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Surgical treatments of recurrent small intestine metastatic melanoma manifesting with gastrointestinal hemorrhage and intussusception:A case report 被引量:1
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作者 Wen-Juan Fan Heng-Hui Cheng Wang Wei 《World Journal of Gastrointestinal Oncology》 SCIE 2023年第1期205-214,共10页
BACKGROUND Melanoma is the most aggressive form of skin cancer,with a tendency to metastasize to any organ.Malignant melanoma is the most frequent cause of skin cancer-related deaths worldwide.Small intestine cancers ... BACKGROUND Melanoma is the most aggressive form of skin cancer,with a tendency to metastasize to any organ.Malignant melanoma is the most frequent cause of skin cancer-related deaths worldwide.Small intestine cancers especially small intestine metastases are relatively rare.Small intestine metastases are seldom described and likely underdiagnosed.Intussusception is most common in pediatric age,and in adults are almost 5%of all cases.CASE SUMMARY A 75-year-old man with a history of acral malignant melanoma was admitted to the Gastroenterology Department of our hospital,complaining of intermittent melena for 1 mo.Magnetic resonance enterography showed partial thickening of the jejunal wall and formation of a soft tissue mass,indicating a neoplastic lesion with jejunojejunal intussusception.The patient underwent partial small bowel resection.Pathological findings and immunohistochemical staining indicated small intestine metastatic melanoma.The patient refused further anti-tumor treatment after the surgery.Ten months after the first surgery,the patient presented with melena again.Computed tomography enterography showed the anastomotic stoma was normal without thickening of the intestinal wall,and routine conservative treatment was given.Three months later,the patient developed melena again.The patient underwent a second surgery,and multiple metastatic melanoma lesions were found.The patient refused adjuvant anti-tumor treatment and was alive at the latest follow-up.CONCLUSION Small intestine metastatic melanoma should be suspected in any patient with a history of malignant melanoma and gastrointestinal symptoms. 展开更多
关键词 MELANOMA METASTASIS gastrointestinal hemorrhage INTUSSUSCEPTION Small bowel resection Case report
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Clinical features of AMPAR2 antibody-positive autoimmune encephalitis with gastrointestinal hemorrhage: a case report
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作者 Yi Bao Zhixuan Chen +1 位作者 Yong Liu Jun Chen 《Journal of Translational Neuroscience》 2023年第3期28-32,共5页
Objective:To describe the clinical features of autoimmune encephalitis complicated with gastrointestinal hemorrhage.Methods:The clinical data of one patient whose initial symptom was mental abnormality were collected ... Objective:To describe the clinical features of autoimmune encephalitis complicated with gastrointestinal hemorrhage.Methods:The clinical data of one patient whose initial symptom was mental abnormality were collected and the related examinations,such as cerebrospinal fluid and magnetic resonance imaging (MRI),were improved.Results: Cerebrospinal fluid examination found that anti-α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor(AMPAR)2 antibody was strongly positive,although the patient had repeated gastrointestinal hemorrhage but,after hormone combined with immunoglobulin treatment,the symptoms gradual-ly improved.Conclusion:Mental disorders are not all psychosis,and autoimmune encephalitis should not be ignored.It is very important to perform anti-AMPAR encephalitis antibody test;accurate diagnosis and timely treatment can improve the prognosis. 展开更多
关键词 gastrointestinal hemorrhage autoim-mune encephalitis α-Amino-3-hydroxy-5-methylisox-azole-4-propionic acid subtype glutamate receptor(AM-PAR) cerebrospinal fluid
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Anorectal hemangioma, a rare cause of lower gastrointestinal bleeding, treated with selective embolization: A case report
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作者 Barbora Pospisilova Jaromir Frydrych +3 位作者 Antonin Krajina JuliusÖrhalmi Ivana M Kajzrlikova Petr Vitek 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第8期2735-2741,共7页
