scholarly journals An anomalous engenderment of a common scenario: upper gastrointestinal bleeding

2017 ◽  
Vol 6 (1) ◽  
pp. 362
Author(s):  
Tirth Nayan Vasa ◽  
Mukhayprana Prabhu ◽  
Rajagopal K. V. ◽  
Devavrata Sahu ◽  
Harnish Bhatia
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Rapid Assessment ◽  
Visceral Artery ◽  
Oesophageal Varices ◽  
Early Management ◽  
Ulcer Disease ◽  
Risk Of Rupture ◽  
Visceral Artery Aneurysms ◽  
Upper Gastrointestinal

Upper gastrointestinal bleeding (UGIB) includes hemorrhage originating from the esophagus to the ligament of Treitz. It is a gastrointestinal emergency that can result in significant morbidity, mortality, along with laborious utilization of health-care resources. With the advent of definite management protocols, the recent trends have revealed that patients rarely die from exsanguination, with decompensation of the underlying disorders, rather, proving to be causative of the same. Rapid assessment, resuscitation, and early endoscopic investigation serve as the foundation of early management. Common sinister underlying aetiology include Oesophageal Varices, Peptic Ulcer Disease, NSAID Induced Acute Gastritis or Malignancy. Arising from a conglomeration of aetiologies, an infrequent one, is a silently sinister pseudoaneurym rupturing into the stomach, stemming from a visceral artery. Since the first description by Beaussier in 1770, the condition has been detected with increasing frequency, primarily as a consequence of the increasing use of accurate imaging methods. Coeliac artery aneurysms (CAAs) occur in approximately 0.2% of the overall population and constitute approximately 4% of all visceral artery aneurysms (VAAs). Their risk of rupture is estimated at 10% to 15% and is associated with high mortality. Associated risk factors include atherosclerosis, hypertension, systemic inflammation, trauma, collagen vascular disease, infection, fibromuscular dysplasia, and cirrhosis

scholarly journals Upper gastro-intestinal bleeding: Aetiology and demographic profile based on endoscopic examination at Dhulikhel Hospital, Kathmandu University Hospital

1970 ◽  
Vol 8 (2) ◽  
pp. 208-211 ◽  
Author(s):  
RB Gurung ◽  
G Joshi ◽  
N Gautam ◽  
P Pant ◽  
B Pokhrel ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Endoscopic Examination ◽  
Oesophageal Varices ◽  
Gi Bleeding ◽  
Ulcer Disease ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Upper Gastrointestinal

Background: The upper gastrointestinal bleeding (UGIB) is defined as bleeding within the intraluminal gastrointestinal tract from any location between the upper oesophagus to the duodenum at the ligament of Treitz. It is one of the important medical emergencies worldwide. Objective: The objective of this study is to study the aetiology of upper gastrointestinal bleeding based on endoscopic examination findings in patients of various demographic characteristics. Materials and methods: This is a retrospective observational study. The endoscopic record book from 2007 January to 2009 October was reviewed for all the cases who underwent oesophago-gastro-duodenoscopic examination for upper GI bleeding. The clinico-epidemiological data of all the patients was reviewed and analyzed in concert with the aetiology of bleeding. Results: A total of 90 patients (58 males, 32 females; mean age 45.32+ 18.47 years) of upper gastrointestinal bleeding was studied and analyzed in terms of aetiology of bleeding and demographic profile. Among the ethnic groups, Aryan 46 (51%) was the most common ethnic group to have upper GI bleeding followed by Newars 24 (27%), Mongolians 16 (18%), Dalits 3 (3%) and others 1 (1%). Out of 90 patients, 47( 52.2%) cases was less than 45 years of age, 30(33.3%) of 46 to 65 age ; and 13(14.4 %) more than 65 years of age. Gastric ulcer 23(25.6%) was the most common endoscopic finding, followed by oesophageal varices 14 (15.6%), acute erosive/haemorrhagic gastropathy 11 (12.2%), duodenal ulcer 9(10%), growth 7(7.8%), vascular lesions 3(3.3%), Mallory-Weiss tear 1(1.1%), fundal varices 1(1.1%) and, no cause was identified in 21(23.3%) cases. The peptic ulcer bleeding was the most common finding in Aryan 22(47.9%), whereas oesophageal varices and growth were more common in Newar 7(29.2%) and 3 (12.5%) respectively. Conclusion: Peptic ulcer disease is the most common cause of upper GI bleeding which was most commonly found in Aryan population; followed by oesophageal varices and growth as second and third most common causes and were more prevalent in Newar and Mongolian people. Key words: Endoscopy; Peptic ulcer disease; Upper GI bleeding; Varices DOI: 10.3126/kumj.v8i2.3560 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 208-211

