Database : MEDLINE
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[PMID]: 29524855
[Au] Autor:Mulkerrin G; Hogan NM; Sheehan M; Joyce MR
[Ad] Address:Department of Colorectal Surgery, University Hospital Galway, Ireland. Electronic address: mulkerrg@tcd.ie.
[Ti] Title:Melena as an unusual presentation of gastrointestinal stromal tumour, a case report.
[So] Source:Int J Surg Case Rep;44:172-175, 2018 Mar 01.
[Is] ISSN:2210-2612
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Gastrointestinal Stromal Tumors (GISTs) are a rare slow growing malignancy, accounting for less than 1% of all gastrointestinal (GI) tract tumors. These tumors are usually discovered incidentally by endoscopy, surgery or radiology. However on occasions they may present with significant symptoms including GI blood loss. This case report discusses an atypical presentation of a GIST in a 57-year-old female. CASE PRESENTATION: A 57-year-old woman presented to the emergency department following one episode of melena. This occurred on a background of two previous presentations with melena over a 10-year period. She had a preceding surgery for a Meckel's Diverticulum. She was admitted for monitoring and investigation. An emergency upper endoscopy showed no upper gastrointestinal pathology to account for the bleeding. Her condition deteriorated with development of hypovolemic shock, requiring blood transfusion. An urgent CT angiogram identified a large mass in the distal ileum. The patient underwent an emergency laparotomy, where a 9.1 cm tumor located on the distal one-third of the ileum was resected. Histopathology confirmed the mass was a GIST. The patient had a successful post-operative period and subsequent treatment with Imatinib. DISCUSSION: The majority of GISTs are found incidentally. This case report describes an unusual presentation of a GIST in which the tumor bled into the intestinal lumen causing significant melena and life threatening hemorrhage. CONCLUSION: We conclude that GIST should be considered as a possible differential in rare cases of GI bleeding where more common causes have been ruled out.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  2 / 3476 MEDLINE  
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[PMID]: 29352439
[Au] Autor:Tan CHN; Kim G; So J; Shabbir A
[Ad] Address:Division of Upper Gastrointestinal Surgery, Department of Surgery, National University Health System Singapore, National University of Singapore, 1E, Kent Ridge Road, NUHS Tower Block, Level 8, Singapore, Singapore.
[Ti] Title:Single-Incision Laparoscopic Transgastric Underrunning and Closure of Cameron Ulcers in Acute Gastrointestinal Bleeding.
[So] Source:J Gastrointest Surg;22(3):553-556, 2018 Mar.
[Is] ISSN:1873-4626
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Endoscopic therapy remains the cornerstone of hemostasis for gastrointestinal bleeding. In situations where hemostasis cannot be achieved via endoscopic or radiological methods, surgery is necessary. Traditional open surgery for bleeding gastric ulcers can be very morbid and unsuitable especially in hemodynamically unstable patients in extremis. We describe a minimally invasive, transgastric approach for underrunning and closure of Cameron ulcers. METHODS: Our patient is a 75-year-old Chinese lady, who presented to the emergency department with fresh melena. She was hemodynamically unstable with severe metabolic acidosis. CT angiography revealed blood clots within the stomach, with no active blush. On urgent gastroscopy, large blood clots obscured the site of hemorrhage. A Mallory-Weiss tear was noted. Our patient subsequently underwent a successful single-incision laparoscopic transgastric (SLT) underrunning and closure of two Cameron ulcers. RESULTS: Our patient had an uneventful recovery and subsequently underwent a successful laparoscopic para-esophageal hernia repair on postoperative day 9. CONCLUSION: A SLT approach is a suitable minimally invasive option for the surgical management of hemostasis and closure of bleeding gastric ulcers not amenable to endoscopic or radiological interventions.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review
[do] DOI:10.1007/s11605-018-3667-3

