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Results for “HEMORRHAGE, GASTROINTESTINAL”

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At least 487 records · Page 27Linked to original sources
PubMed1989

Evaluation and management of massive lower gastrointestinal hemorrhage.

Sixty-eight patients with massive lower gastrointestinal (G.I.) hemorrhage underwent emergency arteriography. Patients were transfused an average of six units of packed red blood cells within 24 hours of admission. The bleeding source was localized arteriographically in 27 (40%), with a sensitivity of 65% among patients requiring emergency resection. However, twelve of the 41 patients with a negative arteriogram still required emergency intestinal resection for continued hemorrhage. Radionuclide bleeding scans had a sensitivity of 86%. The right colon was the most common site of bleeding (35%). Diverticulosis and arteriovenous malformation were the most common etiologies. Selective intra-arterial infusion of vasopressin and embolization were successful in 36% of cases in which they were employed and contributed to fatality in two patients. Twenty-three patients underwent segmental resection, whereas seven patients required subtotal colectomy for multiple bleeding sites or negative studies in the face continued hemorrhage. Intraoperative infusion of methylene blue via angiographic catheters allowed successful localization and resection of bleeding small bowel segments in three patients. Overall mortality was 21%. The mortality for patients without a malignancy, with a positive preoperative arteriogram, and emergency segmental resection was 13%.

Aged↗
PubMed1994

Systemic antibiotic therapy prevents bacterial infection in cirrhotic patients with gastrointestinal hemorrhage.

This randomized prospective study was aimed at assessing the efficiency of a systemic antibiotic therapy for the prevention of bacterial infections in cirrhotic patients with gastrointestinal hemorrhage by ruptured esophageal varices. For 15 mo, all patients hospitalized with no infection on admission, were included in the study. Starting on admission day, patients in group A received ofloxacin (400 mg/day) for 10 days, first intravenously then orally. They also received an intravenous bolus of amoxicillin plus clavulanic acid (1 g) before each endoscopy performed during hemorrhage. Patients in group B received antibiotic therapy only in cases of established or suspected infection. Chest X-ray, blood culture, urine culture and sputum and ascitic fluid culture were performed every day for 7 days, then every other day for the next 7 days. A bronchial sampling was performed with the Wimberley technique on patients with endotracheal intubation. Ninety-one patients (55 men, 54 +/- 11 years, 78% Child Pugh class C) were included in the study (46 in group A, 45 in group B). Group A showed a lower incidence of bacterial infections than group B (20% vs. 66%; p < 0.001). Breakdown of positive bacteriological sampling was as follows: blood (6 vs. 17), ascites (3 vs. 7), lungs (2 vs. 18), urine (1 vs. 10). The 2-wk mortality rate was 24% in group A and 35% in group B.

Adult↗
PubMed1985

Abdominal varices mimicking an acute gastrointestinal hemorrhage during technetium-99m red blood cell scintigraphy.

Abdominal varices consisting of a caput medusae and dilated mesenteric veins resulted in pooling of Tc-99m tagged red blood cells (RBC) within these dilated vessels in a 57-year-old man with severe Laennec's cirrhosis. The atypical radiotracer localization within the abdomen mimicked an acute gastrointestinal hemorrhage. Clinical suspicion and careful evaluation of scintigraphic gastrointestinal bleeding studies will avoid false-positive interpretations.

Acute Disease↗
PubMed2002

[Prophylaxis of gastrointestinal hemorrhage in patients with noninflammatory pancreatic disease complicated by jaundice].

Frequency, severity of clinical course, pathophysiological mechanisms of occurrence and consequences of gastroduodenal erosion and ulcer, complicated by hemorrhage, were analyzed in patients with noninflammatory diseases of pancreas, complicated by jaundice, by cancer, in particular. Basing on investigations done there was elaborated complex programme of prophylaxis of gastrointestinal hemorrhage occurrence in such patients.

Gastrointestinal Hemorrhage↗
PubMed1992

Massive upper gastrointestinal hemorrhage with normal findings on arteriography: value of prophylactic embolization of the left gastric artery.