BACKGROUND Anorectal hemangioma is a rare and frequently misdiagnosed cause of lower gastrointestinal(GI)bleeding.Here,we present a minimally invasive therapy with selective embolization.CASE SUMMARY A 21-year-old mal... BACKGROUND Anorectal hemangioma is a rare and frequently misdiagnosed cause of lower gastrointestinal(GI)bleeding.Here,we present a minimally invasive therapy with selective embolization.CASE SUMMARY A 21-year-old male patient experienced painless rectal bleeding since childhood and was treated for ulcerative colitis.Diagnostic studies later revealed specific characteristics for vascular lesions-anorectal hemangiomas.The severity of rectal bleeding caused symptomatic anemia and possible surgical treatment was asso-ciated with a high risk of fecal incontinence.Here,we present selective emboli-zation,a minimally invasive therapeutic approach that is proven as an alternative therapeutic method of choice.The patient significantly improved temporarily and had a small ischemic ulcer,which healed with a control colonoscopy and deve-loped no stenosis.CONCLUSION Awareness of the clinical and radiological features of GI hemangiomas may help improve diagnostics and avoid inappropriate therapeutic procedures. 展开更多
关键词 HEMANGIOMA Vascular malformation gastrointestinal hemorrhage Rectal bleeding Phlebolith Selective embolization Case report
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Intestinal tuberculosis with small bowel stricture and hemorrhage as the predominant manifestation: Three case reports
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作者 Gang Huang Kang-Kang Wu +2 位作者 Xiao-Na Li Jing-Hua Kuai Ai-Jun Zhang 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第1期248-256,共9页
BACKGROUND Intestinal tuberculosis is a chronic disease caused by Mycobacterium tuberculosis that mainly affects the ileum and cecum.Small bowel tuberculosis,characterized by predominant involvement of the small intes... BACKGROUND Intestinal tuberculosis is a chronic disease caused by Mycobacterium tuberculosis that mainly affects the ileum and cecum.Small bowel tuberculosis,characterized by predominant involvement of the small intestine,is an extremely rare condition with highly atypical clinical presentations,making diagnosis even more challenging.CASE SUMMARY We report three cases of small intestinal tuberculosis,two of the patients pre-sented primarily with abdominal pain,and one presented with gastrointestinal bleeding.All patients underwent blood tests and imaging examinations.Small bowel endoscopy(SBE)revealed that the main lesions in these patients were in-testinal stenosis or gastrointestinal bleeding caused by small intestinal ulcers.One patient ultimately underwent surgical treatment.Following a complex diagnostic process and comprehensive analysis,all patients were confirmed to have small intestinal tuberculosis and received standard antituberculosis treatment,leading to an improvement in their condition.CONCLUSION Patients with SBTs present with nonspecific symptoms such as abdominal pain,weight loss,and occasional gastrointestinal bleeding.Accurate diagnosis requires a thorough evaluation of clinical symptoms and various tests to avoid misdiagno-sis and complications. 展开更多
关键词 Intestinal tuberculosis gastrointestinal hemorrhage Small bowel endoscopy Case report
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Resuscitative endovascular balloon occlusion of the aorta in the treatment of severe hemorrhagic shock caused by upper gastrointestinal bleeding 被引量:1
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作者 Yu-lin Li Jun-yang Wang +3 位作者 Wen Han Tao Sun Kang Lyu Shan-xiang Xu 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2023年第3期247-249,共3页
Hemorrhagic shock is a life-threatening disease often encountered in emergency departments(EDs).Hemorrhagic shock caused by extensive bleeding from multiple sites is often associated with high mortality and morbidity.... Hemorrhagic shock is a life-threatening disease often encountered in emergency departments(EDs).Hemorrhagic shock caused by extensive bleeding from multiple sites is often associated with high mortality and morbidity.In recent years,resuscitative endovascular balloon occlusion of the aorta(REBOA)has been widely used in traumatic hemorrhagic shock and is considered to be an effective resuscitation measure.[1]Some studies reported that REBOA was also effective for non-traumatic hemorrhage.[2,3]In this study,we report a case of hemorrhagic shock caused by acute upper gastrointestinal bleeding that was successfully treated and received REBOA to obtain a transition time.This report may provide feasible options for emergency physicians,gastroenterologists,or surgeons to more actively treat refractory gastrointestinal bleeding. 展开更多
关键词 BALLOON hemorrhagIC gastrointestinal
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Endoscopic hemostasis techniques for upper gastrointestinal hemorrhage: A review 被引量:13
