scholarly journals Gastric Protection and Gastrointestinal Bleeding with Aspirin Thromboprophylaxis in Hip and Knee Joint Replacements

2008 ◽  
Vol 90 (4) ◽  
pp. 332-335 ◽  
Author(s):  
TR Madhusudhan ◽  
A Rangan ◽  
PJ Gregg
Keyword(s):  
Knee Arthroplasty ◽  
University Hospital ◽  
Peptic Ulcers ◽  
Gi Bleeding ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Hip And Knee Arthroplasty ◽  
Group 2 ◽  
Gi Bleed ◽  
Group 1

INTRODUCTION Upper gastrointestinal (GI) bleeding in patients who undergo hip and knee arthroplasty tends to be associated with non-steroidal anti-inflammatory drug use, steroid intake, pre-existing peptic ulcers and smoking. The use of aspirin for thromboprophylaxis is an added risk for the occurrence of GI bleed. The aim of this study was to determine the incidence of upper GI bleeding and whether the use of peri-operative oral ranitidine reduces the incidence of upper GI bleeding when aspirin thromboprophylaxis is used for hip and knee arthroplasty. PATIENTS AND METHODS Data from 1491 and 886 patients who underwent hip and knee replacements at the James Cook University Hospital (group 1) and at Friarage Hospital, Northallerton (group 2), respectively, were analysed in retrospect. All patients received 150 mg of aspirin per day for a period of 6 weeks from the day of surgery. Additionally, patients operated at the Friarage Hospital received 300 mg of oral ranitidine per day, for three postoperative days. RESULTS We observed that patients in group 1 had a higher incidence of overt upper GI haemorrhage, which was statistically significant (P <0.014) compared to patients in group 2. CONCLUSIONS Based on this experience, we recommend the use of peri-operative gastric protection with ranitidine when aspirin is used for thromboprophylaxis in hip and knee arthroplasty.

scholarly journals Facteurs Épidémiologiques et Pronostiques Associés Aux Étiologies Des Hémorragies Digestives Hautes au CHU Campus de Lomé

2021 ◽  
Vol 17 (34) ◽  
pp. 44
Author(s):  
Aklesso Bagny ◽  
Lidawu Roland-Moise Kogoe ◽  
Laconi Yeba Kaaga ◽  
Late Mawuli Lawson-Ananissoh ◽  
Debehoma Redah ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Cross Sectional Study ◽  
Mean Value ◽  
Peptic Ulcers ◽  
Gi Bleeding ◽  
Cross Sectional ◽  
Hémorragies Digestives ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
The Mean

Objectif : Décrire les aspects épidémiologique, clinique et pronostique associés aux étiologies des hémorragies digestives hautes au CHU Campus de Lomé Patients et méthode: Etude transversale à collecte rétrospective, à visée descriptive et analytique menée du 1er Janvier 2014 au 31 Décembre 2019. Le seuil de significativité était retenu pour p<0,05. Résultats: Deux cent cinquante et un patients avaient été inclus. L’hémorragie était d’origine hypertensive portale chez 69 patients (27,71%) ; ulcéreuse gastro-duodénale chez 100 patients (39,84%). Chez 25 patients (9,96%), la fibroscopie oesogastroduodénale était normale. Une rupture de varices oesophagiennes était retrouvée chez 98,55% des patients présentant une hypertension portale. Les ulcères gastroduodénaux représentaient 54,94% des hémorragies digestives hautes d’origine non hypertensive portale. La valeur moyenne du score de Rockall était de 4(±1) chez les patients présentant une hémorragie d’origine hypertensive et de 3(±1) chez les patients avec hémorragie non hypertensive portale (p<0,001). La valeur moyenne du score de Glasgow-Blatchford était de 10(±3) chez les patients présentant une hémorragie d’origine hypertensive et 9(±3) chez les patients avec hémorragie digestive haute d’origine non hypertensive (p<0,001). La récidive hémorragique et le décès étaient survenus chez les patients présentant un saignement d’origine hypertensive portale dans respectivement 54,84% (p<0,001) et 71,42% (p<0,001). Conclusion: Les lésions inflammatoires aiguës et chroniques représentent la première étiologie des hémorragies digestives hautes dans le service d’Hépato-gastroentérologie du CHU Campus. Ces hémorragies sont associées à la prise de médicaments gastrotoxiques et à un moindre risque de récidive hémorragique et de décès. Objective: To describe epidemiological et prognostic outcomes associated with etiologies upper gastrointestinal bleeding in Campus Teaching Hospital of Lome Patients and method: Cross-sectional study with retrospective collection, descriptive and analytical aim carried out from January 1, 2014 to December 31, 2019. Results: Two hundred and one patients were included. The hemorrhage was of portal hypertensive origin in 69 patients (27.71%); peptic ulcer in 100 patients (39.84%). In 25 patients (9.96%), the oesogastroduodenal fibroscopy was normal. Ruptured esophageal varices were found in 98.55% of patients with portal hypertension. Peptic ulcers accounted for 54.94% of upper GI bleeding of non-portal hypertensive origin. The mean value of the Rockall score was 4(±1) in patients with hemorrhage of hypertensive origin and 3(±1) in patients with non-portal hypertensive hemorrhage (p<0.001). The mean Glasgow-Blatchford score was 10(±3) in patients with hemorrhage of hypertensive origin and 9(±3) in patients with upper GI hemorrhage of nonhypertensive origin (p<0.001). Hemorrhagic recurrence and death occurred in patients with bleeding of hypertensive origin in 54.84% (p<0.001) and 71.42% (p<0.001) respectively. Conclusion: Acute and chronic inflammatory lesions represent the first etiology of upper GI bleeding in the Gastroenterology Department of the Campus Teaching Hospital of Lome. These hemorrhages are associated with the use of gastrotoxic drugs and with a lower risk of recurrence of hemorrhage and death.

