6,434 results match your criteria Lower Gastrointestinal Bleeding


Optimal Laparoscopic Management and Oncological Outcomes of Gastrointestinal Stromal Tumors in Duodenum: Pancreaticoduodenectomy or Pancreas-Sparing Duodenectomy?

Cancer Manag Res 2020 19;12:4725-4734. Epub 2020 Jun 19.

Department of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang Province, People's Republic of China.

Background: Gastrointestinal stromal tumors (GIST) of the duodenum are rarely reported and optimal minimally invasive management has not been well proposed. Pancreaticoduodenectomy and different types of pancreas-sparing duodenectomy can be chosen; however, which to choose and its corresponding clinical outcomes and oncological concerns remain controversial.

Patients And Methods: Patients diagnosed with GIST of duodenum underwent laparoscopic pancreaticoduodenectomy (L-PD) or pancreas-sparing duodenectomy (L-PSD) in Zhejiang Provincial People's Hospital were enrolled. Read More

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http://dx.doi.org/10.2147/CMAR.S254972DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310982PMC

The diagnostic yield of urgent colonoscopy in acute lower gastrointestinal bleeding.

Acta Gastroenterol Belg 2020 Apr-Jun;83(2):265-270

Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.

Background And Aims: Lower Gastrointestinal Bleeding (LGIB) is one of the leading causes of ER visits. Colonoscopy is indicated in all patients with LGIB, yet the time frame for performing colonoscopy remains unclear. Whether or not urgent endoscopic evaluation improves outcomes of LGIB has been questioned. Read More

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Current role of cyanoacrylate glue transcatheter embolization in the treatment of acute nonvariceal gastrointestinal bleeding.

Expert Rev Gastroenterol Hepatol 2020 Jun 30. Epub 2020 Jun 30.

Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital , Dijon, France.

Introduction: Over the past three decades, transcatheter arterial embolization (TAE) has become the first-line therapy for the management of acute nonvariceal gastrointestinal bleeding (NVGIB) that is refractory to endoscopic hemostasis. Advances in catheter-based techniques and newer liquid embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options, have expanded the role of interventional radiology in the treatment of acute NVGIB. Many embolic agents have been used successfully. Read More

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http://dx.doi.org/10.1080/17474124.2020.1790355DOI Listing

EUS guided cyanoacrylate injection to prevent rebleeding in hepatocellular carcinoma patients with variceal hemorrhage.

J Gastroenterol Hepatol 2020 Jun 30. Epub 2020 Jun 30.

Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong.

Background And Aim: Secondary prophylaxis (SP) of variceal rebleeding was reported to improve outcomes of hepatocellular carcinoma (HCC) patients, but the optimal endoscopic approach is not well defined. We compared outcomes in HCC patients who underwent SP by EUS-guided cyanoacrylate obturation (EUS-CYA) vs no SP.

Methods: Between 2014-2018, 30 consecutive patients with inoperable HCC and recent endoscopically controlled variceal bleeding were prospectively recruited. Read More

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http://dx.doi.org/10.1111/jgh.15168DOI Listing

[Successful treatment of an aortoduodenal fistula after operation on the abdominal portion of the aorta].

Angiol Sosud Khir 2020 ;26(2):170-174

I.P. Pavlov Ryazan State Medical University of the Ministry of Healthcare of the Russian Federation, Ryazan, Russia; Regional Clinical Hospital, Ryazan, Russia.

Gastrointestinal haemorrhage is a common cause of emergency admission of patients to surgical hospitals. Within the structure of nosological entities, not unreasonably referred to the rarest causes of gastrointestinal bleeding is the formation of an aortointestinal fistula whose early diagnosis is of paramount importance. The clinical picture may be different but it is mostly represented by gastrointestinal haemorrhage. Read More

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http://dx.doi.org/10.33529/ANGIO2020213DOI Listing
January 2020

Superselective transcatheter arterial embolization for acute small bowel bleeding: clinical outcomes and prognostic factors for ischemic complications.

Acta Radiol 2020 Jun 26:284185120936258. Epub 2020 Jun 26.

Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea.

Background: Small bowel bleeding (SBB) accounts for 5%-10% of all cases of acute gastrointestinal bleeding. Transcatheter arterial embolization (TAE) plays an important role in the treatment of SBB.

Purpose: To evaluate the safety and efficacy of superselective TAE exclusively for SBB and to assess factors associated with clinical outcomes. Read More

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http://dx.doi.org/10.1177/0284185120936258DOI Listing

THE EFFECT OF AGE ON OUTCOMES FOLLOWING DESTINATION THERAPY LEFT VENTRICULAR ASSIST DEVICE IMPLANTATION: AN ANALYSIS OF THE IMACS REGISTRY.

