Gastrointestinal Hemorrhage
Hematemesis
Duodenal Diseases
Endoscopy, Gastrointestinal
Arteriovenous Malformations
Ulcer
Intractable oesophageal variceal bleeding caused by splenic arteriovenous fistula: treatment by transcatheter arterial embolization. (1/106)
We describe a rare case of splenic arteriovenous fistula and venous aneurysm which developed after splenectomy in a 40-year-old woman who presented with epigastralgia, watery diarrhoea, repeated haematemesis and melaena caused by hyperkinetic status of the portal system and bleeding of oesophageal varices. It was diagnosed by computed tomography and angiography, and obliterated with giant Gianturco steel coils. (+info)Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. (2/106)
BACKGROUND: Anthranoid laxatives are the most commonly used purgatives in the therapy of acute and chronic constipation. Recent experimental data and a prospective cohort study provide evidence of a possible risk of anthranoid use for the development of colorectal neoplasms. MATERIALS AND METHODS: We performed a prospective case control study at the University of Erlangen to investigate the risk of anthranoid laxative use for the development of colorectal adenomas or carcinomas. A total of 202 patients with newly diagnosed colorectal carcinomas, 114 patients with adenomatous polyps, and 238 patients (controls) with no colorectal neoplasms who had been referred for total colonoscopy were studied. The use of anthranoid preparations was assessed by standardised interview, and endoscopically visible or microscopic melanosis coli was studied by histopathological examination. RESULTS: There was no statistically significant risk of anthranoid use for the development of colorectal adenomas (unadjusted odds ratio 1.0; 95% CI 0.5-1.9) or carcinomas (unadjusted odds ratio 1.0; 95% CI 0.6-1.8). Even after adjustment for the risk factors age, sex, and blood in the stools by logistic regression analysis the odds ratio for adenomas was 0.84 (95% CI 0. 4-1.7) and for carcinomas 0.93 (95% CI 0.5-1.7). Also, there were no differences between the patient and control groups for duration of intake. Macroscopic and high grade microscopic melanosis coli were not significant risk factors for the development of adenomas or carcinomas. CONCLUSION: Neither anthranoid laxative use, even in the long term, nor macroscopic or marked microscopic melanosis coli were associated with any significant risk for the development of colorectal adenoma or carcinoma. (+info)Further studies of canine von Willebrand's disease. (3/106)
Additional characterization of von Willebrand's disease (VWD) in a family of German shepherd dogs is presented. Genetic studies of three generations of affected dogs indicate that about 50% of the progeny are affected if one parent has VWD and about 60% if both parents have the defect. Some of these progeny manifested an incomplete form of VWD, suggesting autosomal dominant inheritance with variable expressivity. The disease become progressively less severe with advancing age and repeated pregnancies. Ristocetin-induced platelet aggregation was significantly reduced in VWD dogs as compared with normal, thrombopathic, and hemophilic carrier dogs. Immunodiffusion and electroimmunodiffusion studies with rabbit anticanine factor VII showed the level of factor VII-related antigen to be low in VWD dogs but present in increased amounts in hemophilic dogs. VWD affected dogs had markedly delayed hemostatic plug formation, but their plugs appeared normal by light and electron microscopy. Their platelet nucleotides, ATP/ADP ration, and platelet protein content were normal. Platelet and fibrinogen survival times with [75Se] selenomethionine were also normal, although platelets from VWD dogs incorporated more radioactivity than did those from normal dogs or from dogs with incomplete VWD. (+info)Comparative study between endoscopy and radiology in acute upper gastrointestinal haemorrhage. (4/106)
A total of 158 patients with acute upper gastrointestinal haemorrhage were studied, and the 53 patients on whom emergency endoscopies were performed were compared with the remaining 105. The cause of the bleeding was found in 51 of the endoscopy group and 39 of the control group. Three patients in the endoscopy group and 16 controls died. In the endoscopy group the correct preoperative diagnosis was made in all cases and there was less delay before operation. In the control group five patients had no diagnosis before operation, the preoperative diagnosis was wrong in nine, and five had laparotomies during which no cause of bleeding was found. The patients in the endoscopy group who did not have operations had a shorter stay in hospital than the controls. (+info)Acute colitis in the renal allograft recipient. (5/106)
