scholarly journals Arteriovenous Fistula of Superior Mesenteric Artery: An Unusual Cause of an Massive Lower Gastrointestinal Bleeding

2019 ◽  
Vol 104 (9-10) ◽  
pp. 499-501
Author(s):  
Yang Yang ◽  
Qisheng Ran ◽  
Dongfeng Chen
Keyword(s):  
Gastrointestinal Bleeding ◽  
Superior Mesenteric Artery ◽  
Arteriovenous Fistula ◽  
Mesenteric Artery ◽  
Right Hemicolectomy ◽  
Lower Gastrointestinal Bleeding ◽  
Gi Bleeding ◽  
Case Presentation ◽  
Common Causes ◽  
Lower Gi Bleeding

Introduction The most common causes of lower gastrointestinal (GI) hemorrhage are diverticulosis and angiodysplasia. Arteriovenous fistula (AVF) of the intestine is an uncommon cause of GI hemorrhage. Case Presentation Herein, we report a case of an embolization of an AVF originated from the superior mesenteric artery and vein as a cause of acute massive lower GI bleeding. Conclusion The patient underwent a right hemicolectomy and ileotransversostomy.

Laparoscopic Small Bowel Resection And Anastmosis For Small Proximal Jejunal Gastrointestinal Stromal Tumor Presented With Acute Massive Lower Gastrointestinal Bleeding: Case report and Literature review

2020 ◽  
Author(s):  
khaled S ahmad ◽  
Mohamed S Essa ◽  
Naif A Alenazi
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Bowel Resection ◽  
Small Bowel Resection ◽  
Gi Bleeding ◽  
Case Presentation ◽  
Pressure Necrosis ◽  
Lower Gi Bleeding ◽  
Small Intestinal ◽  
Work Up

Abstract Background Gastrointestinal stromal tumors (GISTs) is the most common primary nonepithelial neoplasms of the gastointestinal tract, mostly expressing the KIT protein determined by immunohistochemical staining for the CD117 antigen. Jejunal GISTs represent approximately 10% of all GISTs. Abdominal discomfort is the usual presentation. Jejunal GISTs may present with complications such as intestinal obstruction or hemorrhage. Gastrointestinal bleeding occurs due to pressure necrosis and ulceration of overlying mucosa, and patients who develop significant bleeding may suffer from fatigue and malaise. Small-bowel GISTs are classified based on size, and several guidelines have recommended conservative treatment for small jejunal GISTs (<2 cm).Case presentation In this report, we describe a 35-year-old male, with a jejunal GIST, who presented with an unusual massive lower GI bleeding. After resuscitation extensive work up, he was taken finally for a diagnostic laparoscopy and resection of the mass.Conclusion Small intestinal GISTs are rare and unusual to present with massive lower GI bleeding.

scholarly journals Lower Gastrointestinal Bleeding in Chronic Hemodialysis Patients

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Fahad Saeed ◽  
Nikhil Agrawal ◽  
Eugene Greenberg ◽  
Jean L. Holley
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Gastrointestinal Bleeding ◽  
Chronic Hemodialysis ◽  
Lower Gastrointestinal Bleeding ◽  
Gi Bleeding ◽  
Common Causes ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Gastrointestinal (GI) bleeding is more common in patients with chronic kidney disease and is associated with higher mortality than in the general population. Blood losses in this patient population can be quite severe at times and it is important to differentiate anemia of chronic diseases from anemia due to GI bleeding. We review the literature on common causes of lower gastrointestinal bleeding (LGI) in chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients. We suggest an approach to diagnosis and management of this problem.

scholarly journals Hemodialysis Increases the Risk of Lower Gastrointestinal Bleeding and Angiodysplasia Bleeding: A Nationwide Population Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Tzung-Jiun Tsai ◽  
Wen-Chi Chen ◽  
Yu-Tung Huang ◽  
Yi-Hsin Yang ◽  
I-Che Feng ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Gastroduodenal Ulcer ◽  
Lower Gastrointestinal Bleeding ◽  
Ulcer Bleeding ◽  
Research Database ◽  
Bleeding Tendency ◽  
Gi Bleeding ◽  
Control Subjects ◽  
Lower Gi Bleeding ◽  
And Control

