scholarly journals Dieulafoy's lesion: current trends in diagnosis and management

2010 ◽  
Vol 92 (7) ◽  
pp. 548-554 ◽  
Author(s):  
M Baxter ◽  
EH Aly
Keyword(s):  
Literature Search ◽  
Surgical Intervention ◽  
Therapeutic Endoscopy ◽  
Gi Bleeding ◽  
Dieulafoy’S Lesion ◽  
Valuable Alternative ◽  
Diagnosis And Management ◽  
Current Trends ◽  
Threatening Condition ◽  
Life Threatening

BACKGROUND Dieulafoy's lesion is a relatively rare, but potentially life-threatening, condition. It accounts for 1–2% of acute gastrointestinal (GI) bleeding, but arguably is under-recognised rather than rare. Its serious nature makes it necessary to include it in the differential diagnosis of obscure GI bleeding. The aim of this study was to review the current trends in the diagnosis and management of Dieulafoy's lesion. MATERIALS AND METHODS Using Medline, a literature search was performed for articles published in English, using the search words ‘Dieulafoy'(s)’ and ‘gastrointestinal bleeding’. All retrieved papers were analysed and the findings are summarised in this review. RESULTS There is no consensus on the treatment of Dieulafoy's lesions. Therapeutic endoscopy can control the bleeding in 90% of patients while angiography is being accepted as a valuable alternative to endoscopy for inaccessible lesions. Currently, surgical intervention is kept for failure of therapeutic endoscopic or angiographic interventions and it should be guided by pre-operative localisation. CONCLUSIONS Advances in endoscopy have increased the detection of Dieulafoy's lesions and decreased the mortality from 80% to 8.6%. There are recent encouraging reports on the successful use of laparoscopic surgery in managing symptomatic Dieulafoy's lesions.

scholarly journals Rectal Dieulafoy’s Lesion: An Underrecognized Cause of Lower Gastrointestinal Bleeding

2017 ◽  
Vol 08 (04) ◽  
pp. 202-204
Author(s):  
Vipul D. Yagnik
Keyword(s):  
Blood Loss ◽  
Gastrointestinal Bleeding ◽  
Alimentary Tract ◽  
Clinical Presentation ◽  
Lower Gastrointestinal Bleeding ◽  
Hospitalized Patients ◽  
Gi Bleeding ◽  
Dieulafoy’S Lesion ◽  
Threatening Condition ◽  
Life Threatening

ABSTRACTDieulafoy’s lesion is a rare but potentially a life-threatening condition. It accounts for 1%–2% of acute gastrointestinal (GI) bleeding. The lesion is most frequently located in the stomach and may be located anywhere in the alimentary tract. It can be present as severe GI bleeding or chronic GI blood loss. The cause of lesion remains uncertain. The range of clinical presentation varies from acute ill hospitalized patients as well as in the newborn.

(Un) conventional complicated pancreatitis

2021 ◽  
Vol 75 (1) ◽  
pp. 61-67
Author(s):  
Michal Rybár ◽  
Ivo Horný
Keyword(s):  
Acute Pancreatitis ◽  
Multidisciplinary Approach ◽  
Pancreatic Necrosis ◽  
Surgical Intervention ◽  
Secondary Infection ◽  
Abdominal Ultrasound ◽  
Stent Migration ◽  
Endoscopic Extraction ◽  
Threatening Condition ◽  
Life Threatening

Acute pancreatitis is sudden inflammatory disease of pancreas, which can vary from a mild form to severe life threatening condition. The management of pancreatitis usually consists of intensive care and multidisciplinary approach, often including surgical intervention or digestive endoscopy. In this article, we present a 68-year-old female with recidivous acute pancreatitis who underwent a series of endoscopic examinations and at the end also an unusual surgical intervention due to numerous complications. At first, it seemed that there was an idiopatic etiology because neither an anamnesis of alcohol consumption nor metabolic risks or CT signs of cholelithiasis were found. The condition was complicated by the development of acute necrotic collection, gastrointestinal bleeding and development of walled-off pancreatic necrosis (WOPN). Later, the biliary etiology was revealed after cholecystolithiasis was found on abdominal ultrasound. The WOPN was endoscopically drained because of the local compression syndrome. After the drainage, we noticed two cases of stent migration and the secondary infection of the WOPN. At the end, the migrated stents caused transient bowel obstruction and were stuck in the distal ileum. After three unsuccessful attempts to endoscopic extraction, the condition was solved by surgical intervention and double enterotomy was performed. The postoperative care was not easy anyway, being complicated by the dehiscence of the surgical wound with the need of opening the wound and use the VAC system to heal it up.

