Search Our Scientific Publications & Authors

Clin Gastroenterol Hepatol 2019 Feb 14. Epub 2019 Feb 14.

Division of Gastroenterology and Liver Disease, Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.

Background & Aims: Upper gastrointestinal bleeding is a common emergency and rebleeding is associated with an increased risk of death. Proper assessment of high-risk lesions and appropriate endoscopic hemostasis are required for the best outcomes. The endoscopic Doppler probe exam (DPE) allows for a more complete assessment of the stigmata of hemorrhage, providing better evaluation of the need for endoscopic hemostasis and determination of its completeness. Read More

Clin Gastroenterol Hepatol 2019 Feb 14. Epub 2019 Feb 14.

School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.

Background & Aims: Gastric variceal bleeding (GVB) frequently recurs after hemostasis by gastric variceal obturation (GVO). We performed a multicenter, randomized controlled trial to determine the efficacy of carvedilol plus GVO in secondary prophylaxis of GVB.

Methods: We performed a prospective study of 121 patients with cirrhosis (ages 20-80 years) with GVB proven by endoscopy within 24 hours of bleeding and stable hemodynamics for at least 3 days after initial GVO. Read More

Arab J Gastroenterol 2019 Feb 12. Epub 2019 Feb 12.

Department of Internal Medicine, Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran. Electronic address:

Background And Study Aims: Acute upper gastrointestinal bleeding is one of the main causes of hospitalisation. The purpose of this study was to determine the prognostic factors in non-variceal upper gastrointestinal bleeding.

Patients And Methods: Clinical outcomes, demographic and laboratory variables of the subjects were collected from the HIS software and national code with the SQL format from three hospitals in Qazvin. Read More

Xenotransplantation 2019 Feb 15:e12496. Epub 2019 Feb 15.

Department of Vascular Surgery, Institute of Hematology and Transfusiology, Warsaw, Poland.

The infection of a vascular prosthesis is potentially fatal, and its effective treatment still remains the greatest challenge for vascular surgeons. We present our initial experience using bovine pericardial vascular prostheses to replace infected aortoiliac vascular grafts. Six consecutive patients with infection of the graft were prospectively included in this study. Read More

Data Brief 2018 Dec 12;21:2526-2530. Epub 2018 Oct 12.

Department of Gastroenterology, Research Center for Infectious Diseases of Digestive System, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Upper gastrointestinal bleeding (UGIB) which occurs proximal to the Treitz ligament is one of the most common cases is emergency medical conditions. The aim of this data article is to evaluation of Rockall and Blatchford scoring systems for predicting the clinical outcomes of patients with upper gastrointestinal bleeding in Imam-Khomeini Hospital, Ahvaz, Iran. This dataset was collected by retrospective descriptive epidemiologic survey which 350 non-cirrhotic patients with UGIB who referred to Ahwaz Imam-Khomeini Hospital for six months. Read More

Langenbecks Arch Surg 2019 Feb 13. Epub 2019 Feb 13.

Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, Sydney, Australia.

Background: Delayed massive post-pancreatectomy haemorrhage (PPH) is a highly lethal complication after pancreatectomy. Angiographic procedures have led to improved outcomes in the management of these patients. In the setting of an acute haemorrhage, laparotomy and packing are often required to help stablise the patient. Read More

Endosc Int Open 2019 Feb 8;7(2):E298-E301. Epub 2019 Feb 8.

Clinic for Internal Medicine I, Department of Gastroenterology, InExEn, University Hospital Ulm, Ulm, Germany.

En-bloc resection of large, flat lesions or early stages of cancer is challenging. No bimanual tasks are possible using standard endoscopes. Dual-channel endoscopes are not available everywhere and have a small distance between the channels. Read More

Eur J Gastroenterol Hepatol 2019 Feb 7. Epub 2019 Feb 7.

Catalyst Medical Consulting, Simpsonville.

Objective: Acute cholangitis (AC) and upper gastrointestinal hemorrhage (UGIH) are common emergencies encountered by gastroenterologists. We aimed to evaluate the impact of UGIH on in-hospital mortality, morbidity and resource utilization among patients with AC.

Patients And Methods: Adult admissions with a principal diagnosis of AC were selected from the National Inpatient Sample 2010-2014. Read More

Scand J Surg 2019 Feb 11:1457496919826722. Epub 2019 Feb 11.

Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.

