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Hemorrhoid Coagulation

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141. Portal Hypertension

. Gastric varices bleed less frequently than esophageal varices, but when they do bleed, the hemorrhage is more severe. Barium study findings of varices in other parts of the gastrointestinal tract Gastric antral and duodenal varices are sometimes seen, usually in association with gastric fundal and esophageal varices. Duodenal varices appear as lobulated filling defects on barium study and are demonstrated best with the patient in a prone position. Internal hemorrhoids frequently are found in patients

2014 eMedicine Radiology

142. Thrombophlebitis, Superficial (Treatment)

is present in an affected area. [ ] In the case of thrombosis of a hemorrhoid, evacuation of the thrombus, though very painful, usually provides rapid relief. Magnesium sulfate compresses may also be used to alleviate swelling and pain, though surgery is sometimes necessary to remove the clot from the hemorrhoid. Next: Compression Stockings Long-leg, heavy-gauge elastic stockings or multiple elastic (Ace) bandages are indicated when the patient becomes ambulatory. Gradient compression stockings (...) compressibility of vein secondary to intraluminal thrombus. Courtesy of Wikimedia Commons ©Nevit Dilmen. Blood coagulation (thrombin) and protein C pathways. Courtesy of Wikimedia Commons ©John H Griffin, PhD. of 3 Tables Contributor Information and Disclosures Author Khanjan H Nagarsheth, MD, MBA Assistant Professor of Surgery, Department of Vascular Surgery, University of Maryland Medical System Khanjan H Nagarsheth, MD, MBA is a member of the following medical societies: Academic Surgical Congress

2014 eMedicine Emergency Medicine

143. Anemia, Acute (Treatment)

intravenous (IV) sites and mucous membranes may be due to disseminated intravascular coagulation (DIC). Patients with alcoholic liver disease may have spider angiomata, caput medusae, umbilical hernias, and hemorrhoids. Acute blood loss may result in agitation. When blood loss exceeds 40% of total volume, the patient may lose consciousness. With chronic anemia, the patient may have a hyperdynamic heart, with a prominent point of maximal impulse (PMI), a systolic flow murmur, and occasionally an S 3 (...) (TTP) is rare. Arteriolar lesions with localized platelet thrombi and fibrin deposits lead to thrombocytopenia and hemolytic anemia. The tissue hypoxia from occlusion of the vessels in the affected organ causes the symptoms of TTP. However, the cause of the occlusion remains unknown. Microangiopathic hemolytic anemia, thrombocytopenia, normal coagulation test results, and renal and neurologic abnormalities should lead the physician to the diagnosis. (ITP) is an autoimmune disease often precipitated

2014 eMedicine Emergency Medicine

144. Lower Gastrointestinal Bleeding: Surgical Perspective (Treatment)

of active bleeding. Transfuse packed red blood cells (PRBCs) to maintain the hemoglobin level above 7 g/dL. Initial resuscitation involves establishing large-bore IV access and administration of normal saline. Besides ordering routine laboratory studies (eg, complete blood cell (CBC) count, electrolyte levels, and coagulation studies), blood should be typed and cross-matched. The patient's blood loss and hemodynamic status should be ascertained, and in cases of severe bleeding, the patient may require (...) be performed initially. [ , ] Once the bleeding site is localized, therapeutic options include coagulation and injection with vasoconstrictors or sclerosing agents. In cases of diverticular bleeding, bipolar probe coagulation, epinephrine injection, and metallic clips may be used. [ ] If recurrent bleeding is present, the affected bowel segment can be resected. In cases of angiodysplasia, thermal therapy, such as electrocoagulation or argon plasma coagulation, is generally successful. Angiodysplastic

