scholarly journals Esophageal Hiatal Hernia: A Possible Scintigraphic Feature

2021 ◽  
Author(s):  
Saeed Farzanefar ◽  
Mahya Zarei ◽  
Arefeh Mirzabeigi ◽  
Mehrshad Abbasi
Keyword(s):  
Gastric Emptying ◽  
Hiatal Hernia ◽  
Supporting Evidence ◽  
Gi Bleeding ◽  
Esophageal Hiatal Hernia ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Paraesophageal Hiatal Hernia ◽  
Solid Liquid ◽  
Upper Gastrointestinal

An 81-year-old woman with symptoms of upper Gastrointestinal (GI) obstruction but with no supporting evidence for obstruction in previous endoscopies was studied with a solid-liquid gastric emptying scintigraphic examination. There was evidence of accumulation of the tracer in a part of the stomach in the thorax before filling the stomach. The paraesophageal hiatal hernia was suspected. The diagnosis was not confirmed by other modalities and the patient passed away after upper GI bleeding a month later.

Optimal timing of vitamin K antagonist resumption after upper gastrointestinal bleeding

2017 ◽  
Vol 117 (03) ◽  
pp. 491-499 ◽  
Author(s):  
Niklas Wallvik ◽  
Joakim Eriksson ◽  
Jonas Höijer ◽  
Matteo Bottai ◽  
Margareta Holmström ◽  
...  
Keyword(s):  
Vitamin K ◽  
Vitamin K Antagonists ◽  
Bleeding Event ◽  
Optimal Timing ◽  
Thromboembolic Events ◽  
Gi Bleeding ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Increased Risk ◽  
Upper Gastrointestinal

SummaryThe optimal timing of vitamin K antagonists (VKAs) resumption after an upper gastrointestinal (GI) bleeding, in patients with continued indication for oral anticoagulation, is uncertain. We included consecutive cases of VKA-associated upper GI bleeding from three hospitals retrospectively. Data on the bleeding location, timing of VKA resumption, recurrent GI bleeding and thromboembolic events were collected. A model was constructed to evaluate the ‘total risk’, based on the sum of the cumulative rates of recurrent GI bleeding and thromboembolic events, depending on the timing of VKA resumption. A total of 121 (58 %) of 207 patients with VKA-associated upper GI bleeding were restarted on anticoagulation after a median (interquartile range) of one (0.2–3.4) week after the index bleeding. Restarting VKAs was associated with a reduced risk of thromboembolism (HR 0.19; 95 % CI, 0.07–0.55) and death (HR 0.61; 95 % CI, 0.39–0.94), but with an increased risk of recurrent GI bleeding (HR 2.5; 95 % CI, 1.4–4.5). The composite risk obtained from the combined statistical model of recurrent GI bleeding, and thromboembolism decreased if VKAs were resumed after three weeks and reached a nadir at six weeks after the index GI bleeding. On this background we will discuss how the disutility of the outcomes may influence the decision regarding timing of resumption. In conclusion, the optimal timing of VKA resumption after VKA-associated upper GI bleeding appears to be between 3–6 weeks after the index bleeding event but has to take into account the degree of thromboembolic risk, patient values and preferences.

scholarly journals Complete Rockall score in predicting outcomes in acute upper gastrointestinal bleeding

2018 ◽  
Vol 14 (4) ◽  
pp. 178-183
Author(s):  
Kush Raj Dewan ◽  
Bhanumati Saikia Patowary ◽  
Subash Bhattarai ◽  
Gaurav Shrestha
Keyword(s):  
Medical Emergency ◽  
Gi Bleeding ◽  
Medical Sciences ◽  
Median Hospital Stay ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleed ◽  
Rockall Score ◽  
Upper Gastrointestinal

Background: Acute upper GI bleeding is a common medical emergency with a hospital mortality of approximately 10%. Higher mortality rate is associated with rebleeding. Complete Rockall scoring system identifies patients at higher risk of rebleed and mortality. Methods: This is a descriptive hospital based study conducted in Gastroenterology unit of College of Medical Sciences and Teaching Hospital, Bharatpur, Nepal from January 2012 to December 2014. It included 200 patients at random presenting with manifestations of UGI bleed. Complete Rockall score was calculated in each patient and its correlation with mortality and rebleed was determined. Scores of >5 has been considered as one category as it comprises of patients with very high risks and scores of 0-4 as another category of low or lesser risks for the purpose of comparison of different risk factors. Results: Males were predominant (71%). Age ranged from 14 to 90 years, mean being 50.43+17.75 years. At presentation 110 patients (55%) had both hematemesis and malena, 56 patients (28%) had only malena and 34 patients (17%) had only hematemesis. Shock was detected in 21%, severe anemia and high blood urea were found in 31% and 41% respectively. Median hospital stay was 6.5+3.10 days.  Comorbidities were present in 83.3%. Complete Rockall score ranged from 0 to 9, mean being 4.30+2.19. One hundred and thirteen (56.5%) had complete Rockall score <4 and 87 (43.5%) >5. Rebleeding was found in 16 (8%) patients. One hundred and eighty eight patients (94%) recovered and discharged from the hospital and 12 patients (6%) expired. The correlations between high Rockall scores (>5) and the occurrence of rebleeding  (p=0.001) and mortality (p=0.001) were statistically significant. Conclusion: Acute Upper GI bleeding is a medical emergency. Predictors of mortality in this series were high complete Rockall score >5, esophageal varices with Child Pugh score C,  massive initial bleed as well as rebleed and multiple comorbidities. Keywords:  acute upper gastrointestinal  bleed, complete Rockall score, comorbiditis, rebleed, mortality        