scholarly journals Diagnosis and management of extrahepatic oesophageal variceal bleed in children in a low resourced setting

2020 ◽  
Vol 54 (4) ◽  
pp. 274-278
Author(s):  
Taiba J. Afaa ◽  
Kokou H. Amegan-Aho ◽  
Elikem Richardson ◽  
Bamenla Goka
Keyword(s):  
Portal Hypertension ◽  
Gastrointestinal Bleeding ◽  
Portal Vein ◽  
Upper Gastrointestinal Bleeding ◽  
Liver Function Tests ◽  
Tertiary Hospital ◽  
Secondary Prophylaxis ◽  
Resource Constraint ◽  
Oesophageal Varices ◽  
Upper Gastrointestinal

Extrahepatic portal vein obstruction (EHPVO) is a major cause of portal hypertension (PH) in children. Portal vein thrombosis (PVT) is the most common cause accounting for up to 75% of cases in developing countries. Upper gastrointestinal bleeding is the most dreaded and commonest presentation of portal hypertension. Successful treatment of paediatric PH, though challenging is performed in resource constraint countries. Cases: Five children presented over three years to a tertiary hospital in Ghana, with massive upper gastrointestinal bleeding. They had anaemia, thrombocytopaenia and four had splenomegaly. Liver function tests, INR, haemoglobin electrophoresis as well as HIV serology, hepatitis B and C screening were all normal. Abdominal doppler ultrasound scan confirmed portal vein thromboses. They were resuscitated and managed with octreotide, propranolol, antibiotics and sclerotherapy or oesophageal variceal banding in the acute setting and long term secondary prophylaxis with propranolol. Subsequently, an algorithm was developed to assist with the management of bleeding from oesophageal varices and the diagnosis of EHPVO. Conclusion: Portal hypertension due to EHPVO is an important cause of upper gastrointestinal (GI) bleeding in children. This can be successfully managed even in a resource constraint setting once the appropriate measures are taken.

Not so Goody’s powder

2021 ◽  
Vol 14 (7) ◽  
pp. e242055
Author(s):  
Raja Samir Khan ◽  
Sardar Momin Shah-Khan ◽  
Justin Kupec
Keyword(s):  
Peptic Ulcer ◽  
Adverse Effects ◽  
Gastrointestinal Bleeding ◽  
Peptic Ulcer Disease ◽  
Upper Gastrointestinal Bleeding ◽  
Gastrocolic Fistula ◽  
Over The Counter ◽  
Ulcer Disease ◽  
Upper Gastrointestinal ◽  
Acute Anaemia

Over-the-counter analgesic medications are widely used amongst American adults and are also available in powder forms. Their adverse effects have been well documented in literature. Gastrocolic fistulas as a complication of peptic ulcer disease from analgesic powder usage have been previously unreported. Here, we report a patient with upper gastrointestinal bleeding and acute anaemia secondary to peptic ulcer complicated by gastrocolic fistula in a patient using analgesic powder.

scholarly journals Histoacryl glue injection without lipiodol dilution and post sclerotherapy bleeding; prevalence among patients with upper GIT bleed.

