- A rare cause of hematemesis. [Journal Article]
- GHGastroenterol Hepatol Bed Bench 2018; 11(2):172-173
- Initial Experience of Endoscopic Radiofrequency Waves Delivery to the Lower Esophageal Sphincter (Stretta Procedure) on Symptomatic Gastroesophageal Reflux Disease Post-Sleeve Gastrectomy. [Journal Article]
- OSObes Surg 2018 Jun 15
- CONCLUSIONS: Stretta did not improve GERD symptoms in patients post-LSG at short-term follow-up, and about 6.7% complication rate was reported. Patients were not satisfied despite the decrease in PPI dose.
- Methylene blue MMX® tablets for chromoendoscopy. Bioavailability, colon staining and safety in healthy volunteers undergoing a full colonoscopy. [Journal Article]
- CCContemp Clin Trials 2018 Jun 02; 71:96-102
- Methylene blue-MMX® tablets are proposed as an aid for detection and visualisation of adenomas and carcinomas in patients undergoing colonoscopy, by improving their detection rate and highlighting th...
Methylene blue-MMX® tablets are proposed as an aid for detection and visualisation of adenomas and carcinomas in patients undergoing colonoscopy, by improving their detection rate and highlighting the presence of the intestinal dysplastic lesions. Single total doses of 100 and 200 mg were administered to healthy volunteers undergoing a bowel cleansing preparation and a full colonoscopy to investigate the colonic staining. The pharmacokinetics of methylene blue and the safety after exposure to the tablets were also investigated. With 200 mg, the best staining, assessed as the sum of acceptable and good staining, was achieved in the ascending colon and rectosigmoid (75% subjects each), the transverse and the descending colon (approximately 63% each). Absence of staining or overstaining were reported for no colonic region of interest in any subject. Similar results were observed in the 100 mg dose group. Methylene blue blood concentrations reached a peak (Cmax) in a median time (Tmax) of 12 h with 100 mg and 16 h with 200 mg. AUC0-t was 10.7 ± 6.7 μg/mLxh after 100 mg and 25.2 ± 7.4 μg/mLxh after 200 mg. Half-life ranged between 9 and 22 h after the lower dose and between 6 and 26 h after the higher dose. The cumulative urinary excretion was about 28% after 100 mg and about 39% after 200 mg up to 60 h post-dose. The overall frequency of adverse events after single dose of the test product administered along with a bowel cleansing preparation was 39%, but only one was related to the test product: abnormal transaminases. The most frequent adverse event was a transient polyuria (17%). One serious adverse event (gastrointestinal haemorrhage) led the subject to study discontinuation and hospitalisation and another subject withdrew the study due to one adverse event (haematemesis). Either event was not related to methylene blue.
- [A case of meningeal carcinomatosis mimicking subarachnoid hemorrhage on MRI]. [Journal Article]
- RSRinsho Shinkeigaku 2018 Jun 01
- We report a case of meningeal carcinomatosis that needed to be distinguished from subarachnoid hemorrhage. A 67-year-old female with acute severe headache was admitted to a previous hospital. Since h...
We report a case of meningeal carcinomatosis that needed to be distinguished from subarachnoid hemorrhage. A 67-year-old female with acute severe headache was admitted to a previous hospital. Since high intensity signal was detected within the parietal cerebral sulci on the right side on brain FLAIR MRI, cerebral angiography was performed due to suspicion of subarachnoid hemorrhage. However, no vascular abnormality was observed. Then, cerebral spinal fluid was collected, which showed an increase in cell count, suggesting meningitis. She was transferred to our hospital for evaluation of neurological disease. After admission to our hospital, there was an episode of hematemesis. Upper gastrointestinal endoscopy was performed, and advanced gastric cancer was found. She was diagnosed as having meningeal carcinomatosis due to gastric cancer. Meningeal carcinomatosis should be considered in addition to subarachnoid hemorrhage when a patient with acute headache shows high intensity signal within the cerebral sulci on brain FLAIR MRI.
- Massive Hematemesis from a Splenic Artery Pseudoaneurysm Presenting Two Years after Penetrating Trauma. [Journal Article]
- CRCase Rep Radiol 2018; 2018:7473168
- Splenic artery pseudoaneurysms (PSA) are rare entities and far less common than true aneurysms of the splenic artery. The most common etiology is pancreatitis, recurrent either in the setting of chro...
