVO in secondary prophylaxis of GVB. METHODS: We performed a prospective study of 121 patients with cirrhosis (ages 20-80 years) with GVB proven by endoscopy within 24 hours of bleeding and stable hemodynamics for at least 3 days after initial GVO...
February 14, 2019: Clinical Gastroenterology and Hepatology
Ali Akbar Hajiagha Mohammadi, Mohammad Reza Azizi
BACKGROUND AND STUDY AIMS: Acute upper gastrointestinal bleeding is one of the main causes of hospitalisation. The purpose of this study was to determine the prognostic factors in non-variceal upper gastrointestinal bleeding. PATIENTS AND METHODS: Clinical outcomes, demographic and laboratory variables of the subjects were collected from the HIS software and national code with the SQL format from three hospitals in Qazvin. The data were linked to the database software designed by the author...
February 12, 2019: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
Michael Schreiber, Clemens-Alexander Greim
The rising impact of perioperative sonography is mainly based on mobile high quality ultrasound systems. Relevant bleedings or functional limitations of the abdomen are easy to identify with sonography. The FAST-Concept can be the first access to continue proceedings in ultrasound examination of the abdomen. This paper demonstrates some important ultrasound examinations of the abdomen. The clinical main issues are traumatic and atraumatic bleedings of heart, liver and spleen with haemodynamic instability and functional limitations of abdominal organs like bile cystitis, gastrointestinal passage disability and obstructive uropathy...
February 2019: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Mette Søgaard, Peter Brønnum Nielsen, Flemming Skjøth, Jette Nordstrøm Kjaeldgaard, Torben Bjerregaard Larsen
BACKGROUND: Rivaroxaban could be an attractive alternative to low molecular weight heparin for the treatment of cancer-associated venous thromboembolism (VTE) but the safety and effectiveness remain unclear. We examined risk of recurrent VTE and major bleeding associated with rivaroxaban treatment of cancer-associated VTE. METHODS: Through linkage of nationwide Danish registries, we identified all adults with cancer-associated VTE initiating treatment with rivaroxaban, 2012-2017...
February 14, 2019: Cancer Medicine
Piotr Terlecki, Tomasz Zubilewicz, Andrzej Wojtak, Eliza Pleban, Stanisław Przywara, Marek Iłżecki, Marcin Feldo, Marek Chrapko, Jan Jakub Kęsik, Karol Terlecki, Tomasz Pedowski, Beata Chrapko, Piotr Szopiński
The infection of a vascular prosthesis is potentially fatal, and its effective treatment still remains the greatest challenge for vascular surgeons. We present our initial experience using bovine pericardial vascular prostheses to replace infected aortoiliac vascular grafts. Six consecutive patients with infection of the graft were prospectively included in this study. Infection of the vascular graft was confirmed by clinical symptoms, laboratory tests and the results of computed tomography and positron emission tomography/computed tomography...
February 15, 2019: Xenotransplantation
Rosalie C Oey, Laurelle van Tilburg, Nicole S Erler, Herold J Metselaar, Manon C W Spaander, Henk R van Buuren, Robert A de Man
Colorectal cancer screening with colonoscopy is commonly used in candidate patients for liver transplantation. We initiated this study to define the risk-benefit ratio of performing screening colonoscopy in this population. A retrospective observational study of all consecutive patients undergoing colonoscopy during pre-liver transplantation screening between 2004-2017 was conducted. Endoscopic and pathological findings and clinical events potentially related to the colonoscopy in the 30 days after the procedure were registered and compared with a 30 days in-patient control time frame...
February 14, 2019: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Amey D Sonavane, Deepak N Amarapurkar, Krantikumar R Rathod, Sundeep J Punamiya
Background: There has been significant improvement in understanding the etiology and management of Budd-Chiari Syndrome (BCS). Patients with chronic or acute-on-chronic BCS need radiological interventions in the form of angioplasty, hepatic vein/inferior vena cava stenting or Transjugular Intrahepatic Portosystemic Shunt (TIPS). Data regarding the long term follow up of patients undergoing TIPS is limited. We thus prospectively followed-up BCS patients who underwent TIPS at our center...
