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Small Intestinal Bleeding

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1. Risk factors for small bowel bleeding in an overt gastrointestinal bleeding presentation after negative upper and lower endoscopy. Full Text available with Trip Pro

Risk factors for small bowel bleeding in an overt gastrointestinal bleeding presentation after negative upper and lower endoscopy. A small bowel source is suspected when evaluation of overt gastrointestinal (GI) bleeding with upper and lower endoscopy is negative. Video capsule endoscopy (VCE) is the recommended next diagnostic test for small bowel bleeding sources. However, clinical or endoscopic predictive factors for small bowel bleeding in the setting of an overt bleeding presentation (...) : 1.25-20.32).Among patients presenting with overt bleeding but negative upper and lower endoscopy, the presence of blood on examination of the terminal ileum is strongly associated with a small bowel bleeding source as well as with small bowel therapeutic intervention. Presence of diverticula on colonoscopy is inversely associated with a positive VCE and therapeutic intervention in univariate analysis.

2019 PLoS ONE

2. Quantitative Blood Loss in Obstetric Hemorrhage

completed implementa- tion of the strategies (27). Additionally, a recent analysis from New York’s Safe Motherhood Initiative did not show a difference in hemorrhage-related morbidity 1 year after initiation of a hemorrhage initiative (40). Conversely, a mandated implementation of an eight-component hem- orrhage protocol based on the hemorrhage safety bundle that included quantitative blood loss measurement in 29 hospitals within a multistate regional health system found a significant reduction in use (...) A, Weeks AD, Lavender DT. Is accurate and reliable blood loss estimation the “crucial step” in early detection of postpartum haemorrhage: an integrative review of the literature. BMC Pregnancy Childbirth 2015;15:230. 33. Andrikopoulou M, D’Alton ME.Postpartum hemorrhage: early identification challenges. Semin Perinatol 2019;43: 11–7. VOL. 134, NO. 6, DECEMBER 2019 Committee Opinion Blood Loss in Obstetric Hemorrhage e15534. Toledo P, Eosakul ST, Goetz K, Wong CA, Grobman WA. Decayinbloodlossestimation

2019 American College of Obstetricians and Gynecologists

3. Misoprostol Heals Small Bowel Ulcers in Aspirin Users With Small Bowel Bleeding Full Text available with Trip Pro

Misoprostol Heals Small Bowel Ulcers in Aspirin Users With Small Bowel Bleeding There is no effective treatment for aspirin-induced small bowel ulcer bleeding. We performed a double-blind, randomized, placebo-controlled trial to determine whether misoprostol can heal small bowel ulcers in patients with small bowel bleeding who require continuous aspirin therapy.We performed a prospective study of 84 aspirin users with small bowel bleeding who required continued aspirin therapy in Hong Kong (...) [range, 0-25]) than in the placebo group (from 7 [range, 1-29] to 4 [range, 0-19] (P = .005).In a double-blind, randomized, placebo-controlled trial, we found misoprostol to be superior to placebo in promoting healing of small bowel ulcers among aspirin users complicated by small bowel ulcer bleeding who require continuous aspirin therapy. However, use of misoprostol alone would provide only limited protection against aspirin on the small bowel. ClinicalTrials.gov ID NCT01998776.Copyright © 2018 AGA

2018 EvidenceUpdates

4. Abdominal Pregnancy in the Small Intestine Presenting as Acute Massive Lower Gastrointestinal Hemorrhage Full Text available with Trip Pro

Abdominal Pregnancy in the Small Intestine Presenting as Acute Massive Lower Gastrointestinal Hemorrhage An abdominal pregnancy is an ectopic pregnancy in which the implantation site occurs in the abdominal cavity outside the female reproductive organs. There have been four reported cases that ruptured into the gastrointestinal tract and into the large intestine. We present the first case of an abdominal pregnancy rupturing into the small intestine with a good outcome.

