A case of atrio-esophageal fistula masquerading as upper GI bleed.
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ABSTRACT:
SUBMITTER: Rali P
PROVIDER: S-EPMC5537396 | biostudies-other | 2017
REPOSITORIES: biostudies-other
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Project description: Not available
| S-EPMC7003128 | biostudies-literature
Project description:Neoplasms of the small intestine are rare. Leiomyomas are the one of the benign neoplasms that can be found in the small intestine. These lesions usually remain asymptomatic and are often found incidentally; however, they can become symptomatic if obstruction occurs or the tumor outgrows its blood supply resulting mucosa. Their clinical manifestations can include abdominal pain, diarrhea, melena, a palpable abdominal mass and weight loss. Due to their vague presentation, leiomyomas of the small intestine are typically diagnosed after failed conservative therapy for other pathologies such as duodenal ulcers and diverticulosis. This case report describes a 34-year-old male who developed an acute GI bleed due to a symptomatic leiomyoma of the jejunum. He was initially treated with non-operative conservative management; however, his symptoms remained unresolved and he went on to require surgical intervention.
| S-EPMC5534017 | biostudies-other
Project description: Not available
| S-EPMC7278024 | biostudies-literature
Project description:BackgroundAtrial-esophageal fistula (AEF) is a rare, but high mortality, complication after catheter ablation. At present, there is no standard treatment for AEF. In this article, we introduce the treatment process of a case diagnosed with AEF and review the latest treatment progress of AEF.Case descriptionA 65-year-old man, who received catheter ablation 2 weeks prior, presented with fever, chills, and loss of consciousness. Blood cultures grew Streptococcus viridans. A computed tomography (CT) scan of the brain showed a large area of left craniocerebral infarction and air emboli in the right lobe. The chest CT demonstrated air between the left atrium and esophagus, as well as pericardial effusions. Gastroscopy showed an esophageal fistula 35 cm away from the incisor teeth. The patient was diagnosed with AEF, sepsis, and cerebral infarction. An urgent surgical operation and supportive treatments were performed after diagnosis. Eventually, he died of sepsis and multiple organ failure 24 days after surgery.ConclusionsWe have reported the treatment process of one case diagnosed with AEF and reviewed the latest treatment progress. AEF is a rare but lethal complication after catheter ablation. At present, austere challenges exist in the diagnosis and treatment of AEF. Repeat chest and head CT/magnetic resonance imaging (MRI) are essential for the identification of abnormal manifestations. In terms of treatment, urgent surgical repair is currently recommended once AEF is diagnosed. More attention should be paid to this complication.
| S-EPMC9929749 | biostudies-literature
Project description:S. stercoralis infection is very common in South East Asian countries including India. Chronic infection is very common with symptoms of diarrhea, abdominal pain, nausea, vomiting, anemia, and cough. Hyperinfection and dissemination usually occur in immunocompromised patients with symptoms mimicking asthma, COPD, or aseptic meningitis. Very few cases of hyperinfection and dissemination have been documented in immunocompetent patients. We report this case for its rarity and future references.
| S-EPMC3999680 | biostudies-literature
Project description:Nasogastric (NG) tube is frequently used in clinical practice for a variety of indications; however, NG tubes are not without risks, and there are a multitude of gastrointestinal complications that are associated with their use. Simple precautions can help prevent these NG tube-related injuries.
