scholarly journals Nonoperative management of gastrointestinal bleeding after a simultaneous pancreas and kidney transplant

2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Atta Nawabi ◽  
Sumaiya Serwar ◽  
Jeffrey Klein ◽  
Perwaiz Nawabi ◽  
Nadia Nawabi ◽  
...  
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Kidney Transplant ◽  
Nonoperative Management ◽  
Cost Effective ◽  
Minimal Invasive ◽  
Gi Bleeding ◽  
Push Enteroscopy ◽  
Enteric Drainage

Abstract With a shift toward enteric drainage techniques, the complications associated with simultaneous pancreas and kidney (SPK) transplant have also changed. Gastrointestinal (GI) bleeding is one of the most common complications associated with SPK. This case report describes the treatment of a postoperative GI hemorrhage using the push endoscopy technique. A 48-year-old male underwent an uneventful SPK transplant with entero-systemic drainage and developed hematochezia. The push enteroscopy technique was utilized to treat the bleeding ulcer. Historically, the use of the push enteroscopy technique to treat GI bleeding from the small bowel is not described in the literature. One of the limitations of duodenojejunostomy is that standard endoscopy cannot be readily used to visualize the duodenojejunostomy. However, the use of push enteroscopy may prove to be a minimal invasive and cost-effective intervention for GI bleeding after SPK.

scholarly journals Massive obscure GI bleeding from Idiopathic Jejunal varices identified using single balloon enteroscopy

2019 ◽  
Vol 16 (1) ◽  
pp. 62-71
Author(s):  
Natasha Harris ◽  
Alaa Rostom ◽  
Husein Moloo
Keyword(s):  
Small Bowel ◽  
Literature Review ◽  
Gastrointestinal Bleeding ◽  
Surgical Resection ◽  
Obscure Gastrointestinal Bleeding ◽  
Gi Bleeding ◽  
Jejunal Varices ◽  
Single Balloon ◽  
Single Balloon Enteroscopy ◽  
Small Bowel Varices

Background:  Obscure gastrointestinal bleeding from idiopathic small bowel varices is both a diagnostic and management challenge for physicians. There are very few cases reported in the literature and there is no consensus on management recommendations. Aims:  To present the case of a 34-year-old male patient with bleeding from idiopathic jejunal varices and to review similar cases in the literature.  Methods:  A case of idiopathic jejunal varices is reported. A literature review was conducted and a total of 24 articles describing idiopathic small bowel varices were identified. Results:  Case Report: A 34-year-old gentleman was referred for worsening obscure gastrointestinal bleeding and anemia. Anterograde single balloon enteroscopy revealed several petechial like lesions that were not classic for angiodysplasia. These lesions were initially treated with argon plasma coagulation and clipped, which did not resolve the patient’s persistent anemia. No venous abnormalities were identified on computed tomography of the abdomen and pelvis with contrast. The patient underwent an endoscopically assisted exploratory laparoscopy that was converted to a laparotomy upon finding of grossly abnormal distal jejunum. Dilated and tortuous varicosities were identified involving approximately 150 cm of small bowel. It was decided to resect the 40 cm segment of jejunum in which varices were visible endoscopically. There was no evidence of thrombosis in the resected specimen. The patient suffered a pulmonary embolism post-operatively, believed to be provoked by the surgery.  The patient has had no re-bleeding 12 months post-resection. Literature Review: Both familial and non-familial accounts of small bowel varices in the absence of a primary cause have been reported in the literature. When supportive therapy is insufficient, the most common treatment modality chosen is surgical resection. Select cases have also demonstrated that sclerotherapy and varix dissection can be used for to treat these lesions. Conclusions:  Idiopathic small bowel varices pose both diagnostic and therapeutic challenges for physicians. In the literature, several treatment modalities have been shown to be successful; these include surgical resection, varix dissection and sclerotherapy. There is no consensus on the preferred treatment strategy. This report demonstrates endoscopically assisted surgical resection as a viable management strategy for bleeding of idiopathic small bowel varices, an uncommon cause of occult GI bleeding.

scholarly journals Dieulafoy Lesion of Ileum: A Case Report

2020 ◽  
Vol 3 (1) ◽  
pp. 64-66
Author(s):  
Prakash Poudel ◽  
Ramesh Dhakwa
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Gastrointestinal Bleeding ◽  
Gastrointestinal Haemorrhage ◽  
Definitive Diagnosis ◽  
Gi Bleeding ◽  
Mucosal Defect ◽  
Life Threatening ◽  
High Index Of Suspicion ◽  
Dieulafoy Lesion

Dieulafoy lesion is a rare cause of massive GI bleeding. It’s an abnormal sub-mucosal artery protruding from a minute mucosal defect (≤3 mm). A 31 yearold male presented with complaints of hematochezia. Preliminary investigations failed to locate the exact source of bleed. Enteroscopy suggested distal ileal bleed. At laparotomy, an ulcerated nodular lesion, approximately 0.5 cm was identified in distal ileum. 30 cm of ileum along with mesentery was resected. Histology revealed it to be Dieulafoy lesion. Dieulafoy lesion is uncommon but one of the causes of obscure gastrointestinal bleeding that could result in treacherous and life-threatening gastrointestinal haemorrhage. This lesion is difficult to identify and high index of suspicion is required to make diagnosis. Hence, it should be considered in the differential diagnosis of active GI bleeding. The definitive diagnosis is based only on histopathology.