Can J Cardiol 2020 Jun 22. Epub 2020 Jun 22.

Peter Munk Cardiac Centre, Toronto General Hospital-University Health Network, Toronto, Canada. Electronic address:

Background: As patients with advanced heart failure are living longer, defining the impact of left ventricular assist devices (LVAD) on outcomes in an aging population is of great importance. We describe overall survival, rates of adverse events (AEs) and post-AE survival in patients age ≥70 vs. age 50-69 following destination therapy(DT) LVAD implantation. Read More

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http://dx.doi.org/10.1016/j.cjca.2020.06.010DOI Listing

Prealbumin and D-dimer as Prognostic Indicators for Rebleeding in Patients with Nonvariceal Upper Gastrointestinal Bleeding.

Dig Dis Sci 2020 Jun 24. Epub 2020 Jun 24.

Department of Digestive Diseases, Huashan Hospital, Fudan University, 12# Middle Wulumuqi Road, Shanghai, 200040, People's Republic of China.

Background: Determining the risk stratification of nonvariceal upper gastrointestinal bleeding (NVUGIB) plays a vital role in treating upper gastrointestinal bleeding (UGIB). Traditional scores like Glasgow-Blatchford score (GBS), Rockall score (RS), and AIMS65 score have been widely utilized in UGIB practice, however exhibiting limited practical use due to relative lack of user-friendly characters. Prealbumin as a nutritional indicator and d-dimer as a fibrinolytic activity monitor, are generally used to evaluate the overall nutritional and fibrinolytic condition in UGIB patients. Read More

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http://dx.doi.org/10.1007/s10620-020-06420-1DOI Listing

Unusual cause of lower gastrointestinal bleed and abdominal pain.

Frontline Gastroenterol 2020 21;11(4):337-338. Epub 2019 Jun 21.

Gastroenterology, Lenox Hill Hospital, New York, New York, USA.

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http://dx.doi.org/10.1136/flgastro-2019-101243DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307049PMC

[Design and application of a new gastrointestinal nutrition pipeline].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2020 May;32(5):611-612

Department of Intensive Care Unit, the First People's Hospital of Fuyang District, Hangzhou 311400, Zhejiang, China. Corresponding author: Tang Weidong, Email:

Gastrointestinal nutrition tube is a special gastrointestinal tube designed for enteral nutrition, diagnosis, treatment and monitoring in severe patients. Clinically, it is inserted into patients' stomach for flushing, provide nutrition through stomach, duodenum or jejunum, and decompress gastrointestinal tract. It also can be used for gastric drainage, gastric juice pH value determination, and early diagnosis and treatment for stomach bleeding and other symptoms. Read More

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http://dx.doi.org/10.3760/cma.j.cn121430-20200327-00236DOI Listing

The impact of albumin infusion on the risk of rebleeding and in-hospital mortality in cirrhotic patients admitted for acute gastrointestinal bleeding: a retrospective study of a single institute.

BMC Gastroenterol 2020 Jun 23;20(1):198. Epub 2020 Jun 23.

Department of Gastroenterology and Hepatology, West China Hospital of Sichuan University, 37# Guoxue Lane, Chengdu, 610041, Sichuan, China.

Background: To investigate the effect of albumin infusion on cirrhotic patients admitted for acute gastrointestinal bleeding.

Methods: Medical records of cirrhotic patients who admitted due to acute gastrointestinal bleeding through January 2009 to December 2018 were reviewed. Clinical data and the total amount of albumin and red blood cell used during hospitalization were recorded. Read More

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http://dx.doi.org/10.1186/s12876-020-01337-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310478PMC

Procalcitonin and C-reactive Protein Levels as Biomarkers to Determine Gastrointestinal Involvement in Adult Henoch-Schönlein Purpura Patients.

Acta Reumatol Port 2020 Jan-Mar;45(1):34-38

Objective: To investigate the association of procalcitonin (PCT) and C-reactive protein (CRP) levels with gastrointestinal (GI) involvement in adult HSP patients.

Method: A retrospective study using clinical data and serum PCT and CRP levels from 121 adult HSP patients was performed.

Results: The proportion of male HSP patients with GI involvement was significantly higher compared to patients without GI involvement. Read More

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Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial.

Authors:

Lancet 2020 Jun;395(10241):1927-1936

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Read More

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http://dx.doi.org/10.1016/S0140-6736(20)30848-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306161PMC

Comparative Outcomes Between Direct Oral Anticoagulants, Warfarin, and Antiplatelet Monotherapy Among Chinese Patients with Atrial Fibrillation: A Population-Based Cohort Study.

Drug Saf 2020 Jun 18. Epub 2020 Jun 18.

Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Pok Fu Lam, Hong Kong.

Introduction: Outcomes associated with suboptimal use of antithrombotic treatments (antiplatelets, warfarin, direct oral anticoagulants [DOACs]) are unclear in Chinese patients with atrial fibrillation (AF).

Objectives: Our objective was to assess the prescription patterns, quality, effectiveness, and safety of antithrombotic treatments.

Methods: This was a population-based cohort study using electronic health records in Hong Kong. Read More

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http://dx.doi.org/10.1007/s40264-020-00961-0DOI Listing
June 2020
2.824 Impact Factor

SMAD4 mutation and the combined juvenile polyposis and hereditary hemorrhage telangiectasia syndrome: a single center experience.

Int J Colorectal Dis 2020 Jun 15. Epub 2020 Jun 15.

Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, USA.

Purpose: Mutations of the SMAD4 gene can result in a distinct syndrome with combined clinical features of both juvenile polyposis syndrome (JPS) and hereditary hemorrhagic telangiectasia (HHT). Even though it is known that patients with the overlap syndrome are at increased risk for colorectal malignancies and bleeding, the outcomes of this patient population have not been extensively studied.

Methods: Retrospective study aiming to describe the phenotype and clinical outcomes of patients with genetically confirmed JP-HHT combined syndrome in a single large tertiary center in North America. Read More

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http://dx.doi.org/10.1007/s00384-020-03670-3DOI Listing

Laparoscopic total mesorectal excision for rectal venous malformation: A case report with a brief literature review.

Asian J Endosc Surg 2020 Jun 16. Epub 2020 Jun 16.

Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.

Rectal vascular malformation is a rare disease on which few reports have been published. Here, we report the case of a 38-year-old woman who presented with severe weakness, dyspnea, and recurrent episodes of rectal bleeding. Her colonoscopy showed an extensive pigmented lesion in the lower rectum. Read More

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http://dx.doi.org/10.1111/ases.12808DOI Listing

Prolapsed giant rectal gastrointestinal stromal tumor presented with incarceration A rare case of emergency rectal lesion.

Ann Ital Chir 2020 Jun 10;9. Epub 2020 Jun 10.

Prolapse of the tumor is an extremely rare clinical presentation in patients with rectal gastrointestinal stromal tumor (GIST). A 79-year-old male patient was consulted in the in-patient ward of internal medicine clinic of our hospital due to his incarcerated hemorrhagic mass protruding from the anal canal. Anal inspection revealed an incarcerated prolapsed hemorrhagic mass larger than 10 cm in diameter that looked like a cauliflower. Read More

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[Comparison of clinical features between patients with acute-on-chronic liver failure and decompensated liver cirrhosis combined with acute kidney injury].

Zhonghua Gan Zang Bing Za Zhi 2020 May;28(5):391-396

Difficult & Complicated Liver Diseases and Artificial Liver Center, Beijing You'an Hospital Affiliated to Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Liver Failure and Artificial Liver Treatment Research, Beijing 100069, China.

To compare the clinical features between patients with acute-on-chronic liver failure (ACLF) and decompensated liver cirrhosis (DC) combined with acute kidney injury (AKI). Demographic data, clinical examination results, diagnosis and treatment information of ACLF and DC patients were collected retrospectively. Clinical characteristics of ACLF combined with AKI and DC combined with AKI and their impact on the 90-day mortality risk were compared. Read More

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http://dx.doi.org/10.3760/cma.j.cn501113-20200417-00192DOI Listing

Clinical outcomes of nonvitamin K oral anticoagulants and acenocoumarol for stroke prevention in contemporary practice: A population-based propensity-weighted cohort study.

Br J Clin Pharmacol 2020 Jun 12. Epub 2020 Jun 12.

Health Services Research Unit. Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO), Valencia, Spain.

Aim: Acenocoumarol is a vitamin-K antagonist (VKA) primarily used in certain countries (e.g India, Netherlands, Spain). The half-life of acenocoumarol is similar to that of non-VKA oral anticoagulants (NOAC), unlike warfarin, and this could affect comparative effectiveness and safety (CES). Read More

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http://dx.doi.org/10.1111/bcp.14430DOI Listing
June 2020
3.878 Impact Factor

Epigastric port retrieval of the gallbladder following laparoscopic cholecystectomy is associated with the reduced risk of port site infection and port site incisional hernia: An updated meta-analysis of randomized controlled trials.

Ann Med Surg (Lond) 2020 Jul 25;55:244-251. Epub 2020 May 25.

Department of Digestive Diseases & Gastrointestinal Surgery, Brighton & Sussex University Hospitals NHS Trust, The Royal Sussex County Hospital, Eastern Road, Brighton, West Sussex, BN2 5BE, United Kingdom.