Background. Patients with chronic kidney disease (CKD) with or without hemodialysis were considered to have bleeding tendency and higher risk for gastrointestinal (GI) bleeding. Previous studies had documented that hemodialysis may increase the gastroduodenal ulcer bleeding. Few studies evaluated the relationship between CKD and lower GI bleeding. Materials and Methods. An observational cohort study design was conducted. The end-stage renal disease (ESRD) patients receiving regular hemodialysis (dialysis CKD), CKD patients without dialysis (dialysis-free CKD), and controls were selected from 1 million randomly sampled subjects in the National Health Insurance Research Database of Taiwan. These three group subjects were matched by age, sex, comorbidity, and enrollment time in a 1 : 2 : 2 ratio. The Cox proportional hazard regression models were used to identify the potential risk factors for lower gastrointestinal bleeding. Results. Dialysis CKD patients (n=574) had a higher incidence of lower GI bleeding than dialysis-free CKD patients (n=1148) and control subjects (n=1148) (12.9% vs. 3.6% and 2.8%; both P<0.001). Multivariate analysis showed that extreme old age (age≥85), male gender, dialysis-free CKD, and dialysis CKD were independent factors of lower GI bleeding. Additionally, dialysis CKD patients also had a higher incidence of angiodysplasia bleeding compared to dialysis-free CKD patients and control subjects (1.1% vs. 0.1% and 0.1%, respectively; both P=0.003). Conclusion. Hemodialysis may have higher risk of lower GI bleeding and angiodysplasia bleeding.

Acute lower gastrointestinal bleeding

2013 ◽  
pp. 21-33
Author(s):  
Daniel Marks ◽  
Marcus Harbord
Keyword(s):  
Gastrointestinal Bleeding ◽  
Lower Gastrointestinal Bleeding ◽  
Lower Threshold ◽  
Outpatient Basis ◽  
Gi Bleeding ◽  
Initial Management ◽  
Urgent Surgery ◽  
Co Morbidity ◽  
Lower Gi Bleeding

Lower gastrointestinal bleeding Initial management Admission Definitive investigations Complications of endoscopy Investigations if cause not identified Treatment of specific conditions Co-morbidity and lower gastrointestinal bleeding Non-severe overt lower gastrointestinal bleeding Lower GI bleeding is common but usually of only modest severity. Most can be managed on an outpatient basis, although unwell patients need admission (have a lower threshold for patients with severe co-morbidity). In total, ~35% of significant bleeds require transfusion and 5% urgent surgery (see the ...

Lower Gastrointestinal Bleeding

2017 ◽  
Author(s):  
Chasen A Croft ◽  
Frederick Moore
Keyword(s):  
Gastrointestinal Bleeding ◽  
Lower Gastrointestinal Bleeding ◽  
Diagnostic Workup ◽  
High Morbidity ◽  
Gi Bleeding ◽  
Primary Methods ◽  
Push Enteroscopy ◽  
Initial Symptoms ◽  
Life Threatening ◽  
Lower Gi Bleeding

Lower gastrointestinal (GI) hemorrhage is a common clinical condition often encountered by the acute care surgeon. Lower GI bleeding, defined as bleeding distal to the ligament of Treitz, may present with diverse manifestations, from occult bleeding as evidenced only by anemia to massive hemorrhage and exsanguination. Severe, life-threatening hemorrhage may present precipitously with few initial symptoms. As such, the astute surgeon must be able to expeditiously identify patients with acute, massive lower GI bleeding and initiate the appropriate therapeutic algorithm to reduce the high morbidity and mortality associated with this condition. After initial resuscitation, the cause of the hemorrhage must be identified. Identification of the bleeding site often includes a multidisciplinary approach, including practitioners from critical care, gastroenterology, radiology, and surgery. In general, the primary methods to locate the site of hemorrhage include CT and endoscopy. Advances in endoscopic localization have increased both the diagnostic and therapeutic yields of such therapy. Surgical intervention is generally reserved for those patients in whom hemodynamic instability precludes further diagnostic workup or those in whom the source of bleeding cannot be controlled with other modalities. In this review, we discuss the diagnostic workup and therapeutic management of life-threatening lower GI hemorrhage. This review contains 10 figures, 3 tables and 93 references Key words: BLEED criteria, colonic ischemia, colonoscopy, CT angiography, diverticular disease, lower gastrointestinal bleeding, mesenteric arteriography, nuclear scintigraphy, push enteroscopy, video capsule endoscopy

scholarly journals Lower GI Bleeding: An Update on Incidences and Causes

2019 ◽  
Vol 33 (01) ◽  
pp. 028-034
Author(s):  
Titilayo Adegboyega ◽  
David Rivadeneira
Keyword(s):  
Small Intestine ◽  
Gastrointestinal Tract ◽  
Gastrointestinal Bleeding ◽  
Vascular Malformations ◽  
Lower Gastrointestinal Bleeding ◽  
Morbidity And Mortality ◽  
Significant Source ◽  
Gi Bleeding ◽  
Lower Gastrointestinal Tract ◽  
Lower Gi Bleeding

