Search results for " gastrointestinal bleeding"

Management of Patients With Nonvariceal Upper Gastrointestinal Bleeding

2011

*Division of Gastroenterology, and Division of Clinical Epidemiology, McGill University and the McGill University Health Centre, Montreal, Quebec, Canada; INSERM IC-P 803, CHU du Bocage, Dijon, France; Universite de Bourgogne, Dijon, France; **Department of Medicine, Division of Gastroenterology, Farncombe Family igestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada; Guelph General Hospital, Guelph and McMaster University, Guelph, Ontario, Division of Gastroenterology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Division of Gastroenterology, Medical University Canada; f South Carlolina, Charleston, South Carolina; and the Departmen…

Impact of fluoroscopy on oral double-balloon enteroscopy: results of a randomized trial in 156 patients

2010

Background and study aims The routine utility of fluoroscopy during double-balloon enteroscopy (DBE) via the oral route has been not prospectively evaluated. Up to now, there have been no prospective randomized trials to assess whether fluoroscopy improves outcomes. The aim of this study was to assess the value of fluoroscopy during oral DBE. Patients and methods A total of 156 patients (88 men, 56.4 %) of mean (standard deviation [SD]) age 56 (19) years were randomly assigned to undergo oral DBE either with or without fluoroscopy. The majority of the patients had obscure gastrointestinal bleeding (n = 96, 62 %). The primary target criteria for the study were postpyloric insertion depth and…

Influence of Patient Selection on the Outcome of Capsule Endoscopy in Patients With Chronic Gastrointestinal Bleeding

2005

Background: In chronic gastrointestinal bleeding, success rates in the range of 48% to 76% have been reported for diagnosing clear bleeding sources using capsule endoscopy. The influence of patient selection on the numbers of positive findings yielded by capsule endoscopy is as yet unclear. Methods: From April 2001 to June 2003, capsule endoscopy was carried out in 74 of a total of 127 patients (58%) who presented for capsule endoscopy with a high suspicion of gastrointestinal bleeding in the small-bowel region. Seventy of the 74 patients were included in the analysis. This group of patients was divided into a study group (32 patients) and a post-study group (38 patients), and the two group…

Prevention of Upper Gastrointestinal Bleeding in Cirrhotic Patients

1987

The prevalence of varices in patients with cirrhosis is stated to be about 50% and the risk of variceal bleeding 40% with mortality ranging from 30% to 60%. Differences may be due to patient selection and diagnostic criteria. The death risk of first bleeding seems to be higher than that of subsequent episodes (Christensen et al. 1981; D’Amico et al. 1986), indicating that the first bleeding episode causes a selection.

STUDIO E VALIDAZIONE DI SISTEMI PER L’IDENTIFICAZIONE E IL MONITORAGGIO DI PARAMETRI BIOMEDICI ATTI ALLA PREVENZIONE DI EVENTI INDESIDERATI E ALL’ASS…

L’aumento delle patologie cronico-degenerative nella popolazione mondiale ha comportato un numero sempre maggiore di individui richiedenti assistenza sanitaria, generando, nell’ambito delle realtà ospedaliere, diverse problematiche relative al miglioramento della qualità di vita dei pazienti, ai costi e alla gestione di un numero sempre crescente di soggetti ammalati. Il trattamento sanitario e la ricerca di base si sono pertanto orientati verso la prevenzione delle condizioni che predispongono i soggetti ai peggioramenti clinici e ai ricoveri ospedalieri, puntando sia su nuovi sistemi indossabili di monitoraggio per individuare precocemente i segni di peggioramento, sia su sistemi che poss…

Small bowel gastrointestinal stromal tumor presenting with gastrointestinal bleeding in patient with type 1 Neurofibromatosis: Management and laparos…

2021

Highlights • A multidisciplinary team is mandatory for the correct management of hemorrhagic GIST and its complications. • There is a well-known association between type 1 Neurofibromatosis and GIST. • Type 1 Neurofibromatosis-GIST and sporadic GIST have different behaviour. • In case of localised and resectable GIST surgical treatment is the mainstay. • Laparoscopic approach, if performed correctly, is safe and effective with better short-term outcomes then open surgery.

Platelet count does not predict bleeding in cirrhotic patients: Results from the PRO-LIVER Study

2018

OBJECTIVES: Thrombocytopenia is a hallmark for patients with cirrhosis and it is perceived as a risk factor for bleeding events. However, the relationship between platelet count and bleeding is still unclear. METHODS: We investigated the relationship between platelet count and major or clinical relevant nonmajor bleedings during a follow-up of ∼4 years. RESULTS: A total of 280 cirrhotic patients with different degrees of liver disease (67% males; age 64±37 years; 47% Child–Pugh B and C) were followed up for a median of 1,129 (interquartile range: 800–1,498) days yielding 953.12 patient-year of observation. The annual rate of any significant bleeding was 5.45%/year (3.57%/year and 1.8…

Prevention of upper gastrointestinal bleeding from portal hypertension in cirrhosis: rationale for medical treatment.

1992

We updated meta-analysis and critical descriptive analysis of randomized clinical trials (RCTs) assessing the value of beta-blockers in preventing first bleeding (prophylactic) or rebleeding (therapeutic) and on survival of patients with cirrhosis. Both the methods of Peto-Mantel-Haenszel and DerSimonian-Laird were used to assess the heterogeneity and obtain cumulative estimates of treatment effects; the L'Abbé plot was also used for a visual assessment of heterogeneity in the direction of treatment effect. Seven prophylactic and nine therapeutic RCTs were analysed. beta-Blockers uniformly reduced the bleeding risk and revealed a trend toward improved survival in non-ascitic, well-compensat…

White Paper of Italian Gastroenterology: Delivery of services for digestive diseases in Italy: Weaknesses and strengths

2014

In 2011 the three major Italian gastroenterological scientific societies (AIGO, the Italian Society of Hospital Gastroenterologists and Endoscopists; SIED, the Italian Society of Endoscopy; SIGE, the Italian Society of Gastroenterology) prepared their official document aimed at analysing medical care for digestive diseases in Italy, on the basis of national and regional data (Health Ministry and Lombardia, Veneto, Emilia-Romagna databases) and to make proposals for planning of care. Digestive diseases were the first or second cause of hospitalizations in Italy in 1999–2009, with more than 1,500,000 admissions/year; however only 5–9% of these admissions was in specialized Gastroenterology un…

Gastric stromal tumor - a rare cause of an upper gastrointestinal bleeding

2001

Gastrointestinal stromal tumors (GISTs) are rare neoplasms arising from connective tissue elements of the gastrointestinal wall. They show a great heterogeneity with respect to their histogenetic, morphologic and prognostic characteristics. GISTs are known with myoid, neural or mixed features of differentiation. Clinical findings are gastrointestinal bleeding, abdominal pain and weight loss. We report on the case of a 50-year-old male patient who presented with melena and acute anemia (hemoglobin 10.5 g/dl). Esophagogastroduodenoscopy revealed a broad-based, centrally ulcerated polypoid formation of 3 cm in the gastric corpus as the cause of the upper gastrointestinal bleeding. Multiple end…