Four renal allograft recipients with evidence of ischemic damage to the colon are presented and compared with 11 cases from 5 major series. Similarities in the patients included: deterioration of renal function, multiple immunosuppressive and antibiotic regimens, the use of cadaver renal allografts, and diagnostic and therapeutic measures requiring frequent enemas with barium and ion-exchange resins. Two of our patients underwent surgery for the removal of segments of necrotic colon after several weeks of fever and abdominal pain initially attributed to either acute rejection, viral infection, or pancreatitis. One patient had three days of melena and responded to non-operative therapy. The fourth patient developed ischemic colonic changes 10 weeks after allograft nephrectomy and was receiving no immunosuppression at the time. Broad spectrum antibiotics were used at various times in all patients. Early aggressive evaluation of gastrointestinal complaints--including barium enema, upper gastrointestinal series with small bowel follow-through, proctosigmoidoscopy or colonoscopy, and arteriography--is indicated, in view of the lethality of the complication of colonic ulceration. The clinical pictures presented emphasize the fact that recipients of renal allografts are commonly heir to many complications which may be considered rare in the normal population. (+info)Post-transfusion purpura: a heterogeneous syndrome. (6/106)
Three new patients with post-transfusion purpura (PTP) are described. As the manifestations in two differ significantly from those of previously reported cases, they serve to expand the definition of this syndrome. Although all 14 previously reported cases have occurred in Pl-A1-negative females, one of our patients was a Pl-A-negative male. Moreover, a female whose postrecovery platelets possessed the Pl-A1 antigen is described. Antiplatelet antibody activity was detected in all three patients by the 51Cr release test; in contrast, only one reacted in the complement (C) fixation assay. Serum obtained during the acute episode from the PlA1-positive patient reacted against platelets from four of 11 normals by C fixation and against platelets from 48 of 53 normals by 51Cr release, including five of nine Pl-A1-negative platelet samples. This case represents the first instance of PTP in which the platelet isoantibody was not specifically directed against the Pl-A1 antigen. These observations suggest that PTP may be a more heterogeneous disorder than previously realized. (+info)Radiation enteritis: a rare complication of the transverse colon in uterine cancer. (7/106)
Radiation therapy is a powerful method for the control of cancer. The utilization of abdominal or pelvic radiation has been extended, and the incidence of radiation enteritis appears to be increasing. The majority of the induced lesions is in the distal ileum, sigmoid colon, or rectum. Reported here is an unusual case of radiation enteritis which caused a severe sequelae of stricture in the transverse colon as a long-term effect of therapeutic irradiation for uterine cancer, and required a surgical resection. (+info)Cooling for acute ischemic brain damage (cool aid): an open pilot study of induced hypothermia in acute ischemic stroke. (8/106)
BACKGROUND AND PURPOSE: Hypothermia is effective in improving outcome in experimental models of brain infarction. We studied the feasibility and safety of hypothermia in patients with acute ischemic stroke treated with thrombolysis. METHODS: An open study design was used. All patients presented with major ischemic stroke (National Institutes of Health Stroke Scale [NIHSS] score >15) within 6 hours of onset. After informed consent, patients with a persistent NIHSS score of >8 were treated with hypothermia to 32+/-1 degrees C for 12 to 72 hours depending on vessel patency. All patients were monitored in the neurocritical care unit for complications. A modified Rankin Scale was measured at 90 days and compared with concurrent controls. RESULTS: Ten patients with a mean age of 71.1+/-14.3 years and an NIHSS score of 19.8+/-3.3 were treated with hypothermia. Nine patients served as concurrent controls. The mean time from symptom onset to thrombolysis was 3.1+/-1.4 hours and from symptom onset to initiation of hypothermia was 6.2+/-1.3 hours. The mean duration of hypothermia was 47.4+/-20.4 hours. Target temperature was achieved in 3.5+/-1.5 hours. Noncritical complications in hypothermia patients included bradycardia (n=5), ventricular ectopy (n=3), hypotension (n=3), melena (n=2), fever after rewarming (n=3), and infections (n=4). Four patients with chronic atrial fibrillation developed rapid ventricular rate, which was noncritical in 2 and critical in 2 patients. Three patients had myocardial infarctions without sequelae. There were 3 deaths in patients undergoing hypothermia. The mean modified Rankin Scale score at 3 months in hypothermia patients was 3.1+/-2.3. CONCLUSION: Induced hypothermia appears feasible and safe in patients with acute ischemic stroke even after thrombolysis. Refinements of the cooling process, optimal target temperature, duration of therapy, and, most important, clinical efficacy, require further study. (+info)Melena is a medical term that refers to the passage of black, tarry stools. It's not a specific disease but rather a symptom caused by the presence of digested blood in the gastrointestinal tract. The dark color results from the breakdown of hemoglobin, the protein in red blood cells, by gut bacteria and stomach acids.