Aims: The objective of this article is to compare the surgical outcomes for epigastric port or umbilical port retrieval of the gallbladder (GB) following laparoscopic cholecystectomy (LC).

Methods: The data retrieved from the published randomized, controlled trials (RCT) comparing the surgical outcomes for epigastric port or umbilical port retrieval of the GB following LC was analysed using the principles of meta-analysis. The summated outcome of continuous variables was expressed as standardized mean difference (SMD) and dichotomous data was presented in odds ratio (OR). Read More

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http://dx.doi.org/10.1016/j.amsu.2020.05.017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7283097PMC

Use of low-dose acetylsalicylic acid for cardiovascular disease prevention: A practical, stepwise approach for pharmacists.

Can Pharm J (Ott) 2020 May-Jun;153(3):153-160. Epub 2020 Mar 19.

Chilliwack General Hospital (Barry), University of British Columbia, Vancouver, British Columbia.

Low-dose acetylsalicylic acid (ASA) is recommended in patients with established cardiovascular disease. However, the role of ASA in those without cardiovascular disease (i.e. Read More

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http://dx.doi.org/10.1177/1715163520909137DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265581PMC

Contemporary Nationwide Trends and In-Hospital Outcomes of Adjunctive Stenting in Patients Undergoing Catheter-Directed Thrombolysis for Proximal Deep Vein Thrombosis.

J Vasc Surg Venous Lymphat Disord 2020 Jun 6. Epub 2020 Jun 6.

Department of Cardiovascular Diseases, Temple University Hospital, Philadelphia, PA. Electronic address:

Objective: Outflow venous stenting as an adjunct to catheter directed thrombolysis is performed to prevent recurrent thrombosis and to reduce the risk of post-thrombotic syndrome. Historical data shows that stenting improves outcomes of surgical thrombectomy in patients with iliofemoral deep vein thrombosis (DVT), and recent observational data suggests that stenting improves long-term outcomes of catheter-directed thrombolysis (CDT). However, the impact of stenting during CDT on acute safety outcomes is unknown. Read More

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http://dx.doi.org/10.1016/j.jvsv.2020.04.034DOI Listing

Over-the-Scope Clip to the Rescue! A Novel Tool for Refractory Acute Nonvariceal Upper Gastrointestinal Hemorrhage.

Case Rep Gastroenterol 2020 May-Aug;14(2):261-270. Epub 2020 May 12.

Department of Gastroenterology, Staten Island University Hospital, Northwell Health, Staten Island, New York, USA.

Nonvariceal upper gastrointestinal hemorrhage (NVUGIH) is more prevalent than lower gastrointestinal hemorrhage and carries a high risk of mortality in the elderly, especially those with significant cardiovascular comorbidities. Traditional endoscopic methods, such as through-the-scope clips, electrocautery, and epinephrine injection, are frequently used to control these bleeds; however, they carry a 10% risk of rebleeding, and this itself carries a mortality risk of 36%. The larger over-the-scope clips (OTSC) that were initially used for the closure of fistulas and perforations are now gradually being implemented to manage NVUGIH. Read More

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http://dx.doi.org/10.1159/000507610DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265719PMC

The Safety and Efficacy of Rivaroxaban Compared with Warfarin in Patients with Atrial Fibrillation and Diabetes: A Systematic Review and Meta-analysis.

Am J Cardiovasc Drugs 2020 Jun 8. Epub 2020 Jun 8.

Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210000, China.

Aims: This meta-analysis was conducted to compare the efficacy and safety of rivaroxaban with warfarin in patients with atrial fibrillation (AF) and diabetes mellitus.

Methods: PubMed, Embase, Cochrane Library, and Web of Science databases were systematically searched from the establishment of databases up to 15 October 2019. Studies on efficacy and safety outcomes of rivaroxaban and warfarin were included. Read More

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http://dx.doi.org/10.1007/s40256-020-00407-zDOI Listing

Risk of Hospitalization With Hemorrhage Among Older Adults Taking Clarithromycin vs Azithromycin and Direct Oral Anticoagulants.

JAMA Intern Med 2020 Jun 8. Epub 2020 Jun 8.

Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Importance: Clarithromycin is a commonly prescribed antibiotic associated with higher levels of direct oral anticoagulants (DOACs) in the blood, with the potential to increase the risk of hemorrhage.

Objective: To assess the 30-day risk of a hospital admission with hemorrhage after coprescription of clarithromycin compared with azithromycin among older adults taking a DOAC.