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作者 Hajime Anjiki Terumi Kamisawa +2 位作者 Masaki Sanaka Taro Ishii Yasushi Kuyama 《World Journal of Gastrointestinal Endoscopy》 CAS 2010年第2期54-60,共7页
Upper gastrointestinal hemorrhage (UGIH) is an urgent disease that is often encountered in daily medical practice. Endoscopic hemostasis is currently indispensable for the treatment of UGIH. Initially, when UGIH is su... Upper gastrointestinal hemorrhage (UGIH) is an urgent disease that is often encountered in daily medical practice. Endoscopic hemostasis is currently indispensable for the treatment of UGIH. Initially, when UGIH is suspected, a cause of UGIH is presumed from the medical interview and physical findings. After ample primary treatment, urgent endoscopy is performed. Many methods of endoscopic hemostasis are in wide use, including hemoclip, injection and thermo-coagulation methods. Although UGIH develops from a wide variety of diseases, such as esophageal varices and gastric and duodenal ulcer, hemostasis is almost always possible. Identification of the causative diseases, primary treatment and characteristic features of endoscopic hemostasis are needed to allow appropriate treatment. 展开更多
关键词 UPPER gastrointestinal hemorrhage Primary treatment ENDOSCOPIC HEMOSTASIS TECHNIQUES
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Gastrointestinal hemorrhage due to ileal metastasis from primary lung cancer 被引量:5
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作者 Wei Liu Wei Zhou +2 位作者 Wei-Lin Qi Ya-Dan Ma Yun-Yun Xu 《World Journal of Gastroenterology》 SCIE CAS 2015年第11期3435-3440,共6页
We report a patient with small intestinal metastasis from lung squamous cell carcinoma.A 66-year-old man who underwent radical lung cancer surgery was admitted to our hospital.Before starting his fifth cycle of chemot... We report a patient with small intestinal metastasis from lung squamous cell carcinoma.A 66-year-old man who underwent radical lung cancer surgery was admitted to our hospital.Before starting his fifth cycle of chemotherapy,he was found to have a positive fecal occult blood test.Abdominal computed tomography scan revealed an ileal tumor with mesenteric lymph node enlargement.He underwent laparoscopic resection of the involved small intestineand mesentery.Histopathological analysis confirmed metastasis from lung cancer.We conducted a review of the literature and 64 documented cases of small intestinal metastasis from lung cancer were found.The pathologic diagnosis,clinical presentation,site of metastasis,and survival time in these cases were reviewed. 展开更多
关键词 LUNG CANCER METASTASIS gastrointestinal hemorrhage
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Crohn's disease presenting as acute gastrointestinal hemorrhage 被引量:5
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作者 Amareshwar Podugu Kanwarpreet Tandon Fernando J Castro 《World Journal of Gastroenterology》 SCIE CAS 2016年第16期4073-4078,共6页
Severe gastrointestinal (GI) hemorrhage is a rare complication of Crohn&#x02019;s disease (CD). Although several surgical and non-surgical approaches have been described over the last 2 decades this complication s... Severe gastrointestinal (GI) hemorrhage is a rare complication of Crohn&#x02019;s disease (CD). Although several surgical and non-surgical approaches have been described over the last 2 decades this complication still poses significant diagnostic and therapeutic challenges. Given the relative infrequency of severe bleeding in CD, available medical literature on this topic is mostly in the form of retrospective case series and reports. In this article we review the risk factors, diagnostic modalities and treatment options for the management of CD presenting as GI hemorrhage. 展开更多
关键词 Crohn’ s disease RECURRENCE gastrointestinal hemorrhage Biologic agents Risk factors
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Multiple endocrine neoplasia type 1 with upper gastrointestinal hemorrhage and perforation:A case report and review 被引量:3
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作者 Ying-Ying Lu Feng Zhu +4 位作者 Da-Dao Jing Xie-Ning Wu Lun-Gen Lu Gen-Quan Zhou Xing-Peng Wang 《World Journal of Gastroenterology》 SCIE CAS 2013年第8期1322-1326,共5页
