Presentation
With a central motif of the biologic dichotomy of vascular tumors and vascular malformations, this book is organized into chapters which address clinical presentation, diagnostic imaging, molecular genetics, pathogenesis, histopathology, and management [books.google.de]
We present a case of 12-year-old boy presenting with recurrent lower gastrointestinal bleeding simulating ulcerative colitis. [jpss.eu]
It can present as a small submucosal nodule with arterial enhancement (image) and sometimes they lead to intussusception. GIST Typical GIST in the ileum presenting as an exophytic tumor. [radiologyassistant.nl]
We report a 39-year-old Egyptian man presenting with multiple jejunal phlebectasia, liver haemangioma and port-wine naevus. [ncbi.nlm.nih.gov]
Common presentation is malena or hematochezia as bleeding is usually low grade. [saudijgastro.com]
Entire Body System
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Pathologist
Vascular Anomalies: Hemangiomas and Malformations is a comprehensive and interdisciplinary textbook ideal for dermatologists, interventional radiologists, surgical specialists, ophthalmologists, pathologists, geneticists, paediatricians, hematologic-oncologists [books.google.de]
The term hereditary hemorrhagic telangiectasia (HHT) was coined by the pathologist Hanes in 1909. With the development of gastrointestinal endoscopy, Renshaw described the "millet seed to pinhe. Video Endoscopic Sequence 7 of 40. [gastrointestinalatlas.com]
He suggested that these patients bled from a vascular lesion in the ascending colon that the pathologists could not demonstrate. [emedicine.medscape.com]
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Pallor
Case report In the first sub-acute presentation, a previously fit and well 12-year-old boy presented with a 2 week history of painless passing of altered blood per rectum, pallor and easy fatigability. [jpss.eu]
Her clinical examination was noncontributory except for the presence of mild pallor. The hematological examination was suggestive of iron deficiency anemia with a normal platelet count and coagulation profile. [pancreas.imedpub.com]
Gastrointestinal
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Blood in Stool
blood in stool). Accompanying symptoms vary, but may include epigastric and diffuse abdominal pain, pale skin, shortness of breath, and alterations of consciousness. [news-medical.net]
Appearances suggestive of cavernous type of venous vascular malformation (venous phlebectasia) Discussion There are several causes of altered lower gastrointestinal blood in stool in a child [2]. [jpss.eu]
All surviving patients were discharged when surgically stable and they were followed up in the outpatient clinic for at least 2 months postoperatively and checked for overt or occult blood in stool. [ejs.eg.net]
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Intestinal Disease
Capsule endoscopy has improved our ability to diagnose small intestinal diseases and has thus helped considerably in the management of patients with obscure gastrointestinal bleeding [ 16 ]. [pancreas.imedpub.com]
Musculoskeletal
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Hip Dislocation
dislocation scoliosis May show a combination of any of the above mentioned clinical features. [radiopaedia.org]
Workup
During workup, packed red blood cells (RBCs) were transfused. The level of hemoglobin increased to 9.3 g/dL and remained stable. Dyspnea was relieved, with stable vital signs. He was discharged with the instruction to take aspirin only. [e-sciencecentral.org]
Treatment
For patients who cannot undergo endoscopic treatment, transcatheter angiography and embolization are encouraged as alternative treatments [ 13 ]. [e-sciencecentral.org]
Angiodysplasia Treatment The treatment of angiodysplasia depends on the nature of symptoms, the hemodynamic stability and the severity of bleeding from the rectum. [primehealthchannel.com]
Large AVMs may require multiple embolization procedures on separate days for complete treatment. For example, two or three treatments may be given at intervals of two to six weeks. [radiologyinfo.org]
