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[Substantiation of indications for low-intensity laser irradiation in combined preoperative care of patients with ulcerative gastrointestinal hemorrhage].

Indications for the low-intensive laser application in preoperative procedure scheme were speculated on the ground of complex investigation data in 175 patients with gastrointestinal ulcerative hemorrhage (GIUH). Indications for intravascular laser blood irradiation (IVLBI), for the projectional action on thymus, spleen and their combined application are established. For the reliable hemostasis guarantee the conduction of laser therapy is the most effective one.

Adolescent↗

Gastrointestinal hemorrhage associated with gastric polyps in Menkes disease.

We describe two infants with Menkes disease who had serious gastrointestinal bleeding from solitary gastric polyps. Hemorrhage in one patient was acute and proved fatal. Histopathologic examinations showed submucosal vascular ectasia with mucosal hyperplasia, edema, and ulceration. Gastric polyps may represent an underappreciated clinical abnormality in Menkes disease.

Gastrointestinal Hemorrhage↗

[Endoscopic injection therapy in acute non-varicose upper gastrointestinal hemorrhage].

Emergency esophago-gastro-duodenoscopy was performed in 45 consecutive patients (26 men, 19 women, mean age 64 [23-91] years) with non-varicose upper gastrointestinal bleeding. The bleeding was arrested endoscopically by circumferential injection of an average of 6 (2-10) ml 1% polidocanol solution. In 10 patients an injection treatment was not possible because of extensive erosion or massive arterial bleeding. Bleeding recurred in seven patients 12-48 hours after initial injection. One patient in whom injection was not possible died during operation from massive intractable bleeding from an aortoduodenal fistula after abdominal aorta aneurysm surgery with implantation of a dacron prosthesis. There were no complications of the injection treatment.

Adult↗

Gastrointestinal hemorrhage due to Mallory-Weiss syndrome in an infant.

A Mallory-Weiss tear of the gastroesophageal mucosa is reported as an unusual cause of upper gastrointestinal bleeding in a 3-week-old infant. The lesion, documented by endoscopy, appeared to follow hiccups. The bleeding responded to conservative medical management and resolved without surgical intervention.

Endoscopy↗

[Comparison of treatment outcome for non-variceal upper gastrointestinal hemorrhage using endoscopic obliteration methods and traditional methods in patients over 60].

UNLABELLED: Authors present results of therapy of patients over 60 treated because of nonvariceal upper gastrointestinal bleeding in General Surgery Department in Oświecim. In 1991-1993 47 patients underwent non-endoscopic therapy. In 1994-1996 endoscopic obliteration with 0.01% epinephrine or 1% polidocanol in patients over 60 was applied. In the group over 60 more often concomitant diseases (cardiovascular, diabetes, atherosclerosis) were noted. Similar endoscopic obliteration efficacy (90% vs. 91%) in patients aged under and over 60 was observed. Patients treated with endoscopic obliteration underwent urgent operation twice rarely then conservative management (6.7% vs. 13%). They obtained less quantity of blood (2.23 vs. 3.4 unit). Their hospital stay was shorter (9 vs. 13 days). In both kind of therapy, mortality in patients over 60 was higher then under 60, but less often in group undergone endoscopic obliteration (traditional treatment 28% vs. 6%, endoscopic 15% vs. 2%). CONCLUSIONS: 1. Reason of worse therapy results of upper gastrointestinal bleeding among patients aged over 60 was great number of concomitant diseases. 2. Efficacy of endoscopic obliteration 0.01% epinephrine and 1% polidocanol was independent from age. 3. Application of endoscopic obliteration improved results of therapy in patients aged over 60.

Aged↗

Endoscopic electrocoagulation of upper gastrointestinal hemorrhage.

Endoscopic electrocoagulation was performed on 40 occasions for 38 patients with bleeding gastrointestinal lesions. Cessation of bleeding was achieved in 95%. Fifteen gastric ulcers, 14 duodenal ulcers, six Mallory-Weiss tears, one gastric varix, one hemorrhagic antral gastritis, and one esophageal ulcer were successfully electrocoagulated. Three duodenal and three gastric ulcers rebled. One duodenal ulcer and one gastric ulcer were successfully reelectrocoagulated. Failure to stop bleeding by electrocoagulation occurred in one Mallory-Weiss tear and one duodenal ulcer. There was no morbidity nor mortality attributed to endoscopic electrocoagulation. A retrospective cost analysis showed that the cost of hospitalization was less in patients treated by electrocoagulation. Patients so treated were hospitalized for a shorter duration.

Adolescent↗

[Seeping gastrointestinal hemorrhage from telangiectasia in CREST syndrome].

A 55-year-old man with CREST syndrome had marked telangiectasias of the palms, the face and the gastrointestinal tract. The latter caused slow bleeding and anemia. The telangiectasias were definitely associated with the CREST syndrome. Iron substitution was sufficient therapy. If a need for further therapy should arise, endoscopic sclerotherapy could be employed. Gastrointestinal bleeding in the CREST syndrome is rarely described, probably because it is unrecognized or interpreted as hemorrhagic gastritis. The possibility of gastrointestinal telangiectasias and concomitant bleeding should be kept in mind in cases of CREST syndrome.

CREST Syndrome↗