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Results for “HEMORRHAGE, GASTROINTESTINAL”

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At least 613 records · Page 34Linked to original sources
PubMed1981

[Gastrointestinal hemorrhage].

More than 90% of all acute gastrointestinal bleeding is localized in the upper gastrointestinal tract. Manifestation of bleeding elucidates a life-threatening situation. An immediate planned approach with rapid resuscitation from shock, localization of the source of bleeding, estimation of the intensity of bleeding, and local control is necessary. The outcome is influenced more by patient factors and type of bleeding than by therapy. If local control of the source of bleeding is not feasible, a definitive procedure must be employed rapidly.

Emergencies↗
PubMed1994

Provocative red blood cell scintiscan in occult chronic gastrointestinal hemorrhage.

A patient with a chronic occult gastrointestinal bleeding site is described. Because an extensive examination failed to locate the site of bleeding, a heparin infusion was used in conjunction with a conventional Tc-99m labeled red cell bleeding study. A mid-jejunal ulcer was safely localized before elective surgery. A protocol for a heparin provocative bleeding study is proposed.

Aged↗
PubMed1997

[Incidence and causes of upper gastrointestinal hemorrhage].

The incidence rate of the upper gastrointestinal haemorrhage in Nowy Sacz region in years 1991-1995 was 43.5/100 thousand/year among men and 20.1/100 thousand/year among women. The most common causes of bleeding among male were: duodenal ulcer, gastric ulcer and haemorrhagic gastritis. Among female gastric ulcer was more frequent than duodenal ulcer. In the whole group of haemorrhage, the average age of men was lower than the age of women. In similar, in the bleeding duodenal ulcer, gastric ulcer, haemorrhagic gastritis and gastric cancer groups--male were significantly younger.

Adult↗
PubMed1997

Predictive value of technetium Tc 99m-labeled red blood cell scintigraphy for positive angiogram in massive lower gastrointestinal hemorrhage.

PURPOSE: This study was performed to evaluate whether the time interval from injection of technetium Tc 99m (99mTc)-labeled red blood cells to the time of a radionuclide "blush" (positive scan) can be used to improve the efficacy in predicting a positive angiogram. METHOD: A retrospective review revealed 160 patients who received 99mTc-labeled red blood cell scintigraphy for evaluation of massive lower gastrointestinal hemorrhage between 1989 and 1994. Patients were included who demonstrated signs of shock on admission, had an initial decrease in hematocrit of > or = 6 percent, or required a minimum transfusion of two units of packed red blood cells. Scanning duration was 90 minutes, with imaging every 2 minutes. Time interval from injection to a positive scan was analyzed to determine predictability of a positive angiography. RESULTS: Of 160 patients, 86 demonstrated positive scans, of whom 47 underwent angiography. These 47 patients were divided into two groups according to scan results. Group 1 (n = 33) had immediate appearance of blush; Group 2 (n = 14) had blush after two minutes. In Group 1, 20 of 33 patients had a positive angiogram, yielding a positive predictive value of 60 percent (P = 0.033). Of the 14 patients with negative angiograms (13 from Group 1, and 1 with a negative scan), 6 had radiographic occlusion of the inferior mesenteric artery and 1 had spasm of the right colic artery, with scans that blushed in the respective distributions. Excluding these seven patients yielded a positive predictive value of 75 percent (P = 0.0072) for angiography. In patients with a delayed blush (Group 2), 13 of 14 had negative angiograms, yielding a negative predictive value of 93 percent (92 percent excluding those with nonvisualization of the inferior mesenteric artery). Twenty of 21 (95 percent) positive angiograms occurred in Group 1 patients. Of the 27 patients with negative angiograms, 13 were Group 2 patients. CONCLUSION: Patients with immediate blush on 99mTc-labeled red blood cell scintigraphy required urgent angiography. Patients with delayed blush have low angiographic yields. These data suggest that patients with delayed blush or negative scans may be observed and evaluated with colonoscopy.

