No abstract

368G astrointestinal (GI) bleeding is one of the major causes of morbidity and mortality, and the incidence of hospital admittance for GI bleeding is 120 per 100 000 cases. Gastrointestinal bleeding primarily occurs in the upper GI tract above the Treitz ligament; however, 15% of GI bleedings occur in the lower GI tract. Although bleeding spontaneously stops in 80% of patients, it progresses or relapses in the other 20% (1). Although endoscopy is the primary diagnostic method to detect upper GI bleeding, scintigraphy is widely used for lower GI bleeding. Sulfur colloid scintigraphy can detect a bleeding in the range of 0.05-0.1 mL/min, and scintigraphic imaging with tagged red blood cells can detect a bleeding in the range of 0.2-0.4 mL/min (2). Consistent with recent technological advances, mesenteric computed tomography angiography (CTA) is a promising diagnostic approach for the detection of GI bleeding. CTA is less invasive than catheter angiography, but it is less sensitive than scintigraphy (0.1 mL/min for scintigraphy compared to 0.35 mL/min for CTA). However, there are several important advantages to CTA, namely that it can be performed 24 h a day in a matter of seconds (using multidetector CT equipment) and it can easily localize the bleeding. In addition, CTA can detect important findings that accompany the bleeding, such as bowel wall thickness, mass, and perforation, through its cross-sectional scanning ability (3).Although the limit of detection of the GI bleeding rate using transcatheter mesenteric angiography and the conventional film cassette technique is 0.5 mL/min, in vivo studies have shown that the limit of detection using digital subtraction angiography (DSA) is 5-9 times greater than conventional systems (2). However, both radiation exposure and the side effects of the contrast media used in nuclear medicine and radiological diagnostic methods must be considered when examining patients with GI bleeding. Although transcatheter mesenteric angiography is an invasive procedure, it is used in patients with massive GI bleeding because it not only detects the bleeding, but the underlying cause can be treated in the same endovascular session. The combination of mesenteric CT angiography and catheter angiography demonstrates that radiology plays a key role in the diagnosis and treatment of GI bleeding, which is a clinical problem requiring a multidisciplinary approach. Even after taking into account the different detection limits and the advantages and disadvantages of imaging, there is currently no defined, standard approach to treat GI bleeding (2).Medical or endoscopic coagulation, transcatheter embolization and surgical resection are the treatment options for GI bleeding. Although surgical resection is the definitive treatment, its mortality and morbidity rates are between 10%-15% (4). Colonoscopy is widely used for the diagnosis of lower GI bleeding, but very few patients benefit from endoscopic treatment (5). Transcatheter embolization is widely used throughout PURPOSEThis retrospective stud...

Painful subacute thyroiditis (PF-SAT) after viral vaccinations is a rare but often go unnoticed. A viral infection and some viral vaccinations may cause PF-SAT as an undesired consequence. Presenting symptoms are sore throat, weight loss, sleep disturbances and palpitation which all are quite similar to those seen in thyrotoxicosis. In the early phase of the illness, hyper thyroid function is a rule, followed by euthyroid and rarely hypo-thyroid phases. Treatment for SAT is usually successful with a very rare recurrence. Here, we report a case of PF-SAT, after immunization with whole virion inactivated Covid-19 vaccine, in a health care worker.