Background And Aims:: Minimally invasive esophagectomy is a favored alternative in high-volume centers. We evaluated the introduction of, and transition to, minimally invasive esophagectomy at a medium volume tertiary referral center (10-20 esophagectomies annually) with focus on surgical results.

Material And Methods:: Patients who underwent minimally invasive esophagectomy or open transthoracic surgery for carcinoma of the esophagus or gastroesophageal junction (Siewert I and II) during 2007-2016 were retrospectively studied. Read More

Esophagus 2019 Feb 8. Epub 2019 Feb 8.

Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.

Purpose: A prospective trial evaluated the feasibility and safety of "mediastinoscopic esophagectomy with lymph node dissection" (MELD).

Methods: Eligible patients had thoracic esophageal squamous cell carcinoma, excluding T4, a bulky primary lesion or distant metastasis. Ten patients were enrolled and treated between September 2015 and March 2018. Read More

World J Emerg Surg 2019 1;14. Epub 2019 Feb 1.

1Emergency Surgery Department, Maggiore Hospital of Parma, University of Parma, Parma, Italy.

Background: Nowadays, very few patients with non-variceal upper gastrointestinal bleeding fail endoscopic hemostasis (refractory NVUGIB). This subset of patients poses a clinical dilemma: should they be operated on or referred to transcatheter arterial embolization (TAE)?

Objectives: To carry out a systematic review of the literature and to perform a meta-analysis of studies that directly compare TAE and surgery in patients with refractory NVUGIB.

Materials And Methods: We searched PubMed, Ovid MEDLINE, and Embase. Read More

Ugeskr Laeger 2019 Feb;181(6)

Upper gastrointestinal bleeding caused by an ulcer is a common condition with approximately 1,500 admissions a year. The mortality is roughly 9%, with an increased risk in elderly with multiple comorbidities. First-line treatment is endoscopic double therapy. Read More

Haemophilia 2019 Feb 6. Epub 2019 Feb 6.

Haemophilia Comprehensive Care Centre, Faculty of Health Sciences, University of the Witwatersrand and NHLS, Parktown, Johannesburg, South Africa.

Introduction: Prospectively collected real-world data on bleeds, haemophilia treatment and safety in persons with haemophilia A (PwHA) without factor VIII (FVIII) inhibitors are limited. A global, non-interventional study (NIS; NCT02476942) prospectively collected real-world data in PwHA who were treated per local routine clinical practice.

Aim: Assess annualized bleeding rate (ABR), haemophilia treatment practices and adverse events (AEs) in adult/adolescent PwHA without inhibitors. Read More

Dan Med J 2019 Feb;66(2)

Introduction: Treatment-requiring acute non-variceal upper gastrointestinal bleeding (NVUGIB) is a common, potentially life-threatening emergency. This study investigated whether hospital admittance volume of patients with NVUGIB was associated with reduced mortality, reduced lasting failure of haemostatic procedures defined as rate of re-endoscopy with repeated haemostasis intervention (ReWHI), transfusion requirements and conversion to surgery.

Methods: Data on Danish nationwide admissions of patients with acute NVUGIB from 2011-2013 were analysed to estimate 30-day mortality, re-bleeding (ReWHI), transfusion rates and rates of conversion to surgery. Read More

BMJ Case Rep 2019 Jan 31;12(1). Epub 2019 Jan 31.

Intensive Care Medicine, Ente Ospedaliero Cantonale, Ospedale Regionale di Mendrisio, Mendrisio, Switzerland.

A middle-aged woman previously in good health arrived to hospital with severe haemorrhagic shock. An abdominal and pelvic CT scan showed hepatomegaly, fluid in the sigmoid colon, perigastric and right sided pelvic varices without a clear source of bleeding. Urgent esophagogastroduodenoscopy excluded gastric varices and active upper gastrointestinal bleeding and the colonoscopy was inconclusive due to haemodynamic instability and massive bleeding which made it impossible to proceed with a full colonoscopy. Read More

Lancet Haematol 2019 Feb;6(2):e100-e109

The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Background: Therapeutic approaches for B-cell malignancies continue to evolve, especially with regard to combination approaches. We assessed the safety and efficacy of the triplet ublituximab, umbralisib, and ibrutinib in patients with advanced B-cell malignancies.

Methods: We did an open-label, phase 1 study with dose-escalation and dose-expansion phases, at five centres in the USA. Read More

Am J Case Rep 2019 Feb 1;20:134-138. Epub 2019 Feb 1.

