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2.
Mymensingh Med J ; 31(4): 1206-1211, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36189574

RESUMO

Solitary rectal ulcer syndrome (SRUS) is an uncommon benign rectal disorder. Typically, young adults are affected and it is rare in children. Straining during defecation, self-induced trauma and paradoxical contraction of puborectalis muscle are the major contributing factors of this condition. Clinical features of SRUS are rectal bleeding, mucorrhoea, excessive straining during defecation, tenesmus, feeling of incomplete defecation and constipation. A complete and thorough history is most important for diagnosis of SRUS. Rectal bleeding may be misinterpreted as originating from an anal fissure caused by constipation or as other causes of rectal bleeding such as a juvenile polyp. The best and most accurate diagnostic method of SRUS is rectal biopsy. The major histological feature of SRUS is fibromuscular obliteration of the lamina propria. Avoiding straining, regular toilet habit, use of bulk laxatives, steroid and sucralfate enemas are the mainstay of treatment. Biofeedback mechanism is another treatment option. Because the clinical presentation varies, the diagnosis requires a high index of suspicion for both the clinician and the pathologist.


Assuntos
Doenças Retais , Úlcera , Criança , Constipação Intestinal/etiologia , Erros de Diagnóstico/efeitos adversos , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/terapia , Humanos , Laxantes/uso terapêutico , Doenças Retais/diagnóstico , Doenças Retais/etiologia , Doenças Retais/terapia , Esteroides/uso terapêutico , Sucralfato/uso terapêutico , Úlcera/diagnóstico , Úlcera/etiologia , Úlcera/terapia , Adulto Jovem
3.
Radiographics ; 42(6): 1829-1844, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36190848

RESUMO

Chronic hemorrhoidal disease is a common anorectal condition that leads to hemorrhoidal hyperplasia, which affects millions of people worldwide and is a significant medical and socioeconomic issue. Rectal bleeding is one of the main chronic symptoms. Recurrent rectal bleeding can alter an individual's quality of life and, more rarely, cause anemia. Pain is less common, occurring only in the event of complications such as congestive exacerbation, external hemorrhoidal thrombosis, or fissures. The most standard treatment involves dietary and hygiene measures, use of phlebotonic drugs, and nonsurgical treatment such as infrared photocoagulation or elastic band ligation. Excisional treatments such as hemorrhoidectomy and hemorrhoidopexy are the reference standards for treatment of hemorrhoidal disease. Embolization of the rectal arteries (ie, emborrhoid) has recently emerged as an effective treatment option, with few reported adverse effects, minimal blood loss, and a same-day hospital procedure. Hemorrhoid embolization is performed by using femoral or radial access. The inferior mesenteric artery and then the superior rectal arteries are catheterized with a microcatheter. Embolization can be performed by using different agents. Studies have shown improvement in symptoms and high technical success rates after treatment. The basic principles of hemorrhoid embolization that must be understood to achieve effective treatment, including those related to patient evaluation, the arterial anatomy, basic embolization, and published results, are reviewed. An invited commentary by Thompson and Kelley is available online. ©RSNA, 2022.


Assuntos
Hemorroidas , Artérias , Hemorragia Gastrointestinal/diagnóstico por imagem , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/terapia , Hemorroidas/complicações , Hemorroidas/cirurgia , Humanos , Qualidade de Vida , Reto/diagnóstico por imagem , Resultado do Tratamento
5.
Arq Gastroenterol ; 59(3): 365-369, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36102433