2020 ◽  
Vol 27 (06) ◽  
pp. 1182-1186
Author(s):  
Muhammad Ayub ◽  
Sagheer Hussain ◽  
Salman Ahmed
Keyword(s):  
Liver Cirrhosis ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Gastric Varices ◽  
Recurrent Bleeding ◽  
Endoscopic Sclerotherapy ◽  
Ulcer Disease ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Glue Injection ◽  
Upper Gastrointestinal

Objectives: To determine role of histoacryl injection in preventing upper acute upper gastrointestinal bleeding. Study Design: Prospective Study. Setting: Gastroenterology ward of DHQ Teaching Hospital Gujranwala. Period: One year from 1st September 2017 to 31st August 2018. Material & Methods: Patients presented to the study hospital having upper gastrointestinal bleeding of acute onset due to gastric varices bleeding were included in this study. All other cases having upper GIT bleeding due to other causes like peptic ulcer disease, Mallory weise syndrome, gastritis or esophageal varices were not included in this study. Both male and female patients were included irrespective of their age. Hemostasis in these cases was achieved by endoscopic sclerotherapy using histoacryl glue (N-butyl-2-cyanoacrylate) injection without lipoidal dilution. After first session of injection patients were called on follow up after 5 days and they were assessed for recurrent GIT bleeding and treatment failure. All data was documented on a predesigned performa. Frequencies and percentage were calculated and results were expressed in tabular form and graphs. Results: Total 80 cases were studied including 56% male and 44% female cases. Endoscopic sclerotherapy using histoacryl injection proved successful in 87.5% cases and recurrent bleeding occurred in 12.5% cases. Minimum age of patients was 25 years and maximum age 70 years with mean age of 45 years. Total 450 cases presented in study institution with Upper GIT bleeding during study period and causes among them were liver cirrhosis in 92% cases, peptic ulcer disease in 4% cases, Malloryweise Syndrome in 2.5% and gastritis in 1.5% cases. In our study group cause of gastric varices was liver cirrhosis due to viral hepatitis in 73% cases and alcoholic hepatitis in 27% cases. After single session of endoscopic histoacryl glue injection to 80 cases, no bleeding occurred after 5 days in 71(88.7%) cases, recurrent bleeding occurred within 5 days in 9(11.2%) cases.  Two cases died due to massive recurrent bleeding and mortality rate was 2.5%. Conclusion: Endoscopic sclerotherapy using Histoacryl injection is very successful treatment for acute upper gastrointestinal bleeding with very low recurrence rate of bleeding and low mortality rate.

Emergency Endoscopy in Patients with Portal Hypertension Having Upper Gastrointestinal Bleeding

1997 ◽  
Vol 27 (1) ◽  
pp. 31-34
Author(s):  
S P Misra ◽  
M Dwivedi
Keyword(s):  
Portal Hypertension ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Gastric Varices ◽  
Oesophageal Varices ◽  
Endoscopic Sclerotherapy ◽  
Emergency Endoscopy ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal ◽  
Definite Role

During the last 4 years, 147 patients suffering from portal hypertension with acute upper gastrointestinal bleeding were subjected to emergency endoscopy soon after they were resuscitated. Seventeen (11.5%) patients were referred to us with a clinical diagnosis other than portal hypertension. The causes of bleeding as seen during endoscopy were: oesophageal varices ( n = 130; 88%), gastric varices ( n =11), gastric ulcer ( n = 2) portal hypertensive gastropathy ( n = 2) and erosive gastritis and duodenal ulcer in one patient each. All patient bleeding from oesophageal varices except one underwent emergency endoscopic sclerotherapy. One hundred and twenty-one (94%) stopped bleeding immediately. Rebleeding was seen in 11% and was effectively controlled by a second session of sclerotherapy in all but one patient. Twenty (14%) patients died. It is concluded that emergency endoscopy has a definite role in the management of patients with portal hypertension complicated by gastrointestinal bleeding.

scholarly journals Do We EradicateHelicobacter pyloriin Hospitalized Patients with Peptic Ulcer Disease?

