scholarly journals Clinical and endoscopic features of aorto-duodenal fistula resulting in its definitive diagnosis: an observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chikamasa Ichita ◽  
Akiko Sasaki ◽  
Chihiro Sumida ◽  
Karen Kimura ◽  
Takashi Nishino ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Ct Scan ◽  
Upper Gastrointestinal Bleeding ◽  
Definitive Diagnosis ◽  
Duodenal Fistula ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
Aortic Pathology ◽  
Upper Gi Endoscopy ◽  
Upper Gastrointestinal

Abstract Background Upper gastrointestinal (GI) bleeding is the most important presentation of an aorto-duodenal fistula (ADF). Early diagnosis is difficult, and the disease is associated with high mortality. The present study aimed to examine the clinical and the endoscopic characteristics of ADF in eight patients who presented to our hospital. We also sought to clarify the diagnostic approach towards the disease. Methods The present study examined the clinical and the endoscopic/computed tomography (CT) characteristics of ADF in eight patients who were definitively diagnosed with this condition in a 12-year period at our hospital. Results The patients comprised of five men and three women, with a mean age of 69.8 years. Upper gastrointestinal bleeding was the chief complaint for all the patients. Out of these, two patients presented with shock. The patients’ mean haemoglobin at presentation was 7.09 g/dL, and the mean number of blood transfusions was 7.5. All patients had undergone intervention to manage an aortic pathology in the past. As the first investigation, an upper GI endoscopy in 5 and a CT scan in 3 patients were performed. In cases where CT scan was performed first, no definitive diagnosis was obtained, and the diagnosis was confirmed by performing an upper GI endoscopy. In cases where endoscopy was performed first, definitive diagnosis was made in only one case, and the other cases were confirmed by the CT scan. In some cases, tip attachments, converting to long endoscopes, and marking clips were found useful. Conclusions In patients who have undergone intervention to manage an aortic pathology and have episodes of upper gastrointestinal bleeding, ADF cannot be definitively diagnosed with only one investigation. In addition, when performing upper GI endoscopy in cases where an ADF is suspected, tip attachment, converting to a long endoscope, and using marking clips can be helpful.

scholarly journals Air, Air Everywhere‑ A Rare Entity

2018 ◽  
Vol 09 (01) ◽  
pp. 022-025
Author(s):  
Gazal Singla ◽  
Shikha Sood ◽  
Sanjeev Sharma
Keyword(s):  
Gastric Perforation ◽  
Rare Complication ◽  
Interesting Case ◽  
Rare Entity ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
Recurrent Vomiting ◽  
Upper Gi Endoscopy ◽  
Gastric Mass ◽  
Upper Gastrointestinal

ABSTRACTUpper gastrointestinal (GI) endoscopy is a widely used diagnostic and therapeutic procedure. Gastric perforation causing pneumothorax, pneumomediastinum, pneumoperitoneum, pneumorrhachis, and subcutaneous emphysema after upper GI endoscopy is an extremely rare complication. We present an interesting case of a 58‑year‑old male who presented to the Emergency Department with recurrent vomiting, abdominal pain and diffuse swelling over abdomen, chest, neck bilateral arms, and thighs after undergoing an endoscopy for a gastric mass.

scholarly journals Systematic review with meta-analysis: age-related malignancy detection rates at upper gastrointestinal endoscopy

2020 ◽  
Vol 13 ◽  
pp. 175628482095922
Author(s):  
Judith J. de Jong ◽  
Marten A. Lantinga ◽  
Ina M. E. Thijs ◽  
Philip R. de Reuver ◽  
Joost P. H. Drenth
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Detection Rates ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
Age Related ◽  
Upper Gi Endoscopy ◽  
Age Limits ◽  
Upper Gi Malignancy ◽  
Upper Gastrointestinal

Background: Age is an important and objective risk factor for upper gastrointestinal (GI) malignancy. The accuracy of various age limits to detect upper GI malignancy is unclear. Determination of this accuracy may aid in the decision to refer symptomatic patients for upper GI endoscopy. The aim of this analysis was to synthesize data on upper GI malignancy detection rates for various age limits worldwide through meta-analysis. Methods: We searched MEDLINE, EMBASE, and Web of Science in November 2018. Selection criteria included studies addressing malignant findings at upper GI endoscopy in a symptomatic population reporting age at time of diagnosis. Meta-analyses were conducted to derive continent-specific cancer detection rates. Results: A total of 33 studies including 346,641 patients across 21 countries fulfilled the inclusion criteria. To detect >80% of malignant cases all symptomatic patients over 40 years of age should be investigated in Africa, over 50 years of age in South America and Asia, and over 55 years of age in North America and Europe. Conclusion: This systematic review and meta-analysis provides data on intercontinental variation in age at time of upper GI malignancy diagnosis in symptomatic patients referred for upper GI endoscopy. Guideline recommendations for age-based selection should be tailored to local age-related detection rates.

