Endoscopic Management of Gastrointestinal Bleeding From Multifocal Lymphangioendotheliomatosis With Thrombocytopenia

2012 ◽  
Vol 54 (6) ◽  
pp. 822-824 ◽  
Author(s):  
Richard J. Noel ◽  
Kelly J. Duffy ◽  
Michael E. Kelly ◽  
Nader Tondravi ◽  
Paula E. North ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Endoscopic Management

Acute gastrointestinal bleeding – a new approach to clinical and endoscopic management

2015 ◽  
Vol 27 (5) ◽  
pp. 483-491 ◽  
Author(s):  
Johannes W. Rey ◽  
Andreas Fischbach ◽  
Daniel Teubner ◽  
Marc Dieroff ◽  
Dominik Heuberger ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Endoscopic Management ◽  
New Approach ◽  
Acute Gastrointestinal Bleeding

scholarly journals Management of Diverticular Bleeding: Evaluation, Stabilization, Intervention, and Recurrence of Bleeding and Indications for Resection after Control of Bleeding

2018 ◽  
Vol 31 (04) ◽  
pp. 243-250 ◽  
Author(s):  
Mohammed Iyoob Mohammed Ilyas ◽  
Eric Szilagy
Keyword(s):  
Gastrointestinal Bleeding ◽  
Hemodynamic Instability ◽  
The United States ◽  
Lower Gastrointestinal Bleeding ◽  
Therapeutic Interventions ◽  
Endoscopic Management ◽  
Diverticular Bleeding ◽  
Bleeding Management ◽  
Management Algorithm ◽  
Partial Colectomy

AbstractDiverticular bleeding is the most common cause of lower gastrointestinal bleeding with nearly 200,000 admissions in the United States annually. Less than 5% of patients with diverticulosis present with diverticular bleeding and present usually as painless, intermittent, and large volume of lower gastrointestinal bleeding. Management algorithm for patients presenting with diverticular bleeding includes resuscitation followed by diagnostic evaluation. Colonoscopy is the recommended first-line investigation and helps in identifying the stigmata of recent hemorrhage and endoscopic management of the bleeding. Radionuclide scanning is the most sensitive but least accurate test due to low spatial resolution. Angiography is helpful when patients are actively bleeding and therapeutic interventions are performed with angioembolization. Surgery for diverticular bleeding is necessary when associated with hemodynamic instability and after failed endoscopic or angiographic interventions. When the bleeding site is localized preoperatively, partial colectomy is sufficient, but subtotal colectomy is necessary when localization is not possible preoperatively.

scholarly journals Recurrent Obscure Gastrointestinal Bleeding: Dilemmas and Success with Pharmacological Therapies. Case Series and Review

2009 ◽  
Vol 23 (9) ◽  
pp. 625-631 ◽  
Author(s):  
Majid Almadi ◽  
Peter M Ghali ◽  
Andre Constantin ◽  
Jacques Galipeau ◽  
Andrew Szilagyi
Keyword(s):  
Gastrointestinal Bleeding ◽  
Case Series ◽  
Obscure Gastrointestinal Bleeding ◽  
Endoscopic Management ◽  
Recurrent Bleeding ◽  
Pharmacological Management ◽  
Transfusion Requirements ◽  
Long Acting ◽  
Difficult Cases

The present article describes three difficult cases of recurrent bleeding from obscure causes, followed by a review of the pitfalls and pharmacological management of obscure gastrointestinal bleeding. All three patients underwent multiple investigations. An intervening complicating diagnosis or antiplatelet drugs may have compounded long-term bleeding in two of the cases. A bleeding angiodysplasia was confirmed in one case but was aggravated by the need for anticoagulation. After multiple transfusions and several attempts at endoscopic management in some cases, long-acting octreotide was associated with decreased transfusion requirements and increased hemoglobin levels in all three cases, although other factors may have contributed in some. In the third case, however, the addition of low-dose thalidomide stopped bleeding for a period of at least 23 months.

scholarly journals Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018

Gut ◽  
2018 ◽  
Vol 67 (10) ◽  
pp. 1757-1768 ◽  
Author(s):  
Joseph JY Sung ◽  
Philip WY Chiu ◽  
Francis K L Chan ◽  
James YW Lau ◽  
Khean-lee Goh ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Working Group ◽  
Upper Gastrointestinal Bleeding ◽  
Endoscopic Therapy ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Asia Pacific ◽  
Endoscopic Management ◽  
Three Stages ◽  
Upper Gastrointestinal