scholarly journals Spontaneous heterotopic pregnancy with tubal rupture

2017 ◽  
Vol 6 (11) ◽  
pp. 5148 ◽  
Author(s):  
Spandana J. C. ◽  
Suresh S. Kanakannavar ◽  
Umashankar K. M. ◽  
Manuja N.
Keyword(s):  
Maternal Morbidity ◽  
Surgical Intervention ◽  
Heterotopic Pregnancy ◽  
Successful Outcome ◽  
Intrauterine Pregnancy ◽  
Pregnant Females ◽  
Maternal Morbidity And Mortality ◽  
Threatening Condition ◽  
Life Threatening ◽  
Ultrasound Assessment

Heterotopic pregnancy is the coexistence of intrauterine pregnancy (IUP) and extrauterine gestation. It is a rare and dangerous life-threatening condition that is difficult to diagnose and easily missed. The incidence in the general population is estimated to be 1 in 30,000. We report a case of a 24-year-old multigravida who was seen in the emergency department with a diagnosis of a ruptured ectopic pregnancy. A careful ultrasound assessment led to the diagnosis of a heterotopic pregnancy despite lack of any notable risk factors. Immediate surgical intervention with supportive measures resulted in a successful outcome. An obstetrician should keep in mind the occurrence of a heterotopic pregnancy while dealing with pregnant females. It also demonstrates that early diagnosis is essential in order to salvage the intrauterine pregnancy and avoid maternal morbidity and mortality.

scholarly journals Under the Radar: A Case Report of a Missed Aortoenteric Fistula

2021 ◽  
Vol 5 (3) ◽  
pp. 312-315
Author(s):  
Blake Briggs ◽  
David Manthey
Keyword(s):  
Case Report ◽  
Surgical Intervention ◽  
Imaging Modality ◽  
Aortic Surgery ◽  
Aortoenteric Fistula ◽  
Prior History ◽  
Gi Bleeding ◽  
Life Threatening ◽  
History Of ◽  
Widespread Availability

Introduction: An aortoenteric fistula (AEF) is an abnormal connection between the aorta and the gastrointestinal tract that develops due to a pathologic cause. It is a rare, but life-threatening, cause of gastrointestinal (GI) bleeding. Although no single imaging modality exists that definitively diagnoses AEF, computed tomography angiography (CTA) of the abdomen and pelvis is the preferred initial test due to widespread availability and efficiency. Case Report: Many deaths occur before the diagnosis is made or prior to surgical intervention. We describe a case of a patient with a history of aortic graft repair who presented with active GI bleeding. Conclusion: Although CTA can make the diagnosis of AEF, it cannot adequately rule it out. In patients with significant GI bleeding and prior history of aortic surgery, vascular surgery should be consulted early on, even if CTA is equivocal.

scholarly journals RARE CASE OF FETAL MIDGUT VOLVULUS DETECTED BY WHIRPOOL SIGN ON ROUTINE ANTENATAL ULTRASOUND.

2021 ◽  
pp. 66-67
Author(s):  
Meghna Barmase
Keyword(s):  
Case Report ◽  
Poor Prognosis ◽  
Rare Case ◽  
Surgical Intervention ◽  
Midgut Volvulus ◽  
Antenatal Ultrasound ◽  
Caesarean Section Delivery ◽  
Threatening Condition ◽  
Life Threatening ◽  
Mesenteric Vessels

Fetal midgut volvulus is an extremely rare life threatening condition with poor prognosis. It often remains undiagnosed on antenatal ultrasound and manifest as intestinal obstruction in both antenatal and post natal period. Following is the case report of intrauterine midgut volvulus causing proximal obstruction of stomach and duodenum. The infant survived postnatally after caesarean section delivery with prompt and appropriate surgical intervention. Twisting of bowel loops around the mesenteric vessels suggestive of whirpool sign was the most signicant clue leading to the diagnosis of volvulus.

scholarly journals Hemobilia: Perspective and Role of the Advanced Endoscopist

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Rani Berry ◽  
James Han ◽  
Mohit Girotra ◽  
James H. Tabibian
Keyword(s):  
Surgical Intervention ◽  
Upper Gastrointestinal Bleeding ◽  
Therapeutic Endoscopy ◽  
First Line ◽  
Quadrant Pain ◽  
Life Threatening ◽  
Relative Rarity ◽  
Upper Gastrointestinal ◽  
Radiologic Intervention