2014 eMedicine Surgery

145. Superficial Thrombophlebitis (Treatment)

is present in an affected area. [ ] In the case of thrombosis of a hemorrhoid, evacuation of the thrombus, though very painful, usually provides rapid relief. Magnesium sulfate compresses may also be used to alleviate swelling and pain, though surgery is sometimes necessary to remove the clot from the hemorrhoid. Next: Compression Stockings Long-leg, heavy-gauge elastic stockings or multiple elastic (Ace) bandages are indicated when the patient becomes ambulatory. Gradient compression stockings (...) compressibility of vein secondary to intraluminal thrombus. Courtesy of Wikimedia Commons ©Nevit Dilmen. Blood coagulation (thrombin) and protein C pathways. Courtesy of Wikimedia Commons ©John H Griffin, PhD. of 3 Tables Contributor Information and Disclosures Author Khanjan H Nagarsheth, MD, MBA Assistant Professor of Surgery, Department of Vascular Surgery, University of Maryland Medical System Khanjan H Nagarsheth, MD, MBA is a member of the following medical societies: Academic Surgical Congress

2014 eMedicine Surgery

146. Deep Venous Thrombosis (Overview)

laboratory studies to be considered include the following: D-dimer testing Coagulation studies (eg, prothrombin time and activated partial thromboplastin time) to evaluate for a hypercoagulable state See for more detail. Management Treatment options for DVT include the following: Anticoagulation (mainstay of therapy) - Heparins, warfarin, factor Xa inhibitors, and various emerging anticoagulants Pharmacologic thrombolysis Endovascular and surgical interventions Physical measures (eg, elastic compression (...) in the legs and PE. DVT is the presence of coagulated blood, a thrombus, in one of the deep venous conduits that return blood to the heart. The clinical conundrum is that symptoms (pain and swelling) are often nonspecific or absent. However, if left untreated, the thrombus may become fragmented or dislodged and migrate to obstruct the arterial supply to the lung, causing potentially life-threatening PE See the images below. Venous thrombus. Pulmonary embolus. DVT most commonly involves the deep veins

2014 eMedicine Surgery

147. Lower Gastrointestinal Bleeding: Surgical Perspective (Overview)

: Complete blood cell (CBC) count Serum electrolytes levels (eg, sequential multiple analysis 7 [SMA7]) Coagulation profile, including activated partial thromboplastin time (aPTT), prothrombin time (PT), platelet count, and/or bleeding time (bleeding time is only recommended in patients with bleeding disorders and in those using antiplatelet agents) Helical computed tomography (CT) scanning of the abdomen and pelvis can be used when a routine workup fails to determine the cause of active GI bleeding (...) bleeding, the patient may require invasive hemodynamic monitoring to direct therapy. Hemostasis Once the bleeding site is localized, nonsurgical therapeutic options that may be considered include the following: Diverticular bleeding: Colonoscopy with bipolar probe coagulation, epinephrine injection, or metallic clips Recurrent bleeding: Resection of the affected bowel segment Angiodysplasia: Thermal therapy (eg, electrocoagulation, argon plasma coagulation) Conservative management, including nothing

2014 eMedicine Surgery

148. Superficial Thrombophlebitis (Follow-up)

is present in an affected area. [ ] In the case of thrombosis of a hemorrhoid, evacuation of the thrombus, though very painful, usually provides rapid relief. Magnesium sulfate compresses may also be used to alleviate swelling and pain, though surgery is sometimes necessary to remove the clot from the hemorrhoid. Next: Compression Stockings Long-leg, heavy-gauge elastic stockings or multiple elastic (Ace) bandages are indicated when the patient becomes ambulatory. Gradient compression stockings (...) compressibility of vein secondary to intraluminal thrombus. Courtesy of Wikimedia Commons ©Nevit Dilmen. Blood coagulation (thrombin) and protein C pathways. Courtesy of Wikimedia Commons ©John H Griffin, PhD. of 3 Tables Contributor Information and Disclosures Author Khanjan H Nagarsheth, MD, MBA Assistant Professor of Surgery, Department of Vascular Surgery, University of Maryland Medical System Khanjan H Nagarsheth, MD, MBA is a member of the following medical societies: Academic Surgical Congress

