1.An audit of upper gastrointestinal bleeding at Seremban Hospital.
Lim TM ; Lu PY ; Meheshinder S ; Selvindoss P ; Balasingh D ; Ramesh J ; Qureshi A
The Medical Journal of Malaysia 2003;58(4):522-525
We retrospectively analyzed all patients presenting with upper gastrointestinal bleeding to Seremban Hospital over a one-year period. A quarter of the oesophagogastro-duodenoscopies (OGD) performed were performed as emergency for upper gastrointestinal tract bleeding. Gastric ulcers and duodenal ulcers were the two most common findings. Our results suggest that there is a male preponderance of 2:1, the Chinese were more likely to be affected and the elderly (> 60 years) were at highest risk.
Endoscopy, Gastrointestinal
;
Gastrointestinal Hemorrhage/ethnology
;
Gastrointestinal Hemorrhage/*etiology
;
Gastrointestinal Hemorrhage/therapy
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Malaysia
;
Retrospective Studies
;
Risk Factors
;
Sex Factors
2.Which Method should We Consider for Treatment of Bleeding Gastric Varix?.
The Korean Journal of Gastroenterology 2004;43(4):268-271
No abstract available.
Esophageal and Gastric Varices/*therapy
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Gastrointestinal Hemorrhage/*therapy
;
Humans
3.Recent Update of Embolization of Upper Gastrointestinal Tract Bleeding.
Korean Journal of Radiology 2012;13(Suppl 1):S31-S39
Nonvariceal upper gastrointestinal (UGI) bleeding is a frequent complication with significant morbidity and mortality. Although endoscopic hemostasis remains the initial treatment modality, severe bleeding despite endoscopic management occurs in 5-10% of patients, necessitating surgery or interventional embolotherapy. Endovascular embolotherapy is now considered the first-line therapy for massive UGI bleeding that is refractory to endoscopic management. Interventional radiologists need to be familiar with the choice of embolic materials, technical aspects of embolotherapy, and the factors affecting the favorable or unfavorable outcomes after embolotherapy for UGI bleeding.
Angiography
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Embolization, Therapeutic/*methods
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Endoscopy, Gastrointestinal
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Gastrointestinal Hemorrhage/etiology/*therapy
;
Hemostasis, Endoscopic
;
Humans
;
*Upper Gastrointestinal Tract
4.Provocative mesenteric angiography for diagnosis and treatment of occult gastrointestinal hemorrhage
Gastrointestinal Intervention 2018;7(3):150-154
Occult gastrointestinal (GI) hemorrhage can be a great challenge to both patients and physicians, exerting a great toll on patients and the healthcare system. While diagnostic capabilities for diagnosing GI bleeding are improving, particularly with the establishment of computed tomography angiography and capsule endoscopy as routine modalities, patients with intermittent massive GI bleeding continue to pose a diagnostic and management dilemma. In this review, the concept, efficacy, and safety of provocative mesenteric angiography is described. The body of literature suggests that this procedure is safe and effective in this patient population with little to no alternative options.
Angiography
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Capsule Endoscopy
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Delivery of Health Care
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Diagnosis
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Gastrointestinal Hemorrhage
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Hemorrhage
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Humans
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Thrombolytic Therapy
6.Severe gastrointestinal bleeding after allogeneic hematopoietic stem cell transplantation--15 case analysis.
Qian JIANG ; Xiao-jun HUANG ; Huan CHEN ; Lan-ping XU ; Dai-hong LIU ; Yu-hong CHEN ; Yao-chen ZHANG ; Kai-yan LIU ; Nai-lan GUO ; Dao-pei LU
Chinese Journal of Hematology 2005;26(5):277-280
OBJECTIVETo analyze the features, causes, treatments and outcomes of severe gastrointestinal (GI) bleeding after allogeneic hematopoietic stem cell transplantation (allo-HSCT).
METHODSFifteen patients suffered from massive GI bleeding (blood loss leading to hemorrhagic shock) or subacute GI bleeding (at least 1 or more units of red blood cell transfusion on each of two consecutive days) were observed and analyzed after allo-HSCT.
RESULTSSeventeen severe GI bleeding episodes occurred in 15 patients. The severe bleeding occurred in three periods of time: within 1 week, 1 to 2 months and 4 to 7 months after transplantation. The main manifestation was hematemesis and hematochezia in the first period, and hematochezia alone in the second and third periods. Platelet counts at the onset of severe bleeding were < or = 50 x 10(9)/L in the majority of patients. Causes of bleeding were conditioning regimen-related toxicity in 2 patients/episodes, graft versus host disease (GVHD) or/and intestinal cytomegalovirus (CMV) or fungal infections in 11 patients/12 episodes, intestinal CMV infections in 1 patient/episode, acid-peptic ulcer in 2 patients/episodes, and cause unknown in 1 patient/episode. Supportive care such as transfusions of platelet, red blood cell and fresh frozen plasma, H2 receptor blockers and omeprazole were given to all patients, immunosuppressive drugs to patients developed GVHD and antiviral drugs to patients with complicated CMV infection. Eight patients/9 episodes of bleeding were controlled. Eight patients continued severe GI bleeding and died of acute GVHD or related serious complications.
