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Specialty: Gastroenterology
Condition: Bleeding

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Total 54 results found since Jan 2013.

Adverse bleeding and stroke risk after high-risk endoscopic procedures in patients taking direct oral anticoagulants
Medical College of Wisconsin, USA.
Source: Gastrointestinal Endoscopy - June 1, 2023 Category: Gastroenterology Authors: Hasan Bader, Zachary Smith Tags: Clinical Endoscopic Practice 1 Saturday, May 6, 2023 12:30 PM - 1:30 PM Source Type: research

A Rare Cause of Life-Threatening Upper Gastrointestinal Bleeding
Question: A 66-year-old woman presented to the hospital with large-volume hematemesis and melena. Her past medical history was significant for an episode of native valve infective endocarditis secondary to a skin infection 4 years earlier, with an associated embolic stroke of the left middle cerebral artery. Her daily medications included aspirin and atorvastatin. She denied any intake of other non-steroidal anti-inflammatory drugs. She had no history of peptic ulcer disease or liver disease. On arrival to the hospital, the patient ’s blood pressure was 90/60 mm Hg, with a heart rate of 140 beats/min.
Source: Gastroenterology - May 26, 2023 Category: Gastroenterology Authors: Howard Guo, Jesse Stach, Paul J. Belletrutti Tags: Electronic Curbside Consult Source Type: research

Periprocedural Management of Antithrombotics — Do Not Hold if you Can!
The decision to hold or not to hold antithrombotic (AT) medications for an endoscopic procedure rests on the balance of the procedural bleeding risk and the patient ’s risk of suffering a thromboembolic event (TE), including stroke, pulmonary embolism, deep vein thrombosis, angina, or a myocardial infarction. Guidelines have categorized procedures into those with high and low bleeding risk. AT may be continued if the bleeding risk is low. If the bleeding risk is high, AT medications should be held or modified.
Source: Clinical Gastroenterology and Hepatology - January 28, 2023 Category: Gastroenterology Authors: Heiko Pohl Tags: Editorial Source Type: research

Comparison of bleeding following gastrointestinal endoscopic biopsy in patients treated with and without direct oral anticoagulants
Conclusions The PS analyses showed no significant differences in complications following gastrointestinal endoscopic biopsy between DOAC users and non-users. These results suggest the safety of endoscopic biopsy without DOAC withdrawal although the need for careful hemostasis remains. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text
Source: Endoscopy International Open - January 13, 2023 Category: Gastroenterology Authors: Konish, Takaaki Ono, Sachiko Okada, Akira Matsui, Hiroki Tanabe, Masahiko Seto, Yasuyuki Yasunaga, Hideo Tags: Original article Source Type: research

Delayed bleeding after precut sphincterotomy successfully treated with a novel self-assembling peptide gel
An 84-year-old woman was referred to our hospital because of obstructive jaundice associated with common bile duct stones. She had a history of cardioembolic stroke and was taking the direct oral anticoagulant (DOAC) edoxaban. ERCP was performed by use of the precut sphincterotomy technique, and  a biliary stent was inserted. After the onset of hematemesis 2 days later, she was mildly anemic (hemoglobin 10.4 g/dL). Emergency ERCP revealed a coagulum and oozing bleeding between the papilla and the stent (A).
Source: Gastrointestinal Endoscopy - September 22, 2022 Category: Gastroenterology Authors: Kimitoshi Kubo, Shuhei Hayasaka, Ikko Tanaka Tags: At the Focal Point Source Type: research

Collateral Effect of Coronavirus Disease 2019 Pandemic on Hospitalizations and Clinical Outcomes in Gastrointestinal and Liver Diseases: A Territory-wide Observational Study in Hong Kong
As of July 22, 2020 there were more than 14.9 million cases and 616,000 deaths due to coronavirus disease 2019 (COVID-19) worldwide.1 Medical resources were shifted to management of infected patients, and declines in hospitalizations for acute coronary syndrome and stroke were observed.2,3 The world is now being exposed to a third wave of the pandemic, and the disruption to endoscopy service is considerable, leading to potential delays in the diagnosis of cancers and management of gastrointestinal (GI) bleeding.
Source: Gastroenterology - July 25, 2020 Category: Gastroenterology Authors: Louis H.S. Lau, Sunny H. Wong, Terry C.F. Yip, Grace L.H. Wong, Vincent W.S. Wong, Joseph J.Y. Sung Tags: Brief Communication Source Type: research

Tu1031 THE INFLUENCE OF DIRECT ORAL ANTICOAGULANTS ON DELAYED BLEEDING IN PATIENTS WITH EARLY GASTRIC NEOPLASMS WHO UNDERWENT ENDOSCOPIC SUBMUCOSAL DISSECTION
Direct oral anticoagulants (DOAC) are widely prescribed for prevention of stroke in elderly patients with atrial fibrillation and approved indication for DOAC has been expanded. We aimed to evaluate the risk of delayed bleeding in patients who had taken DOAC and underwent endoscopic submucosal dissection (ESD) for gastric neoplasms.
Source: Gastrointestinal Endoscopy - May 31, 2020 Category: Gastroenterology Authors: Jinju Choi, Soo-Jeong Cho, Ayoung Lee, Jue L. Kim, Hyunsoo Chung, Sang Gyun Kim Tags: Poster abstracts Source Type: research

Risk of Stroke in Liver Cirrhosis: A Systematic Review and Meta-Analysis
Conclusions: Stroke is uncommon in cirrhotic patients. However, considering a positive relationship of liver cirrhosis with subarachnoid and intracranial hemorrhage, the prophylactic strategy may be selectively adopted in cirrhotic patients.
Source: Journal of Clinical Gastroenterology - December 7, 2019 Category: Gastroenterology Tags: LIVER, PANCREAS & BILIARY TRACT: Original Articles Source Type: research