scholarly journals Giant Left Atrium - A Rare Case of Acute Upper Gastrointestinal Bleeding

2016 ◽  
Vol 54 (201) ◽  
pp. 40-42
Author(s):  
Khus Raj Dewan ◽  
Bhanumati Saikia Patowary ◽  
Subash Bhattarai
Keyword(s):  
Left Atrium ◽  
Upper Gastrointestinal Bleeding ◽  
Medical Emergency ◽  
Oesophageal Varices ◽  
Gi Bleeding ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Giant Left Atrium ◽  
Upper Gastrointestinal

Acute upper GI bleeding is a common medical emergency with a hospital mortality of approximately10%. Non variceal UGI bleeding is the most common cause followed by oesophageal varices. Variousrare causes have been described in the literature but there are very few cases of giant left atriumleading to oesophageal erosion and causing upper GI bleeding. We are presenting a case of rheumaticvalvular heart disease with giant left atrium who presented in our department with acute upper GIbleeding. Keywords: giant left atrium;oesophgeal erosion; upper GI bleeding. | PubMed

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 Upper GI Endoscopy in Children: An Experience from Bangabandhu Sheikh Mujib Medical University (BSMMU)

2017 ◽  
Vol 40 (1) ◽  
pp. 17-20
Author(s):  
Md Wahiduzzaman Mazumder ◽  
Md Rukunuzzaman ◽  
Atiar Rahman ◽  
SM Baqui Billah ◽  
Kaniz Sultana ◽  
...  
Keyword(s):  
Esophageal Varices ◽  
Common Finding ◽  
Gi Bleeding ◽  
Gi Endoscopy ◽  
Upper Gi Bleeding ◽  
Endoscopic Findings ◽  
Upper Gi ◽  
Post Procedure ◽  
Upper Gi Endoscopy ◽  
Upper Gastrointestinal

Background: Upper gastrointestinal (UGI) endoscopy is a safe and sensitive investigation in the diagnosis of upper gastrointestinal diseases. There is limited study on paediatric upper GI endoscopy in our country. This study was done only in BSMMU, a tertiary care health facility of Bangladesh.Objectives: The aim of the study was to find out the indications, common endoscopic findings and immediate post procedure complication of UGI endoscopy in children.Methods: This is a retrospective analysis of 100 patients from August 2013 to October 2014. The indications for UGI endoscopy, common endoscopic findings and immediate post procedure complications were collected from case recording &were analyzed.Results: The commonest indication was upper GI bleeding in the form of hematemesis with or without melenae (41%). The most common finding was esophageal varices (49%). Less common findings were esophagitis, gastritis & gastro-duodenal ulcer. There was no post procedure complication.Conclusion: In the study, the commonest indication for Pediatric UGI endoscopy was upper GI bleeding and the commonest endoscopic abnormality was esophageal varices. No immediate post procedure complication was noted in the study.Bangladesh J Child Health 2016; VOL 40 (1) :17-20

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

Hospitalisation for Upper Gastrointestinal Bleeding Associated with Use of Oral Anticoagulants

2001 ◽  
Vol 86 (08) ◽  
pp. 563-568 ◽  
Author(s):  
Henrik Toft Sørensen ◽  
Lene Mellemkjœr ◽  
William Blot ◽  
Gunnar Lauge Nielsen ◽  
Joseph McLaughlin ◽  
...  
Keyword(s):  
Record Linkage ◽  
Upper Gastrointestinal Bleeding ◽  
Oral Anticoagulants ◽  
Population Based ◽  
Prescription Database ◽  
Gi Bleeding ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Increased Risk ◽  
Upper Gastrointestinal

SummaryThe incidence of hospitalisation for upper GI bleeding with use of oral anticoagulants (OA) alone or in combination with other drugs was examined in a cohort of 4,204 users of OA, identified through record linkage between a population-based prescription database and a hospital discharge registry in Denmark, and compared with the incidence in the general population not exposed to OA. The standardised incidence ratio (SIR) was 2.8 (95% CI = 1.6-4.5) for use of OA alone. SIRs tended to be higher for use of OA combined with acetaminophen alone (4.4, 95% CI = 1.2-11.4), non-aspirin NSAIDs alone (8.0, 95% CI = 2.1 to 20.4) or aspirin/corticosteroids alone (3.8, 95% CI = 0.8-11.0), respectively.These results indicate that use of OA is associated with a significantly increased risk of upper GI bleeding, with still higher risks associated with the concomitant use of other medications including acetaminophen. Further research is needed to clarify the extent to which drugs interacting with oral anticoagulants may cause GI bleeding and the mechanisms through which these associations operate.

