Original Articles
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Effect of antithrombotic therapies on small bowel bleeding: an European multicenter retrospective study
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Lucia Scaramella, Stefania Chetcuti Zammit, Reena Sidhu, Maurizio Vecchi, Gian Eugenio Tontini, Nicoletta Nandi, Matilde Topa, Luca Elli
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Clin Endosc 2025;58(1):102-111. Published online December 2, 2024
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DOI: https://doi.org/10.5946/ce.2024.073
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- Background
/Aims: Small bowel bleeding (SBB) is the main indication for videocapsule endoscopy (VCE); the diagnostic yield (DY) could be influenced by antithrombotic therapies. We explored the effects of these therapies on SBB.
Methods
Consecutive patients from two centers (Milan, Italy and Sheffield, UK) who underwent VCE between March 2001 and July 2020 were considered. Demographic data, clinical parameters, drug therapy, and technical characteristics of the procedure were collected. VCE findings and DY were evaluated.
Results
In total, 957 patients (1,052 VCEs) underwent VCE for SBB (DY 50.6%, no retention); 27 patients (27 VCEs) received direct oral anticoagulants, 87 (88 VCEs) received other anticoagulants, 115 (135 VCEs) received antiplatelet therapy, 198 (218 VCEs) received monotherapy, and 31 (32 VCEs) received combined therapy. There were no differences in the completion rate, findings, and DYs between each subgroup or between monotherapy and combined therapy. The overt bleeding rate was similar in all groups, even when comparing antithrombotic users versus those not on therapy (p=0.59) or monotherapy versus combined therapy (p=0.34).
Conclusions
VCE is safe and has a high clinical impact on SBB. Antithrombotic therapies did not affect DY or overt bleeding rate and, consequently, can be considered safe in terms of SBB risk.
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Citations
Citations to this article as recorded by

- Do all antithrombotic agents have a similar impact on small bowel bleeding?
Chung Hyun Tae, Ki-Nam Shim
Clinical Endoscopy.2025; 58(1): 80. CrossRef
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Efficacy of hemostasis by gastroduodenal covered metal stent placement for hemorrhagic duodenal stenosis due to pancreatobiliary cancer invasion: a retrospective study
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Yasunari Sakamoto, Taku Sakamoto, Akihiro Ohba, Mitsuhito Sasaki, Shunsuke Kondo, Chigusa Morizane, Hideki Ueno, Yutaka Saito, Yasuaki Arai, Takuji Okusaka
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Clin Endosc 2024;57(5):628-636. Published online June 14, 2024
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DOI: https://doi.org/10.5946/ce.2023.155
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- Background
/Aims: Advanced pancreatic and biliary tract cancers can invade the duodenum and cause duodenal hemorrhagic stenosis. This study aimed to evaluate the efficacy of covered self-expandable metal stents in the treatment of cancer-related duodenal hemorrhage with stenosis.
Methods
Between January 2014 and December 2016, metal stents were placed in 51 patients with duodenal stenosis. Among these patients, a self-expandable covered metal stent was endoscopically placed in 10 patients with hemorrhagic duodenal stenosis caused by pancreatobiliary cancer progression. We retrospectively analyzed the therapeutic efficacy of the stents by evaluating the technical and clinical success rates based on successful stent placement, degree of oral intake, hemostasis, stent patency, and overall survival.
Results
The technical and clinical success rates were 100%. All 10 patients achieved a gastric outlet obstruction scoring system score of three within two weeks after the procedure and had no recurrence of melena. The median stent patency duration and overall survival after stent placement were 52 days (range, 20–220 days) and 66.5 days (range, 31–220 days), respectively.
Conclusions
Endoscopic placement of a covered metal stent for hemorrhagic duodenal stenosis associated with pancreatic or biliary tract cancer resulted in duodenal hemostasis, recanalization, and improved quality of life.
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Clinical outcomes of nonvariceal upper gastrointestinal bleeding in nonagenarians and octogenarians: a comparative nationwide analysis
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Khaled Elfert, James Love, Esraa Elromisy, Fouad Jaber, Suresh Nayudu, Sammy Ho, Michel Kahaleh
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Clin Endosc 2024;57(3):342-349. Published online February 7, 2024
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DOI: https://doi.org/10.5946/ce.2023.130
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- Background
/Aims: Nonagenarians will purportedly account for 10% of the United States population by 2050. However, no studies have assessed the outcomes of nonvariceal upper gastrointestinal bleeding (NVUGIB) in this age group.
Methods
The National Inpatient Sample database between 2016 and 2020 was used to compare the clinical outcomes of NVUGIB in nonagenarians and octogenarians and evaluate predictors of mortality and the use of esophagogastroduodenoscopy (EGD).
Results
Nonagenarians had higher in-hospital mortality than that of octogenarians (4% vs. 3%, p<0.001). EGD utilization (30% vs. 48%, p<0.001) and blood transfusion (27% vs. 40%, p<0.001) was significantly lower in nonagenarians. Multivariate logistic regression analysis revealed that nonagenarians with NVUGIB had higher odds of mortality (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.3–1.7) and lower odds of EGD utilization (OR, 0.86; 95% CI, 0.83–0.89) than those of octogenarians.
Conclusions
Nonagenarians admitted with NVUGIB have a higher mortality risk than that of octogenarians. EGD is used significantly in managing NVUGIB among nonagenarians; however, its utilization is comparatively lower than in octogenarians. More studies are needed to assess predictors of poor outcomes and the indications of EGD in this growing population.
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Novel upper gastrointestinal bleeding sensor capsule: a first human feasibility and safety trial
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Lukas Bajer, Marvin Ryou, Christopher C. Thompson, Pavel Drastich
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Clin Endosc 2024;57(2):203-208. Published online January 17, 2024
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DOI: https://doi.org/10.5946/ce.2023.111
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- Background
/Aims: Upper gastrointestinal bleeding (UGIB) is the most common GI condition requiring hospitalization, and can be diagnosed by direct visualization. The present study aimed to evaluate the safety and feasibility of using the PillSense system (EnteraSense Ltd.), a novel diagnostic tool designed for the rapid in vivo detection of UGIB, in human volunteers.
Methods
In the present study, 10 volunteers swallowed a PillSense capsule, followed by 2 servings of an autologous blood preparation. Participants were monitored for capsule passage, overall tolerability of the procedure, and adverse events.
Results
The procedure was completed per the protocol established in the present study in 9/10 cases. In 9 of the subjects, after capsule ingestion, the device indicated the absence of blood with sensor output values of 1. After the ingestion of the first blood mixture, the sensor outputs of all devices increased from 2.8 to 4, indicating that each camera detected blood. The sensor output remained within that range after the ingestion of the second mixture; however, in one case, the baseline capsule signal was positive, because of a preexisting condition. The passage of the capsule was verified in all patients, and no adverse events were reported.
Conclusions
The first trial of the PillSense system in human subjects demonstrated the feasibility, safety, and tolerability of utilizing this product as a novel, noninvasive, and easy-to-use triage tool for the diagnosis of patients suspected of having UGIB.
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Citations
Citations to this article as recorded by

- Advances in implantable capsule robots for monitoring and treatment of gastrointestinal diseases
Xiaofeng Wang, Hao Xu, Yanlong Ren, Ying Yuan, Fei Deng, Wei Gao, Zheng Lou, Xian-Tao Song, Hao Guo, Wei Han, Lili Wang
Materials Science and Engineering: R: Reports.2025; 163: 100943. CrossRef - Could a bleeding-sensor device be established as a new paradigm for detecting upper gastrointestinal bleeding before performing endoscopy?
Sun Gyo Lim
Clinical Endoscopy.2024; 57(2): 191. CrossRef - Approaches of wearable and implantable biosensor towards of developing in precision medicine
Elham Ghazizadeh, Zahra Naseri, Hans-Peter Deigner, Hossein Rahimi, Zeynep Altintas
Frontiers in Medicine.2024;[Epub] CrossRef
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Review
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Endoscopic management of postoperative bleeding
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Sung Hyeok Ryou, Ki Bae Bang
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Clin Endosc 2023;56(6):706-715. Published online November 2, 2023
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DOI: https://doi.org/10.5946/ce.2023.028
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- Postoperative gastrointestinal bleeding is a rare but serious complication that can lead to prolonged hospitalization and significant morbidity and mortality. It can be managed by reoperation, endoscopy, or radiological intervention. Although reoperation carries risks, particularly in critically ill postoperative patients, minimally invasive interventions, such as endoscopy or radiological intervention, confer advantages. Endoscopy allows localization of the bleeding focus and hemostatic management at the same time. Although there have been concerns regarding the potential risk of creating an anastomotic disruption or perforation during early postoperative endoscopy, endoscopic management has become more popular over time. However, there is currently no consensus on the best endoscopic management for postoperative gastrointestinal bleeding because most practices are based on retrospective case series. Furthermore, there is a wide range of individual complexities in anatomical and clinical settings after surgery. This review focused on the safety and effectiveness of endoscopic management in various surgical settings.
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Citations
Citations to this article as recorded by

- Letter to the editor on “early postoperative endoscopy for predicting anastomotic leakage after minimally invasive esophagectomy: A large-volume retrospective study”
Judith Sánchez-Zavaleta, Doyler Cubas-García
Surgery.2024; : 108890. CrossRef - Evaluating the efficacy of a novel hemostatic powder compared with traditional treatments in nonvariceal upper GI bleeding: a multicenter, randomized, noninferiority study
Da Hyun Jung, Jun Chul Park, Joon Sung Kim, Moon Won Lee, Hyuk Lee, Gwang Ha Kim
Gastrointestinal Endoscopy.2024;[Epub] CrossRef
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203
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Original Articles
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Preclinical study of a novel ingestible bleeding sensor for upper gastrointestinal bleeding
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Kimberly F. Schuster, Christopher C. Thompson, Marvin Ryou
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Clin Endosc 2024;57(1):73-81. Published online May 31, 2023
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DOI: https://doi.org/10.5946/ce.2022.293
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- Background
/Aims: Upper gastrointestinal bleeding (UGIB) is a life-threatening condition that necessitates early identification and intervention and is associated with substantial morbidity, mortality, and socioeconomic burden. However, several diagnostic challenges remain regarding risk stratification and the optimal timing of endoscopy. The PillSense System is a noninvasive device developed to detect blood in patients with UGIB in real time. This study aimed to assess the safety and performance characteristics of PillSense using a simulated bleeding model.
Methods
A preclinical study was performed using an in vivo porcine model (14 animals). Fourteen PillSense capsules were endoscopically placed in the stomach and blood was injected into the stomach to simulate bleeding. The safety and sensitivity of blood detection and pill excretion were also investigated.
Results
All the sensors successfully detected the presence or absence of blood. The minimum threshold was 9% blood concentration, with additional detection of increasing concentrations of up to 22.5% blood. All the sensors passed naturally through the gastrointestinal tract.
Conclusions
This study demonstrated the ability of the PillSense System sensor to detect UGIB across a wide range of blood concentrations. This ingestible device detects UGIB in real time and has the potential to be an effective tool to supplement the current standard of care. These favorable results will be further investigated in future clinical studies.
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Citations
Citations to this article as recorded by

- Ingestible electrochemical sensors: Emerging tools for gastrointestinal disease detection and monitoring
Zhaodong Wang
International Journal of Electrochemical Science.2025; 20(3): 100952. CrossRef - Miniaturized Capsule System Toward Real‐Time Electrochemical Detection of H2S in the Gastrointestinal Tract
Justin M. Stine, Katie L. Ruland, Luke A. Beardslee, Joshua A. Levy, Hossein Abianeh, Santiago Botasini, Pankaj J. Pasricha, Reza Ghodssi
Advanced Healthcare Materials.2024;[Epub] CrossRef
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Comparison of conventional and new endoscopic band ligation devices for colonic diverticular bleeding
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Ayaka Takasu, Takashi Ikeya, Yasutoshi Shiratori
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Clin Endosc 2022;55(3):408-416. Published online February 18, 2022
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DOI: https://doi.org/10.5946/ce.2021.200
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- Background
/Aims: Endoscopic band ligation (EBL) is used to treat colonic diverticular bleeding (CDB). An endoscopic variceal ligation device for esophageal varices is used as a conventional EBL device (C-EBL). A new EBL device (N-EBL) was developed by Sumitomo Bakelite Co. in August 2018. We aimed to evaluate the clinical outcomes of N-EBL compared with those of C-EBL.
Methods
Seventy-nine patients who underwent EBL for CDB at St. Luke’s International Hospital, Japan, between 2017 and 2020 were included in this retrospective study. Patients were divided into the C-EBL and N-EBL groups. Their clinical outcomes, including achieving initial hemostasis, early rebleeding, procedure time, and EBL-associated adverse events, were evaluated.
Results
Of the 79 patients, 36 (45.6%) were in the C-EBL group and 43 (54.4%) were in the N-EBL group. The rate of achieving initial hemostasis was 100% in the C-EBL group and 93.0% in the N-EBL group. No significant difference was noted in the early rebleeding rate between the groups (p=0.24). The N-EBL group achieved a shorter median EBL procedure time than the C-EBL group (18.2 minutes vs. 14.2 minutes, p=0.02). No adverse events were observed in either group.
Conclusions
The N-EBL device is safe and useful and may reduce EBL procedure time.
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Citations
Citations to this article as recorded by