Multiple endocrine neoplasia type 1(MEN1) is a rare hereditary syndrome known to predispose subjects to endocrine neoplasms in a variety of tissues such as the parathyroid glands,pituitary gland,pancreas and gastroint... Multiple endocrine neoplasia type 1(MEN1) is a rare hereditary syndrome known to predispose subjects to endocrine neoplasms in a variety of tissues such as the parathyroid glands,pituitary gland,pancreas and gastrointestinal tract.We herein report a patient with a past history of pituitary adenoma,presenting with symptoms of chronic diarrhea for nearly one year and a sudden upper gastrointestinal hemorrhage as well as perforation without signs.Nodules in the duodenum and in the uncinate process and tail of pancreas and enlargement of the parathyroid glands were detected on preoperative imaging.Gastroscopy revealed significant ulceration and esophageal reflux diseases.The patient underwent subtotal parathyroidectomy and autotransplantation,pylorus-preserving pancreaticoduodenectomy and pancreatic tail resection and recovered well.The results observed in our patient suggest that perforation and bleeding of intestine might be symptoms of ZollingerEllison Syndrome in patients with MEN1. 展开更多
关键词 PITUITARY ADENOMA HYPERPARATHYROIDISM GASTRINOMA gastrointestinal hemorrhage PERFORATION
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Inverted Meckel's diverticulum as a cause of occult lower gastrointestinal hemorrhage 被引量:9
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作者 Omar M Rashid Joseph K Ku +2 位作者 Masayuki Nagahashi Akimitsu Yamada Kazuaki Takabe 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第42期6155-6159,共5页
Meckel's diverticulum is a common asymptomatic congenital gastrointestinal anomaly,but rarely it can present with hemorrhage.Over the last few years inverted Meckel's diverticulum has been reported in the lite... Meckel's diverticulum is a common asymptomatic congenital gastrointestinal anomaly,but rarely it can present with hemorrhage.Over the last few years inverted Meckel's diverticulum has been reported in the literature with increasing frequency as an occult source of lower gastrointestinal hemorrhage.Here,we report a case of a 54-year-old male,who was referred for surgical evaluation with persistent anemia and occult blood per rectum after a work up which failed to localize the source over 12 mo,including upper and capsule endoscopy,colonoscopy,enteroclysis,Meckel scan,and tagged nuclear red blood cell scan.An abdominal computed tomography scan showed a possible mid-ileal intussusception and intraluminal mass.During the abdominal exploration,inverted Meckel's diverticulum was diagnosed and resected.We review the literature,discuss the forms in which the disease presents,the diagnostic modalities utilized,pathological findings,and treatment.Although less than 40 cases have been reported in the English literature from 1978 to 2005,19 cases have been reported in the last 6 years alone(2006-2012) due to improved diagnostic modalities.Successful diagnosis and treatment of this disease requires a high index of clinical suspicion,which is becoming increasingly relevant to general gastroenterologists. 展开更多
关键词 Inverted Meckel's diverticulum gastrointestinal hemorrhage Lower gastrointestinal bleeding Intussusceptions
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Characteristics of nonvariceal upper gastrointestinal hemorrhage in patients with chronic kidney disease 被引量:3
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作者 Chang Seok Bang Yong Seop Lee +9 位作者 Yun Hyeong Lee Hotaik Sung Hong Jun Park Hyun Soo Kim Jin Bong Kim Gwang Ho Baik Yeon Soo Kim Jai Hoon Yoon Dong Joon Kim Ki Tae Suk 《World Journal of Gastroenterology》 SCIE CAS 2013年第43期7719-7725,共7页
AIM:To evaluate the clinical characteristics of nonvariceal upper gastrointestinal hemorrhage(NGIH)in patients with chronic kidney disease(CKD).METHODS:From 2003 to 2010,a total of 72 CKD patients(male n=52,72.2%;fema... AIM:To evaluate the clinical characteristics of nonvariceal upper gastrointestinal hemorrhage(NGIH)in patients with chronic kidney disease(CKD).METHODS:From 2003 to 2010,a total of 72 CKD patients(male n=52,72.2%;female n=20,27.8%)who had undergone endoscopic treatments for NGIH were retrospectively identified.Clinical findings,endoscopic features,prognosis,rebleeding risk factors,and mortality-related factors were evaluated.The characteristics of the patients and rebleeding-related data were recorded for the following variables:gender,age,alcohol use and smoking history,past hemorrhage history,endoscopic findings(the cause,location,and size of the hemorrhage and the hemorrhagic state),therapeutic options for endoscopy,endoscopist experience,clinical outcomes,and mortality.RESULTS:The average size of the hemorrhagic site was 13.7±10.2 mm,and the most common hemorrhagic site in the stomach was the antrum(n=21,43.8%).The most frequent method of hemostasis was combination therapy(n=32,44.4%).The incidence of rebleeding was 37.5%(n=27),and 16.7%(n=12)of patients expired due to hemorrhage.In a multivariate analysis of the risk factors for rebleeding,alcoholism(OR=11.19,P=0.02),the experience of endoscopists(OR=0.56,P=0.03),and combination endoscopic therapy(OR=0.06,P=0.01)compared with monotherapy were significantly related to rebleeding after endoscopic therapy.In a risk analysis of mortality after endoscopic therapy,only rebleeding was related to mortality(OR=7.1,P=0.02).CONCLUSION:Intensive combined endoscopic treatments by experienced endoscopists are necessary for the treatment of NGIH in patients with CKD,especially when a patient is an alcoholic. 展开更多
