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UPPER GASTROINTESTINAL HEMORRHAGE (upper + gastrointestinal_hemorrhage)

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Medical Sciences100%

Selected Abstracts

CLINICAL INVESTIGATION OF UPPER GASTROINTESTINAL HEMORRHAGE AFTER PERCUTANEOUS ENDOSCOPIC GASTROSTOMY

DIGESTIVE ENDOSCOPY, Issue 3 2010
Shinji Nishiwaki
Background:, Upper gastrointestinal (GI) hemorrhage after percutaneous endoscopic gastrostomy (PEG) is sometimes reported as one of the serious complications. Our purpose was to clarify the cause of upper GI hemorrhage after PEG. Patients and Methods:, We retrospectively investigated the causes of upper GI hemorrhage among a total of 416 patients out of 426 consecutive patients who underwent PEG in our institution, excluding 10 patients who showed upper GI tumors on PEG placement. Results:, Among 17 patients who developed upper GI hemorrhage after PEG, three and four patients showed PEG tube placement and replacement-related hemorrhage, respectively; these lesions were vascular or mucosal tears around the gastrostomy site. Ten patients experienced 12 episodes of upper GI hemorrhage during PEG tube feeding. The lesions showing bleeding were caused by reflux esophagitis (five patients), gastric ulcer (two patients), gastric erosion due to mucosal inclusion in the side hole of the internal bolster (two patients), and duodenal diverticular hemorrhage (one patient). Anticoagulants were administered in six patients, including four patients with replacement-related hemorrhage and one patient each with reflux esophagitis and gastric ulcer. Conclusions:, Reflux esophagitis was the most frequent reason for upper GI hemorrhage after PEG. The interruption of anticoagulants should be considered for the prevention of hemorrhage on the placement as well as replacement of a gastrostomy tube. [source]

AORTO-DUODENAL FISTULA: MULTIDETECTOR COMPUTED TOMOGRAPHY AND GASTRODUODENOSCOPY FINDINGS OF A RARE CAUSE OF UPPER GASTROINTESTINAL HEMORRHAGE

DIGESTIVE ENDOSCOPY, Issue 3 2007
Massimo De Filippo
An aorto-enteric fistula is a serious complication of abdominal aortic aneurysm. Acute upper gastrointestinal bleeding may be a life-threatening condition that calls for immediate diagnosis and action. Morbidity and mortality remain high despite progress in diagnosis and therapeutic procedures. In the literature, the aorto-enteric fistula diagnostic suspicion by multidetector computed tomography scan is assumed on the basis of the interruption of the aortic wall, with the presence of duodenal gas situated to tightened contact with the aorta. We report a patient with an aorto-duodenal fistula associated with inflammatory abdominal aortic aneurysm detected by gastro-duodenoscopy and multidetector computed tomography scan, with gas found in the lumen of the abdominal aorta, between the aneurysm wall and the thrombus. [source]

Gastric bleeding due to Dieulafoy's ulcer successfully treated with an esophageal variceal ligation (EVL) kit

DIGESTIVE ENDOSCOPY, Issue 3 2001
Yoshihide Chino
Dieulafoy's ulcer is a cause of life-threatening upper gastrointestinal hemorrhage. With advanced endoscopic procedures, Dieulafoy's ulcer is easily diagnosed and treated. However, a few patients still need surgery to stop bleeding or they will die of shock. Further improved procedures are therefore required to treat bleeding in Dieulafoy's ulcer. A 77-year-old man was admitted to our hospital with hematemesis and general malaise. He had moderate anemia and azotemia but no past history of gastric ulcer. He was diagnosed with Dieulafoy's ulcer endoscopically. Dieulafoy's ulcer was ligated with an endoscopic variceal ligation kit without surgery. Although an ulcer was found at the ligation point after 1 week, the ulcer changed to the scar on administration of Histamine H2 receptor blockers. The patient has suffered no recurrent ulcer and no bleeding for 24 months. Endoscopic variceal ligation may be an alternative new method for hemostasis of Dieulafoy's ulcer. [source]

Unusual hepatic-portal-systemic shunting demonstrated by Doppler sonography in children with congenital hepatic vein ostial occlusion

JOURNAL OF CLINICAL ULTRASOUND, Issue 4 2004
Maha Barakat MD
Abstract Purpose This report describes unusual changes in the hepatic vasculature in 3 children presenting with upper gastrointestinal hemorrhage. Methods The study included 3 children (ages 5,8 years) who presented with hematemesis. All had mild hepatosplenomegaly and normal liver function. Esophageal varices were demonstrated in all on upper endoscopy. Color and spectral Doppler sonography was performed to assess the hepatic vasculature, including the hepatic veins (HVs), portal vein (PV), hepatic artery (HA), and inferior vena cava (IVC). Results The HVs were all patent but with ostial occlusion at the point of their communication with the IVC. Complete flow reversal was shown inside the HVs, with blood draining into collateral vessels at the liver surface and paraumbilical vein. In one patient, the paraumbilical vein could be traced to its communication with the right external iliac vein. In all children, the direction of flow in the PV, HA, and IVC was normal. After endoscopic sclerotherapy, all children were shown to be in good general condition and to have normal liver function for a follow-up period of 15,36 months. Conclusions Ostial occlusion of the HV is a rare cause of hepatic outflow obstruction in children. Doppler sonography is a valuable, noninvasive imaging technique for evaluation of the hepatic vasculature and the accompaning shunting pathways in such cases. © 2004 Wiley Periodicals, Inc. J Clin Ultrasound 32:172,178, 2004; Published online in Wiley InterScience (www. interscience.wiley.com). DOI: 10.1002/jcu.20019 [source]