Splenic artery pseudoaneurysms (PSA) are rare entities and far less common than true aneurysms of the splenic artery. The most common etiology is pancreatitis, recurrent either in the setting of chronic pancreatitis or as an episode of acute pancreatitis. Less common causes include trauma, peptic ulcer disease, or iatrogenic causes. Almost all of the trauma-related case reports have been due to blunt trauma. We believe this to be the first reported case of a splenic artery PSA presenting with massive hematemesis at a significant time frame after penetrating trauma. Successful transcatheter treatment was performed and alternative techniques are also discussed.
- Gastric Glomus Tumor: An Uncommon Source for an Acute Upper GI Bleed. [Journal Article]
- CRCase Rep Gastrointest Med 2018; 2018:7961981
- CONCLUSIONS: Gastric glomus tumors are rare solitary submucosal tumors for which preoperative diagnosis is challenging and can be confused with a GIST. Local resection with negative margins is the preferred treatment and the exact diagnosis relies heavily on histopathological examinations. Currently, there are no clear guidelines regarding the staging and malignant potential of glomus tumors of the stomach.
- Massive hematemesis after radiofrequency ablation of metastatic liver tumor with successful hemostasis achieved through transarterial embolization. [Journal Article]
- CIClin Imaging 2018 Mar 03; 51:192-195
- Hemorrhagic complications are the most common major complications that occur after radiofrequency ablation, but hematemesis as a complication after radiofrequency ablation for hepatic tumor has not b...
Hemorrhagic complications are the most common major complications that occur after radiofrequency ablation, but hematemesis as a complication after radiofrequency ablation for hepatic tumor has not been mentioned before. A hepatogastric fistula as a delayed complication is also rare. We present the case of a 77-year-old man with severe hematemesis that occurred 2 months after radiofrequency ablation of a liver metastasis of gastric cancer. A ruptured hepatic artery pseudoaneurysm and a hepatogastric fistula were confirmed through serial imaging examinations. The current case is reported in combination with 2 rare major complications after radiofrequency ablation of a liver tumor.
- Primary Aortoenteric Fistula after Nissen Fundoplication. [Journal Article]
- CCureus 2018 Mar 28; 10(3):e2386
- We present the rare case of a primary gastro-aortic fistula involving the native aorta and proximal stomach in a patient with a chronic gastric ulcer and prior history of Nissen fundoplication. Our c...
We present the rare case of a primary gastro-aortic fistula involving the native aorta and proximal stomach in a patient with a chronic gastric ulcer and prior history of Nissen fundoplication. Our case highlights the importance of keeping this rare and fatal condition as a differential diagnosis in patients with prior history of Nissen fundoplication surgery.
- Bilateral Caudate Nucleus Infarctions Following Upper Gastrointestinal Bleeding. [Journal Article]
- JSJ Stroke Cerebrovasc Dis 2018 May 24
- A 75-year-old woman presented with consciousness disturbance accompanied by hematemesis. Brain imaging revealed ischemia in the bilateral caudate nuclei and right cerebral watershed area due to steno...
A 75-year-old woman presented with consciousness disturbance accompanied by hematemesis. Brain imaging revealed ischemia in the bilateral caudate nuclei and right cerebral watershed area due to stenosis of the right anterior cerebral artery (ACA) and bilateral internal carotid arteries (ICA), and hypoperfusion in the right caudate nucleus. The patient's only symptom was abulia, which gradually resolved. Further brain scans showed that the ICA stenosis had improved, although the right ACA stenosis persisted. This was a rare case of bilateral caudate nucleus infarctions with a hemodynamic etiology.
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- Phytobezoar: A Brief Report with Surgical and Radiological Correlation. [Journal Article]
- CRCase Rep Surg 2018; 2018:5253162
- Gastrointestinal bezoars, collections of incompletely digested material within the alimentary tract, can present as a diagnostic challenge and should be considered in the differential diagnosis and m...
Gastrointestinal bezoars, collections of incompletely digested material within the alimentary tract, can present as a diagnostic challenge and should be considered in the differential diagnosis and management of small bowel obstruction, ischemic bowel, or bowel perforation. We present a case of a 37-year-old man with a distant history of laparotomy for superior mesenteric artery thrombosis requiring partial small bowel resection of the jejunum who presented with worsening abdominal pain, nausea, vomiting, and hematemesis. An abdominal computed tomography revealed dilated loops of small bowel with a transition point at the ileum, distal to his prior bowel anastomosis. He was managed initially nonoperatively, but persistent vomiting and worsening distention necessitated urgent exploratory laparotomy. During the procedure, a 4 cm by 3 cm phytobezoar was discovered at the midjejunum. The patient had an unremarkable postoperative course with no further symptoms at 1-year follow-up. Timely diagnosis and treatment of bezoar is essential to minimize patient complications.