Melena stools are often associated with upper gastrointestinal bleeding, which can occur due to various reasons such as gastric ulcers, esophageal varices (dilated veins in the esophagus), Mallory-Weiss tears (tears in the lining of the esophagus or stomach), or tumors.
It is essential to differentiate melena from hematochezia, which refers to the passage of bright red blood in the stool, typically indicating lower gastrointestinal bleeding. A healthcare professional should evaluate any concerns related to changes in bowel movements, including the presence of melena or hematochezia.
Gastrointestinal (GI) hemorrhage is a term used to describe any bleeding that occurs in the gastrointestinal tract, which includes the esophagus, stomach, small intestine, large intestine, and rectum. The bleeding can range from mild to severe and can produce symptoms such as vomiting blood, passing black or tarry stools, or having low blood pressure.
GI hemorrhage can be classified as either upper or lower, depending on the location of the bleed. Upper GI hemorrhage refers to bleeding that occurs above the ligament of Treitz, which is a point in the small intestine where it becomes narrower and turns a corner. Common causes of upper GI hemorrhage include gastritis, ulcers, esophageal varices, and Mallory-Weiss tears.
Lower GI hemorrhage refers to bleeding that occurs below the ligament of Treitz. Common causes of lower GI hemorrhage include diverticulosis, colitis, inflammatory bowel disease, and vascular abnormalities such as angiodysplasia.
The diagnosis of GI hemorrhage is often made based on the patient's symptoms, medical history, physical examination, and diagnostic tests such as endoscopy, CT scan, or radionuclide scanning. Treatment depends on the severity and cause of the bleeding and may include medications, endoscopic procedures, surgery, or a combination of these approaches.
Hematemesis is the medical term for vomiting blood. It can range in appearance from bright red blood to dark, coffee-ground material that results from the stomach acid digesting the blood. Hematemesis is often a sign of a serious condition, such as bleeding in the esophagus, stomach, or duodenum, and requires immediate medical attention. The underlying cause can be various, including gastritis, ulcers, esophageal varices, or tumors.
A diverticulum of the colon is a small sac or pouch that forms in the wall of the large intestine (colon). These sacs usually develop in areas where the blood vessels pass through the muscle layer of the colon, creating a weak spot that eventually bulges outward. Diverticula can occur anywhere along the length of the colon, but they are most commonly found in the lower part of the colon, also known as the sigmoid colon.
Diverticula themselves are not harmful and often do not cause any symptoms. However, when these sacs become inflamed or infected, it can lead to a condition called diverticulitis, which can cause pain, fever, nausea, vomiting, constipation, or diarrhea. Diverticulitis is usually treated with antibiotics and a liquid diet, but in severe cases, surgery may be required.
