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Predictors of re-bleeding after endoscopic hemostasis for delayed post-endoscopic sphincterotomy bleeding 被引量:12
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作者 Mu-Hsien Lee Yung-Kuan Tsou +4 位作者 Cheng-Hui Lin Ching-Song Lee Nai-Jen Liu Kai-Feng Sung Hao-Tsai Cheng 《World Journal of Gastroenterology》 SCIE CAS 2016年第11期3196-3201,共6页
AIM: To predict the re-bleeding after endoscopic hemostasis for delayed post-endoscopic sphincterotomy(ES) bleeding.METHODS: Over a 15-year period, data from 161 patients with delayed post-ES bleeding were retrospecti... AIM: To predict the re-bleeding after endoscopic hemostasis for delayed post-endoscopic sphincterotomy(ES) bleeding.METHODS: Over a 15-year period, data from 161 patients with delayed post-ES bleeding were retrospectively collected from a single medical center. To identify risk factors for re-bleeding after initial successful endoscopic hemostasis, parameters before, during and after the procedure of endoscopic retrograde cholangiopancreatography were analyzed. These included age, gender, blood biochemistry, comorbidities, endoscopic diagnosis, presence of periampullary diverticulum, occurrence of immediate postES bleeding, use of needle knife precut sphincterotomy, severity of delayed bleeding, endoscopic features on delayed bleeding, and type of endoscopic therapy.RESULTS: A total of 35 patients(21.7%) had rebleeding after initial successful endoscopic hemostasis for delayed post-ES bleeding. Univariate analysis revealed that malignant biliary stricture, serum bilirubin level of greater than 10 mg/d L, initial bleeding severity, and bleeding diathesis were significant predictors of rebleeding. By multivariate analysis, serum bilirubin level of greater than 10 mg/d L and initial bleeding severity remained significant predictors. Re-bleeding was controlled by endoscopic therapy in a single(n = 23) or multiple(range, 2-7; n = 6) sessions in 29 of the 35 patients(82.9%). Four patients required transarterial embolization and one went for surgery. These five patients had severe bleeding when delayed post-ES bleeding occurred. One patient with decompensated liver cirrhosis died from re-bleeding.CONCLUSION: Re-bleeding occurs in approximately one-fifth of patients after initial successful endoscopic hemostasis for delayed post-ES bleeding. Severity of initial bleeding and serum bilirubin level of greater than 10 mg/d L are predictors of re-bleeding. 展开更多
关键词 DELAYED BLEEDING ENDOSCOPIC hemostasis ENDOSCOPIC sphincterotomy PREDICTORS re-bleeding
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Risk factors and outcomes of peptic ulcer bleed in a Pakistani population:A single-center observational study
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作者 Nazish Butt Muhammad Tayyab Usmani +4 位作者 Nimrah Mehak Saba Mughal Fakhar Ali Qazi-Arisar Ghulam Mohiuddin Gulzar Khan 《World Journal of Gastrointestinal Pharmacology and Therapeutics》 2024年第3期1-9,共9页
BACKGROUND Peptic ulcer disease(PUD)remains a significant healthcare burden,contributing to morbidity and mortality worldwide.Despite advancements in therapies,its prevalence persists,particularly in regions with wide... BACKGROUND Peptic ulcer disease(PUD)remains a significant healthcare burden,contributing to morbidity and mortality worldwide.Despite advancements in therapies,its prevalence persists,particularly in regions with widespread nonsteroidal antiinflammatory drugs(NSAIDs)use and Helicobacter pylori infection.AIM To comprehensively analyse the risk factors and outcomes of PUD-related upper gastrointestinal(GI)bleeding in Pakistani population.METHODS This retrospective cohort study included 142 patients with peptic ulcer bleeding who underwent upper GI endoscopy from January to December 2022.Data on demographics,symptoms,length of stay,mortality,re-bleed,and Forrest classification was collected.RESULTS The mean age of patients was 53 years,and the majority was men(68.3%).Hematemesis(82.4%)and epigastric pain(75.4%)were the most common presenting symptoms.Most patients(73.2%)were discharged within five days.The mortality rates at one week and one month were 10.6%and 14.8%,respectively.Re-bleed within 24 h and seven days occurred in 14.1%and 18.3%of patients,respectively.Most ulcers were Forrest class(FC)Ⅲ(72.5%).Antiplatelet use was associated with higher mortality at 7 and 30 d,while alternative medications were linked to higher 24-hour re-bleed rates.NSAID use was associated with more FCⅢulcers.Re-bleed at 24 h and 7 d was strongly associated with one-week or one-month mortality.CONCLUSION Antiplatelet use and rebleeding increase the risk of early mortality in PUD-related upper GI bleeding,while alternative medicines are associated with early rebleeding. 展开更多