关键词 Chronic kidney diseases gastrointestinal hemorrhage ENDOSCOPY PEPTIC ULCER ALCOHOLICS
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Super-selective arterial embolization in the control of acute lower gastrointestinal hemorrhage 被引量:4
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作者 Liang-Shan Lv Jing-Tao Gu 《World Journal of Clinical Cases》 SCIE 2019年第22期3728-3733,共6页
BACKGROUND Acute gastrointestinal bleeding is an emergency condition that can lead to significant morbidity and mortality.Embolization is considered the preferred therapy in the treatment of lower gastrointestinal ble... BACKGROUND Acute gastrointestinal bleeding is an emergency condition that can lead to significant morbidity and mortality.Embolization is considered the preferred therapy in the treatment of lower gastrointestinal bleeding when it is unrealistic to perform the surgery or vasopressin infusion in this population.Treatment of acute lower gastrointestinal(GI)bleeding(any site below the ligament of Treitz)using this technique has not reached a consensus,because of the belief that the risk of intestinal infarction in this condition is extremely high.The purpose of the study is to evaluate the effectiveness and safety of this technique in a retrospective group of patients who underwent embolization for acute lower GI bleeding.AIM To evaluate the efficacy and safety of super-selective arterial embolization in the management of acute lower GI bleeding.METHODS A series of 31 consecutive patients with angiographically demonstrated small intestinal or colonic bleeding was retrospectively reviewed.The success rate and complication rate of super-selective embolization were recorded.RESULTS Five out of thirty-one patients(16.1%)could not achieve sufficiently selective catheterization to permit embolization.Initial control of bleeding was achieved in 26 patients(100%),and relapsed GI bleeding occurred in 1 of them at 1 wk after the operation.No clinically apparent bowel infarctions were observed in patients undergoing embolization.CONCLUSION Super-selective embolization is a safe therapeutic method for acute lower GI bleeding,and it is suitable and effective for many patients suffering this disease.Importantly,careful technique and suitable embolic agent are essential to the successful operation. 展开更多
关键词 Lower gastrointestinal BLEEDING EMBOLIZATION INFARCTION BOWEL hemorrhage SELECTIVE arterial EMBOLIZATION
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Gastric hyperplastic polyps causing upper gastrointestinal hemorrhage in a young adult 被引量:2
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作者 Brian J Secemsky Kenika R Robinson +2 位作者 Kumar Krishnan Kristina A Matkowskyj Barbara H Jung 《World Journal of Clinical Cases》 SCIE 2013年第1期25-27,共3页
Here, we report a case of a young man who presented with a significant upper gastrointestinal bleed treated by endoscopic removal of multiple hyperplastic polyps. Gastric hyperplastic polyps are a relatively uncommon ... Here, we report a case of a young man who presented with a significant upper gastrointestinal bleed treated by endoscopic removal of multiple hyperplastic polyps. Gastric hyperplastic polyps are a relatively uncommon cause of overt gastrointestinal bleeding. While most hyperplastic gastric polyps are asymptomatic, they may present with abdominal pain, iron def iciency anemia or gastric outlet obstruction. These polyps are associated with conditions such as Helicobacter pylori gastritis and atrophic autoimmune gastritis, which predispose the epithelium to chronic inf lammation and epithelial repair.The patient presented to Northwestern Memorial Hospital in July 2011. The polyps were resected by clip-assisted snare polypectomy. Histopathologic assessment of the resected polyps demonstrated multiple, nonulcerative hyperplastic polyps measuring 1.3-1.8 cm in size, without evidence of dysplasia or malignancy. This case describes a young adult patient with multiple, large gastric polyps causing overt gastrointestinal bleeding. This is a rare presentation in a young individual, as these polyps are typically identifi ed in patients older than 60 years of age and less commonly, pediatric populations. 展开更多