- Advances in endoscopic management of colonic diverticular bleeding
Yasutoshi Shiratori, Syed Matthew Kodilinye, Ahmed E. Salem
Current Opinion in Gastroenterology.2024; 40(5): 363. CrossRef - Endoscopic Hemostasis and Antithrombotic Management
Jamie Bering, Mashal J. Batheja, Neena S. Abraham
Gastroenterology Clinics of North America.2024; 53(4): 573. CrossRef - Management of Patients With Acute Lower Gastrointestinal Bleeding: An Updated ACG Guideline
Neil Sengupta, Joseph D. Feuerstein, Vipul Jairath, Amandeep K. Shergill, Lisa L. Strate, Robert J. Wong, David Wan
American Journal of Gastroenterology.2023; 118(2): 208. CrossRef - Effective endoscopic band ligation for diverticular perforation with a refractory pelvic abscess
Koichi Soga, Atsushi Majima
Clinical Endoscopy.2023; 56(2): 252. CrossRef - A new band ligation device to treat colonic diverticular bleeding
Yunho Jung
Clinical Endoscopy.2022; 55(3): 367. CrossRef
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Case Reports
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Management of Biliopancreatic Limb Bleeding after Roux-en-Y Gastric Bypass: A Case Report
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Christophe Riquoir, Luis Antonio Díaz, David Chiliquinga, Roberto Candia, Fernando Pimentel, Alex Arenas
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Clin Endosc 2021;54(5):754-758. Published online May 25, 2021
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DOI: https://doi.org/10.5946/ce.2021.060
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- The Roux-en-Y gastric bypass is one of the most extensive surgical treatments for obesity. The treatment of upper gastrointestinal bleeding after Roux-en-Y gastric bypass is complex due to the difficulty of accessing the excluded gastric antrum and duodenal bulb. There is no consensus regarding the management of this complication. While various techniques have been described to access the biliopancreatic limb, double-balloon enteroscopy is the most commonly used. If double-balloon enteroscopy is unavailable, a pediatric colonoscope may be used as an alternative; however, its use in such cases has not been described. We report the case of a 50-year-old male patient who underwent gastric bypass 13 years ago and was admitted for a second episode of upper gastrointestinal bleeding. The initial approach using upper endoscopy, colonoscopy, and abdominal computed tomography angiography did not reveal the cause of gastrointestinal hemorrhage; therefore, an endoscopic study of the biliopancreatic limb was performed using a pediatric colonoscope. A Forrest Ib ulcer was found in the duodenal bulb, and endoscopic therapy was administered. The evolution was found to be satisfactory.
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Citations
Citations to this article as recorded by

- Endoscopic management of postoperative bleeding
Sung Hyeok Ryou, Ki Bae Bang
Clinical Endoscopy.2023; 56(6): 706. CrossRef
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Rare and Fatal Gastrointestinal Mucormycosis (Zygomycosis) in a COVID-19 Patient: A Case Report
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Epifanio Silvino do Monte Junior, Marcos Eduardo Lera dos Santos, Igor Braga Ribeiro, Gustavo de Oliveira Luz, Elisa Ryoka Baba, Bruno Salomão Hirsch, Mateus Pereira Funari, Eduardo Guimarães Hourneaux de Moura
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Clin Endosc 2020;53(6):746-749. Published online November 19, 2020
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DOI: https://doi.org/10.5946/ce.2020.180
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- The novel coronavirus disease (COVID-19) quickly spread to all continents. However, data regarding all the signs and symptoms of COVID-19 are insufficient. Patients with COVID-19 might present higher susceptibility to fungal coinfections. Mucormycosis is a rare and often life-threatening fungal disease characterized by vascular invasion by hyphae, resulting in thrombosis and necrosis. This is the first case report of mucormycosis in a COVID-19 patient. An 86-year-old male patient was admitted to the emergency room with acute diarrhea, cough, dyspnea, and fever from 5 days prior. Blood tests revealed a hemoglobin level of 14.3 mg/dL. Five days following the admission, the patient presented with melena and a hemoglobin level of 5.6 mg/dL. A transfusion of three units of red blood cells was required. Esophagogastroduodenoscopy revealed two giant gastric ulcers with necrotic debris and a deep hemorrhagic base without active bleeding. Furthermore, biopsies confirmed mucormycosis. Despite intensive care, the patient died 36 hours after the esophagogastroduodenoscopy.
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Citations to this article as recorded by

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Christopher R. Thornton
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Academic Radiology.2024; 31(3): 1055. CrossRef - Development of a Machine Learning Model to Predict Risk of Development of COVID-19-Associated Mucormycosis
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Neetu Jain, Seema Bhadauria
Biomedical and Biotechnology Research Journal.2024; 8(1): 13. CrossRef - Mucorales: A systematic review to inform the World Health Organization priority list of fungal pathogens
C Orla Morrissey, Hannah Yejin Kim, Katherine Garnham, Aiken Dao, Arunaloke Chakrabarti, John R Perfect, Ana Alastruey-Izquierdo, Thomas S Harrison, Felix Bongomin, Marcelo Galas, Siswanto Siswanto, Daniel Argaw Dagne, Felipe Roitberg, Valeria Gigante, Ha
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Ayoung Lee, Sung Woo Jung, Jung Mogg Kim
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2024; 24(2): 136. CrossRef - COVID-19 as a critical risk factor for osteonecrosis of the jaw: diagnostic challenge and surgical treatment
Antonio Romano, Roberta Gasparro, Maria Domenica Campana, Biagio Pinchera, Rosa Maria Di Crescenzo, Donatella Del Guercio, Marco Sarcinella, Marco Tatullo, Gilberto Sammartino
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Journal of Experimental Biology and Agricultural Sciences.2024; 12(3): 457. CrossRef -
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Olivér Jáger, Csilla Szebenyi, Tammam Khaliefeh Siliman Abu Saleem, Anna Molnár, Vanda Kovács, Karina Kiss, Mónika Homa, Bernadett Vágó, Sándor Kiss-Vetráb, Mónika Varga, Rita Sinka, Csaba Vágvölgyi, Gábor Nagy, Tamás Papp, Renato Kovacs
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Parisa Saberi-Hasanabai, Milad Esmaeilzadeh Farmad, Ramin Ataee
Journal of Medical Microbiology and Infectious Diseases.2024; 12(2): 84. CrossRef - Epidemiology, pathogenesis, clinical characteristics, and treatment of mucormycosis: a review
Mei Liang, Jian Xu, Yanan Luo, Junyan Qu
Annals of Medicine.2024;[Epub] CrossRef - Effectiveness of hyperbaric oxygen therapy in the management of COVID-19-associated mucormycosis
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Journal of Medical Virology.2022; 94(1): 99. CrossRef - Rhino-orbito-cerebral mucormycosis during the COVID-19 third wave in 2021: an Egyptian preliminary report from a single tertiary hospital
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Manas Pustake, Purushottam Giri, Mohammad Arfat Ganiyani
Journal of Family Medicine and Primary Care.2021; 10(12): 4619. CrossRef - Incidence, cumulative mortality and factors affecting the outcome of COVID-19-associated mucormycosis from Western India
Archana Ajay Vare, Snehalata Yellambkar, Asma Farheen, Varsha Nandedkar, Swati S Bhombe, Rachana Shah
Indian Journal of Ophthalmology.2021; 69(12): 3678. CrossRef
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Original Articles
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Utility of the Gel Immersion Method for Treating Massive Colonic Diverticular Bleeding
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Kazuki Yamamoto, Yasutoshi Shiratori, Takashi Ikeya
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Clin Endosc 2021;54(2):256-260. Published online August 11, 2020
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DOI: https://doi.org/10.5946/ce.2020.081
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Abstract
PDF
Supplementary Material
PubReader
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- Background
/Aims: In Asia, right-sided diverticular bleeding is more common than that of the left side. It often causes massive bleeding and difficulties in identifying the stigmata of recent hemorrhage (SRH) of colonic diverticular bleeding (CDB). This case series demonstrates the efficacy of the gel immersion method using OS-1 Jelly (Otsuka Pharmaceuticals Factory, Tokushima, Japan) in patients with CDB.
Methods
This retrospective case series analyzed data of patients with CDB who underwent the gel immersion method from April 2016 to February 2020 at St. Luke’s International Hospital, Japan. All patients diagnosed with CDB who underwent the gel immersion method were included. We collected data on the site of bleeding, identification of SRH, and efficacy of the method from the electronic medical records.
Results
A total of 9 patients (including 7 with right-sided CDB) underwent gel immersion method and were included in this study. SRH were successfully found in 66.7% (6/9) of patients. Moreover, effective hemostasis was achieved in 85.7% (6/7) of patients with right-sided CDB. There were no adverse events.
Conclusions
The gel immersion method was found to be effective, especially for massive right-sided CDB.
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Citations
Citations to this article as recorded by