| S-EPMC5538083 | biostudies-other
Project description:ObjectiveTo develop and validate risk algorithms (QBleed) for estimating the absolute risk of upper gastrointestinal and intracranial bleed for patients with and without anticoagulation aged 21-99 years in primary care.DesignOpen cohort study using routinely collected data from general practice linked to hospital episode statistics data and mortality data during the five year study period between 1 January 2008 and 1 October 2013.Setting565 general practices in England contributing to the national QResearch database to develop the algorithm and 188 different QResearch practices to validate the algorithm. All 753 general practices had data linked to hospital episode statistics and mortality data at individual patient level.EndpointGastrointestinal bleed and intracranial bleed recorded on either the linked mortality data or the linked hospital records.ParticipantsWe studied 4.4 million patients in the derivation cohort with 16.4 million person years of follow-up. During follow-up, 21,641 patients had an incident upper gastrointestinal bleed and 9040 had an intracranial bleed. For the validation cohort, we identified 1.4 million patients contributing over 4.9 million person years of follow-up. During follow-up, 6600 patients had an incident gastrointestinal bleed and 2820 had an intracranial bleed. We excluded patients without a valid Townsend score for deprivation and those prescribed anticoagulants in the 180 days before study entry.Risk factorsCandidate variables recorded on the general practice computer system before entry to the cohort, including personal variables (age, sex, Townsend deprivation score, ethnicity), lifestyle variables (smoking, alcohol intake), chronic diseases, prescribed drugs, clinical values (body mass index, systolic blood pressure), and laboratory test results (haemoglobin, platelets). We also included previous bleed recorded before entry to the study.ResultsThe final QBleed algorithms incorporated 21 variables. When applied to the validation cohort, the algorithms in women explained 40% of the variation for upper gastrointestinal bleed and 58% for intracranial bleed. The corresponding D statistics were 1.67 and 2.42. The receiver operating curve statistic values were 0.77 and 0.86. The sensitivity values for the top 10th of men and women at highest risk were 38% and 51%, respectively. There were similar results for men.ConclusionThe QBleed algorithms provided valid measures of absolute risk of gastrointestinal and intracranial bleed in patients with and without anticoagulation as shown by the performance of the algorithms in a separate validation cohort. Further research is needed to evaluate the clinical outcomes and the cost effectiveness of using these algorithms in primary care.
| S-EPMC4113281 | biostudies-literature
Project description:Conventional embolization such as coiling of acute upper gastrointestinal bleeding may be rendered impossible or unsuitable due to anatomical and technical factors. Liquid (Onyx) embolization in such situations may prove valuable and life saving, though literature on the subject, particularly of acute upper gastrointestinal bleeding due to duodenal ulcer, is sparse. We present a technically challenging case of acutely rebleeding duodenal ulcer embolized successfully using ethylene polyvinyl alcohol polymer (Onyx).
| S-EPMC3693373 | biostudies-other
Project description:Esophageal diverticulum with secondary bronchoesophageal fistula is a rare clinical entity that manifests as respiratory infections, coughing during eating or drinking, hemoptysis, and sometimes fatal complications. In the present study, we describe a case of bronchoesophageal fistula emanating from esophageal diverticulum in a 45-year-old man who presented with bronchiectasis. We summarize the characteristics of this rare condition based on a review of the relevant literature.
| S-EPMC7897816 | biostudies-literature
Project description:Video 1The mass was identified at the upper- to mid-esophagus, 25 cm from the central incisors. No varices were seen on further examination of the esophagus. A 4-mm injector force needle was used to create a large submucosal injection using BlueBoost lifting agent proximal to the mass. A longitudinal mucosal incision was then made using the hybrid T-type electrocautery knife, 20 cm from the central incisors.The cutting current was the preset Endocut Q mode, and the coagulation setting was spray coag mode, effect 2 and 40 W.Next, tunnel creation by submucosal dissection was performed with a focus on keeping the submucosal space as clean as possible. Carbon dioxide was used for insufflation to prevent pneumoperitoneum.A smooth-surfaced oval mass was identified originating from the muscularis propria layer. Dissection was extended 2 cm distally beyond the mass. Next, resection of the mass was performed. First, the mucosal surface of the mass was dissected. Dissection began at the distal portion, proceeded to the left and right lateral borders, and then continued toward the proximal portion. The mass was dissected away from the muscularis propria.We focused on freeing the mass, ensuring this esophageal mass was intact throughout dissection. The attached bands of muscularis propria at the distal portion were carefully resected completely.Water irrigation was used at this time to ensure better visualization for resection. The remaining attached bands of muscularis propria were resected, ensuring complete en bloc resection. Afterward, the mass was suctioned into the cap and carefully retrieved as shown, and then sent to pathology for processing.The entire defect bed was inspected post-resection, and no perforation or bleeding was identified.The mucosal defect was completely closed with through-the-scope hemostatic clips in a longitudinal fashion beginning with approximation of the defect at the distal portion.
| S-EPMC10927991 | biostudies-literature