CONCLUSIONSSevere GI bleeding after allo-HSCT are mainly caused by regimen-related toxicity, GVHD or/and intestinal CMV infection. Bleeding caused by conditioning regimen-related toxicity is self-limited and has a better prognosis. However, treatment failure and mortality are high if the patient's bleeding resulted from GVHD and intestinal CMV infection.
Gastrointestinal Hemorrhage ; etiology ; therapy ; Hematopoietic Stem Cell Transplantation ; Humans ; Postoperative Complications ; therapy ; Prognosis
7.Laparoscopic diagnosis and treatment of rectum telangiectasia: report of a rare form of lower gastrointestinal hemorrhage.
Zhao-Cheng CHEN ; Hai-Jun DENG
Journal of Southern Medical University 2015;35(10):1508-1510
We report a case of rectum telangiectasia, a rare form of lower gastrointestinal hemorrhage caused by vascular malformation. The patient underwent laparoscopic assisted abdomino-perineal resection of the sigmoid colon-rectum telangiectasia. The extent and degree of pathological changes were observed directly from the intestinal wall during laparoscopic surgery, and after collection of biopsy evidence, concomitant definitive surgery was performed to achieve a minimally invasive effect.
Gastrointestinal Hemorrhage
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diagnosis
;
therapy
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Humans
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Laparoscopy
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Rectum
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pathology
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Telangiectasis
;
diagnosis
;
therapy
8.The diagnosis and management strategies for gastrointestinal hemorrhage following pancreaticoduodenectomy.
Hong-qiao GAO ; Yan ZHUANG ; Xiao-dong TIAN ; Guang-dong WU ; Yin-mo YANG
Chinese Journal of Surgery 2013;51(8):685-687
OBJECTIVETo analyze the causes and clinical features of gastrointestinal hemorrhage following pancreaticoduodenectomy (PD), and to provide the management strategies for this complication.
METHODSThe clinic data of 412 patients who underwent PD from January 2000 to April 2010 was retrospectively reviewed. There were 232 male and 180 female patients, average age was (60 ± 12) years. The mode of procedure was standard PD and the Child's reconstruction of digestive tract, whose anastomosic steps encluded gastroenterostomy following chlangioenterostomy and pancreaticoenterostomy, was employed. Etiology of gastrointestinal haemorrhage, diagnostic methods and treatment strategy was recorded and analyzed.
RESULTSThe postoperative mobidity was 37.1% (153/412), the rate of haemorrhagic complications was 6.6% (27/412), and gastrointestinal hemorrhage was recorded in 11 patients (2.7%). The bleeding rate of pancreaticointestinal anastomosis and gastricointestinal anastomosis were 5/11 and 4/11, respectively. Among these 11 patients, early hemorrhage occurred in 6 patients, 7 patients were due to technical failure. In order to control this kind of complication, open abdominal operation alone was performed on 4 patients, endoscopic management was performed on 3 patients and succeeded in 2 patients, vascular interventional therapy was performed on 5 patients and succeeded in 2 patients, and Re-laparotomy following vascular interventional therapy was performed on 2 patients successfully.
CONCLUSIONSGastrointestinal hemorrhage following PD always occurred in early stage and reliable hemostasis during operation is the key points for prevention. Angiography is minimally invasive and holds the diagnostic value. Timely and decisive reoperation is an important method to management of postoperative gastrointestinal hemorrhage.
Aged ; Female ; Gastrointestinal Hemorrhage ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Pancreaticoduodenectomy ; adverse effects ; Postoperative Hemorrhage ; therapy ; Retrospective Studies ; Treatment Outcome
9.Prognostic Value of Emergency Endoscopy in Patient with Upper Gastrointestinal Bleeding.
The Korean Journal of Gastroenterology 2009;53(4):265-268
No abstract available.
Acute Disease
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*Emergency Service, Hospital
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*Endoscopy, Gastrointestinal
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Gastrointestinal Hemorrhage/*diagnosis/mortality/therapy
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Humans
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Prognosis
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Risk Factors
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Time Factors
;
Treatment Outcome
10.A Case of Gastric Kaposi's Sarcoma Successfully Treated with VP-16.
Ung Suk YANG ; Chul Soo SONG ; Mong CHO ; Geun Am SONG ; Jae Seung LEE ; Hyong Wook KIM ; Young Min KIM ; Soo Bong LEE ; Tae Oh KIM ; Seong Hwun LEE
Korean Journal of Gastrointestinal Endoscopy 1999;19(4):613-617
Kaposi's sarcoma, a rare tumor, usually presents itself with skin lesions. However, extracutaneous lesions are common and the gastrointestinal tract is often involved. Gastric Kaposi's sarcoma is usually asymptomatic, but may cause massive gastrointestinal hemorrhage, perforation, intestinal obstruction, intussusception, protein-losing enteropathy, or sepsis. The gastroscopic appearances of Kaposi's sarcoma range from reddish purple maculopapules to polypoid, umbilicated nodules. In Korea, only one case of gastric Kaposi's sarcoma had been reported until now. A case of gastric Kaposi's sarcoma treated with VP-16 (etoposide) is here in reported with the endoscopic findings before and after chemotherapy.
Drug Therapy
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Etoposide*
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Gastrointestinal Hemorrhage
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Gastrointestinal Tract
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Intestinal Perforation
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Intussusception
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Korea
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Protein-Losing Enteropathies
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Sarcoma, Kaposi*
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Sepsis
;
Skin