scholarly journals Clinical outcome of patients with obscure gastrointestinal bleeding during antithrombotic drug therapy

2018 ◽  
Vol 11 ◽  
pp. 1756283X1774693 ◽  
Author(s):  
Yoshiyasu Kono ◽  
Seiji Kawano ◽  
Yuki Okamoto ◽  
Yuka Obayashi ◽  
Yuki Baba ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Clinical Outcome ◽  
Gastrointestinal Bleeding ◽  
Therapeutic Intervention ◽  
Drug Users ◽  
University Hospital ◽  
Obscure Gastrointestinal Bleeding ◽  
Antithrombotic Drug ◽  
Significant Difference ◽  
Rebleeding Rate

Background: The clinical outcome of patients with obscure gastrointestinal bleeding (OGIB) during antithrombotic drug therapy has not been fully investigated. Methods: Patients who underwent video capsule endoscopy (VCE) for the investigation of OGIB at Okayama University Hospital from January 2009 to March 2016 were enrolled. We evaluated the VCE findings, the patterns of OGIB, and the rate of rebleeding within 1 year in antithrombotic drug users and antithrombotic drug nonusers. Results: A total of 181 patients were enrolled. Among the antithrombotic drug users, the rate of VCE positivity in the patients with overt OGIB was significantly higher in comparison with patients with occult OGIB (45% versus 16%, p = 0.014), whereas there was no significant difference among the antithrombotic drug nonusers (27% versus 26%, p = 1.0). Among the antithrombotic drug users, the rate of rebleeding among the VCE-positive patients was significantly higher in comparison with the VCE-negative patients (50% versus 5.9%, p = 0.011). Moreover, among antithrombotic drug users who did not receive therapeutic intervention, the rate of rebleeding among the VCE-positive patients was significantly higher in comparison with the VCE-negative patients (75% versus 6.3%, p = 0.001). However, among the antithrombotic drug nonusers who did not receive therapeutic intervention, the rebleeding rate of the VCE-positive patients was not significantly different from that of the VCE-negative patients (20% versus 9.4%, p = 0.43). Conclusion: Therapeutic intervention should be considered for patients with overt OGIB who are VCE positive and who use antithrombotic drugs due to the high risk of rebleeding.

scholarly journals Clinical Outcomes between P1 and P0 Lesions for Obscure Gastrointestinal Bleeding with Negative Computed Tomography and Capsule Endoscopy

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 657
Author(s):  
Young Kyu Cho ◽  
Heesu Park ◽  
Jung Rock Moon ◽  
Seong Ran Jeon ◽  
Hyun Gun Kim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Gastrointestinal Bleeding ◽  
Predictive Factors ◽  
Capsule Endoscopy ◽  
Obscure Gastrointestinal Bleeding ◽  
Negative Results ◽  
Significant Difference ◽  
Negative Findings ◽  
Rebleeding Rate ◽  
Comorbidity Index

Background: A simple classification for the relevance of lesions (P0, P1, and P2; no bleeding potential, less likely to bleed, and more likely to bleed, respectively) based on capsule endoscopy (CE) findings has been used. This study aimed at investigating rebleeding rates and predictive factors of P0 and P1 lesions after obtaining negative findings in both, CE and computed tomography (CT), for patients with obscure gastrointestinal bleeding (OGIB). Methods: Among 193 patients resulted in negative CE findings defined as P0 or P1 lesions, 84 patients with negative results on CT images were enrolled in this study. The rebleeding rates and predictive factors were assessed in the P0 and P1 groups. Results: Overall rebleeding rate in patients with negative CT and CE was 17.9%; 18.4% in the P0 group; 17.4% in the P1 group within a median follow-up duration of 18.5 months. In the P0 and P1 groups, the cumulative rebleeding rates were 9.2%, 25.4%, and 25.4%, and 6.9%, 11.8%, and 18.6% at 12, 24, and 60 months, respectively (p = 0.97). There were no independent rebleeding associated factors in the P0 group, whereas Charlson comorbidity index (CCI) (hazard ratio (HR) = 2.019, 95% confidence interval (CI): 1.158–3.519, p = 0.013), and initial low hemoglobin (Hb) level (<8 g/dL) (HR = 15.085, 95% CI: 1.182–192.514, p = 0.037) were independent predictive factors responsible for rebleeding in the P1 group. Conclusions: Despite having negative findings on CT and CE, patients with OGIB have a significant potential rebleeding risk. Although there was no significant difference in rebleeding rates between the P0 and P1 groups on CE, the P1 group, with CCI or low initial Hb level, should be cautiously observed after the first bleeding episode.

scholarly journals Diagnostic Value and Safety of Emergency Single-Balloon Enteroscopy for Obscure Gastrointestinal Bleeding

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Yipin Liu ◽  
Weiwei Jiang ◽  
Guoxun Chen ◽  
Yanqing Li
Keyword(s):  
Adverse Events ◽  
Gastrointestinal Bleeding ◽  
General Anesthesia ◽  
Conscious Sedation ◽  
Obscure Gastrointestinal Bleeding ◽  
Detection Rates ◽  
Balloon Enteroscopy ◽  
Significant Difference ◽  
Single Balloon ◽  
Single Balloon Enteroscopy

