Endoscopy, angiography, surgery: diagnostic and therapeutic algorithms for diverticular bleeding.

[Endoscopy, angiography, surgery: diagnostic and therapeutic algorithms for diverticular bleeding]. Chirurg. 2019 Apr 11;: Authors: Schwenk W Abstract Diverticular bleeding is a complication of diverticular disease but in contrast to diverticulitis, publications concerning diverticular bleeding are less common. Diverticular bleeding is the cause of approximately 20-50% of cases of lower gastrointestinal bleeding and in rare cases can be life-threatening. The main symptom of diverticular hemorrhage is painless hematochezia and the German guidelines recommend that further diagnostics of suspected diverticular bleeding should be performed in hospital. Interdisciplinary diagnostic and therapeutic algorithms recommend primary endoscopy in acute as well as chronic recurrent diverticular bleeding. If endoscopy fails to provide an exact localization of the origin of bleeding, angiography or computed tomography (CT) angiography can be performed. The 99mTc erythrocyte scintigraphy should only be performed if endoscopy and angiography are unable to identify the localization of the bleeding source. More than 90% of diverticular hemorrhages stop spontaneously; however, it is general agreed that an active diverticular bleeding detected during colonoscopy should be immediately treated endoscopically. Alternative radiological techniques for hemostasis are rarely needed and attention must be paid to the complications. In the rare case of severe bleeding that cannot ...
Source: Der Chirurg - Category: Surgery Authors: Tags: Chirurg Source Type: research

Related Links:

Authors: Musio F Abstract INTRODUCTION: Anemia has and will continue to be a central theme in medicine particularly as clinicians are treating a burgeoning population of complex multi-organ system processes. As a result of multiple randomized controlled trials (RCTs), meta-analyses, and societal recommendations overly restrictive paradigms and under-administration of erythropoiesis stimulating agents (ESAs) have likely been followed by clinicians among all specialties. AREAS COVERED: A review of anemia in the context of chronic kidney disease, hematologic malignancies and cancer is presented with focus on the e...
Source: Expert Review of Hematology - Category: Hematology Tags: Expert Rev Hematol Source Type: research
Publication date: Available online 9 October 2020Source: Mutation Research/Reviews in Mutation ResearchAuthor(s): Klaudia Kulczynska-Figurny, James J. Bieker, Miroslawa Siatecka
Source: Mutation Research Reviews in Mutation Research - Category: Genetics & Stem Cells Source Type: research
CONCLUSIONS: Immunohistochemistry seems to be a promising option not only in clinical recognition, but also in the selection and monitoring of treatment effects. However, these methods have not yet recommended for routine clinical use. PMID: 33032462 [PubMed - as supplied by publisher]
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
CONCLUSION: In this study, no influence of tear substitutes containing different viscosities of hyaluronic acid on the measurement results of optical coherence tomography could be determined. Therefore, 0.1%, 0.2% and 0.3% hyaluronic acid can be applied to the patient to improve the corneal surface before the examination with optical coherence tomography, without influencing the measurement results of optical coherence tomography. PMID: 33036058 [PubMed - as supplied by publisher]
Source: Klinische Monatsblatter fur Augenheilkunde - Category: Opthalmology Tags: Klin Monbl Augenheilkd Source Type: research
Authors: Zhao N, Xiang Q, Liu Z, Zhao X, Cui Y Abstract INTRODUCTION: There remains an unmet need for better anticoagulants. The phase I clinical trial is of great significance in the development of anticoagulants, and the design is special. This system review aims to provide insights for the design of future phase I clinical trials of anticoagulants. AREAS COVERED: We searched the database PubMed and ClinicalTrail.gov website, to collate the phase I clinical trial of anticoagulants in healthy people. The study protocol, inclusion exclusion criteria, safety and pharmacodynamic indexes were reviewed. EXPERT ...
Source: Expert Review of Clinical Pharmacology - Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research
Complicated Meckel's diverticulum represents a common etiology of acute abdomen in children. However, this condition is less frequent in adults. We reviewed the records of adult patients who underwent the surgical removal of complicated Meckel's diverticulum between 2001 and 2017 at 2 tertiary French medical centers. We then analyzed the clinical characteristics, mode of presentation, and management for all patients. The Meckel's diverticulum was resected in 37 patients (24 males and 13 females). The mean patient age was 46.1 ± 21.4 years. The most common clinical presentations of complicated Meckel's diverticu...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
By ANISH KOKA, MD A poignant piece recently appeared in the journal Health Affairs and was rapidly devoured on social media by the health policy community. The story is a harrowing first person account of a woman’s multiple interactions with doctors. The doctors in the story are either very good or very bad. One pediatrician turns the author and her sick son away on three consecutive days with colic, only to have a more careful partner sound the alarm and discover pyloric stenosis. The author then recounts the tale of her father’s death at age 42 due to a surgeon who operated for diverticulitis unnecessarily. ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Source Type: blogs
A 64-year-old woman presented to the colorectal clinic with 3 months of symptoms of loose stools, flatulence and some weight loss. There was no history of abdominal pain, rectal bleeding or anaemia. A similar episode 5 years earlier resolved spontaneously but was investigated with a colonoscopy at that time and revealed diverticular disease and a 3 mm hyperplastic polyp at the hepatic flexure. To investigate the current symptoms, a repeat colonoscopy was advised but this was initially declined in favour of CT colonography (CTC) to avoid the laxative preparation and pain experienced during the previous examin...
Source: Gut - Category: Gastroenterology Authors: Tags: GUT Snapshot Editor ' s quiz: GI snapshot Source Type: research
ABSTRACT: Giant colonic diverticula are extremely rare; however, they should be considered in a patient with a history or susceptibility to diverticular disease because of the nonspecific presentation and life-threatening complications. Giant colonic diverticula often are overlooked because of their nonspecific gastrointestinal (GI) symptoms, leading to complications of obstruction, perforation, abscess formation, and sepsis. A rare and unusual presentation of a giant colonic diverticulum is the development of a bezoar. This case describes a patient whose GI bleeding led to the diagnosis of a giant colonic diverticulum with a bezoar.
Source: Journal of the American Academy of Physician Assistants - Category: Primary Care Tags: Case Report Source Type: research
Publication date: May 2015 Source:Journal of Pediatric Surgery Case Reports, Volume 3, Issue 5 Author(s): Satohiko Yanagisawa , Yasuhide Morikawa , Mototoshi Kato An 11-year-old boy had previously been diagnosed with repeated Meckel's diverticulitis at another hospital. Emergency laparoscopy was performed under general anesthesia, and an inflammatory mass was seen in the ileocecal region of the mesentery. However, no Meckel's diverticulum (MD) was observed, and so the patient was diagnosed with lymphadenitis. Three days after the operation, he developed anemia and gastrointestinal bleeding of unknown origin. Thus, he was...
Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research
More News: Anemia | Angiography | Bleeding | Colectomy | Colonoscopy | CT Scan | Diverticular Disease | Endoscopy | Gastroenterology | Germany Health | Hospitals | Laparotomy | Lower Endoscopy | Surgery