Blood Urea Nitrogen to Creatinine ratio in Differentiation of Upper and Lower Gastrointestinal Bleedings; a Diagnostic Accuracy Study.

Conclusion: Considering the relatively proper specificity and positive predictive value of BUN/Cr ratio, in cases that bleeding source cannot be determined using other non-invasive methods, values higher than 35 can predict upper GI bleeding with high probability. However, due to the low sensitivity, values less than 35 are not diagnostic. PMID: 31432040 [PubMed]
Source: Accident and Emergency Nursing - Category: Emergency Medicine Authors: Tags: Arch Acad Emerg Med Source Type: research

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Obscure GI bleeding is persistent bleeding from the GI tract without an identifiable source on both upper and lower endoscopy. In most cases of obscure GI bleeding, the source is eventually found in the small intestine, the majority of which cannot be examined using routine esophagogastroduodenoscopy or colonoscopy. Double balloon enteroscopy (DBE) is an endoscopic technique which allows for visual examination of the entire GI tract. It also provides the ability to intervene on any active GI bleed using techniques such as argon plasma coagulation, hemoclipping, or epinephrine injection.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Sunday abstract Source Type: research
A 66-year-old man was referred for gastrointestinal bleeding after a negative upper endoscopy. He underwent a colonoscopy with bowel preparation using sodium picosulfate/magnesium citrate (SPMC). The patient reported having chest discomfort after taking the first dose of SPMC. The colonoscopy suggested small-bowel bleeding and an enteroscopy was performed. Mucosal necrosis of the middle to lower esophagus (Figure A) and linear erythema in the proximal stomach (Figure B and Video 1) was found during enteroscopy.
Source: Clinical Gastroenterology and Hepatology - Category: Gastroenterology Authors: Tags: Electronic Image of the Month Source Type: research
Endosc Int Open 2019; 07: E337-E346 DOI: 10.1055/a-0824-6647 Background and study aims We evaluated the utility of esophagogastroduodenoscopy (EGD) or capsule endoscopy (CE) as the next diagnostic approach after negative colonoscopy (CS) results in acute-onset hematochezia. Patients and methods We retrospectively analyzed 401 patients emergently hospitalized for acute hematochezia who underwent CS within 48 hours of arriving at two large emergency hospitals and in whom a definitive bleeding source was not identified. The positive endoscopic findings, requirement for additional therapeutic procedures, and 30...
Source: Endoscopy International Open - Category: Gastroenterology Authors: Tags: Original article Source Type: research
Conclusions Urgent bedside colonoscopy is feasible and safe for routine use. The highest advantage was observed in patients with red blood hemorrhage, diarrhea, and colon distension when symptoms were not associated with multiorgane failure, heart transplantation, or septic shock. As revealed by colonoscopy and pathological features, ischemic colitis is associated with a bad prognosis, and patients experience a higher rate of early mortality regardless of whether they undergo urgent colon surgery. [...] © Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |...
Source: Endoscopy International Open - Category: Gastroenterology Authors: Tags: Original article Source Type: research
The recent American College of Gastroenterology recommendations on the treatment of patients presenting with acute lower GI bleeding,1 which complement earlier recommendations put out by the American Society for Gastrointestinal Endoscopy,2 have provided an impetus for a more objective review of existing evidence in this area. Although some of the recommendations with regard to initial resuscitation, and to hemoglobin and international normalized ratio thresholds allowing for subsequent colonoscopy, stem from the literature on upper GI bleeding,3 many are specific to the target population of interest and justify the timely...
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Systematic review and meta-analysis Source Type: research
Conclusions: Among patients hospitalized with LGIB, large variation in gastroenterologist density did not predict EGD, but relevant clinical history did, with association strengths commensurate with risk for upper gastrointestinal bleeding. In the scenario studied, no evidence was found that specialty physician supply increases will result in more discretionary care within commercially insured populations.
Source: Academic Medicine - Category: Universities & Medical Training Tags: Research Reports Source Type: research
Conclusions: Early EGD may be effective for diagnosis and hemostatic treatment in ICU patients with GI bleeding. However, early CS should be carefully performed after adequate bowel preparation. PMID: 28286937 [PubMed - as supplied by publisher]
Source: The Korean Journal of Internal Medicine - Category: Internal Medicine Authors: Tags: Korean J Intern Med Source Type: research
Gastrointestinal bleeding is a common cause of hospitalization and results in extensive use of health care resources. By the most conservative measures, the cost of inpatient care alone for GI bleeding in the United States exceeds $6.5 billion each year.1 The vast majority of GI bleeding from the upper or lower GI tract is identified or managed with standard endoscopic techniques including upper endoscopy, colonoscopy, or radiologic evaluation. The rare cases in which the aforementioned techniques, in combination with video capsule endoscopy (VCE), device-assisted enteroscopy (DAE), or both, are unsuccessful in identifying...
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Original article Source Type: research
Kiss L, Papp J, Gecse K, Lakatos PL Abstract INTRODUCTION AND AIM: The aim was to assess the incidence of endoscopic findings based on the indication of the procedures in upper/lower endoscopies, and measuring quality indicators of colonoscopies at the 1st Department of Medicine, Semmelweis University, Budapest. METHOD: Data of 2987 patients (male/female:1361/1626, mean age: 60.7 years(y), SD: 16.7y) between 01.01.2010 and 31.12.2011 were analyzed. Both inpatient and outpatient records were collected. RESULTS: Incidence of peptic ulcer disease, esophageal varices, gastric polyps and gastric cancer were 1...
Source: Orvosi Hetilap - Category: Journals (General) Authors: Tags: Orv Hetil Source Type: research
Conclusions: Hematochezia should prompt colonoscopy and hematemesis or melena should prompt esophagogastroduodenoscopy. If no source of bleeding is found, additional procedures are often non-diagnostic. [...] © Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text
Source: Endoscopy International Open - Category: Gastroenterology Authors: Tags: Original article Source Type: research
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