Department of Surgical Oncology, HCG Manavata Cancer Centre, Nashik, Maharashtra, India.

BACKGROUND Anaplastic thyroid carcinoma (ATC) is an uncommon and aggressive form of human cancer. Despite advancement in multimodal therapy for patients with ATC, the prognosis remains poor. Most patients presenting with ATC have metastasis to the lungs and regional lymph nodes. Read More

Am J Gastroenterol 2019 Feb;114(2):244-249

Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.

Objectives: Little is known about how reports on the adverse effects of proton pump inhibitors (PPIs) impact patients' perceptions of these drugs and medication use. We sought to determine patients' level of concern about PPI adverse effects and its association with attempts to discontinue these drugs.

Methods: This study is an online survey of US adults who use PPIs for gastroesophageal reflux disease. Read More

Pol Merkur Lekarski 2018 Dec;45(270):248-250

3rd Department of Internal Medicine and Cardiology, 2nd Medical Faculty, Medical University of Warsaw, Warsaw, Poland.

Patients with severe diabetic acidosis may present varying electrocardiography (ECG) abnormalities including ST-segment elevation. The authors described a case of 70-year-old type 2 diabetic woman hospitalized due to ST elevation myocardial infarction and serious metabolic disorders. According to the clinical presentation, the ECG abnormalities and the significant rise in myocardial necrosis biomarkers the patient was diagnosed with myocardial infarction and received a typical pharmacological treatment. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):1955-1957

Dept. of Surgery, Tokyo Metropolitan Ohtsuka Hospital.

A 57-year-old man visited our hospital with right hypochondralgia. Abdominal contrast CT showed a 10 cm sized mass in S6-7of the liver and abdominal hemorrhage areas. The tumor showed extrahepatic growth. Read More

Clin Toxicol (Phila) 2019 Jan 28:1-9. Epub 2019 Jan 28.

a National Poisons Centre , University of Otago , Dunedin , New Zealand.

Introduction: Sodium hypochlorite is used as a bleaching and disinfecting agent and is commonly found in household bleach.

Objective: The objective is to review critically the epidemiology, mechanisms of toxicity, clinical features, diagnosis, and management of hypochlorite poisoning.

Methods: PubMed was searched from January 1950 to June 2018 using the terms "Hypochlorite", "Sodium Hypochlorite", "Sodium Oxychloride", "Hypochlorous Acid", "Bleach", "Chlorine Bleach", in combination with the keywords "poisoning", "poison", "toxicity", "ingestion", "adverse effects", "overdose", and "intoxication". Read More

Indian J Gastroenterol 2019 Jan 22. Epub 2019 Jan 22.

Department of Vascular Surgery, Sir Ganga Ram Hospital, Old Rajinder Nagar, Rajinder Nagar, New Delhi, 110 060, India.

Int J Epidemiol 2019 Jan 21. Epub 2019 Jan 21.

Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.

Background: In 2006, the Bowel Cancer Screening Programme (BCSP) in England began offering biennial faecal occult blood testing (FOBt) at ages 60-69 years. Although FOBt is aimed at detecting colorectal neoplasms, other conditions can affect the result. In a large UK prospective study, we examined associations, both before and after screening, between FOBt positivity and 10 conditions that are often associated with gastrointestinal bleeding. Read More

Pediatr Transplant 2019 Jan 20:e13357. Epub 2019 Jan 20.

Faculty of Medicine Ramathibodi Hospital, Department of Pediatrics, Division of Gastroenterology, Mahidol University, Bangkok, Thailand.

PTLD is a rare but potentially life-threatening condition, which shows a higher prevalence in children than in adults. From 129 children who underwent LT, we reported 5 cases with biopsy-proven PTLD at a single teaching hospital. Four patients had shared clinical presentations including fever, lymphadenopathy, and splenomegaly. Read More

Hernia 2019 Jan 19. Epub 2019 Jan 19.

Department of Surgery, EKHUFT, Ashford, Kent, UK.

Purpose: Repair of giant paraoesophageal herniae (GPEH) is technically challenging and requires significant experience in advanced foregut surgery. Controversy continues on suture versus mesh cruroplasty with the most recent systematic review and meta-analysis putting the onus on the operating surgeon. Study aim was to review whether the biological prosthesis (non-cross-linked bovine pericardium and porcine dermis) and the technique adopted for patients with GPEH had an influence on clinical and radiological recurrences. Read More

Am J Med 2019 Jan 17. Epub 2019 Jan 17.