Risk factors for developing colonic diverticula include aging, obesity, smoking, low fiber intake, and lack of physical activity. Regular screening is recommended for individuals over the age of 50 to detect and prevent complications associated with diverticular disease.
Ileal neoplasms refer to abnormal growths in the ileum, which is the final portion of the small intestine. These growths can be benign or malignant (cancerous). Common types of ileal neoplasms include:
1. Adenomas: These are benign tumors that can develop in the ileum and have the potential to become cancerous over time if not removed.
2. Carcinoids: These are slow-growing neuroendocrine tumors that typically start in the ileum. They can produce hormones that cause symptoms such as diarrhea, flushing, and heart problems.
3. Adenocarcinomas: These are malignant tumors that develop from the glandular cells lining the ileum. They are relatively rare but can be aggressive and require prompt treatment.
4. Lymphomas: These are cancers that start in the immune system cells found in the ileum's lining. They can cause symptoms such as abdominal pain, diarrhea, and weight loss.
5. Gastrointestinal stromal tumors (GISTs): These are rare tumors that develop from the connective tissue of the ileum's wall. While most GISTs are benign, some can be malignant and require treatment.
It is important to note that early detection and treatment of ileal neoplasms can significantly improve outcomes and prognosis. Regular screenings and check-ups with a healthcare provider are recommended for individuals at higher risk for developing these growths.
Duodenal diseases refer to a range of medical conditions that affect the duodenum, which is the first part of the small intestine. Here are some examples of duodenal diseases:
1. Duodenitis: This is inflammation of the duodenum, which can cause symptoms such as abdominal pain, nausea, vomiting, and bloating. Duodenitis can be caused by bacterial or viral infections, excessive use of nonsteroidal anti-inflammatory drugs (NSAIDs), or chronic inflammation due to conditions like Crohn's disease.
2. Peptic ulcers: These are sores that develop in the lining of the duodenum, usually as a result of infection with Helicobacter pylori bacteria or long-term use of NSAIDs. Symptoms can include abdominal pain, bloating, and heartburn.
3. Duodenal cancer: This is a rare type of cancer that affects the duodenum. Symptoms can include abdominal pain, weight loss, and blood in the stool.
4. Celiac disease: This is an autoimmune disorder that causes the immune system to attack the lining of the small intestine in response to gluten, a protein found in wheat, barley, and rye. This can lead to inflammation and damage to the duodenum.
5. Duodenal diverticulosis: This is a condition in which small pouches form in the lining of the duodenum. While many people with duodenal diverticulosis do not experience symptoms, some may develop complications such as inflammation or infection.
6. Duodenal atresia: This is a congenital condition in which the duodenum does not form properly, leading to blockage of the intestine. This can cause symptoms such as vomiting and difficulty feeding in newborns.
Jejunal neoplasms refer to abnormal growths or tumors in the jejunum, which is the middle section of the small intestine. These neoplasms can be benign (non-cancerous) or malignant (cancerous). Malignant jejunal neoplasms are often aggressive and can spread to other parts of the body, making them potentially life-threatening.
There are several types of jejunal neoplasms, including:
1. Adenocarcinomas: These are cancerous tumors that develop from the glandular cells lining the jejunum. They are the most common type of jejunal neoplasm.
2. Carcinoid tumors: These are slow-growing neuroendocrine tumors that arise from the hormone-producing cells in the jejunum. While they are usually benign, some can become malignant and spread to other parts of the body.
3. Gastrointestinal stromal tumors (GISTs): These are rare tumors that develop from the connective tissue cells in the jejunum. They can be benign or malignant.
4. Lymphomas: These are cancerous tumors that develop from the immune system cells in the jejunum. They are less common than adenocarcinomas but can be aggressive and spread to other parts of the body.
5. Sarcomas: These are rare cancerous tumors that develop from the connective tissue cells in the jejunum. They can be aggressive and spread to other parts of the body.
Symptoms of jejunal neoplasms may include abdominal pain, bloating, diarrhea, weight loss, and bleeding in the stool. Treatment options depend on the type and stage of the neoplasm but may include surgery, chemotherapy, radiation therapy, or a combination of these approaches.
