Gastrointestinal Bleeding and Management

Pai, Anita K; Fox, Victor L.

doi:10.1016/j.pcl.2017.01.014

Cited by 24 publications

(40 citation statements)

References 59 publications

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“…Imaging, endoscopy, and interventional radiology are becoming increasingly important in the diagnosis and treatment of colorectal vascular malformations, especially given their morbidity and mortality 16 . In 70% of the cases, endoscopy can reveal the correct diagnosis of a malformation 14 and endoscopic options are often applied to control bleeding 17 .…”

Section: Discussionmentioning

confidence: 99%

Rectosigmoidal manifestations of venous malformations: MR imaging findings and interdisciplinary therapeutic modalities

Brill

Brill²,

Uller

et al. 2019

Sci Rep

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The aim of this study was to identify the frequency of rectosigmoidal involvement in patients with venous malformations (VM) of the lower extremities and to demonstrate multidisciplinary therapeutic options. The medical records and magnetic resonance images (MRI) of patients with VM of the lower extremities, over a six-year period, were reviewed retrospectively in order to determine the occurrence of rectosigmoidal involvement. Vascular interventions, surgical treatments, percutaneous and hybrid (endoscopy-guided angiography) sclerotherapy and procedural complications (according to Clavien-Dindo classification) were also noted. Of the 378 patients with vascular malformation of the lower limbs, 19 patients (5%) had documented venous rectosigmoidal malformation. All of these 19 patients reported episodes of rectal bleeding, while seven patients (36.8%) also had anemia. All patients underwent endoscopy. By endoscopy, seven patients (36.8%) showed discreet changes, and 12 patients (63.2%) showed pronounced signs of submucosal VM with active (47.3%) or previous (15.7%) bleeding. Treatment was performed in all patients with pronounced findings. Six patients underwent endoscopy-guided hybrid sclerotherapy, one patient underwent endoscopic tissue removal, one patient received percutaneous sclerotherapy and one patient received a combination of transvenous embolization and hybrid sclerotherapy. Three patients required open surgery. No complications occurred after conservative treatments; however, one complication was reported after open surgery. None of the treated patients reported further bleeding and anemia at the end of the follow-up period. In this cohort, rectosigmoidal VM occurred in 5% of patients presenting with a high incidence of rectal bleeding. Percutaneous or endoscopy-guided hybrid sclerotherapy appeared to be a safe and effective alternative to surgery.

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Section: Discussionmentioning

confidence: 99%

Rectosigmoidal manifestations of venous malformations: MR imaging findings and interdisciplinary therapeutic modalities

Brill

Brill²,

Uller

et al. 2019

Sci Rep

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“…Also, diffuse involvement of bowel precludes curative surgical excision. Nd YAG laser has limited application in cases where the mucosal vascular lesions are not amenable for surgical excision [8].…”

Section: Discussionmentioning

confidence: 99%

Bowel Arteriovenous Malformation: An Unusual Cause of Lower Gastrointestinal Bleeding in a Child

Govindarajan

Ananthakrishnan

Jacob

2020

GE Port J Gastroenterol

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“…The causes of gastrointestinal bleeding in an infant can be multiple [11], the most common being breastfeeding infant’s mother with cracked nipples (swallowed blood), erosive esophagitis due to gastroesophageal reflux disease, gastric or duodenal mucosal injury caused by infections or food allergy, malformations and portal cavernoma.…”

Section: Discussionmentioning

confidence: 99%

“…This case, along with recent literatures reports, reminds that EG should be considered among the possible causes. Gastrointestinal endoscopy is the most important diagnostic tool for the diagnosis of EGID due to its superior sensitivity and specificity [11]. Endoscopic abnormalities include nodular mucosa, erythema, and ulcers/erosions, but the mucosa may appear normal [1].…”

Section: Discussionmentioning

confidence: 99%

Severe anaemia after gastric biopsy in an infant with eosinophilic gastritis

et al. 2019

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Background Eosinophilic gastrointestinal disorders (EGID) are characterized by eosinophilic inflammation and are subclassified according to the affected site(s) as eosinophilic esophagitis, eosinophilic gastritis, eosinophilic enteritis and eosinophilic colitis. Clinical presentation includes dyspeptic symptoms, vomiting, abdominal pain, diarrhoea and gastrointestinal bleeding. Peripheral eosinophilia is usually found but is not required for the diagnosis. The treatment is based on dietary elimination therapy, consisting of removal of common food triggers, most frequently cow’s milk in infants. Corticosteroids are used as first line drug therapy in EG if dietary therapy fails to achieve an adequate clinical response or is impractical. Case presentation A four month old infant was admitted for an episode of melena and hematemesis. An esophagogastroduodenoscopy showed haemorrhagic gastritis with ulcerative lesions and fibrin. A significant gastric bleeding was noted after the procedure. The gastric mucosa biopsies showed an eosinophilic infiltration. Conclusions A clinically relevant anaemia is a quite rare complication in infants with eosinophilic gastritis and a biopsy may worsen bleeding, to a potentially severe level of low haemoglobin. In infants with low haemoglobin levels and suspect eosinophilic gastritis a watchful follow up after the biopsy should be considered, as well as the possibility of postponing the biopsy to reduce the bleeding risk.

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Gastrointestinal Bleeding and Management

Cited by 24 publications

References 59 publications

Rectosigmoidal manifestations of venous malformations: MR imaging findings and interdisciplinary therapeutic modalities

Rectosigmoidal manifestations of venous malformations: MR imaging findings and interdisciplinary therapeutic modalities

Bowel Arteriovenous Malformation: An Unusual Cause of Lower Gastrointestinal Bleeding in a Child

Severe anaemia after gastric biopsy in an infant with eosinophilic gastritis

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