- Gel immersion in endoscopy: Exploring potential applications
Hiroki Sato, Hidemasa Kawabata, Mikihiro Fujiya
World Journal of Gastroenterology.2025;[Epub] CrossRef - Efficacy and safety of conservative treatment for colonic diverticular bleeding: Prospective study
Hirosato Doi, Masanori Takahashi, Keita Sasajima, Takehiro Yoshii, Ryo Chinzei
Endoscopy International Open.2025;[Epub] CrossRef - Advances in endoscopic management of colonic diverticular bleeding
Yasutoshi Shiratori, Syed Matthew Kodilinye, Ahmed E. Salem
Current Opinion in Gastroenterology.2024; 40(5): 363. CrossRef - Successful direct clipping of the bleeding source of a colonic diverticular hemorrhage using the “long-hood gel-filling” method
Satoshi Abiko, Koji Hirata, Kazuharu Suzuki, Kenji Kinoshita, Kazuteru Hatanaka, Yoshiya Yamamoto, Hirohito Naruse
Endoscopy.2023; 55(S 01): E606. CrossRef - Utility of under-gel endoscopic mucosal resection with partial submucosal injection for a laterally spreading tumor
Kazuki Yamamoto, Naoki Kanomata, Takashi Ikeya
Endoscopy.2022; 54(03): E88. CrossRef - Localizing spontaneously hemostatic colonic diverticular bleeding using VISCOCLEAR gel: A case report
Daisuke Suto, Masashi Yoshida, Takaaki Otake, Eiichiro Ichiishi, Kiichi Sato, Yosuke Osawa, Hirotoshi Ebinuma, Hironori Odaira, Yutaka Suzuki, Yutaka Kohgo
Annals of Medicine & Surgery.2022;[Epub] CrossRef - Gel Immersion Endoscopic Mucosal Resection (EMR) for Superficial Nonampullary Duodenal Epithelial Tumors May Reduce Procedure Time Compared with Underwater EMR (with Video)
Takeshi Yamashina, Masaaki Shimatani, Yu Takahashi, Masahiro Takeo, Natsuko Saito, Hironao Matsumoto, Takeshi Kasai, Masataka Kano, Kimi Sumimoto, Toshiyuki Mitsuyama, Hiroyuki Marusawa, Akiyoshi Nishio, Takafumi Yuba, Toshihito Seki, Makoto Naganuma, Tat
Gastroenterology Research and Practice.2022; 2022: 1. CrossRef - Digital compression for hemostasis in acute hemorrhagic rectal ulcer: a report of 4 cases and review of the literature
Takeshi Okamoto, Ayaka Takasu, Takaaki Yoshimoto, Kazuki Yamamoto, Yasutoshi Shiratori, Takashi Ikeya, Katsuyuki Fukuda
Clinical Journal of Gastroenterology.2021; 14(3): 796. CrossRef - Efficiency of a novel gel product for duodenal ulcer bleeding
Shuichi Miyamoto, Kazuharu Suzuki, Kenji Kinoshita
Digestive Endoscopy.2021;[Epub] CrossRef - Development of a gel dedicated to gel immersion endoscopy
Tomonori Yano, Atsushi Ohata, Yuji Hiraki, Makoto Tanaka, Satoshi Shinozaki, Alan Kawarai Lefor, Hironori Yamamoto
Endoscopy International Open.2021; 09(06): E918. CrossRef - Gel immersion endoscopy: Innovation in securing the visual field – Clinical experience with 265 consecutive procedures
Tomonori Yano, Takahito Takezawa, Kousei Hashimoto, Ayako Ohmori, Satoshi Shinozaki, Manabu Nagayama, Hirotsugu Sakamoto, Yoshimasa Miura, Yoshikazu Hayashi, Keijiro Sunada, Alan Kawarai Lefor, Hironori Yamamoto
Endoscopy International Open.2021; 09(07): E1123. CrossRef
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6,132
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11
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Efficacy of the Envelope Method in Applying Polyglycolic Acid Sheets to Post-Endoscopic Submucosal Dissection Ulcers in Living Pigs
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Hiroya Sakaguchi, Toshitatsu Takao, Yoshitaka Takegawa, Yuki Koga, Kazunori Yamanaka, Masataka Sagata, Shinwa Tanaka, Yoshinori Morita, Takashi Toyonaga, Yuzo Kodama
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Clin Endosc 2021;54(1):64-72. Published online July 16, 2020
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DOI: https://doi.org/10.5946/ce.2020.014
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Abstract
PDF
Supplementary Material
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ePub
- Background
/Aims: Application of polyglycolic acid (PGA) sheets using fibrin glue in post-endoscopic submucosal dissection (ESD) ulcers to prevent bleeding has been reported to be difficult with the conventional delivery method because of gravity. This study assessed the usefulness of the envelope-based delivery system with and against gravity in living pigs.
Methods
PGA sheets were applied on post-ESD ulcers with and against gravity six times each using the conventional and envelope methods, respectively. The PGA sheet delivery time and the endoscopic and histological findings of the treated ulcer floors were compared.
Results
With gravity, the median PGA sheet application time was 1.00 (0.68–1.30) min/cm2 and 0.32 (0.18–0.52) min/cm2 with the conventional and envelope techniques (p=0.002), respectively, and against gravity, it was 1.20 (1.13–1.63) min/cm2 and 0.50 (0.39–0.58) min/cm2 (p=0.002), respectively. Against gravity, the endoscopic and histological findings revealed that the conventional group had insufficient fixation of the PGA sheets, but the envelope groups had sufficient fixation. The results with gravity were similar between the groups.
Conclusions
The envelope method makes it possible to deliver PGA sheets to the stomach quickly and cover ulcers appropriately both with and against gravity in living pigs.
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Citations
Citations to this article as recorded by

- Endoscopic sealing hemostasis with polyglycolic acid sheet and fibrin glue as a novel endoscopic hemostatic technique: a report of three cases
Kai Korekawa, Atsushi Kunimitsu
Clinical Journal of Gastroenterology.2024; 17(4): 626. CrossRef - Advances in Valorization of Biomass-Derived Glycolic Acid Toward Polyglycolic Acid Production
Congzhi Liu, Guochun Yan, Jie Gao, Haixin Guo, Qidong Hou
Catalysts.2024; 14(12): 903. CrossRef - Clinical Impact of Different Reconstruction Methods on Remnant Gastric Cancer at the Anastomotic Site after Distal Gastrectomy
Kei Matsumoto, Shinwa Tanaka, Takashi Toyonaga, Nobuaki Ikezawa, Mari Nishio, Masanao Uraoka, Tomoatsu Yoshihara, Hiroya Sakaguchi, Hirofumi Abe, Tetsuya Yoshizaki, Madoka Takao, Toshitatsu Takao, Yoshinori Morita, Hiroshi Yokozaki, Yuzo Kodama
Clinical Endoscopy.2022; 55(1): 86. CrossRef - The importance of pH adjustment for preventing fibrin glue dissolution in the stomach: an in vitro study
Yoshitaka Takegawa, Toshitatsu Takao, Hiroya Sakaguchi, Tatsuya Nakai, Kazuhiro Takeo, Yoshinori Morita, Takashi Toyonaga, Yuzo Kodama
Scientific Reports.2022;[Epub] CrossRef - A Novel Self-Assembled Gel for Gastric Endoscopic Submucosal Dissection-Induced Ulcer: A Preclinical Study in a Porcine Model
Meng Li, Haifeng Jin, Changpei Shi, Bin Lyu, Xiao Ying, Yuan Shi
Frontiers in Pharmacology.2021;[Epub] CrossRef
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5,537
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130
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5
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Endoscopic Findings in Patients Under the Age of 40 Years with Hematochezia in Singapore
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Man Hon Tang, Fung Joon Foo, Chee Yung Ng
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Clin Endosc 2020;53(4):466-470. Published online June 18, 2020
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DOI: https://doi.org/10.5946/ce.2019.029
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Abstract
PDF
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- Background
/Aims: Sigmoidoscopy is performed in most medical centers to evaluate the distal colons of young adults presenting with hematochezia who are at risk of developing proximal lesions. Colonoscopies offer more complete evaluations but are associated with a higher incidence of complications and possible low yield.
Methods
An analysis was conducted on colonoscopies performed in our center on patients 40 years of age or younger. The study population was sub-divided into 2 age groups for analysis: <30 years of age and 30–39 years of age.
Results
We recruited 453 patients for the study. Patients were 115 and 338 individuals that were <30 and 30–39 years of age, respectively. Hemorrhoids was identified as the cause of bleeding in the majority of cases. The overall incidence of polyps was 6.5%; this was significantly higher in the 30–39 age group (7.4% vs. 1.7%, p=0.026). There were two cases of advanced/malignant polyps. While the majority of the polyps were in the distal colon, 28% of the polyps in the older age group were found in the proximal colon. There was one case of colonic perforation.
Conclusions
Colonic polyps are more prevalent in patients aged 30–39. Colonoscopies should be considered for patients over the age of 30 with rectal bleeding.
-
Citations
Citations to this article as recorded by

- The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease
Antonio Brillantino, Adolfo Renzi, Pasquale Talento, Luigi Brusciano, Luigi Marano, Maurizio Grillo, Mauro Natale Maglio, Fabrizio Foroni, Alessio Palumbo, Maria Laura Sandoval Sotelo, Luciano Vicenzo, Michele Lanza, Giovanna Frezza, Massimo Antropoli, Cl
Annals of Coloproctology.2024; 40(4): 287. CrossRef - The Value of Colonoscopy in Assessing Rectal Bleeding in Patients Referred From Outpatient Care Units in Erbil, Iraq
Rawand Haweizy, Farman N Qader
Cureus.2024;[Epub] CrossRef - Evaluating the necessity of colonoscopy in patients under 40 with rectal bleeding: insights from a large-scale retrospective analysis
Ibrahim M. Obeidat, Yousef Yahia, Prem Chandra, Amani Altaiam, Ethar Mohamed, Husam Saffo, Raya Abualsuod, Ala’a Al-deen Mousa, Duha Shalatouni, Khaled Alsa’ed, Mahmoud Y. Arabyat
International Journal of Colorectal Disease.2024;[Epub] CrossRef - Comparing efficacy and factors of postoperative bleeding in endoscopic mucosal resection vs coagulation for intestinal polyps
Zhiang Li, Fei Yu, Chaoqian Wang, Zhang Du
Medicine.2023; 102(37): e34941. CrossRef - The role of colonoscopy in young patients with rectal bleeding: a systematic review and meta-analysis
Tuane Colles, Patrícia K. Ziegelmann, Daniel C. Damin
International Journal of Colorectal Disease.2023;[Epub] CrossRef - Usefulness of Colonoscopy in Patients with Hematochezia Aged under 40 Years
Hee Chan Yang, Sang Wook Kim
Clinical Endoscopy.2020; 53(4): 385. CrossRef
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4,950
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94
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6
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Case Report
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Endoscopic Ultrasound-Guided Vascular Therapy for Portoduodenal Fistula
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Tanyaporn Chantarojanasiri, Apichet Sirinawasatien, Chalermrat Bunchorntavakul, Aroon Siripun, Sa-ard Treepongkaruna, Thawee Ratanachu-ek
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Clin Endosc 2020;53(6):750-753. Published online February 13, 2020
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DOI: https://doi.org/10.5946/ce.2019.167
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Abstract
PDF
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ePub
- Portoenteric fistula is a rare cause of massive upper gastrointestinal bleeding. Most cases can be treated with radiointervention or surgery, but portoenteric fistula is associated with a high mortality. We reported a case of intermittent massive upper gastrointestinal bleeding in a 33-year-old man with cholangiocarcinoma who underwent surgical resection followed by chemoradiation. A portoduodenal fistula due to chronic duodenal ulceration was identified. The bleeding was successfully controlled by endoscopic ultrasound-guided coil placement through the duodenal bulb using the anchoring technique. Follow-up endoscopy and computed tomography scan showed multiple coil placements between a part of the portal vein and the duodenal bulb without any evidence of portal vein thrombosis. There were no complications, and bleeding did not recur during the 8-month follow-up period.
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Citations
Citations to this article as recorded by

- An unusual case of high gastrointestinal bleeding after Whipple surgery
E Dubois, R Geelen
Acta Gastro Enterologica Belgica.2024; 87(3): 430. CrossRef - Management of non-variceal upper gastrointestinal bleeding: role of endoscopic ultrasound-guided treatments
Chaoqun Han, Xin Ling, Jun Liu, Rong Lin, Zhen Ding
Therapeutic Advances in Gastroenterology.2022;[Epub] CrossRef - A Case of an Internal Pancreatic Stent Penetrating the Portal Vein after Pancreaticoduodenectomy for Ampullary Carcinoma
Masanobu Taniguchi, Atsushi Mitsunaka, Yumi Zen, Takayuki Higashiguchi, Masaru Nagato, Yasuhisa Tango, Ichiro Nakamura, Tomoaki Nakamura, Hisanori Shiomi
The Japanese Journal of Gastroenterological Surgery.2022; 55(2): 99. CrossRef - Endoscopic ultrasound-guided portal vein coiling: troubleshooting interventional endoscopic ultrasonography
Shin Haba, Kazuo Hara, Nobumasa Mizuno, Takamichi Kuwahara, Nozomi Okuno, Akira Miyano, Daiki Fumihara, Moaz Elshair
Clinical Endoscopy.2022; 55(3): 458. CrossRef
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4,656
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101
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3
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4
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Original Article
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Endoscopic Management with a Novel Over-The-Scope Padlock Clip System
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Mahesh Kumar Goenka, Gajanan Ashokrao Rodge, Indrajeet Kumar Tiwary
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Clin Endosc 2019;52(6):574-580. Published online November 26, 2019
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DOI: https://doi.org/10.5946/ce.2019.122
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Abstract
PDF
PubReader
ePub
- Background
/Aims: The Padlock clip is a recently introduced over-the-scope clip (OTSC) that requires the use of an alternate technique and has a different design from previous OTSCs. However, data regarding its clinical use are limited. The aim of this study is to present our clinical experience using this novel Padlock clip system.
Methods
Between September 2018 and June 2019, 7 consecutive patients underwent Padlock clip application at our center by an experienced endoscopist. A Padlock clip was used for achieving hemostasis in 4 patients presenting with gastrointestinal (GI) bleeding, as well as for endoscopic full-thickness resection in the remaining 3 patients.
Results
All 7 patients achieved technical as well as clinical success, with absence of complications or rebleeding, during a follow-up of a minimum of 3 weeks. All patients were hospitalized post procedure for a minimum of 48 hours, and an absence of adverse events was noted in our patient population throughout the procedure and post-procedure period. Antiplatelet therapy was reinstated shortly after the application of the Padlock clip, with no GI bleeding observed.
Conclusions
The Padlock clip is a novel OTSC, with benefits that include safe, simple, and rapid deployment. Antiplatelet therapy may be reinstated for patients, when necessary, shortly after applying the Padlock clip due to full-thickness closure of the tissue.
-
Citations
Citations to this article as recorded by

