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At least 631 records · Page 35Linked to original sources
PubMed2001

[Multiple lymphomatous polyposis--rare case of gastrointestinal hemorrhage].

The authors report a case of a 57 years old male patient, who was admitted to gastroenterology department with upper gastrointestinal haemorrhage. The urgent upper gastrointestinal endoscopy revealed an ulcerated polypoid tumor in the region of angulus of the stomach, and multiple polypoid lesions in the bulbar part of the duodenum. Upon this endoscopic appearance colonoscopy was performed, which revealed a polyposis syndrome in the colorectum. Computer tomography detected mesenterial, retroperitoneal and mediastinal lymph node involvement as well. In this case the primary or secondary origin of the gastrointestinal lymphoma was not verifiable. According to literature data this histological type of the gastrointestinal lymphoma has poor response to chemotherapy, the prognosis is unfavourable. In this particular case the administered chemotherapy resulted in total remission at the lymphoma patient clinically staging III Ae. In the proper follow-up examinations of the patient upper and lower endoscopy, histology samples, laboratory parameters, computer tomography, and physical examination in every 3 months are the methods.

Antineoplastic Agents↗
PubMed1998

Massive gastrointestinal hemorrhage after transoesophageal echocardiography probe insertion.

PURPOSE: To describe a case of a massive gastric bleeding following emergency coronary artery bypass surgery associated with transoesophageal echocardiographic (TEE) examination. CLINICAL FEATURES: A 50-yr-old man was referred for an acute myocardial infarction and pulmonary edema (Killip class 3). Twelve hours after his myocardial infarction, he was still having chest pain despite an i.v. heparin infusion. Coronary angiography revealed severe three-vessel disease with multifocal stenosis of the left anterior descending, circumflex and total occlusion of the right coronary artery. The patient was transferred to the operating room for emergency coronary artery bypass graft surgery. After total systemic heparinization (3 mg.kg-1) was obtained for cardiopulmonary bypass, a multiplane TEE probe was inserted without difficulty to monitor myocardial contractility during weaning from CPB. During sternal closure, the TEE probe was removed and an orogastric tube was inserted with immediate drainage of 1,200 ml red blood. Endoscopic examination demonstrated a mucosal tear near the gastro-oesophageal junction and multiple erosions were seen in the oesophagus. These lesions were successfully treated with submucosal epinephrine injections and the patient was discharged from the hospital eight days after surgery. CONCLUSION: This is a report of severe gastrointestinal hemorrhage following TEE examination in a fully heparinized patient. This incident suggest that, if the use of TEE is expected, the probe should preferably be inserted before the administration of heparin and the beginning of CPB.

Anticoagulants↗
PubMed1983

Upper gastrointestinal hemorrhage.

Hemorrhage in the upper gastrointestinal tract can be a diagnostic and therapeutic challenge to the physician. Although some advances have been made in patient care, mortality from gastrointestinal bleeding has not decreased during the past 40 years. The initial priorities in the physical examination of the bleeding patient should be a rapid assessment of the hemodynamic status and evaluation of the circulatory state. Once the patient has been hemodynamically stabilized, endoscopy is the best available technique for identifying the bleeding lesion. Potential sources of the bleeding are duodenal ulcers, gastric ulcers, Mallory-Weiss tears, and esophageal varices. The classic indications for surgical intervention are loss of 30% of the estimated blood volume in the first 24 hours, a need for 1,500 ml of transfused blood per 24 hours to maintain stable hemodynamics, hemorrhage to the point of hypotension or shock, and rebleeding during medical therapy.

Endoscopy↗