2014 eMedicine Surgery

149. Anemia, Acute (Diagnosis)

intravenous (IV) sites and mucous membranes may be due to disseminated intravascular coagulation (DIC). Patients with alcoholic liver disease may have spider angiomata, caput medusae, umbilical hernias, and hemorrhoids. Acute blood loss may result in agitation. When blood loss exceeds 40% of total volume, the patient may lose consciousness. With chronic anemia, the patient may have a hyperdynamic heart, with a prominent point of maximal impulse (PMI), a systolic flow murmur, and occasionally an S 3 (...) (TTP) is rare. Arteriolar lesions with localized platelet thrombi and fibrin deposits lead to thrombocytopenia and hemolytic anemia. The tissue hypoxia from occlusion of the vessels in the affected organ causes the symptoms of TTP. However, the cause of the occlusion remains unknown. Microangiopathic hemolytic anemia, thrombocytopenia, normal coagulation test results, and renal and neurologic abnormalities should lead the physician to the diagnosis. (ITP) is an autoimmune disease often precipitated

2014 eMedicine Emergency Medicine

150. Deep Venous Thrombosis and Thrombophlebitis (Diagnosis)

) are required The main laboratory studies to be considered include the following: D-dimer testing Coagulation studies (eg, prothrombin time and activated partial thromboplastin time) to evaluate for a hypercoagulable state See for more detail. Management Treatment options for DVT include the following: Anticoagulation (mainstay of therapy) - Heparins, warfarin, factor Xa inhibitors, and various emerging anticoagulants Pharmacologic thrombolysis Endovascular and surgical interventions Physical measures (eg (...) thrombosis in the legs and PE. DVT is the presence of coagulated blood, a thrombus, in one of the deep venous conduits that return blood to the heart. The clinical conundrum is that symptoms (pain and swelling) are often nonspecific or absent. However, if left untreated, the thrombus may become fragmented or dislodged and migrate to obstruct the arterial supply to the lung, causing potentially life-threatening PE See the images below. Venous thrombus. Pulmonary embolus. DVT most commonly involves

2014 eMedicine Emergency Medicine

151. Thrombophlebitis, Superficial (Follow-up)

is present in an affected area. [ ] In the case of thrombosis of a hemorrhoid, evacuation of the thrombus, though very painful, usually provides rapid relief. Magnesium sulfate compresses may also be used to alleviate swelling and pain, though surgery is sometimes necessary to remove the clot from the hemorrhoid. Next: Compression Stockings Long-leg, heavy-gauge elastic stockings or multiple elastic (Ace) bandages are indicated when the patient becomes ambulatory. Gradient compression stockings (...) compressibility of vein secondary to intraluminal thrombus. Courtesy of Wikimedia Commons ©Nevit Dilmen. Blood coagulation (thrombin) and protein C pathways. Courtesy of Wikimedia Commons ©John H Griffin, PhD. of 3 Tables Contributor Information and Disclosures Author Khanjan H Nagarsheth, MD, MBA Assistant Professor of Surgery, Department of Vascular Surgery, University of Maryland Medical System Khanjan H Nagarsheth, MD, MBA is a member of the following medical societies: Academic Surgical Congress

2014 eMedicine Emergency Medicine

152. Gastrointestinal Bleeding: Surgical Perspective (Treatment)

intravenous (IV) catheters must be obtained. Patients with severe GI bleeds should be admitted to the pediatric ICU. For variceal bleeds, GI consultants may endoscopically control active hemorrhage with sclerotherapy, an elastic ligature (for esophageal varices or for hemorrhoids), or (in rare cases) a transjugular intrahepatic portosystemic shunt (TIPS). Failure to control bleeding may require the placement of a Sengstaken-Blakemore balloon for temporary tamponade if endoscopic treatment fails (...) , nasogastric suction, and IV H2 blockers or PPIs. Studies have advocated identifying high-risk neonates and treating them prophylactically with acid-reducing agents. Extremely rarely, continued or massive hematemesis despite medical therapy leads to operative interventions, such as gastric resection, vagotomy and pyloroplasty, or antrectomy and vagotomy. Hemorrhagic disease of the newborn is a bleeding disorder resulting from a deficiency in vitamin K–dependent coagulation factors. Although it is normally

