scholarly journals Evaluation and Management of Mallory – Weiss Syndrome: A Review

2021 ◽  
pp. 788-794
Author(s):  
Mohammed Salah Hussein ◽  
Fatimah Ali Alfaraj ◽  
Abdulrahman Dhafer Alshabwi ◽  
Aljawhara Abdullah Altheyab ◽  
Khulood Tariq Alhasan ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Gastroesophageal Junction ◽  
Gastric Cardia ◽  
Common Cause ◽  
Medicinal Treatment ◽  
Bleeding Episodes ◽  
Upper Gastrointestinal

Upper gastrointestinal bleeding is a symptom of Mallory-Weiss syndrome, which is caused by longitudinal mucosal lacerations (known as Mallory-Weiss tears) near the gastroesophageal junction or gastric cardia. Mallory-Weiss syndrome is rather prevalent, accounting for 3 to 10% of all upper gastrointestinal bleeding episodes. In mild circumstances, the disease may be asymptomatic. Hematemesis is the presenting symptom in 85 percent of patients. Blood is present in varying amounts, ranging from blood-streaked mucous to huge bright red haemorrhage. Other symptoms such as melena, dizziness, or syncope might occur as a result of heavy bleeding. The majority of the time, the bleeding is little and ends on its own. Endoscopy is frequently used to confirm the diagnosis of MWS. Although most patients may be treated with monitoring or conservative medicinal treatment, certain cases require endoscopic or surgical treatment. Despite the fact that MWS is a common cause of nonvariceal upper gastrointestinal bleeding (NVUGIB), little research has been done on it. This article discusses MWS Etiology, epidemiology, evaluation and management.

Upper GI Bleed, Etiology, Role of Endoscopy in Rural Population of Punjab

2010 ◽  
Vol 1 (3) ◽  
pp. 55-68 ◽  
Author(s):  
Ravinder Singh Malhotra ◽  
K. S. Ded ◽  
Arun Gupta ◽  
Darpan Bansal ◽  
Harneet Singh
Keyword(s):  
Peptic Ulcer ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Common Cause ◽  
Endoscopic Techniques ◽  
Gi Bleed ◽  
Upper Gastrointestinal ◽  
Common Variable ◽  
Important Progress

Haematemesis and malena are the two most important symptoms of upper gastrointestinal bleeding . The most common cause of upper gastrointestinal bleeding is due to a peptic ulcer. In this paper, the authors research the cause of bleeding. Contrary to previous studies, results favor esophageal varices, e.g., alcoholism or cirrhosis liver post necrotic, as the most common cause of bleeding rather than a peptic ulcer. The authors’ study is based on an observational retrospective protocol with records of 50 consecutive patients with GI bleeding, attending the emergency room from February 2007 until September 2009. Results show that the treatment of UGI bleeding has made important progress since the introduction of emergency endoscopy and endoscopic techniques for haemostasis. The application of specific protocols significantly decreases rebleeding and the need for surgery, whereas mortality is still high. The data highlight the decreasing trend of peptic ulcer as the sole cause of bleeding, as shown in previous literature, ascertaining that varices are now the most common variable.

scholarly journals Peptic Ulcer Is the Most Common Cause of Non-Variceal Upper-Gastrointestinal Bleeding (NVUGIB) in China

2018 ◽  
Vol 24 ◽  
pp. 7119-7129
Author(s):  
Mingliang Lu ◽  
Gang Sun ◽  
Xiao-Mei Zhang ◽  
You-Qing Xv ◽  
Shi-Yao Chen ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Common Cause ◽  
Upper Gastrointestinal

scholarly journals Non Cirrhotic Portal Vein Thrombosis: Diagnostic and Therapeutic Challenge

2021 ◽  
Vol 22 (1) ◽  
pp. 79-83
Author(s):  
Syifa Mustika ◽  
Pratista Adi Krisna
Keyword(s):  
Gastrointestinal Bleeding ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Upper Gastrointestinal Bleeding ◽  
Recurrent Thrombosis ◽  
Common Cause ◽  
Vein Thrombosis ◽  
Physical Laboratory ◽  
Prevention And Treatment ◽  
Upper Gastrointestinal

Portal vein thrombosis (PVT), the second most common cause of portal hypertension, can be found in cirrhosis and non-cirrhosis patients. Various factors can cause non-cirrhosis PVT, such as biliary infection. Upper gastrointestinal bleeding without sign of liver failure, must be considered as non-cirrhosis PVT manifestation. Combining physical, laboratory, endoscopic and radiological examination is needed to establish the diagnosis of PVT. The principle of PVT management consists of 3 keypoints. They are prevention and treatment of gastrointestinal bleeding, prevention of recurrent thrombosis and portal cholangiopathy therapy. Many aspect should be considered regarding the administration of anticoagulants in PVT patients, especially chronic PVT with cavernomas.

scholarly journals Clinical and endoscopic features of aorto-duodenal fistula resulting in definitive diagnosis: an observational study