Adolescent↗
PubMed1984

[Treatment of gastrointestinal hemorrhage in patients following kidney transplant].

In 179 patients there were 218 operations of transplantation of the cadaveric kidney. Gastro-intestinal hemorrhages were found to develop in 16 of them (8.9%) at different terms after operations. Four patients were reoperated, 3 of them died. Twelve patients were treated by conservative methods. Eight patients survived. The transplant was functioning in 6 of them. Analysis of the material showed the conservative treatment to be the method of choice in gastrointestinal hemorrhages in the posttransplantation period. In such cases the transplant function should be given up for the sake of the patient's life. Before transplantation it is necessary to select a group of "high risk" patients. Part of them should be treated by hemodialysis only.

Adult↗
PubMed2004

Massive gastrointestinal hemorrhage due to rupture of a donor pancreatic artery pseudoaneurysm in a pancreas transplant patient.

Enteric drainage of secretions by anastomosing the donor duodenum to the recipient's small bowel has become common in pancreatic transplantation. While it eliminates many problems, endoscopic access to the transplanted duodenum and pancreas is made difficult. After a pancreas kidney transplant, the patient presented with massive hematochezia. Upper and lower endoscopy revealed large amounts of red blood in the colon but no specific bleeding site. Mesenteric angiography was normal but pelvic angiography showed rapid extravasation of contrast from a pseudoaneurysm of the pancreatic transplant artery. This was successfully embolized with coils. To the best of our knowledge, this is the first case of massive gastrointestinal hemorrhage because of rupture of a pseudoaneurysm of the donor pancreatic artery in a pancreas transplant patient. We report this case and review our institution's experience with all forms of gastrointestinal bleeding in pancreas transplant patients.

Aneurysm, False↗
PubMed1999

Both massive upper and lower gastrointestinal hemorrhage secondary to tuberculosis.

We report a case of gastrointestinal tuberculosis, presenting with both massive upper and lower gastrointestinal bleeding that required two emergency operations. Massive bleeding is rare in gastrointestinal tuberculosis because of associated obliterative endarteritis. Tuberculosis should be considered in the differential diagnosis of massive gastrointestinal bleeding in the appropriate clinical setting even in an immunocompetent patient.

Adult↗
PubMed1984

Endoscopic control of upper gastrointestinal hemorrhage with a bipolar coagulation device.

It has been difficult to determine the real efficacy of endoscopic treatment for upper gastrointestinal tract bleeding sites for several reasons. First, since 80 per cent of an unselected group are expected to stop bleeding spontaneously, it is important to focus upon those individuals who continue to bleed instead of a group in whom bleeding would have stopped spontaneously in the majority. Second, it is difficult, if not impossible, to have comparable groups of patients with similar lesions and similar rates of bleeding who can be randomized into different treatment groups. This report describes the use of a bipolar endoscopic coagulation device in 28 patients with active massive upper gastrointestinal tract hemorrhage who represent 10 per cent of the patients with hemorrhage during a one year interval. Endoscopic treatment controlled bleeding initially in 23 of these patients. Another eight patients with recent hemorrhage who were at high risk for recurrent bleeding (visible vessels) had endoscopic coagulation without subsequent hemorrhage. Immediate operations were required in five of the 28 and delayed operations in another four. Mortality in the patients treated by endoscopic or surgical therapy was comparable (20 per cent), but no patient died of hemorrhage. The high mortality in this group of patients is explained by associated illnesses. B-C is as effective as other endoscopic treatments for nonvariceal sources of upper gastrointestinal tract hemorrhage. This modality is relatively cheap compared with other devices, is theoretically less complicated and has minimal risk to the individual patient. Because of these considerations, it is a technique which deserves wider application and may become the endoscopic treatment of choice for control of upper gastrointestinal tract hemorrhage. Patients with endoscopic control of upper gastrointestinal tract bleeding avoid perioperative morbidity, have a lower transfusion requirement and may have a shorter hospital stay than comparable individuals who require operative control of bleeding sites.

