• Title/Summary/Keyword: Gastrointestinal hemorrhage

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A Case of Microscopic Polyangiitis with Diffuse Alveolar Hemorrhage (폐출혈을 동반한 현미경적 다발혈관염 1예)

  • Lee, Sang-Jin;Lee, Jae-Woung;Kim, Hye-Jin;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Kwan-Ho;Park, Hye-Jung
    • Journal of Yeungnam Medical Science
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    • v.21 no.1
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    • pp.101-107
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    • 2004
  • Diffuse alveolar hemorrhage is a rare but serious and frequently life-threatening complication of a variety of conditions. The first goal in the management of patients with diffuse alveolar hemorrhage is to achieve or preserve stability of the respiratory status. Subsequently, the differential diagnosis is aimed at the identification of a remediable cause of the alveolar hemorrhage. The most common causes of diffuse alveolar hemorrhage with glomerulonephritis are microscopic polyangiitis and Wegener's granulomatosis, followed by Goodpasture syndrome and systemic lupus erythematosus. Microscopic polyangiitis (MPA) is a distinct systemic small vessle vasculitis affecting small sized vessels with few or no immune deposits and with no granulomatosus inflammation. The disease may involve multiple organs such as kidney, lung, skin, joint, muscle, gastrointestinal tract, eye, and nervous system. MPA is strongly associated with antineutrophil cytoplasmic autoantibody (ANCA) that is a useful serological diagnostic marker for the most common form of necrotizing vasculitis. Our report concerns a case of microscopic polyangiitis with diffuse alveolar hemorrhage in a 54-year-old man. He was admitted to our hospital due to dyspnea upon exertion and recurrent hemoptysis. Laboratory findings showed hematuria, proteinuria and deterioration of renal function. In the chest CT scan, diffuse ground glass appearance was seen in both lower lungs. A lung biopsy revealed small vessel vasculitis with intraalveolar hemorrhage and showed a positive reaction to against perinuclear ANCA. The patient was treated with prednisolone and cyclophosphamide. Chest infiltration decreased and hemoptysis and hypoxia improved. He is still being followed up in our hospital with a low dose of prednisolone.

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Risk Factors of Gastrointestinal Bleeding in Patients Receiving New Oral Anticoagulants (New Oral Anticoagulants를 복용하는 환자들에서 위장관 출혈의 위험인자)

  • Lee, Ju Yup
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.4
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    • pp.219-224
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    • 2018
  • New oral anticoagulants (NOACs) are now widely used for the prevention and treatment of venous thrombosis, and for the prevention of stroke and systemic embolism in patients with atrial fibrillation. As compared with warfarin, NOACs have the advantage of rapid onset of action and less drug interaction. However, they carry a higher risk of gastrointestinal (GI) bleeding than warfarin. The risk of GI bleeding in patients using NOACs varies according to the type and dose of the drug. By contrast, apixaban and edoxaban are reported to carry similar risks as warfarin, and the risks with dabigatran and rivaroxaban are higher than that with warfarin. In patients using NOACs, old age, impaired renal function, impaired liver function, concurrent use of antiplatelet agents, and nonsteroidal anti-inflammatory drugs are considered major risk factors of GI bleeding, and gastroprotective agents such as histamine-2 receptor antagonist and proton pump inhibitor have preventive effects. To prevent GI bleeding associated with NOACs, the characteristics of each NOAC and the risk factors of bleeding should be recognized.

Gastric Ulceration and Bleeding with Hemodynamic Instability Caused by an Intragastric Balloon for Weight Loss

  • Reed, Larrite;Edriss, Hawa;Nugent, Kenneth
    • Clinical Endoscopy
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    • v.51 no.6
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    • pp.584-586
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    • 2018
  • 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.

Toxicity Studies of DA-l25, an Anthracycline Antitumor Antibiotic : Intravenous Repeated Doses for 26 Weeks in Beagle Dogs (Anthracycline계 항암성 항생물질 DA-125의 Beagle dog에 대한 26주 반복정맥투여독성시험)

