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Results for “HEMORRHAGE, GASTROINTESTINAL”

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At least 379 records · Page 21Linked to original sources
PubMed1986

Influence of selective mesenteric arteriography on the outcome of emergency surgery for massive, lower gastrointestinal hemorrhage. A 15-year experience.

From 1970 to 1984, 64 patients with massive hemorrhage of lower gastrointestinal origin were treated at the intensive care unit, Surgical Department, Malmö General Hospital. The records of these patients have been studied retrospectively. Emergency exploration for hemostasis was performed on 31 patients, while in 33 patients hemorrhage stopped with conservative therapy. Acute selective mesenteric arteriography revealed the bleeding site in 16 of 28 patients (57 percent). The commonest bleeding sources detected by selective mesenteric arteriography were diverticular disease and angiodysplastic lesions of the colon. Fourteen patients with positive arteriography finding were operated on as emergencies, resulting in two postoperative deaths. Ten patients were operated on as emergencies without preoperative arteriography. Despite intraoperative efforts, no bleeding source was found in three of those patients. In the remaining seven patients, the diagnoses were similar to the 14 patients with positive arteriography. Five of 10 patients in this group died postoperatively. Emergency laparotomy eventually was necessary in seven of 12 patients with negative arteriography. This group had a variety of diagnoses and no postoperative mortality. Positive preoperative mesenteric arteriography findings allowed the surgeon to perform a limited resection of the bleeding bowel segment with a reduced postoperative mortality.

Adolescent↗
PubMed1976

Upper gastrointestinal hemorrhage clinical, radiological and endoscopic correlation of 100 consecutive cases.

One hundred consecutive cases of upper gastrointestinal hemorrhage were studied clinically, radiologically and endoscopically. Erosive gastritis, duodenal and gastric ulcer, and bleeding esophageal varices accounted for 85% of the cases. The presenting sign of hematamesis or melena was of no value in localizing the bleeding site relative to the pyloric sphincter. Erosive lesions of the esophagus and stomach were suspected clinically in less than 50% of the cases and were the lesions least amenable to radiologic diagnosis and where early endoscopy was most useful. Our observations demonstrate again the frequent association between ethanol or aspirin ingestion and erosive gastritis.

Adult↗
PubMed2003

Early gastrointestinal hemorrhage after laparoscopic gastric bypass.

BACKGROUND: Early gastrointestinal (GI) hemorrhage after open gastric bypass has been infrequently reported. The aim of this study was to examine the incidence of early GI hemorrhage after laparoscopic Roux-en-Y gastric bypass (LRYGBP), its presentation, and possible treatment options. METHODS: A retrospective review of 5 patients who developed early postoperative GI hemorrhage after LRYGBP was performed. The charts were reviewed for demographics, clinical presentation, diagnostic evaluation, and treatment. All patients underwent a transected LRYGBP with creation of the gastrojejunostomy anastomosis with a circular stapler and the jejunojejunostomy anastomosis with a linear stapler. RESULTS: Of the 155 patients in our database who underwent LRYGBP, 5 (3.2%) developed early clinical GI hemorrhage. There were 2 males with an average age of 40 years. Clinical presentations of GI hemorrhage were hematemesis (2 patients), bright red blood per rectum (1 patient), melena (1 patient), and hypotension (1 patient). A diagnostic study (nuclear scintigraphy) was performed in only 1 of 5 patients. 3 of 5 patients were managed nonoperatively; 2 patients required fluid and blood resuscitation, and the other patient was managed without blood transfusion. The onset of hemorrhage in these 3 patients occurred 24 hours postoperatively or later. 2 of 5 patients required operative intervention for control of hemorrhage. The onset of hemorrhage or hypotension in these 2 patients occurred within 12 hours after surgery. The sites of hemorrhage were at the gastric remnant staple-lines in 1 patient and at the gastrojejunostomy and gastric remnant staple-lines in the other patient. CONCLUSION: Early GI hemorrhage is a potential complication after transected LRYGBP. Early reoperative intervention should be performed for patients with hemodynamic instability and patients with early onset of hemorrhage after surgery.

Adult↗
PubMed1979

Intramural hematoma of the small intestine presenting with major upper gastrointestinal hemorrhage. Case report and review of the literature.

We report a case of an anticoagulated patient presenting with a massive upper gastrointestinal hemorrhage, abdominal pain, and a palpable abdominal mass, demonstrated to be an intramural hematoma of the jejunum. Approximately two-thirds of intramural hematomas of the small intestine are preceded by abdominal trauma with the remainder associated with pancreatic disease, alcoholism, unknown causes, or clotting defects. Spontaneous occurrence of intramural hemorrhage is uncommon. Of the varied clinical presentations, gastrointestinal bleeding, previously thought unusual, is seen in 30% of cases, although major hemorrhage is rare. Conversely, reports of intramural hematoma of the small intestine as a case of major gastrointestinal bleeding has not been recognized. A review of the literature follows, and the authors stress that abdominal trauma should raise the possibility of an intramural hematoma of the small bowel.

Abdominal Injuries↗
PubMed1978

Hemosuccus pancreaticus (hemoductal pancreatitis): gastrointestinal hemorrhage due to rupture of a splenic artery aneurysm into the pancreatic duct.

A patient with recurrent upper gastrointestinal bleeding was found to have pancreatitis and a pseudoaneurysm of the splenic artery that communicated with the pancreatic duct. Similar pathology noted in ten other patients found in an extensive review of the literature suggest that this rare entity must be considered in the diagnosis of gastrointestinal hemorrhage of obscure origin. In this collected experience, the combination of recurrent left upper quadrant pain, a history of pancreatitis, and recurrent bouts of gastrointestinal bleeding of obscure origin were usually present in those patients who were found to have a splenic artery aneurysm as the source of the blood loss. Distal pancreatectomy with resection of the splenic artery aneurysm is curative.