2017 Case reports in surgery

5. Hemorrhagic necrosis of small bowel following small bowel obstruction as a late complication of sex reassignment surgery—a gap in transgender care Full Text available with Trip Pro

Hemorrhagic necrosis of small bowel following small bowel obstruction as a late complication of sex reassignment surgery—a gap in transgender care For decades, Thailand has been at the forefront of sex reassignment surgeries. The neovagina created by recto-sigmoid vaginoplasty is much more complex procedure when compared with penile skin version technique, but yielded more satisfactory functional outcomes. We reported an unusual case of life-threatening small bowel obstruction following (...) previously successful recto-sigmoid vaginoplasty in a transgender woman. Transgender individuals have unique healthcare needs. However, various gaps still exist to provide multi-disciplinary care for these patients. The rate of adhesive small bowel obstruction is highest in the early period of any intra-abdominal post-operative surgeries, but the risk remains life-long. Transgender women receiving complicated vaginoplasty should be instructed to continue long-term follow-up to ensure early detection

2018 Journal of surgical case reports

6. Gastrointestinal hemorrhage caused by adult intussusception secondary to small intestinal tumors: Two case reports. Full Text available with Trip Pro

Gastrointestinal hemorrhage caused by adult intussusception secondary to small intestinal tumors: Two case reports. Adult intussusception is rarely observed, and the clinical manifestations are very atypical. The most common symptom is abdominal pain, while the incidence of hematochezia is relatively low. We report two cases of adult intussusception secondary to small intestinal tumors with gastrointestinal hemorrhage as the main symptom.Two men aged 19 and 54 years were successively referred (...) . The two patients were diagnosed as adult intussusception caused by small intestinal tumors.Emergency laparoscopic explorations were performed. Enteroenteric intussusceptions caused by ileal tumors were found during surgery. Reduction of the intussusceptions and resection of the ileal tumors were performed.The patients recovered well after surgery, and postoperative pathology showed that the tumors were a vascular hamartoma polyp and a lipoma.Adult intussusception is very rare, particularly

2018 Medicine

7. The role of endoscopy in the management of suspected small-bowel bleeding

Assessment, Development and Evaluation. Adapted from Guyatt et al. 1 The role of endoscopy in the management of suspected small-bowel bleeding www.giejournal.org Volume 85, No. 1 : 2017 GASTROINTESTINAL ENDOSCOPY 23VCE is considered the ?rst diagnostic step in the evalu- ation of small-bowel sources of occult bleeding once the upper GI tract and colon have been satisfactorily cleared as potential sources. A follow-up push enteroscopy or DAE is usually recommended for further management of positive (...) include large hiatal hernias, hematemesis, and a history of NSAID use. 43 Patients with upper GI mucosal lesions also may have other contributing causes of iron de?ciency anemia, such as malabsorption. 44,45 Small-bowel biopsy to evaluate for underlying celiac disease should be considered in patients with iron-de?ciency anemia. 46 In patients with an unrecognized bleeding source, repeat ileocolonoscopy should be considered when clinical suspicion exists for missed colon lesions, although studies have

2017 American Society for Gastrointestinal Endoscopy

8. Single Balloon Enteroscopy System for Obscure GI Bleeding (Small Bowel)

of DBE. The algorithm was amended to remove the small population of patients with small bowel pathology, without obscure GI bleeding, as DBE was listed on the MBS to be used only for those with obscure GI bleeding. It is possible that balloon enteroscopy may be useful in patients with small bowel disease who present without bleeding e.g. pain, obstruction, weight loss, diarrhoea. However, the application did not seek funding to be expanded to cover any indications not already listed for DBE (...) . Lay summary Patients with obscure gastrointestinal (GI) bleeding – that is, bleeding where the cause is not determined from initial medical procedures examining the GI tract – may be further investigated with balloon enteroscopy. A balloon enteroscope allows for a detailed investigation of the small bowel. Currently, MBS items are available for procedures using a double balloon technique. The application requested that a single balloon technique be included on the MBS. The available evidence

2013 Medical Services Advisory Committee

9. Development of a Comorbidity Index to Identify Patients With Small Bowel Bleeding at Risk for Rebleeding and Small Bowel Vascular Diseases. (Abstract)

