Fast Medical Image Auto-segmentation for Bleeding Gastric Tissue Detection based on Deep DuS-KFCM Clustering

Detection and classification of gastric bleeding tissues are one of the challenging tasks in endoscopy image analysis. Lesion detection plays an important role in gastric cancer (GC) diagnosis and follow-up. Manual segmentation of endoscopy images is a very time-consuming task and subject to intra- and inter-rater variability. Accurate GB segmentation in abdominal sequences is an essential and crucial task for surgical planning and navigation in gastric lesion ablation. However, GB segmentation in endoscope is a substantially challenging work because the intensity values of gastric blood are similar to those of adjacent structures. Objective: In this paper the idea is to combine two parts: Neural Network and Fuzzy Logic--Hybrid Neuro-Fuzzy system. The objective of this manuscript is to provide an efficient way to segment the gastric bleeding lesion area. This work focuses on design and development of an automated diagnostic system using gastric bleeding cancer endoscopy images. Methods: In this paper, a coarse-to-fine method was applied to segment gastric bleeding lesion from endoscopy images, which consists of two stages including rough segmentation and refined segmentation. The rough segmentation is based on a kernel fuzzy C-means algorithm with spatial information (SKFCM) algorithm combined with spatial gray level co-occurrence matrix (GLCM) and the refined segmentation is implemented with deeplabv3+ (backbone with resnet50) algorithm to improve the overall accuracy. Results: Experimental results for gastric bleeding segmentation show that the method provides an accuracy of 87.9476% with specificity of 96.3343% and performs better than other related methods. Conclusions: The performance of the method was evaluated using two benchmark datasets: The GB Segmentation and the healthy datasets. Then use the gastric red spots (GRS) dataset to do the final test to verify weak bleeding symptoms. Our method achieves high accuracy in gastric bleeding lesion segmentation. The work describes an innovative way of using GLCM based textural features to extract underlying information in gastric bleeding cancer imagery. Modified deep DuS-KFCM endoscopy image segmentation method based on GLCM feature, The experimental results shown to be effective in image segmentation and has good performance of resisting noise, segmentation effect more ideal.

Oral Healthcare and Idiopathic Thrombocytopenic Purpura: Early Recognition, Dental Management and Case Report

A 47-year-old Caucasian man, in good general, oral and periodontal health, presented with a non-bleeding bluish lesion on the back of his tongue, presumably due to an ecchymotic area of traumatic origin which was left untreated. The day after, other ecchymotic-type lesions on the mucous membranes of the cheeks and the upper lip, a bleeding lesion at the apex of the tongue and gingivorrhagia, along with petechiae on the back, scalp, lower limbs and feet, occurred, with rapid clinical deterioration, requiring immediate hospitalization. Oral, dermatological, and hematological evaluations lead to idiopathic thrombocytopenic purpura (ITP) diagnosis and hydrocortisone prescription, with a complete recovery in the next few days.The presented case of ITP, with early intra-oral manifestations,aimed both to emphasize the role of oral healthcare workers in theearly recognition of ITP, which may be especially relevant for those cases with extremely fast platelet depletion, high risk of internal bleeding and consequent potentially fatal complications, and in the differential diagnosis of the diseasethat may be aided by the diagnostic protocol described, and to provide dentists with recommendations on oral care management of cases ofITP, both in dental and multi-disciplinary settings.

Recurrent massive bleeding from a small intestinal arteriovenous malformation after surgery for biliary atresia in an infant: a case report and literature review

Background Small intestinal arteriovenous malformation (AVM) can cause bleeding. Most small intestinal AVMs occur during adulthood, rarely in infancy. We report a case of an infant with hemorrhage due to small intestinal AVM early and recurrently after Kasai portoenterostomy (PE) for biliary atresia (BA). Case presentation A 51-day-old male infant was admitted to our institution for obstructive jaundice. Laparotomic cholangiography revealed BA (IIIb1μ), and Kasai PE was performed at 60 days of age. On postoperative day 17, he developed massive melena and severe anemia. Contrast-enhanced computed tomography (CT) revealed that the jejunum around the PE site was strongly enhanced with enhancing nodules in the arterial phase, and a wide area of the Roux limb wall was slightly enhanced in the venous phase. As melena continued, emergency laparotomy was performed. There were no abnormal macroscopic findings at the PE site except for a clot in the Roux limb 5 cm away from the PE site, and the Roux limb was resected 5 cm. On further investigation, a red spot was detected on the jejunal serosa 30 cm away from the Roux-en-Y anastomosis site. PE and wedge resection for the red spot were performed. Histopathologically, both specimens indicated AVM. He was jaundice-free 65 days after the first surgery. However, at 7 months of age, he developed massive melena again. Contrast-enhanced CT and upper gastrointestinal endoscopy revealed no bleeding lesions. Hemorrhagic scintigraphy showed a slight accumulation at the hepatic hilum prompting an emergency surgery. Intraoperative endoscopy detected a bleeding lesion at the PE site, and the Roux limb was resected (approximately 6 cm). Intraoperative frozen section analysis of the stump of the resected jejunum revealed no abnormal vessels. PE was performed, and permanent section analysis revealed an AVM in the resected jejunum. The postoperative course was uneventful without re-bleeding. Conclusions We experienced a case of recurrent massive bleeding from small intestinal AVM in an infant after surgery for BA. Intraoperative endoscopy and frozen section analysis helped identify the bleeding lesion and perform a complete resection of the small intestinal AVM, even after surgery, in the infant.

Fibroblastic meningioma mimicking an intracerebral hemorrhage: case report

ABSTRACT A 50-year-old woman presented to the emergency room complaining of severe headache. A non-contrasted head CT was obtained, which demonstrated a hyperdense image compatible with an intracerebral hemorrhage in the posterior region of the left temporal lobe. The patient displayed no neurological deficit during the consultation and a subsequent MRI showed a temporoinsular bleeding lesion that was suggestive of an atypic meningioma or a metastatic lesion. Afterwards, neck, chest and abdomen CT scans were performed, and the imaging ruled out a secondary neoplasm. The patient underwent surgical resection of the lesion, and a solid tumor was found with no bleeding associated. The pathology reported a WHO I fibroblastic meningioma.

Rare case of small intestine bleeding

We present a case of a healthy 59-year-old woman who presented for a capsule endoscopy to evaluate melaena and iron deficiency anaemia. She had previously underwent an oesophagogastroduodenoscopy and colonoscopy at an outside institution which were unremarkable. Capsule endoscopy showed an ulcerated, bleeding lesion likely in the duodenum. Differential diagnosis included adenocarcinoma, carcinoid tumour, lymphoma, gastrointestinal stromal tumour and metastatic disease. A push enteroscopy was performed after which showed an ulcerated mass in the third portion of the duodenum. Biopsies confirmed adenocarcinoma. Computed tomography of the abdomen showed no signs of distant metastasis and the patient was referred to surgery for evaluation. The patient underwent a pancreaticoduodenectomy, with resection of the mass and negative lymph nodes in all nine that were removed (T3N0). The patient was classified as stage II duodenal adenocarcinoma. Duodenal adenocarcinoma is a rare but clinically significant cause of small bowel bleeding.