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Results for “HEMORRHAGE, GASTROINTESTINAL”

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PubMed1999

[An unusual cause of gastrointestinal hemorrhage: pseudoaneurysm of the gastroduodenal artery in chronic pancreatitis].

Pseudoaneurysm of the peripancreatic arteries is a typical cause of gastrointestinal bleeding (GIB) in patients with chronic pancreatitis. 1-10% of chronic pancreatitis are associated with an a pseudoaneurysm, especially of the splenic or gastroduodenal artery. Endoscopy often is not successful in finding the cause of bleeding. Sonography, especially color Doppler ultrasound, is the best diagnostic tool, indicating the need for celiac angiography. We report on a 59-year-old woman with recurrent severe GIB since 1995. In 1998 another bleeding occurred and sonography showed a pseudoaneurysm of the gastroduodenal artery. Typical criteria are an echo-free, pulsatile lesion with an ring-like border. Color Doppler proves a turbulent perfusion inside and shows the feeding vessel. A transcatheter embolization with stainless steel coils was successful, six months later the pseudoaneurysm was mainly obliterated.

Aneurysm↗
PubMed1979

[Emergency endoscopy in acute upper gastrointestinal hemorrhage: Does the effectiveness justify the effort?].

On the basis of a common care of patients with acute upper gastrointestinal haemorrhage by internists, surgeons, and anaesthetists lasting several years advantages and disadvantages of emergency endoscopy are analysed from the standpoint of effectivity. High diagnostic ability, help in the decision concerning operative or conservative activity, the influence of the operative-tactic approach and the furthering influence on the close cooperation of the specialities are to be emphasized. Criteria of effectivity, such as mortality rates, duration of the stay in the hospital and frequency of relapsing haemorrhages underlie many factors of influence. They express results of therapy, to which emergency endoscopy may at present contribute only limitedly. The basic decision to medical activity -- active striving for a rapid, exact diagnosis or waiting when the diagnosis is uncertain -- does not inessentially influence the standpoint in the controversy about the emergency endoscopy.

Acute Disease↗