scholarly journals Most small bowel cancers are revealed by a complication

2015 ◽  
Vol 13 (4) ◽  
pp. 500-505 ◽  
Author(s):  
Ionut Negoi ◽  
Sorin Paun ◽  
Sorin Hostiuc ◽  
Bodgan Stoica ◽  
Ioan Tanase ◽  
...  
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Emergency Situation ◽  
Emergency Setting ◽  
Emergency Center ◽  
Local Complication ◽  
East European ◽  
Stromal Tumors ◽  
Advanced Stages ◽  
Primary Small Bowel

ABSTRACT Objective To characterize the pattern of primary small bowel cancers in a tertiary East-European hospital. Methods A retrospective study of patients with small bowel cancers admitted to a tertiary emergency center, over the past 15 years. Results There were 57 patients with small bowel cancer, representing 0.039% of admissions and 0.059% of laparotomies. There were 37 (64.9%) men, mean age of 58 years; and 72 years for females. Out of 57 patients, 48 (84.2%) were admitted due to an emergency situation: obstruction in 21 (38.9%), perforation in 17 (31.5%), upper gastrointestinal bleeding in 8 (14.8%), and lower gastrointestinal bleeding in 2 (3.7%). There were 10 (17.5%) duodenal tumors, 21 (36.8%) jejunal tumors and 26 (45.6%) ileal tumors. The most frequent neoplasms were gastrointestinal stromal tumor in 24 patients (42.1%), adenocarcinoma in 19 (33.3%), lymphoma in 8 (14%), and carcinoids in 2 (3.5%). The prevalence of duodenal adenocarcinoma was 14.55 times greater than that of the small bowel, and the prevalence of duodenal stromal tumors was 1.818 time greater than that of the small bowel. Obstruction was the complication in adenocarcinoma in 57.9% of cases, and perforation was the major local complication (47.8%) in stromal tumors. Conclusion Primary small bowel cancers are usually diagnosed at advanced stages, and revealed by a local complication of the tumor. Their surgical management in emergency setting is associated to significant morbidity and mortality rates.

Small bowel stromal tumors diagnosed by capsule endoscopy

2008 ◽  
Vol 149 (15) ◽  
pp. 697-701
Author(s):  
Márta Kovács ◽  
Péter Pák ◽  
Andrea Uhlyarik ◽  
Gábor Pák ◽  
Attila Török ◽  
...  
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Capsule Endoscopy ◽  
Clinical Symptoms ◽  
Intestinal Bleeding ◽  
Testing Time ◽  
Upper Endoscopy ◽  
Stromal Tumors ◽  
Definitive Therapy ◽  
Small Intestinal

Small intestinal stromal tumors acccount for approximately 35% of all gastrointestinal stromal tumors. Gastrointestinal bleeding is considered as one of the main clinical symptoms for SISTs. Capsule endoscopy has brought revolution in small bowel diagnostics, as it is considered the best method of visualisation of the entire small intestine. Besides, it is well tolerated by patients and is accompanied by a low number of complications. It is also indicated as the first diagnostic method in gastrointestinal bleeding of obscure origin, following negative upper endoscopy and colonoscopy. Case report: 2 patients (a male and a female, aged 58 and 69, respectively) presented with obscure gastrointestinal bleeding have been examined by capsule endoscopy after negative upper endoscopy and colonoscopy. Videorecords have been assessed in both cases by two independent experts. The capsule reached the Bauchin-valve in both cases during the 8 hours of the testing time and the entire small bowel was clearly visible. – Based on the capsule endoscopic images, for one of the two cases a tumor has been reported as the background of the small intestinal bleeding. In the other case we could mark the location of the bleeding, while we were unable to ascertain the type of the actively bleeding lesion during the test. In order to determine the accurate bleeding source double-balloon enteroscopy was performed in the second case. After surgery the histological and immunhistochemical tests have justified the presence of spindle cell GISTs. Taking into consideration the Fletcher-classification, for the tumor size and the mitotic index, both cases can be classified as a GIST of low malignant potencial. Conclusions: An early diagnosis and application of a definitive therapy become possible by using capsule endoscopy, therefore the chance of survival of the patients might be increased.

