scholarly journals Pyogenic Granuloma: An Unusual Cause of Massive Gastrointestinal Bleeding from the Small Bowel

2009 ◽  
Vol 23 (4) ◽  
pp. 261-264 ◽  
Author(s):  
Dana C Moffatt ◽  
Paul Warwryko ◽  
Harminder Singh
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Clinical Presentation ◽  
Relevant Literature ◽  
Pyogenic Granuloma ◽  
Vascular Tumour ◽  
First Case ◽  
Massive Gastrointestinal Bleeding ◽  
Gastrointestinal Lesion ◽  
Small Bowel Bleeding

Small bowel hemorrhage is responsible for approximately 4% of all cases of gastrointestinal bleeding. The etiology of bleeding from the small bowel is a tumour in approximately 10% of cases. Pyogenic granuloma is a common inflammatory vascular tumour of the dermis, which rarely occurs in the gastrointestinal tract. Pyogenic granuloma is a rare cause of overt or obscure small bowel bleeding. The present paper reports the first case of pyogenic granuloma presenting as a massive gastrointestinal bleed, and reviews the relevant literature to date regarding the clinical presentation, diagnosis and management of this rare gastrointestinal lesion.

scholarly journals Management of Multiple Arteriovenous Malformations of the Small Bowel

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Masahiro Hirakawa ◽  
Rie Ishizuka ◽  
Masanori Sato ◽  
Naotaka Hayasaka ◽  
Hiroyuki Ohnuma ◽  
...  
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Surgical Margin ◽  
Small Bowel Resection ◽  
Arterial Phase ◽  
Selective Angiography ◽  
Double Balloon Enteroscopy ◽  
Patient Reported ◽  
Vascular Ectasias ◽  
Small Bowel Bleeding

A 62-year-old Japanese female was referred to our hospital with gastrointestinal bleeding. Although small-bowel bleeding was suspected, no bleeding source was identified by enhanced computed tomography (CT), video capsule endoscopy (VCE), and double-balloon enteroscopy (DBE). Five years later, the patient had recurrent intermittent bloody stools with a significant decrease in hemoglobin levels. Although no active bleeding was observed on antegrade DBE, we detected a pulsatile submucosal uplift accompanied by a small red patch on the top of the uplift in the jejunum. Arteriovenous malformation (AVM) was suspected as the cause of small-bowel bleeding. Multiple-phase CT showed a number of small vascular ectasias during the arterial phase in the jejunum, and we confirmed the presence of multiple AVMs in the jejunum by selective angiography. To identify the location of the lesions and determine the minimal surgical margins, we performed intraoperative selective angiography with indocyanine green (ICG) injection. This technique allowed us to clearly observe the region and perform segmental small-bowel resection with minimal surgical margin. The patient reported that she has had no gastrointestinal bleeding at the two years follow-up visit.

scholarly journals Risk factors for small bowel bleeding in an overt gastrointestinal bleeding presentation after negative upper and lower endoscopy

PLoS ONE ◽  
2019 ◽  
Vol 14 (2) ◽  
pp. e0212509 ◽  
Author(s):  
Dejan Micic ◽  
John N. Gaetano ◽  
Neha Nigam ◽  
Matthew Peller ◽  
Vijaya L. Rao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Lower Endoscopy ◽  
Small Bowel Bleeding

Superselective transcatheter arterial embolization for acute small bowel bleeding: clinical outcomes and prognostic factors for ischemic complications

2020 ◽  
pp. 028418512093625
Author(s):  
Yong Seek Kim ◽  
Joon Ho Kwon ◽  
Kichang Han ◽  
Man-Deuk Kim ◽  
Junhyung Lee ◽  
...  
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Arterial Embolization ◽  
Recurrent Bleeding ◽  
Technical Success ◽  
Major Complications ◽  
Ischemic Complications ◽  
Small Bowel Bleeding

Background Small bowel bleeding (SBB) accounts for 5%–10% of all cases of acute gastrointestinal bleeding. Transcatheter arterial embolization (TAE) plays an important role in the treatment of SBB. Purpose To evaluate the safety and efficacy of superselective TAE exclusively for SBB and to assess factors associated with clinical outcomes. Material and Methods From January 2006 to April 2017, 919 patients were admitted with signs and symptoms of gastrointestinal bleeding; 74 patients (mean age = 57.5 years; age range = 14–82 years) with positive angiographic findings for SBB were retrospectively analyzed. The technical success of TAE and clinical outcomes, including recurrent bleeding, major complications, and in-hospital mortality were evaluated. The associations of various clinical and technical factors with clinical outcomes were analyzed. Results The bleeding foci were in the ileum in 48 (65%) patients and the jejunum in 26 (35%). Technical success was achieved in 72 (97%) patients. The rates of recurrent bleeding, major complications, and in-hospital mortality were 12% (7/57), 21% (15/71), and 25% (18/72), respectively. Superselective embolization was a significant prognostic factor associated with fewer major complications (OR = 0.069; P = 0.003). The increased number of embolized vasa recta was significantly associated with a higher probability of major complications (OR = 2.64; P < 0.001). The use of N-butyl cyanoacrylate was associated with lower rates of major complication (OR = 0.257; P = 0.027). Conclusion TAE is a safe and effective treatment modality for SBB. In addition, whenever possible, TAE should be performed in a superselective manner to minimize ischemic complications.