Design, Setting, And Participants: This population-based, retrospective cohort study was conducted among adults of advanced age (mean [SD] age, 77. Read More

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http://dx.doi.org/10.1001/jamainternmed.2020.1835DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7281381PMC

Lower gastrointestinal bleeding due to colonic fistula caused by a gossypiboma: Case report and literature review.

Int J Surg Case Rep 2020 May 29;72:59-62. Epub 2020 May 29.

Department of General and Digestive Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Universitat Autonoma de Barcelona, Spain.

Introduction: Even in modern surgery, human mistakes cannot be totally avoided. Retained surgical items are among the most feared ones. Forgotten sponges inside patients can cause a wide range of complications due to the foreign body reaction, called gossypiboma. Read More

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http://dx.doi.org/10.1016/j.ijscr.2020.05.053DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7283079PMC

Watchman outcomes comparing post-implantation anticoagulation with warfarin versus direct oral anticoagulants.

J Interv Card Electrophysiol 2020 Jun 5. Epub 2020 Jun 5.

Department of Medicine, Division of Cardiology, Baylor Scott & White Health, Scott & White Memorial Hospital, 2401 S 31st Street, Temple, TX, 76508, USA.

Purpose: As left atrial appendage occlusion devices (LAAO) implantation rates grow, continued evaluation on best patient practices is important. We report pooled Watchman outcomes at a multicenter Texas healthcare system with an emphasis on clinical outcomes and post-implantation anticoagulation with direct oral anticoagulants (DOACs) versus warfarin.

Methods: Data for 163 patients with atrial fibrillation (AF) undergoing Watchman implantation was collected via retrospective chart review between June 2016 and June 2018. Read More

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http://dx.doi.org/10.1007/s10840-020-00790-2DOI Listing

An Unusual Cause of Lower Gastrointestinal Bleeding: Cecal Dieulafoy's Lesion.

Cureus 2020 May 2;12(5):e7928. Epub 2020 May 2.

Internal Medicine: Gastroenterology, Tufts Medical Center, Boston, USA.

Colonic Dieulafoy's lesions are an exceptionally rare cause of lower gastrointestinal (GI) bleeding. These lesions are almost exclusively found in the upper GI tract based on previous reviews. We present a case of an 81-year-old man who presented with melena progressing to hematochezia and was found to have a cecal Dieulafoy's lesion on colonoscopy. Read More

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http://dx.doi.org/10.7759/cureus.7928DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265779PMC

Rivaroxaban Versus Warfarin in African American Patients with Nonvalvular Atrial Fibrillation.

J Natl Med Assoc 2020 May 31. Epub 2020 May 31.

Department of Pharmacoepidemiology, New England Health Analytics LLC, Granby, CT, USA.

Introduction: Black patients are under-represented in randomized trials evaluating oral anticoagulants in non-valvular atrial fibrillation (NVAF). We sought to evaluate the effectiveness and safety of rivaroxaban versus warfarin in African Americans with NVAF.

Methods: We performed an analysis using Optum® De-Identified Electronic Health Record (EHR) data from 1/1/2012-9/30/2018. Read More

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http://dx.doi.org/10.1016/j.jnma.2020.04.014DOI Listing

Effect of low-dose aspirin on health outcomes: An umbrella review of systematic reviews and meta-analyses.

Br J Clin Pharmacol 2020 Jun 2. Epub 2020 Jun 2.

Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.

Aims: This study aimed to use an umbrella review methodology to capture the range of outcomes that were associated with low-dose aspirin and to systematically assess the credibility of this evidence.

Methods: Aspirin is associated with several health outcomes, but the overall benefit/risk balance related to aspirin use is unclear. We searched three major databases up to 15 August 2019 for meta-analyses of observational studies and randomized controlled trials (RCTs) including low-dose aspirin compared to placebo or other treatments. Read More

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http://dx.doi.org/10.1111/bcp.14310DOI Listing
June 2020
3.878 Impact Factor

Endoscopic papillectomy of benign papillary tumors: A single-center experience.

Medicine (Baltimore) 2020 May;99(22):e20414

Department of Gastroenterology, Changhai Hospital, Changhai Road 168, Shanghai.

Endoscopic treatment of duodenal papillary tumors is well described. This study aims to provide new evidence for the treatment of benign papillary tumors through comparisons between endoscopic snare papillectomy (ESP) and endoscopic mucosal resection (EMR).Between May 2010 and December 2017, 72 patients were enrolled. Read More

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http://dx.doi.org/10.1097/MD.0000000000020414DOI Listing
May 2020
5.723 Impact Factor

Computed tomography versus lower endoscopy as initial diagnostic method for evaluating patients with hematochezia at emergency room.

Medicine (Baltimore) 2020 May;99(22):e20311

Division of Gastroenterology, Department of Internal medicine, Chungnam National University School of Medicine, Daejeon, Korea.

