Severe gastrointestinal haemorrhage from an eroding jejuno-jejunal fistula

We present the case of an 11-year old boy with mosaic trisomy 13 and an end ileostomy (for gut dysmotility) who presented with a catastrophic gastrointestinal haemorrhage during a prolonged Paediatric Intensive Care (PICU) stay recovering from an episode of presumed sepsis. A normal upper GI endoscopy was followed by a laparoscopy which revealed a small bowel adhesion to the anterior abdominal wall which had facilitated the creation of a jejuno-jejunal fistula that had eroded through a mesenteric artery. The child recovered well after a limited laparotomy and segmental small bowel resection.This case highlights an extremely unusual cause of gastrointestinal bleeding in a child and emphasises the role of Laparoscopy in the comprehensive assessment of this presentation.
Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research

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In a recent [1] retrospective analysis in 325 non-valvular atrial fibrillation (NVAF) patients treated with novel oral anticoagulants (NOAC), authors suggested a higher risk of thrombosis in obese/overweight vs. other patients, particularly those treated with dabigatran; and a higher risk of bleeding, particularly related to factor Xa inhibitors (rivaroxaban, apixaban). They proposed that obesity moderated the NOAC effects, differently for different NOACs. However a) the study did not test for moderation [(warfarin vs.
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Letter to the editor Source Type: research
CONCLUSION: We report that the use of mid-cycle tranexamic acid in patients with recurrent haemorrhagic cysts can lower ovulation-associated pain. PMID: 32482469 [PubMed - as supplied by publisher]
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
We present the case of an 11-year old boy with mosaic trisomy 13 and an end ileostomy (for gut dysmotility) who presented with a catastrophic gastrointestinal haemorrhage during a prolonged Paediatric Intensive Care (PICU) stay recovering from an episode of presumed sepsis. A normal upper GI endoscopy was followed by a laparoscopy which revealed a small bowel adhesion to the anterior abdominal wall which had facilitated the creation of a jejuno-jejunal fistula that had eroded through a mesenteric artery. The child recovered well after a limited laparotomy and segmental small bowel resection.This case highlights an extremel...
Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research
Gastrointestinal amyloidosis most notably occurs in the liver and small intestine. Its presentation is highly nonspecific and may include gastrointestinal bleeding, malabsorption syndromes, and protein-losing enteropathy. Chronic gastrointestinal dysmotility, while relatively uncommon, carries a particularly grave prognosis. In those with amyloidosis, gastric involvement occurs in 8% of patients, with only 1% being symptomatic.1
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: CLINICAL COMMUNICATION TO THE EDITOR Source Type: research
Gastrointestinal amyloidosis most notably occurs in the liver and small intestine. Its presentation is highly nonspecific and may include gastrointestinal bleeding, malabsorption syndromes and protein-losing enteropathy. Chronic gastrointestinal dysmotility, while relatively uncommon, carries a particularly grave prognosis. In those with amyloidosis, gastric involvement occurs in 8% of patients with only 1% being symptomatic.1
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: CLINICAL COMMUNICATION TO THE EDITOR Source Type: research
AbstractPurpose of ReviewEfforts to provide early enteral nutrition in critical illness are thwarted by gastrointestinal dysfunction and feeding intolerance. While many of the signs and symptoms of this dysfunction reflect gastroparesis and intestinal dysmotility, other symptoms which may or may not be related are often included such as diarrhea, bleeding, and intra-abdominal hypertension. This paper discusses the need to monitor tolerance of nutritional therapy in the critical care setting and reviews the results of those clinical trials which have helped establish objective measures, define feeding intolerance, and provi...
Source: Current Gastroenterology Reports - Category: Gastroenterology Source Type: research
We present our experience with laparoscopic surgery for epiphrenic esophageal diverticulum. Short- and long-term results of surgical therapy were analyzed. Methods: Eight patients were examined with a symptom-causing epiphrenic diverticulum. Patients underwent complex gastroenterologic examinations before and after surgery. Laparoscopic transhiatal epiphrenic diverticulectomy, Heller cardiomyotomy, and Dor anterior partial fundoplication were performed on 7 patients. One patient underwent only diverticulectomy, where no motility disorder was present. Results from surgical treatments and changes in patients' pre- and po...
Source: JSLS : Journal of the Society of Laparoendoscopic Surgeons - Category: Surgery Tags: JSLS Source Type: research
Conclusion The endoscopic fragmentation of large gastric bezoars in the outpatient setting is safe with a good clinical course.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Conclusion The endoscopic fragmentation of large gastric bezoars in the outpatient setting is safe with a good clinical course.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Conclusions Scanning patients before CE did not predict capsule retention. Retention is a complication of CE, but occurs as a result of the underlying disease. The risk of retention is increased in patients with motility disorders, suspected small bowel ulcers or malignancies.
Source: Journal of International Medical Research - Category: Research Authors: Tags: Clinical Notes Source Type: research
More News: Bleeding | Children | Dysmotility | Endoscopy | Gastroenterology | Hospitals | Intensive Care | Laparoscopy | Laparotomy | Pediatrics | Surgery | Upper Endoscopy