Background. This study assesses the diagnostic performance of emergency single-balloon enteroscopy (SBE) for obscure gastrointestinal bleeding (OGIB) under general anesthesia versus conscious sedation. Study. The data of 102 OGIB in-patients from June 2015 to June 2018 were retrospectively analyzed. The diagnosis and detection rates and adverse events were calculated overall and in relation to age, gender, type of operation and anesthesia, bleeding type, different times of examination, and SBE route. All statistical analyses were performed using SPSS 24.0, and the diagnosis and detection rates were compared using the Chi-square test. Results. Among the 102 patients, 66 patients had positive findings, while 11 patients had suspected positive findings, and the diagnosis and detection rates were 64.7% and 75.5%, respectively. Ulcers (19.6%) and tumors (16.7%) were the most common causes of OGIB. There were no statistical differences in diagnosis and detection rates between the ages of ≥60 and <60 and between different genders. Patients with emergency SBE had higher diagnosis and detection rates (68.6% vs. 35.3%, P=0.023; 80.0% vs. 47.1%, P=0.016, respectively), when compared with nonemergency SBE patients. The diagnosis rate at 24 hours was higher than that at 2-7 days and one week (88.0% vs. 61.5%, P=0.030; 88.0% vs. 53.8%, P=0.007). For overt bleeding, the difference in diagnosis rates at 24 hours, 2-7 days, and one week was statistically significant (100.0% vs. 57.1%, P=0.006; 100.0% vs. 57.1%, P=0.006). For occult bleeding, the pairwise comparison revealed no statistical difference. Patients with general anesthesia had a higher detection rate, when compared to patients with conscious sedation (87.9% vs. 63.9%, P=0.004). In addition, adverse events under general anesthesia were lower, when compared to adverse events under conscious sedation (28.8% vs. 69.4%, P=0.020). There was no significant difference in adverse events at the different time points (P>0.05). Conclusion. Emergency SBE under general anesthesia achieves higher diagnosis and detection rates, and fewer adverse events under conscious sedation, when compared to nonemergency SBE, regardless of the route. For patients with overt bleeding, it is easier to find lesions by emergency SBE within 24 hours.

scholarly journals Enteroscopic Diagnosis and Management of Small Bowel Diverticular Hemorrhage: A Multicenter Report from the Taiwan Association for the Study of Small Intestinal Diseases

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Yang-Yuan Chen ◽  
Cheng-Tang Chiu ◽  
Chen-Ming Hsu ◽  
Tsung-Hsing Chen ◽  
Yi-Chun Chiu ◽  
...  
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Endoscopic Therapy ◽  
Case Series ◽  
Obscure Gastrointestinal Bleeding ◽  
Intestinal Diseases ◽  
Diverticular Hemorrhage ◽  
Medical Centers ◽  
Rebleeding Rate ◽  
Small Intestinal

Small bowel diverticulum is a rare cause of gastrointestinal bleeding. The diagnosis and treatment of small bowel diverticular hemorrhage is clinically challenging before the development of deep enteroscopy. In this multicenter study from the Taiwan Association for the Study of Small Intestinal Diseases (TASSID), 608 patients underwent deep enteroscopy for obscure gastrointestinal bleeding during January 2004 and April 2010 from eight medical centers in Taiwan. Small bowel diverticular hemorrhage account for 7.89% of obscure gastrointestinal bleeding in this study. Most of the patients received endoscopic therapy with an initial hemostasis rate of 85.71% and rebleeding rate of 20%. In this large case series investigating the enteroscopic management of small intestinal diverticular hemorrhage, we found that, as to patients with peptic ulcer hemorrhage, most of these patients can be successfully managed by endoscopic therapy before surgery in the era of deep enteroscopy.

scholarly journals Clinical outcome after liver resection for colorectal versus non-colorectal metastasis: a comparative study

2018 ◽  
Vol 5 (2) ◽  
pp. 390
Author(s):  
Ashraf M. El-Badry ◽  
Omar Abdelraheem
Keyword(s):  
Liver Resection ◽  
Postoperative Complications ◽  
Clinical Outcome ◽  
Medical Records ◽  
Multivisceral Resection ◽  
University Hospital ◽  
Significant Difference ◽  
Complication Score ◽  
Primary Neoplasm

Background: Liver resection is the only curative treatment option for specific types of metastatic neoplasms. Comparative studies on the clinical outcome of liver resection for colorectal liver metastasis (CRLM) and non CRLM (N-CRLM) in Egypt remain inadequate.Methods: Medical records of patients who underwent liver metastasectomy (April 2013-May 2017) at Sohag University Hospital were reviewed. Patients were categorized according to the origin of the primary tumor into CRLM versus N-CRLM. Demographic, clinical, operative and histopathologic data, postoperative surgical complications and survival were analyzed.Results: Twenty-six patients (15 CRLM and 11 N-CRLM) were retrospectively enrolled. N-CRLM group comprised metastatic gall bladder (6), pancreas (2), breast (1) lung (1) and recurrent ovarian (1) cancers. There was no significant difference regarding age or gender predilection. The complication score in CRLM group was not significantly different compared with N-CRLM patients. However, subgroups of multivisceral resections showed significantly higher grades of postoperative complications compared with sole liver resection in both groups. Elderly patients (>70-year-old) exhibited high risk of morbidity compared with younger patients. Early post-operative mortality within the first month was 7.7% (2 patients died, one per each group). After a mean follow up of 32 months, the overall survival rate among patients with CRLM and N-CRLM was 75% and 64% respectively.Conclusions: Liver resection for CRLM and N-CRLM can be safely accomplished. Multivisceral resection and advanced age were associated with increased severity of postoperative complications irrespective of the location of primary neoplasm.

Sa1764 Rebleeding Rate and Predictors of Rebleeding in Obscure Gastrointestinal Bleeding With Negative Capsule Endoscopy

2012 ◽  
Vol 75 (4) ◽  
pp. AB269
Author(s):  
Ji-Beom Kim ◽  
Byong Duk Ye ◽  
Yelim Song ◽  
Dong-Hoon Yang ◽  
Kee Wook Jung ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Capsule Endoscopy ◽  
Obscure Gastrointestinal Bleeding ◽  
Rebleeding Rate
Sign in / Sign up

Export Citation Format

Share Document