Department of Medicine, Medical University of South Carolina, Charleston, South Carolina. Electronic address:

Objective: The belief that cirrhotic patients are "auto-anticoagulated" often results in anticoagulation therapy being withheld in these patients. We aimed to understand patterns of use of anticoagulation and to determine the risk of bleeding complications in cirrhotic patient.

Methods: We retrospectively analysed 320 cirrhotic patients treated with anticoagulation therapy from July 15 ,2014 to January 30, 2018. Read More

CVIR Endovasc 2018 28;1(1). Epub 2018 Jun 28.

2University College London Hospital, Euston Road, London, NW1 2BU UK.

Background: Haemobilia, defined as bleeding from the biliary tree, is a rare entity. The most common cause of haemobilia is iatrogenic trauma, which accounts for 70% of cases. Pseudoaneurysms of the portal vein are an extremely rare cause of haemobilia with only four reported cases to date. Read More

Frontline Gastroenterol 2019 Jan 9;10(1):35-42. Epub 2018 Feb 9.

Division of Surgery and Interventional Science, University College London, London, UK.

Acute upper gastrointestinal bleeding (AUGIB) is one of the most common medical emergencies in the UK. Despite advancement in technology the management of AUGIB remains a challenge. The clinical community recognise the need for improvement in the treatment of these patients. Read More

Oncotarget 2018 Dec 11;9(97):36891-36893. Epub 2018 Dec 11.

Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong.

Aim: Although proton pump inhibitors (PPIs) can prevent aspirin-induced upper gastrointestinal bleeding, a clinical dilemma exists as long-term use of PPI may also increase the risk of gastric cancer even after (HP) eradication. We aimed to investigate the potential interaction between aspirin and PPIs on GC risk in patients who have HP eradicated.

Results: Of the 63,397 HP eradicated subjects (median follow-up 7. Read More

J Radiol Case Rep 2018 Aug 31;12(8):12-16. Epub 2018 Aug 31.

Department of Diagnostic Radiology, the University of Toledo Medical Center, Ohio, USA.

A case of a 52-year old male patient who presented to the emergency department with severe nausea and vomiting following accidental ingestion of H2O2. A computed tomography (CT) abdomen performed at our institution demonstrated extensive portal venous gas throughout the liver with few gas droplets seen in the extrahepatic portal vein portion. Pneumatosis was also noted in the wall of the gastric antrum. Read More

BMC Geriatr 2019 Jan 16;19(1):14. Epub 2019 Jan 16.

Diabetes Center and Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109 West Xueyuan Road, Wenzhou, China.

Background: Geriatric nutritional risk index (GNRI) is a simple and useful nutritional marker for predictor of adverse outcomes in patients undergoing a variety of conditions. This study explored the relationship between GNRI and adverse outcomes of Pyogenic Liver Abscess (PLA) patients and assessed GNRI predictive value.

Methods: This was one retrospective study involving 240 PLA patients. Read More

Clin Endosc 2019 Jan 17;52(1):1-2. Epub 2019 Jan 17.

Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.

ACG Case Rep J 2018 19;5:e101. Epub 2018 Dec 19.

Sanford School of Medicine, University of South Dakota, Sioux Falls, SD.

Esophageal bleeding has a broad differential. One rare cause of esophageal bleeding is an intercostal artery pseudoaneurysm, which usually presents as hemothorax secondary to trauma or an iatrogenic cause; we identified only 9 reported cases in the English literature. Rarer still is pseudoaneurysm of the intercostal-bronchial trunk, which has not been reported in the literature. Read More

World J Gastroenterol 2019 Jan;25(1):69-84

Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo 113-8655, Japan.

Acute lower gastrointestinal bleeding (LGIB) is a common indication for hospital admission. Patients with LGIB often experience persistent or recurrent bleeding and require blood transfusions and interventions, such as colonoscopic, radiological, and surgical treatments. Appropriate decision-making is needed to initially manage acute LGIB, including emergency hospitalization, timing of colonoscopy, and medication use. Read More

Emergencias 2018 Dic;30(6):419-423

Servicio de Aparato Digestivo, Hospital Universitari ParcTaulí. Institut d'Investigació i Innovació ParcTaulí, Barcelona, España. Departamento de Medicina. Universitat Autònoma de Barcelona, España.