关键词 gastrointestinal hemorrhage Hyperplastic POLYPS ENDOSCOPY POLYP Therapeutic ENDOSCOPY
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Rare presentation of primary (AL) amyloidosis as gastrointestinal hemorrhage without systemic involvement 被引量:2
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作者 Mohammad F Ali Anik Patel +1 位作者 Stephanie Muller David Friedel 《World Journal of Gastrointestinal Endoscopy》 CAS 2014年第4期144-147,共4页
We are reporting a rare case of a patient with primary(AL) amyloidosis presenting with an acute non-varicealupper gastrointestinal hemorrhage in the absence ofother systemic involvement. The case report involves a58-y... We are reporting a rare case of a patient with primary(AL) amyloidosis presenting with an acute non-varicealupper gastrointestinal hemorrhage in the absence ofother systemic involvement. The case report involves a58-year-old woman with significant cardiac history andhereditary blood disorder who came in complaining ofabdominal pain and coffee-ground emesis for two days.Computed tomography(CT) scan of the abdomen andpelvis with contrast revealed segmental wall thickeningof the proximal jejunum with hyperdense, heterog-enous luminal content. Similar findings were evident inthe left lower small bowel region, suspicious for smallbowel hematoma and the possibility of intraluminalclots. Esophagogastroduodenoscopy performed postresuscitation showed punctate, erythematous lesionsthroughout the stomach as well as regions of smallbowel mucosa that appeared scalloped, ulcerated, andhemorrhaged on contact. Despite initial treatment for immunostain-positive focal cytomegalovirus gastritis, follow-up esophagogastroduodenoscopy after two months continued to demonstrate friable and irregular duodenal mucosa hinting at a different underlying etiol-ogy. Pathology reports from analyses of biopsy samples highlighted infiltration and expansion of the lamina pro-pria and submucosa. Subsequent staining with congo red/crystal violet and appropriate subtyping established the diagnosis of AL(kappa)-type amyloidosis. The sig-nificance of this case lies in the fact that our patient did not have the typically seen diagnostic systemic involvements-namely of heart and kidneys-usually seen in primary(AL) amyloidosis patients. It was the persis-tent endoscopic findings and biopsy results which gave clues to the physicians regarding the possibility of an abnormal protein-deposition entity. 展开更多
关键词 PRIMARY AMYLOIDOSIS AL AMYLOIDOSIS gastrointestinal hemorrhage Endoscopic finding Endo-scopic biopsy Upper gastrointestinal bleeding Amyloid deposition Gastric/intestinal MUCOSA Mucosal inflammation
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Upper gastrointestinal hemorrhage caused by superwarfarin poisoning 被引量:1
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作者 Zhao, Shu-Lei Li, Peng +2 位作者 Ji, Ming Zong, Ye Zhang, Shu-Tian 《World Journal of Gastroenterology》 SCIE CAS CSCD 2010年第13期1680-1682,共3页
Superwarfarins are a class of rodenticides. Gastrointestinal hemorrhage is a fatal complication of superwarfarin poisoning, requiring immediate treatment. Here, we report a 55-year-old woman with tardive upper gastroi... Superwarfarins are a class of rodenticides. Gastrointestinal hemorrhage is a fatal complication of superwarfarin poisoning, requiring immediate treatment. Here, we report a 55-year-old woman with tardive upper gastrointestinal hemorrhage caused by superwarfarin poisoning after endoscopic cold mucosal biopsy. 展开更多
关键词 ESOPHAGOGASTRODUODENOSCOPY Upper gastrointestinal hemorrhage Superwarfarin poisoning
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Urgent Endoscopy in Nonvariceal Upper Gastrointestinal Hemorrhage:A Retrospective Analysis 被引量:2
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作者 Jia-lun GUAN Ying-ying HAN +4 位作者 Dan FANG Mu-ru WANG Ge WANG De-an TIAN Pei-yuan LI 《Current Medical Science》 SCIE CAS 2022年第4期856-862,共7页