RESUMO

BACKGROUND: Suspicion of food protein-induced proctocolitis based on empirical understanding of rectal bleeding can lead to misdiagnosis. OBJECTIVE: to verify clinical and evaluative characteristics of patients who presented neonatal rectal bleeding and were on a restricted cow's milk diet. METHODS: A cross-sectional retrospective study included patients followed up in a tertiary care center, who presented rectal bleeding in the neonatal period. The analyzed data included gender, gestational age, type of delivery, use of antibiotics during the last trimester of pregnancy, use of parenteral nutrition before the first manifestation, use of mechanical ventilation, initial clinical manifestations associated with rectal bleeding, diet before the first manifestation, period of elimination diet, oral food challenge (OFC) results and symptoms presented in cases of positive OFC. Fisher's exact test and Mann-Whitney test were used to analyze the data. The level of significance was set to 5%. RESULTS: Forty-two patients were selected: 30 preterm infants, 34 cesarean deliveries, 10 exclusively breastfed patients before rectal bleeding. Median age at OFC was 6.3 months old. Median of length of the elimination period before OFC was 5.9 months. OFC was negative in 33/42 (79%) patients and positive in 9/42 (21%). There was no association between OFC results and the evaluated data. The main symptom observed in patients with positive OFC was blood in stools. CONCLUSION: OFC was negative in most cases of suspected cow's milk allergy due to rectal bleeding in neonates, most of them with a history of prematurity.


Assuntos
Hipersensibilidade a Leite , Proctocolite , Estudos Transversais , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Hipersensibilidade a Leite/complicações , Hipersensibilidade a Leite/diagnóstico , Proctocolite/complicações , Proctocolite/etiologia , Estudos Retrospectivos
6.
Arq Gastroenterol ; 59(3): 434-438, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36102444

RESUMO

BACKGROUND: In natural history of cirrhosis, variceal bleeding is one of the earliest decompensations to happen, and, if adequately managed, survival is improved. Gastric varices have challenges in management due to their location, size and propensity to bleed. The N-butyl 2-cyanoacrylate (NBC) glue application has emerged as definitive therapy in bleeding gastric varices. Here we present our experience with use of NBC in management of gastric and difficult cases of esophageal varices. METHODS: A total of 75 patients underwent NBC glue application for varices which included 69 patients with gastric varices and six patients with esophageal varices. All the procedures were done with flexible endoscope and sclerotherapy needle after due precautionary measures. RESULTS: Hemostasis was varices in all patients after endotherapy. The average quantity of glue used was 2.75±0.95 mL. Complete obliteration with single session of NBC application was achieved in 55 patients. Re-bleeding occurred in five patients within 5 days of index event. 20 patients had in-hospital mortality but none was related to gastrointestinal bleeding. 6-week all-cause mortality was 26 (35%). CONCLUSION: Glue therapy with NBC is a life saving therapy in patients with bleeding gastric varices and esophageal varices not amenable to endoscopic variceal ligation or sclerotherapy.


Assuntos
Embucrilato , Varizes Esofágicas e Gástricas , Varizes , Cianoacrilatos/uso terapêutico , Embucrilato/uso terapêutico , Varizes Esofágicas e Gástricas/complicações , Varizes Esofágicas e Gástricas/terapia , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/terapia , Humanos , Índia , Resultado do Tratamento , Varizes/complicações
7.
Medicine (Baltimore) ; 101(36): e30410, 2022 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-36086775

RESUMO

Few studies have focused on assessing the usefulness of scoring systems such as the Rockall score (RS), Glasgow-Blatchford score (GBS), and AIMS65 score for risk stratification and prognosis prediction in peptic ulcer bleeding patients. This study aimed to assess scoring systems in predicting clinical outcomes of patients with peptic ulcer bleeding. A total of 682 peptic ulcer bleeding patients who underwent esophagogastroduodenoscopy between January 2013 and December 2017 were found eligible for this study. The area under the receiver-operating characteristic curve (AUROC) of each score was calculated for predicting rebleeding, hospitalization, blood transfusion, and mortality. The median age of patients was 64 (interquartile range, 56-75) years. Of the patients, 74.9% were men, and 373 underwent endoscopic intervention. The median RS, GBS, and AIMS65 scores were significantly higher in patients who underwent endoscopic intervention than in those who did not. The AUROC of RS for predicting rebleeding was significantly higher than that of GBS (P = .022) or AIMS65 (P < .001). GBS best predicted the need for blood transfusion than either pre-RS (P = .013) or AIMS65 (P = .001). AIMS65 score showed the highest AUROC for mortality (0.652 vs. 0.622 vs. 0.691). RS was significantly associated with rebleeding (odds ratio, 1.430; P < .001) and overall survival (hazard ratio, 1.217; P < .001). The RS, GBS, and AIMS65 scoring systems are acceptable tools for predicting clinical outcomes in peptic ulcer bleeding. RS is an independent prognostic factor of rebleeding and overall survival.


