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Ma Q, Du JJ. Appendiceal bleeding caused by vascular malformation: A case report. World J Clin Cases 2024; 12:2457-2462. [PMID: 38765744 PMCID: PMC11099410 DOI: 10.12998/wjcc.v12.i14.2457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/09/2024] [Accepted: 04/03/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Acute lower gastrointestinal bleeding (LGIB) is a common occurrence in clinical practice. However, appendiceal bleeding is an extremely rare condition that can easily be overlooked and misdiagnosed. The preoperative detection of appendiceal bleeding often poses challenges due to the lack of related guidelines and consensus, resulting in controversial treatment approaches. CASE SUMMARY We presented a case of a 33-year-old female who complained of hematochezia that had lasted for 1 d. Colonoscopy revealed continuous bleeding in the appendiceal orifice. A laparoscopic appendectomy was performed immediately, and a pulsating blood vessel was observed in the mesangium of the appendix, accordingly, active bleeding into the appendicular lumen was considered. Pathological examination revealed numerous hyperplastic vessels in the appendiceal mucosa and dilated capillary vessels. CONCLUSION The preoperative detection of appendiceal bleeding is often challenging, colonoscopy is extremely important, bowel preparation is not routinely recommended for patients with acute LGIB or only low-dose bowel preparation is recommended. Laparoscopic appendectomy is the most appropriate treatment for appendiceal bleeding.
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Affiliation(s)
- Qin Ma
- Department of General Surgery, Fuling Hospital Affiliated to Chongqing University, Chongqing 408000, China
| | - Jin-Jie Du
- Department of Geriatrics, Fuling Hospital Affiliated to Chongqing University, Chongqing 408000, China
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Ma Q, Du J. WITHDRAWN: Appendiceal bleeding caused by vascular malformation: A case report and literature review. Int J Surg Case Rep 2023:108903. [PMID: 38008682 DOI: 10.1016/j.ijscr.2023.108903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/27/2023] [Accepted: 09/30/2023] [Indexed: 11/28/2023] Open
Abstract
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal.
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Affiliation(s)
- Qin Ma
- Department of General Surgery, Fuling Hospital Affiliated to Chongqing University, China
| | - Jinjie Du
- Department of General Surgery, Fuling Hospital Affiliated to Chongqing University, China.
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Lv LS, Gu JT. Super-selective arterial embolization in the control of acute lower gastrointestinal hemorrhage. World J Clin Cases 2019; 7:3728-3733. [PMID: 31799297 PMCID: PMC6887619 DOI: 10.12998/wjcc.v7.i22.3728] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 11/14/2019] [Accepted: 11/15/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Acute gastrointestinal bleeding is an emergency condition that can lead to significant morbidity and mortality. Embolization is considered the preferred therapy in the treatment of lower gastrointestinal bleeding when it is unrealistic to perform the surgery or vasopressin infusion in this population. Treatment of acute lower gastrointestinal (GI) bleeding (any site below the ligament of Treitz) using this technique has not reached a consensus, because of the belief that the risk of intestinal infarction in this condition is extremely high. The purpose of the study is to evaluate the effectiveness and safety of this technique in a retrospective group of patients who underwent embolization for acute lower GI bleeding.
AIM To evaluate the efficacy and safety of super-selective arterial embolization in the management of acute lower GI bleeding.
METHODS A series of 31 consecutive patients with angiographically demonstrated small intestinal or colonic bleeding was retrospectively reviewed. The success rate and complication rate of super-selective embolization were recorded.
RESULTS Five out of thirty-one patients (16.1%) could not achieve sufficiently selective catheterization to permit embolization. Initial control of bleeding was achieved in 26 patients (100%), and relapsed GI bleeding occurred in 1 of them at 1 wk after the operation. No clinically apparent bowel infarctions were observed in patients undergoing embolization.
CONCLUSION Super-selective embolization is a safe therapeutic method for acute lower GI bleeding, and it is suitable and effective for many patients suffering this disease. Importantly, careful technique and suitable embolic agent are essential to the successful operation.
