Case Report
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Massive Duodenal Bleeding after the Migration of Endovascular Coils into the Small Bowel
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Chung-Jo Choi, Hyun Lim, Dong-Suk Kim, Yong-Seol Jeong, Sang-Young Park, Jeong-Eun Kim
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Clin Endosc 2019;52(6):612-615. Published online May 20, 2019
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DOI: https://doi.org/10.5946/ce.2019.020
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Abstract
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- Among gastrointestinal emergencies, acute upper gastrointestinal bleeding remains a challenging clinical problem owing to significant patient morbidity and costs involved in management. Endoscopic hemostatic therapy is the mainstay of treatment and decreases the incidence of re-bleeding, the need for surgery, morbidity, and mortality. However, in 8%–15% of patients with upper gastrointestinal bleeding, endoscopic hemostatic therapy does not successfully control bleeding. Trans-arterial coil embolization is an effective alternative treatment for endoscopic hemostatic failure; however, this procedure can induce adverse outcomes, such as non-target vessel occlusion, vessel dissection and perforation, and coil migration. Coil migration is rare but causes severe complications, such as re-bleeding and bowel ischemia. However, in most cases, coil migration is local and involves spontaneous healing without serious complications. Here, we report the case of a patient who underwent trans-arterial coil embolization of the gastroduodenal artery with the purpose of controlling massive duodenal bleeding, resulting in a fatal outcome caused by coil migration.
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Citations
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Dennis Chang, Purvi Patel, Seth Persky, Joseph Ng, Alan Kaell
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Review
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Recent Developments in the Endoscopic Treatment of Patients with Peptic Ulcer Bleeding
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Jae-Young Jang
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Clin Endosc 2016;49(5):417-420. Published online September 30, 2016
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DOI: https://doi.org/10.5946/ce.2016.135
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Abstract
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- Peptic ulcer bleeding is an internal medical emergency. Endoscopic hemostasis has been shown to improve the survival rate of patients with peptic ulcer bleeding. Although the established hemostatic modalities, including injection, thermal therapy, and mechanical therapy, are effective in controlling peptic ulcer bleeding, hemostasis can be difficult to achieve in some cases. As a result, recent, new endoscopic hemostatic modalities, including over-the-scope clips, topical hemostatic sprays, and endoscopic ultrasonography-guided angiotherapy, have been developed.
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Citations
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- 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 - Endoscopic Hemostasis and Antithrombotic Management
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Gastroenterology Clinics of North America.2024; 53(4): 573. CrossRef - Endoscopic clipping in non-variceal upper gastrointestinal bleeding treatment
Giuseppe Galloro, Angelo Zullo, Gaetano Luglio, Alessia Chini, Donato Alessandro Telesca, Rosa Maione, Matteo Pollastro, Giovanni Domenico De Palma, Raffaele Manta
Clinical Endoscopy.2022; 55(3): 339. CrossRef - Mortality Trends of Gastrointestinal, Liver, and Pancreaticobiliary Diseases: A Hospital-Based Prospective Study in the Southeast of Iran
Mohammad Javad Zahedi, Sara Shafieipour, Mohammad Mahdi Hayatbakhsh Abbasi, Mohsen Nakhaie, Mohammad Rezaei Zadeh Rukerd, Mohammad Mehdi Lashkarizadeh, Farbood Noorbini, Mohammad Hasan Baghaei, Abbas Pourjafari, Ebrahim Aminian, Fatemeh Karami Robati, Aza
Middle East Journal of Digestive Diseases.2022; 14(4): 404. CrossRef - Urban-Rural Disparities and Temporal Trends in Peptic Ulcer Disease Epidemiology, Treatment, and Outcomes in the United States
Howard Guo, Angela Y. Lam, Abdel Aziz Shaheen, Nauzer Forbes, Gilaad G. Kaplan, Christopher N. Andrews, Michael Laffin, Siddharth Singh, Vipul Jairath, Anouar Teriaky, Jeffrey K. Lee, Christopher Ma
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Ja Young Ryu, Byung Kwan Park, Won-Seok Kim, Kisung Kim, Jae Young Lee, Young Kim, Jae Yong Park, Beom Jin Kim, Jeong Wook Kim, Chang Hwan Choi
Surgical Endoscopy.2019; 33(4): 1342. CrossRef - Endoscopic Hemostatic Treatment of Peptic Ulcer Bleeding
Yeon Hwa Choe, Jun Chul Park
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2018; 18(4): 235. CrossRef
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10,333
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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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Citations
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A Comparison of the Effect of High-dose Oral and Intravenous Proton Pump Inhibitor on the Prevention of Rebleeding after Endoscopic Treatment of Bleeding Peptic Ulcers
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Jae Young Jang, M.D., Kwang Ro Joo, M.D., Young Hwangbo, M.D., Lae Ik Jeong, M.D., Sun Young Choi, M.D., Ji Heon Jung, M.D., Myung Jong Chae, M.D., Sang Kil Lee, M.D., Seok Ho Dong, M.D., Hyo Jong Kim, M.D., Byung-Ho Kim, M.D., Young Woon Chang, M.D., Jou
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Korean J Gastrointest Endosc 2006;33(1):6-11. Published online July 30, 2006
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Abstract
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/Aims: The use of proton pump inhibitor (PPI) prevents rebleeding by elevating the intragastric pH in patients with bleeding peptic ulcers after hemostasis has been achieved. We assessed if high-dose oral pantoprazole is as effective as high-dose intravenous pantoprazole for their ability to prevent rebleeding after having achieved initial hemostasis in patients with active bleeding or nonbleeding visible vessels. Methods: Thirty eight patients with bleeding peptic ulcers who had achieved initial hemostasis were enrolled in this randomized controlled trial. In the high-dose oral pantoprazole group (n=19), 40 mg of pantoprazole was given orally twice daily for 5 days. In the high-dose intravenous pantoprazole group (n=19), an 80 mg intravenous bolus of pantoprazole was given; this was followed by 8 mg/hour of continuous infusion daily for 3 days. Thereafter, 40 mg of pantoprazole was given orally once daily for 8 weeks. Results: The two groups were similar with respect to all the background variables. Rebleeding occurred in 2 patients (10.5%) in the intravenous group and in 1 patient in the oral group (5.3%) by day 30 after enrollment (p=1.000). There was no significant difference in terms of the number of therapeutic endoscopic sessions (1 vs. 1.13⁑0.52), the surgery (0% vs. 0%), the bleeding related mortality (0% vs. 0%), and the mean number of units of transfused blood. Conclusions: The high-dose oral pantoprazole is as effective as an intravenous administration in reducing rebleeding episodes in patients with bleeding peptic ulcers after successful endoscopic therapy. (Korean J Gastrointest Endosc 2006;33:611)