scholarly journals Cholecysto-duodenal fistula as the source of upper gastrointestinal bleeding

Endoscopy ◽  
2013 ◽  
Vol 45 (S 02) ◽  
pp. E250-E251 ◽  
Author(s):  
N. Mohammed ◽  
E. Godfrey ◽  
V. Subramanian
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Duodenal Fistula ◽  
Upper Gastrointestinal

scholarly journals Bleeding Ectopic Varices as the First Manifestation of Portal Hypertension

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Brij Sharma ◽  
Sujeet Raina ◽  
Rajesh Sharma
Keyword(s):  
Portal Hypertension ◽  
Upper Gastrointestinal Bleeding ◽  
Venous Obstruction ◽  
Gastroesophageal Varices ◽  
Upper Gi ◽  
Ectopic Varices ◽  
Extrahepatic Portal Venous Obstruction ◽  
Portosystemic Collateral ◽  
Upper Gi Endoscopy ◽  
Upper Gastrointestinal

Ectopic varices are defined as dilated portosystemic collateral veins in locations other than the gastroesophageal region. We present a case of recurrent upper gastrointestinal bleeding as the first manifestation of portal hypertension. We diagnosed ectopic duodenal varices without gastroesophageal varices on upper GI endoscopy and extrahepatic portal venous obstruction (EHPVO) on CT angiography and managed this case.

scholarly journals Clinical and endoscopic features of aorto-duodenal fistula resulting in definitive diagnosis: an observational study

2020 ◽  
Author(s):  
Chikamasa Ichita ◽  
Akiko Sasaki ◽  
Chihiro Sumida ◽  
Karen Kimura ◽  
Takashi Nishino ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Surgical Treatment ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Vital Signs ◽  
Diagnostic Methods ◽  
Upper Endoscopy ◽  
Duodenal Fistula ◽  
Endoscopic Characteristics ◽  
Upper Gastrointestinal

Abstract Background: An aorto-duodenal fistula presents with upper gastrointestinal bleeding and hematemesis. Early diagnosis is difficult, and the disease is associated with high mortality. Sometimes, a small amount of bleeding, known as herald bleed, occurs repeatedly and may be judged as upper gastrointestinal bleeding, prompting emergency upper endoscopy. Diagnostic methods and surgical treatment during herald bleeding are important for saving lives. However, most fistulas form in the horizontal duodenum, and active bleeding is rarely found in patients with herald bleeding. Moreover, an aorto-duodenal fistula is rarely diagnosed based on upper endoscopy alone. Methods: The present study examined the clinical and endoscopic characteristics of aorto-duodenal fistula in eight patients who underwent upper endoscopy before diagnosis at our hospital. It also sought to clarify how aorto-duodenal fistula can be appropriately diagnosed. Results: All patients had a history of aortic treatment, and many could not be diagnosed by computed tomography scan or upper endoscopy alone. Regarding the endoscopic findings, patients were seen to have stent/vascular prosthesis exposure, which is diagnostic of aorto-duodenal fistula as well as pulsatile lesions and massive fresh bleeding of obscure origin in the duodenum. Conclusions: If the diagnosis is unclear, clinicians may need to observe the horizontal duodenum using a fitted tip attachment or long scope. Since vital signs may fluctuate during endoscopy, a series of tests should be performed immediately. Proactive placement of marking clips in likely areas of the fistula may facilitate diagnosis via computed tomography. The present results demonstrate that proper diagnosis and prompt surgical treatment save lives in patients with aorto-duodenal fistula.

scholarly journals Evaluation of persistent upper abdominal pain by upper gastrointestinal endoscopy

2020 ◽  
Vol 7 (3) ◽  
pp. 791
Author(s):  
Keyur Suryakant Patel ◽  
Prabhat B. Nichkaode ◽  
Sunil V. Panchabhai ◽  
Manichandra Reddy ◽  
Balaji Prathep Santhan ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Common Finding ◽  
Rapid Urease Test ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
Duodenal Lesions ◽  
Urease Test ◽  
Upper Gi Endoscopy ◽  
Upper Abdominal ◽  
Upper Gastrointestinal