- Updates on the Prevention and Management of Post-Polypectomy Bleeding in the Colon
Hisham Wehbe, Aditya Gutta, Mark A. Gromski
Gastrointestinal Endoscopy Clinics of North America.2024; 34(2): 363. CrossRef - Advancements in endoscopic hemostasis for non-variceal upper gastrointestinal bleeding
Xue Jing Li, Brian M Fung
World Journal of Gastrointestinal Endoscopy.2024; 16(7): 376. CrossRef - Usage of Padlock Over-the-Scope-Clip in Difficult-to-Control Recurrent Gastrointestinal Bleeding Due to a Gastric Dieulafoy Lesion
John Joyce, Vishnu Kumar, Dayana Nasr, Ganesh Aswath, Hafiz M. Khan, Savio John
Journal of Investigative Medicine High Impact Case Reports.2024;[Epub] CrossRef - Impact of Size on Endoluminal Approaches to Submucosal Tumors of the Stomach
Jad P. AbiMansour, Ryan J. Law
Foregut: The Journal of the American Foregut Society.2024;[Epub] CrossRef - Analysis of Reported Adverse Events Related to Over-the-Scope Clips: A MAUDE Database Analysis
Daniyal Abbas, Mohamed Abdallah, Khalid Ahmed, Abubaker O. Abdalla, Nicholas McDonald, Shifa Umar, Brian J. Hanson, Mohammad Bilal
Techniques and Innovations in Gastrointestinal Endoscopy.2023; 25(2): 106. CrossRef - Colonic diverticular bleeding: An update on pathogenesis and management
Sneha Annie Sebastian, Edzel Lorraine Co, Venkatesh Panthangi, Radha Bansal, Vaishnavi Narayanan, Shachi Paudel, Rabab Raja, Inderbir Padda, Babu P Mohan
Disease-a-Month.2023; 69(11): 101543. CrossRef - Endoscopic Recognition and Resection of Malignant Colorectal Polyps
Natalie Wilson, Moamen Gabr, Mohammad Bilal
Techniques and Innovations in Gastrointestinal Endoscopy.2023; 25(4): 385. CrossRef - Endoscopic Salvage of Gastrointestinal Anastomosis Leaks—Past, Present, and Future—A Narrated Review
Alexandra Menni, George Stavrou, Georgios Tzikos, Anne D. Shrewsbury, Katerina Kotzampassi
Gastrointestinal Disorders.2023; 5(3): 383. CrossRef - Boerhaave’s Syndrome: Better Late than Never – Delayed Management Using Endoscopic Over-the-Scope Clip
Arulprakash Sarangapani, Tarun J George, S Malathi
Gastroenterology, Hepatology and Endoscopy Practice.2023; 3(4): 167. CrossRef - Tratamiento endoscópico de la perforación mediante Padlock Clip®, a propósito de 2 casos
M. Reyes Busta Nistal, Lourdes del Olmo Martínez, Benito Velayos Jimenez, Luis Fernández Salazar, Miguel Durà Gil
Gastroenterología y Hepatología.2022; 45: 99. CrossRef - The application of endoscopic loop ligation in defect repair following endoscopic full-thickness resection of gastric submucosal tumors originating from the muscularis propria layer
Guoxiang Wang, Yanli Xiang, Yangde Miao, Honggang Wang, Meidong Xu, Guang Yu
Scandinavian Journal of Gastroenterology.2022; 57(1): 119. CrossRef - OTSC (Padlock Clip) as a Rescue Endoscopic Method for a Severe Post-Bariatric Complication
Luiza L. Ramos, Ravi C. Marques, Hugo G. Guedes
Obesity Surgery.2022; 32(5): 1761. CrossRef - Editors' Choice of Noteworthy Clinical Endoscopy Publications in the First Decade
Gwang Ha Kim, Kwang An Kwon, Do Hyun Park, Jimin Han
Clinical Endoscopy.2021; 54(5): 633. CrossRef - Mucosectomy device‐assisted endoscopic resection of gastric subepithelial lesions
Lian Yong Li, Bai Wen Li, Parit Mekaroonkamol, Hui Min Chen, Shan Shan Shen, Hui Luo, Sunil Dacha, Yue Xue, Sarah Cristofaro, Steven Keilin, Field Willingham, Qiang Cai
Journal of Digestive Diseases.2020; 21(4): 215. CrossRef - Another Use for Padlock Clip
Awf Mouchli, Vikas Chitnavis
Cureus.2020;[Epub] CrossRef - Successful Endoscopic Removal of Toothpick Perforating Gastric Antrum With Over-the-Scope Padlock Clip Closure
Darshan Suthar, Elisabeth H Kramer, Harshit S Khara
Cureus.2020;[Epub] CrossRef
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Focused Review Series: Endoscopic Hemostasis: An Overview of Principles and Recent Applications
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Endoscopic Hemostasis for Non-Variceal Upper Gastrointestinal Bleeding: New Frontiers
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Adam Kichler, Sunguk Jang
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Clin Endosc 2019;52(5):401-406. Published online July 16, 2019
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DOI: https://doi.org/10.5946/ce.2018.103
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Abstract
PDF
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ePub
- Non-variceal upper gastrointestinal bleeding (NVUGIB) refers to blood loss from the gastrointestinal tract proximal to the ligament of Treitz due to lesions that are non-variceal in origin. The distinction of the bleeding source as non-variceal is important in numerous aspects, but none more so than endoscopic approaches for successful hemostasis. When a patient presents with acute overt blood loss, NVUGIB is a medical emergency, which requires immediate intervention. There have been major strides in pharmacologic and endoscopic interventions for successful induction and remission of hemostasis in the last two decades. Despite achieving tangible improvements, the burden of the disease and the consequent mortality remain high. To address endoscopic outcomes better, several new technologies have emerged and have been subsequently incorporated to the armamentarium of hemostatic tools. This study aims to provide a succinct review on novel technologies for endoscopic hemostasis.
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Citations
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Butros Fakhoury, Mohanad Awadalla, Michael Talanian, Tanya Zeina, Erika Tsuchiyose, Nikola Natov, Erik Holzwanger
Endoscopy.2025; 57(S 01): E58. CrossRef - Clinical characteristics of acute non-varicose upper gastrointestinal bleeding and the effect of endoscopic hemostasis
Xiao-Juan Wang, Yu-Peng Shi, Li Wang, Ya-Ni Li, Li-Juan Xu, Yue Zhang, Shuang Han
World Journal of Clinical Cases.2024; 12(9): 1597. CrossRef - MODERN TRENDS IN ENDOSCOPIC HEMOSTASIS IN PATIENTS WITH EROSIVE-ULCERATIVE GASTROINTESTINAL BLEEDING WITH PREROGATIVE USE OF ARGON PLASMA COAGULATION AND TAKING INTO ACCOUNT THE SPECIAL CONDITIONS OF THE ENDOSCOPY DEPARTMENT IN WARTIME
V. V. Boiko, V. H. Hroma, I. A. Taraban, Y. V. Hroma
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Xinyi Chen, Xinqun Li, Guangju Zhao, Wen Xu
Frontiers in Medicine.2024;[Epub] CrossRef - Progress in Diagnosis and Treatment of Acute Upper Gastrointestinal Bleeding
泗云 李
Advances in Clinical Medicine.2024; 14(08): 1674. CrossRef - Endoscopic Hemostasis and Antithrombotic Management
Jamie Bering, Mashal J. Batheja, Neena S. Abraham
Gastroenterology Clinics of North America.2024; 53(4): 573. CrossRef - UI-EWD hemostatic powder in the management of refractory lower gastrointestinal bleeding: a multicenter study
Gyeol Seong, Boram Cha, Jongbeom Shin, Sung Min Kong, Ji Taek Hong, Kye Sook Kwon
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ACG Case Reports Journal.2021; 8(3): e00550. CrossRef - Diode Laser—Can It Replace the Electrical Current Used in Endoscopic Submucosal Dissection? (with Video)
Yunho Jung, Gwang Ho Baik, Weon Jin Ko, Bong Min Ko, Seong Hwan Kim, Jin Seok Jang, Jae-Young Jang, Wan-Sik Lee, Young Kwan Cho, Sun Gyo Lim, Hee Seok Moon, In Kyung Yoo, Joo Young Cho
Clinical Endoscopy.2021; 54(4): 555. CrossRef -
In Vivo Investigation of Noncontact Rapid Photothermal Hemostasis on Venous and Arterial Bleeding
Myeongjin Kim, Van Gia Truong, Sungwon Kim, Hyejin Kim, Thomas Hasenberg, Hyun Wook Kang
IEEE Transactions on Biomedical Engineering.2021; 68(9): 2689. CrossRef - Comparison of high and low-dose epinephrine & endoclip application in peptic ulcer bleeding
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Case Report
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Acquired Hemophilia A with Gastrointestinal Bleeding
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Narae Park, Jin Seok Jang, Jae Hwang Cha
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Clin Endosc 2020;53(1):90-93. Published online July 8, 2019
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DOI: https://doi.org/10.5946/ce.2019.036
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Abstract
PDF
PubReader
ePub
- Peptic ulcer disease is the most common cause of acute gastrointestinal bleeding, followed by variceal bleeding, Mallory–Weiss syndrome, and malignancy. On the contrary, acquired hemophilia A is a very rare hemorrhagic disease, which usually manifests with musculocutaneous bleeding, caused by autoantibodies against coagulation factor VIII.
A 78-year-old man presented to the Emergency Department with melena. Dieulafoy’s lesions were observed on esophagogastroduodenoscopy, and endoscopic cauterization was performed. However, the patient complained of back pain and symptoms indicative of upper gastrointestinal bleeding. Abdominopelvic computed tomography was performed, and hematoma in the psoas muscle was detected. Antibodies against coagulation factor VIII were confirmed with a blood test, and the diagnosis of acquired hemophilia A was made. Here, we report a case of acquired hemophilia A presenting with upper gastrointestinal bleeding symptoms and present a brief review of literature.
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Citations
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- Variceal hemorrhage in a patient with cirrhosis and congenital hemophilia A: A therapeutic challenge
Rafael Gregorio Peña Amaya, María del Carmen Figueredo Peña
SAGE Open Medical Case Reports.2024;[Epub] CrossRef - Acquired hemophilia A as a disease of the elderly: A comprehensive review of epidemiology, pathogenesis, and novel therapy
Andrea Lehoczki, Mónika Fekete, Gábor Mikala, Imre Bodó
GeroScience.2024;[Epub] CrossRef - A case of refractory bleeding from duodenal angioectasia with acquired hemophilia A
Hiroko Abe, Masahiro Saito, Kaname Uno, Tomoyuki Koike, Satoshi Ichikawa, Masashi Saito, Takeshi Kanno, Waku Hatta, Naoki Asano, Atsushi Masamune
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Dimitra S. Mouliou
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Mert Yurtsever, İrfan Arda Aykut, Beste Girgin, Berkay Aldemir, Oğuzhan Alp Öztürk, Zeliha Türkyılmaz
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Pilar Del Pino Bellido, María Fernanda Guerra Veloz, Reyes Aparcero López
Revista Española de Enfermedades Digestivas.2021;[Epub] CrossRef - Undiagnosed Acquired Hemophilia A: Presenting as Recurrent Gastrointestinal Bleeding
Arya Mariam Roy, Aisha Siddiqui, Anand Venkata
Cureus.2020;[Epub] CrossRef
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Original Article
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Endoscopy Timing in Patients with Acute Upper Gastrointestinal Bleeding
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Gonçalo Alexandrino, Tiago Dias Domingues, Rita Carvalho, Mariana Nuno Costa, Luís Carvalho Lourenço, Jorge Reis
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Clin Endosc 2019;52(1):47-52. Published online October 5, 2018
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DOI: https://doi.org/10.5946/ce.2018.093
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Abstract
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- Background
/Aims: The role of very early (≤12 hours) endoscopy in nonvariceal upper gastrointestinal bleeding is controversial. We aimed to compare results of very early and early (12–24 hours) endoscopy in patients with upper gastrointestinal bleeding demonstrating low-risk versus high-risk features and nonvariceal versus variceal bleeding.
Methods
This retrospective study included patients with nonvariceal and variceal upper gastrointestinal bleeding. The primary outcome was a composite of inpatient death, rebleeding, or need for surgery or intensive care unit admission. Endoscopy timing was defined as very early and early. We performed the analysis in two subgroups: (1) high-risk vs. low-risk patients and (2) variceal vs. nonvariceal bleeding.
Results
A total of 102 patients were included, of whom 59.8% underwent urgent endoscopy. Patients who underwent very early endoscopy received endoscopic therapy more frequently (p=0.001), but there was no improvement in other clinical outcomes. Furthermore, patients at low risk and with nonvariceal bleeding who underwent very early endoscopy had a higher risk of the composite outcome.
Conclusions
Very early endoscopy does not seem to be associated with improved clinical outcomes and may lead to poorer outcomes in specific populations with upper gastrointestinal bleeding. The actual benefit of very early endoscopy remains controversial and should be further clarified.
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Citations
Citations to this article as recorded by