2014 eMedicine Pediatrics

153. Gastrointestinal Bleeding: Surgical Perspective (Follow-up)

intravenous (IV) catheters must be obtained. Patients with severe GI bleeds should be admitted to the pediatric ICU. For variceal bleeds, GI consultants may endoscopically control active hemorrhage with sclerotherapy, an elastic ligature (for esophageal varices or for hemorrhoids), or (in rare cases) a transjugular intrahepatic portosystemic shunt (TIPS). Failure to control bleeding may require the placement of a Sengstaken-Blakemore balloon for temporary tamponade if endoscopic treatment fails (...) , nasogastric suction, and IV H2 blockers or PPIs. Studies have advocated identifying high-risk neonates and treating them prophylactically with acid-reducing agents. Extremely rarely, continued or massive hematemesis despite medical therapy leads to operative interventions, such as gastric resection, vagotomy and pyloroplasty, or antrectomy and vagotomy. Hemorrhagic disease of the newborn is a bleeding disorder resulting from a deficiency in vitamin K–dependent coagulation factors. Although it is normally

2014 eMedicine Pediatrics

154. Pediatrics, Gastrointestinal Bleeding (Treatment)

intravenous (IV) catheters must be obtained. Patients with severe GI bleeds should be admitted to the pediatric ICU. For variceal bleeds, GI consultants may endoscopically control active hemorrhage with sclerotherapy, an elastic ligature (for esophageal varices or for hemorrhoids), or (in rare cases) a transjugular intrahepatic portosystemic shunt (TIPS). Failure to control bleeding may require the placement of a Sengstaken-Blakemore balloon for temporary tamponade if endoscopic treatment fails (...) , nasogastric suction, and IV H2 blockers or PPIs. Studies have advocated identifying high-risk neonates and treating them prophylactically with acid-reducing agents. Extremely rarely, continued or massive hematemesis despite medical therapy leads to operative interventions, such as gastric resection, vagotomy and pyloroplasty, or antrectomy and vagotomy. Hemorrhagic disease of the newborn is a bleeding disorder resulting from a deficiency in vitamin K–dependent coagulation factors. Although it is normally

2014 eMedicine Emergency Medicine

155. Pediatrics, Gastrointestinal Bleeding (Follow-up)

intravenous (IV) catheters must be obtained. Patients with severe GI bleeds should be admitted to the pediatric ICU. For variceal bleeds, GI consultants may endoscopically control active hemorrhage with sclerotherapy, an elastic ligature (for esophageal varices or for hemorrhoids), or (in rare cases) a transjugular intrahepatic portosystemic shunt (TIPS). Failure to control bleeding may require the placement of a Sengstaken-Blakemore balloon for temporary tamponade if endoscopic treatment fails (...) , nasogastric suction, and IV H2 blockers or PPIs. Studies have advocated identifying high-risk neonates and treating them prophylactically with acid-reducing agents. Extremely rarely, continued or massive hematemesis despite medical therapy leads to operative interventions, such as gastric resection, vagotomy and pyloroplasty, or antrectomy and vagotomy. Hemorrhagic disease of the newborn is a bleeding disorder resulting from a deficiency in vitamin K–dependent coagulation factors. Although it is normally

2014 eMedicine Emergency Medicine

157. A Two-part Study in Edoxaban-treated Healthy Subjects to Establish a Punch Biopsy Bleeding Model and to Evaluate the Effect of a 4-factor Prothrombin Complex Concentrate on Anticoagulation

