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 Acute upper gastrointestinal bleeding in liver cirrhosis patients

2012 ◽  
Vol 156 (3) ◽  
pp. 266-270 ◽  
Author(s):  
Pavel Svoboda ◽  
Michal Konecny ◽  
Arnost Martinek ◽  
Vladimir Hrabovsky ◽  
Vlastimil Prochazka ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal

scholarly journals Should vasoconstrictors be considered in a cirrhotic patient with acute non-variceal upper gastrointestinal bleeding?

2017 ◽  
Vol 5 (4) ◽  
pp. 240-244 ◽  
Author(s):  
Xingshun Qi ◽  
Hongyu Li ◽  
Xiaodong Shao ◽  
Zhendong Liang ◽  
Xia Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Gastrointestinal Bleeding ◽  
Variceal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
International Normalized Ratio ◽  
Endoscopic Examination ◽  
Vein Thrombosis ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal

Abstract Varices manifest as a major etiology of upper gastrointestinal bleeding in patients with chronic liver diseases, such as liver cirrhosis and hepatocellular carcinoma. By contrast, non-variceal upper gastrointestinal bleeding is rare. Pharmacological treatment differs between patients with variceal and non-variceal bleeding. Vasoconstrictors are recommended for the treatment of variceal bleeding, rather than non-variceal bleeding. In contrast, pump proton inhibitors are recommended for the treatment of non-variceal bleeding, rather than variceal bleeding. Herein, we present a case with liver cirrhosis and acute upper gastrointestinal bleeding who had a high risk of rebleeding (i.e., Child–Pugh class C, hepatocellular carcinoma, portal vein thrombosis, low albumin, and high international normalized ratio and D-dimer). As the source of bleeding was obscure, only terlipressin without pump proton inhibitors was initially administered. Acute bleeding episode was effectively controlled. After that, an elective endoscopic examination confirmed that the source of bleeding was attributed to peptic ulcer, rather than varices. Based on this preliminary case report, we further discussed the potential role of vasoconstrictors in a patient with cirrhosis with acute non-variceal upper gastrointestinal bleeding.

Acute Upper Gastrointestinal Bleeding in Patients With Liver Cirrhosis and in Noncirrhotic Patients

2005 ◽  
Vol 39 (4) ◽  
pp. 321-327 ◽  
Author(s):  
St??phane Lecleire ◽  
Fr??d??ric Di Fiore ◽  
V??ronique Merle ◽  
Sophie Herv?? ◽  
Christian Duhamel ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal

Stopping antithrombotic therapy after acute upper gastrointestinal bleeding is associated with reduced survival

2017 ◽  
Vol 94 (1109) ◽  
pp. 137-142 ◽  
Author(s):  
Keith Siau ◽  
Jack L Hannah ◽  
James Hodson ◽  
Monika Widlak ◽  
Neeraj Bhala ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Adverse Events ◽  
Gastrointestinal Bleeding ◽  
Peptic Ulcer Disease ◽  
Antithrombotic Therapy ◽  
Upper Gastrointestinal Bleeding ◽  
University Hospital ◽  
Ulcer Disease ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal

IntroductionAntithrombotic drugs are often stopped following acute upper gastrointestinal bleeding (AUGIB) and frequently not restarted. The practice of antithrombotic discontinuation on discharge and its impact on outcomes are unclear.ObjectiveTo assess whether restarting antithrombotic therapy, prior to hospital discharge for AUGIB, affected clinical outcomes.DesignRetrospective cohort study.SettingUniversity hospital between May 2013 and November 2014, with median follow-up of 259 days.PatientsPatients who underwent gastroscopy for AUGIB while on antithrombotic therapy.InterventionsContinuation or cessation of antithrombotic(s) at discharge.Main outcomes measuresCause-specific mortality, thrombotic events, rebleeding and serious adverse events (any of the above).ResultsOf 118 patients analysed, antithrombotic treatment was stopped in 58 (49.2%). Older age, aspirin monotherapy and peptic ulcer disease were significant predictors of antithrombotic discontinuation, whereas dual antiplatelet use predicted antithrombotic maintenance. The 1-year postdischarge mortality rate was 11.3%, with deaths mainly due to thrombotic causes. Stopping antithrombotic therapy at the time of discharge was associated with increased mortality (HR 3.32; 95% CI 1.07 to 10.31, P=0.027), thrombotic events (HR 5.77; 95% CI 1.26 to 26.35, P=0.010) and overall adverse events (HR 2.98; 95% CI 1.32 to 6.74, P=0.006), with effects persisting after multivariable adjustment for age and peptic ulcer disease. On subgroup analysis, the thromboprotective benefit remained significant with continuation of non-aspirin regimens (P=0.016). There were no significant differences in postdischarge bleeding rates between groups (HR 3.43, 0.36 to 33.04, P=0.255).ConclusionIn this hospital-based study, discontinuation of antithrombotic therapy is associated with increased thrombotic events and reduced survival.

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