  3 / 3476 MEDLINE  
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[PMID]: 29516329
[Au] Autor:Zhu CN; Friedland J; Yan B; Wilson A; Gregor J; Jairath V; Sey M
[Ad] Address:Schulich School of Medicine and Dentistry, Western University, London, Canada.
[Ti] Title:Presence of Melena in Obscure Gastrointestinal Bleeding Predicts Bleeding in the Proximal Small Intestine.
[So] Source:Dig Dis Sci;, 2018 Mar 08.
[Is] ISSN:1573-2568
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND AND AIMS: Melena is a symptom of upper gastrointestinal bleeding and usually indicates bleeding proximal to the ligament of Treitz. However, whether melena predicts bleeding in the proximal small intestine in patients with obscure gastrointestinal bleeding (OGIB) is unknown and the objective of this study. METHODS: A retrospective cohort study of consecutive patients undergoing capsule endoscopy for OGIB between July 2009 and May 2016 was conducted. Subjects were categorized based on the presence of melena, and the primary outcome was identification of a bleeding source within the proximal 2/3 of the small intestine. Multi-variable regression was performed to control for confounders. RESULTS: During the study, 288 patients met the eligibility criteria. Subjects with melena accounted for 37.1% of the cohort and were more likely to be older (mean age 66.9 vs. 63.9, p = 0.0457), take warfarin (15.1 vs. 9.4%, p = 0.0122), and have a lower 12-month hemoglobin nadir (7.3 vs. 8.3 g/dL, p = 0.0002). On crude analysis, 56.1% of patients with melena had a bleeding source within the proximal small intestine compared to 34.8% for those without (RR 1.61, 95% CI 1.24-2.09, p = 0.0004). On multi-variable analysis, the presence of melena doubled the odds of finding a bleeding site within the proximal small intestine (OR 1.97, 95% CI 1.17-3.33, p = 0.010). CONCLUSIONS: The presence of melena doubles the odds of finding a bleeding site within the proximal small intestine among patients with OGIB, and deep enteroscopy, if performed before a capsule study, should begin with an antegrade approach in these patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1007/s10620-018-5003-x

  4 / 3476 MEDLINE  
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[PMID]: 29500336
[Au] Autor:Kamimura H; Yamagiwa S; Tomohiro I; Higuchi W; Ogata N; Tsuchiya A; Kamimura K; Takamura M; Kawai H; Terai S
[Ad] Address:Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan.
[Ti] Title:Bleeding from a Small-Intestinal Ulcer Associated with Chronic Hepatitis C.
[So] Source:Am J Case Rep;19:234-237, 2018 Mar 03.
[Is] ISSN:1941-5923
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND Hepatitis C virus infection is probably the most common chronic viral infection and affects an estimated 180 million people worldwide. Extrahepatic manifestations are well recognized among patients with chronic HCV infection. CASE REPORT We report a case of melena occurring in a 69-year-old Japanese man who had been diagnosed with CHC and who was treated with antiviral therapy. CONCLUSIONS Finally, he was diagnosed with multiple small intestine ulcers in a short time. We herein report the case of HCV with rapidly developing small intestine ulcers.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:In-Process

  5 / 3476 MEDLINE  
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[PMID]: 29499083
[Au] Autor:Blanco-Velasco G; Solorzano-Pineda O; Hernández-Mondragón OV
[Ad] Address:Department of Endoscopy, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
[Ti] Title:Overt gastrointestinal bleeding caused by hookworm infection, diagnosed by capsule endoscopy.
[So] Source:Dig Endosc;, 2018 Mar 02.
[Is] ISSN:1443-1661
[Cp] Country of publication:Australia
[La] Language:eng
[Ab] Abstract:A 60-year-old man was admitted due to a chronic anaemia and intermittent melena since two months ago. Laboratory data revealed: haemoglobin 9.4 g/dl, haematocrit 26%, mean corpuscular volume 78 µm , white cell count 9500/mm with 4% eosinophils. Esophagogastroduodenoscopy and colonoscopy were realized without identifying the bleeding cause. This article is protected by copyright. All rights reserved.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[St] Status:Publisher
[do] DOI:10.1111/den.13047