2020 ◽  
Author(s):  
Chikamasa Ichita ◽  
Akiko Sasaki ◽  
Chihiro Sumida ◽  
Karen Kimura ◽  
Takashi Nishino ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Surgical Treatment ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Vital Signs ◽  
Diagnostic Methods ◽  
Upper Endoscopy ◽  
Duodenal Fistula ◽  
Endoscopic Characteristics ◽  
Upper Gastrointestinal

Abstract Background: An aorto-duodenal fistula presents with upper gastrointestinal bleeding and hematemesis. Early diagnosis is difficult, and the disease is associated with high mortality. Sometimes, a small amount of bleeding, known as herald bleed, occurs repeatedly and may be judged as upper gastrointestinal bleeding, prompting emergency upper endoscopy. Diagnostic methods and surgical treatment during herald bleeding are important for saving lives. However, most fistulas form in the horizontal duodenum, and active bleeding is rarely found in patients with herald bleeding. Moreover, an aorto-duodenal fistula is rarely diagnosed based on upper endoscopy alone. Methods: The present study examined the clinical and endoscopic characteristics of aorto-duodenal fistula in eight patients who underwent upper endoscopy before diagnosis at our hospital. It also sought to clarify how aorto-duodenal fistula can be appropriately diagnosed. Results: All patients had a history of aortic treatment, and many could not be diagnosed by computed tomography scan or upper endoscopy alone. Regarding the endoscopic findings, patients were seen to have stent/vascular prosthesis exposure, which is diagnostic of aorto-duodenal fistula as well as pulsatile lesions and massive fresh bleeding of obscure origin in the duodenum. Conclusions: If the diagnosis is unclear, clinicians may need to observe the horizontal duodenum using a fitted tip attachment or long scope. Since vital signs may fluctuate during endoscopy, a series of tests should be performed immediately. Proactive placement of marking clips in likely areas of the fistula may facilitate diagnosis via computed tomography. The present results demonstrate that proper diagnosis and prompt surgical treatment save lives in patients with aorto-duodenal fistula.

scholarly journals Clinical and endoscopic profile of patients with upper gastrointestinal bleeding at tertiary care center of North India

2014 ◽  
Vol 05 (04) ◽  
pp. 139-143 ◽  
Author(s):  
Deep Anand ◽  
Rohit Gupta ◽  
Minakshi Dhar ◽  
Vivek Ahuja
Keyword(s):  
Peptic Ulcer ◽  
Portal Hypertension ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Tertiary Care ◽  
North India ◽  
Medical Emergency ◽  
Female Ratio ◽  
Common Cause ◽  
Upper Gastrointestinal

Abstract Background: Upper gastrointestinal bleeding (UGIB) is a common medical emergency associated with significant morbidity and mortality. The presentation of bleeding depends on the amount and location of hemorrhage and the endoscopic profile varies according to different etiology. Despite advancements in medical intervention UGIB still carries considerable morbidity, mortality and economic burden on health care system. At present, there is limited epidemiological data on UGIB and associated mortality from India. Aims: The aim was to study clinical, endoscopic profile, and associated mortality in patients presenting with UGIB. Materials and Methods: One hundred and fourteen patients came to Emergency Department with UGIB during the study period and were subjected to endoscopy to identify the etiology. The clinical and endoscopic profile was analyzed and mortality pattern was studied. Results: The mean age of patients was 49 ± 14.26. Majority of them were males (83.33%) and male to female ratio was 5:1. The most common cause of UGIB was portal hypertension related (Esophageal and gastric varices) seen in 56.14% of patients, peptic ulcer-related bleed was seen in 14.91% patients, gastric erosions were responsible for bleed in 12.28% patients, Mallory–Weiss tear was seen in 8.77% cases, gastric malignancy accounted for 4.38% of cases, Dieulafoy’s lesion was responsible for bleed in 1.75% cases and 1.75% had Duodenal polyp. The mortality rate because of UGIB in our cohort of patients was 21.05%. Conclusions: In the present study, variceal bleed was the most common cause of UGIB, followed by peptic ulcer bleed. Overall mortality was seen in 21.05% of cases; however, majority of mortality was seen in portal hypertension related bleeding.

scholarly journals Aorto-esophageal fistula associated with vascular ring: Double the arch trouble

2017 ◽  
Vol 3 (3) ◽  
pp. 24
Author(s):  
Umar S. Boston ◽  
Peter E. Fischer ◽  
Shyam K. Sathanandam ◽  
Christopher J. Knott-Craig
Keyword(s):  
Surgical Treatment ◽  
Foreign Body ◽  
Gastrointestinal Bleeding ◽  
Aortic Arch ◽  
Upper Gastrointestinal Bleeding ◽  
Vascular Ring ◽  
Esophageal Fistula ◽  
Rare Form ◽  
Thoracic Aneurysms ◽  
Upper Gastrointestinal

Aorto-esophageal fistula (AEF) is a rare form of upper gastrointestinal bleeding that is associated with high mortality if not surgically addressed. It is most commonly associated with descending thoracic aneurysms and foreign body ingestion. We report a case of surgical treatment of AEF associated with double aortic arch vascular ring.