Jejunal diseases refer to a range of medical conditions that affect the jejunum, which is the middle section of the small intestine. These diseases can cause various symptoms such as abdominal pain, diarrhea, bloating, nausea, vomiting, and weight loss. Some examples of jejunal diseases include:
1. Jejunal inflammation or infection (jejunitis)
2. Crohn's disease, which can affect any part of the gastrointestinal tract including the jejunum
3. Intestinal lymphoma, a type of cancer that can develop in the small intestine
4. Celiac disease, an autoimmune disorder that causes damage to the small intestine when gluten is consumed
5. Intestinal bacterial overgrowth (SIBO), which can occur due to various reasons including structural abnormalities or motility disorders of the jejunum
6. Meckel's diverticulum, a congenital condition where a small pouch protrudes from the wall of the intestine, usually located in the ileum but can also affect the jejunum
7. Intestinal strictures or obstructions caused by scarring, adhesions, or tumors
8. Radiation enteritis, damage to the small intestine caused by radiation therapy for cancer treatment.
The diagnosis and management of jejunal diseases depend on the specific condition and its severity. Treatment options may include medications, dietary modifications, surgery, or a combination of these approaches.
Endoscopy of the digestive system, also known as gastrointestinal (GI) endoscopy, is a medical procedure that allows healthcare professionals to visually examine the inside lining of the digestive tract using a flexible tube with a light and camera attached to it, called an endoscope. This procedure can help diagnose and treat various conditions affecting the digestive system, including gastroesophageal reflux disease (GERD), ulcers, inflammatory bowel disease (IBD), and cancer.
There are several types of endoscopy procedures that focus on different parts of the digestive tract:
1. Esophagogastroduodenoscopy (EGD): This procedure examines the esophagus, stomach, and duodenum (the first part of the small intestine). It is often used to investigate symptoms such as difficulty swallowing, abdominal pain, or bleeding in the upper GI tract.
2. Colonoscopy: This procedure explores the large intestine (colon) and rectum. It is commonly performed to screen for colon cancer, as well as to diagnose and treat conditions like inflammatory bowel disease, diverticulosis, or polyps.
3. Sigmoidoscopy: Similar to a colonoscopy, this procedure examines the lower part of the colon (sigmoid colon) and rectum. It is often used as a screening tool for colon cancer and to investigate symptoms like rectal bleeding or changes in bowel habits.
4. Upper GI endoscopy: This procedure focuses on the esophagus, stomach, and duodenum, using a thin, flexible tube with a light and camera attached to it. It is used to diagnose and treat conditions such as GERD, ulcers, and difficulty swallowing.
5. Capsule endoscopy: This procedure involves swallowing a small capsule containing a camera that captures images of the digestive tract as it passes through. It can help diagnose conditions in the small intestine that may be difficult to reach with traditional endoscopes.
Endoscopy is typically performed under sedation or anesthesia to ensure patient comfort during the procedure. The images captured by the endoscope are displayed on a monitor, allowing the healthcare provider to assess the condition of the digestive tract and make informed treatment decisions.
Gastrointestinal endoscopy is a medical procedure that allows direct visualization of the inner lining of the digestive tract, which includes the esophagus, stomach, small intestine, large intestine (colon), and sometimes the upper part of the small intestine (duodenum). This procedure is performed using an endoscope, a long, thin, flexible tube with a light and camera at its tip. The endoscope is inserted through the mouth for upper endoscopy or through the rectum for lower endoscopy (colonoscopy), and the images captured by the camera are transmitted to a monitor for the physician to view.
Gastrointestinal endoscopy can help diagnose various conditions, such as inflammation, ulcers, tumors, polyps, or bleeding in the digestive tract. It can also be used for therapeutic purposes, such as removing polyps, taking tissue samples (biopsies), treating bleeding, and performing other interventions to manage certain digestive diseases.