For acute lower gastrointestinal bleeding (LGIB), lower gastrointestinal endoscopy is the preferred initial diagnostic test. However, it is difficult to perform urgently. Computed tomography (CT) is a convenient alternative. Read More

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http://dx.doi.org/10.1097/MD.0000000000020311DOI Listing

Plasma perfusion combined with plasma exchange in chronic hepatitis B-related acute-on-chronic liver failure patients.

Hepatol Int 2020 May 29. Epub 2020 May 29.

Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095, Jiefang Avenue, Wuhan, 430030, Hubei Province, China.

Background And Aims: Artificial liver support systems (ALSS) have been shown to significantly reduce mortality in patients with acute-on-chronic liver failure (ACLF). However, the characteristics of patients who would benefit most from ALSS treatment are poorly understood. This study aimed to delineate the indicators for ALSS and evaluate the effectiveness of plasma perfusion combined with plasma exchange (PP + PE) in patients with hepatitis B virus-related ACLF (HBV-ACLF). Read More

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http://dx.doi.org/10.1007/s12072-020-10053-xDOI Listing
May 2020
2.468 Impact Factor

Risks and outcomes of gastrointestinal malignancies in anticoagulated atrial fibrillation patients experiencing gastrointestinal bleeding: A nationwide cohort study.

Heart Rhythm 2020 May 26. Epub 2020 May 26.

Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan. Electronic address:

Background: Oral anticoagulants (OACs) may serve as a "screening test" for gastrointestinal (GI) tract malignancies through the clinical presentation of bleeding.

Objective: The purpose of this study was to investigate the 1-year incidence and predictors of GI cancer after GI bleeding among atrial fibrillation (AF) patients treated with warfarin or non-vitamin K antagonist oral anticoagulants (NOACs). The risks of mortality after GI cancers between patients receiving warfarin and those receiving NOACs were compared. Read More

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http://dx.doi.org/10.1016/j.hrthm.2020.05.026DOI Listing
May 2020
5.076 Impact Factor

Temporary Trend, Characteristics and Clinical Outcomes of Acute Pancreatitis Patients Infected with Human Immunodeficiency Virus.

Dig Dis Sci 2020 May 28. Epub 2020 May 28.

Department of Health Statistics, Second Military Medical University, No. 800 Xiangyin Road, Shanghai, 200433, China.

Background: Compared to general population, human immunodeficiency virus (HIV) infection may increase frequency of acute pancreatitis (AP); however, evidence regarding effects of HIV infection on AP-related outcomes is limited and controversial.

Aims: We aim to investigate the temporary trend, characteristics and clinical outcomes of AP infected with HIV.

Methods: We reviewed data from the 2003-2014 National Inpatient Sample to identify patients with a primary diagnosis of AP. Read More

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http://dx.doi.org/10.1007/s10620-020-06355-7DOI Listing

Hemostatic spray powder TC-325 in the primary endoscopic treatment of peptic ulcer related bleeding: multicentre international registry.

Endoscopy 2020 May 26. Epub 2020 May 26.

University College London Hospitals NHS Foundation Trust, Gastroenterology, London, United Kingdom of Great Britain and Northern Ireland.

Introduction Upper gastrointestinal bleeding (UGIB) is a leading cause of morbidity and associated with a 2-17% mortality in the United Kingdom (UK) and USA [1]. Peptic ulcers account for 50% of UGIB's. Endoscopic intervention in a timely manner can improve outcomes. Read More

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http://dx.doi.org/10.1055/a-1186-5360DOI Listing

Comparison among Transanal Endoscopic Operation (TEO), Endoscopic Submucosal Dissection (ESD) and Full-Thickness Resection Device (FTRD) based on the Over-the-Scope (OVESCO) Clip System: which is the best technique for en bloc resection of rectal lesions?

Minerva Chir 2020 May 26. Epub 2020 May 26.

Gastrointestinal Surgical Unit, Department of Surgery and Translational Medicine, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.

Introduction: Aim of Our retrospective study is comparing efficacy and indications of transanal endoscopic microsurgery (TEM), endoscopic submucosal dissection (ESD) and endoscopic full- thickness resection device (FTRD) with over-the-scope (OVESCO) closure for en bloc resection of rectal lesions, together.

Methods: This study collected 76 cases of rectal neoplasms from a single hospital institution. Primary endpoints were complete en bloc resection, intraprocedural adverse events, R0 en bloc resection and an early discharge of the patient. Read More

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http://dx.doi.org/10.23736/S0026-4733.20.08298-XDOI Listing

The diagnostic value of video capsule endoscopy for Meckel's diverticulum in children.