478 what kind of direct oral anticoagulant presents the lowest bleeding risk after endoscopic resection of colorectal polyps?
Direct oral anticoagulants (DOACs), including dabigatran, rivaroxaban, apixaban, and edoxaban, have become popular as equivalent to warfarin for stroke prevention in non-valvular atrial fibrillation; however, bleeding risk from DOACs, especially the difference in risks among DOACs in endoscopic treatment, has not been reported. The study aimed to evaluate delayed bleeding risk related to early resumption of DOACs and compare the bleeding risk among DOACs after endoscopic resection of colorectal polyps.
Source: Gastrointestinal Endoscopy - May 31, 2019 Category: Gastroenterology Authors: Kazuko Beppu, Kazunori Yokoi, Hisafumi Yamagata, Satoko Suzuki, Tatsuo Ogihara Tags: Oral abstract Source Type: research

Percutaneous endoscopic gastrostomy for enteral nutrition: a 5-year clinical experience with 324 patients.
CONCLUSIONS: Our experience reconfirmed PEG as a minimally invasive and safe procedure for long-term enteral nutrition in patients with impaired oral intake. However, significant prognostic factors should be taken into account during the preoperative evaluation of patients. Deferral of procedure or specialized postoperative care may be indicated in high risk patients. PMID: 30676011 [PubMed - in process]
Source: Minerva Gastroenterologica e Dietologica - January 26, 2019 Category: Gastroenterology Tags: Minerva Gastroenterol Dietol Source Type: research

Antithrombotic therapy and gastric EMR or endoscopic submucosal dissection: The bleeding edge?
The number and complexity of endoscopic procedures performed by gastroenterologists and surgeons have increased in parallel with the increasing number of antithrombotic agents in clinical use.1,2 The decision to stop and resume 1 or more of these antithrombotic agents in the periprocedural period is challenging, and one must consider several patient-specific and procedure-specific factors, most notably the indication for antithrombotic use and the bleeding risk associated with the procedure. Acute coronary syndrome and stroke carry high rates of  morbidity and mortality and are dreaded adverse events of withholding antithrombotic agents.
Source: Gastrointestinal Endoscopy - January 19, 2019 Category: Gastroenterology Authors: Theodore W. James, Todd H. Baron Tags: Original article Source Type: research

Acute Esophageal Necrosis: A View in the Dark
Acute esophageal necrosis (AEN), also known as Gurvits syndrome, black esophagus, or acute necrotizing esophagitis, is a rare clinical entity and an unusual reason for upper gastrointestinal bleeding. It is typically described in critically ill patients with multiple medical conditions, arising from a combination of ischemic insult to the esophageal mucosa due to low-flow vascular states, corrosive injury caused by reflux of acid and pepsin, and decreased function of the mucosal barrier systems and reparative mechanisms as occurs in malnourished and debilitated physical states. Patients with AEN tend to be older men, as me...
Source: Case Reports in Gastroenterology - January 16, 2019 Category: Gastroenterology Source Type: research

Efficacy and Safety of Anticoagulation for Atrial Fibrillation in Patients with Cirrhosis: A Systematic Review and Meta-analysis
The atrial fibrillation-related stroke is clearly prevented by anticoagulation treatment, however, management of anticoagulation for AF in patients with cirrhosis represents a challenge due to bleeding concerns. To address this issue, a systematic review and meta-analysis of the literature was performed.
Source: Digestive and Liver Disease - December 13, 2018 Category: Gastroenterology Authors: Ronpichai Chokesuwattanaskul, Charat Thongprayoon, Tarun Bathini, Aldo Torres-Ortiz, Oisin A. O ’Corragain, Kanramon Watthanasuntorn, Ploypin Lertjitbanjong, Konika Sharma, Somchai Preechawat, Patompong Ungprasert, Paul T. Kröner, Karn Wijarnpreecha, W Tags: Meta-Analysis Source Type: research

Increased susceptibility of aging gastric mucosa to injury and delayed healing: Clinical implications.
Abstract In this editorial we comment on the article by Fukushi K et al published in the recent issue of the World Journal of Gastroenterology 2018; 24(34): 3908-3918. We focus specifically on the mechanisms of the anti-thrombotic action of aspirin, gastric mucosal injury and aging-related increased susceptibility of gastric mucosa to injury. Aspirin is widely used not only for the management of acute and chronic pain and arthritis, but also importantly for the primary and secondary prevention of cardiovascular events such as myocardial infarcts and strokes. Clinical trials have consistently shown that antiplatele...
Source: World Journal of Gastroenterology : WJG - November 14, 2018 Category: Gastroenterology Authors: Tarnawski AS, Ahluwalia A Tags: World J Gastroenterol Source Type: research

Adverse effects of proton pump inhibitors: fact or fake news?
Purpose of review The present review summarizes the past year's literature, both clinical and basic science, regarding potential adverse effects of proton pump inhibitors. Recent findings Proton pump inhibitors are amongst the most widely prescribed and overprescribed medications worldwide. Although generally considered well tolerated, epidemiologic studies mining large databases have reported a panoply of purported serious adverse effects associated with proton pump inhibitors, including chronic kidney disease, cognitive decline, myocardial infarction, stroke, bone fracture and even death. It should be noted that the...
Source: Current Opinion in Gastroenterology - October 16, 2018 Category: Gastroenterology Tags: STOMACH AND DUODENUM: Edited by Mitchell L. Schubert Source Type: research