There are different types of gastrointestinal endoscopy procedures, including:
1. Upper Endoscopy (Esophagogastroduodenoscopy or EGD): This procedure examines the esophagus, stomach, and duodenum.
2. Colonoscopy: This procedure examines the colon and rectum.
3. Sigmoidoscopy: A limited examination of the lower part of the colon (sigmoid colon) using a shorter endoscope.
4. Enteroscopy: An examination of the small intestine, which can be performed using various techniques, such as push enteroscopy, single-balloon enteroscopy, or double-balloon enteroscopy.
5. Capsule Endoscopy: A procedure that involves swallowing a small capsule containing a camera, which captures images of the digestive tract as it passes through.
Gastrointestinal endoscopy is generally considered safe when performed by experienced medical professionals. However, like any medical procedure, there are potential risks and complications, such as bleeding, infection, perforation, or adverse reactions to sedatives used during the procedure. Patients should discuss these risks with their healthcare provider before undergoing gastrointestinal endoscopy.
Duodenal neoplasms refer to abnormal growths in the duodenum, which is the first part of the small intestine that receives digestive secretions from the pancreas and bile duct. These growths can be benign or malignant (cancerous).
Benign neoplasms include adenomas, leiomyomas, lipomas, and hamartomas. They are usually slow-growing and do not spread to other parts of the body. However, they may cause symptoms such as abdominal pain, bleeding, or obstruction of the intestine.
Malignant neoplasms include adenocarcinomas, neuroendocrine tumors (carcinoids), lymphomas, and sarcomas. They are more aggressive and can invade surrounding tissues and spread to other parts of the body. Symptoms may include abdominal pain, weight loss, jaundice, anemia, or bowel obstruction.
The diagnosis of duodenal neoplasms is usually made through imaging tests such as CT scans, MRI, or endoscopy with biopsy. Treatment depends on the type and stage of the tumor and may include surgery, chemotherapy, radiation therapy, or a combination of these modalities.
Arteriovenous malformations (AVMs) are abnormal tangles of blood vessels that directly connect arteries and veins, bypassing the capillary system. This results in a high-flow and high-pressure circulation in the affected area. AVMs can occur anywhere in the body but are most common in the brain and spine. They can vary in size and may cause symptoms such as headaches, seizures, or bleeding in the brain. In some cases, AVMs may not cause any symptoms and may only be discovered during imaging tests for other conditions. Treatment options include surgery, radiation therapy, or embolization to reduce the flow of blood through the malformation and prevent complications.
A medical definition of an ulcer is:
A lesion on the skin or mucous membrane characterized by disintegration of surface epithelium, inflammation, and is associated with the loss of substance below the normal lining. Gastric ulcers and duodenal ulcers are types of peptic ulcers that occur in the gastrointestinal tract.
Another type of ulcer is a venous ulcer, which occurs when there is reduced blood flow from vein insufficiency, usually in the lower leg. This can cause skin damage and lead to an open sore or ulcer.
There are other types of ulcers as well, including decubitus ulcers (also known as pressure sores or bedsores), which are caused by prolonged pressure on the skin.
Capsule endoscopy is a medical procedure that uses a small, pill-sized camera to capture images of the digestive tract. The capsule is swallowed and transmits images wirelessly as it moves through the gastrointestinal (GI) tract, allowing doctors to examine the lining of the small intestine, which can be difficult to reach with traditional endoscopes.
The procedure is commonly used to diagnose and monitor conditions such as Crohn's disease, celiac disease, obscure gastrointestinal bleeding, and tumors in the small intestine. The images captured by the capsule are transmitted to a recorder worn by the patient, and then reviewed and analyzed by a healthcare professional.
Capsule endoscopy is generally considered safe and non-invasive, with few risks or side effects. However, it may not be suitable for everyone, including patients with swallowing difficulties, pacemakers, or certain gastrointestinal obstructions. It's important to consult with a healthcare provider to determine if capsule endoscopy is the right diagnostic tool for a particular condition.