Rev Esp Enferm Dig 2020 Jun;112(6):429-433

Gastroenterology, Children's Hospital of Fudan University.

Background: Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract and is also an important cause of bloody stool and anemia in children. However, there are few data about video capsule endoscopy (VCE) for MD in children. This study aimed to evaluate the diagnostic value of VCE for MD in children. Read More

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http://dx.doi.org/10.17235/reed.2020.6708/2019DOI Listing

Universal antibiotic prophylaxis may no longer be necessary for patients with acute variceal bleeding: A retrospective observational study.

Medicine (Baltimore) 2020 May;99(20):e19981

A few decades ago, antibiotic prophylaxis for patients with acute variceal bleeding was reported beneficial. However, endoscopic and systemic therapy for variceal bleeding has dramatically improved since then, so the necessity of prophylactic antibiotics can be questioned. In this study, we reevaluated the efficacy of antibiotic prophylaxis in acute variceal bleeding, using the most recent data in our hospital. Read More

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http://dx.doi.org/10.1097/MD.0000000000019981DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7253534PMC

A Therapeutic Approach to Cecal Varices.

ACG Case Rep J 2020 Feb 2;7(2):e00315. Epub 2020 Mar 2.

Department of Gastroenterology, Upstate Medical University, Syracuse, NY.

Ectopic varices account for 1%-5% of all variceal bleeding episodes. The most common presentation of cecal varices is an acute episode of a massive lower gastrointestinal hemorrhage. However, cecal varices can be found incidentally and can be silent for a prolonged period of time before presenting with a massive gastrointestinal hemorrhage. Read More

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http://dx.doi.org/10.14309/crj.0000000000000315DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7209800PMC
February 2020

Readmissions Rates After Myocardial Infarction for Gastrointestinal Bleeding: A National Perspective.

Dig Dis Sci 2020 May 20. Epub 2020 May 20.

Department of Gastroenterology, UMMS-Baystate Medical Center, Springfield, MA, USA.

Background And Aims: Gastrointestinal (GI) bleeding is one most common complications of acute myocardial infarction (AMI). We aimed to determine the incidence, in-hospital outcomes, associated healthcare burden and predictors of GI bleeding within 30 days after AMI.

Methods: Data were extracted from Nationwide Readmission Database 2010-2014. Read More

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http://dx.doi.org/10.1007/s10620-020-06315-1DOI Listing
May 2020
2.550 Impact Factor

Faecal calprotectin and ultrasonography as non-invasive screening tools for detecting colorectal polyps in children with sporadic rectal bleeding: a prospective study.

Ital J Pediatr 2020 May 20;46(1):66. Epub 2020 May 20.

Gastroenterology and Gastrointestinal Endoscopy Unit, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy.

Background: Colorectal polyps are reported in 6,1% of paediatric colonoscopies and in 12% of those performed for lower gastrointestinal bleeding. Although colonoscopy is widely used in paediatric patients, it requires bowel preparation and general anaesthesia or deep sedation, and in rare cases, it can cause complications. Non-invasive screening techniques able to predict polyps in children with isolated and sporadic rectal bleeding may play a key role in the selection of patients needing colonoscopy. Read More

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http://dx.doi.org/10.1186/s13052-020-00828-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238517PMC

Natural history of upper and lower gastrointestinal bleeding in hemodialysis patients: A dual-center long-term cohort study.

J Gastroenterol Hepatol 2020 May 20. Epub 2020 May 20.

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Background And Aim: Knowledge on the risk of gastrointestinal (GI) bleeding in hemodialysis patients is limited. We evaluated the risk of GI bleeding in hemodialysis patients compared with non-hemodialysis patients.

Methods: We performed a retrospective cohort study from 1996 to 2017 at the Graduate School of Medicine, University of Tokyo, and Horinouchi Hospital. Read More

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http://dx.doi.org/10.1111/jgh.15110DOI Listing

Provocative Angiography, Followed by Therapeutic Interventions, in the Management of Hard-To-Diagnose Gastrointestinal Bleeding.

World J Surg 2020 May 13. Epub 2020 May 13.

Division of Trauma, Department of Surgery, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street, Suite 810, Boston, MA, 02114, USA.

Background: Despite significant advances in imaging and endoscopic diagnostic techniques, adequate localization of gastrointestinal bleeding (GIB) can be challenging. Provocative angiography (PROVANGIO) has not been part of the standard diagnostic algorithms yet. We sought to examine the ability of PROVANGIO to identify the bleeding source when conventional radiography fails. Read More

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http://dx.doi.org/10.1007/s00268-020-05545-8DOI Listing

Prevention of acute radiation-induced Proctitis by Aloe vera: a prospective randomized, double-blind, placebo controlled clinical trial in Pelvic Cancer patients.