scholarly journals Less frequent causes of upper gastrointestinal bleeding

2007 ◽  
Vol 54 (1) ◽  
pp. 119-123
Author(s):  
P. Sabljak ◽  
D. Velickovic ◽  
D. Stojakov ◽  
M. Bjelovic ◽  
K. Ebrahimi ◽  
...  
Keyword(s):  
Upper Gastrointestinal Bleeding ◽  
Endoscopic Therapy ◽  
Gastric Varices ◽  
Peptic Ulcers ◽  
Gi Bleeding ◽  
Watermelon Stomach ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Initial Control ◽  
Upper Gastrointestinal

Upper gastrointestinal (GI) bleeding represents emergency which despites modern advances in treatment still carry substantial mortality. Mortality remained relatively constant in the last 50 years at approximately 12%. Peptic ulcers remain the most common cause of upper GI bleeding and account approximately 50% of all cases. Next leading causes are esophageal and gastric varices, and gastroduodenal erosions. Mallory Weiss tears, angiodysplasia and gastric antral vascular ectasia (GAVE)-Watermelon stomach are less frequent but important causes of upper GI bleeding that contribute substantially to the overall morbidity and mortality. Recognition of such lesions is crucial to provide effective hemostasis. In most cases endoscopic therapy is procedure of choice which significantly improved the outcome of patients. In cases where endoscopic hemostasis is not effective, or patients rebleed after initial control surgical therapy may be required. This article will review recent advances in diagnosis and therapy of upper GI bleeding caused by Mallory Weiss tears, angiodysplasia or Watermelon stomach.

scholarly journals CIRRHOTIC PATIENTS;

2013 ◽  
Vol 20 (06) ◽  
pp. 876-881
Author(s):  
MUHAMMAD ADNAN BAWANY ◽  
JAHANGIR LIAQUAT ◽  
MUHMMAD AKBER ◽  
Falak Naz ◽  
Shereen Rahat Khanzada ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Esophageal Varices ◽  
University Hospital ◽  
Oesophageal Varices ◽  
Gi Bleeding ◽  
Upper Gi Bleeding ◽  
Hospital Design ◽  
Upper Gi ◽  
Predicting Factors ◽  
Cirrhotic Patients