A Review on the Use of Reversal Agents of Direct Oral Anticogulant Drugs in Case of Gastrointestinal Bleeding

2020 ◽  
Vol 15 ◽  
Author(s):  
Veronica Ojetti ◽  
Angela Saviano ◽  
Mattia Brigida ◽  
Luisa Saviano ◽  
Alessio Migneco ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Major Bleeding ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Medical Emergency ◽  
Management Approach ◽  
Emergency Setting ◽  
Reversal Agents ◽  
Life Threatening ◽  
Andexanet Alfa

Background : Major bleeding is a life-threatening condition and a medical emergency with high mortality risk. It is often the complication of anticoagulant’s intake. Anticoagulants are commonly used for the prevention and the treatment of thrombotic events. The standard therapy with vitamin K antagonist (warfarin) has been frequently replaced by direct oral anticoagulants (DOACs). The latter agents (rivaroxaban, apixaban, edoxaban, dabigatran, betrixaban) showed a better efficacy and safety compared to standard warfarin treatment and they are recommended for the reduction of ischemic stroke. Literature data reported a high risk of gastrointestinal bleeding with DOACs, in particular with dabigatran and rivaroxaban. In case of life-threatening gastrointestinal bleeding, these patients could benefit from the use of reversal agents. Methods: We performed an electronic search on PUBMED of the literature concerning reversal agents for DOACs and gastrointestinal bleeding in the Emergency Department from 2004 to 2020. AIM: This review summarizes the current evidences about three reversal agents idarucizumab, andexanet alfa and ciraparantag, and the use of the first two in the emergency setting in patients with an active major bleeding or who need urgent surgery to offer physicians indications for a better management approach in order to increase patient’s safety. Conclusion: Although these agents have been marketed for five years (idarucizumab) and two years (andexanet alfa) respectively, and despite guidelines considering antidotes as first-line agents in treating life-threatening hemorrhage when available, these antidotes seem to gain access very slowly in the clinical practice. Cost, logistical aspects and need for plasma level determination of DOAC for an accurate therapeutic use probably have an impact on this phenomenon.. An expert multidisciplinary bleeding team should be established so as to implement international guidelines based on local resources and organization.

ID: 3520773 RHEMITT SCORE: PREDICTING THE RISK OF REBLEEDING FOR PATIENTS WITH MID-GASTROINTESTINAL BLEEDING SUBMITTED TO SMALL BOWEL CAPSULE ENDOSCOPY – A PROSPECTIVE VALIDATION

2021 ◽  
Vol 93 (6) ◽  
pp. AB350-AB351
Author(s):  
Rui S. Magalhães ◽  
Bernardo Sousa-Pinto ◽  
Tiago Cúrdia Gonçalves ◽  
Pedro Boal Carvalho ◽  
Bruno Rosa ◽  
...  
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Capsule Endoscopy

Primary Small Bowel Adenocarcinoma Presenting as a Malignant Ovarian Neoplasm

1985 ◽  
Vol 150 (2) ◽  
pp. 105-106 ◽  
Author(s):  
D. G. Gallup ◽  
R. J. Stock ◽  
J. J. Sammons ◽  
W. E. Paulk
Keyword(s):  
Small Bowel ◽  
Ovarian Neoplasm ◽  
Small Bowel Adenocarcinoma ◽  
Primary Small Bowel

scholarly journals Obscure Gastrointestinal Bleeding Caused by Small Bowel Lipoma

2008 ◽  
Vol 47 (18) ◽  
pp. 1601-1603 ◽  
Author(s):  
Jen-Wei Chou ◽  
Chun-Lung Feng ◽  
Hsueh-Chou Lai ◽  
Chin-Chi Tsai ◽  
Sheng-Hung Chen ◽  
...  
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Obscure Gastrointestinal Bleeding
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