January 2019: Journal of Clinical and Experimental Hepatology
Masahiko Komagome, Yoshifumi Beck, Ryota Kogure, Tetsuya Mitsui, Rihito Nagata, Yoichi Miyata, Riki Ninomiya, Akira Maki
It is known that gastrointestinalbl eeding occurs due to portalstenosis as a complication in the hepato-biliary-pancreatic region at later postoperative stages. Our department has treated 5 portal stent cases since 2015. The pressure difference between the hepatic side and intestinalside at the portalstenosis site decreased from 9-14(median: 10)cmH2O to 0-6 (median: 2)cmH2O in all cases before and after placement of the stent, resulting in hemostasis(observation period 4-18 months, median: 12 months). In surgery of the hepato-biliary-pancreatic regions, veins flowing into the portal vein are also incised by dissection of the hepatoduodenal ligament...
January 2019: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Lucien Chassin-Trubert, Giorgio Prousse, Baris Ata Ozdemir, Youcef Lounes, William Alonso, Myriam Clapiès, Pierre Alric, Ludovic Canaud
OBJECTIF: The aim of this paper is to report a case of filter associated inferior vena cava (IVC) thrombosis with perforation of the duodenum and penetration of a vertebral body by the filter struts. CASE REPORT: A 37 year old woman with a medical history of Behcet`s disease treated with corticosteroids, underwent placement of a retrievable IVC filter because of recurrent ileofemoral venous thrombosis regardless of therapeutic levels of anticoagulation. Despite a correct positioning of the filter, the second follow-up CT-scan, performed at 1 year, showed a complete thrombosis of the infra-renal IVC segment, with perforation of the vessel wall by the filter struts and penetration in the duodenum...
February 11, 2019: Annals of Vascular Surgery
Lidia Ruiz-Llorente, Elisa Chiapparino, Sara Plumitallo, Cesare Danesino, Pinar Bayrak-Toydemir, Fabio Pagella, Guido Manfredi, Carmelo Bernabeu, Luca Jovine, Carla Olivieri
Hereditary hemorrhagic telangiectasia (HHT) is a vascular rare disease characterized by nose and gastrointestinal bleeding, skin and mucosa telangiectasias, and arteriovenous malformations in internal organs. HHT shows an autosomal dominant inheritance and a worldwide prevalence of approximately 1:5000 individuals. In >80% of patients, HHT is caused by mutations in either ENG (HHT1) or ACVRL1 (HHT2) genes, which code for the membrane proteins Endoglin and Activin A Receptor Type II-Like Kinase 1 (ALK1), respectively, both belonging to the TGF-β/BMP signaling pathway...
February 11, 2019: Gene
Sung-Min Cho, Nader Moazami, Stuart Katz, Randall Starling, Jennifer A Frontera
BACKGROUND: Little data exists regarding reversal and resumption of antithrombotics following left ventricular assist device (LVAD)-associated intracranial hemorrhage (ICH). METHODS: Prospectively collected data of LVAD patients with ICH was reviewed. Coagulopathy reversal agents, antithrombotic regimens and thrombotic (venous thromboembolism, ischemic stroke, myocardial infarction) and hemorrhagic (recurrent ICH, gastrointestinal bleed, anemia requiring transfusion) complications were recorded...
February 11, 2019: Annals of Thoracic Surgery
Grace Lai-Hung Wong, Andy Jinhua Ma, Huiqi Deng, Jessica Yuet-Ling Ching, Vincent Wai-Sun Wong, Yee-Kit Tse, Terry Cheuk-Fung Yip, Louis Ho-Shing Lau, Henry Hin-Wai Liu, Chi-Man Leung, Steven Woon-Choy Tsang, Chun-Wing Chan, James Yun-Wong Lau, Pong-Chi Yuen, Francis Ka-Leung Chan
BACKGROUND: Patients with a history of Helicobacter pylori-negative idiopathic bleeding ulcers have an increased risk of recurring ulcer complications. AIM: To build a machine learning model to identify patients at high risk for recurrent ulcer bleeding. METHODS: Data from a retrospective cohort of 22 854 patients (training cohort) diagnosed with peptic ulcer disease in 2007-2016 were analysed to build a model (IPU-ML) to predict recurrent ulcer bleeding...
