scholarly journals The Clinical Outcomes of Transcatheter Microcoil Embolization in Patients with Active Lower Gastrointestinal Bleeding in the Small Bowel

2009 ◽  
Vol 10 (4) ◽  
pp. 391 ◽  
Author(s):  
Hyo-Sung Kwak ◽  
Young-Min Han ◽  
Soo-Teik Lee
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Clinical Outcomes ◽  
Lower Gastrointestinal 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.

scholarly journals Feasibility and safety of colonoscopy performed by nonexperts for acute lower gastrointestinal bleeding: post hoc analysis

2021 ◽  
Vol 09 (06) ◽  
pp. E943-E954
Author(s):  
Tsutomu Nishida ◽  
Ryota Nikura ◽  
Naoyoshi Nagata ◽  
Tetsuro Honda ◽  
Hajime Sunagozaka ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Gastrointestinal Bleeding ◽  
Clinical Outcomes ◽  
Endoscopic Treatment ◽  
Controlled Trial ◽  
Lower Gastrointestinal Bleeding ◽  
Transfusion Rate ◽  
Expert Group ◽  
Treatment Rate ◽  
Identification Rate

Abstract Background and study aims It remains unclear whether the experience of endoscopists affects clinical outcomes for acute lower gastrointestinal bleeding (ALGIB). We aimed to determine the feasibility and safety of colonoscopies performed by nonexperts using secondary data from a randomized controlled trial for ALGIB. Patients and methods We analyzed clinical outcomes in 159 patients with ALGIB who underwent colonoscopies performed by two groups of endoscopists: experts and nonexperts. We compared endoscopy outcomes, including identification of stigmata of recent hemorrhage (SRH), successful endoscopic treatment, adverse events (AEs), and clinical outcomes between the two groups, including 30-day rebleeding, transfusion, length of stay, thrombotic events, and 30-day mortality. Results Expert endoscopists alone performed colonoscopies in 96 patients, and nonexperts performed colonoscopies in 63 patients. The use of antiplatelets and warfarin was significantly higher in the expert group. The SRH identification rate (24.0 and 17.5 %), successful endoscopic treatment rate (95.0 and 100 %), rate of AEs during colonoscopy (0 and 0 %), transfusion rate (6.3 and 4.8 %), length of stay (8.0 and 6.4 days), rate of thrombotic events (0 and 1.8 %), and mortality (0 and 0 %) were not different between the expert and nonexpert groups. Rebleeding within 30 days occurred more often in the expert group than in the nonexpert group (14.3 vs. 5.4 % P = 0.0914). Conclusions The performance of colonoscopies for ALGIB by nonexperts did not result in worse clinical outcomes, suggesting that its use could be feasible for nonexperts for diagnosis and treatment of ALGIB.

A Case of Lower Gastrointestinal Bleeding and Small Bowel Tumorous Masses

2005 ◽  
Vol 129 (6) ◽  
pp. 800-802
Author(s):  
Mireille Bitar ◽  
James A. Strauchen ◽  
Rodrigo J. Sequeira ◽  
Maoxin Wu
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Lower Gastrointestinal Bleeding

scholarly journals Angiographically Negative Acute Arterial Upper and Lower Gastrointestinal Bleeding: Incidence, Predictive Factors, and Clinical Outcomes

2009 ◽  
Vol 10 (4) ◽  
pp. 384 ◽  
Author(s):  
Jin Hyoung Kim ◽  
Ji Hoon Shin ◽  
Hyun-Ki Yoon ◽  
Eun Young Chae ◽  
Seung-Jae Myung ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Clinical Outcomes ◽  
Predictive Factors ◽  
Lower Gastrointestinal Bleeding

scholarly journals Massive Gastrointestinal Bleeding due to Jejunal Diverticula in a Community Hospital: A Case Report and Review of Diagnostic and Therapeutic Options

2021 ◽  
Vol 12 (2) ◽  
pp. 196-201
Author(s):  
Cynthia Abbasi ◽  
M. Carolina Jimenez ◽  
Michael Lisi
Keyword(s):  
Interventional Radiology ◽  
Differential Diagnosis ◽  
Case Report ◽  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Community Hospital ◽  
Lower Gastrointestinal Bleeding ◽  
Therapeutic Options ◽  
Upper Endoscopy ◽  
Massive Gastrointestinal Bleeding

Small bowel diverticula are rare and often asymptomatic. Severe lower gastrointestinal bleeding from jejunal diverticula is rarely reported and, therefore, should be considered a differential diagnosis in all cases of lower gastrointestinal bleeding with nonconclusive gastroscopy and colonoscopy. In this case report, we discuss a case of a 75-year-old male with massive lower gastrointestinal bleeding from jejunal diverticula. Initial gastroscopy did not reveal the source of bleeding. Repeat upper endoscopy with a pediatric colonoscope identified jejunal diverticula as the likely source of bleeding. Angiography identified the site of extravasation, and successful angioembolization was done by interventional radiology.

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