Development of a Comorbidity Index to Identify Patients With Small Bowel Bleeding at Risk for Rebleeding and Small Bowel Vascular Diseases. We aimed to establish a comorbidity index for small bowel vascular diseases (SBVD) associated with small bowel bleeding (SBB) and recurrent bleeding.We performed a retrospective analysis of 404 patients diagnosed with SBB via double-balloon enteroscopy, at 2 hospitals in Japan from June 2003 through July 2016. We collected data on comorbidities, computed (...) Charlson Comorbidity Index and anticoagulation and risk factors in atrial fibrillation (ATRIA) scores, and analyzed associations with SBVD, rebleeding, and overall survival associated with bleeding and/or comorbidities. We used these data to develop a comorbidity index to identify patients at risk for SBVD, rebleeding, and reduced survival time. We validated our findings in a separate, prospective cohort of 88 patients with SBB.We developed a weighted index (the Ohmiya index) that identified patients

2018 Clinical Gastroenterology and Hepatology

10. Gastrointestinal bleeding prophylaxis for critically ill patients: a clinical practice guideline Full Text available with Trip Pro

concerns Proton pump inhibitors reduce the risk of gastrointestinal bleeding. For people with a 1-2% risk of clinically important bleeding however, the effect is probably small enough that most people would choose not to use them Moderate GRADE score, because of: Uncertainty in baseline risk for some risk factors GRADE certainty ratings The authors have a lot of confidence that the true effect is similar to the estimated effect The authors believe that the true effect is probably close to the estimated (...) different from the estimated effect Moderate Low Very low 23 fewer Important bleeding (4-8% risk) Moderate More 60 37 Risk of Bias No serious concerns Imprecision Serious Indirectness No serious concerns Inconsistency No serious concerns Publication bias No serious concerns Proton pump inhibitors reduce the risk of gastrointestinal bleeding. For people with a 4-8% risk of clinically important bleeding, the effect is probably large enough that most people would choose to use them Moderate GRADE score

2020 BMJ Rapid Recommendations

11. Usefulness of small bowel reexamination in obscure gastrointestinal bleeding patients with negative capsule endoscopy findings: Comparison of repeat capsule endoscopy and double-balloon enteroscopy Full Text available with Trip Pro

Usefulness of small bowel reexamination in obscure gastrointestinal bleeding patients with negative capsule endoscopy findings: Comparison of repeat capsule endoscopy and double-balloon enteroscopy Although capsule endoscopy (CE) is a noninvasive diagnostic tool for patients with obscure gastrointestinal bleeding (OGIB), bleeding lesions are often not detected. No strategies have been established to determine whether CE or double-balloon enteroscopy (DBE) should be performed after negative (...) CE.Among 652 patients who underwent CE for OGIB, a total of 359 patients had negative findings. Of these, 41 and 48 patients underwent repeat CE and DBE for small bowel reexamination, respectively. We compared the rate of positive findings between the two groups. The findings were considered positive if mucosal break, vascular lesion, tumor, or active bleeding was observed.The rate of positive findings in the repeat CE group was significantly higher than that in the DBE group (73.2% vs. 39.6%; p

2018 United European gastroenterology journal

12. An Overt, Obscure Gastrointestinal Bleed Caused by a Primary Small Bowel Fibroblastic Reticular Cell Sarcoma Full Text available with Trip Pro

An Overt, Obscure Gastrointestinal Bleed Caused by a Primary Small Bowel Fibroblastic Reticular Cell Sarcoma Small bowel bleeding should be considered in patients who continue to bleed despite a negative upper endoscopy and colonoscopy. The differential diagnosis of small bowel bleeding can include infection, inflammatory conditions, vascular malformations, and, rarely, malignancy. This report demonstrates a rare, primary, small bowel, reticular cell sarcoma presenting as an overt (...) gastrointestinal bleed. These tumors are difficult to diagnose because they are rarely seen on traditional cross-sectional imaging and can present with multiple synchronous lesions throughout the intestinal tract.