AbstractBleeding from the lower gastrointestinal tract represents a significant source of morbidity and mortality. The colon represents the vast majority of the location of bleeding with only a much smaller incidence occurring in the small intestine. The major causes of lower gastrointestinal bleeding (LGIB) are from diverticulosis, vascular malformations, and cancer. We discuss the incidence and causes of LGIB.

scholarly journals Superior mesenteric artery dissection with prolonged abdominal angina treated by laparotomy, endarterectomy, patch angioplasty, and retrograde open mesenteric stenting: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Shinichi Tanaka ◽  
Atsushi Fukuda ◽  
Eisuke Kawakubo ◽  
Takuya Matsumoto
Keyword(s):  
Case Report ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Artery Dissection ◽  
Surgical Revascularization ◽  
Invasive Treatment ◽  
Case Presentation ◽  
Abdominal Angina ◽  
Patch Angioplasty ◽  
Superior Mesenteric Artery Dissection

Abstract Background Most patients with isolated superior mesenteric artery (SMA) dissection are successfully managed conservatively. However, some patients require more invasive treatment. Case presentation We herein describe a 45-year-old man with isolated SMA dissection. He initially underwent conservative treatment. However, because of persistent abdominal angina, we considered the need for surgical revascularization. He was successfully treated by endarterectomy, patch angioplasty, and retrograde open mesenteric stenting. The abdominal angina was stabilized thereafter. Conclusions The combination of endarterectomy, patch angioplasty, and retrograde open mesenteric stenting is useful for isolated SMA dissection, and long patency can be expected for some patients.

scholarly journals Etiological profile, gender difference and age group patterns of 415 patients presenting with lower gastrointestinal bleeding in the western region of Nepal

2015 ◽  
Vol 3 (2) ◽  
pp. 52-55
Author(s):  
Umid Kumar Shrestha
Keyword(s):  
Colon Cancer ◽  
Gender Difference ◽  
Gastrointestinal Bleeding ◽  
Lower Gastrointestinal Bleeding ◽  
Colon Polyp ◽  
Colon Polyps ◽  
Age Group ◽  
Gender And Age ◽  
Common Causes ◽  
Radiation Colitis

Background: Lower gastrointestinal bleeding (LGIB) is a common clinical condition associated with significant morbidity and mortality. The aims of our study were to determine the etiological profile, gender difference and age group patterns of LGIB in Nepal.Methods: A total of 415 consecutive patients presenting with LGIB from April 2011 to September 2014 underwent colonoscopy and the etiology of LGIB was determined. Each diagnosis was compared with respect to the gender and age group.Results: Among 415 LGIB patients (males 62.2%, females 37.8%), the different etiologies of LGIB were as following: hemorrhoid 35.2%, non-specific colitis 24.8%, colon polyp 18.3%, inflammatory bowel disease (IBD) 10.4%, colon cancer 6.5%, diverticulosis 1.7%, unknown 1.4%, upper gastrointestinal bleeding 1.2% and radiation colitis 0.5%. The overall LGIB was more common in male; however, colon polyps were diagnosed more commonly in female (p<0.001). Among LGIB patients, the hemorrhoid was more common in the age group of 30-49 years, colon polyp in 50-69 years, colon cancer in 70-84 years, and non-specific colitis and IBD in 16-29 years (p<0.001).Conclusion: Hemorrhoid and non-specific colitis were the common causes of LGIB in Nepal; colon polyp, IBD and colon cancer were the next common causes. More males presented with LGIB than females; however, colon polyp was diagnosed more in females, which needs to be explored further. When LGIB was presented after 50 years of age, the most likely causes were colon polyp and colon cancer; hence colonoscopy is recommended in all LGIB patients after 50 years.Journal of Advances in Internal Medicine 2014;3(2):52-55

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