- [Pancreatic arteriovenous malformation perforated into the common bile and pancreatic ducts:a case report]. [Journal Article]
- NSNihon Shokakibyo Gakkai Zasshi 2018; 115(11):1011-1017
- A 54-year-old man presented with melena and was conservatively monitored for duodenitis. He developed epigastric pain, and dynamic computed tomography revealed abnormal blood flow in the pancreatic h...
A 54-year-old man presented with melena and was conservatively monitored for duodenitis. He developed epigastric pain, and dynamic computed tomography revealed abnormal blood flow in the pancreatic head. The endoscopic retrograde cholangiography revealed that the common bile and pancreatic ducts were simultaneously enhanced, thereby indicating the perforation of an arteriovenous malformation into both ducts. Despite medical treatment, the epigastric pain rapidly worsened and therefore, pancreatoduodenectomy was performed. The present report suggests that if the patient's general condition permits, surgical resection should be actively considered for the treatment of symptomatic pancreatic arteriovenous malformation.
- Efficacy of second-look endoscopy in preventing delayed bleeding after endoscopic submucosal dissection of early gastric cancer. [Journal Article]
- ETExp Ther Med 2018; 16(5):3855-3862
- The present study aimed to evaluate whether second-look endoscopy (SLE) is able to prevent delayed bleeding after endoscopic submucosal dissection (ESD) of gastric carcinoma and to identify which typ...
The present study aimed to evaluate whether second-look endoscopy (SLE) is able to prevent delayed bleeding after endoscopic submucosal dissection (ESD) of gastric carcinoma and to identify which types of lesion require SLE. ESD of gastric cancer at the early stage was performed on 210 patients between October 2014 and September 2016. Mucosal damage-associated bleeding within 24 h after ESD was considered as delayed bleeding. The association of the characteristics of patients and lesions, as well as surgical factors, with the incidence of bleeding as a measure of outcome was analyzed. A total of 110 patients with melena and/or hematemesis underwent SLE on the second day following gastric ESD. Within the entire cohort (n=210), late delayed bleeding (LDB) was defined as hematemesis or melena occurring following second-look endoscopy. Early delayed bleeding (EDB) was defined as hematemesis or melena occurring from the end of ESD to second-look endoscopy, or as active or possible bleeding at the time of the second-look endoscopy was reported in 17 (8.1%) and 20 patients(9.5%), respectively. The median interval between late delayed bleeding and ESD was one day (range, 1-10 days). The incidence of late delayed bleeding was significantly decreased in the SLE group compared with that in the non-SLE group (4.5 vs. 12%, P=0.028). Multivariate analyses revealed that ulcer, flat gross type, lesion diameter (>2 cm), the resected tumor size of >40 mm and Helicobacter pylori infection were independently associated with late delayed bleeding after ESD, while flat gross type, ulcer, the resected tumor size of >40 mm and artificial ulcer diameter >3 cm were independently associated with early delayed bleeding. Thus, the data of the present study indicates that second-look endoscopy following gastric ESD may be useful in preventing post-ESD delayed bleeding and should be performed on the second day.
- A male Korean who was diagnosed with chronic enteropathy associated with SLCO2A1 (CEAS): case report with literature review. [Journal Article]
- BOBMJ Open Gastroenterol 2018; 5(1):e000223
- CONCLUSIONS: CEAS is not uniquely found in Japanese individuals. There are lots of similarities between CEAS and primary hypertrophic osteoarthropathy, the two entity may just be the two sides of one same coin. International and multidisciplined efforts are required to further study this complicated disorder.
- Treatment strategies for bleeding from gastroduodenal artery pseudoaneurysms complicating the course of chronic pancreatitis-A case series of 10 patients. [Journal Article]
- IJIndian J Gastroenterol 2018 Oct 30
- We analyzed our experience with management of gastroduodenal artery (GDA) pseudoaneurysms associated with chronic pancreatitis using a multidisciplinary approach. We treated 10 patients with GDA pseu...
We analyzed our experience with management of gastroduodenal artery (GDA) pseudoaneurysms associated with chronic pancreatitis using a multidisciplinary approach. We treated 10 patients with GDA pseudoaneurysms (all men, aged 24-62 year) who underwent treatment during April 1998 to December 2016. All had presented with recent hematemesis and/or melena. Hemodynamically, stable patients were initially subjected to transcatheter embolization or radiologically guided thrombin injection. Recurrence of bleeding within 48 h was taken as failure. Emergency surgery was done for hemodynamic instability and recurrent bleeding, and elective surgery was carried out as per specific indications. Ten interventional procedures were performed in nine patients, while one was directly subjected to surgery. Angioembolization was done in five patients (with success in four) and thrombin injection in five patients (including one with embolization failure; with success in three). Six patients underwent surgery, two on emergency basis, for hemodynamic instability and recurrent bleeding in one each, and four for definitive treatment of pancreatitis/associated complication. One patient died while the other nine survived and well with no recurrence of bleeding during follow up (6 months to 10 years). Management of GDA pseudoaneurysms requires a multidisciplinary approach. Pseudoaneurysms with narrow neck are suitable for thrombin injection while those with wide neck should be subjected to angioembolization. Emergency surgical treatment is reserved for non-surgical failures, and choice between trans-ductal or trans-cystic approach is based on the location of the aneurysm.