Clinical Trials as Topic↗
PubMedDate not supplied

[Ileal carcinoid tumor manifesting as gastrointestinal hemorrhage and diagnosed with capsule endoscopy: Case report].

OBJECTIVE: To present a case of carcinoid tumor of the small bowel that produced hemorrhage and was identified by capsule endoscopy before surgery. INTRODUCTION: Carcinoid tumors of the small bowel are difficult to diagnose since most of them are asymptomatic and endoscopic examination by standard methods is not possible. Therefore they are rarely detected before a surgical procedure. METHOD: A review of the literature is done. Emphasis in the importance of early diagnosis due to its invasive tendency is also made. RESULTS: Male patient who had 3 episodes of malena along three years before hospitalisation. During this period three upper gastrointestinal endoscopies (EGD), three colonoscopies, two small bowel scintigraphies, one mesenteric angiography and one CAT scan were done before a capsule endoscopy was performed. This procedure revealed a tumor 0.8 cm diameter in the ileum, which was surgically resected. The pathological examination revealed carcinoid tumor invading the serosa. CONCLUSIONS: The carcinoid tumor is highly infiltrating, therefore early diagnose is mandatory. Since the capsule endoscopy makes possible the complete examination of the small bowel, it should be indicated in patients with gastrointestinal hemorrhage in whom EGD and colonoscopy are negative.

Capsules↗
PubMed1985

Surgonomics: the cost of gastrointestinal hemorrhage, the identifier concept.

The Tax Equity and Fiscal Responsibility Act will pay hospitals a set price for Medicare patients by one of 467 Diagnostic Related Groups (DRGs). The purpose of this study was to examine one DRG and perform indepth financial analysis in order to develop strategies for cost containment. In addition, we tested the hypothesis that an entity called an identifier (here, the presence or absence of transfusions) could be used to group patients within a specific DRG and demonstrate differences in costs. All patients (n = 46) with gastrointestinal hemorrhage under 70 years old without complications and not requiring surgery (DRG 175) treated at the Long Island Jewish-Hillside Medical Center during 1983 had their hospital charges examined. Total charges (hospital charges exclusive of physician fees) were $3891 +/- 2128 (mean +/- SEM)/patient. Patients requiring transfusion (n = 26) had total charges of $4707 +/- 2292, whereas those not requiring transfusion (n = 20) had total charges of $2765 +/- $1300. Findings in this study are: 1) within a given DRG there is a wide variance of hospital charges, 2) identifiers (in this case transfusion) may be used to clinically aggregate patients with similar resource consumption within a DRG, 3) patients receiving transfusion had 170% greater total charges, 165% greater hematology charges, and 526% greater total blood charges than those not receiving transfusion.

Adult↗
PubMed1995

Intra-abdominal mass associated with gastrointestinal hemorrhage: a new manifestation of bacillary angiomatosis.

Bacillary angiomatosis is a recently described vascular proliferative lesion that occurs most commonly in individuals infected with human immunodeficiency virus. Cutaneous lesions are the most frequently described manifestations of bacillary angiomatosis. However, as culture techniques and disease recognition have improved, additional manifestations have been identified in human immunodeficiency virus-infected individuals, including bacillary peliosis hepatis and isolated bacteremia. Two species of the genus Bartonella (formerly Rochalimaea), Bartonella henselae or Bartonella quintana, have been cultured from the cutaneous lesions of bacillary angiomatosis. A new manifestation of Bartonella infection is reported: an intra-abdominal mass presenting with massive gastrointestinal hemorrhage in a patient with human immunodeficiency virus infection. B. quintana was cultured from a percutaneous needle-biopsy specimen obtained from the highly vascularized intra-abdominal mass. The bacillary angiomatosis lesion resolved after 3 months of tetracycline treatment. Recognition of Bartonella infection is extremely important because it is readily treatable with antibiotic therapy.

Adult↗