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Affiliation(s)
- Liang-Shan Lv
- Department of Gastroenterology and Interventional Radiography, Xi’an Gaoxin Hospital, Xi’an Jiaotong University, Xi’an 710075, Shaanxi Province, China
| | - Jing-Tao Gu
- Department of Vascular Surgery, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
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Massive lower gastrointestinal bleeding after low anterior resection for middle rectal cancer – case report. JOURNAL OF ACUTE DISEASE 2015. [DOI: 10.1016/s2221-6189(14)60088-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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5
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Bustamante-Balén M, Plumé G. Role of hemostatic powders in the endoscopic management of gastrointestinal bleeding. World J Gastrointest Pathophysiol 2014; 5:284-292. [PMID: 25133029 PMCID: PMC4133526 DOI: 10.4291/wjgp.v5.i3.284] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 05/16/2014] [Accepted: 06/18/2014] [Indexed: 02/06/2023] Open
Abstract
Acute gastrointestinal bleeding (AGIB) is a prevalent condition with significant influence on healthcare costs. Endoscopy is essential for the management of AGIB with a pivotal role in diagnosis, risk stratification and management. Recently, hemostatic powders have been added to our endoscopic armamentarium to treat gastrointestinal (GI) bleeding. These substances are intended to control active bleeding by delivering a powdered product over the bleeding site that forms a solid matrix with a tamponade function. Local activation of platelet aggregation and coagulation cascade may be also boosted. There are currently three powders commercially available: hemostatic agent TC-325 (Hemospray®), EndoClot™ polysaccharide hemostatic system, and Ankaferd Bloodstopper®. Although the available evidence is based on short series of cases and there is no randomized controlled trial yet, these powders seem to be effective in controlling GI bleeding from a variety of origins with a very favorable side effects profile. They can be used either as a primary therapy or a second-line treatment, and they seem to be especially indicated in cases of cancer-related bleeding and lesions with difficult access. In this review, we will comment on the mechanism of action, efficacy, safety and technical challenges of the use of powders in several clinical scenarios and we will try to define the main current indications of use and propose new lines of research in this area.
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Albeldawi M, Ha D, Mehta P, Lopez R, Jang S, Sanaka MR, Vargo JJ. Utility of urgent colonoscopy in acute lower gastro-intestinal bleeding: a single-center experience. Gastroenterol Rep (Oxf) 2014; 2:300-5. [PMID: 24958253 PMCID: PMC4219142 DOI: 10.1093/gastro/gou030] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background. The role of urgent colonoscopy in lower gastro-intestinal bleeding (LGIB) remains controversial. Over the last two decades, a number of studies have indicated that urgent colonoscopy may facilitate the identification and treatment of bleeding lesions; however, studies comparing this approach to elective colonoscopy for LGIB are limited. Aims. To determine the utility and assess the outcome of urgent colonoscopy as the initial test for patients admitted to the intensive care unit (ICU) with acute LGIB. Methods. Consecutive patients who underwent colonoscopy at our institution for the initial evaluation of acute LGIB between January 2011 and January 2012 were analysed retrospectively. Patients were grouped into urgent vs. elective colonoscopy, depending on the timing of colonoscopy after admission to the ICU. Urgent colonoscopy was defined as being performed within 24 hours of admission and those performed later than 24 hours were considered elective. Outcomes included length of hospital stay, early re-bleeding rates, and the need for additional diagnostic or therapeutic interventions. Multivariable logistic regression analysis was performed to identify factors associated with increased transfusion requirements. Results. Fifty-seven patients underwent colonoscopy for the evaluation of suspected LGIB, 24 of which were urgent. There was no significant difference in patient demographics, co-morbidities, or medications between the two groups. Patients who underwent urgent colonoscopy were more likely to present with hemodynamic instability (P = 0.019) and require blood transfusions (P = 0.003). No significant differences in length of hospital stay, re-bleeding rates, or the need for additional diagnostic or therapeutic interventions were found. Patients requiring blood transfusions (n = 27) were more likely to be female (P = 0.016) and diabetics (P = 0.015). Fourteen patients re-bled at a median of 2 days after index colonoscopy. Those with hemodynamic instability were more likely to re-bleed [HR 3.8 (CI 1.06–13.7)], undergo angiography [HR 9.8 (CI 1.8–54.1)], require surgery [HR 13.5 (CI 3.2–56.5)], and had an increased length of hospital stay [HR 1.1 (1.05–1.2)]. Conclusion: The use of urgent colonoscopy, as an initial approach to investigate acute LGIB, did not result in significant differences in length of ICU stay, re-bleeding rates, the need for additional diagnostic or therapeutic interventions, or 30-day mortality compared with elective colonoscopy. In a pre-specified subgroup analysis, patients with hemodynamic instability were more likely to re-bleed after index colonoscopy, to require additional interventions (angiography or surgery) and had increased length of hospital stay.