Assuntos
Hemorragia Gastrointestinal , Úlcera Péptica , Idoso , Feminino , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera Péptica/complicações , Úlcera Péptica/diagnóstico , Úlcera Péptica Hemorrágica/diagnóstico , Úlcera Péptica Hemorrágica/terapia , Medição de Risco , Índice de Gravidade de Doença
8.
Crit Care Nurs Clin North Am ; 34(3): 303-309, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36049849

RESUMO

Gastroesophageal variceal (GEV) bleeding is one of the most fatal complications of cirrhosis and can result in increased morbidity and mortality rates. This discussion focuses on management of acute gastrointestinal bleeding caused by esophageal and gastric varices and measures aimed at prevention of an initial or secondary GEV bleed.


Assuntos
Varizes Esofágicas e Gástricas , Hipertensão Portal , Varizes Esofágicas e Gástricas/etiologia , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/terapia , Humanos , Hipertensão Portal/complicações , Cirrose Hepática/complicações
9.
Eur J Gastroenterol Hepatol ; 34(10): 1090-1097, 2022 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-36062499

RESUMO

BACKGROUND AND AIM: The aim of this study was to evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of portal hypertension caused by schistosomiasis. METHODS: This study included 43 patients with schistosomiasis-induced portal hypertension treated with TIPS in our institution from December 2015 to May 2021. The demographic, imaging, clinical and follow-up data of patients were recorded retrospectively to evaluate the efficacy and safety of the procedure. RESULTS: All patients were successfully implanted with stents to establish shunt, and 90.7% of the patients were in good postoperative condition with no complications. After TIPS, the Yerdel grade of portal vein thrombosis decreased, and the portal pressure gradient decreased from 27.0 ± 4.9 mmHg to 11.3 ± 3.8 mmHg (P < 0.001). Bleeding was effectively controlled, with a postoperative rebleeding rate of 9.3%, which was an 87.9% reduction from the preoperative rate. The cumulative incidence of postoperative refractory ascites, shunt dysfunction, overt hepatic encephalopathy (OHE) and death were all similar to those of TIPS for nonschistosomiasis portal hypertension. There were no differences in liver and kidney function and blood coagulation indexes before and 3 months after TIPS. Albumin was identified as an independent risk factor for mortality after TIPS for schistosomal liver fibrosis. CONCLUSION: TIPS can be used as a well-tolerated and effective treatment for schistosomiasis-induced portal hypertension, effectively reduce portal pressure gradient and improve portal vein thrombosis.


Assuntos
Varizes Esofágicas e Gástricas , Hipertensão Portal , Derivação Portossistêmica Transjugular Intra-Hepática , Esquistossomose , Trombose Venosa , Varizes Esofágicas e Gástricas/complicações , Varizes Esofágicas e Gástricas/cirurgia , Hemorragia Gastrointestinal/etiologia , Humanos , Hipertensão Portal/complicações , Hipertensão Portal/cirurgia , Derivação Portossistêmica Transjugular Intra-Hepática/efeitos adversos , Derivação Portossistêmica Transjugular Intra-Hepática/métodos , Estudos Retrospectivos , Esquistossomose/complicações , Esquistossomose/diagnóstico , Esquistossomose/cirurgia , Resultado do Tratamento , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/etiologia , Trombose Venosa/cirurgia
10.
Pediatrics ; 150(4)2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-36082608