Non-variceal upper gastrointestinal bleeding remains an important emergency condition, leading to significant morbidity and mortality. As endoscopic therapy is the ’gold standard' of management, treatment of these patients can be considered in three stages: pre-endoscopic treatment, endoscopic haemostasis and post-endoscopic management. Since publication of the Asia-Pacific consensus on non-variceal upper gastrointestinal bleeding (NVUGIB) 7 years ago, there have been significant advancements in the clinical management of patients in all three stages. These include pre-endoscopy risk stratification scores, blood and platelet transfusion, use of proton pump inhibitors; during endoscopy new haemostasis techniques (haemostatic powder spray and over-the-scope clips); and post-endoscopy management by second-look endoscopy and medication strategies. Emerging techniques, including capsule endoscopy and Doppler endoscopic probe in assessing adequacy of endoscopic therapy, and the pre-emptive use of angiographic embolisation, are attracting new attention. An emerging problem is the increasing use of dual antiplatelet agents and direct oral anticoagulants in patients with cardiac and cerebrovascular diseases. Guidelines on the discontinuation and then resumption of these agents in patients presenting with NVUGIB are very much needed. The Asia-Pacific Working Group examined recent evidence and recommends practical management guidelines in this updated consensus statement.

scholarly journals Use of over-the-scope clips (OTSC) for hemostasis in gastrointestinal bleeding in patients under antithrombotic therapy

2017 ◽  
Vol 05 (05) ◽  
pp. E324-E330 ◽  
Author(s):  
Regina Lamberts ◽  
Anna Koch ◽  
Christian Binner ◽  
Marcus Zachäus ◽  
Ingrid Knigge ◽  
...  
Keyword(s):  
High Risk ◽  
Gastrointestinal Bleeding ◽  
Anticoagulant Therapy ◽  
Endoscopic Therapy ◽  
High Risk Patient ◽  
Antiplatelet Agents ◽  
High Rate ◽  
Endoscopic Management ◽  
Success Rates ◽  
Primary Hemostasis

Abstract Background and study aims In patients taking different regimens of antithrombotic and/or anticoagulant therapy, endoscopic management of gastrointestinal bleeding represents a major challenge due to failing endogenous hemostasis. In this retrospective study we report on success rates with the over-the-scope clip (OTSC) system in upper and lower gastrointestinal bleeding in this high-risk patient population. Patients and methods Between February 2011 and June 2014, 75 patients were treated with an OTSC for active gastrointestinal bleeding. Success rates with the first endoscopic therapy, rebleeding episodes, their management and the influence of antithrombotic or anticoagulant therapy were analyzed retrospectively. Results Application of the OTSC resulted in immediate hemostasis (primary success rate) in all 75 patients. However, in 34.7 % a rebleeding episode was noted that could be treated by further endoscopic interventions. Only 3 patients had to be sent to the operating room because of failure of endoscopic therapy. In the rebleeding group the use of antiplatelet therapies was higher (73.1 % vs. 48.9 %). Conclusions Application of the OTSC in GI bleeding results in a high rate of primary hemostasis. Rebleeding occurs in up to 35 % of patients receiving antithrombotic/anticoagulant therapy but can be managed successfully with further endoscopic treatments. Patients in the rebleeding group were more frequently treated with antiplatelet agents. Radiological or surgical therapy was reserved for a small subgroup not successfully managed by repeated endoscopic therapies. OTSC application is the treatment of choice in high-risk patients when conventional clips used as first-line treatment fail.

scholarly journals A study of upper gastrointestinal endoscopy in management of acute upper gastrointestinal bleed

2021 ◽  
Vol 8 (2) ◽  
pp. 631
Author(s):  
Atish N. Bansod ◽  
Amarsingh Shingade ◽  
Sarvagya Mishra
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Past History ◽  
Endoscopic Management ◽  
First Episode ◽  
Upper Gastrointestinal Endoscopy ◽  
Common Symptom ◽  
Pharmacological Management ◽  
Common Diagnosis ◽  
Upper Gastrointestinal

Background: Upper gastrointestinal bleeding (UGIB) is life threatening emergency that remains a common cause of hospitalization worldwide. In spite of tremendous advancement in management of upper gastrointestinal bleeding (UGIB) over past two decades, it carries considerable mortality, morbidity. The present study was undertaken to know the clinical profile, endoscopic profile, intervention, outcome and mortality of upper GI bleed.Methods: A total of 110 patients of UGIB were evaluated over a period of 30 months for etiology of UGIB like peptic ulcer, variceal bleeding, gastritis, Barrett’s esophagus and malignancy. Therapeutic Intervention (Band ligation, glue injection, clipping etc.) was done as required on case to case basis.Results: Hematemesis was the most common symptom with 62(56.36%) patients. 85(77.27%) patients were presented during first episode of their bleeding. Esophageal varices 50 (45.45%) was the most common diagnosis and the most common past history was alcohol intake 48 (43.63%). 55 (50%) patients required only medical (Pharmacological) management and 50 (44.54%) patients require endoscopic management. 102 (92.72%) were improved and subsequently discharged while 8 (7.27%) patients expired during the course of treatment.Conclusions: Endoscopic examination is an important modality in both diagnosis and managing UGIB and helps to reduce morbidity, mortality and also need for surgery of the disease significantly.

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