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Affiliation(s)
- Mazen Albeldawi
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA; Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA; Department of Quantitative Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Duc Ha
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA; Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA; Department of Quantitative Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Paresh Mehta
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA; Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA; Department of Quantitative Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Rocio Lopez
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA; Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA; Department of Quantitative Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Sunguk Jang
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA; Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA; Department of Quantitative Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Madhusudhan R Sanaka
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA; Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA; Department of Quantitative Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - John J Vargo
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA; Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA; Department of Quantitative Sciences, Cleveland Clinic, Cleveland, OH, USA
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7
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The role of endoscopy in the patient with lower GI bleeding. Gastrointest Endosc 2014; 79:875-85. [PMID: 24703084 DOI: 10.1016/j.gie.2013.10.039] [Citation(s) in RCA: 127] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 10/22/2013] [Indexed: 02/06/2023]
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8
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Raphaeli T, Menon R. Current treatment of lower gastrointestinal hemorrhage. Clin Colon Rectal Surg 2013; 25:219-27. [PMID: 24294124 DOI: 10.1055/s-0032-1329393] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Massive lower gastrointestinal bleeding is a significant and expensive problem that requires methodical evaluation, management, and treatment. After initial resuscitation, care should be taken to localize the site of bleeding. Once localized, lesions can then be treated with endoscopic or angiographic interventions, reserving surgery for ongoing or recurrent bleeding.
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Affiliation(s)
- Tal Raphaeli
- Swedish Colon and Rectal Clinic, Seattle, Washington
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9
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Abstract
Lower gastrointestinal bleeding is common and can result from several colonic causes including diverticulosis, arteriovenous malformations, ischemia, inflammatory bowel disease, infectious colitis, neoplasm, postpolypectomy, and anastomotic and radiation proctitis. Following resuscitation and evaluation, colonoscopy can be used for diagnosis and treatment. Most physicians prescribe a bowel preparation for their patients. Therapeutic options include injection, coagulation (monopolar or bipolar cautery, argon plasma coagulator), and mechanical (clips, bands, detachable loops) devices.
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Affiliation(s)
- Charles B Whitlow
- Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, New Orleans, Louisiana
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10
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Laine L, Shah A. Randomized trial of urgent vs. elective colonoscopy in patients hospitalized with lower GI bleeding. Am J Gastroenterol 2010; 105:2636-41; quiz 2642. [PMID: 20648004 DOI: 10.1038/ajg.2010.277] [Citation(s) in RCA: 128] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES We sought to determine, in patients with serious hematochezia, the proportion who have an upper gastrointestinal (GI) source and whether urgent colonoscopy improves outcomes as compared with elective colonoscopy in those without an upper source. METHODS Patients with hematochezia were eligible if they also had heart rate >100, systolic blood pressure <100, orthostatic change in heart rate or blood pressure >20, hemoglobin drop ≥ 1.5 g/dl, or blood transfusion. Patients had upper endoscopy within 6 h. Those without an upper source were randomized to urgent (≤ 12 h) or elective (36-60 h after presentation) colonoscopy. The primary end point was further bleeding. Patients were followed for the duration of hospitalization. RESULTS Eighty-five eligible patients had urgent upper endoscopy; 13 (15%) had an upper source. The remaining 72 were randomized to urgent (N=36) or elective (N=36) colonoscopy. Further bleeding occurred in 8 (22%) vs. 5 (14%) of the urgent vs. elective groups (difference=8%, 95% confidence interval (CI)=-9 to 26%). Units of blood (1.5 vs. 0.7), hospital days (5.2 vs. 4.8), subsequent diagnostic or therapeutic interventions for bleeding (36% vs. 33%), and hospital charges ($27,590 vs. $26,633) also were not lower in the urgent group. A major limitation is that the study was terminated before reaching the prespecified sample size. CONCLUSIONS Patients with clinically serious hematochezia should have upper endoscopy initially to rule out an upper GI source. Use of urgent colonoscopy in a population hospitalized with serious lower GI bleeding showed no evidence of improving clinical outcomes or lowering costs as compared with routine elective colonoscopy.
