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At least 991 records · Page 55Linked to original sources
PubMed1980

Successful embolization of the dorsal pancreatic artery to control massive upper gastrointestinal hemorrhage.

Selective arterial embolization is an established technique to control gastrointestinal bleeding in patients who are poor surgical risks and in whom bleeding is uncontrolled by other methods. This article describes the control of upper gastrointestinal bleeding by subselective embolization of a bleeding branch of the dorsal pancreatic artery in a patient with severe pancreatitis. This is the first recorded successful embolization of the dorsal pancreatic artery to control hemorrhage.

Adult↗
PubMed1998

[Gastrointestinal hemorrhage caused by rupture of an aneurysm of visceral arteries. Presentation of 4 cases].

STUDY AIM: Gastrointestinal bleeding by rupture of splanchnic artery aneurysms is very rare. The aim of this study is to report four cases observed between 1990 and 1996. MATERIALS AND METHODS: In the first case, the celiac trunk aneurysm was revealed by hematemesis due to erosion of the posterior wall of the stomach. Excision of the aneurysm associated with splenopancreatectomy was followed by revascularization of the common hepatic artery with a bypass implanted in the aorta. The second case concerned a splenic artery aneurysm revealed by hemosuccus pancreaticus and intestinal bleeding which was treated by excision and splenopancreatectomy. In the third case, the common hepatic artery aneurysm revealed by hemosuccus pancreaticus and intestinal bleeding was treated by obstructive endoaneurysmorrhaphy. The fourth case concerned a superior mesenteric aneurysm revealed by duodenal erosion causing gastric and intestinal bleeding, which was treated by obstructive endoaneurysmorrhaphy and revascularization of the mesenteric artery by a spleno-mesenteric bypass. RESULTS: Surgical treatment was successful in all four patients. In the first case, an acute acalculous cholecystitis required a cholecystectomy after 3 weeks. In the fourth case, a splenic infarction disappeared spontaneously. CONCLUSION: Such observations are rare. The site of the bleeding was located by endoscopy. The aneurysm was recognized by contrast-enhanced computerized tomography (CT) scan and/or celiac and mesenteric arteriography which was performed in all cases and was very useful for the management of such aneurysms. After excision (n = 2) or obliterative endoaneurysmorrhaphy (n = 2), revascularization had to be done in two cases for celiac and mesenteric aneurysms.

Adult↗
PubMed1996

Enteric fistulization of a common iliac artery aneurysm: an unusual cause of gastrointestinal hemorrhage and shock.

A 78-year-old man with a history of recent unexplained lower gastrointestinal bleeding presented to the emergency department with the acute onset of abdominal pain, tenesmus, and shock. Computed tomography of the abdomen showed a fistula between a common iliac artery aneurysm and the small intestine. Laparotomy demonstrated a saccular aneurysm of the common and proximal internal iliac arteries with fistulous communication to the distal ileum. Aneurysmectomy, arteriorrhaphy, and segmental ileal resection with primary anastomosis were successfully performed. This case illustrates a rare complication of an uncommon aneurysm, emphasizing the need for emergency physicians to consider complicated vascular disease in the evaluation of a patient with abdominal pain and shock.

Aged↗
PubMed1995

[Evaluation of the clinical status of patients with gastrointestinal hemorrhage and acute pancreatitis using the APACHE II score].

In the group of 35 patients with gastrointestinal bleeding and in the group of 15 patients with acute edematous pancreatitis before beginning of treatment Apache II score was calculated. The obtained score values ranging from 2 to 18 were subsequently compared with the duration of the interval from appearing of the clinical signs to the beginning of treatment, the way of treatment, duration of hospitalization and recurrence of the diseases during hospitalization. The relations were evaluated through correlation analysis and T-test. Although the studied relations were in our conditions statistically insignificant we suppose, that Apache II score contributes to detachment of clinical assessment of patient in correlation to its severity and prognosis.

APACHE↗
PubMed1983

[Neurogenic gastrointestinal hemorrhage in hypertensive cerebral hemorrhage].