Laparoscopic Small Bowel Resection And Anastmosis For Small Proximal Jejunal Gastrointestinal Stromal Tumor Presented With Acute Massive Lower Gastrointestinal Bleeding: Case report and Literature review

2020 ◽  
Author(s):  
khaled S ahmad ◽  
Mohamed S Essa ◽  
Naif A Alenazi
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Bowel Resection ◽  
Small Bowel Resection ◽  
Gi Bleeding ◽  
Case Presentation ◽  
Pressure Necrosis ◽  
Lower Gi Bleeding ◽  
Small Intestinal ◽  
Work Up

Abstract Background Gastrointestinal stromal tumors (GISTs) is the most common primary nonepithelial neoplasms of the gastointestinal tract, mostly expressing the KIT protein determined by immunohistochemical staining for the CD117 antigen. Jejunal GISTs represent approximately 10% of all GISTs. Abdominal discomfort is the usual presentation. Jejunal GISTs may present with complications such as intestinal obstruction or hemorrhage. Gastrointestinal bleeding occurs due to pressure necrosis and ulceration of overlying mucosa, and patients who develop significant bleeding may suffer from fatigue and malaise. Small-bowel GISTs are classified based on size, and several guidelines have recommended conservative treatment for small jejunal GISTs (<2 cm).Case presentation In this report, we describe a 35-year-old male, with a jejunal GIST, who presented with an unusual massive lower GI bleeding. After resuscitation extensive work up, he was taken finally for a diagnostic laparoscopy and resection of the mass.Conclusion Small intestinal GISTs are rare and unusual to present with massive lower GI bleeding.

Small-bowel obstruction due to Bezoar following pancreas transplantation with portal-enteric drainage: a case report

2004 ◽  
Vol 36 (3) ◽  
pp. 575-576 ◽  
Author(s):  
U Boggi ◽  
F Vistoli ◽  
L Morelli ◽  
M Del Chiaro ◽  
T.Vanadia Bartolo ◽  
...  
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Pancreas Transplantation ◽  
Enteric Drainage

scholarly journals Small Bowel Pleomorphic Liposarcoma: A Rare Cause of Gastrointestinal Bleeding

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Simon Nennstiel ◽  
Martin Mollenhauer ◽  
Christoph Schlag ◽  
Valentin Becker ◽  
Bruno Neu ◽  
...  
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Male Patient ◽  
Capsule Endoscopy ◽  
Clinical Work ◽  
Final Diagnosis ◽  
Video Capsule Endoscopy ◽  
Pleomorphic Liposarcoma ◽  
Work Up

In this case report we present a 60-year-old male patient with overt midgastrointestinal bleeding of a primary ileal pleomorphic liposarcoma diagnosed by video capsule endoscopy (VCE). Clinical work-up for final diagnosis and the pathological background of this uncommon tumorous entity of the small bowel will be discussed in this paper.

Diagnosis of a small bowel adenocarcinoma by push enteroscopy: A case report

2000 ◽  
Vol 32 ◽  
pp. A140
Author(s):  
Giampiero Macarri ◽  
Simona Piergallini ◽  
Maxemiliano Giardini ◽  
Armando Gabrielli ◽  
Giovanni Pomponio ◽  
...  
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Small Bowel Adenocarcinoma ◽  
Push Enteroscopy

scholarly journals Massive Gastrointestinal Bleeding due to Jejunal Diverticula in a Community Hospital: A Case Report and Review of Diagnostic and Therapeutic Options

2021 ◽  
Vol 12 (2) ◽  
pp. 196-201
Author(s):  
Cynthia Abbasi ◽  
M. Carolina Jimenez ◽  
Michael Lisi
Keyword(s):  
Interventional Radiology ◽  
Differential Diagnosis ◽  
Case Report ◽  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Community Hospital ◽  
Lower Gastrointestinal Bleeding ◽  
Therapeutic Options ◽  
Upper Endoscopy ◽  
Massive Gastrointestinal Bleeding

Small bowel diverticula are rare and often asymptomatic. Severe lower gastrointestinal bleeding from jejunal diverticula is rarely reported and, therefore, should be considered a differential diagnosis in all cases of lower gastrointestinal bleeding with nonconclusive gastroscopy and colonoscopy. In this case report, we discuss a case of a 75-year-old male with massive lower gastrointestinal bleeding from jejunal diverticula. Initial gastroscopy did not reveal the source of bleeding. Repeat upper endoscopy with a pediatric colonoscope identified jejunal diverticula as the likely source of bleeding. Angiography identified the site of extravasation, and successful angioembolization was done by interventional radiology.

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