- Acute Nonvariceal Upper Gastrointestinal Bleeding in Patients Using Anticoagulants: Does the Timing of Endoscopy Affect Outcomes?
Tiago Lima Capela, Vítor Macedo Silva, Marta Freitas, Tiago Cúrdia Gonçalves, José Cotter
Digestive Diseases and Sciences.2024; 69(2): 570. CrossRef - The Time of Endoscopy for Nonvariceal Upper Gastrointestinal Bleeding: An Observational Study
Seong Woo Jeon, Joong Goo Kwon, Ju Yup Lee, Si Hyung Lee, Ho Jin Lee
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2024; 24(3): 267. CrossRef - Endoscopia urgente frente a endoscopia precoz: ¿tiene algún papel la endoscopia urgente en la hemorragia digestiva alta aguda no varicosa?
Javier Lucas Ramos, Jorge Yebra Carmona, Irene Andaluz García, Marta Cuadros Martínez, Patricia Mayor Delgado, Maria Ángeles Ruiz Ramírez, Joaquín Poza Cordón, Cristina Suárez Ferrer, Ana Delgado Suárez, Nerea Gonzalo Bada, Consuelo Froilán Torres
Gastroenterología y Hepatología.2023; 46(8): 612. CrossRef - Urgent endoscopy versus early endoscopy: Does urgent endoscopy play a role in acute non-variceal upper gastrointestinal bleeding?
Javier Lucas Ramos, Jorge Yebra Carmona, Irene Andaluz García, Marta Cuadros Martínez, Patricia Mayor Delgado, Maria Ángeles Ruiz Ramírez, Joaquín Poza Cordón, Cristina Suárez Ferrer, Ana Delgado Suárez, Nerea Gonzalo Bada, Consuelo Froilán Torres
Gastroenterología y Hepatología (English Edition).2023; 46(8): 612. CrossRef - Clinical outcome of early endoscopy in patients with acute upper gastrointestinal bleeding in Alexandria emergency department
Mina Montasser, Wael Nabil Abdel Salam, Amany Elbanna, Dina Magdy, Ahmed A. Sabry
Egyptian Journal of Anaesthesia.2023; 39(1): 840. CrossRef - Az akut gastroduodenalis fekélyvérzés gyógyszeres és endoszkópos kezelésének újabb szempontjai
István Rácz
Orvosi Hetilap.2023; 164(23): 883. CrossRef - How Can Patient’s Risk Dictate the Timing of Endoscopy in Upper Gastrointestinal Bleeding?
Marta Freitas, Vítor Macedo Silva, Tiago Cúrdia Gonçalves, Carla Marinho, José Cotter
GE - Portuguese Journal of Gastroenterology.2022; 29(2): 96. CrossRef - Impacto del tiempo a la endoscopia digestiva en pacientes con hemorragia de tubo digestivo alto no variceal: una revisión sistemática y metaanálisis
H.G. Bilder, C. Soccini, J.S. Lasa, I. Zubiaurre
Revista de Gastroenterología de México.2022; 87(3): 320. CrossRef - Impact of time to esophagogastroduodenoscopy in patients with nonvariceal upper gastrointestinal bleeding: A systematic review and meta-analysis
H.G. Bilder, C. Soccini, J.S. Lasa, I. Zubiaurre
Revista de Gastroenterología de México (English Edition).2022; 87(3): 320. CrossRef - Urgent Endoscopy in Nonvariceal Upper Gastrointestinal Hemorrhage: A Retrospective Analysis
Jia-lun Guan, Ying-ying Han, Dan Fang, Mu-ru Wang, Ge Wang, De-an Tian, Pei-yuan Li
Current Medical Science.2022; 42(4): 856. CrossRef - Acute upper gastrointestinal bleeding: a clinical review
Katherine Haggan, Gerri Mortimore
Gastrointestinal Nursing.2022; 20(5): 20. CrossRef - Endoscopic management of acute oesophageal variceal bleeding within 12 hours of admission is superior to 12–24 hours
N Mousa, A Abdel-Razik, T Sheta, A G Deiab, A Habib, M Diasty, A Eldesoky, A Taha, E Mousa, A Yassen, A Fathy, A Elgamal
British Journal of Biomedical Science.2021; 78(3): 130. CrossRef - Endoscopic diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH): European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2021
Ian M. Gralnek, Adrian J. Stanley, A. John Morris, Marine Camus, James Lau, Angel Lanas, Stig B. Laursen, Franco Radaelli, Ioannis S. Papanikolaou, Tiago Cúrdia Gonçalves, Mario Dinis-Ribeiro, Halim Awadie, Georg Braun, Nicolette de Groot, Marianne Udd, A
Endoscopy.2021; 53(03): 300. CrossRef - Optimal timing of endoscopy for acute upper gastrointestinal bleeding: a systematic review and meta-analysis
Elettra Merola, Andrea Michielan, Giovanni de Pretis
Internal and Emergency Medicine.2021; 16(5): 1331. CrossRef - Which scoring system should be used for non‐variceal upper gastrointestinal bleeding? Old or new?
Hong Jae Jeon, Hee Seok Moon, In Sun Kwon, Sun Hyung Kang, Jae Kyu Sung, Hyun Yong Jeong
Journal of Gastroenterology and Hepatology.2021; 36(10): 2819. CrossRef - Biopsy in emergency gastroscopy does not increase the risk of rebleeding in patients with Forrest I acute nonvariceal upper gastrointestinal bleeding combined with suspected malignant gastric ulcer: a multicenter retrospective cohort study
Quchuan Zhao, Tianyu Chi
BMC Gastroenterology.2021;[Epub] CrossRef - The mortality rate among patients with acute upper GI bleeding (with/without EGD) at Aleppo University Hospital: A retrospective study
Ziad Aljarad, Bashir Badawi Mobayed
Annals of Medicine and Surgery.2021; 71: 102958. CrossRef - Validation of a new risk score system for non-variceal upper gastrointestinal bleeding
Min Seong Kim, Hee Seok Moon, In Sun Kwon, Jae Ho Park, Ju Seok Kim, Sun Hyung Kang, Jae Kyu Sung, Eaum Seok Lee, Seok Hyun Kim, Byung Seok Lee, Hyun Yong Jeong
BMC Gastroenterology.2020;[Epub] CrossRef - Interventional Algorithm in Gastrointestinal Bleeding—An Expert Consensus Multimodal Approach Based on a Multidisciplinary Team
Anabela Rodrigues, Alexandre Carrilho, Nuno Almeida, Cilénia Baldaia, Ângela Alves, Manuela Gomes, Luciana Gonçalves, António Robalo Nunes, Carla Leal Pereira, Mário Jorge Silva, José Aguiar, Rosário Orfão, Pedro Duarte, Rui Tato Marinho
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Heng Guo, Ying Li, Weizhi Qi, Lei Xi
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Ahmet Surek, Eyup Gemici, Abdussamet Bozkurt, Mehmet Karabulut
Sanamed.2020; 15(3): 309. CrossRef - When Should We Perform Endoscopy for Patients with Upper Gastrointestinal Bleeding?
Kyoungwon Jung, Moo In Park
Clinical Endoscopy.2019; 52(1): 1. CrossRef - Current Controversies Concerning Capsule Endoscopy
David R. Cave, Shahrad Hakimian, Krunal Patel
Digestive Diseases and Sciences.2019; 64(11): 3040. CrossRef
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Case Reports
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Gastric Ulceration and Bleeding with Hemodynamic Instability Caused by an Intragastric Balloon for Weight Loss
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Larrite Reed, Hawa Edriss, Kenneth Nugent
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Clin Endosc 2018;51(6):584-586. Published online June 1, 2018
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DOI: https://doi.org/10.5946/ce.2018.038
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Abstract
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- Obesity in the United States is a medical crisis with many people attempting to lose weight with caloric restriction. Some patients choose minimally invasive weight loss solutions, such as intragastric balloon systems. These balloon systems were approved by the Federal Drug Administration (FDA) in 2015–2016 and have been considered safe, with minimal side effects. We report a patient with a two-day history of melena, abdominal pain, hypotension, and syncope which developed five months after placement of an intragastric balloon. Esophagogastroduodenoscopy with balloon removal revealed a small 8-mm gastric ulcer in the incisura. This gastric ulcer probably developed secondary to mechanical compression of the stomach mucosa by the gastric balloon which contained 900 mL of saline. The FDA is now investigating five deaths since 2016 associated with these second-generation balloons. Clinicians should be aware of these complications when evaluating patients with gastrointestinal complications, such as bleeding.
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Citations
Citations to this article as recorded by