Objectives: The American College of Gastroenterology's 2016 clinical guidelines for treating lower gastrointestinal (GI) tract bleeding recommends evaluating of nasogastric tube aspiration and the ratio of blood urea nitrogen (BUN) to creatinine to differentiate upper from lower GI bleeds. However, the evidence base to support recommending these 2 diagnostic variables is low. This study aimed to evaluate the diagnostic utility of nasogastric tube aspiration and the BUN-to-creatinine ratio for distinguishing between upper and lower GI bleeding. Read More

J Transl Int Med 2018 Dec 31;6(4):189-193. Epub 2018 Dec 31.

Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang 110840, Liaoning Province, China.

Acute-on-chronic liver failure (ACLF) is a potentially lethal syndrome, which is characterized by an acute deterioration of liver function in patients with chronic liver diseases. The present paper reported that an alcoholic cirrhotic patient with ACLF developed septic shock, hydrothorax, ascites, hepatic encephalopathy, acute kidney injury, and acute upper gastrointestinal bleeding at the same hospitalization and was successfully rescued by pharmacotherapy alone without any invasive intervention. Read More

Can J Gastroenterol Hepatol 2018 29;2018:3541365. Epub 2018 Nov 29.

Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, 110840, China.

Background And Aims: Acute upper gastrointestinal bleeding (AUGIB) is a lethal complication of liver cirrhosis. We aimed to compare the outcomes of patients with liver cirrhosis and AUGIB who were admitted to hospital on regular hours and off-hours.

Methods: This retrospective study screened all cirrhotic patients with AUGIB who were admitted to our hospital from January 2010 to June 2014 for the test cohort and from December 2014 to March 2018 for the validation cohort. Read More

World J Gastrointest Endosc 2018 Dec;10(12):400-421

Department of Endoscopy of Clinics Hospital of São Paulo University, São Paulo 05403-00, Brazil.

Aim: To compare the diagnostic accuracy of video capsule endoscopy (VCE) and double-balloon enteroscopy (DBE) in cases of obscure gastrointestinal bleeding (OGIB) of vascular origin.

Methods: MEDLINE ( PubMed), LILACS ( BVS) and Cochrane/CENTRAL virtual databases were searched for studies dated before 2017. We identified prospective and retrospective studies, including observational, cohort, single-blinded and multicenter studies, comparing VCE and DBE for the diagnosis of OGIB, and data of all the vascular sources of bleeding were collected. Read More

Endoscopy 2019 Jan 10. Epub 2019 Jan 10.

Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon, Republic of Korea.

Background:  A new hemostatic adhesive powder (UI-EWD) has been developed to reduce the high re-bleeding rates associated with the currently available hemostatic powders. The current study aimed to assess the efficacy of UI-EWD as a salvage therapy for the treatment of refractory upper gastrointestinal bleeding (UGIB).

Methods:  A total of 17 consecutive patients who had failed to achieve hemostasis with conventional endoscopic procedures and had undergone treatment with UI-EWD for endoscopic hemostasis in refractory UGIB were prospectively enrolled in the study. Read More

Dis Aquat Organ 2019 Jan;132(2):85-97

Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida 32608, USA.

Cold-stress syndrome (CSS) is a leading natural cause of mortality in free-ranging Florida manatees Trichechus manatus latirostris, but comprehensive investigations into blood analyte derangements and prognostic indicators in CSS are lacking. The objectives of this study were to (1) compare admission blood analyte data of manatees pre and post rehabilitation for CSS to identify clinicopathological derangements, (2) identify blood analyte prognostic indicators for survival, and (3) correlate post-mortem anatomic pathological changes with clinicopathological findings to improve the understanding of CS pathophysiology. CSS manatees admitted to a rehabilitation facility between 2007 and 2017 were included: 59 manatees with data for clinicopathological analysis (7 non-survivors and 49 survivors) and 14 manatees with necropsy data (7 with and 7 without blood analyte data). Read More

Aliment Pharmacol Ther 2019 Mar 9;49(5):537-545. Epub 2019 Jan 9.

Division of Gastroenterology, Department of Medicine, Western University, London, Ontario, Canada.

Background: Outcomes after Nonvariceal upper gastrointestinal bleeding (NVUGIB) have historically focused on ulcer-related causes. Little is known regarding non-ulcer bleeding, the most common cause of NVUGIB.