关键词 Non variceal bleed MORTALITY re-bleed Forrest classification ANTIPLATELETS Alternative medicines
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Effectiveness of therapeutic barium enema for diverticular hemorrhage 被引量:2
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作者 Mizue Matsuura Masahiko Inamori +12 位作者 Atsushi Nakajima Yasuhiko Komiya Yumi Inoh Keigo Kawasima Mai Naitoh Yuji Fujita Akiko Eduka Noriyoshi Kanazawa Shiori Uchiyama Rie Tani Kennichi Kawana Setsuya Ohtani Hajime Nagase 《World Journal of Gastroenterology》 SCIE CAS 2015年第18期5555-5559,共5页
AIM:To evaluate the effectiveness of barium impaction therapy for patients with colonic diverticular bleeding.METHODS:We reviewed the clinical charts of patients in whom therapeutic barium enema was performed for the ... AIM:To evaluate the effectiveness of barium impaction therapy for patients with colonic diverticular bleeding.METHODS:We reviewed the clinical charts of patients in whom therapeutic barium enema was performed for the control of diverticular bleeding between August2010 and March 2012 at Yokohama Rosai Hospital.Twenty patients were included in the review,consisting of 14 men and 6 women.The median age of the patients was 73.5 years.The duration of the followup period ranged from 1 to 19 mo(median:9.8 mo).Among the 20 patients were 11 patients who required the procedure for re-bleeding during hospitalization,6patients who required it for re-bleeding that developed after the patient left the hospital,and 3 patients who required the procedure for the prevention of rebleeding.Barium(concentration:150 w%/v%)was administered per the rectum,and the leading edge of the contrast medium was followed up to the cecum by fluoroscopy.After confirmation that the ascending colon and cecum were filled with barium,the enema tube was withdrawn,and the patient’s position was changed every 20 min for 3 h.RESULTS:Twelve patients remained free of rebleeding during the follow-up period(range:1-19mo)after the therapeutic barium enema,including 9men and 3 women with a median age of 72.0 years.Re-bleeding occurred in 8 patients including 5 men and 3 women with a median age of 68.5 years:4developed early re-bleeding,defined as re-bleeding that occurs within one week after the procedure,and the remaining 4 developed late re-bleeding.The DFI(disease-free interval)decreased 0.4 for 12 mo.Only one patient developed a complication from therapeutic barium enema(colonic perforation).CONCLUSION:Therapeutic barium enema is effective for the control of diverticular hemorrhage in cases where the active bleeding site cannot be identified by colonoscopy. 展开更多
关键词 NON-STEROIDAL ANTIINFLAMMATORY drugs BARIUM ENEMA Diverticular HEMORRHAGE re-bleeding BARIUM IMPACTION
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Role of proton pump inhibitors in the management of peptic ulcer bleeding 被引量:1
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作者 Hwai-Jeng Lin 《World Journal of Gastrointestinal Pharmacology and Therapeutics》 CAS 2010年第2期51-53,共3页
Peptic ulcer bleeding is a serious medical problem with significant morbidity and mortality.Endoscopic therapy significantly reduces further bleeding,surgery and mortality in patients with bleeding peptic ulcers and i... Peptic ulcer bleeding is a serious medical problem with significant morbidity and mortality.Endoscopic therapy significantly reduces further bleeding,surgery and mortality in patients with bleeding peptic ulcers and is now recommended as the first hemostatic modality for these patients.The efficacy of large-dose proton pump inhibitor(PPI) therapy in reducing re-bleeding after endoscopic therapy has been supported by evidence derived from randomized controlled trials.It may be premature to recommend small-dose intravenous injection PPI after endoscopic hemostasis in patients with bleeding ulcers.An updated systematic review shows that PPI therapy before endoscopy significantly reduces the proportion with major stigmata and requirement for endoscopic therapy at index endoscopy.Some studies show that there is no significant difference between oral and intravenous PPIs in raising intragastric pH.However,clinical data is lacking in patients with peptic ulcer bleeding to date. 展开更多
关键词 PROTON pump inhibitor PEPTIC ULCER BLEEDING re-bleeding HEMOSTASIS Endoscopic therapy
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