Acute Disease↗
PubMed1995

Epidemiology of hospitalization for acute upper gastrointestinal hemorrhage: a population-based study.

OBJECTIVES: To obtain epidemiological data on hospitalization for acute upper gastrointestinal hemorrhage (AUGIH) in a demographically defined population. METHODS: Adults hospitalized in 1991 with AUGIH [from a San Diego health maintenance organization (270,699 adult members)] were identified from discharge codes in the International Classification of Diseases, 9th Revision, Clinical Modifications, and their records were reviewed. RESULTS: There were 276 hospitalizations among 258 patients, an annual incidence rate of 102.0 hospitalizations per 100,000. Patient analysis, including the first admission of 15 patients with multiple hospitalizations, revealed rates of 128.3 in males and 65.8 in females. The rate increased with age in males (p = 0.008) and females (p = 0.001) more than 30-fold between the 3rd and 9th decades of life. AUGIH started before admission in 242 (93.8%) patients and after admission for other disorders in 16 (6.2%) patients. Endoscopy was performed in 241 (93.4%) patients. Diagnoses were: peptic ulcer, 159 (61.6%); mucosal erosive disease, 37 (14.3%); varices, 16 (6.2%); miscellaneous, 25 (9.7%); and unknown, 21 (8.1%). Peptic ulcer patients were similar to other patients (mean +/- SE) in age [60.6 +/- 1.2 vs. 60.7 +/- 1.5 yr] and gender [104 (65.4%) vs. 60 (60.6%) males], but were more often nonsteroidal anti-inflammatory drug (NSAID)-users [87 (54.7%) vs. 34 (34.3%) (p = 0.002)]. Older age, female gender, and NSAID use independently predicted gastric ulcer (p < or = 0.03). The severity of bleeding was similar in patients with peptic ulcers and in those with mucosal erosive disease and was not related to NSAID use in peptic ulcer patients. Patients whose AUGIH started after admission were older than those whose AUGIH began before admission [70.4 +/- 2.9 vs. 60.0 +/- 1.0 yr (p = 0.002)], and they had a higher mortality rate [4 (25%) vs. 9 (3.7%) (p = 0.005)]. CONCLUSIONS: 1) The annual incidence of hospitalization for AUGIH was 102.0 per 100,000, increased markedly with age, and was twice as high in males as in females. 2) Peptic ulcer was the most common cause. 3) Gastric ulcer was associated with older age, female gender, and NSAID use. 4) Mortality rates were high when AUGIH started after hospitalization for another disorder.

Acute Disease↗
PubMed1989

Gastrointestinal hemorrhage as a complication of cardiac catheterization.

This report describes three patients who developed the rate complication of gastrointestinal hemorrhage following cardiac catheterization. These cases illustrate the diverse mechanisms by which bleeding may occur. The important predisposing factors appear to be widespread atherosclerosis, prolonged hypotension, and gastrointestinal disease potentially associated with bleeding.

Aged↗
PubMed1996

[Value of the emergency therapeutic endoscopy in gastrointestinal hemorrhage].

The experience in therapeutic digestive endoscopy is presented using injection technique with adrenalin-polidocanol of gastrointestinal hemorrhage lesions. One hundred and twenty nine patients were treated endoscopically; the medium age was 60 years; in almost 80% of the cases, peptic ulcer disease were found. The effectiveness was 91.4% when one session procedure was used and in some cases two sessions were applied, giving a final total arrest of hemorrhage of 95.3%. The total mortality still remain high (16.3%) even without bleeding, due to coexisting poor general conditions of the patients. The technique of endoscopic injection is reviewed and the final results of our work are presented.

Adult↗
PubMed2002

Massive life-threatening lower gastrointestinal hemorrhage following hemorrhoidal rubber band ligation.

Hemorrhoids are common, and a significant proportion of patients who have hemorrhoids experience symptoms such as bleeding, pain and itching. Endoscopic hemorrhoidal ligation is a safe and effective technique indicated for the treatment of grade 1 to 3 hemorrhoids, with a high success and low complication rate. Complications, when they occur, are minor and may include painful thrombosed prolapsed hemorrhoids, slippage of bands, minor rectal bleeding and chronic longitudinal ulcer. Rare, potentially life-threatening complications are massive hemorrhage and pelvic sepsis. A case of massive, life-threatening lower gastrointestinal hemorrhage following endoscopic hemorrhoidal rubber-band ligation is presented. Our patient ingested aspirin intermittently following the procedure. In a study documenting complications after hemorrhoidal band ligation, two of three individuals requiring transfusion for massive hemorrhage were taking aspirin on a regular basis. The risk of massive hemorrhage after hemorrhoidal rubber band ligation is probably increased by ingestion of nonsteroidal anti-inflammatory drugs. It may be wise to withhold such drugs soon after the procedure, if feasible.

Digestive System Surgical Procedures↗
PubMed2003

Lower gastrointestinal hemorrhage from an arterioenteric fistula in a pancreatorenal transplant patient.

We report a case of a severe lower gastrointestinal hemorrhage caused by arterioenteric fistula formation in a pancreas transplant patient. A rare but potentially deadly complication of pancreas transplant surgery, arterioenteric fistulas should be considered in every transplant patient presenting with voluminous gastrointestinal bleeding. If diagnosed promptly, angiographic and surgical intervention can prevent serious morbidity and mortality.

Adult↗