- Thrombolysis Using Tissue Plasminogen Activator: Experience from a Critical Care Setting. [Journal Article]
- IJIndian J Hematol Blood Transfus 2018; 34(4):723-726
- To describe the experience of thrombolysis using tissue plasminogen activator (tPA) in critically ill children admitted to the pediatric intensive care unit (PICU), retrospective review of medical re...
To describe the experience of thrombolysis using tissue plasminogen activator (tPA) in critically ill children admitted to the pediatric intensive care unit (PICU), retrospective review of medical records of all children (1 month-16 years), who were admitted in PICU since January 2014 to December 2017 and received systemic tPA for thrombolysis was done. Data was collected on a structured proforma and included thrombus location, tPA dose and duration, outcome (resolution, survival) and complications (bleeding). Total 9 patients (7 males, 2 females) received systemic tPA therapy for thrombolysis with mean age of 74.64 ± 69.58 months. Two patients had thrombus in femoral artery, 3 in IVC and 4 had intra-cardiac thrombosis. Median number of doses was 2 with a range of 1-5 doses. Complete resolution of the clot was noted in all except one patient. A standard starting dose of 0.01 mg/kg/h was used in all patients. Only one patient developed melena after TPA therapy which self-resolved. Systemic tPA therapy was very safe in pediatric critically ill patients and was effective for thrombolysis and did not show any adverse effects in children with varying underlying diagnosis.
- Yield of capsule endoscopy in obscure gastrointestinal bleeding: A comparative study between premenopausal and menopausal women. [Journal Article]
- WJWorld J Gastrointest Endosc 2018 Oct 16; 10(10):301-307
- CONCLUSIONS: PMW with suspected OGIB are less likely to have significant findings in CE. In MW DY, need for endoscopic treatment and rebleeding were significantly higher while time to rebleed was lower.
- A rare endoscopic appearance of granulomatosis with polyangiitis involving the intestine: a case report. [Case Reports]
- BGBMC Gastroenterol 2018 Oct 25; 18(1):154
- CONCLUSIONS: Biopsy of the black membrane revealed degenerative colonic mucosal tissues, while deep colonic biopsy revealed inflammatory granulation tissues. This has not been reported in previous documents.
- Reverse shoulder arthroplasty for fracture sequelae: Clinical outcome and prognostic factors. [Journal Article]
- JOJ Orthop Sci 2018 Oct 19
- CONCLUSIONS: Metaphyseal bone loss was unfavourable prognostic factors in patients with FS treated with RTSA. However, the Boileau classification did not serve as a prognostic criterion. Previous operative or conservative treatment had no influence on the outcome and scapular notching was associated with inferior clinical results.
- A Newborn with Gastric Hemangioma Treated Using Propranolol. [Journal Article]
- PGPediatr Gastroenterol Hepatol Nutr 2018; 21(4):341-346
- Gastric hemangiomas are rare benign vascular tumors that can cause severe gastrointestinal system bleeding. We presented the case of a neonate with fresh bleeding and melena from the orogastric tube ...
Gastric hemangiomas are rare benign vascular tumors that can cause severe gastrointestinal system bleeding. We presented the case of a neonate with fresh bleeding and melena from the orogastric tube and detected gastric hemangioma in esophagogastroduodenoscopic examination. Propranolol is widely used in treatment of cutaneous hemangiomas and non-gastric gastrointestinal system hemangiomas. However, the surgical approach is preferred for treating gastric hemangiomas, and there are few reports of gastric hemangiomas associated with non-surgical treatment. Gastric hemorrhage decreased with antacid and somatostatin treatment. Propranolol treatment was initiated before the surgery decision. After three weeks of treatment, we observed regression in the hemangioma with endoscopic evaluation. During the course of treatment, the patient's gastrointestinal system bleeding did not recur, and there were no side effects associated with propranolol.
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- Pediatric Esophageal Squamous Cell Carcinoma Staged With 18F-FDG PET/CT. [Journal Article]
- CNClin Nucl Med 2018; 43(12):946-948
- A 15-year-old boy with autism and swallowing dysfunction presented with a 6-month history of fatigue, intermittent abdominal pain, and weight loss. He later became febrile and had multiple episodes o...
A 15-year-old boy with autism and swallowing dysfunction presented with a 6-month history of fatigue, intermittent abdominal pain, and weight loss. He later became febrile and had multiple episodes of coffee ground emesis and melena stools. An upper endoscopy showed an esophageal mass, and a subsequent F-FDG PET/CT scan confirmed this finding. PET/CT also revealed metastatic disease in local lymph nodes, thus upstaging the patient and indicating poor prognosis. Consideration of these severe results and the patient's quality of life helped guide decision making in patient management, with the ultimate decision to pursue palliative care.