The purpose of this paper is to obtain the correlation between CT scan findings and neurogenic gastrointestinal bleeding in hypertensive intracerebral hemorrhage. Fifty patients with hypertensive intracerebral hemorrhage were operated upon during past nearly 3 years in our clinic. Of these, 27 patients (54%) showed macroscopic gastrointestinal bleeding (GI-bleeding) demonstrated by stomach catheter after the onset of hypertensive intracerebral hemorrhage. GI-bleeding was about 46% in the survived patients and about 77% in the expired ones. Most patients revealed neurogenic GI-bleeding within 9 days (85.2%) and more than half of the cases (51.9%) in 4 to 6 days after the onset. Neurogenic GI-bleeding was frequently complicated in patients with disturbed consciousness, over 60 gram hematoma (particularly 60-80 gram hematomas), severe ventricular hemorrhage and right-sided hematomas. It was also exclusively observed in patients with extension of hemorrhage into the midbrain and recurring hypertensive intracerebral hemorrhage.

Adult↗
PubMed1989

[The aorto-enteric fistula--a rare, but important cause of upper gastrointestinal hemorrhage].

During the last two years two patients with upper gastrointestinal bleeding caused by an aortoenteric fistula were admitted to the hospital. The first patient had a primary fistula between an arteriosclerotic aneurysm of the abdominal aorta and the duodenum. The second patient had an infected aortobifemoral graft which had penetrated into the upper jejunum. The aortoenteric fistula is one of the very rare causes of upper gastrointestinal bleeding. Referring to previous surgery at the aorta a primary and secondary type of fistula are differentiated. The primary fistula often induces a small initial bleeding followed by a severe hemorrhage with hematemesis and melaena. The secondary form is mostly caused by bacterial infection of the graft. Recurrent fever attacks are a common clinical symptom without any evidence of the origin of the bacteriemia. Principally the combination of upper gastrointestinal bleeding and aortic graft is always suspicious of an aortoenteric fistula. The most important preoperative examinations are endoscopy, computed tomography scan, and arteriography. The treatment must be surgical. Either a synthetic graft surrounded by omentum is implanted or an axillobifemoral or aortobifemoral bypass is constructed. Even if the diagnosis is made early mortality of the disease is about 20-30%.

Aged↗
PubMed1992

[2 cases of life threatening gastrointestinal hemorrhage from Meckel's diverticulum].

Meckel's diverticulum is one of the commonest congenital anomalies of the gastrointestinal tract. Two cases requiring emergency laparotomy due to massive gastrointestinal bleeding are presented. Only at laparotomy the correct diagnosis was established. In the first case a segment of small bowel was resected and diverticulectomy was performed in the second case. Both patients are free of complaints now at 2 and 3 years of follow-up respectively. The genesis of diverticular bleeding, the difficulties of the preoperative diagnosis of the complicated diverticulum and the uncertain indication for operation in cases of uncomplicated diverticulum are discussed and the literature is reviewed.

Adolescent↗
PubMed1989

[Gastrointestinal hemorrhage--change in therapy concepts by endoscopy].

Since the introduction of endoscopy in diagnosis and treatment of gastrointestinal bleeding in the early seventies, emergency endoscopy has changed the therapeutic concept of this disease. At first the task of emergency endoscopy was limited to location of the bleeding site. In the eighties endoscopic hemostasis was established in many hospitals. In addition, preselection of patients who will benefit from surgery has become possible by endoscopic means. These factors have reduced significantly mortality due to GI bleeding.

Endoscopes, Gastrointestinal↗
PubMed1996

[Administrative handling of gastrointestinal hemorrhage in Norway].

Rapid and adequate endoscopic treatment is a vital part of the initial handling of gastrointestinal haemorrhage. A national survey was carried out to study the logistics of the initial handling of these patients. Replies were received from 97% of the hospitals, each of which received an average of 11 patients per month with haematemesis/melena or rectal bleeding. Patients with haematemesis or melena were admitted primarily to medical departments or intensive care units, while patients with haematochezia were admitted most often to the surgical department. 47% of the hospitals performed emergency endoscopy as a routine on patients with red haematemesis, but even in this group of patients, endoscopy was postponed until the first working day in some instances, provided that the patient's condition was stable. The majority of emergency flexible endoscopies are performed by internists, but most hospitals describe close inter-departmental cooperation in the handling of these patients. The situation was deemed satisfactory at 91% of the hospitals.

Emergency Service, Hospital↗