2018 ACG case reports journal

13. Does discontinuation of antithrombotics affect the diagnostic yield of small bowel capsule endoscopy in patients demonstrating obscure gastrointestinal bleeding? Full Text available with Trip Pro

Does discontinuation of antithrombotics affect the diagnostic yield of small bowel capsule endoscopy in patients demonstrating obscure gastrointestinal bleeding? A large proportion of patients demonstrating obscure gastrointestinal bleeding (OGIB) are antithrombotic users and need to undergo small bowel capsule endoscopy (SBCE). We examined the effect of discontinuation of antithrombotics on the diagnostic yield of SBCE. Additionally, we assessed predictive factors associated with positive SBCE

2018 Journal of clinical biochemistry and nutrition

14. The Impact of Small Bowel Endoscopy in Patients with Hereditary Hemorrhagic Telangiectasia Full Text available with Trip Pro

The Impact of Small Bowel Endoscopy in Patients with Hereditary Hemorrhagic Telangiectasia 30040069 2018 12 07 1308-5263 35 4 2018 Nov 13 Turkish journal of haematology : official journal of Turkish Society of Haematology Turk J Haematol The Impact of Small Bowel Endoscopy in Patients with Hereditary Hemorrhagic Telangiectasia 300-301 10.4274/tjh.2018.0253 Chetcuti Zammit Stefania S orcid.org/0000-0002-1361-2204 Sheffield Teaching Hospitals, Royal Hallamshire Hospital, Academic Department (...) İnce Barsak Endoskopisinin Önemi 2018 07 24 Turkey Turk J Haematol 9606065 1300-7777 Hereditary hemorrhagic telangiectasia Small bowel capsule endoscopy Argon plasma coagulation 2018 7 25 6 0 2018 7 25 6 0 2018 7 25 6 0 ppublish 30040069 10.4274/tjh.2018.0253 PMC6256829 Am J Pathol. 2000 Jan;156(1):151-8 10623662 Leukemia. 2008 Feb;22(2):414-23 18094721 Farm Hosp. 2016 May 01;40(3):230-2 27145393 Hum Mutat. 2002 Feb;19(2):140-8 11793473 Turk J Haematol. 2018 Jun 8;:null 29880465 United European

2018 Turkish Journal of Hematology

15. Haemangiomas of the Small Intestine: Poorly Known Cause of Gastrointestinal Bleeding of Uncertain Origin Full Text available with Trip Pro

Haemangiomas of the Small Intestine: Poorly Known Cause of Gastrointestinal Bleeding of Uncertain Origin Small bowel haemangiomas are benign vascular tumours that may cause gastrointestinal bleeding of uncertain origin, are frequently chronic, and are rarely acute. We report a case of an haemangioma located in the distal ileum of a 29-year-old male with a history of chronic anemia since childhood. Imaging studies showed a mural thickening in the distal ileum with phleboliths, which is a key

2018 Cureus

16. Successful Treatment of Recurrent Gastrointestinal Bleeding Due to Small Intestine Angiodysplasia and Multiple Myeloma with Thalidomide: Two Birds with One Stone Full Text available with Trip Pro

Successful Treatment of Recurrent Gastrointestinal Bleeding Due to Small Intestine Angiodysplasia and Multiple Myeloma with Thalidomide: Two Birds with One Stone 29911985 2018 12 07 1308-5263 35 4 2018 Nov 13 Turkish journal of haematology : official journal of Turkish Society of Haematology Turk J Haematol Successful Treatment of Recurrent Gastrointestinal Bleeding Due to Small Intestine Angiodysplasia and Multiple Myeloma with Thalidomide: Two Birds with One Stone 305-306 10.4274/tjh (...) Dražen D 0000-0002-1177-8921 University Hospital Center Zagreb, Department of Internal Medicine, Division of Hematology, Zagreb, Croatia University of Zagreb Faculty of Medicine, Zagreb, Croatia Josip Juraj Strossmayer University of Osijek Faculty of Medicine, Osijek, Croatia eng Journal Article İnce Barsak Anjiyodisplazi ve Multipl Miyeloma Bağlı Gelişen Tekrarlayan Gastrointestinal Kanamanın Talidomid ile Başarılı Tedavisi: Bir Taşla İki Kuş 2018 06 18 Turkey Turk J Haematol 9606065 1300-7777