  6 / 3476 MEDLINE  
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[PMID]: 29465551
[Au] Autor:Wang KL; Ma SF; Pang LY; Zhang MN; Hu LY; Liu MJ; Zou LP
[Ad] Address:Department of Pediatrics, Chinese PLA General Hospital, Beijing, China.
[Ti] Title:Sirolimus alternative to blood transfusion as a life saver in blue rubber bleb nevus syndrome: A case report.
[So] Source:Medicine (Baltimore);97(8):e9453, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Blue rubber bleb nevus syndrome (BRBNS) is a rare disease characterized by multiple venous malformations. The gastrointestinal bleeding and secondary iron deficiency anemia are the most common complications. There are currently no effective treatments for BRBNS. Here, we report a case of successful treatment with a small dose of sirolimus of a BRBN patient with a de novo gene mutation. PATIENT CONCERNS: A 12-year-old female was admitted to our hospital with multiple hemangiomas for 12 years. The patient often displayed melena; she recently received transfusion of 2 units of red blood cells once every 2 weeks. Multiple fist-sized hemangiomas were piled up on both sides and back of the neck, and were also noted on the arms, legs, chest, back, and on the tip of the tongue. The laboratory findings demonstrated severe anemia. Blood sample sequencing detected a heterozygous de novo mutation c.2545C > Tin the TEK gene. DIAGNOSES: Based on these findings, final diagnosis of Blue rubber bleb nevus syndrome (BRBNS) was made. INTERVENTIONS: After the diagnosis, low-dose sirolimus was orally administered. OUTCOMES: The patient's hemoglobin was increased after treatment with sirolimus for 1 month. Since the initial treatment with sirolimus, she had not received any blood transfusions. The skin and mucosal hemangioma decreased significantly, and new digestive tract hemorrhage, muscle hematoma, or adverse drug reactions were not observed. LESSONS: we report a case of a mutation in exon 15 of the TEK gene leading to BRBN. It was successfully treated with a small dose of sirolimus as an alternative to blood transfusion in order to save the of BRBN patient's life.
[Mh] MeSH terms primary: Gastrointestinal Neoplasms/drug therapy
Immunosuppressive Agents/administration & dosage
Nevus, Blue/drug therapy
Sirolimus/administration & dosage
Skin Neoplasms/drug therapy
[Mh] MeSH terms secundary: Blood Transfusion
Child
Female
Gastrointestinal Neoplasms/diagnosis
Gastrointestinal Neoplasms/genetics
Humans
Mutation
Nevus, Blue/diagnosis
Nevus, Blue/genetics
Skin Neoplasms/diagnosis
Skin Neoplasms/genetics
Treatment Outcome
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Nm] Name of substance:0 (Immunosuppressive Agents); W36ZG6FT64 (Sirolimus)
[Em] Entry month:1803
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009453

  7 / 3476 MEDLINE  
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[PMID]: 29368483
[Au] Autor:Ahmed R; Davitt J; Rayyan Y
[Ti] Title:Using Capsule Endoscopy at an Academic Teaching Hospital in West Virginia: A Descriptive Analysis of our 7 year Experience and Determination of Diagnostic Yield for Obscure Gastrointestinal Bleeding.
[So] Source:W V Med J;112(5):54-8, 2016 Sep-Oct.
[Is] ISSN:0043-3284
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Background: The aim of our study was to describe, analyze, and evaluate results of wireless capsule endoscopy (CE) as an imaging modality for various indications. Methods: We conducted a retrospective chart review study of all CE studies performed between January 1, 2007 and June 30, 2014 at Marshall University. The study included 272 patients between the ages of 21-85 years old. Results: The most common finding in our study was a normal study (57.7%) followed by small bowel erosions (14.3%), neoplasms (11.4%), Arteriovenous malformations (10.7%), inflammatory bowel disease (2.6%), and nonspecific findings (3.3%). Discussion: 90/209 patients who had indications for IDA, melena, or heme-positive stools demonstrated positive findings by CE; our diagnostic yield for obscure GI bleeding was therefore 43.1%.
[Mh] MeSH terms primary: Capsule Endoscopy
Gastrointestinal Hemorrhage/diagnosis
Hospitals, University
[Mh] MeSH terms secundary: Academic Medical Centers
Adult
Aged
Aged, 80 and over
Capsule Endoscopy/methods
Diagnosis, Differential
Female
Humans
Intestinal Diseases/diagnosis
Jejunal Neoplasms/diagnosis
Male
Middle Aged
Predictive Value of Tests
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity
West Virginia
[Pt] Publication type:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[Js] Journal subset:IM
[Da] Date of entry for processing:180126
[St] Status:MEDLINE

