scholarly journals Chronic gastrointestinal bleeding caused by a Dieulafoy’s lesion in the small intestine: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Javad Salimi ◽  
Mohamad Behzadi ◽  
Alireza Ramandi ◽  
Mehdi Jafarinia ◽  
Hamid Zand ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Bowel Loop ◽  
Case Presentation ◽  
Chronic Anemia ◽  
Dieulafoy’S Lesion ◽  
History Of ◽  
Upper Gastrointestinal ◽  
Chronic Gastrointestinal Bleeding

Abstract Introduction Dieulafoy’s lesion, first found by Paul Georges Dieulafoy, is an infrequent but important cause of recurrent upper gastrointestinal bleeding. The bleeding is usually severe, but patients rarely present with chronic, occult gastrointestinal bleeding. Case presentation In this article, we discuss the case of a 68-year-old caucasian man with a history of recurrent hematemesis and chronic anemia with evidence of extravasation of contrast in the lumen of the bowel loop on computed tomography angiography. The patient was taken to the operating room, and a laparotomy procedure was performed. Conclusion Due to the infrequency of Dieulafoy’s lesion compared with other causes of gastrointestinal bleeding, it is often missed in the process of differential diagnosis. In this article, we have demonstrated the importance of this disease and different approaches to the treatment of this lesion, considering the location of the lesion among other factors.

scholarly journals Massive hemobilia caused by rupture of gastroduodenal artery pseudoaneurysm, a delayed complication of laparoscopic cholecystectomy: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Kurniawan Kurniawan ◽  
I Dewa Nyoman Wibawa ◽  
Gde Somayana ◽  
I Ketut Mariadi ◽  
I Made Mulyawan
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gastrointestinal Bleeding ◽  
Abdominal Trauma ◽  
Upper Gastrointestinal Bleeding ◽  
Rare Complication ◽  
Gastroduodenal Artery ◽  
Time Interval ◽  
Artery Pseudoaneurysm ◽  
History Of ◽  
Upper Gastrointestinal

Abstract Background Hemobilia is a rare cause of upper gastrointestinal bleeding that originates from the biliary tract. It is infrequently considered in diagnosis, especially in the absence of abdominal trauma or history of hepatopancreatobiliary procedure, such as cholecystectomy, which can cause arterial pseudoaneurysm. Prompt diagnosis is crucial because its management strategy is distinct from other types of upper gastrointestinal bleeding. Here, we present a case of massive hemobilia caused by the rupture of a gastroduodenal artery pseudoaneurysm in a patient with a history of laparoscopic cholecystectomy 3 years prior to presentation. Case presentation A 44-year-old Indonesian female presented to the emergency department with complaint of hematemesis and melena accompanied by abdominal pain and icterus. History of an abdominal trauma was denied. However, she reported having undergone a laparoscopic cholecystectomy 3 years prior to presentation. On physical examination, we found anemic conjunctiva and icteric sclera. Nonvariceal bleeding was suspected, but esophagogastroduodenoscopy showed a blood clot at the ampulla of Vater. Angiography showed contrast extravasation from a gastroduodenal artery pseudoaneurysm. The patient underwent pseudoaneurysm ligation and excision surgery to stop the bleeding. After surgery, the patient’s vital signs were stable, and there was no sign of rebleeding. Conclusion Gastroduodenal artery pseudoaneurysm is a rare complication of laparoscopic cholecystectomy. The prolonged time interval, as compared with other postcholecystectomy hemobilia cases, resulted in hemobilia not being considered as an etiology of the gastrointestinal bleeding at presentation. Hemobilia should be considered as a possible etiology of gastrointestinal bleeding in patients with history of cholecystectomy, regardless of the time interval between the invasive procedure and onset of bleeding.

Upper gastrointestinal bleeding and a unique computed tomography scan

Gut ◽  
2008 ◽  
Vol 57 (12) ◽  
pp. 1681-1681
Author(s):  
G S Abi Saad ◽  
K M Musallam ◽  
J Karam ◽  
A Al-Kutoubi ◽  
A N Tawil ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Computed Tomography Scan ◽  
Upper Gastrointestinal ◽  
Tomography Scan

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.

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.

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