- [Gastrointestinal bleeding due to arteriovenous malformation of the jejunum]. [Journal Article]
- RGRev Gastroenterol Peru 2017 Oct-Dec; 37(4):387-390
- A 23-year old male patient with no history of importance was admitted to Emergency because of dark red stools, tendency to lethargy and hypotension, with significant anemia proceeding to perform on b...
A 23-year old male patient with no history of importance was admitted to Emergency because of dark red stools, tendency to lethargy and hypotension, with significant anemia proceeding to perform on blood transfusion, upper endoscopy, abdominal angiotomography and arteriography with clinical diagnosis of Dieulafoy lesion motivated exploratory laparotomy finding injury vascular, the jejunum with active bleeding. The management of severe gastrointestinal bleeding with hemodynamic compromise and uncommon cause of arteriovenous malformation in the jejunum is discussed.
- Death and gastrointestinal bleeding complicate encephalomyelitis in mice with delayed appearance of CNS IgM after intranasal alphavirus infection. [Journal Article]
- JGJ Gen Virol 2018 Feb 01
- Central nervous system (CNS) infection of C57BL/6 mice with the TE strain of Sindbis virus (SINV) provides a valuable animal model for studying the pathogenesis of alphavirus encephalomyelitis. While...
Central nervous system (CNS) infection of C57BL/6 mice with the TE strain of Sindbis virus (SINV) provides a valuable animal model for studying the pathogenesis of alphavirus encephalomyelitis. While SINV TE inoculated intracranially causes little mortality, 20-30 % of mice inoculated intranasally (IN) died 8 to 11 days after infection, the period during which immune cells typically infiltrate the brain and clear infectious virus. To examine the mechanism behind the mortality, mice infected IN with SINV TE were monitored for evidence of neurological disease, and those with signs of severe disease (moribund) were sacrificed and tissues collected. Mice showing the usual mild signs of encephalomyelitis were concurrently sacrificed to serve as time-matched controls (sick). Sixty-eight per cent of the moribund mice, but none of the sick mice, showed upper gastrointestinal bleeding due to gastric ulceration. Clinical disease and gastrointestinal pathology could not be attributed to direct viral infection of tissues outside of the CNS, and brain pathology and inflammation were comparable in sick and moribund mice. However, more SINV antigen was present in the brains of moribund mice, and clearance of infectious virus from the CNS was delayed compared to sick mice. Lower levels of SINV-specific IgM and fewer B220+B cells were present in the brains of moribund mice compared to sick mice, despite similar levels of antiviral IgM and IgG in serum. These findings highlight the importance of the local antibody response in determining the outcome of viral encephalomyelitis and offer a model system for understanding individual variation in this response.
- Relationship between nurse staffing level and adult nursing-sensitive outcomes in tertiary hospitals of Korea: Retrospective observational study. [Journal Article]
- IJInt J Nurs Stud 2018 Jan 02; 80:155-164
- CONCLUSIONS: We demonstrated strong evidence for the relationships of nurse staffing level with six nursing-sensitive outcomes. We can use this study to improve nursing quality and to inform patients of the nursing quality of hospitals so they can choose hospitals with better nursing quality. The nurse staffing level should be optimized for better outcomes.
- Unexpected cause for duodenal obstruction: Brunner's gland hyperplasia. [Journal Article]
- PPathologica 2017; 109(4):414-417
- Brunner's gland hyperplasia is a rare benign lesion arising from the duodenum. It is often an incidental finding on endoscopy with the majority of patients being asymptomatic. It may also present wit...
Brunner's gland hyperplasia is a rare benign lesion arising from the duodenum. It is often an incidental finding on endoscopy with the majority of patients being asymptomatic. It may also present with various symptoms depending on location and tumor size, such as gastrointestinal bleeding, obstruction and abdominal pain. We report an unusual case of large Brunner's gland hyperplasia in 72-years old man, admitted to hospital for epigastric pain, recurrent vomiting and significantly weight loss. Upper endoscopy showed an obstructive submucosis tumour of the bulb. Abdominal computed tomography scan revealed a circumferential thickening and stenosing mass of the first part of the duodenum leading to severe obstruction. Though pre-operative biopsies were negative, imaging studies and endoscopy were strongly suggestive of malignancy and the patient underwent duodenocephalopancreatectomy. Brunner's gland hyperplasia may have unusual presentation, mimicking malignancy. Therefore, extensive pre-operative evaluation, including repetitive tumor biopsies, is necessary to avoid radical surgical procedure.
- Gastric metastasis from cervix carcer: a case report. [Journal Article]
- PPathologica 2017; 109(4):398-400
- Gastric metastasis by solid tumor cancer is a rare event. Concomitant metastases to other organs are frequent, so that this condition is often associated to a poor prognosis. Upper gastrointestinal b...