Abstract 2026: Incidence, Predictors and Outcome of Upper Gastrointestinal Bleeding in Patients with Acute Coronary Syndromes

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Aryeh Shalev ◽  
Alexander Fich ◽  
Harel Gilutz ◽  
Carlos Cafri ◽  
Victor Novack ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Acute Coronary Syndromes ◽  
Upper Gastrointestinal Bleeding ◽  
H2 Blockers ◽  
Lv Dysfunction ◽  
Substantial Risk ◽  
Coronary Syndromes ◽  
Receptor Blockers ◽  
Bleeding Episodes ◽  
Upper Gastrointestinal

Purpose: The broad utilization of revascularization and antithrombotic drugs has improved outcome of patients with acute coronary syndromes (ACS). Nevertheless, these strategies are associated with a substantial risk of bleeding, which is associated in turn with increased mortality. Most bleeding episodes are related to arterial punctures. The characteristics and outcome of patients who develop upper gastrointestinal bleeding (UGIB) in this setting have received little attention. Methods: Using computerized databases we identified all patients admitted to our center between 10/96 and 11/07 for an ACS who developed UGIB during their hospital stay. For each case 3 control cases matched for age, gender, and ACS subtype were randomly selected. Multiple baseline characteristics, as well as antithrombotic agents, revascularization strategy, endoscopy reports and 30-day mortality were recorded. Results: 7240 ACS patients were admitted to our ICCU during the study period, of whom 64 (0.9%) developed UGIB. There were no significant differences between groups in the prevalence of diabetes and other risk factors, revascularization strategy, or the use of proton pump inhibitors or H2-blockers. Patients who bled suffered more from renal impairment and LV dysfunction and were more frequently treated with thienopyridines (89% vs. 68%, p=0.002) and GPIIb/IIIa receptor blockers (39% vs. 24%, p=0.03), but were treated equally with aspirin (100% vs. 96%, p=0.2). The combination of unfractionated heparin (UFH) with either GP IIb/IIIa receptor blockers or enoxaparin was also associated with UGIB (30% vs. 7%, p=0.001 and 36% vs. 18%, p=0.005, respectively). Patients who developed UGIB had a substantially higher 30-day mortality rate (33% vs. 6%, p<0.001). Among patients for whom endoscopy was available (35 patients of 64) the source of bleeding was similarly distributed between the esophagus, stomach and duodenum. Gastritis and duodenitis were the most common findings. Conclusions: UGIB in patients with ACS is associated with very high mortality. Patients who bled tended to have a greater degree of cardiac and renal dysfunction. The use of combined anti-platelet therapy, especially in conjunction with UFH is a strong risk factor for this serious complication.

scholarly journals Approach to Upper Gastrointestinal Bleeding - When to Treat?

1990 ◽  
Vol 4 (9) ◽  
pp. 647-649
Author(s):  
P Rutgeerts
Keyword(s):  
Risk Factors ◽  
Peptic Ulcer ◽  
Surgical Treatment ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Fatal Outcome ◽  
Ulcer Bleeding ◽  
Recurrent Bleeding ◽  
Life Threatening ◽  
Upper Gastrointestinal

Upper gastrointestinal bleeding from peptic ulcer is a life threatening emergency. Clinical risk factors for fatal outcome have been defined, and endoscopic predictors for rebleeding have been identified. Active ulcer bleeding at endoscopy carries an 80% chance of persistent or recurrent bleeding. A non bleeding visible vessel is associated with a 50% chance of rebleeding. These endoscopic lesions should be treated endoscopically. Failure to obtain definitive hemostasis endoscopically will necessitate emergency surgical treatment.

Upper GI Bleed, Etiology, Role of Endoscopy in Rural Population of Punjab

2012 ◽  
pp. 208-221
Author(s):  
Ravinder Singh Malhotra ◽  
K. S. Ded ◽  
Arun Gupta ◽  
Darpan Bansal ◽  
Harneet Singh
Keyword(s):  
Peptic Ulcer ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Common Cause ◽  
Endoscopic Techniques ◽  
Upper Gi ◽  
Gi Bleed ◽  
Upper Gastrointestinal ◽  
Common Variable

Haematemesis and malena are the two most important symptoms of upper gastrointestinal bleeding . The most common cause of upper gastrointestinal bleeding is due to a peptic ulcer. In this paper, the authors research the cause of bleeding. Contrary to previous studies, results favor esophageal varices, e.g., alcoholism or cirrhosis liver post necrotic, as the most common cause of bleeding rather than a peptic ulcer. The authors’ study is based on an observational retrospective protocol with records of 50 consecutive patients with GI bleeding, attending the emergency room from February 2007 until September 2009. Results show that the treatment of UGI bleeding has made important progress since the introduction of emergency endoscopy and endoscopic techniques for haemostasis. The application of specific protocols significantly decreases rebleeding and the need for surgery, whereas mortality is still high. The data highlight the decreasing trend of peptic ulcer as the sole cause of bleeding, as shown in previous literature, ascertaining that varices are now the most common variable.

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