- Prediction Factors of Early Postoperative Bleeding after Bariatric Surgery
Mahdieh Golzarand, Karamollah Toolabi, Reza Parsaei
Obesity Surgery.2022; 32(7): 1. CrossRef - Clinical follow-up on weight loss, glycemic control, and safety aspects of 24 months of duodenal-jejunal bypass liner implantation
B. Betzel, M. I. Cooiman, E. O. Aarts, I. M. C. Janssen, P. J. Wahab, M. J. M. Groenen, J. P. H. Drenth, F. J. Berends
Surgical Endoscopy.2020; 34(1): 209. CrossRef - Hidden dangers and updated labels on gastric balloons
Sindhura Kolli, Andrew Ofosu, Harini Gurram, Simcha Weissman, Paul Khoi Dang‐Ho, Tej I. Mehta, Hailie Gill, Krishna C. Gurram
Clinical Case Reports.2020; 8(11): 2116. CrossRef
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5,057
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3
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3
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Congenital Jejunal Diverticular Bleeding in a Young Adult
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Ji-Yung Lee, Jae-Young Jang, Min-Je Kim, Tae-In Lee, Jung-Wook Kim, Young-Woon Chang
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Clin Endosc 2017;50(5):495-499. Published online June 14, 2017
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DOI: https://doi.org/10.5946/ce.2016.154
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Abstract
PDF
Supplementary Material
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- Diverticular bleeding of the small bowel is rare and occurs primarily in adults aged more than 60 years. In younger adults, Meckel’s diverticulum, a true diverticulum that congenitally occurs in the distal ileum, is the most common cause of diverticular bleeding of the small bowel. Unlike Meckel’s diverticula, other kinds of small bowel diverticula are not congenital and their incidence is related to age. Furthermore, congenital true diverticular bleeding of the jejunum in adults is very rare. We report the case of a 24-year-old man with subepithelial tumor-like lesion accompanied with obscure overt gastrointestinal bleeding (OOGIB). This lesion was initially suspected to be a subepithelial tumor based on radiologic tests and capsule endoscopy. He was finally diagnosed with a congenital true diverticulum in the jejunum with the appearance of a Meckel’s diverticulum after surgical resection.
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Citations
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- Diverticular hemorrhage of terminal ileum successfully treated by ultra-selective transcatheter arterial embolization using triaxial system: a case report
Yuki Yaginuma, Kenichi Utano, Yuka Utano, Daiki Nemoto, Masato Aizawa, Hajime Matsuida, Noriyuki Isohata, Shungo Endo, Kazutomo Togashi
Clinical Journal of Gastroenterology.2021; 14(2): 517. CrossRef - Small bowel bleeding
Stefania Chetcuti Zammit, Reena Sidhu
Current Opinion in Gastroenterology.2018; 34(3): 165. CrossRef - Diagnosis of Meckel’s Diverticulum Using Colon Capsule Endoscopy for Small Bowel Investigation
Lidia Ciobanu, Oliviu Pascu, Marcel Tanțău
Clinical Endoscopy.2018; 51(4): 395. CrossRef
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7,274
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126
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4
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3
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Combined Endoscopic and Surgical Treatment of Severe Gastrointestinal Bleeding in a Patient with Heart Assist Device under Therapeutic Anticoagulation
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Edris Wedi, Mohamed Bounnah, Riccardo Memeo, Carlo Jung
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Clin Endosc 2017;50(6):598-601. Published online June 1, 2017
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DOI: https://doi.org/10.5946/ce.2017.024
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Abstract
PDF
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- Gastrointestinal (GI) bleeding is a common complication after heart assist device placement. Reasons for bleeding are multifactorial. Endoscopic therapy is the treatment of choice, whereas invasive procedures are avoided in these critically ill patients. We present the case of a 65-year-old male patient experiencing severe GI bleeding after left ventricular assist device (LVAD) and right ventricular assist device (RVAD) placement with therapeutic anticoagulation. Endoscopically, multiple gastric bleeding sources were found but could not be treated effectively due to a large blood clot. A combined endoscopic and surgical treatment was initiated, including gastrotomy for blood clot removal, surgical transgastric suturing, endoscopic over-the-scope clip (OTSC) placement and hemospray application. Postoperative endoscopic visualization showed effective bleeding control. The patient unfortunately died due to causes unrelated to the treatment. This case shows that a minimal invasive combination of endoscopic and surgical techniques can be an alternative treatment for severe upper GI bleeding in critically ill and anticoagulated patients.
Original Article
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Endoscopic Management of Gastrointestinal Leaks and Bleeding with the Over-the-Scope Clip: A Prospective Study
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Mahesh Kumar Goenka, Vijay Kumar Rai, Usha Goenka, Indrajit Kumar Tiwary
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Clin Endosc 2017;50(1):58-63. Published online October 31, 2016
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DOI: https://doi.org/10.5946/ce.2016.028
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Abstract
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- Background
/Aims: The over-the-scope clip (OTSC) is a device used for endoscopic closure of perforations, leaks and fistulas, and for endoscopic hemostasis. To evaluate the clinical effectiveness and safety of OTSC.
Methods
Between October 2013 and November 2015, 12 patients underwent OTSC placement by an experienced endoscopist. OTSC was used for the closure of gastrointestinal (GI) leaks and fistula in six patients, three of which were iatrogenic (esophageal, gastric, and duodenal) and three of which were inflammatory. In six patients, OTSC was used for hemostasis of non-variceal upper GI bleeding. Endoscopic tattooing using India ink was used to assist the accurate placement of the clip.
Results
All subjects except one with a colonic defect experienced immediate technical success as well as long-term clinical success, during a mean follow-up of 6 weeks. Only one clip was required to close each of the GI defects and to achieve hemostasis in all patients. There were no misfirings or complications of clips. The procedure was well tolerated, and patients were hospitalized for an average of 8 days (range, 3 to 10). Antiplatelet therapy was continued in patients with GI bleeding.
Conclusions
In our experience, OTSC was safe and effective for the closure of GI defect and to achieve hemostasis of non-variceal GI bleeding.
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Citations
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Alessandrino Terceiro de Oliveira, Márcio Alencar Barreira, José Wilson da Cunha Parente Júnior, José Ruver Lima Herculano Junior, Jeany Borges e Silva Ribeiro, Orleancio Gomes Ripardo de Azevedo, Paulo Roberto Cavalcante de Vasconcelos
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Review
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Novel Therapeutic Strategies in the Management of Non-Variceal Upper Gastrointestinal Bleeding
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Ari Garber, Sunguk Jang
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Clin Endosc 2016;49(5):421-424. Published online September 30, 2016
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DOI: https://doi.org/10.5946/ce.2016.110
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Abstract
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- Non-variceal upper gastrointestinal bleeding, the most common etiology of which is peptic ulcer disease, remains a persistent challenge despite a reduction in both its incidence and mortality. Both pharmacologic and endoscopic techniques have been developed to achieve hemostasis, with varying degrees of success. Among the pharmacologic therapies, proton pump inhibitors remain the mainstay of treatment, as they reduce the risk of rebleeding and requirement for recurrent endoscopic evaluation. Tranexamic acid, a derivative of the amino acid lysine, is an antifibrinolytic agent whose role requires further investigation before application. Endoscopically delivered pharmacotherapy, including Hemospray (Cook Medical), EndoClot (EndoClot Plus Inc.), and Ankaferd Blood Stopper (Ankaferd Health Products), in addition to standard epinephrine, show promise in this regard, although their mechanisms of action require further investigation. Non-pharmacologic endoscopic techniques use one of the following two methods to achieve hemostasis: ablation or mechanical tamponade, which may involve using endoscopic clips, cautery, argon plasma coagulation, over-the-scope clipping devices, radiofrequency ablation, and cryotherapy. This review aimed to highlight these novel and fundamental hemostatic strategies and the research supporting their efficacy.
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Ramazan Üstün, Elif Oğuz, Ayşe Şeker, Filiz Taspinar
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Dong-Shuai Su, Cheng-Kun Li, Cong Gao, Xing-Shun Qi
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Sergiu Marian Cazacu, Adina Turcu-Stiolica, Dan Nicolae Florescu, Bogdan Ungureanu, Vlad Florin Iovanescu, Carmen Daniela Neagoe, Daniela Burtea, Amelia Valentina Genunche-Dumitrescu, Taina Elena Avramescu, Sevastita Iordache
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Emrah EGEMEN, Ümit Akın DERE, Başak ÜNVER KOLUMAN, Yücel DOĞRUEL, Ahmet KOLUMAN, Batuhan BAKIRARAR, Nazlı ÇİL, Esin AVCI, Emine TURAL, Fatih YAKAR
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Volodymyr Mamchych, Sergiy Vereshchagin, Volodymyr Maksymchuk, Dmytro Maksymchuk
EUREKA: Health Sciences.2021; (2): 37. CrossRef - Case Report: Peptic ulcer disease following short-term use of nonsteroidal anti-inflammatory drugs in a 3-year-old child
Alin Dumitru Ciubotaru, Carmen-Ecaterina Leferman
F1000Research.2021; 9: 419. CrossRef - Outcomes from an international multicenter registry of patients with acute gastrointestinal bleeding undergoing endoscopic treatment with Hemospray
Durayd Alzoubaidi, Mohamed Hussein, Radu Rusu, Duncan Napier, Selena Dixon, Johannes W. Rey, Cora Steinheber, Sina Jameie‐Oskooei, Martin Dahan, Bu Hayee, Shraddha Gulati, Edward Despott, Alberto Murino, Sharmila Subramaniam, Sulleman Moreea, Phil Boger,
Digestive Endoscopy.2020; 32(1): 96. CrossRef - Comprehensive Bioanalysis of Ultrahigh Molecular Weight, Highly Disperse Poly(ethylene oxide) in Rat via Microsolid Phase Extraction and RPLC-Q-Q-TOF Coupled with the MSALL Technique
Zhi Zhang, Hui Jiang, Yuyao Zhang, Di Zhang, John Paul Fawcett, Jingkai Gu
Analytical Chemistry.2020; 92(8): 5978. CrossRef - Case Report: Peptic ulcer disease following short-term use of nonsteroidal anti-inflammatory drugs in a 3-year-old child
Alin Dumitru Ciubotaru, Carmen-Ecaterina Leferman
F1000Research.2020; 9: 419. CrossRef - Helicobacter pylori–Negative MALT Lymphoma Presenting as a Massive Recurrent Gastrointestinal Hemorrhage
Prateek S. Harne, Samiran Mukherjee, Ted Achufusi, Dhruv Lowe, Divey Manocha
Journal of Investigative Medicine High Impact Case Reports.2020;[Epub] CrossRef - Management of non-variceal upper gastrointestinal bleeding: where are we in 2018?
Durayd Alzoubaidi, Laurence B Lovat, Rehan Haidry
Frontline Gastroenterology.2019; 10(1): 35. CrossRef - New endoscopic techniques in treating gastrointestinal bleeding
Young Sin Cho
International Journal of Gastrointestinal Intervention.2018; 7(3): 131. CrossRef - First-line endoscopic treatment with over-the-scope clips in patients with either upper or lower gastrointestinal bleeding: a multicenter study
Raffaele Manta, Santi Mangiafico, Angelo Zullo, Helga Bertani, Angelo Caruso, Giuseppe Grande, Francesco Paolo Zito, Benedetto Mangiavillano, Luigi Pasquale, Andrea Parodi, Bastianello Germanà, Gabrio Bassotti, Fabio Monica, Maurizio Zilli, Antonio Pisani
Endoscopy International Open.2018; 06(11): E1317. CrossRef - Hémorragies digestives : qui ? quand ? place des nouveaux traitements ?
D. Heresbach, A. Laquière
Acta Endoscopica.2017; 47(5): 281. CrossRef - Neuromuscular degenerative effects of Ankaferd Blood Stopper® in mouse sciatic nerve model
Ramazan Üstün, Elif Kaval Oğuz, Çağrı Delilbaşı, Ayşe Şeker, Filiz Taşpınar, Mehmet Reşit Öncü, Ahmet Regaip Oğuz
Somatosensory & Motor Research.2017; 34(4): 248. CrossRef - Pharmacologic Management of Nonvariceal Upper Gastrointestinal Bleeding
Jeong Hwan Kim
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2016; 16(4): 189. CrossRef
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11,105
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571
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18
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Case Report
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Multiple Polypoid Angiodysplasia with Obscure Overt Bleeding
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Jooyoung Lee, Sung Wook Hwang, Jihye Kim, Jinwoo Kang, Gyeong Hoon Kang, Kyu Joo Park, Jong Pil Im, Joo Sung Kim
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Clin Endosc 2016;49(1):91-96. Published online January 28, 2016
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DOI: https://doi.org/10.5946/ce.2016.49.1.91
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Abstract
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- Angiodysplasia (AD) is increasingly being recognized as a major cause of gastrointestinal bleeding. Morphologically flat lesions are common types of AD, whereas the polypoid types are rare. We report a case of multiple polypoid AD in the small bowel causing severe anemia and requiring surgical treatment. A 60-year-old male patient visited our hospital with dyspnea and hematochezia. He had a history of myocardial infarction and was taking both aspirin and clopidogrel. Capsule endoscopy, enteroscopy, computed tomography, and angiography revealed multifocal vascular lesions with a polypoid shape in the jejunum. Surgical resection was performed because endoscopic treatment was considered impossible with the number and the location of lesions. The risk of recurrent bleeding related to the use of antiplatelet agents also contributed to the decision to perform surgery. AD was histologically diagnosed from the surgical specimen. He resumed taking both aspirin and clopidogrel after surgery. He fully recovered and has been doing well during the several months of follow-up.
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Citations
Citations to this article as recorded by