Gastric metastasis by solid tumor cancer is a rare event. Concomitant metastases to other organs are frequent, so that this condition is often associated to a poor prognosis. Upper gastrointestinal bleeding and anemia are the most common presenting symptoms. We present the case of a 81 years old women previously treated for cervix carcinoma showing later a stomach metastasis. The patient is alive and disease free 39 months after salvage gastrectomy. A radical surgery in selected patients could be useful for symptom palliation and prolonged survival.
- Upper Gastrointestinal Bleeding in Aluminium Phosphide Poisoning. [Journal Article]
- KUKathmandu Univ Med J (KUMJ) 2017 Jan.-Mar.; 15(57):99-101
- Aluminium phosphide is one of the most common poisons used for suicide in an agricultural country like India. Death is usually due to myocarditis which occurs within few hours of ingestion. There are...
Aluminium phosphide is one of the most common poisons used for suicide in an agricultural country like India. Death is usually due to myocarditis which occurs within few hours of ingestion. There are many late complications reported in medical literature, however toxic effects on the gastrointestinal system, particularly corrosive action leading to massive haemorrhage is rarely reported. A 30 year old male developed upper gastrointestinal bleeding on the second day after consumption of aluminium phosphide. An exploratory laprotomy was done followed by adhesinolysis, gastrostomy closure with feeding jejunostomy and drainage. He died after eight days of ingestion. The autopsy findings of this rarely reported case along with review of literature on corrosive action of Aluminium Phosphide is discussed.
- Need of Emergency Surgery in Elderly Patients with Upper Gastrointestinal Bleeding: Survival Analysis during 2009-2015. [Journal Article]
- DSDig Surg 2018 Feb 13
- CONCLUSIONS: Today, emergency surgery is seldom needed in the patients with UGIB. In comparison to the age-matched control population, long-term survival was significantly lower after UGIB in the elderly.
- Assessment of prognostic performance of Albumin-Bilirubin, Child-Pugh, and Model for End-stage Liver Disease scores in patients with liver cirrhosis complicated with acute upper gastrointestinal bleeding. [Journal Article]
- EJEur J Gastroenterol Hepatol 2018 Feb 12
- CONCLUSIONS: In our series, the ALBI score accurately predicted both in-stay and 30-day mortality, whereas CP and MELD scores could not predict these outcomes. All scores showed a fair prognostic prediction performance for first-year and global mortality. These results suggest that the ALBI score is particularly useful in the assessment of short-term outcomes, with a better performance than the most commonly used scores.
- NSAIDs and the small bowel. [Journal Article]
- COCurr Opin Gastroenterol 2018 Feb 12
- CONCLUSIONS: NSAID- related enteropathy is common and often presents subclinically. The most common presentation is anaemia, which may be less common in those on cyclo-oxygenase (COX)-2 inhibitors than nonselective NSAIDs. PPI use worsens NSAID enteropathy with more occult bleeding and ulceration and has been linked to gram-negative intestinal dysbiosis. If NSAID cessation is not possible, COX-2 inhibition without PPI therapy should be considered in patients with upper gastrointestinal risk factors. Mucoprotective agents such as misoprostol and rebamipide show promise and probiotics may have a future role.
New Search Next
- Dieulafoy's Lesion In The Oesophagus: A Rare Cause Of Upper Gastrointestinal Bleeding. [Journal Article]
- BCBMJ Case Rep 2018 Feb 07; 2018
- A Dieulafoy's lesion is defined as a dilated, aberrant, submucosal artery that erodes overlying mucosa in the absence of an underlying ulcer, aneurysm or intrinsic mural abnormality. It is a rare cau...
A Dieulafoy's lesion is defined as a dilated, aberrant, submucosal artery that erodes overlying mucosa in the absence of an underlying ulcer, aneurysm or intrinsic mural abnormality. It is a rare cause of upper gastrointestinal (GI) bleed with a very high mortality rate if it goes unidentified. It is most commonly located in the lesser curvature of the stomach but is extremely rare in the oesophagus. We are reporting a 55-year-old man who had massive haematemesis. Emergent endoscopy showed Dieulafoy's lesion in the distal oesophagus. It was sclerosed using endoscopic therapy. Patient's symptoms of GI bleeding resolved, and he was discharged home in a stable manner. Although a Dieulafoy's lesion is exceedingly rare in the oesophagus, it is associated with a high mortality if undiscovered. Its amenability to life-saving endoscopic therapy prompts us to keep this as a possible differential diagnosis of an upper GI bleed.