2018 Turkish Journal of Hematology

17. Experimental Hemorrhagic Shock Protocol in Swine Models: The Effects of 21-Aminosteroid on the Small Intestine Full Text available with Trip Pro

administered lazaroid U-74389G in addition to fluid. Control Group S underwent all the surgical procedures without hemorrhagic shock. Vital signs, complete blood count, and biochemical markers were analyzed, and tissue samples of the small intestine were collected from all animals. Further, malondialdehyde, tumor necrosis factor-α, and levels of inflammation in the tissue sample were measured.In Group S-A-A' and Group S-C-C', the analysis did not show statistically significant differences in the percentage (...) Experimental Hemorrhagic Shock Protocol in Swine Models: The Effects of 21-Aminosteroid on the Small Intestine The protective potential of lazaroids has been reported in previous studies on ischemia/reperfusion and induced hemorrhagic shock protocols.The present study is the first experimental protocol on the effects of the antioxidant factor U-74389G on the small intestine of swine models in a hemorrhagic shock protocol and resuscitation with 3 different types of fluids.The study included 49

2018 Current therapeutic research, clinical and experimental

18. Capsule endoscopy of the small bowel for obscure gastrointestinal bleeding

Capsule endoscopy of the small bowel for obscure gastrointestinal bleeding Capsule endoscopy of the small bowel for obscure gastrointestinal bleeding Capsule endoscopy of the small bowel for obscure gastrointestinal bleeding Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Capsule endoscopy of the small bowel for obscure gastrointestinal bleeding. Lansdale: HAYES (...) , Inc.. Directory Publication. 2013 Authors' conclusions Capsule endoscopy, also called wireless capsule endoscopy or video capsule endoscopy, is a noninvasive procedure in which the patient swallows a multivitamin-sized capsule containing a miniaturized video camera, light transmitter, and batteries. The camera takes a video recording of the mucosal lining of the esophagus, small bowel, and/or colon as the capsule moves through the gastrointestinal tract. This procedure is intended to detect signs

2013 Health Technology Assessment (HTA) Database.

19. Haemorrhagic gastritis following Gastrografin administration for adhesive small bowel obstruction: A case report of a rare outcome Full Text available with Trip Pro

Haemorrhagic gastritis following Gastrografin administration for adhesive small bowel obstruction: A case report of a rare outcome Adhesive small bowel obstruction (ASBO) is common after abdominal surgery. Water soluble contrast agents (WSCA) such as Gastrografin have been demonstrated to be safe and effective in predicting resolution of ASBO with conservative management while decreasing the time to resolution, decreasing the need for surgery and reducing overall length of stay. Few adverse (...) effects have been reported. To the authors knowledge this is the first report of haemorrhagic gastritis following administration of Gastrografin for ASBO.We present a case of haemorrhagic gastritis following Gastrografin administration in a 69-year-old male with adhesive small bowel obstruction who was managed conservatively with a good outcome. The report complies with the criteria outlined in the SCARE statement (Product Information Gastrografin [Product information], 2013).The characteristics

2017 International journal of surgery case reports

20. Primary postpartum haemorrhage

(which includes antepartum haemorrhage) was responsible for 12 (11%) of Australian maternal deaths in 2008–2012 (a maternal mortality ratio of 0.8 per 100,000). 8 1.1 Definition Although there is no single definition, PPH is termed as excessive bleeding in the first 24 hours post birth. In an emergent situation, diagnosis most commonly occurs through estimation of blood loss volume and changes in the haemodynamic state. Table 1. Postpartum haemorrhage definitions Aspect Definition Blood loss volume (...) risk of nausea (OR 4.07, 95% CI 3.43 to 4.84), vomiting (OR 4.92, 95% CI 4.03 to 6.00) and hypertension (OR 2.40, 95% CI 1.58 to 3.64) 51 · If risk of PPH, individually assess the potential benefit of a small reduction in blood loss versus the more common adverse effects associated with the use of syntometrine Refer to online version, destroy printed copies after use Page 13 of 35 Queensland Clinical Guideline: Primary postpartum haemorrhage 2.3.2 Fourth stage monitoring If risk factors for PPH

2019 Queensland Health

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