Arterial embolization for endoscopically unmanageable gastrointestinal bleeding remains the first-line therapy whatever the angiographic features.

Arterial embolization for endoscopically unmanageable gastrointestinal bleeding remains the first-line therapy whatever the angiographic features. Scand J Gastroenterol. 2020 Sep 16;:1 Authors: Loffroy R, Falvo N, Midulla M, Chevallier O PMID: 32937085 [PubMed - as supplied by publisher]
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research

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Rationale: Although surgery has been the standard treatment for pancreaticoduodenal trauma because of the complex anatomical relation of the affect organs, transcatheter arterial embolization (TAE) has recently been introduced as a safe and effective treatment. However, TAE for pancreaticoduodenal arterial hemorrhage (PDAH) can be challenging because it is difficult to localize the involved artery and to embolize the bleeding completely due to the abundant collateral channels of the pancreaticoduodenal artery (PDA). Patient concerns: Herein, we report 2 cases of PDAH that occurred after falling down in case 1 and a pe...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
We present three cases of colonic ischemia that can be attributed to the hypercoagulable state related with SARS-CoV2 and disseminated intravascular coagulation. Three males aged 76, 68 and 56 with respiratory distress presented episodes of rectal bleeding, abdominal distension and signs of peritoneal irritation. Endoscopy (case 1) and computed tomography angiography revealed colonic ischemia. One patient (case 2) in which a computed tomography (CT) scan showed perforation of the gangrenous cecum underwent surgery. D-dimer levels were markedly increased (2,170, 2,100 and 7,360 ng/ml) in all three patients. All three patien...
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
We report a 70-year-old gentleman who attended the emergency department with a one day history of sudden onset right sided flank pain. He was on warfarin due to metallic mitral valve. On presentation, he was hemodynamically stable, but his international normalised ratio was deranged at 4.7. An initial non-contrast computed tomography (CT) scan of abdomen showed a large right retroperitoneal hematoma and subsequent CT renal angiogram revealed evidence of active bleeding. There were dilemmas whether or not to reverse the effect of warfarin, proceed with angio-embolisation or explore the patient surgically.
Source: Urology - Category: Urology & Nephrology Authors: Tags: Clinical Challenges in Urology Source Type: research
We report a 70-year-old gentleman who attended the emergency department with a 1 day history of sudden onset right-sided flank pain. He was on warfarin due to metallic mitral valve. On presentation, he was hemodynamically stable, but his international normalized ratio was deranged at 4.7. An initial noncontrast computed tomography (CT) scan of abdomen showed a large right retroperitoneal hematoma and subsequent CT renal angiogram revealed evidence of active bleeding. There were dilemmas whether or not to reverse the effect of warfarin, proceed with angioembolization or explore the patient surgically.
Source: Urology - Category: Urology & Nephrology Authors: Tags: Clinical Challenges in Urology Source Type: research
CONCLUSIONS: The causes of NVGIB are complex and the onset, location, risk, and clinical presentations are variable. NVGIB can be generally divided into three types: vascular abnormality, neoplastic disease, and iatrogenic condition. TAE is a safe, effective, and fast procedure in the management of gastrointestinal bleeding. PMID: 32650690 [PubMed - as supplied by publisher]
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
In this study, 5% of VF arrest was due to PE: V fib is initial rhythm in PE in 3 of 60 cases. On the other hand, if the presenting rhythm is PEA, then pulmonary embolism is likely.  When there is VF in PE, it is not the initial rhythm, but occurs after prolonged PEA renders the myocardium ischemic.--Another study by Courtney and Kline found that, of cases of arrest that had autopsy and found that a presenting rhythm of VF/VT had an odds ratio of 0.02 for massive pulmonary embolism as the etiology, vs 41.9 for PEA.    ===================================MY Comment by KEN ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Authors: Zhu J, Yin L, Che Y, Liu Z, Qi X, Zhou K, Zheng B, Pan E, Chen J Abstract Giant intracranial aneurysms, especially giant aneurysms of the distal posterior inferior cerebellar artery (PICA), remain the most difficult and challenging cerebrovascular lesions for neurosurgeons to treat. The morbidity and mortality rates of microsurgical clipping are relatively high, and endovascular embolization is also associated with many complications. In the present report, the case of a 46-year-old female patient who presented with headache and dizziness for 3 years, which was aggravated and combined with limb weakness fo...
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
This post was originally written in 2013. A middle-aged man with STEMI  came to our CCU.  It is just another case of STEMI and asked my fellow to lyse. But it was not the case . He, told me, Sir, the patient had a syncope following chest pain and he has injured his face and Jaw. He was actively bleeding. When I saw this face, it was indeed  frightening. What shall we do ? When a patient  with STEMI presents with bleeding facial Injury Rush for Immediate PCI (Which was  of course not possible in our place as it happened out of office hours! ) Take that ultimate risk and thrombolysis Give only hepa...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: bio ethics Cardiology -Therapeutic dilemma cardiology -Therapeutics Cardiology -unresolved questions Cardiology Risk assesment cardiology- coronary care Cardiology-Coronary artery disese Primary PCI Thrombolysis relative and absolute con Source Type: blogs
Conclusions: Imaging is proving itself critical in assessing frostbite injuries and guiding invasive and noninvasive care. While angiography is historically a gold standard, multiphase MDP imaging is readily available and a noninvasive modality which can aid prognostication.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Technologist Poster Session Source Type: research
CONCLUSION: The absence of vasospasm in the first DSA performed in patients with SAH and negative tomographic angiography could be a useful criterion for establishing an optimal follow-up protocol in these patients, without exposing them to unnecessary risks and radiation. PMID: 32242335 [PubMed - in process]
Source: Revista de Neurologia - Category: Neurology Authors: Tags: Rev Neurol Source Type: research
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