RESUMO

A 15-year-old-boy with Noonan syndrome and status post orthoptic heart transplant developed mixed mitral valve disease and underwent mechanical mitral valve replacement 6 months before presentation with acute respiratory distress. He developed massive pulmonary hemorrhage that required veno-venous extracorporeal membrane oxygenation (ECMO) support. He had a prolonged anticoagulation free ECMO course of 4 weeks, with ongoing recurrent pulmonary hemorrhage and underwent several rounds of coil embolization of aortopulmonary collaterals. ECMO course was complicated by significant nasopharyngeal bleeding that required embolization of the sphenopalatine artery. Shortly after decannulation, he developed massive gastrointestinal and peritoneal hemorrhage that was treated by embolization of the left gastric artery and a branch of the internal iliac artery. His bleeding was attributed to neo-angiogenesis. Initial treatment with propranolol was unsuccessful. Subsequent treatment with interferon α 2b demonstrated efficacy, but severe neutropenia required cessation of therapy. Because functional alterations of the rat sarcoma virus-mitogen activated protein kinase signaling pathway and protein tyrosine phosphatase nonreceptor type (PTPN11) mutations in Noonan syndrome are known to be associated with neo-angiogenesis, we used the mitogen-activated protein kinase inhibitor selumetinib as a gene-targeted therapy with the hope of controlling bleeding and inhibiting neo-angiogenesis. After initiation of selumetinib, bleeding stopped and allowed the patient to be discharged from the hospital on dipyridamole as antiplatelet prophylaxis for his mechanical mitral valve. He had no further bleeding episodes through 1 year after hospital discharge.


Assuntos
Síndrome de Noonan , Benzimidazóis , Dipiridamol , Hemorragia Gastrointestinal/tratamento farmacológico , Hemorragia Gastrointestinal/etiologia , Humanos , Interferon-alfa , Masculino , Proteínas Quinases Ativadas por Mitógeno , Síndrome de Noonan/complicações , Síndrome de Noonan/tratamento farmacológico , Propranolol , Proteínas Tirosina Fosfatases , Proteínas Proto-Oncogênicas p21(ras)
11.
Niger J Clin Pract ; 25(9): 1580-1583, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36149222

RESUMO

Background: Colonoscopy is an important procedure in the management of colorectal diseases. During a colonoscopy, one can visualize the mucosa of the large bowel and perform therapeutic procedures. Aim: The aim of this study is to review the indications and findings of colonoscopy in our center. Data on age, gender, indications, and findings at endoscopy were extracted from the endoscopy unit register. Patients and Methods: The study is a retrospective descriptive one and included all patients who underwent colonoscopy between June 2017 to December 2019 at the endoscopy unit of Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. Data on age, gender, indications, and findings at endoscopy were extracted from the endoscopy unit register. The data obtained were analyzed using the Statistical Package for the Social Sciences (SPSS) statistical software version 20. Results: One hundred and twenty-five patients had a colonoscopy during the period under review with a male to female ratio of 1.9:1. The age range of the patients was 3 to 85 years and the mean age was 46.7 ± 16.7 The most common indications for colonoscopy in our center were lower gastrointestinal bleeding (40 (32%)), followed by suspected colonic tumors (37 (29.6%)), and hemorrhoids (18 (14.4%)). The commonest findings were hemorrhoids (50 (40%)), colonic tumors (25 (20%)), and colitis (21 (16.8%)). Conclusion: A colonoscopy is an effective tool in the management of colorectal diseases. Lower gastrointestinal bleeding was the commonest indication for colonoscopy in our center and hemorrhoids and colorectal tumors were the commonest findings.


Assuntos
Doenças do Colo , Neoplasias do Colo , Neoplasias Colorretais , Hemorroidas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Doenças do Colo/diagnóstico , Colonoscopia/métodos , Feminino , Hemorragia Gastrointestinal/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Estudos Retrospectivos , Adulto Jovem
12.
Acta Med Indones ; 54(3): 456-458, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36156475

RESUMO

Obscure gastrointestinal bleeding is defined as recurrent or persistent gastrointestinal bleeding in the setting of normal upper and lower endoscopies. There are reported use of numerous pharmacological agents to halt the bleeding, including oestrogen. We report a case of middle age gentleman with multiple comorbidities, presented with life threatening gastrointestinal bleeding. He underwent bidirectional endoscopies and mesenteric angiogram, but failed to localise the bleeding. Red blood cell scintigraphy showed numerous bleeding points in small and large bowels. A 5-day oral high dose oestrogen was prescribed in view of difficulty to manage the bleeding, in which the hemostasis was ultimately achieved.