procoagulant markers D dimer [ Time Frame: Day 1 ] To evaluate the effects of Beriplex P/N following 60 mg edoxaban on the procoagulant markers D dimer and prothrombin fragment F1 + 2 (F1 + 2) prothrombin fragment F1 + 2 [ Time Frame: Day 1 ] To evaluate the effects of Beriplex P/N following 60 mg edoxaban on the procoagulant markers D dimer and prothrombin fragment F1 + 2 (F1 + 2) coagulation factor concentrations [ Time Frame: Day 1 ] To evaluate the effects of Beriplex P/N following 60 mg edoxaban (...) on coagulation factor concentrations cmax of edoxaban and its active metabolite, D21-2393 [ Time Frame: Day 1 ] To evaluate single dose pharmacokinetics (PK) of edoxaban and its active metabolite, D21-2393 tmax of edoxaban and its active metabolite, D21-2393 [ Time Frame: Day 1 ] To evaluate single dose pharmacokinetics (PK) of edoxaban and its active metabolite, D21-2393 AUC 0-24 of edoxaban and its active metabolite, D21-2393 [ Time Frame: Day 1 ] To evaluate single dose pharmacokinetics (PK) of edoxaban

2013 Clinical Trials

158. An Open Label Multi-Dose Study to Examine the Effect of Coated Nifedipine Suppository on Anal Fissure Pain and Healing

hypertension (sitting blood pressure <160/95 mmHg at screening) History of chronic gastrointestinal disease. History of rectal surgery. History of gastrointestinal surgery. History of HIV, hepatitis B, hepatitis C. In need of chronic use of medication, with the exception of birth control medications. Currently uses medication for acute illness (other than medications for use of treatment/pain relief of anal fissure). Has used, in the last two weeks, drugs that may affect blood coagulation, such as Aspirin (...) ) Isosrbid mononitrate (Monocord, Monolong, Mononit) Nitroglycerine (Nitrocine, Nitroderm, Nitrolingual) Has upon physical examination a rectal deformation or signs of rectal disease such as bleeding hemorrhoids, fistula. infection or space occupying lesion. Is an immediate family member of personnel directly affiliated with the study at the investigative site, or is personally directly affiliated with the study at the investigative site; or Is employed by RDD Pharma Ltd. Contacts and Locations Go

2013 Clinical Trials

159. Effects of a Double-Blind, Single Dose of PER977 Administered Alone, and Following a Single Dose of Edoxaban

Last Update Posted : October 2, 2017 Sponsor: Perosphere, Inc. Information provided by (Responsible Party): Perosphere, Inc. Study Details Study Description Go to Brief Summary: PER977 monotherapy and co-administration following 60 mg edoxaban will have an acceptable safety and tolerability profile with no impact on pro-coagulant biomarkers. A dose of PER977 that reverses the effects of edoxaban on the pharmacodynamic (PD) biomarkers (point of care prothrombin time [PoC-PT]), and/or secondary (...) Laboratory values (chemistry, complete blood count coagulation assessments) and urinalysis performed during screening up to 21 days prior to administration of study treatment are within normal limits. No clinically significant findings on 12-lead electrocardiogram (ECG) performed during screening. Body mass index (BMI) 18 to ≤32 kg/m2, inclusive Male subjects agree to use appropriate contraception (i.e., double barrier contraception such as a latex condom with spermicide with a female partner of child

2013 Clinical Trials

160. Relative Bioavailability of Oral Suspension of Rivaroxaban Compared to Standard Tablet

) at the first screening examination Exclusion Criteria: Incompletely cured pre-existing diseases for which it can be assumed that the absorption, distribution, metabolism, elimination and effects of the study drugs will not be normal Known coagulation disorders (eg von Willebrand's disease, hemophilia) Known disorders with increased bleeding risk (eg periodontosis, hemorrhoids, acute gastritis, peptic ulcer) Known sensitivity to common causes of bleeding (eg nasal) Regular use of medicines Clinically (...) Research & Development, LLC Information provided by (Responsible Party): Bayer Study Details Study Description Go to Brief Summary: Rivaroxaban is a substance developed for use in the treatment of blood coagulation disorders. Thrombosis (blood clots) can occur as a result of excessive coagulation activity in the blood vessels. Excessive coagulation activity can occur in children as well, and rivaroxaban is therefore being developed for the treatment of thromboembolic events in children and adolescents

2013 Clinical Trials

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