- Heterotopic Pancreas: A Rare Cause of Gastrointestinal Bleeding in Children. [Journal Article]
- DDDig Dis Sci 2018 Feb 22
- Gastric and duodenal ischaemia after transarterial chemoembolisation for hepatocellular carcinoma: an unexpected but significant complication. [Journal Article]
- BCBMJ Case Rep 2018 Feb 21; 2018
- Transarterial chemoembolisation (TACE) is commonly used for unresectable intermediate-stage hepatocellular carcinoma (HCC). TACE is usually well-tolerated. We report a case of a patient who presented...
Transarterial chemoembolisation (TACE) is commonly used for unresectable intermediate-stage hepatocellular carcinoma (HCC). TACE is usually well-tolerated. We report a case of a patient who presented with a gastrointestinal bleed from TACE. A 64-year-old man presented with chronic hepatitis C cirrhosis and multifocal bilobar HCC. He had previously undergone multiple TACE sessions, radiofrequency ablation and stereotactic body radiation therapy. In the evening of his TACE procedure, he developed abdominal pain and haematemesis. An oesophagogastroduodenoscopy (OGD) showed non-bleeding oesophageal varices and ulcerations in the stomach and duodenum, with pathology demonstrating mucosal necrosis. The patient recovered and was discharged on omeprazole. While TACE is considered safe with most patients only experiencing postembolisation syndrome, vascular complications have been reported. In our patient, OGD revealed ulcerations, with biopsies confirming ischaemic ulceration. The likely aetiology was seepage of the embolic particles into neighbouring arteries. Patients should be carefully selected for TACE and monitored post procedure.
- Esophageal submucosal hematoma developed after endovascular surgery for unruptured cerebral aneurysm under general anesthesia: a case report. [Journal Article]
- JCJA Clin Rep 2017; 3(1):54
- CONCLUSIONS: Careful extubation and postoperative observation are required in patients receiving antiplatelet and anticoagulant therapy.
- Ductus Aneurysm Ruptured Into the Esophagus With Massive Bleeding. [Journal Article]
- ATAnn Thorac Surg 2018; 105(3):e109-e111
- We report a patient with life-threatening hematemesis caused by the rupture of a ductus aneurysm into the esophagus, which was successfully treated by coil embolism for the esophageal fistula through...
We report a patient with life-threatening hematemesis caused by the rupture of a ductus aneurysm into the esophagus, which was successfully treated by coil embolism for the esophageal fistula through the aorta and subsequent thoracic endovascular aortic replacement. Second-stage therapy was performed surgically after proactive antibiotic treatment and in consideration of the patient's improved general condition. This included debridement with drainage, aortic encasement with remnant aneurysmal wall, omentopexy, and jejunostomy. The esophagus was preserved, and satisfactory healing and natural closure of the fistula were achieved. Although repeated aspirations were later required for pleural fluid, such inflammatory complications finally subsided.
- An Unusual Cause of Haematemesis. [Journal Article]
- EJEur J Vasc Endovasc Surg 2018 Feb 14
- A traumatic hepatic artery pseudoaneurysm and arterioportal fistula, with severe diarrhea as the first symptom: A case report and review of the literature. [Journal Article]
- MMedicine (Baltimore) 2018; 97(7):e9893
- CONCLUSIONS: A penetrating abdominal stab wound is a rare cause of hepatic APFs, and occasionally leads to portal hypertension, the medical history and physical examination are the most important cornerstones of clinical diagnosis. Interventional radiology is essential for the diagnosis and treatment of an APF.
- 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.
- Carcinosarcoma of Stomach Confined to the Mucosa. [Journal Article]
- YAYonago Acta Med 2017; 60(4):246-250
- Carcinosarcoma is a malignant tumor composed of both epithelial and mesenchymal malignant tumor components. A 78-year-old man was transferred to our hospital because of hematemesis and tarry stool. A...
Carcinosarcoma is a malignant tumor composed of both epithelial and mesenchymal malignant tumor components. A 78-year-old man was transferred to our hospital because of hematemesis and tarry stool. An emergency gastrointestinal endoscopic examination revealed active bleeding from an ulcerative lesion on the posterior wall of the gastric body; endoscopic hemostasis was successfully performed. A gastrointestinal endoscopy performed two months later showed a polypoid lesion at the same place where the ulcer had been. The biopsy specimen was histologically diagnosed as well to moderately differentiated tubular adenocarcinoma. The patient underwent a laparoscopic distal gastrectomy with D2 lymph node dissection under a diagnosis of gastric adenocarcinoma. A 28 × 15 mm polypoid tumor was resected from the gastric body, and was found on microscopic examination to consist of both carcinoma and sarcoma components, showing atypical spindle cells, which were positive for α-smooth muscular actin, calponin, and h-caldesmon, but negative for CD34, CD117 (c-kit), desmin, and dog 1. These findings led to a diagnosis of gastric carcinosarcoma. The tumor was confined to the mucous membrane. Lymph node metastasis was found in one node and contained only the carcinoma component. The postoperative course was uneventful. The patient lived without recurrence for 2 years. Carcinosarcoma of the stomach is a rare tumor with high malignant potential and poor prognosis. Careful follow up is required for early detection of any recurrence.
- Phytotherapeutic Activities of Sanguisorba officinalis and its Chemical Constituents: A Review. [Journal Article]
- AJAm J Chin Med 2018 Feb 12; :1-20
- Sanguisorba officinalis Linne (S. officinalis, Rosaceae) has been used as a medicinal plant for the treatment of burns, hematemesis, melena, intestinal infections, and dermatitis for a long time in C...
Sanguisorba officinalis Linne (S. officinalis, Rosaceae) has been used as a medicinal plant for the treatment of burns, hematemesis, melena, intestinal infections, and dermatitis for a long time in China, Korea, and Japan. The therapeutic efficacy of this herb is intimately associated with its anti-oxidant, anti-inflammatory, antiviral, antifungal, hemostatic, and anticancer activities. Its root contains triterpenoid saponins (zigyuglycoside I: C[Formula: see text]H[Formula: see text]O[Formula: see text] and ziyuglycoside II: C[Formula: see text]H[Formula: see text]O8) and tannins (sanguiin H-6: C[Formula: see text]H[Formula: see text]O[Formula: see text]). It has been recently revealed that these active constituents of S. officinalis possess antiwrinkle properties without cytotoxicity. They also have anticancer effects by inducing apoptosis and cell cycle arrest. Moreover, they can inhibit proliferative tumorigenesis. The underlying mechanism involved in the pharmacological actions of these active constituents is mainly related to p38 MAPK signaling. Although various studies have reported its therapeutic activities and major chemical components, review articles that extensively organize various properties of S. officinalis and its major constituents are still scarce. Taken together, the objective of this paper is to provide overall pharmacological and phytochemical profiles of S. officinalis and its constituents (including ziyuglycoside I, ziyuglycoside II, and sanguiin H-6), and their potential roles in clinical applications for the treatment of inflammatory diseases, bleeding disorders, and cancer.
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- Preventing Rescue Surgeries by Endoscopic Clipping: A Valuable Resource in the Surgeon Toolbox. [Journal Article]
- JLJ Laparoendosc Adv Surg Tech A 2018 Feb 12
- CONCLUSIONS: The OTSC System can be a very successful treatment for iatrogenic or spontaneous GI leaks and bleeds. Treatment success is more likely in patients treated within 6 months of diagnosis and less likely to when used for palliation. It was also successfully used as bridging therapy in several patients.