scholarly journals Features of the diagnostics and treatment of a rare source of small bowel bleeding — venous malformations of the small bowel with Blue rubber bleb nevus syndrome (Bean’s syndrome)

2020 ◽  
pp. 108-112
Author(s):  
E. V. Ivanova ◽  
E. V. Tikhomirova ◽  
S. G. Shapovalyants ◽  
E. D. Fedorov ◽  
L. M. Mikhaleva
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Intestinal Bleeding ◽  
Early Age ◽  
Venous Malformations ◽  
Blue Nevus ◽  
Endoscopic Methods ◽  
First Time ◽  
Small Bowel Bleeding ◽  
Surgery Resection

The aim of the study is to demonstrate the possibilities of enteroscopy in diagnostics of rare source of small bowel bleeding in patient with blue rubber blue nevus syndrome.A 31-years old patient with severe anemia from the early age applied to our Hospital to diagnose the source of gastrointestinal bleeding. Previously performed EGD and colonoscopy didn’t reveal any sources of bleeding. Scintigraphy detected the signs of ongoing intestinal bleeding. Endoscopic methods (videocapsule and balloon-assisted enteroscopy) revealed multiple venous malformations of small bowel, as the source of gastrointestinal bleeding of «unknown source». The patient was performed surgery — resection of segments of small bowel with malformations. The diagnosis was verified morphologically. Postoperative period was without complications. For the first time in several years the patient had a fully restored level of hemoglobin.

scholarly journals Management of Multiple Arteriovenous Malformations of the Small Bowel

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Masahiro Hirakawa ◽  
Rie Ishizuka ◽  
Masanori Sato ◽  
Naotaka Hayasaka ◽  
Hiroyuki Ohnuma ◽  
...  
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Surgical Margin ◽  
Small Bowel Resection ◽  
Arterial Phase ◽  
Selective Angiography ◽  
Double Balloon Enteroscopy ◽  
Patient Reported ◽  
Vascular Ectasias ◽  
Small Bowel Bleeding

A 62-year-old Japanese female was referred to our hospital with gastrointestinal bleeding. Although small-bowel bleeding was suspected, no bleeding source was identified by enhanced computed tomography (CT), video capsule endoscopy (VCE), and double-balloon enteroscopy (DBE). Five years later, the patient had recurrent intermittent bloody stools with a significant decrease in hemoglobin levels. Although no active bleeding was observed on antegrade DBE, we detected a pulsatile submucosal uplift accompanied by a small red patch on the top of the uplift in the jejunum. Arteriovenous malformation (AVM) was suspected as the cause of small-bowel bleeding. Multiple-phase CT showed a number of small vascular ectasias during the arterial phase in the jejunum, and we confirmed the presence of multiple AVMs in the jejunum by selective angiography. To identify the location of the lesions and determine the minimal surgical margins, we performed intraoperative selective angiography with indocyanine green (ICG) injection. This technique allowed us to clearly observe the region and perform segmental small-bowel resection with minimal surgical margin. The patient reported that she has had no gastrointestinal bleeding at the two years follow-up visit.

scholarly journals Risk factors for small bowel bleeding in an overt gastrointestinal bleeding presentation after negative upper and lower endoscopy

PLoS ONE ◽  
2019 ◽  
Vol 14 (2) ◽  
pp. e0212509 ◽  
Author(s):  
Dejan Micic ◽  
John N. Gaetano ◽  
Neha Nigam ◽  
Matthew Peller ◽  
Vijaya L. Rao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Lower Endoscopy ◽  
Small Bowel Bleeding

Superselective transcatheter arterial embolization for acute small bowel bleeding: clinical outcomes and prognostic factors for ischemic complications

2020 ◽  
pp. 028418512093625
Author(s):  
Yong Seek Kim ◽  
Joon Ho Kwon ◽  
Kichang Han ◽  
Man-Deuk Kim ◽  
Junhyung Lee ◽  
...  
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Arterial Embolization ◽  
Recurrent Bleeding ◽  
Technical Success ◽  
Major Complications ◽  
Ischemic Complications ◽  
Small Bowel Bleeding