Objective: To determine the frequency of upper GI bleeding and its predicting factors and esophageal varices in the patientswith liver cirrhosis disease admitted at medicine ward of Isra university hospital. Design: Prospective and observational study. Setting:Isra university hospital. Period: March 2012 to August 2012 (six months). Methods: Containing 100 patients, mean age was 45.8, and allthe patients with cirrhosis disease were included in this study with liver cirrhosis disease. All patients were under went endoscopy andFrequency of upper GI bleeding and varices presentation and classification according to grade were noted. Results: All the 100 patientswere selected on the basis of presenting liver cirrhosis disease. Male were more found than the female with the mean age 45.8. Mostlycirrhotic patients were found with HCV positive and upper GI bleeding were noted in (40%) of the cases. With the endoscopic findingmostly patients were noted in ll - lll grad of esophageal varices and according to child pug classification majority of patients was noted inclass “C” In addition, thrombocytopenia and red wale markings along with the presence of large sized varices were associated with thepresence of esophageal varices. Conclusions: In the conclusion of this study we found majority of the cirrhotic patients with HCV,Esophageal varices and thrombocytopenia are the important factors of upper GI bleeding. Knowledge and etiology of this manuscript mayhelpful in the prevention of oesophageal varices and upper GI bleeding.

Nonvariceal upper GI bleeding: it's not just about peptic ulcers

2012 ◽  
Vol 75 (2) ◽  
pp. 273-275 ◽  
Author(s):  
Vipul Jairath ◽  
Alan N. Barkun
Keyword(s):  
Peptic Ulcers ◽  
Gi Bleeding ◽  
Upper Gi Bleeding ◽  
Upper Gi

scholarly journals Clinical profile of patients presenting with gastrointestinal bleeding in a tertiary care hospital

2017 ◽  
Vol 4 (6) ◽  
pp. 1616
Author(s):  
Chandan Kumar ◽  
Sumit Kumar Chakrabarti ◽  
Sucharita Chakraborty ◽  
Keshab Sinharay
Keyword(s):  
Peptic Ulcer ◽  
Gastrointestinal Bleeding ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Oesophageal Varices ◽  
Care Hospital ◽  
Gi Bleeding ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Gi Bleed

Background: It has been seen that Upper gastrointestinal bleeding (UGIB) is one of the most mutual gastrointestinal emergencies for physicians and surgeons. In the recent past studies, there is raised incidence of peptic ulcer with raised frequency of bleeding from it. The range of upper GI bleeding fluctuates from region to region and relies on the status of the centre in hospital hierarchy.Methods: An observational, cross-sectional, hospital-based, single centre study was carried out on 150 patients admitted in tertiary care hospital with the presentation of GI bleeding. A detailed patient history was taken followed by required clinical and laboratory investigations. Then patients were resuscitated and subjected to endoscopic procedure.Results: 150 patients were treated among which 105 were male (70%) and 45 females (30%). 111 patients (74%) had upper GI bleed, 28 patients (19%) had lower GI bleed, and 11 patients (7%) had obscure bleed. 41% of the population were diagnosed to have peptic ulcer (gastric or duodenal) as the cause behind GI bleed forming the main aetiology in this study population, 26% had oesophageal varices constituting second important cause of GI bleed, and 7% had obscure bleed. Those who had undergone UGI endoscopy or sigmoidoscopy or colonoscopy within last one month and who were having GI bleed following GI surgery were excluded from the study.Conclusions: It was seen that upper GI bleeding is more common than lower GI bleeding. Peptic ulcer was the chief cause resulting in gastrointestinal bleed followed by oesophageal varices. Gastrointestinal bleeding was more common in male population affecting mainly subjects over 40 years of age.

scholarly journals Causes of Upper GI Bleed: Variceal or non-variceal.

2020 ◽  
Vol 27 (04) ◽  
pp. 820-824
Author(s):  
Talha Munir ◽  
Muhammad Naeem Safdar ◽  
Salman Azhar ◽  
Rizwan Rasool Khan ◽  
Samara Siddique ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Tertiary Care ◽  
Care Hospital ◽  
Gi Bleeding ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Variceal Bleed ◽  
Gi Bleed

Objectives: To determine the frequency of esophageal variceal bleed in patients with upper GI bleed presenting in a tertiary care hospital. Study Design: Cross sectional survey. Setting: Department of Medicine, Mayo Hospital, Lahore and Madinah Teaching Hospital, Faisalabad. Period: 6 months from 01-06-2018 to 31-12-2018. Material & Methods: Two hundred patients with upper GI bleed were included in the study. All the patients had upper GI endoscopy to determine the esophageal variceal bleeding which was documented as frequency distribution table. Results: Esophageal variceal bleed was seen among 108 (54%) patients while it was not present among 92 (46%) patients. Conclusion: Esophageal variceal bleeding is frequently present among patients with upper GI bleeding and should be suspected in every patient with upper GI bleeding.

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