Hemobilia refers to bleeding from and/or into the biliary tract and is an uncommon cause of gastrointestinal hemorrhage. Hemobilia has been documented since the 1600s, but due to its relative rarity, it has only been more critically examined in recent decades. Most cases of hemobilia are iatrogenic and caused by procedures involving the liver, pancreas, bile ducts, and/or the hepatopancreatobiliary vasculature, with trauma and malignancy representing the two other major causes. A classic triad of right upper quadrant pain, jaundice, and overt upper gastrointestinal bleeding has been described, but this is present in only 25–30% of patients with hemobilia. Historically, the gold standard for diagnosis and treatment has been angiography and interventional radiologic intervention, respectively. However, the paradigm is shifting, at least in select cases, towards first-line reliance on noninvasive imaging (e.g., computed tomography) and therapeutic endoscopy, owing to advances in and the less invasive nature of both, while saving interventional radiological and/or surgical intervention for refractory or imminently life-threatening cases.

scholarly journals Management ofVaricellaGangrenosa: A Life-Threatening Condition from Chickenpox

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Judith P. M. Schots ◽  
Peter Moons ◽  
Jan H. M. B. Stoot
Keyword(s):  
Conservative Treatment ◽  
Antiviral Therapy ◽  
Surgical Intervention ◽  
Skin Lesions ◽  
Threatening Condition ◽  
Life Threatening ◽  
Bacterial Superinfection ◽  
Early Surgical Intervention

Varicellagangrenosa, in which gangrenous ulceration of the skin and/or deeper tissues is seen, is a rare but alarming complication ofVaricellainfection. An early surgical intervention is generally advised, especially in case of sepsis and/or the presence of large necrotic lesions. We describe a case of a previously healthy 12-month-old boy presenting with sepsis due toVaricellagangrenosa. He presented with moderate lesions of moist gangrene. We treated our patient initially with antibiotics (ceftriaxone and metronidazole) and later on flucloxacillin and antiviral therapy (acyclovir) whereupon his condition rapidly improved and all skin lesions healed entirely. This report highlights the possibility of conservative treatment and emphasizes the significance of acyclovir in the management of chickenpox complicated by moist gangrene due to bacterial superinfection.

scholarly journals Emergency Management of Variceal

2003 ◽  
Vol 2 (2) ◽  
pp. 58-63
Author(s):  
Salim I Khakoo ◽  
◽  
William MC Rosenberg ◽  
Keyword(s):  
Airway Management ◽  
Emergency Management ◽  
Fluid Resuscitation ◽  
Therapeutic Endoscopy ◽  
Variceal Haemorrhage ◽  
Acute Setting ◽  
Balloon Tamponade ◽  
Threatening Condition ◽  
Life Threatening ◽  
Key Aspects

Variceal haemorrhage is a life-threatening condition requiring prompt emergency therapy. This paper summarises the key aspects of management of this condition in the acute setting, including airway management, fluid resuscitation, and pharmacotherapy. The value of therapeutic endoscopy, balloon tamponade and radiological shunt procedures are also highlighted.

scholarly journals Diffuse alveolar hemorrhage

2015 ◽  
Vol 3 (9) ◽  
pp. 19
Author(s):  
Deepa Panikkath ◽  
Swetha Gadwala ◽  
Brooke Mills ◽  
Ragesh Panikkath
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Diagnosis And Management ◽  
Threatening Condition ◽  
Life Threatening

Diffuse alveolar hemorrhage (DAH) is a rare life threatening condition characterized bybleeding into the alveolar spaces. Although it classically presents as hemoptysis, anemia,diffuse alveolar infiltrates, and acute respiratory failure, it is often a diagnostic and therapeuticchallenge for clinicians. It is associated with both immune and nonimmune causes.Prompt recognition and treatment of this entity are crucial. This article reviews the commonetiologies, diagnosis, and management of the patients with DAH.

scholarly journals Neonatal Pneumothoraces With Atypical Location: The Role of Lung Ultrasound

2021 ◽  
Author(s):  
Rebeca Gregorio-Hernández ◽  
Alba Pérez-Pérez ◽  
Almudena Alonso-Ojembarrena ◽  
María Arriaga-Redondo ◽  
Cristina Ramos-Navarro ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Lung Ultrasound ◽  
X Rays ◽  
Diagnosis And Management ◽  
Thoracic Diseases ◽  
Threatening Condition ◽  
Life Threatening ◽  
Higher Sensitivity

Abstract Neonatal pneumothorax (NP) is a potentially life-threatening condition. Lung ultrasound (LU) has shown higher sensitivity and specificity in diagnosis compared to x-rays, but evidence regarding its usefulness in complex NP is lacking. We report four neonates suffering from cardiac or esophagueal malformations who developed lateral and/or posterior pneumothoraces, in which LU helped, making NP diagnosis and management easier and faster. In conclusion, LU is an easy-to-use, fast, simple and accurate tool when evaluating newborns with complex thoracic diseases.

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