Diagnosis and treatment of obscure small bowel bleedings - analysis of double balloon enteroscopy role in diagnosing and treatment algorythm on basis of own material

2018 ◽  
Vol 90 (3) ◽  
pp. 25-30 ◽  
Author(s):  
Paweł Wojtkiewicz ◽  
Tomasz Nowak ◽  
Kamil Jankowski ◽  
Dariusz Łaski
Keyword(s):  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Medical Care ◽  
Therapeutic Procedure ◽  
Medical Care System ◽  
Double Balloon Enteroscopy ◽  
Balloon Enteroscopy ◽  
Double Balloon ◽  
Small Bowel Bleeding

Introduction Obscure gastrointestinal bleeding (OGIB) is defined as a reccurent bleeding to gastrointestinal tract without evaluated origin, despite detiled endoscopic and image diagnostics. Mots common reason of OGIB i small bowel bleeding (SBB). Methodology Retrospective analysis of patients hospitalised in Gastroenterology Department of 7 Szpital Marynarki Wojennej w Gdańsku with suspicion of OIGB. Results Double balloon enteroscopy was performed in 31 cases. Origin of bleeding was founded in small bowel in 87% of cases and in 64 % successfull,simultaneous therapeutic procedure was performed. No clinically relevant complications were noticed. Conclusion According to actual diagnostic algorythms of OGIB, double balloon enteroscopy is highly effective also in polish medical care system. This tehnique is a safe and effective tool in diagnostics and treatment of SBB, but its availability is still limited in Poland. Abstrakt

scholarly journals New Trends and Advances in Non-Variceal Gastrointestinal Bleeding—Series II

2021 ◽  
Vol 10 (14) ◽  
pp. 3045
Author(s):  
Pablo Cañamares-Orbís ◽  
Ángel Lanas Arbeloa
Keyword(s):  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Successful Outcome ◽  
Cardiovascular Patients ◽  
Number Of Patients ◽  
Colonic Bleeding ◽  
Small Bowel Bleeding ◽  
Antithrombotic Management ◽  
Entire Gastrointestinal Tract

The gastrointestinal tract is a long tubular structure wherein any point in the mucosa along its entire length could be the source of a hemorrhage. Upper (esophagel and gastroduodenal) and lower (jejunum, ileum, and colon) gastrointestinal bleeding are common. Gastroduodenal and colonic bleeding are more frequent than bleeding from the small bowel, but nowadays the entire gastrointestinal tract can be explored endoscopically and bleeding lesions can be locally treated successfully to stop or prevent further bleeding. The extensive use of antiplatelet and anticoagulants drugs in cardiovascular patients is, at least in part, the cause of the increasing number of patients suffering from gastrointestinal bleeding. Patients with these conditions are usually older and more fragile because of their comorbidities. The correct management of antithrombotic drugs in cases of gastrointestinal bleeding is essential for a successful outcome for patients. The influence of the microbiome in the pathogenesis of small bowel bleeding is an example of the new data that are emerging as potential therapeutic target for bleeding prevention. This text summarizes the latest research and advances in all forms of acute gastrointestinal bleeding (i.e., upper, small bowel and lower). Diagnosis is approached, and medical, endoscopic or antithrombotic management are discussed in the text in an accessible and comprehensible way.

scholarly journals Pyogenic granuloma of the scrotum after treatment of a condyloma with tricholoroacetic acid

2021 ◽  
Vol 12 (e) ◽  
pp. e34-e34
Author(s):  
Aida Oulehri ◽  
Zakia Douhi ◽  
Hanane Baybay, ◽  
Sara Elloudi
Keyword(s):  
Trichloroacetic Acid ◽  
Condylomata Acuminata ◽  
Pyogenic Granuloma ◽  
Genital Warts ◽  
Capillary Hemangioma ◽  
Vascular Tumour ◽  
Lobular Capillary Hemangioma ◽  
First Case ◽  
Mucous Membranes ◽  
Original Case

Pyogenic granuloma (PG) – also known as lobular capillary hemangioma – is a benign vascular tumour that occurs on the skin and mucous membranes. Genital warts—also known as condylomata acuminata—are raised lesions that develop on the skin and mucous membranes after infection with some types of human papillomavirus (HPV). Trichloroacetic acid is very often used, given the availability of the product and its low price. We report an original case of pyogenic granuloma, by its etiology and location. A 33-year-old patient developed a pyogenic granuloma on the scrotum following treatment of a condyloma with trichloroacetic acid. To the best of our knowledge, it’s the first case of PG secondary to the application of trichloroacetic acid for the treatment of a scrotal condyloma published in the literature.

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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