  8 / 3476 MEDLINE  
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[PMID]: 29390331
[Au] Autor:Tang Q; Zhou Z; Chen J; Di M; Ji J; Yuan W; Liu Z; Wu L; Zhang X; Li K; Shu X
[Ad] Address:Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
[Ti] Title:Correlation of metastasis characteristics with prognosis in gastric mixed adenoneuroendocrine carcinoma: Two case reports.
[So] Source:Medicine (Baltimore);96(50):e9189, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: This article is aimed to retrospect the clinicopathological data of 2 cases of gastric MANENCs. MANEC is a rare biphasic tumor type that is coexistence of dual neuroendocrine and adenocarcinoma differentiation with each composing exceeding 30% volume. Gastric MANEC have just been reported anecdotally in the literature due to their rarity and heterogeneity. According to our study, these neoplasms have 3 different metastasis patterns: only adenocarcinomatous or neuroendocrine carcinoma and both of the 2 components. We first focus on the correlation of metastasis characteristics with prognosis in gastric MANEC, which may be potential implications for the choice of chemotherapy. PATIENT CONCERNS: The 2 cases of patient shared several symptoms: epigastric discomfort, weight loss, hematemesis, or melena. DIAGNOSIS: The 2 patients were diagnosis as MANEC based on the identification of histopathological analysis. In case 1, the poor differentiated adenocarcinoma accounted for 30%, the neuroendocrine part account for 70% and both of the 2 components metastasized to the lymph nodes, whereas in case 2, poorly differentiated adenocarcinoma accounted for 70%, the neuroendocrine part for 30% and only the glandular component invaded regional lymph nodes. INTERVENTIONS: The first patient underwent laparoscopic radical gastrectomy and underwent adjuvant chemotherapy, combination of cisplatin, and etoposide successfully. The second patient received radical gastronomy, and did not receive any chemotherapy due to general weakness. OUTCOMES: The first patient is alive with no evidence of recurrence, and the second patient died 6 months after the operation. LESSONS: The assessment of metastatic sites should be a routine pathological practice, which is crucial for clinical decision-making and the selection of management.
[Mh] MeSH terms primary: Adenocarcinoma/pathology
Carcinoma, Neuroendocrine/pathology
Neoplasm Metastasis/pathology
Stomach Neoplasms/pathology
[Mh] MeSH terms secundary: Adenocarcinoma/surgery
Carcinoma, Neuroendocrine/surgery
Fatal Outcome
Humans
Male
Middle Aged
Prognosis
Stomach Neoplasms/surgery
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009189

  9 / 3476 MEDLINE  
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[PMID]: 29483428
[Au] Autor:Kamada Y; Fukuda K; Iguchi M; Inoue M; Kashimoto K; Iwata G; Yamaoka N; Tsukamoto K
[Ad] Address:Division of General Surgery and Pediatric Surgery, Kyoto Chubu Medical Center.
[Ti] Title:[A Case of Ischemic Colitis Four Months after Laparoscopic Left Hemicolectomy Preserving Superior Rectal Artery].
[So] Source:Gan To Kagaku Ryoho;45(2):303-305, 2018 Feb.
[Is] ISSN:0385-0684
[Cp] Country of publication:Japan
[La] Language:jpn
[Ab] Abstract:The case was for a male at the age of 80. We performed laparoscopic left hemicolectomy and D3 lymph node dissection for descending colon cancer. He had a good postoperative prognosis and was discharged on the 14th day after the operation. Later, he was receiving the treatment on an outpatient basis without postoperative adjuvant chemotherapy during the followup period. He visited the hospital for sudden abdominal pain and melena as chief complaint approximately 4 months after the operation. We found prominent edematous wall thickening and increased surrounding fat concentration in the anal side of colon from the anastomosis site with plain abdominal CT scan. We also found that the anal side of colon from the anastomosis site an edematous change broadly in the lower gastrointestinal endoscopy. We conducted conservative treatment with the diagnosis of ischemic colitis at the anal side of colon from the anastomosis site. He was discharged on the 11th day after the hospitalization. Later, we conducted a follow-up examination for him on an outpatient basis. We recognized the symptom improvement approximately 2 months after the onset of the ischemic colitis.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180227
[Lr] Last revision date:180227
[St] Status:In-Data-Review

  10 / 3476 MEDLINE  
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[PMID]: 29470885
[Au] Autor:Genna AD
[Ti] Title:Pólipo fibroid inflamatorio gástrico como causa de hemorragia digestive alta con descompensacion hemodiánamica. [Inflammatory fibroid polyp as the cause of upper gastrointestinal bleeding.]
[So] Source:Acta Gastroenterol Latinoam;46(1):48-51, 2016 Mar.
[Is] ISSN:0300-9033
[Cp] Country of publication:Argentina
[La] Language:spa
[Ab] Abstract:The inflammatory fibroid polyp or Vanek's tumor is a benign polypoid lesion that can be found in any section of the digestive tract. It is most frequently located in the stomach and when found in this organ, the symptoms include upper gastrointestinal bleeding (often silent), anemia and melena. The case described below, on the contrary, presents a gastric inflammatory fibroid polyp which developed acute upper gastrointestinal bleeding and required surgical treatment.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180227
[Lr] Last revision date:180227
[St] Status:In-Process


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