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Results for “HEMORRHAGE, GASTROINTESTINAL”

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At least 235 records · Page 13Linked to original sources
PubMed2001

Prognostic value of fibrinolytic tests for hospital outcome in patients with acute upper gastrointestinal hemorrhage.

GOALS: We assessed the predictive value of fibrinolytic tests for hospital outcome in a prospective study of 84 nonconsecutive patients with acute upper gastrointestinal hemorrhage. STUDY: Six readily available parameters of activated fibrinolysis (fibrinogen, D-dimer, tissue plasminogen activator [TPA], plasminogen activator inhibitor type 1 [PAI-1], TPA--PAI-1 complexes, and plasmin-alpha 2-antiplasmin complexes) were tested for association with hospital outcome. Patients were divided into the following three groups: patients who survived and did not require transfusion or surgery, those who survived without surgery but required transfusion, and those who required surgery or died. RESULTS: Patients with adverse outcome (surgery and/or death) showed significantly higher plasma levels of D-dimer than patients with favorable outcome (p = 0.01). Plasma concentrations of D-dimer >300 ng/mL showed a 20.5% positive predictive value of adverse outcome, with a relative risk of 7.5 (95% CI: 1--57%). Patients who required transfusion showed significantly higher plasma levels of TPA (p = 0.01). A positive correlation between endoscopic bleeding stigmata and D-dimer in the subgroup of patients without liver cirrhosis was found (p = 0.02); however, in the multivariate logistic regression analysis the concentration of D-dimer did not appear as an independent predictor of adverse outcome. CONCLUSIONS: These findings are consistent with the role of increased local fibrinolysis in the digestive tract, particularly of D-dimer, in patients with upper gastrointestinal hemorrhage and adverse outcome. Accordingly, plasma fibrinolytic tests may constitute an appropriate prognostic marker in upper gastrointestinal bleeding.

Aged↗
PubMed1984

Scintigraphy of gastrointestinal hemorrhage: superiority of 99mTc red blood cells over 99mTc sulfur colloid.

The relative efficacy of 99mTc sulfur colloid and in vitro-labeled 99mTc red blood cells in detecting and localizing gastrointestinal hemorrhage was evaluated in a prospective tandem study of 100 patients referred for suspicion of gastrointestinal tract hemorrhage. Thirty-eight true-positive scintigrams were obtained with 99mTc red blood cells, whereas 99mTc sulfur colloid detected only five sites of hemorrhage. Scintigraphic findings were corroborated by clinical, endoscopic, arteriographic, and surgical findings. 99mTc red blood cells were clearly superior, with a sensitivity of 93%, specificity of 95%, and overall accuracy of 94% in detecting and localizing gastrointestinal hemorrhage.

Adolescent↗
PubMedDate not supplied

Kawasaki disease presenting with lymphadenopathy and gastrointestinal hemorrhage: report of one case.

We report a 5-year-old boy with Kawasaki disease (KD) initially presenting with cervical lymphadenitis and complicated by gastrointestinal hemorrhage before the use of salicylates (aspirin). A previously well and fully immunized 5-year-old Japanese boy presented with a 5-day history of neck mass and fever. Physical examination showed bilateral lymphadenopathy but not nonexudative conjunctivitis, oral cavity changes, skin rash, or extremity changes. He was admitted with a diagnosis of neck lymphadenitis and treated with parenteral antibiotics. Tarry stool was noted on the second day of admission, before the definitive diagnosis of KD was made, and cimetidine was given to treat the gastrointestinal hemorrhage. On the fourth day of admission, he fulfilled the diagnostic criteria for KD (fever for 9 days plus lymphadenopathy, lip fissure, conjunctivitis, and skin rash). He was treated with intravenous immunoglobulin (2 g/kg/day) and aspirin (80 mg/kg/day), and the fever subsided promptly. Massive gastrointestinal bleeding occurred on the ninth day of admission and was treated with whole blood transfusion, after which the vital signs were stable.

Aspirin↗
PubMedDate not supplied

Fatal gastrointestinal hemorrhage caused by cytomegalovirus duodenitis and ulceration after heart transplantation.

The case of a 61-year-old man, in whom heart transplantation was complicated by fatal gastrointestinal hemorrhage from duodenal ulcers 50 days after surgery, is described. Autopsy examination revealed extensive mucosal ulceration and hemorrhage into the bowel and peritoneal hemorrhage. Microscopy showed classical cytomegalovirus inclusions in clusters of cells in necrotic foci in the duodenum, lungs, and colon. This unusual case is the first reported example of cytomegalovirus-associated fatal gastrointestinal hemorrhage after heart transplantation. It is discussed in the context of the known features of the morbidity and mortality associated with cytomegalovirus infection in transplant patients.

Cytomegalovirus↗
PubMedDate not supplied

[Portable hemoglobinometer for bedside monitoring of capillary blood hemoglobin in patients with acute gastrointestinal hemorrhage].

INTRODUCTION: Monitoring of hemoglobin is necessary in patients with gastrointestinal haemorrhage. Take blood sample and analysis at laboratory with automatum is the gold standard. A fast determination of hemoglobin at the bedside is possible with a portable haemoglobinometer Hemocue. AIMS AND METHODS: To assess correlation of capillary hemoglobin by Hemocue at the bedside, with venous hemoglobin by Coulter STKS in laboratory, for the monitoring of patients with a gastrointestinal haemorrhage hospitalized at november 2001 to july 2002. Statistical analysis used t test student apparied, and the determination of correlation coefficient r. RESULTS: Fourteen males and 8 females 61+/-17 aged had taking 204 venous blood samples and 204 capillaries blood simultaneously. Gastrointestinal haemorrhage was related with variceal bleeding (n=11), a duodenal ulcer (n =6), an esophagitis peptic ulcer (n =1), a diverticulous colitis (n =2), a gastric cancer (n =1), and an ischemic colitis (n =1). Initial hemoglobin was at 7.6+/-2,4 g/dL. Transfusion of 3+/-3 blood unit were realised in 17 patients. Means of hemoglobin were 9.15+/-1,62 g/dL on venous blood analyzed in laboratory, and 9.43 +/- 1,72 g/dL on blood capillary by Hemocue at the bedside. Correlation coefficient r was 0.87 (p <0.001). Variceal or others bleeding, fluid infusion for hypovolaemia, red cell transfusion and widespread of low level hemoglobin do not disturbed the validity of results. CONCLUSION: In acute period of a gastrointestinal hemorrhage, monitoring of hemoglobin by Hemocue with capillary blood at the bedside is a reliable method.

Acute Disease↗