Gastroenterological emergencies

2010 ◽  
pp. 223-280
Author(s):  
Punit S. Ramrakha ◽  
Kevin P. Moore ◽  
Amir Sam
Keyword(s):  
Peptic Ulcer ◽  
Acute Gastroenteritis ◽  
Medical Management ◽  
Gi Bleeding ◽  
Variceal Haemorrhage ◽  
Ulcer Disease ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Bacterial Gastroenteritis ◽  
Upper Gastrointestinal

Acute upper gastrointestinal (GI) bleeding 1 224 Acute upper GI bleeding 2 226 Acute upper GI bleeding 3 228 Peptic ulcer disease 230 Erosive gastritis/oesophagitis 230 Variceal haemorrhage: medical management 232 Variceal haemorrhage: further management 234 Mallory–Weiss tear 234 Acute gastroenteritis: assessment 236 Bacterial gastroenteritis ...

scholarly journals Familial Abdominal and Intestinal Lipomatosis Presenting with Upper GI Bleeding

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Yilmaz Bilgic ◽  
Hasan Baki Altinsoy ◽  
Nezahat Yildirim ◽  
Ozkan Alatas ◽  
Burhan Hakan Kanat ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Gastrointestinal Bleeding ◽  
Clinical Symptoms ◽  
Upper Gastrointestinal Bleeding ◽  
Benign Tumors ◽  
Gi Bleeding ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Upper Gastrointestinal

Although lipomas are encapsulated benign tumors, systemic lipomatosis defines infiltrative nonencapsulated tumors resembling normal adipose tissue. Abdominal lipomatosis and intestinal lipomatosis are different clinicopathological entities with similar clinical symptoms. We describe here a case presenting with upper gastrointestinal bleeding from eroded submucosal lipoma at duodenum secondary to intestinal lipomatosis and abdominal lipomatosis.

scholarly journals Clinico-etiological pattern of upper gastrointestinal bleeding in children

2016 ◽  
Vol 4 (1) ◽  
pp. 132
Author(s):  
Shiv Ram Krishna Dubey ◽  
Neha Bhadauria ◽  
Mukesh Shukla ◽  
Purvi Mittal ◽  
Arun Kumar Arya ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Age Group ◽  
Gi Bleeding ◽  
Venous Obstruction ◽  
Upper Gi Bleeding ◽  
Upper Gi ◽  
Group 5 ◽  
Hepatic Portal ◽  
Upper Gastrointestinal

Background: Upper GI bleeding (UGIB) is defined as bleeding occurring proximal to ligament of treitz. Upper gastrointestinal bleeding (UGIB) can lead to potentially serious and life-threatening clinical situation in children. Globally, the cause of UGIB differs significantly depending on variations in patient population and the presence of comorbid conditions. The objective of this study was to understand the clinico-etiological pattern of upper gastrointestinal bleeding in children in the age group 5-18 years, at a tertiary care centre in central India.Methods: This prospective study was carried out at a tertiary health care centre between January 2011 and August 2012. We consecutively enrolled all patients in the age group 5-18 years who came to our centre with hematemesis or hematemesis and malena both. Blood sample for CBC, stool sample for occult blood was taken and Ultrasonography of abdomen for liver echotexture, portal vein diameter/pressure and splenomegaly, done. Then, all patients underwent upper gastro intestinal endoscopy (Olympus GIF-V70 upper GI video endoscope).Results: Total 112 patients were included in the study during the study period. UGIB is most common in the age group 5-10 years (71.4%), followed by 10-14 years (26.8%). Hematemesis is the most common presenting symptom (75%) followed by both hematemesis and melena (25%). The most common causes of UGIB on EGD were oesophageal or gastric varices (91.1%) followed by erosive gastritis (5.3%), gastric ulcer (1.8%) and esophagitis (1.8%). Most common finding on ultrasonography (USG) abdomen was extra-hepatic portal venous obstruction (EHPVO) 75%, followed by liver cirrhosis (16.1%). No abnormality was detected on USG in 8.9% of patients.Conclusions: We conclude that Upper GI bleeding is more common in 5-10 years age group with hematemesis as the main presenting symptom. The causes of upper GI bleeding in children in developing countries are different from those in developed countries (variceal bleeding due to extra hepatic portal venous obstruction is the most common cause and peptic ulcer is rare).

Sign in / Sign up

Export Citation Format

Share Document