  • 차신우;박종일;정태천;신호철;하창수;김형진;양중익;한상섭;노정구
    • Biomolecules & Therapeutics
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    • v.4 no.2
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    • pp.127-137
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    • 1996
  • This study was performed to investigate the toxicity of DA-125 in beagle dogs, an anthracycline antitumor antibiotic. The dogs were administered DA-125 i.v. at 0.0023, 0.0375, 0.15 and 0.6 mg/kg/day, 6 days/week for 26 weeks. At 0.6 mg/kg, all male and female dogs were either sacrificed moribundly or dead during the 26-week treatment. The dogs revealed inactivity, salivation, dark bloody discharge, swelling of the subcutaneous injection site, abscess, and ulceration in the abdominal wall and legs. At 0.15 mg/kg, anorexia, salivation, and swelling of the injection site were observed. The food consumption was decreased with a statistical significance at 6 and 12 weeks treatment in males of 7.6 mg/kg. At 0.0375, 0.15 and 0.6 mg/kg, body weights were decreased significantly in a dose-related fashion after 17 weeks treatment. Total white blood cell counts for male dogs at 0.6 mg/kg were lower than those of control dogs after 13 weeks treatment, which appeared mainly due to decreased neutrophils. At 0.15 mg/kg, testicular atrophy was found in all males by gross pathology and the testicular weights were significantly decreased when compared to those of control males. Microscopically, the testis showed moderate atrophy of the seminiferous tubules and marked decrease in number of spermatozoa in the epididymal tubules. At 0.6 mg/kg, petechia or echymotic hemorrhage was observed in gastrointestinal tract, heart, lungs, and other organs at the necropsy, Marked atrophy of thymus were observed in both males and females. In addition, severe testicular atrophy was noted in all males. Microscopically, gastrointestinal tract showed hemorrhage, epithelial denudation, hypermucus secretion, and atrophy of intestinal villi. Seminiferous tubules of the atrophic testis were lined with Sertoli cells only and devoid of germ cells. Severe oligospermia or aspermia was present in the epididymal tubules. Bone marrow showed marked depletion of hemopoietic cells. In addition, marked atrophy was found in the lymphoid tissue of gastrointestinal tract, various Iymph nodes, and thymus. Injection sites showed marked inflammatory response with necrosis, necrotizing vasculitis, thrombus formation, and ulceration in the skin. According to the present results, no observed effect level appeared to be 0.0375 mg/kg. At 0.15 mg/kg, testis was a target organ, while at 0.6 mg/kg hemopoietic tissue, gastrointestinal tract, and testis were considered to be target organs. At 0.6 mg/kg the test compound seems to inflict a damage on the blood vessels causing hemorrhage in the various organs and tissues.

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Pathological Studies on Experimental Poisoning of Organic Phosphate Insecticide (유기인제 중독에 관한 병리학적 연구)

  • Lee, Cha Soo;Lim, Chang Hyeong
    • Korean Journal of Veterinary Research
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    • v.15 no.1
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    • pp.39-45
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    • 1975
  • The authors believe that farm livestok will be greatly affected by the marked increasing use of organic phosphate. This study was carried out to observe the clinical signs and histopathological changes of mouse, guinea pig, hamster and rabbit that were orally administered with diazinon used usually as agricultural insecticide, and cholinesterase (ChE) activity was histochemically examined in the liver, heart, kidney, adrenal gland, duodenum and salivary gland of these experimental animals administered with diazinon. The results obtained were as follows: 1. Clinical signs such as dullness, severe salivation, ataxia, dyspnea, irregular slight convulsion and inappetance and as the histopathological changes cloudy swelling, congestion and hemorrhage of parenchymal organs, catarrh or local necrsois of the gastrointestinal tract, congestion or hemorrhage of the other organs were observed. Especially, hemorrhage of adrenal glands (rabbit, guinea pig) and pulmonary congestion and hemorrhage were necessarily constant. 2. In the histochemical study, ChE activity appeared intensely in the liver, heart, medulla of adrenal glands and salivary glands (submaxillary and parotid) of control animals, but ChE activity was negative or markedly decreased in experimental animals administered with diazinon. There was no marked difference between the control and experimental animals in ChE activity of the kidney. 3. Histochemical observation of ChE activity was helpful to explain the clinical signs and histopathological changes and was regarded as a diagnostic method for organic phosphate poisoning.

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A Case of Gastric Lipoma with Upper Gastrointestinal Bleeding (상부위장관 출혈을 동반한 위 지방종 1예)

  • Gu, Min Geun;Kim, Kook Hyun;Park, Byung Sam;Jung, Sung Yun;Jeong, Yo Han;Lee, Dong Won;Shin, Hyeong Chan;Gu, Mi Jin
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.132-135
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    • 2013
  • Gastric lipoma is a typical benign submucosal tumor that is usually asymptomatic and is generally detected incidentally when performing gastroscopy. However, depending on its size and location, an atypical gastrointestinal lipoma can cause abdominal pain, diarrhea, constipation, intestinal obstruction, intussuception and life-threatening gastrointestinal bleeding. We report herein a case of gastric lipoma with bleeding in a 43-year-old man. The gastroscopy showed a $4{\times}4$ cm ulcero-fungating submucosal mass at the anterior wall of the gastric antrum. Laparoscopic gastric wedge resection was performed and the lesion was diagnosed as gastric lipoma.

