1/13. Ulcer perforation in gastric urinary conduit: never use a gastric segment in the urinary tract if there are other options available.A male patient, who had had a conservatively treated hemorrhagic peptic ulcer 12 years earlier, underwent gastrocystoplasty after radical cystoprostatectomy for carcinoma of the urinary bladder. After operation the patient suffered urinary incontinence and dysuria which he found so bothersome that the gastric bladder was converted to diversion using the same gastric segment as a tube. Postoperatively there were clots of blood in stomal urine and after the kidneys had been drained intestinal fluid oozed from the stoma. On the 14th postoperative day the patient died of pulmonary embolism. The autopsy showed a perforated peptic ulcer in the gastric segment resulting in a closed fistula to the small bowel. Most probably the reason for development of the peptic ulcer was stress caused by the operation and it might have been avoided by using hydrogen-blocking agents. This case seriously questions whether a gastric segment should be used in the urinary tract at all, and at least it should never be used as a conduit.- - - - - - - - - - ranking = 1keywords = bowel (Clic here for more details about this article) |
2/13. strongyloides stercoralis associated with a bleeding gastric ulcer.infection with the helminthic parasite, strongyloides stercoralis, is usually acquired by skin invasion (or occasionally via ingestion of larvae). After transformation to the adult form, the parasite preferentially localises in the small intestine, especially in the duodenal and jejunal part. A remarkable feature of Strongyloides is its property of endogenous reinfection. In the case of an immunocompromised host a massive infection, called hyperinfections Strongyloides, may occur. Numerous gastrointestinal complications of strongyloides infections, sometimes with a lethal outcome, have been reported. The intestinal manifestations are usually limited to the small bowel, and rarely involve the stomach. We report a patient with complicated strongyloides infection of the stomach.- - - - - - - - - - ranking = 1keywords = bowel (Clic here for more details about this article) |
3/13. Low-dose particulate polyvinylalcohol embolization in massive small artery intestinal hemorrhage. Experimental and clinical results.The branches of the superior mesenteric artery were embolized with polyvinylalcohol (PVA) particles 149 to 250 mu (small), 420 to 590 mu (medium), and 590 to 1000 mu (large), respectively, in three groups of dogs. In the small PVA particle group, all three dogs died. In the medium and the large PVA particle groups, nine of the 11 dogs showed no significant ischemic change and the remaining two (one dog in the medium PVA group and one in the large PVA group) had a superficial ulcer. This study suggests that PVA embolization can be performed safely if particles of 420 mu or larger are used. In clinical studies, large PVA particles were used in embolization therapy for massive intestinal hemorrhage from small arteries in five patients. All had the hemorrhage from ulcer disease in the small bowel (four patients) and the ascending colon (one patient). Three patients were completely controlled with no recurrence of hemorrhage. The remaining two experienced rebleeding after embolization. No major complication was found in this series. It is concluded that low-dose large PVA particles are suitable as an embolic material for transcatheter occlusion of small-artery intestinal hemorrhage.- - - - - - - - - - ranking = 1keywords = bowel (Clic here for more details about this article) |
4/13. Nonreflux complications of hiatal hernia.patients with massive incarcerated hiatal hernia and no appreciable esophagitis present with a distinctly different clinical picture from those with hiatal hernia and reflux peptic esophagitis. In a recent review, 17 patients were encountered with this problem. The patients were often elderly and presented with the following grave complications: upper gastrointestinal obstruction; upper gastrointestinal bleeding, both acute and chronic, from gastric ulcerations; and perforated gastric ulcerations. In these patients, the surgical approach is better accomplished through the abdominal route. These patients should be distinguished from those with a shortened esophagus resulting from chronic reflux peptic esophagitis who often require thoracotomy for surgical correction.- - - - - - - - - - ranking = 0.044595571497867keywords = short (Clic here for more details about this article) |
5/13. A caliber-persistent artery of the gastric wall resulting in fatal haemorrhage.A 12-year-old girl was admitted to hospital with haematemesis. Her family suffered from histidinaemia. Due to her numerous injuries the police suspected a crime. After a short period of clinical treatment she died. autopsy showed the left ureter to be narrowed and a consecutive abscedens pyelonephritis. Pyloric ulcer caused erosion of a caliber-persistent artery which led to death with haemorrhage. The death had nothing to do with violence. Adequate surgical treatment could have saved the patient's life.- - - - - - - - - - ranking = 0.044595571497867keywords = short (Clic here for more details about this article) |
6/13. Image subtraction in acute gastrointestinal bleeding studies using 99Tcm-DTPA.99Tcm-DTPA has been evaluated in our clinical and experimental programme for the detection of acute gastrointestinal bleeding. As an adjunct to this programme, a protocol for image subtraction has been developed. The patient remains still while sequential static images I(i) (i = 1, . . ., N) are taken. They are first normalized to equal total counts and then subtracted images are produced according to the following three methods (a) I(i 1)-I(i) (b) I(i) - I(mask) (c) I(mask) - I(i) where i not equal to mask and I(mask) denotes a user-selected mask image. Method (a) demonstrates fresh bleeding and sequential movement of blood in the bowel. methods (b) and (c) demonstrate overall migration of blood and accumulated bleeding depending on the choice of the mask image.- - - - - - - - - - ranking = 1keywords = bowel (Clic here for more details about this article) |
7/13. Bleeding peptic ulcer caused by ectopic gastric mucosa in a duplicated segment of jejunum.The authors present a case in which a patient suffered a bleeding jejunal ulcer caused by heterotopic gastric mucosa in a congenital duplication of a segment of jejunum. This is the first case diagnosed preoperatively by two different radiographic means. These lesions were shown by both pertechnetate flow and barium small bowel studies. The rarity of these entities and the modalities used for diagnosis are described.- - - - - - - - - - ranking = 1keywords = bowel (Clic here for more details about this article) |
8/13. Exogastric leiomyosarcoma with ultrastructural analysis.A 50-year-old man was found to have a large exogastric leiomyosarcoma during exploratory laparotomy for a bleeding duodenal ulcer. Although the tumor appeared grossly malignant and was associated with small bowel metastases, its light microscopic appearance was relatively benign. Electron microscopy helped to established the diagnosis of gastric leiomyosarcoma.- - - - - - - - - - ranking = 1keywords = bowel (Clic here for more details about this article) |
9/13. "Spontaneous rupture of the stomach". A case report.Spontaneous rupture of the stomach is a rare condition with a high lethality. Two cases of a previously undescribed aetiology are reported. One rupture occurred because of a bleeding ulcer in combination with a nonfunctioning Sengstaken's tube and the other because of cancer pancreatis occluding the duodenum. Aetiology, pathogenesis and clinical course of spontaneous rupture of the stomach is shortly discussed together with a brief review of the literature.- - - - - - - - - - ranking = 0.044595571497867keywords = short (Clic here for more details about this article) |
10/13. Amaurosis and blood loss.A 57-year-old alcoholic man sustained permanent bilateral blindness and optic atrophy as a complication of hemorrhage from peptic ulcer disease. Post-hemorrhagic visual loss occurs in middle-aged, debilitated persons a short time after repeated episodes of hemorrhage from any site.- - - - - - - - - - ranking = 0.044595571497867keywords = short (Clic here for more details about this article) |
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