During a 5-year period, 13 patients who presented with massive upper gastrointestinal hemorrhage had normal findings on arteriography. Seven had prophylactic embolization of the left gastric artery, and six had conservative therapy. Normal angiographic findings were associated with clinical cessation of bleeding in 12 of 13 patients. Lesions not treated by embolization or other invasive therapy had a high rate of massive recurrent hemorrhage (four of six). Of lesions subsequently found to be supplied by the left gastric artery, two of four cases not treated by embolization or surgery had clinically significant recurrent hemorrhage, whereas none of six cases treated by embolization had recurrent hemorrhage. Prophylactic embolization of the left gastric artery appears warranted when (1) there is definite prior identification of a lesion in the left gastric artery territory or (2) there is no prior localization of a lesion but the patient is at risk for multiorgan failure if bleeding recurs.

Adult↗
PubMed1985

Optimal technetium-99m RBC labeling for gastrointestinal hemorrhage study.

Four methods of Tc-99m red blood cell labeling were tested for labeling efficiency and kinetics in normal adults. From a perspective of the gastrointestinal hemorrhage study, the in vivo method was least appropriate because of extravascular loss of pertechnetate. The modified in vitro method was disadvantageous because of long labeling intervals in a syringe fixed to the patient's forearm (45 minutes). The pure in vitro methods produced the highest labeling efficiency (95% +) and are preferred by the authors.

Erythrocytes↗
PubMed1989

[Orthograde intestinal irrigation with a mannitol solution in reducing hepatic encephalopathy in patients with liver cirrhosis and gastrointestinal hemorrhage].

The development of hepatic encephalopathy and coma hepaticum in patients with acute gastrointestinal bleeding and hepatic cirrhosis is a serious problem. Since 1983 we perform a whole gut irrigation with mannite for cleansing the bowel via naso-gastric tube. The aim of this therapy is to reduce the severity of hepatic encephalopathy. The first 20 patients with the new therapeutic concept were compared with the last 20 patients with the prevailing therapy. We studied the effect of the new therapeutic concept as to reduction of hepatic encephalopathy and possible electrolyte loss. None of the patients in the mannite group had hepatic encephalopathy stage III or IV, whereas 75% of the patients without mannite showed clinical signs of stage III or IV. Serum potassium, sodium and chloride were not significantly different between both groups. In the group with mannite application no change in serum creatinine was observed, whereas in the other group a minute increase of serum creatinine was seen.

Adult↗
PubMed1985

Recent advances in diagnosis and treatment of gastrointestinal hemorrhage in infants and children.

Gastrointestinal bleeding is a common and occasionally life-threatening problem in infants and children. A careful history and physical examination as well as the application of new endoscopic and radiographic techniques will reveal the source of hemorrhage in most patients. The utility of recently introduced pharmacologic agents and endoscopic techniques in the treatment of peptic disease and variceal hemorrhage in children remains to be determined. A cooperative effort among pediatricians, radiologists, and surgeons should minimize the morbidity and mortality from gastrointestinal tract bleeding in this population.

Angiography↗
PubMed1993

A scoring system to predict rebleeding after endoscopic therapy of nonvariceal upper gastrointestinal hemorrhage, with a comparison of heat probe and ethanol injection.

We prospectively and randomly compared heat probe and ethanol injection in 80 patients with major nonvariceal upper gastrointestinal hemorrhage who were bleeding actively or had endoscopic stigmata associated with a high risk for rebleeding. We also attempted to predict which patients would rebleed within 72 h after successful endoscopic therapy, using a three-component scoring system. Heat probe and ethanol injection proved to be similar in efficacy and safety. Active bleeding was controlled with equal success with heat probe and ethanol injection (92% vs. 82%), and there was no difference in the rebleeding rate (11% vs. 13%). The scoring system was useful in predicting which patients would rebleed. Significant differences were seen in the mean values of all three scores, and specific cut-offs in the pre-endoscopy and post-endoscopy scores predicted patients who rebled. High likelihood ratios and post-test probabilities for rebleeding were found for the number and severity of concurrent illnesses, but not for endoscopic stigmata, implying that the excess risk associated with stigmata is eliminated after effective endoscopic therapy, and clinical factors become the primary determinants of rebleeding.

Electrocoagulation↗