Background Small bowel bleeding (SBB) accounts for 5%–10% of all cases of acute gastrointestinal bleeding. Transcatheter arterial embolization (TAE) plays an important role in the treatment of SBB. Purpose To evaluate the safety and efficacy of superselective TAE exclusively for SBB and to assess factors associated with clinical outcomes. Material and Methods From January 2006 to April 2017, 919 patients were admitted with signs and symptoms of gastrointestinal bleeding; 74 patients (mean age = 57.5 years; age range = 14–82 years) with positive angiographic findings for SBB were retrospectively analyzed. The technical success of TAE and clinical outcomes, including recurrent bleeding, major complications, and in-hospital mortality were evaluated. The associations of various clinical and technical factors with clinical outcomes were analyzed. Results The bleeding foci were in the ileum in 48 (65%) patients and the jejunum in 26 (35%). Technical success was achieved in 72 (97%) patients. The rates of recurrent bleeding, major complications, and in-hospital mortality were 12% (7/57), 21% (15/71), and 25% (18/72), respectively. Superselective embolization was a significant prognostic factor associated with fewer major complications (OR = 0.069; P = 0.003). The increased number of embolized vasa recta was significantly associated with a higher probability of major complications (OR = 2.64; P < 0.001). The use of N-butyl cyanoacrylate was associated with lower rates of major complication (OR = 0.257; P = 0.027). Conclusion TAE is a safe and effective treatment modality for SBB. In addition, whenever possible, TAE should be performed in a superselective manner to minimize ischemic complications.

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.

Diagnosis and treatment of obscure small bowel bleedings - analysis of double balloon enteroscopy role in diagnosing and treatment algorythm on basis of own material

2018 ◽  
Vol 90 (3) ◽  
pp. 25-30 ◽  
Author(s):  
Paweł Wojtkiewicz ◽  
Tomasz Nowak ◽  
Kamil Jankowski ◽  
Dariusz Łaski
Keyword(s):  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Medical Care ◽  
Therapeutic Procedure ◽  
Medical Care System ◽  
Double Balloon Enteroscopy ◽  
Balloon Enteroscopy ◽  
Double Balloon ◽  
Small Bowel Bleeding

Introduction Obscure gastrointestinal bleeding (OGIB) is defined as a reccurent bleeding to gastrointestinal tract without evaluated origin, despite detiled endoscopic and image diagnostics. Mots common reason of OGIB i small bowel bleeding (SBB). Methodology Retrospective analysis of patients hospitalised in Gastroenterology Department of 7 Szpital Marynarki Wojennej w Gdańsku with suspicion of OIGB. Results Double balloon enteroscopy was performed in 31 cases. Origin of bleeding was founded in small bowel in 87% of cases and in 64 % successfull,simultaneous therapeutic procedure was performed. No clinically relevant complications were noticed. Conclusion According to actual diagnostic algorythms of OGIB, double balloon enteroscopy is highly effective also in polish medical care system. This tehnique is a safe and effective tool in diagnostics and treatment of SBB, but its availability is still limited in Poland. Abstrakt

scholarly journals Pyogenic Granuloma: An Unusual Cause of Massive Gastrointestinal Bleeding from the Small Bowel

2009 ◽  
Vol 23 (4) ◽  
pp. 261-264 ◽  
Author(s):  
Dana C Moffatt ◽  
Paul Warwryko ◽  
Harminder Singh
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Clinical Presentation ◽  
Relevant Literature ◽  
Pyogenic Granuloma ◽  
Vascular Tumour ◽  
First Case ◽  
Massive Gastrointestinal Bleeding ◽  
Gastrointestinal Lesion ◽  
Small Bowel Bleeding

Small bowel hemorrhage is responsible for approximately 4% of all cases of gastrointestinal bleeding. The etiology of bleeding from the small bowel is a tumour in approximately 10% of cases. Pyogenic granuloma is a common inflammatory vascular tumour of the dermis, which rarely occurs in the gastrointestinal tract. Pyogenic granuloma is a rare cause of overt or obscure small bowel bleeding. The present paper reports the first case of pyogenic granuloma presenting as a massive gastrointestinal bleed, and reviews the relevant literature to date regarding the clinical presentation, diagnosis and management of this rare gastrointestinal lesion.