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Affiliation(s)
- Loren Laine
- Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA.
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Margolius DM, Cataldo TE. Nonsteroidal Anti-inflammatory Drug Colopathy Mimicking Malignant Masses of the Colon: A Report of Three Cases and Review of the Literature. Am Surg 2010. [DOI: 10.1177/000313481007601132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on the colon have been reported as a wide spectrum of symptoms, signs, and endoscopic findings. Despite the extensive use of NSAIDs, and the potential seriousness of NSAID colopathy, this condition often goes unrecognized or misdiagnosed. We report three cases of NSAID colopathy in which the diagnosis of malignancy was incorrectly made based on endoscopic findings. Before any surgical intervention, we entertained the diagnosis of NSAID colopathy based on clinical presentation. Ultimately, in two of the three cases, surgery was avoided and the lesions resolved. We present their clinical course and a review of the pertinent literature reviewing theories of the pathophysiology, the range of clinical presentations, and the pathological findings of this entity.
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Affiliation(s)
- David M Margolius
- Warren Alpert Medical School of Brown University, Brown University, Providence, Rhode Island
| | - Thomas E. Cataldo
- Division of Colon and Rectal Surgery, Department of Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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13
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Greer SE, Gupta R. Lower gastrointestinal bleeding of unknown origin: tricks of the trade. Scand J Surg 2010; 99:103-5. [PMID: 20679046 DOI: 10.1177/145749691009900211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- S E Greer
- Department of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, USA
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Gayer C, Chino A, Lucas C, Tokioka S, Yamasaki T, Edelman DA, Sugawa C. Acute lower gastrointestinal bleeding in 1,112 patients admitted to an urban emergency medical center. Surgery 2009; 146:600-6; discussion 606-7. [PMID: 19789018 DOI: 10.1016/j.surg.2009.06.055] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Accepted: 06/25/2009] [Indexed: 12/11/2022]
Abstract
BACKGROUND This study was performed to elucidate the etiology, effectiveness of diagnostic and therapeutic modalities, and outcomes in patients with acute lower gastrointestinal bleeding. METHODS A retrospective review of the medical records of 1,112 consecutive patients admitted to the surgical service of a single urban emergency hospital with lower gastrointestinal bleeding from 1988 to 2006. Two groups were compared: 1988-1997 and 1998-2006. RESULTS All patients underwent colonoscopy, 33.2% within 24 h of admission. Hematochezia was the most frequent presentation (55.5%), followed by maroon stool (16.7%) and melena (11.0%). Most patients, 690 (62.1%) also had upper endoscopy. Sixty-six patients subsequently had barium enemas. Eleven of 27 nuclide scans were positive. Arteriography was performed on 22 patients, with 11 positive results and 2 therapeutic. No statistical difference was found in procedures performed in our 2 time periods. Diverticulosis (33.5%), hemorrhoids (22.5%), and carcinoma (12.7%) were the most common etiologies with the diagnosis of diverticulosis more common in the 1998-2006 time period. The small bowel was the source in 14 total patients. Spontaneous cessation of the bleeding occurred in 863 (77.6%) patients. Endoscopic control increased from 1% in 1997-1998 to 4.4% in 1998-2006 (P < .05) with a corresponding decrease in the need for operative control from 22.6% to 16.6% in this same time period (P < .05). Furthermore, among elective operations, there was a decrease in right hemicolectomies from 31.6% of total elective cases to 13.9% (P < .05). Emergent operations were needed in 3.4% and 4.8% of patients. The readmission rate did not change over time and was 5.2% overall with >50% because of diverticular bleeding. CONCLUSION In this urban setting, diverticulosis, hemorrhoids, and carcinoma were the most common causes of severe acute lower gastrointestinal bleeding (LGIB) with diverticular bleed causing the highest recurrence. Colonoscopy allows for diagnosis in most patients with severe acute LGIB requiring hospitalization. Furthermore, it is now being used more effectively for hemostasis resulting in less operative intervention to control bleeding.