Objective:The role of urgent endoscopy in nonvariceal upper gastrointestinal hemorrhage(NVUGIH)remains controversial.We designed a retrospective study to compare the outcomes between urgent endoscopy(within 12 h)and n... Objective:The role of urgent endoscopy in nonvariceal upper gastrointestinal hemorrhage(NVUGIH)remains controversial.We designed a retrospective study to compare the outcomes between urgent endoscopy(within 12 h)and non-urgent endoscopy for patients with NVUGIH.Methods:A total of 540 hospitalized patients with NVUGIH were included in our study.Patients who received endoscopy within 12 h or after 12 h were divided into two groups,the urgent and non-urgent endoscopy groups,respectively.The clinical outcomes including rebleeding,mortality,endoscopic re-intervention,need for emergency surgery and interventional radiotherapy were compared between the groups.Patients with Glasgow-Blatchford scores(GBS)<12 and>12 were defined as the lower-and high-risk groups,respectively,and the predictors of rebleeding and mortality in both groups were analyzed individually.Results:Patients with NVUGIH in the urgent endoscopy group had a higher rate of rebleeding(27.6%vs.16.9%,P=0.003)and blood transfusion(73.2%vs.55.5%,P<0.001)than those in the non-urgent endoscopy group,while the mortality and the length of hospitalization were not significantly different between the groups(P>0.05).For lower-risk patients,urgent endoscopy was independently associated with a higher likelihood of rebleeding(adjusted OR:1.73,95%CI:1.03-2.88),while it was not associated with in-hospital mortality.However,the urgent need for endoscopy was not associated with rebleeding and in-hospital mortality in high-risk patients.Conclusion:Endoscopy within 12 h did not provide any advantage in the outcomes of patients with NVUGIH,and may even lead to an increased rebleeding rate in lower-risk patients. 展开更多
关键词 nonvariceal upper gastrointestinal hemorrhage urgent endoscopy Glasgow-Blatchford score REBLEEDING clinical outcomes
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Gastrointestinal hemorrhage in the setting of gastrointestinal cancer: Anatomical prevalence, predictors, and interventions 被引量:2
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作者 Mohamad A Minhem Ahmad Nakshabandi +2 位作者 Rabia Mirza Mohd Amer Alsamman Mark C Mattar 《World Journal of Gastrointestinal Endoscopy》 2021年第9期391-406,共16页
BACKGROUND Gastrointestinal hemorrhage(GIH)is a common complication with gastrointestinal cancers(GIC).There is no comprehensive research that examines GIH in different types of GIC.AIM To study the prevalence,predict... BACKGROUND Gastrointestinal hemorrhage(GIH)is a common complication with gastrointestinal cancers(GIC).There is no comprehensive research that examines GIH in different types of GIC.AIM To study the prevalence,predictors,and interventions of GIH based on the anatomical location of GIC.METHODS This is a retrospective analysis of the 2016-2018 National Inpatient Sample database,the largest inpatient care database in the United States.All adult inpatients(≥18-year-old)were included.ICD-10-CM codes were used to identify patients with GIH and GIC.Prevalence of GIH was obtained based on the anatomical location of GIC.Predictors of GIH in the GIC population were studied using multivariate analysis.Interventions including endoscopy were compared to the non-intervention group to determine the differences in inpatient mortality.RESULTS Out of a total of 18173885 inpatients,321622(1.77%)cases had a diagnosis of GIC.Within GIC patients,30507(9.5%)inpatients had GIH,which was significantly(P<0.001)more than the prevalence of GIH in patients without GIC(3.4%).The highest to lowest GIH rates are listed in the following order:Stomach cancer(15.7%),liver cancer(13.0%),small bowel cancer(12.7%),esophageal cancer(9.1%),colorectal cancer(9.1%),pancreatic cancer(7.2%),bile duct cancer(6.0%),and gallbladder cancer(5.1%).Within gastric cancer,the GIH rate ranged from 14.8%in cardia cancer to 25.5%in fundus cancer.Within small bowel cancers,duodenal cancers had a higher GIH rate(15.6%)than jejunal(11.1%)and ileal cancers(5.7%).Within esophageal cancers,lower third cancers had higher GIH(10.7%)than the middle third(8.0%)or upper third cancers(6.2%).When studying the predictors of GIH in GIC,socioeconomic factors such as minority race and less favorable insurances(Medicaid and self-pay)were associated with significantly higher GIH on multivariate analysis(P<0.01).Chemotherapy and immunotherapy were also identified to have a lower risk for GIH[odds ratios(OR)=0.74(0.72-0.77),P<0.001].Out of 30507 GIC inpatients who also had GIH,16267(53.3%)underwent an endoscopic procedure,i.e.,upper endoscopy or colonoscopy.Inpatient mortality was significantly lower in patients who underwent endoscopy compared to no endoscopy[5.5%vs 14.9%,OR=0.42(0.38-0.46),P<0.001].CONCLUSION The prevalence of GIH in patients with GIC varies significantly based on the tumor’s anatomical location.Endoscopy,which appears to be associated with a substantial reduction in inpatient mortality,should be offered to GIC patients with GIH.Nevertheless,the decision on intervention in the GIC population should be tailored to individual patient's goals of care,the benefit on overall care,and long-term survival. 展开更多