Assuntos
Angiodisplasia , Endoscopia Gastrointestinal , Estrogênios , Hemorragia Gastrointestinal/etiologia , Humanos , Masculino , Pessoa de Meia-Idade
13.
World J Gastroenterol ; 28(33): 4773-4786, 2022 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-36156923

RESUMO

Mortality in cirrhosis is mostly associated with the development of clinical decompensation, characterized by ascites, hepatic encephalopathy, variceal bleeding, or jaundice. Therefore, it is important to prevent and manage such complications. Traditionally, the pathophysiology of decompensated cirrhosis was explained by the peripheral arterial vasodilation hypothesis, but it is currently understood that decompensation might also be driven by a systemic inflammatory state (the systemic inflammation hypothesis). Considering its oncotic and nononcotic properties, albumin has been thoroughly evaluated in the prevention and management of several of these decompensating events. There are formal evidence-based recommendations from international medical societies proposing that albumin be administered in individuals with cirrhosis undergoing large-volume paracentesis, patients with spontaneous bacterial peritonitis, those with acute kidney injury (even before the etiological diagnosis), and those with hepatorenal syndrome. Moreover, there are a few randomized controlled trials and meta-analyses suggesting a possible role for albumin infusion in patients with cirrhosis and ascites (long-term albumin administration), individuals with hepatic encephalopathy, and those with acute-on-chronic liver failure undergoing modest-volume paracentesis. Further studies are necessary to elucidate whether albumin administration also benefits patients with cirrhosis and other complications, such as individuals with extraperitoneal infections, those hospitalized with decompensated cirrhosis and hypoalbuminemia, and patients with hyponatremia.


Assuntos
Varizes Esofágicas e Gástricas , Encefalopatia Hepática , Síndrome Hepatorrenal , Peritonite , Albuminas/uso terapêutico , Ascite/tratamento farmacológico , Ascite/terapia , Varizes Esofágicas e Gástricas/complicações , Hemorragia Gastrointestinal/etiologia , Encefalopatia Hepática/tratamento farmacológico , Síndrome Hepatorrenal/etiologia , Humanos , Cirrose Hepática/tratamento farmacológico , Peritonite/microbiologia
14.
Rev Med Suisse ; 18(786): 1228-1229, 2022 Jun 15.
Artigo em Francês | MEDLINE | ID: mdl-36172991

RESUMO

Adherence to international guidelines limits the potentially deleterious consequences for patients with upper gastrointestinal bleeding (UGIB). We report the case of 81-year-old patient admitted for UGIB due to a stomach ulcer (Forrest IIb), with a high risk of rebleeding. Antiaggregation was stopped for 8 days which contrasts with international guidelines that recommend stopping treatment only for 3 to 5 days. Fortunately, he did not present any cardiovascular complication during his stay (near miss). In addition, the patient was left fasting for several days, which necessitated parenteral nutrition, resulting in diabetic decompensation and an extended length of stay.


Assuntos
Hemorragia Gastrointestinal , Úlcera Gástrica , Idoso de 80 Anos ou mais , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/terapia , Hospitalização , Humanos , Masculino
15.
Ulus Travma Acil Cerrahi Derg ; 28(10): 1531-1533, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36169473

RESUMO

Dieulafoy lesions (DLs) are dilated submucosal arterial structures visualized on endoscopy as bleeding foci on the superficial mucosa without erosion or ulceration. DLs account for 1-5.8% of acute non-variceal upper gastrointestinal bleeding cases. A 72-year-old male patient with known Alzheimer's disease and coronary artery disease, being followed up at a nursing home, presented to our emergency department with foul-smelling, loose, and tarry stool. Esophagogastroduodenoscopy revealed a 3 mm DL immediately adjacent to the Z line in the distal esophagus, demonstrating a fresh blood clot without the appearance of a surrounding ulcer. Two endoscopic hemo-clips were applied to this lesion. The patient was monitored at the intensive care unit for the following 2 days and later transferred to internal medicine inpatient unit. He developed hematochezia on the 8th day of hospitalization. Emergent rectosigmoidoscopy was performed showing two separate 3 and 4 mm sized DLs, located immediately proximal to the dentate line. These lesions were successfully treated using two endoscopic band ligations. DLs can occur synchronously, albeit very rarely, and a careful search for multiple lesions is necessary to avoid further bleeding.


