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Results for “HEMORRHAGE, GASTROINTESTINAL”

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PubMed1976

[Hemorrhagic erosion as a cause for gastrointestinal hemorrhages].

It is necessary in clinical diagnosis more than hitherto done to take into consideration haemorrhagic erosions as the most frequent cause of gastrointestinal haemorrhages. They are found as concomitant diseases of certain basic diseases, whereby the spectre of causes deviates in adults and children. In adults dominate heart insufficiency and cerebral diseases including skull-brain trauma, in children, however, infections of the respiratory and digestive tract, followed by cerebral affections and haemoblastoses. A differentiation concerning age and sex cannot be proved.

Adult↗
PubMed1997

Hepatocellular carcinoma with gastrointestinal hemorrhage caused by direct tumor invasion to the duodenum.

Gastrointestinal hemorrhage from hepatocellular carcinoma invading the duodenum is very rare. A 60-year-old man with multiple hepatocellular carcinoma was admitted to our hospital because of massive melena and hematemesis. We succeeded in hemostasis of an esophageal variceal rupture by endoscopic varicial ligation. The duodenum could not be observed endoscopically due to extramural compression to the stomach from the liver tumor. Massive gastrointestinal hemorrhage occurred again and the patient died of hepatic failure. The postmortem examination revealed that the liver tumor had invaded the second portion of the duodenum and perforated into the lumen.

Carcinoma, Hepatocellular↗
PubMed1983

Acute upper gastrointestinal hemorrhage in patients with chronic renal disease.

In order to reassess the role of duodenal ulcers as a cause of acute upper gastrointestinal hemorrhage in patients with chronic renal failure, 20 consecutive patients with moderate to severe chronic renal failure and a comparison group of patients without renal disease who were seen for acute upper gastrointestinal hemorrhage were reviewed. Gastric bleeding sites (gastric ulcer in 35 percent and gastritis in 20 percent) rather than duodenal ulcers were the most common sources of bleeding and were significantly associated with the use of ulcerogenic drugs. Patients with renal disease in whom acute upper gastrointestinal hemorrhage developed had significantly more morbidity and a trend toward higher mortality than the comparison group of patients without renal disease. It is concluded that gastric mucosal lesions, at least in part due to the use of ulcerogenic drugs, are the most common cause of significant acute upper gastrointestinal hemorrhage in patients with chronic renal failure.

Duodenal Ulcer↗
PubMed1985

Gastrointestinal hemorrhage in children. A pragmatic update.

Gastrointestinal hemorrhage in infants and children is notable for its association with benign disease and its varied, age-dependent etiologies. We have presented these in brief. Much of the information presented, particularly that related to diagnostic endoscopy and sclerotherapy, represents extension of commonly used adult techniques to the pediatric population. Guidelines for resuscitation and diagnosis are provided with the expectation that an individual clinical assessment will lead to modification. Rigidity in approach is to be avoided. Notable recent changes in the management of children with GI hemorrhage are summarized and placed in perspective.

Acute Disease↗
PubMed2000

Transcatheter embolization for acute lower gastrointestinal hemorrhage.

PURPOSE: The authors review their experience using transcatheter embolization in the treatment of acute lower gastrointestinal hemorrhage. MATERIALS AND METHODS: A retrospective review was conducted on 17 patients who underwent superselective transcatheter embolization for an acute lower gastrointestinal hemorrhage. All 17 patients were followed clinically 4 days to 60 months (mean, 18.5 months) after embolization for the presence of ischemia or for recurrent bleeding. In addition, 12 of 17 patients were examined 1 day to 12 months (mean, 38.8 months) after embolization by means of colonoscopy or by pathologic review. RESULTS: Transcatheter embolization achieved immediate hemostasis in 15 of 17 patients (88%) and was the definitive treatment in 76%. The other two patients underwent successful surgical resections after incomplete hemostasis of cecal lesions. Two patients of the 15, with initially successful embolizations, had recurrent hemorrhage within 30 days; both underwent further embolization with one failure. No intestinal infarction or stricture developed in the 15 patients who underwent successful embolization. CONCLUSIONS: The authors' experience supports the role of transcatheter embolization as a primary means of therapy for patients with an acute lower gastrointestinal hemorrhage. Their data further supports growing evidence that superselective embolization may be most efficacious in reducing complication rates.

