Cameron lesions represent linear gastric erosions and ulcers on the crests of mucosal folds in the distal neck of a hiatal hernia(HH).Such lesions may be found in upto 50% of endoscopies performed for another indicati...Cameron lesions represent linear gastric erosions and ulcers on the crests of mucosal folds in the distal neck of a hiatal hernia(HH).Such lesions may be found in upto 50% of endoscopies performed for another indication.Though typically asymptomatic,these may rarely present as acute,severe upper gastrointestinal bleed(GIB).The aim is to report a case of a non-anemic 87-year-old female with history of HH and atrial fibrillation who presented with hematemesis and melena resulting in hypovolemic shock.Repeat esophagogastroduodenoscopy was required to identify multiple Cameron ulcers as the source.Endoscopy in a patient with HH should involve meticulous visualization of hernia neck and surrounding mucosa.Cameron ulcers should be considered in all patients with severe,acute GIB and especially in those with known HH with or without chronic anemia.展开更多
Surgical options developed to treat carotid artery stenosis have evolved in the last six decades,and studies have shown the superiority of carotid endarterectomy(CEA)compared to medical therapy.Similarly,as endovascul...Surgical options developed to treat carotid artery stenosis have evolved in the last six decades,and studies have shown the superiority of carotid endarterectomy(CEA)compared to medical therapy.Similarly,as endovascular therapy has evolved over the last two decades,studies refl ecting safety,feasibility,and equivalence of carotid artery stenting(CAS)to CEA have been replicated in several studies for intermediate to high surgical risk patients.However,since its inception,the field of CAS has been mired in several controversies and has been subject to intense scrutiny from multiple stakeholders within the field of medicine.This review discusses specifi cissues concerning CAS that are relevant in the current era.展开更多
文摘Cameron lesions represent linear gastric erosions and ulcers on the crests of mucosal folds in the distal neck of a hiatal hernia(HH).Such lesions may be found in upto 50% of endoscopies performed for another indication.Though typically asymptomatic,these may rarely present as acute,severe upper gastrointestinal bleed(GIB).The aim is to report a case of a non-anemic 87-year-old female with history of HH and atrial fibrillation who presented with hematemesis and melena resulting in hypovolemic shock.Repeat esophagogastroduodenoscopy was required to identify multiple Cameron ulcers as the source.Endoscopy in a patient with HH should involve meticulous visualization of hernia neck and surrounding mucosa.Cameron ulcers should be considered in all patients with severe,acute GIB and especially in those with known HH with or without chronic anemia.
文摘Surgical options developed to treat carotid artery stenosis have evolved in the last six decades,and studies have shown the superiority of carotid endarterectomy(CEA)compared to medical therapy.Similarly,as endovascular therapy has evolved over the last two decades,studies refl ecting safety,feasibility,and equivalence of carotid artery stenting(CAS)to CEA have been replicated in several studies for intermediate to high surgical risk patients.However,since its inception,the field of CAS has been mired in several controversies and has been subject to intense scrutiny from multiple stakeholders within the field of medicine.This review discusses specifi cissues concerning CAS that are relevant in the current era.
