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[Gastrointestinal hemorrhage--angiodysplasia].

Clinico-pathological conference on the clinical picture of angiodysplasia--a rare source of bleeding in the upper gastrointestinal tract. In patients with relevant hemorrhagic symptomatology (tarry stools, anemia, possibly hemorrhagic shock), the diagnosis is established with the aid of angiography and endoscopy. Treatment consists in the resection of the section of bowel involved.

Aged↗

Effects of aspirin and acetaminophen in gastrointestinal hemorrhage. Results from the Boston Collaborative Drug Surveillance Program.

All patients observed in this analysis of the Boston Collaborative Drug Surveillance Program data had no known disease predisposing them to gastrointestinal (GI) bleeding. Major GI bleeding occurred in hospitalized patients recently exposed to ethacrynic acid (5/111; 4.5%), heparin sodium (7/575; 1.2%), corticosteroids (7/1,484; 0.5%), aspirin (6/2,081; 0.3%), and warfarin sodium (1/423; 0.2%); combinations of two or more of these drugs also resulted in substantial incidences of bleeding. The rates for minor GI bleeding in hospitalized patients varied from 8.3% for heparin to 1.6% for aspirin. In outpatients admitted because of serious GI bleeding, 14/88 (16%) had a history of heavy, regular aspirin use compared with 1,015/14,813 (6.9%) control subjects admitted for other reasons (relative risk, 2.1). No association between light regular use of aspirin and GI bleeding was noted. No association between the use of acetaminophen and GI bleeding was noted in any of the patients studied.

Acetaminophen↗

Nonfamilial juvenile polyposis coli manifesting as massive lower gastrointestinal hemorrhage: report of two cases.

Juvenile polyposis syndrome is an uncommon hamartomatous disorder with gastrointestinal (GI) manifestations of varying degree and malignant potential. We report the cases of an 8-year-old girl and a 5-year-old girl who suffered massive lower GI hemorrhage. Neither patient had a family history of polyposis. After the patients were stabilized, radiological evaluation, laparotomy, and intraoperative colonoscopy revealed multiple polyps in the colon. Both patients underwent total colectomy, mucosal proctectomy, and ileoanal anastomosis. The diagnosis of nonfamilial juvenile polyposis was based on the histological findings and the absence of a family history. To our knowledge, this presentation of juvenile polyposis has been reported only twice before. We discuss the clinical features and diagnosis of juvenile polyposis and the treatment options. Although juvenile polyposis is a rare condition in children, it should be considered in the differential diagnosis of life-threatening GI hemorrhage.

Child↗