2013 ◽  
Vol 27 (11) ◽  
pp. 636-638 ◽  
Author(s):  
Frank Wong ◽  
George Ou ◽  
Sigrid Svarta ◽  
Ricky Kwok ◽  
Kieran Donaldson ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Breath Test ◽  
Upper Gastrointestinal Bleeding ◽  
Urea Breath Test ◽  
Gastric Ulcers ◽  
Treatment Rate ◽  
Ulcer Disease ◽  
Tertiary Centre ◽  
H Pylori ◽  
Upper Gastrointestinal

BACKGROUND:Helicobacter pyloriinfection is the most common chronic infection in humans. It is a major contributor to the cause of duodenal and gastric ulcers worldwide. Its eradication has been shown to reduce rates ofH pylori-related ulcers as well as other complications such as gastric cancer.OBJECTIVE: To determine the rate of appropriate treatment in patients following a diagnosis ofH pyloriinfection on biopsy during esophagoduodenoscopy for upper gastrointestinal bleeding over a four-year period at a tertiary centre in Vancouver, British Columbia. Also evaluated was the rate of eradication confirmation using the urea breath test.METHODS: A retrospective review of 1501 inpatients who underwent esophagoduodenoscopy for upper gastrointestinal bleeding (January 2006 to December 2010) was undertaken. Patients who were biopsy stain positive forH pyloriwere selected for drug review either via a provincial database (PharmaNet) or via records from patients’ family practitioners. Data were also obtained via two provincial laboratories that perform the urea breath test to determine the rates of confirmation of eradication.RESULTS: Ninety-eight patients had biopsy-provenH pylori. The mean (± SD) age was 56.13±17.9 years and 65 were male. Data were not available for 22 patients; the treatment rate was 52.6% (40 of 76). Of those treated, 12 patients underwent a post-treatment urea breath test for eradication confirmation.CONCLUSION: There was substantial discrepancy between the number of diagnosedH pyloriinfections and the rate of treatment as well as confirmation of eradication. Numerous approaches could be taken to improve treatment and eradication confirmation.

scholarly journals Description of Prescribing Practices in Patients with Upper Gastrointestinal Bleeding Receiving Intravenous Proton-Pump Inhibitors: A Multicentre Evaluation

2004 ◽  
Vol 18 (9) ◽  
pp. 567-571 ◽  
Author(s):  
Robert Enns ◽  
Christopher N Andrews ◽  
Martin Fishman ◽  
Michael Hahn ◽  
Kenneth Atkinson ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Upper Gastrointestinal Bleeding ◽  
Prescribing Practices ◽  
Clinical Practices ◽  
Ulcer Disease ◽  
Inappropriate Use ◽  
Endoscopic Findings ◽  
Upper Gastrointestinal

BACKGROUND:Intravenous forms of proton pump inhibitors (IV PPI) are routinely used for patients with acute upper gastrointestinal bleeding, but a significant concern for their inappropriate use has been suggested.PATIENTS and METHODS:All consecutive patients who received IV PPI (pantoprazole) over 20 months in six Canadian hospitals were reviewed. Prescribing practices, endoscopic findings and outcomes were recorded.RESULTS:A total of 854 patients received IV PPI. Over 90% of patients were given IV PPI for treatment of known or suspected active upper gastrointestinal bleeding. Most patients (69%) underwent upper endoscopy, and 58% of these patients had peptic ulcer disease (PUD). The majority of patients who had endoscopy (57%) had IV PPI administered in advance of the procedure. Of the 334 patients who had IV PPI given in advance, 46 (13.8%) were found to have high risk bleeding PUD stigmata at endoscopy. The remaining 288 patients (86.2%) with advance IV PPI had low-risk PUD lesions or non-PUD lesions; IV PPI was continued after endoscopy in 164 (56.9%) of these patients.CONCLUSIONS:IV PPI is often used before endoscopy in suspected upper gastrointestinal bleed and maintained, regardless of endoscopic findings, after the endoscopy in many Canadian centres. Further study is required to support these clinical practices.

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