February 13, 2019: Alimentary Pharmacology & Therapeutics
Seyed Saeidseyedian, Ali Akbar Shayesteh, Fereshteh Beyranvandi
Upper gastrointestinal bleeding (UGIB) which occurs proximal to the Treitz ligament is one of the most common cases is emergency medical conditions. The aim of this data article is to evaluation of Rockall and Blatchford scoring systems for predicting the clinical outcomes of patients with upper gastrointestinal bleeding in Imam-Khomeini Hospital, Ahvaz, Iran. This dataset was collected by retrospective descriptive epidemiologic survey which 350 non-cirrhotic patients with UGIB who referred to Ahwaz Imam-Khomeini Hospital for six months...
December 2018: Data in Brief
Marcel Tomaszewski, Marc Bienz, Omar Kherad, Sophie Restellini, Tania Laflèche, Alan Barkun, Margaret Warner, Talat Bessissow
INTRODUCTION: Haemophilia A and haemophilia B, von Willebrand disease (VWD), factor VII deficiency and factor XI deficiency are congenital bleeding disorders predisposing to bleeding during invasive procedures. The ageing population of people with congenital bleeding disorders will likely increasingly require gastrointestinal endoscopy. The bleeding risk postgastrointestinal endoscopy and optimal prophylactic treatment regimens are not well described. METHODS: We performed a retrospective chart review at the McGill University Health Centre...
February 12, 2019: Haemophilia: the Official Journal of the World Federation of Hemophilia
Jean R Kuo, Shabana F Pasha, Jonathan A Leighton
Small bowel bleeding accounts for 5-10% of gastrointestinal bleeding. With the advent of capsule endoscopy, device-assisted enteroscopy, and multiphase CT scanning, a small bowel source can now be found in many instances of what has previously been described as obscure gastrointestinal bleeding. We present a practical review on the evaluation and management of small bowel bleeding for the practicing clinician.
December 20, 2018: American Journal of Gastroenterology
Flora Peyvandi, Giancarlo Castaman, Paolo Gresele, Raimondo De Cristofaro, Piercarla Schinco, Antonella Bertomoro, Massino Morfini, Gabriella Gamba, Giovanni Barillari, Víctor Jiménez-Yuste, Cristoph Königs, Alfonso Iorio, Augusto B Federici
BACKGROUND: There is a lack of prospective clinical trials specifically designed to evaluate the benefits of prophylaxis with vWF/FVIII concentrates in patients with inherited von Willebrand disease (vWD). The aim of the study was to compare efficacy of secondary long-term prophylaxis (PRO) with vWF/FVIII in the prevention of bleeding episodes in severe vWD patients to standard of care (on-demand treatment; ODT). MATERIALS AND METHODS: In this 12-month, phase III, open-label study (PRO...
February 4, 2019: Blood Transfusion, Trasfusione del Sangue
Lindsay B Wilson, Mark R Cox, Matthew V Benns, Christina M Pinkston, Leigh A Scherrer
Serotonin-modulating antidepressants have been associated with increased risk of gastrointestinal bleeding and increased blood loss during elective surgery. This study sought to investigate the effect of preinjury selective-serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitor (SSRI/SNRI) use on transfusion requirements after trauma, and to evaluate whether resumption of SSRI/SNRI after trauma may worsen bleeding risk. This was a retrospective matched-cohort study evaluating patients with solid organ injury...
November 1, 2018: American Surgeon
Chien-Ho Lee, Tzu-Hsien Tsai, Cheng-Jui Lin, Shu-Kai Hsueh, Wen-Jung Chung, Cheng-I Cheng
OBJECTIVE: This study investigated the efficacy and safety of ticagrelor compared with clopidogrel in patients with end-stage renal disease (ESRD) and acute myocardial infarction (AMI). METHODS: We retrospectively enrolled patients who had received regular dialysis and had undergone percutaneous coronary intervention (PCI) for AMI at our hospital between January 2013 and December 2016. Outcomes analyzed included cardiovascular death, death from any cause, MI, stroke, and bleeding events...
February 12, 2019: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
Benjamin Walter, Simone Schmidbaur, Yannick Krieger, Alexander Meining
Background  En-bloc resection of large, flat lesions or early stages of cancer is challenging. No bimanual tasks are possible using standard endoscopes. Dual-channel endoscopes are not available everywhere and have a small distance between the channels. Patients and methods  A new external additional working channel (AWC) (Ovesco, Tuebingen, Germany) was designed and developed potentially enabling bimanual tasks. Fixed to the tip of a standard gastroscope or pediatric colonoscope, a second endoscopic tool can be inserted through the AWC and used for tissue retraction during endoscopic resection...
February 2019: Endoscopy International Open
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