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.

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

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.

scholarly journals The Diagnostic Yields and Safety of Double-Balloon Enteroscopy in Obscure Gastrointestinal Bleeding and Incomplete Small Bowel Obstruction: Comparison between the Adults and Elderly

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Lei Wang ◽  
Mengfan Xie ◽  
Liwen Hong ◽  
Chen Zhang ◽  
Tianyu Zhang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
The Elderly ◽  
Obscure Gastrointestinal Bleeding ◽  
Double Balloon Enteroscopy ◽  
Balloon Enteroscopy ◽  
Double Balloon

Background. Double-balloon enteroscopy (DBE) is widely used worldwide. However, comparisons between the diagnostic yields in adults and the elderly remain scarce. Aim. The aim of this study is to compare the diagnostic yields and safety of DBE between adults and elderly with obscure gastrointestinal bleeding and incomplete small bowel obstruction. Method. We retrospectively reviewed patients who underwent DBE with indication of obscure gastrointestinal bleeding or incomplete small bowel obstruction in Ruijin Hospital and classified them into adults (18–64 years old) and elderly (≥65 years old). Clinical characteristics, diagnostic yields, and postoperative complications were collected and further analyzed. Results. A total of 877 DBE procedures, 729 in adults and 148 in the elderly, were performed. In the patients with OGIB, the adults showed a higher frequency of Meckel’s diverticulum compared with the elderly (4.6% vs. 0.9%, P=0.032). Angioectasia was higher in frequency in the elderly than in the adults (25.9% vs. 17.9%, P=0.048). In patients with incomplete small bowel obstruction, the elderly were more likely to have adenocarcinoma than the adults (19.4% vs. 7.1%, P=0.038). The adults had higher tendency to have Crohn’s disease than the elderly (23.4% vs. 8.3%, P=0.045). Most of the postoperative complications were mild. The adults and elderly displayed comparable tolerance to DBE (P>0.05) Conclusion. DBE has a high diagnostic yield in small bowel disorders, and a slight difference in disease spectrum was observed between the adults and elderly. DBE can be well-tolerated in the elderly.

Late Gastrointestinal Bleeding and Protein Loss after Distal Small-Bowel Resection in Infancy

1989 ◽  
Vol 9 (4) ◽  
pp. 454-460 ◽  
Author(s):  
R. T. L. Couper ◽  
P. R. Durie ◽  
S. E. Stafford ◽  
R. M. Filler ◽  
M. A. Marcon ◽  
...  
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Bowel Resection ◽  
Small Bowel Resection ◽  
Protein Loss ◽  
Distal Small Bowel

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.

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