Background: The upper gastrointestinal tract is affected by a spectrum of conditions which span from infectious, idiopathic, inflammatory diseases, polyps, motility disorders and malignancy. Upper gastrointestinal scopy is believed to be the most effective screening modality as it not only allows direct visualization of oesophagus, gastric and duodenal mucosa but to perform biopsies in suspected malignancies. Aim: To evaluate persistent upper abdominal pain by upper gastrointestinal scopy.Methods: A total of 100 patients presented with complains of persistent upper abdominal pain were subjected to upper gastrointestinal scopy. Biopsies in indicated cases were taken from abnormal areas and sent for histopathology.Results: Most common finding in patients according to upper gastrointestinal scopy was gastritis (27%), followed by duodentitis (9%), and gastroduodenitis (7%). Rapid urease test in cases of gastritis and duodenitis to determine H. pylori infection were positive in 53.8% cases.Conclusions: Because of its precision and relatively safe technique upper GI endoscopy can be considered in patients above age of 50 years presenting to surgical OPD with complaints of persistent pain in upper abdomen. Investigating helicobacter pylori should be considered in all patients found to have gastric or duodenal lesions on upper GI endoscopy as its association with these lesions ranges from 50 to 80%.

scholarly journals Upper GI Endoscopy in Children: An Experience from Bangabandhu Sheikh Mujib Medical University (BSMMU)

2017 ◽  
Vol 40 (1) ◽  
pp. 17-20
Author(s):  
Md Wahiduzzaman Mazumder ◽  
Md Rukunuzzaman ◽  
Atiar Rahman ◽  
SM Baqui Billah ◽  
Kaniz Sultana ◽  
...  
Keyword(s):  
Esophageal Varices ◽  
Common Finding ◽  
Gi Bleeding ◽  
Gi Endoscopy ◽  
Upper Gi Bleeding ◽  
Endoscopic Findings ◽  
Upper Gi ◽  
Post Procedure ◽  
Upper Gi Endoscopy ◽  
Upper Gastrointestinal

Background: Upper gastrointestinal (UGI) endoscopy is a safe and sensitive investigation in the diagnosis of upper gastrointestinal diseases. There is limited study on paediatric upper GI endoscopy in our country. This study was done only in BSMMU, a tertiary care health facility of Bangladesh.Objectives: The aim of the study was to find out the indications, common endoscopic findings and immediate post procedure complication of UGI endoscopy in children.Methods: This is a retrospective analysis of 100 patients from August 2013 to October 2014. The indications for UGI endoscopy, common endoscopic findings and immediate post procedure complications were collected from case recording &were analyzed.Results: The commonest indication was upper GI bleeding in the form of hematemesis with or without melenae (41%). The most common finding was esophageal varices (49%). Less common findings were esophagitis, gastritis & gastro-duodenal ulcer. There was no post procedure complication.Conclusion: In the study, the commonest indication for Pediatric UGI endoscopy was upper GI bleeding and the commonest endoscopic abnormality was esophageal varices. No immediate post procedure complication was noted in the study.Bangladesh J Child Health 2016; VOL 40 (1) :17-20

Variceal Bleeding is Leading Cause of Upper GI Bleed: A Study from Northern Part of Pakistan

2021 ◽  
Vol 15 (7) ◽  
pp. 1837-1839
Author(s):  
Tanveer Ahmed ◽  
Mustafa Kamal ◽  
Ramish Riaz ◽  
Mashhood Ali
Keyword(s):  
Hepatitis C ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Age Group ◽  
Gastrointestinal Bleed ◽  
Upper Gi ◽  
Variceal Bleed ◽  
History Of ◽  
Gi Bleed ◽  
Upper Gastrointestinal