Assuntos
Trato Gastrointestinal Superior , Doenças Vasculares , Idoso , Artérias , Endoscopia Gastrointestinal , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/cirurgia , Humanos , Masculino , Úlcera/patologia
16.
Khirurgiia (Mosk) ; (9): 35-39, 2022.
Artigo em Russo | MEDLINE | ID: mdl-36073581

RESUMO

OBJECTIVE/: To objectify patient condition and improve treatment outcomes in patients with benign severe gastroduodenal bleeding. MATERIAL AND METHODS: We analyzed the immediate results of staged surgical treatment of patients with benign severe gastroduodenal bleeding according to the accepted concept of «Damage Control Surgery¼. The Rockall risk scoring system and the Glasgow-Blatchford score (GBS) were used. We preferred two-stage intervention in patients with Rockall score ≥5 and Glasgow-Blatchford score ≥11. RESULTS: Staged approach according to the concept of «Damage Control Surgery¼ in patients with benign severe gastroduodenal bleeding ensures positive results by minimizing surgical trauma and perioperative bleeding, early stabilization of hemostasis and subsequent successful restoration of digestive function. CONCLUSION: The concept of «Damage Control Surgery¼ in patients with benign severe gastroduodenal bleeding can reduce mortality and incidence of postoperative complications.


Assuntos
Hemorragia Gastrointestinal , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/cirurgia , Humanos , Prognóstico , Medição de Risco/métodos , Índice de Gravidade de Doença , Resultado do Tratamento
17.
Ann Ital Chir ; 112022 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-36065803

RESUMO

Duodenal lipomas are uncommon and rare causes of gastrointestinal bleeding. Here, we present the case of a 45-yearold male patient who was admitted to University Clinical Centre because of melaena. After initial diagnostics, including echosonography, esophagogastroduodenoscopy revealed bleeding from protruding blood vessel at the polypoid submucosal change in the posterior duodenal bulb. Upon two urgent unsuccessful endoscopic hemostasis, a duodenotomy was performed. Definitive diagnosis was based on histological findings, describing duodenal lipoma with Bruner's gland hyperplasia. Upper GI bleeding is a serious challenge that requires adequate diagnostics necessary for the right choice of therapeutic approach. Unsuccessful endoscopic hemostasis could be followed by serious complications in bleeding duodenal lipoma when surgery should be always considered as the treatment of choice in patients with this kind of bleeding tumor. KEY WORDS: Bruner Glands Hyperplasia, Duodenal Lipoma, Upper Gastrointestinal Bleeding.


Assuntos
Hemorragia Gastrointestinal , Lipoma , Duodeno , Hemorragia Gastrointestinal/etiologia , Humanos , Hiperplasia , Lipoma/complicações , Lipoma/diagnóstico por imagem , Lipoma/cirurgia , Masculino , Melena , Pessoa de Meia-Idade
18.
BMJ Case Rep ; 15(9)2022 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-36109092

RESUMO

We present a case of a patient with recurrent squamous cell cancer of the base of the tongue and right tonsil who developed severe haematemesis. An elongated blood cast of the upper gastrointestinal tract was noted in the emesis. The patient required emergent intubation and blood transfusions. A CT scan with contrast revealed the presence of a pseudoaneurysm of the right lingual artery. Successful control of bleeding was achieved with coil embolisation of the pseudoaneurysm and its feeding artery. This case highlights that oropharyngeal bleeding can mimic gastrointestinal bleeding.


Assuntos
Falso Aneurisma , Trato Gastrointestinal Superior , Falso Aneurisma/complicações , Falso Aneurisma/diagnóstico por imagem , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/terapia , Humanos , Recidiva Local de Neoplasia , Tomografia Computadorizada por Raios X
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