BMC Complement Med Ther 2020 May 13;20(1):146. Epub 2020 May 13.

Gastrointestinal Cancer Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.

Background: Acute radiation-induced proctitis (ARP) is the most common side effect following radiotherapy for malignant pelvic disease. This study evaluated the efficacy of Aloe vera ointment in prevention of ARP.

Methods: Forty-two patients receiving external-beam radiotherapy (RT) for pelvic malignancies were randomized to receive either Aloe vera 3% or placebo topical ointment during radiotherapy for 6 weeks. Read More

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http://dx.doi.org/10.1186/s12906-020-02935-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7222341PMC

Aspirin Is Associated With Reduced Rates of Venous Thromboembolism in Older Patients With Cancer.

J Cardiovasc Pharmacol Ther 2020 May 13:1074248420925021. Epub 2020 May 13.

Wafic Said Molecular Cardiology Research Laboratory, Texas Heart Institute, Houston, TX, USA.

Background: Older patients with cancer are at high risk of developing venous thromboembolism (VTE) and bleeding. Aspirin may decrease VTE in the general population without significant bleeding. Here, we examined whether aspirin is associated with reduced rates of VTE in older patients with cancer. Read More

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http://dx.doi.org/10.1177/1074248420925021DOI Listing

Trends and Outcomes of Gastrointestinal Bleeding Among Septic Shock Patients of the United States: A 10-Year Analysis of a Nationwide Inpatient Sample.

Cureus 2020 May 8;12(5):e8029. Epub 2020 May 8.

Pulmonary and Critical Care Medicine, Robert Packer Hospital, Sayre, USA.

Introduction Gastrointestinal bleeding (GIB) complicating septic shock (SS) presents a therapeutic challenge in intensive care units. Large-scale data regarding utilization, length of stay, and cost outcomes of this association are lacking. Methods We queried the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample from 2003 to 2012, and identified all adult patients aged ≥18 years hospitalized for SS by the International Classification of Diseases, Ninth Revision (ICD-9) diagnostic code for SS and GIB. Read More

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http://dx.doi.org/10.7759/cureus.8029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7212718PMC

Non-Vitamin K Antagonist Oral Anticoagulants and the Gastrointestinal Bleeding Risk in Real-World Studies.

J Clin Med 2020 May 9;9(5). Epub 2020 May 9.

Internal Medicine Department, "Grigore T. Popa" University of Medicine and Pharmacy, 700503 Iași, Romania.

In the present study, we aimed to provide evidence from high-quality real world studies for a comprehensive and rigorous analysis on the gastrointestinal bleeding (GIB) risk for non-vitamin K antagonist oral anticoagulants (NOACs). We performed a systematic search of MEDLINE, EMBASE and PUBMED, and of 286 records screened, we included data from 11 high-quality real-world studies, coordinated by independent research groups over the last 3 years, that reported major GIB events in patients given NOACs or vitamin K antagonists for patients with nonvalvular atrial fibrillation. The lowest risk of gastrointestinal bleeding was with apixaban compared with warfarin (hazard ratio (HR) for GIB for apixaban ranging between 0. Read More

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http://dx.doi.org/10.3390/jcm9051398DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290290PMC

Clinical Factors Associated with Mortality in Cirrhotic Patients Presenting with Upper Gastrointestinal Bleeding.

J Can Assoc Gastroenterol 2020 Jun 10;3(3):127-134. Epub 2019 Mar 10.

Division of Gastroenterology and Hepatology, The Ottawa Hospital, Ottawa, Ontario, Canada.

Background: Whether certain clinical or laboratory characteristics are able to differentiate cirrhotic patients with upper gastrointestinal bleeds (UGIB) at high-risk inpatient mortality is unknown. The objective of this study is to elucidate patient factors at presentation that are associated with in-hospital mortality.

Methods: A retrospective analysis of cirrhotic patients presenting with UGIB was performed. Read More

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http://dx.doi.org/10.1093/jcag/gwy075DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204794PMC

Massage of the Hepatoduodenal Ligament Recovers Portal Vein Flow Immediately After the Pringle Maneuver in Hepatectomy.

World J Surg 2020 May 11. Epub 2020 May 11.

Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 1-5-1, Bunkyo-ku Sendagi, Tokyo, 113-8603, Japan.

Background: The Pringle maneuver is often used in liver surgery to minimize bleeding during liver transection. Many authors have demonstrated that intermittent use of the Pringle maneuver is safe and effective when performed appropriately. However, some studies have reported that the Pringle maneuver is a significant risk factor for portal vein thrombosis. Read More

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http://dx.doi.org/10.1007/s00268-020-05570-7DOI Listing