Background: Upper gastrointestinal bleeding (UGIB) is a leading cause of hospitalization in medical emergencies around the world, with a high death and morbidity rate. In all cases of upper gastrointestinal bleeding, endoscopy is the primary diagnostic tool. Key management of depends on diagnosing the exact cause of disease. Methodology: This descriptive study was carried out at Gastroenterology Department, PIMS, Islamabad from January 2019 to December 2019. All patients having history of upper gastrointestinal bleed were included in the study. Patients unfit for endoscopy i.e. with perforation, peritonitis, comatose needing intubation and those unwilling to undergo the procedure were excluded. Total 490 patients fulfilled the criterion. The cause of GI bleed was noted upon endoscopy. Data was noted on set performa and further statistical analysis was performed via SPSS v 26. Results: Among 490 patients, 298 (61%) were males while 192 (39%) were females. Most common age group presenting with upper GI bleed belongs to old age group i.e. had age above 60 years (n=235, 47.9%) followed by 40 to 59 years (n=174, 35.5%).Most common cause of upper GI bleed was found to be variceal bleed (n=292, 59.5%), followed by ulcer bleed (n=88, 18.0%) and stomach cancer (n=28, 6%). In 82 (17%) cases no reason for gastrointestinal bleed could be found out. Chi-square test showed Variceal bleed to be the most significant reason (χ2=65.2, P-Value<0.001) of Upper GI bleed. Conclusion: Variceal bleed is the most significant cause of upper GI bleed in our study population. This trend can be attributed to increased prevalence of hepatitis C in Pakistan. Special attention to the patient’s symptoms especially with history of HCV can help in early diagnosis and timely management. Keywords: Variceal Bleed, Upper GI Bleed, Endoscopy, Ulcer, Hepatitis C.

ENDOSCOPIC PROFILE OF UPPER GASTROINTESTINAL BLEEDING IN A TERTIARY CARE CENTRE.

2021 ◽  
pp. 45-46
Author(s):  
Pavan Kumar V ◽  
Kani Shaikh Mohamed
Keyword(s):  
Peptic Ulcer ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Tertiary Care ◽  
Gi Bleeding ◽  
Care Centre ◽  
Gastric Erosions ◽  
Tertiary Care Centre ◽  
Upper Gi ◽  
Upper Gastrointestinal

Background:Astudy describing the endoscopic prole of upper gastrointestinal bleeding in a tertiary care centre. Aim:The aim was to study endoscopic prole in patients presenting with upper GI bleeding. Introduction: Upper gastrointestinal bleeding is a common medical emergency associated with signicant morbidity and mortality. The presentation of bleeding depends on the amount and location of bleed. The primary diagnostic test for evaluation of upper gastrointestinal bleeding is endoscopy. The aim was to study endoscopic prole in patients presenting with upper GI bleeding. Methods: This is a cross sectional study data conducted in Department of Gastroenterology DDHD Anna nagar Chennai from January 2019 to January 2020 . In this patients presenting with manifestations of upper gastrointestinal bleed were included and were subjected to upper GI endoscopy. Results: Atotal of 160 patients presenting with hematemesis and melena were studied. 124(77.5%) were males and 36(22.5%) were females. The mean age was 47.15 ± 17.12 . The most common ndings on endoscopy of upper gastrointestinal bleeding was portal hypertension related (esophageal and gastric varices, portal hypertensive gastropathy ) seen in 40% of patients, gastric erosions in 17.5% patients, peptic ulcer disease was seen in 13.75%, Esophagitis in 6.25% cases, Mallory-Weiss tear was seen in 6.25% patients, gastric malignancy in 5% patients, post EVL ulcers in 3.75% patients, Normal study in 3.75%, Duodenal erosions in 2.5% patients, Vascular ectasia of stomach in 1.25%. Conclusion: The present study reported portal hypertension as the most common cause of upper gastrointestinal bleeding, while most common endoscopic lesions reported were esophageal varices, followed by gastric erosions and peptic ulcer.

scholarly journals Hemostasis Achieved Endoscopically for Diverticular Bleeding from the Horizontal Portion of the Duodenum

2015 ◽  
Vol 8 ◽  
pp. CGast.S32421
Author(s):  
Yasumasa Matuso ◽  
Hiroshi Yasuda ◽  
Midori Suzuki ◽  
Shinya Ishigooka ◽  
Shun-Ichiro Ozawa ◽  
...  
Keyword(s):  
Endoscopic Hemostasis ◽  
Gi Bleeding ◽  
Force Transmission ◽  
Diverticular Bleeding ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
Upper Gi Endoscopy ◽  
Horizontal Portion ◽  
Upper Gastrointestinal

Diverticulum of the horizontal portion of the duodenum is a rare cause of upper gastrointestinal (GI) bleeding. Since it is difficult to access the horizontal portion of the duodenum by standard upper GI endoscopy, only a very few cases of endoscopic hemostasis have been reported. Herein, we report a case of diverticular bleeding from the horizontal portion of the duodenum for which hemostasis was achieved using a small-caliber colonoscope, which has an insertion part designed with a passive-bending function/high-force transmission and a transparent tip hood.

Sign in / Sign up

Export Citation Format

Share Document