Acute Disease↗
PubMed1992

[Acute gastrointestinal hemorrhages].

It was thought formerly that gastrointestinal hemorrhage is an integral part of gastric ulcer. At present this is not a regularity, occurs only in some patients with ulcer disease and in other kinds of pathology (liver cirrhosis, dilated esophageal veins and oth.). Surgical treatment during hemorrhage is connected with risk for the patients. We recommend temporary tamponade of the bleeding blood vessels, improvement of the general condition of the patient and then transferring the patient to a surgical department for determination of further tactics.

Acute Disease↗
PubMed1995

Peptic ulcer and gastrointestinal hemorrhage associated with nonsteroidal anti-inflammatory drug use in patients younger than 65 years. A large health maintenance organization cohort study.

BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with an elevated risk of peptic ulcer and upper gastrointestinal hemorrhage, but published reports have lacked information on rates of outpatient disease, have concentrated on the elderly, and have not provided comparisons of rates for specific types of NSAIDs. METHODS: We compared incidence rates of peptic ulcer and upper gastrointestinal hemorrhage in 68 028 people younger than 65 years who used diclofenac sodium, naproxen, piroxicam, or sulindac, and who were members of a network of health maintenance organizations. We reviewed automated insurance claims data and medical records to ascertain cases and included conditions treated on an outpatient basis. RESULTS: Medical claims data were adequate for crude identification of potential cases, but review of medical records led to rejection of 63% of these, representing either no abnormality or diseases other than peptic ulcer or upper gastrointestinal hemorrhage. Of the total 112 cases, 64 (57%) were treated as outpatients. The crude incidence rate per 1000 person-years in users of any current, recent, or past NSAID was 2.2 and in distant-past users of NSAIDs was 0.75. For diclofenac, naproxen, piroxicam, and sulindac, we found a consistent pattern of decreasing NSAID effects from current to recent to past exposure. The risk of peptic ulcer or upper gastrointestinal hemorrhage was 1.6 cases per 1000 people using NSAIDs. CONCLUSIONS: Combining use of automated claims records with review of medical records promotes efficiency while maintaining specificity of case ascertainment. This study, with 57% of cases treated as outpatients, had results consistent with other published reports that were based on hospitalized patients. Within the limits of statistical error, the incidence rates of peptic ulcer and upper gastrointestinal hemorrhage appeared to be similar for the various NSAIDs studied.

Adult↗
PubMed2006

[Electrocardiographic changes related to acute upper gastrointestinal hemorrhage].

INTRODUCTION: Upper gastrointestinal bleeding is a common cause of medical attention, with a mortality in Mexico of 8.5%. Our main objective was to determine the association of this pathology with cardiac conduction disturbances and other clinical variables. MATERIAL AND METHODS: We reviewed the electrocardiograms and files of patients attended for acute upper gastrointestinal bleeding at the Internal Medicine Service of the National Medical Center "20 de Noviembre", they must have had a previous normal electrocardiogram; excluding those with severe hemorrhage, this means, presented with hypotension managed with intravenous fluids and/or vasoactive drugs. Statistical analysis was performed using the SPSS10 program. RESULTS AND CONCLUSIONS: 56 patients were included, 34 women and 22 men; 60.7% were older than 70 years. We report an association between acute upper gastrointestinal bleeding and electrocardiographic changes, principally right bundle branch block in 30.35% of cases.

Acute Disease↗
PubMed1991

[Blood coagulation in patients with ulcerous gastrointestinal hemorrhage].

In 108 patients with ulcerous gastrointestinal hemorrhage, the indices which characterize the coagulative and fibrinolytic systems of the blood were studied. At the moment of admission, in patients with severe blood loss, the moderate manifestations of the disseminated intravascular coagulation, which is the most characteristic in globular volume deficiency of more than 50%, were noted. After the operation, the revealed changes in the system of hemostasis increased. Beginning from the day 5, a tendency for normalization of the indices was noted, however by the moment of discharge of the patients they do not achieve the normal ones.