Aim: To compare outcomes between ulcer- and non-ulcer-related NVUGIB and explore whether these could be explained by differences in baseline characteristics, bleeding severity or processes of care. Read More

Gut 2019 02;68(2):380

Diagn Pathol 2019 Jan 8;14(1). Epub 2019 Jan 8.

Department of Pathology, MD Anderson Cancer Center, Houston, USA.

Background: Carcinomas composed predominantly or purely of malignant Paneth cells were rarely reported in gastrointestinal system. They have not been reported at gastroesophageal junction nor has the association with Barrett esophagus been explored. None of the previous studies has mentioned any peculiar histologic features other than typical adenocarcinoma containing neoplastic Paneth cells. Read More

Br J Nurs 2019 Jan;28(1):53-59

Consultant Gastroenterologist, Department of Gastroenterology, Queen Elizabeth Hospital, Birmingham.

This article outlines latest evidence-based care for patients with acute upper gastrointestinal (GI) bleeding. It aims to help gastroenterology and general medical ward nurses plan nursing interventions and understand the diagnostic treatment options available. Acute upper GI bleeding can present as variceal or non-variceal bleeding and has a high death rate. Read More

J Clin Med 2019 Jan 2;8(1). Epub 2019 Jan 2.

Department of Emergency Medicine, Asan Medical Center, College of Medicine, University of Ulsan, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea.

Risk assessment for upper gastrointestinal bleeding (UGIB) is important; however, current scoring systems are insufficient. We aimed to develop and validate a prediction model for rapidly determining the occurrence of hypotension in non-variceal UGIB patients with normotension (systolic blood pressure ≥90 mmHg) at emergency department presentation. In this prospective observational cohort study, consecutive non-variceal UGIB patients between January 2012 and April 2017 were enrolled. Read More

Surg Endosc 2019 Jan 2. Epub 2019 Jan 2.

Division of Upper GI and Metabolic Surgery, Department of Surgery and State Key Laboratory of Digestive Diseases, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong S.A.R., The People's Republic of China.

Background: Endoscopic submucosal tunneling has evolved to allow endoscopic resection of subepithelial tumors of gastrointestinal tract without full-thickness perforation. This study aimed to investigate safety and efficacy of submucosal tunnel resection for these tumors.

Method: Patients with subepithelial tumors (SET) located in esophagus, gastric cardia, lesser curvature, and antrum were recruited. Read More

Clin J Gastroenterol 2019 Jan 2. Epub 2019 Jan 2.

Department of Gastroenterology, Tokai University Hachioji Hospital, Tokyo, Japan.

We reported the case of a 50-year-old man diagnosed with extrinsic NK/T-cell lymphoma. He was initially diagnosed with locally advanced unresected pancreatic duct carcinoma and was treated with combination chemotherapy using gemcitabine and nabpaclitaxel. One month after treatment, he developed bleeding. Read More

Ann Transl Med 2018 Dec;6(23):463

Department of Cardiology, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.

Esophageal varices can cause life-threatening complications and are most often a sequela of liver disease. Although a rare cause of gastrointestinal bleeding, downhill variceal bleeding secondary to superior vena cava (SVC) obstruction should be considered in the differential diagnosis for patients with upper gastrointestinal hemorrhage. We discuss two such cases of downhill esophageal varices presenting with hematemesis in patients with end stage renal disease and no history of cirrhosis. Read More

Circulation 2019 Feb;139(6):748-756

Department of Thrombosis and Hemostasis, Leiden University Medical Center, the Netherlands (S.J.V.d.W., F.A.K., M.V.H.).

Background: Although dabigatran has a favorable risk-benefit profile compared with vitamin K antagonist therapy for venous thromboembolism and nonvalvular atrial fibrillation, major bleeding events, including gastrointestinal (GI) bleeding, may occur. Therefore, our aim was to provide insights into the efficacy and safety of idarucizumab for urgent dabigatran reversal in patients with major GI bleeding.

Methods: Patients with uncontrollable GI bleeding requiring reversal were enrolled from June 2014 through July 2016 in the RE-VERSE AD study (Reversal of Dabigatran Anticoagulant Effect With Idarucizumab), a prospective, multicenter, open-label study of idarucizumab, and were followed up for 90 days for primary and secondary outcomes. Read More