关键词 gastrointestinal hemorrhage gastrointestinal cancer ANATOMY Risk factors gastrointestinal endoscopy
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Gastrointestinal stromal tumor of appendix incidentally diagnosed by appendiceal hemorrhage 被引量:1
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作者 Kyu-Jong Kim Won Moon +3 位作者 Moo In Park Seun Ja Park Seung Hyun Lee Bong Kwon Chun 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第23期3265-3267,共3页
Gastrointestinal stromal tumor is rare, which arises from the mesenchymal tissues in the gastrointestinal tract, and it is extremely rare in the appendix. Only a few cases have been found in this location to date. Alt... Gastrointestinal stromal tumor is rare, which arises from the mesenchymal tissues in the gastrointestinal tract, and it is extremely rare in the appendix. Only a few cases have been found in this location to date. Although the annual incidence of lower gastrointestinal bleeding has been increasing, bleeding related to the appendix is quite rare. We herein present a very rare case of gastrointestinal stromal tumor incidentally found by appendiceal hemorrhage. 展开更多
关键词 gastrointestinal stromal tumor gastrointestinal tract APPENDIX Lower gastrointestinal bleeding Appendiceal hemorrhage
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Pseudoxantoma elasticum,as a repetitive upper gastrointestinal hemorrhage cause in a pregnant woman
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作者 Vedat Goral Dogan Demir +4 位作者 Yekta Tuzun Ugur Keklikci Huseyin Buyukbayram Kadim Bayan Asur Uyar 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第28期3897-3899,共3页
Pseudoxantoma elasticum is a rare, hereditary, multisystemic disease affecting the skin, eye, and cardiovascular system. A twenty-eight-year-old female has presented to emergency unit with the complaint of gastrointes... Pseudoxantoma elasticum is a rare, hereditary, multisystemic disease affecting the skin, eye, and cardiovascular system. A twenty-eight-year-old female has presented to emergency unit with the complaint of gastrointestinal hemorrhage. This patient, who had been monitored in the gastroenterology clinic more than 10 times in the past 8 years, noted a repetitive hemorrhage during her previous pregnancy in her history. The examination of the patient revealed the following signs and symptoms: atrophy in the epithelium of the retina pigment; typical angioid streaks and peau d'orange finding in the fundus; thinning of the retinal nerve fiber in OCT (optic coherence tomography); bilateral and reticular papillary lesions with yellowish- color in the neck region (plucked chicken appearance); presence of bleeding loci in fundus, and nephrocalcinosis in kidneys. In light of these symptoms, the patient was diagnosed with pseudoxantoma elasticum. Skin biopsy confirmed the pseudoxantoma elasticum diagnose. PXE is an uncommon, hereditary disease. Early diagnosis of pseudoxantoma elasticum cases, is important for minimalizing systemic complications and informing the other family members through genetic counseling. 展开更多
关键词 Pseudoxantoma elasticum Upper gastrointestinal hemorrhage
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Ileal Lymphangioma Presenting with Gastrointestinal Hemorrhage: A Case Report
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作者 Hong-qun ZHENG Ming LIU Bei-qiu HAN Qi-fan ZHANG 《Clinical oncology and cancer researeh》 CAS CSCD 2010年第1期67-68,共2页
Introduction Lymphangioma is a rare benign tumor of lymphatic vessel origin. The tumor often appears in the head and neck region at a young age and can occasionally be found in the abdomen of adults with protean degre... Introduction Lymphangioma is a rare benign tumor of lymphatic vessel origin. The tumor often appears in the head and neck region at a young age and can occasionally be found in the abdomen of adults with protean degrees of symptoms depending on the tumor size and location. How- ever, lymphangioma of the small intestine is extremely rare with only a few cases reported in the literature. As the tumor is not well-recog- nized, many patients with small intestine lymphangioma have been given an incorrect preoperative diagnosis. The ideal treatment for the disease is surgical excision, and the prognosis is comparatively good. In this paper, we report a rare case of ileal lymphangioma with gas- trointestinal hemorrhage preoperatively diagnosed using enteroscopy and treated with surgery. 展开更多
关键词 LYMPHANGIOMA gastrointestinal hemorrhage treatment.
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