Identifying Small Bowel Gastrointestinal Stromal Tumor as the Culprit Lesion in Obscure Gastrointestinal Bleeding: Emphasis on Angiographic Findings (원인불명의 위장관 출혈을 보인 소장 위장관 기질종양 식별: 혈관조영술 소견의 강조)

  • Hyung In Choi;Min Jeong Choi;Bong Man Kim;Hwan Namgung;Seung Kyu Choi
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.400-405
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    • 2022
  • Gastrointestinal stromal tumors (GISTs) are not uncommon and often cause gastrointestinal bleeding. GISTs occurring in the small intestine are occasionally difficult to identify by endoscopy and CT. In this case, the patient underwent CT three times before surgery, and the lesion was found to be located in a different area of the abdominal cavity on each CT scan. Moreover, the lesion was missed in the first two CT images because it was difficult to distinguish it from the nearby collapsed small intestine. The lesion was eventually detected through angiography; however, the correct diagnosis and treatment were delayed for 3 years because it was mistaken for a vascular malformation, which is the most common cause of obscure GI bleeding in elderly patients. This report emphasizes the need for interventional radiologists to be updated and vigilant of the angiographic features of GISTs to make an accurate diagnosis and establish a management strategy.

Traumatic Hemobilia Following Blunt Chest Trauma -Report of 2 Cases- (흉벽 손상후 발생한 외상성 Hemobilia -2례 보고-)

  • Hahn, Young Sook;Lee, Hong Kyun
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.117-124
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    • 1976
  • Hemorrhage into the biliary system as a consequence of injury to the liver has been called "traumatic hemobilia," a term introduced by Sandblom in 1948. The source of gastrointestinal hemorrhage has been frequently misinterpreted, resulting in inadequate or inappropriate treatment, often with catastrophic results and needless fatalities. It is now being diagnosed with increasing frequency, due to more widespread knowledge of the syndrome and improved diagnostic means. we experienced 2 cases of hemobilia following blunt chest trauma, One patient had! multiple rib fractures on right chest by car traffic accident and 13 days later, suddenly massive melena was developed with nausea, vomiting, jaundice and severe pain on right upper quadrant. And so, he had operated on the ligation of Rt. hepatic artery and partial right hepatectomy for a traumatic hemobilia. The other one also revealed similar symptoms 20 days later following blunt chest injury by falling down accident. However, uneventful recovery was seen without any of surgical intervention in this case.

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Spontaneous Perforation of Meckel's Diverticulum in a Neonate (멕켈 게실 천공에 의한 신생아 복막염 1례)

  • Kim, Dong Won;Kim, Seung Sin;Park, Jae Ock;Lee, Do Sang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.119-123
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    • 2004
  • Meckel's diverticulum is the most common malformation of gastrointestinal tract. Symptoms of Meckel's diverticulum usually arise within 2 years of life. The most common presentations include hemorrhage, perforation, diverticulitis and intestinal obstruction. Perforation of the Meckel's diverticulum in a neonate is uncommon but life threatening condition. We describe the first case of perforation of Meckel's diverticulum in a 1-day-old neonate who presented with abdominal distension without hemorrhage.

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A Case of Pulmonary Hemorhage Associated with Henoch-Schönlein Purpura

  • Sim, Yun Su;Choi, Moon Young;Oh, Ji Young;Lee, Jin Hwa;Moon, Jin Wook;Choi, Kyu Bock;Ahn, Jae Ho;Kim, Yoo Kyung;Sung, Sun Hee;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.3
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    • pp.226-228
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    • 2009
  • Henoch-$Sch\ddot{o}nlein$ purpura (HSP) is an immunologically mediated systemic vasculitis of small blood vessels that primarily involves the skin, gastrointestinal tract, joints and kidneys. HSP is a common vasculitic syndrome in children who, in most cases, achieve complete recovery. Pulmonary hemorrhage is a very rare manifestation of HSP. The authors present a case of a 46-year-old male presenting with pulmonary hemorrhage and renal involvement and the diagnosis of HSP. The patient responded to prednisolone therapy.