- Intraoperative Endoscopic-Guided Bowel Resection for Persistent Gastrointestinal Bleeding Caused by Angiodysplasia: A Case Report and Literature Review
Emily Fellows, Joy Harris, Tania Kibble, Nicholas M. McDonald, Nabeel Azeem, James V. Harmon
The Surgery Journal.2023; 09(04): e112. CrossRef - Ileal angiodysplasia presentation as a bowel obstruction: A case report
Ons Ghdes, Ali Gaja, Ahlem Blel, Hichem Jarraya, Najla Mnif
International Journal of Surgery Case Reports.2017; 39: 301. CrossRef - Solitary Polypoid Angiodysplastic Lesion Mimicking a Tumor in the Jejunum
Abhishek D. Polavarapu, Mayurathan Kesavan, Vivek V. Gumaste, Monika Wrzolek, Elias Purow
ACG Case Reports Journal.2017; 4(1): e83. CrossRef
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10,328
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3
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Original Articles
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The AIMS65 Score Is a Useful Predictor of Mortality in Patients with Nonvariceal Upper Gastrointestinal Bleeding: Urgent Endoscopy in Patients with High AIMS65 Scores
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Sun Wook Park, Young Wook Song, Dae Hyun Tak, Byung Moo Ahn, Sun Hyung Kang, Hee Seok Moon, Jae Kyu Sung, Hyun Yong Jeong
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Clin Endosc 2015;48(6):522-527. Published online November 30, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.6.522
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Abstract
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- Background
/Aims: To validate the AIMS65 score for predicting mortality of patients with nonvariceal upper gastrointestinal bleeding and to evaluate the effectiveness of urgent (<8 hours) endoscopic procedures in patients with high AIMS65 scores.
Methods
This was a 5-year single-center, retrospective study. Nonvariceal, upper gastrointestinal bleeding was assessed by using the AIM65 and Rockall scores. Scores for mortality were assessed by calculating the area under the receiver-operating characteristic curve (AUROC). Patients with high AIMS65 scores (≥2) were allocated to either the urgent or non-urgent endoscopic procedure group. In-hospital mortality, success of endoscopic procedure, recurrence of bleeding, admission period, and dose of transfusion were compared between groups.
Results
A total of 634 patients were analyzed. The AIMS65 score successfully predicted mortality (AUROC=0.943; 95% confidence interval [CI], 0.876 to 0.99) and was superior to the Rockall score (AUROC=0.856; 95% CI, 0.743 to 0.969) in predicting mortality. The group with high AIMS65 score included 200 patients. The urgent endoscopic procedure group had reduced hospitalization periods (p<0.05)
Conclusions
AIMS65 score may be useful in predicting mortality in patients with nonvariceal upper gastrointestinal bleeding. Urgent endoscopic procedures in patients with high scores may be related to reduced hospitalization periods.
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- Management of gastrointestinal bleed in the intensive care setting, an updated literature review
Vignesh K Nagesh, Sai Priyanka Pulipaka, Ruchi Bhuju, Emelyn Martinez, Shruthi Badam, Gomathy Aarthy Nageswaran, Hadrian Hoang-Vu Tran, Daniel Elias, Charlene Mansour, Jaber Musalli, Sanket Bhattarai, Lokeash Subramani Shobana, Tannishtha Sethi, Ritvik Se
World Journal of Critical Care Medicine.2025;[Epub] CrossRef - ASSESSMENT OF PATIENTS WITH NON-VARICEAL UPPER GASTROINTESTINAL BLEEDING USING AIMS65 SCORE
Farahnaz Joukar, Raheleh Sadat Hosseini Basti, Fakhrieh Sadat Hosseini Basti, Fatemeh Mosafer, Hoorieh Sadat Hosseini Basti, Zahra Hedayatzadeh, Afshin Shafaghi
Studies in Medical Sciences.2024; 35(1): 51. CrossRef - Prediction of 30-day in-hospital mortality in older UGIB patients using a simplified risk score and comparison with AIMS65 score
Zaiyao Xue, Hebin Che, Deyou Xie, Jiefeng Ren, Quanjin Si
BMC Geriatrics.2024;[Epub] CrossRef - Turn over the new leaf of the treatment in peptic ulcer bleeding: a review of the literature
Meng-Hsuan Lu, Hsueh-Chien Chiang
Therapeutic Advances in Gastroenterology.2024;[Epub] CrossRef - Performance of Six Clinical Physiological Scoring Systems in Predicting In-Hospital Mortality in Elderly and Very Elderly Patients with Acute Upper Gastrointestinal Bleeding in Emergency Department
Po-Han Wu, Shang-Kai Hung, Chien-An Ko, Chia-Peng Chang, Cheng-Ting Hsiao, Jui-Yuan Chung, Hao-Wei Kou, Wan-Hsuan Chen, Chiao-Hsuan Hsieh, Kai-Hsiang Ku, Kai-Hsiang Wu
Medicina.2023; 59(3): 556. CrossRef - Outcomes in Patients Admitted for Upper Gastrointestinal Bleeding and COVID-19 Infection: A Study of Two Years of the Pandemic
Sergiu Cazacu, Daniela Burtea, Vlad Iovănescu, Dan Florescu, Sevastița Iordache, Adina Turcu-Stiolica, Victor Sacerdotianu, Bogdan Ungureanu
Life.2023; 13(4): 890. CrossRef - Pre-Endoscopic Scores Predicting Low-Risk Patients with Upper Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis
Antoine Boustany, Ali A. Alali, Majid Almadi, Myriam Martel, Alan N. Barkun
Journal of Clinical Medicine.2023; 12(16): 5194. CrossRef - A nomogram to predict in-hospital mortality of gastrointestinal bleeding patients in the intensive care unit
Xueyan Zhang, Jianfang Ni, Hongwei Zhang, Mengyuan Diao
Frontiers in Medicine.2023;[Epub] CrossRef - Scoring systems for predicting clinical outcomes in peptic ulcer bleeding
Jin Hee Noh, Boram Cha, Ji Yong Ahn, Hee Kyong Na, Jeong Hoon Lee, Kee Wook Jung, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
Medicine.2022; 101(36): e30410. CrossRef - ABC score: a new risk score that accurately predicts mortality in acute upper and lower gastrointestinal bleeding: an international multicentre study
Stig Borbjerg Laursen, Kathryn Oakland, Loren Laine, Vered Bieber, Riccardo Marmo, Eduardo Redondo-Cerezo, Harry R Dalton, Jeffrey Ngu, Michael Schultz, Marco Soncini, Ian Gralnek, Vipul Jairath, Iain A Murray, Adrian J Stanley
Gut.2021; 70(4): 707. CrossRef - AIMS65 scoring system is comparable to Glasgow-Blatchford score or Rockall score for prediction of clinical outcomes for non-variceal upper gastrointestinal bleeding
Min Seong Kim, Jeongmin Choi, Won Chang Shin
BMC Gastroenterology.2019;[Epub] CrossRef - Comparison of three risk scores to predict outcomes in upper gastrointestinal bleeding; modifying Glasgow-Blatchford with albumin
Afshin Shafaghi, Faeze Gharibpoor, Zahra Mahdipour, Ali Akbar Samadani
Romanian Journal of Internal Medicine.2019; 57(4): 322. CrossRef - Comparison of AIMS65, Glasgow–Blatchford and Rockall scoring approaches in predicting the risk of in-hospital death among emergency hospitalized patients with upper gastrointestinal bleeding: a retrospective observational study in Nanjing, China
Lei Gu, Fei Xu, Jie Yuan
BMC Gastroenterology.2018;[Epub] CrossRef - How to Use Scoring Systems for Upper Gastrointestinal Bleeding?
Heung Up Kim
The Korean Journal of Gastroenterology.2016; 67(1): 1. CrossRef - Risk Strategy in Non-Variceal Upper Gastrointestinal Bleeding
Joon Sung Kim, Byung-Wook Kim
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2016; 16(4): 173. CrossRef - Comparison of three scoring systems in predicting clinical outcomes in patients with acute upper gastrointestinal bleeding: a prospective observational study
Min Zhong, Wan Jun Chen, Xiao Ye Lu, Jie Qian, Chang Qing Zhu
Journal of Digestive Diseases.2016; 17(12): 820. CrossRef - Can AIMS65 Save the Endoscopists from Midnight Calls?
Joon Sung Kim, Byung-Wook Kim
Clinical Endoscopy.2015; 48(6): 459. CrossRef
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11,465
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Predictors of Rebleeding in Upper Gastrointestinal Dieulafoy Lesions
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Sang-Hun Park, Du-Hyeon Lee, Chang-Hwan Park, Jin Jeon, Ho-Jun Lee, Sung-Uk Lim, Seon-Young Park, Hyun-Soo Kim, Sung-Kyu Choi, Jong-Sun Rew
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Clin Endosc 2015;48(5):385-391. Published online September 30, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.5.385
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Abstract
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- Background/Aims
Dieulafoy lesions (DLs) are a rare but significant cause of upper gastrointestinal bleeding. We aimed to define the clinical significance of rebleeding and identify the predictors of rebleeding and mortality in upper gastrointestinal Dieulafoy lesions (UGIDLs).
MethodsPatients diagnosed with UGIDLs between January 2004 and June 2013 were retrospectively evaluated. Multivariate logistic regression analyses were performed to define the predictors of rebleeding and mortality in patients with UGIDLs.
ResultsThe study group consisted of 81 male and 36 female patients. Primary hemostasis was achieved in 115 out of 117 patients (98.3%) with various endoscopic therapies. Rebleeding occurred in 10 patients (8.5%). The mortality rate was significantly higher in patients with rebleeding than in those without rebleeding (30.0% vs. 4.7%, p=0.020). Multivariate logistic regression analysis revealed that kidney disease (p=0.006) and infection (p=0.005) were significant predictors of rebleeding in UGIDLs and that kidney disease (p=0.004) and platelet count (p=0.013) were significant predictors of mortality.
ConclusionsRebleeding has an important prognostic significance in patients with UGIDLs. Kidney disease and infection are major predictors of rebleeding and mortality in patients with UGIDLs.
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Citations
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- Clinical outcomes of Dieulafoy's lesion compared with peptic ulcer in upper gastrointestinal bleeding
Sang Yong Jo, Jin Hee Noh, Boram Cha, Ji Yong Ahn, Seung‐pyo Oh, Jun‐young Seo, Hee Kyong Na, Jeong Hoon Lee, Kee Wook Jung, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon‐Yong Jung
Journal of Gastroenterology and Hepatology.2023; 38(6): 888. CrossRef - Intragastric Single-Port Surgery: An Innovative and Multipurpose Technique for the Therapy of Upper Digestive Tract Lesions
Renjie Li, Wilfried Veltzke-Schlieker, Andreas Adler, Mahmoud Ismail, Harun Badakhshi, Ricardo Zorron
Surgical Innovation.2022; 29(1): 56. CrossRef - Outcomes in Severe Upper GI Hemorrhage from Dieulafoy’s Lesion with Monitoring of Arterial Blood Flow
B. Nulsen, D. M. Jensen, T. O. G. Kovacs, K. A. Ghassemi, M. Kaneshiro, G. S. Dulai, R. Jutabha, J. A. Gornbein
Digestive Diseases and Sciences.2021; 66(10): 3495. CrossRef - Hybrid surgical technologies in the treatment of patients with Dieulafoy’s lesion complicated by recurrent gastrointestinal bleeding
S.E. Voskanyan, M.V. Shabalin, A.I. Artemyev, I.Yu. Kolyshev, Z. Bogoevich, A.N. Bashkov, E.V. Naidenov
Endoskopicheskaya khirurgiya.2020; 26(1): 40. CrossRef - Dieulafoy Lesion: Predictive Factors of Early Relapse and Long-Term Follow-Up
Paulo Massinha, Inês Cunha, Luís Tomé
GE - Portuguese Journal of Gastroenterology.2020; 27(4): 237. CrossRef - A Rare Cause of Gastrointestinal Bleeding in a 65-Year-Old Man with History of Polycythemia Vera
Najmeh Aletaha, Hoda Hamid, Niloofar Ayoobi Yazdi, Reza Taslimi, Bijan Shahbazkhani, Pardis Ketabi Moghadam
Middle East Journal of Digestive Diseases.2019; 11(4): 225. CrossRef - Lesión de Dieulafoy en estómago como causa de sangrado gastrointestinal alto: presentación de un caso
Jairo Alonso Sierra-Avendaño, Fabián Andrés Mejía-Casadiegos, María Paula Pérez-Barón, Gabriel Eduardo Pérez-García
Revista Médicas UIS.2019; 32(1): 27. CrossRef - Endoscopic Management of Nonvariceal, Nonulcer Upper Gastrointestinal Bleeding
Michael A. Chang, Thomas J. Savides
Gastrointestinal Endoscopy Clinics of North America.2018; 28(3): 291. CrossRef - Refractory Gastric Hemorrhage from Caliber Persistent Arteries of the Left Inferior Phrenic Artery
Takahiro Hosoi, Norihiro Yuasa, Eiji Takeuchi, Hideo Miyake, Hidemasa Nagai, Yuichiro Yoshioka, Masataka Okuno, Takayuki Minami, Kanji Miyata, Masahiko Fujino
The Japanese Journal of Gastroenterological Surgery.2017; 50(2): 112. CrossRef
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Case Report
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Eosinophilic Gastroenteritis Due to Rhus Ingestion Presenting with Gastrointestinal Hemorrhage
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Wonsuk Choi, Seon-Young Park, Chan Choi, Kyuman Cho, Chang-Hwan Park, Hyun-Soo Kim, Sung-Kyu Choi, Jong-Sun Rew
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Clin Endosc 2015;48(2):174-177. Published online March 27, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.2.174