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Affiliation(s)
- Christopher Gayer
- Department of Surgery, Wayne State University, Detroit, MI 48201, USA
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Plummer JM, Gibson TN, Mitchell DIG, Herbert J, Henry T. Emergency subtotal colectomy for lower gastrointestinal haemorrhage: over-utilised or under-estimated? Int J Clin Pract 2009; 63:865-8. [PMID: 18248394 DOI: 10.1111/j.1742-1241.2007.01632.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION A minority of patients with unlocalised massive lower gastrointestinal bleeding (LGIB) will require treatment with emergency subtotal colectomy (STC). METHODS To determine the outcome of STC in this high-risk group, we retrospectively reviewed the histopathology reports and case records of all subtotal colectomies performed for LGIB over a 8-year period. RESULTS Fifty-eight patients (mean age: 71 years; male to female ratio, 1 : 1) underwent emergency surgery for unlocalised LGIB, 45% of which were massive on admission, and unresponsive to resuscitation. The remainder had persistent or recurrent bleeding during the index hospitalisation. The hospitalisation for colectomy represented the first for LGIB for 56% of the study group, while 38% were on at least their third such admission. All but three patients underwent preoperative rigid proctosigmoidoscopy. Fifty-five of the 58 patients were treated with STC and primary ileorectal anastomosis. The major causes of bleeding were diverticular disease only (68%), angiodysplasia only (12%) and both diseases (12%). Overall mortality was 17%, with the main contributor being sepsis resulting from anastomotic leak. Non-fatal complications occurred in 20%, resulting in a mean postoperative length of stay of 13 days. All patients were doing well on their first follow-up visit with a mean number of four stools per day after 1 month. CONCLUSION While emergency STC is an effective and definitive method of treating unlocalised massive LGIB, its associated morbidity and mortality may limit its usefulness.
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Affiliation(s)
- J M Plummer
- Department of Surgery, Radiology, Anaesthesia and Intensive Care, University of the West Indies, Kingston, Jamaica.
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Chaptini L, Peikin S. Gastrointestinal Bleeding. Crit Care Med 2008. [DOI: 10.1016/b978-032304841-5.50079-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Syed MI, Chaudhry N, Shaikh A, Morar K, Mukerjee K, Damallie E. Catheter-directed middle hemorrhoidal artery embolization for life-threatening rectal bleeding. CANADIAN JOURNAL OF GASTROENTEROLOGY = JOURNAL CANADIEN DE GASTROENTEROLOGIE 2007; 21:117-23. [PMID: 17299617 PMCID: PMC2657672 DOI: 10.1155/2007/272641] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Over the past 10 years, arteriography has become a well-established technique for the diagnosis of acute lower gastrointestinal bleeding, but not particularly for rectal bleeding. However, to the authors' knowledge, the technique of middle hemorrhoidal artery embolization has rarely been reported in the literature. In the present report, three patients with life-threatening rectal bleeding are presented, which was controlled by superselective embolization of the middle hemorrhoidal artery or selective embolization of the internal iliac artery as a last resort.
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Affiliation(s)
- Mubin I Syed
- Department of Interventional Radiology, Mercy Medical Center, Springfield, OH, USA.
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Affiliation(s)
- Don C Rockey
- Department of Medicine, Division of Digestive and Liver Disease, University of Texas Southwestern Medical Center, Dallas, Texas 75390-8887, USA.
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