Adolescent↗
PubMed1988

Gastrointestinal hemorrhage from fistula between traumatic pseudoaneurysm of the right hepatic artery and the duodenum.

The evaluation of gastrointestinal hemorrhage after abdominal trauma may be both urgent and difficult. After gunshot trauma, a fistula between the duodenum and a post-traumatic, hepatic artery pseudoaneurysm presented as a gastrointestinal hemorrhage. Tc-99m labeled RBC imaging demonstrated the pseudoaneurysm but did not show it as the source of the gastrointestinal hemorrhage--a large clot had formed, occluding the fistula. Angiography further delineated the lesion as arising from the right hepatic artery and transcatheter embolization was performed.

Aneurysm↗
PubMed1999

Treatment of acute nonvariceal upper gastrointestinal hemorrhage.

Hospitalization for nonvariceal upper gastrointestinal hemorrhage (UGIH) is still common with an incidence of 100/100,000 adults/year. Mortality rates range between 8 and 14%. The most common etiologies of acute UGIH are gastric and duodenal ulcers which are associated with older age, Helicobacter pylori gastritis and nonsteroidal anti-inflammatory drugs. Approximately 70% of UGIH stop spontaneously, 10% bleed continuously and about 20% rebleed in the first 24-72 h. Mortality and the probability of rebleeding have been related to the ulcers' stigmata (Forrest) and to a variety of clinical findings (hematemesis, low initial hemoglobin, signs of shock, coagulopathy and liver disease). It is well established that only patients with continued bleeding or with a risk of rebleeding benefit from endoscopic or medical treatment. Endoscopic treatment (including heater probe, bipolar electrocoagulation, laser and injection therapy) control active bleeding in up to 90% and reduce significantly the rates of further bleeding, the need for blood transfusions, hospital costs and emergency surgery. Medical treatment is still controversial although positive results for somatostatin and octreotide have been found. A meta-analysis including 1,829 patients from 14 randomized trials showed the relative risk for continued bleeding or rebleeding of 0.53 (95% CI, 0.43-0.63) in favor of somatostatin and octreotide. Interventional endoscopy is the first line of treatment for UGIH. Somatostatin and its analogue octreotide may be a useful adjunct to endoscopic management or alternative when endoscopy is unsuccessful, contraindicated or unavailable.

Acute Disease↗
PubMed2000

Impact of blood transfusion on outcome in patients admitted for gastrointestinal hemorrhage.

PURPOSE:Patients admitted with the diagnosis of gastrointestinal bleeding at our institution typically undergo diagnostic/therapeutic endoscopy. Surgery is consulted and operative intervention considered when the patient has reached a 6-unit transfusion requirement for resuscitation. The purpose of this study is to examine the association between number of units transfused and clinical outcome in patients admitted for gastrointestinal hemorrhage.A retrospective review of records of patients admitted to the 81st Medical Group between January 1996 and January 2000 was conducted. Patients admitted with a diagnosis of upper or lower gastrointestinal hemorrhage were identified. Of this group, the records of those patients receiving at least 1 unit of packed red blood cells were examined.Thirty-five complete records were available for review. Patients ranged from 3 to 79 years of age. The male to female ratio was 4:1. The group received an average of 5.2 units of packed red blood cells. Eight patients were identified as having received more than 6 units of packed red cells. Three of 4 patients who underwent operative intervention had transfusion requirements in excess of 6 units. All 4 operative patients were classified as ASA class IIIE. Seven deaths (20%) occurred among the 35 patients, 3 of whom had received more than 6 units of blood.Patients admitted with gastrointestinal hemorrhage who require less than 6 units of blood may have a lower chance of dying (15%) than do patients requiring more than 6 units of blood (38%). Emergent surgical intervention, even in high-risk patients, can be safely performed.

Journal Article↗