scholarly journals New Trends and Advances in Non-Variceal Gastrointestinal Bleeding—Series II

2021 ◽  
Vol 10 (14) ◽  
pp. 3045
Author(s):  
Pablo Cañamares-Orbís ◽  
Ángel Lanas Arbeloa
Keyword(s):  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Successful Outcome ◽  
Cardiovascular Patients ◽  
Number Of Patients ◽  
Colonic Bleeding ◽  
Small Bowel Bleeding ◽  
Antithrombotic Management ◽  
Entire Gastrointestinal Tract

The gastrointestinal tract is a long tubular structure wherein any point in the mucosa along its entire length could be the source of a hemorrhage. Upper (esophagel and gastroduodenal) and lower (jejunum, ileum, and colon) gastrointestinal bleeding are common. Gastroduodenal and colonic bleeding are more frequent than bleeding from the small bowel, but nowadays the entire gastrointestinal tract can be explored endoscopically and bleeding lesions can be locally treated successfully to stop or prevent further bleeding. The extensive use of antiplatelet and anticoagulants drugs in cardiovascular patients is, at least in part, the cause of the increasing number of patients suffering from gastrointestinal bleeding. Patients with these conditions are usually older and more fragile because of their comorbidities. The correct management of antithrombotic drugs in cases of gastrointestinal bleeding is essential for a successful outcome for patients. The influence of the microbiome in the pathogenesis of small bowel bleeding is an example of the new data that are emerging as potential therapeutic target for bleeding prevention. This text summarizes the latest research and advances in all forms of acute gastrointestinal bleeding (i.e., upper, small bowel and lower). Diagnosis is approached, and medical, endoscopic or antithrombotic management are discussed in the text in an accessible and comprehensible way.

scholarly journals Suspected blood indicator in capsule endoscopy: a valuable tool for gastrointestinal bleeding diagnosis

2017 ◽  
Vol 54 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Pedro BOAL CARVALHO ◽  
Joana MAGALHÃES ◽  
Francisca DIAS DE CASTRO ◽  
Sara MONTEIRO ◽  
Bruno ROSA ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Negative Predictive Value ◽  
Capsule Endoscopy ◽  
Predictive Value ◽  
High Sensitivity ◽  
Single Centre ◽  
Small Bowel Bleeding ◽  
Very High

ABSTRACT BACKGROUND Small bowel bleeding is a leading indication for small bowel capsule endoscopy. The Suspected Blood Indicator (SBI) is a software feature directed to automatically detect bleeding lesions during small bowel capsule endoscopy. OBJECTIVE We aimed to assess SBI diagnostic accuracy for small bowel haemorrhage or potentially bleeding lesions during small bowel capsule endoscopy for small bowel bleeding. Methods - Single-centre retrospective study including 281 consecutive small bowel capsule endoscopy performed for small bowel bleeding during 6 years. The investigators marked lesions with high bleeding potential (P2), such as angioectasias, ulcers and tumours, as well as active bleeding during regular small bowel capsule endoscopy viewing with PillCam SB2(r). All small bowel capsule endoscopy were independently reviewed by another central reader using SBI. RESULTS Among the 281 patients, 29 (10.3%) presented with active haemorrhage while 81 (28.9%) presented with a P2 lesion. The most frequently observed P2 lesions were angioectasias (52), ulcers (15), polyps (7) and ulcerated neoplasias (7). SBI showed a 96.6% (28/29) sensitivity for active small bowel bleeding, with a 97.7% negative predictive value. Regarding P2 lesions, the SBI displayed an overall sensitivity of 39.5%, being highest for ulcerated neoplasias (100%), but significantly lower for angioectasias (38.5%) or ulcers (20.0%). CONCLUSION Although SBI sensitivity for the automatic detection of potentially bleeding lesions was low, it effectively detected active small bowel bleeding with very high sensitivity and negative predictive value.

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