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Rhus-related illnesses in Korea are mostly caused by ingestion of parts of the Rhus tree. Contact dermatitis occurrence after ingestion of Rhus-related food is very common in Korea. However, Rhus-related gastrointestinal disease is very rare. Herein, we present a case of eosinophilic
gastroenteritis caused by Rhus ingestion. A 75-year-old woman was admitted with hematemesis and hematochezia after Rhus extract ingestion. Routine laboratory tests revealed leukocytosis without eosinophilia. Endoscopy showed friable and granular mucosal changes with touch bleeding in the second portion of the duodenum. Abdominal computed tomography revealed edematous wall thickening
of the duodenum and proximal jejunal loops. Patch testing with Rhus extracts showed a strong positive reaction, suggesting Rhus as the allergen. Her symptoms improved after avoidance of the allergen.
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Systemic contact dermatitis induced by
Rhus
allergens in Korea: exercising caution in the consumption of this nutritious food
S. J. Park, J. W. Park, K. Y. Park, K. Li, S. J. Seo, B. J. Kim, K. H. Yoo
Clinical and Experimental Dermatology.2021; 46(2): 324. CrossRef - Upper Gastrointestinal Bleeding as the First Presentation of Eosinophilic Gastrointestinal Disease
Elif Ozdogan, Latife Doganay Caglayan, Ozlem Mizikoglu, Cigdem Arikan
JPGN Reports.2020; 1(2): e017. CrossRef - Severe upper gastrointestinal bleeding due to eosinophilic gastritis
Valentín Gonzalez-Canalizo, Nerea Segues, Andrea Medina, Silvia Torrente, Vanessa Aguilar-Gama, Paula Ortega, Luis Bujanda
Gastroenterología y Hepatología.2019; 42(5): 307. CrossRef - Severe upper gastrointestinal bleeding due to eosinophilic gastritis
Valentín Gonzalez-Canalizo, Nerea Segues, Andrea Medina, Silvia Torrente, Vanessa Aguilar-Gama, Paula Ortega, Luis Bujanda
Gastroenterología y Hepatología (English Edition).2019; 42(5): 307. CrossRef
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9,174
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4
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Review
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Should Capsule Endoscopy Be the First Test for Every Obscure Gastrointestinal Bleeding?
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Chung Hyun Tae, Ki-Nam Shim
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Clin Endosc 2014;47(5):409-414. Published online September 30, 2014
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DOI: https://doi.org/10.5946/ce.2014.47.5.409
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Abstract
PDF
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Obscure gastrointestinal bleeding (OGIB) refers to gastrointestinal (GI) bleeding of unclear origin that persists or recurs after negative findings on esophagogastroduodenoscopy and colonoscopy. OGIB accounts for approximately 5% of all types of GI bleeding. More than 80% of OGIB cases originate in the small bowel. The ability to detect OGIB in the small bowel has significantly advanced and been revolutionized since the introduction of the capsule endoscopy and double-balloon enteroscopy techniques in 2000 and 2001, respectively. With these new methods for small-bowel evaluation, new guidelines have been proposed for the diagnosis and management of OGIB. However, some issues remain unsolved. The purpose of this article is to review the various modalities used for evaluating OGIB, including capsule endoscopy and double-balloon enteroscopy, and to help guide clinicians in their decisions on which modality will be the most effective.
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Citations
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- Early intervention with double balloon enteroscopy for higher yield for inpatient overt obscure gastrointestinal bleeding: A propensity matched analysis
Mahmoud Aryan, Krishna V R Venkata, Tyler Colvin, Lauren Daley, Parth Patel, T. Mark Beasley, Benjamin Nunley, Nicholas Baldwin, Ali M Ahmed, Kondal R Kyanam Kabir Baig, Klaus Mönkemüller, Shajan Peter
JGH Open.2023; 7(7): 509. CrossRef - Clinical features of obscure gastrointestinal bleeding undergoing capsule endoscopy: A retrospective cohort study
Yuga Komaki, Shuji Kanmura, Kazuki Yutsudo, Kosuke Kuwazuru, Fukiko Komaki, Akihito Tanaka, Hidehito Maeda, Shiho Arima, Shiroh Tanoue, Fumisato Sasaki, Shinichi Hashimoto, Masahisa Horiuchi, Akio Ido, Gopal Krishna Dhali
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J.J.E. García-Correa, J.J. Ramírez-García, L.F. García-Contreras, C. Fuentes-Orozco, L. Irusteta-Jiménez, L.R. Michel-Espinoza, A.S. Carballo Uribe, J.A. Torres Chávez, A. González-Ojeda
Revista de Gastroenterología de México.2018; 83(1): 31. CrossRef - Double-balloon enteroscopy: Indications, approaches, diagnostic and therapeutic yield, and safety. Early experience at a single center
J.J.E. García-Correa, J.J. Ramírez-García, L.F. García-Contreras, C. Fuentes-Orozco, L. Irusteta-Jiménez, L.R. Michel-Espinoza, A.S. Carballo Uribe, J.A. Torres Chávez, A. González-Ojeda
Revista de Gastroenterología de México (English Edition).2018; 83(1): 31. CrossRef - Double-Balloon Endoscopy in Overt and Occult Small Bowel Bleeding: Results, Complications, and Correlation with Prior Videocapsule Endoscopy in a Tertiary Referral Center
Carlijn Hermans, Arnold Stronkhorst, Annemarie Tjhie-Wensing, Jan Kamphuis, Bas van Balkom, Rob Dahlmans, Lennard Gilissen
Clinical Endoscopy.2017; 50(1): 69. CrossRef - What is the Role of Double-Balloon Endoscopy in Patients Presenting with Obscure Gastrointestinal Bleeding?
Jung Ho Kim, Kwang An Kwon
Clinical Endoscopy.2017; 50(1): 8. CrossRef - Colonic lesions in patients undergoing small bowel capsule endoscopy: incidence, diagnostic and therapeutic impact
José Francisco Juanmartiñena Fernández, Iñaki Fernández-Urién Sainz, Beatriz Zabalza Ollo, Ana Borda Martín, Juan José Vila Costas
Revista Española de Enfermedades Digestivas.2017;[Epub] CrossRef - Gastroduodenal lesions detected during small bowel capsule endoscopy: incidence, diagnostic and therapeutic impact
José Francisco Juanmartiñena Fernández, Ignacio Fernández-Urien Sainz, Beatriz Zabalza Ollo, Cristina Saldaña Dueñas, Marta Montañés Guimera, Alfonso Elosua González, Juan José Vila Costas
Revista Española de Enfermedades Digestivas.2017;[Epub] CrossRef - Systematic review: Safety of balloon assisted enteroscopy in Crohn’s disease
Ahilan Arulanandan, Parambir S Dulai, Siddharth Singh, William J Sandborn, Denise Kalmaz
World Journal of Gastroenterology.2016; 22(40): 8999. CrossRef - Different roles of capsule endoscopy and double-balloon enteroscopy in obscure small intestinal diseases
Zhi-Hong Zhang, Chun-Hua Qiu, Yi Li
World Journal of Gastroenterology.2015; 21(23): 7297. CrossRef - A jejunal GIST presenting with obscure gastrointestinal bleeding and small bowel obstruction secondary to intussusception
Peter Sadeghi, Sandro Lanzon-Miller
BMJ Case Reports.2015; : bcr2014207650. CrossRef
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8,231
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Case Reports
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Endoscopic Management of Rectal Dieulafoy's Lesion: A Case Series and Optimal Treatment
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Jung Gil Park, Jung Chul Park, Yong Hwan Kwon, Sun Young Ahn, Seong Woo Jeon
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Clin Endosc 2014;47(4):362-366. Published online July 28, 2014
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DOI: https://doi.org/10.5946/ce.2014.47.4.362
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Abstract
PDF
Supplementary Material
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ePub
Rectal Dieulafoy's lesion (DL) is rare cause of lower gastrointestinal bleeding. Because of its rarity, there is no consensus on the optimal endoscopic hemostasis technique for rectal DL. We analyzed six patients who underwent endoscopic management for rectal DL after presenting with hematochezia at a single institute over 10 years. Of the six patients, three underwent endoscopic band ligation (EBL) and three underwent endoscopic hemoclip placement (EHP). Only one patient was treated with thermocoagulation. There were no immediate complications in any of the patients. None of the patients required a procedure or surgery for the treatment of rebleeding. Mean procedure times of EBL and EHP were 5.25 minutes and 7 minutes, respectively. Both EHP and EBL are shown to be effective in the treatment of bleeding rectal DL. We suggest that EBL may have potential as the preferred therapy owing to its superiority in technical and economic aspects, especially in elderly and high-risk patients.
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Citations
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- Over-the-scope clip as a rescue treatment for massive bleeding due to Dieulafoy lesion at the colorectal anastomosis: A case report
Ping Han, Demin Li, Qiaozhen Guo, Yu Lei, Jingmei Liu, Dean Tian, Wei Yan
Medicine.2024; 103(16): e37871. CrossRef - Severe lower gastrointestinal bleeding caused by rectal Dieulafoy’s lesion: Case reports and literature review
Ping Han, Yu Lei, Wei Hou, Nianjun Chen, Jingmei Liu, Dean Tian, Qiaozhen Guo, Wei Yan
Medicine.2022; 101(48): e32031. CrossRef - Endoscopic management of massive rectal bleeding from a Dieulafoy's lesion: Case report
Mario Rene Pineda-De Paz, Massiel Madelin Rosario-Morel, Jose Guadalupe Lopez-Fuentes, Luis Ariel Waller-Gonzalez, Rodrigo Soto-Solis
World Journal of Gastrointestinal Endoscopy.2019; 11(7): 438. CrossRef - Georges-Paul Dieulafoy (1839–1911) de l’ulcération…
V. de Parades, J. -D. Zeitoun, N. Fathallah, D. Bouchard, G. Rahmi, J. -F. Contou
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Omar N Nadhem, Omar A Salh, Omar H Bazzaz
SAGE Open Medical Case Reports.2017;[Epub] CrossRef
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7,784
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Two Cases of Ileal Dieulafoy Lesion with Massive Hematochezia Treated by Single Balloon Enteroscopy
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Young Chul Choi, Sang Hyun Park, Byoung Wook Bang, Kye Sook Kwon, Hyung Gil Kim, Yong Woon Shin
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Clin Endosc 2012;45(4):440-443. Published online November 30, 2012
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DOI: https://doi.org/10.5946/ce.2012.45.4.440
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Abstract
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Ileal Dieulafoy lesion is an unusual vascular abnormality that can cause gastrointestinal bleeding. It can be associated with massive, life-threatening hemorrhage and requires urgent angiographic intervention or surgery. Ileal Dieulafoy lesion is hard to recognize due to inaccessibility and normal-appearing mucosa. With advances in endoscopy, aggressive diagnostic and therapeutic approaches including enteroscopy have recently been performed for small bowel bleeding. We report two cases of massive ileal Dieulafoy lesion bleeding diagnosed and treated successfully by single balloon enteroscopy with a review of the literature.
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Special Issue Articles of IDEN 2012
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Management of Non-Variceal Upper Gastrointestinal Bleeding
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Seung Young Kim, Jong Jin Hyun, Sung Woo Jung, Sang Woo Lee
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Clin Endosc 2012;45(3):220-223. Published online August 22, 2012
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DOI: https://doi.org/10.5946/ce.2012.45.3.220
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Abstract
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Upper gastrointestinal bleeding (UGIB) is a critical condition that demands a quick and effective medical management. Non-variceal UGIB, especially peptic ulcer bleeding is the most significant cause. Appropriate assessment and treatment have a major influence on the prognosis of patients with UGIB. Initial fluids resuscitation and/or transfusion of red blood cells are necessary in patients with clinical evidence of intravascular volume depletion. Endoscopy is essential for diagnosis and treatment of UGIB, and should be provided within 24 hours after presentation of UGIB. Pre-endoscopic use of intravenous proton pump inhibitor (PPI) can downstage endoscopic signs of hemorrhage. Post-endoscopic use of high-dose intravenous PPI can reduce the risk of rebleeding and further interventions such as repeated endoscopy and surgery. Eradication of Helicobacter pylori and withdrawal of non-steroidal anti-inflammatory drugs are recommended to prevent recurrent bleeding.
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