The treatment measures for Colonic Arteriovenous Malformation may include the following: Endoscopic cautery using techniques such as argon plasma coagulation Arterial embolization Medications to help with coagulation, such as antifibrinolytics, and treatment [dovemed.com]
Hereditary Hemorrhagic Telangiectasia The treatment was successful, the patient stopped bleeding, we expect the long-term outcome. These treatments were successful and the Gi bleeding stopped, pending treatment to stop nosebleeds. [gastrointestinalatlas.com]
Prognosis
Prognosis Life expectancy is largely normal, depending on the severity of the malformation and thus the likelihood of complications. [ 1 ] Possibly about 10% of patients develop a pulmonary embolism. [patient.info]
Alternatively, in patients with refractory bleeding Interventional Radiology may be consulted for an angiogram with subselective embolization. [7] Prognosis [ edit ] The mortality rate for Dieulafoy's was much higher before the era of endoscopy, where [en.wikipedia.org]
[…] gastrointestinal or genitourinary hemorrhage if there is visceral involvement (see above) If capillary malformations are large enough, they may sequester platelets, possibly leading to the Kasabach-Merritt syndrome (consumptive coagulopathy) Treatment and prognosis [radiopaedia.org]
Among the treatment modalities, surgery can be considered when endoscopic or angiographic treatment is not suitable, or when the patient has poor prognosis factors. [e-sciencecentral.org]
Etiology
Acute upper gastrointestinal hemorrhage has an incidence of 50–150/100,000 cases each year and a mortality rate of 7–10%. 2,3 The etiology of the vast majority of upper gastrointestinal hemorrhages is peptic ulcer disease. [gastroenterologyandhepatology.net]
(Etiology) The exact cause of Colonic Arteriovenous Malformation is unknown, but studies indicate that it is a congenital malformation The condition arises owing to malformations in arteries and veins of the large intestine (colon). [dovemed.com]
Boley SJ, Sammartano R, Adams A, Diliase A, Klinhaus S, Sprayregen S: On the nature and etiology of vascular ectasias of the colon. Degenerative lesions of aging. Gastroenterology 72:650–660, 1977 Google Scholar 14. [link.springer.com]
The most likely etiologies are broken down by age group. [wjes.biomedcentral.com]
Selective arteriography of the celiac trunk and the superior mesenteric artery was performed in eight patients (89%) and enabled the etiological diagnosis in all cases. [em-consulte.com]
Epidemiology
Bleeding Dieulafoy lesions of the small bowel: a systematic study on the epidemiology and efficacy of enteroscopic treatment. Gastrointest Endosc. 2011; 74 (3): 573-80[ DOI ][ PubMed ] 12. Prachayakul V, Deesomsak M, Aswakul P, Leelakusolvong S. [ijp.tums.pub]
Visceral involvement is thought to be more common than previously supposed, occurring in perhaps 20% of patients. [ 3 ] Aetiology and epidemiology The cause is is unknown. [patient.info]
EPIDEMIOLOGY • Upper GI bleed remains a major medical problem. • About 75% of patient presenting to the emergency room with GI bleeding have an upper source. • In-hospital mortality of 5% can be expected. • The most common cause are peptic ulcer, erosions [slideshare.net]
Epidemiologic data from Europe indicated an upper GI bleeding annual incidence of 48 to 145 per 100,000 population in the 1960s and 1970s [Gilbert,1990]. [uwgi.org]
[…] endoscopic modality in the treatment of GAVE and radiation proctitis. [28] GAVE is often associated with systemic illnesses, such as cirrhosis of the liver, autoimmune connective tissue disorders, bone marrow transplantation, and chronic renal failure. [29] Epidemiology [emedicine.medscape.com]
Pathophysiology
Pathophysiology [ edit ] Dieulafoy's lesions are characterized by a single large tortuous small artery [5] in the submucosa which does not undergo normal branching or a branch with caliber of 1–5 mm (more than 10 times the normal diameter of mucosal capillaries [en.wikipedia.org]
Of note, the aforementioned pathophysiologic mechanisms responsible for the development of cecal lesions are unlikely to apply to lesions in the upper GI tract, despite being morphologically identical. [emedicine.medscape.com]
Boley SJ, Sprayregen S, Sammartano R, Adams A, Kleinhaus S: The pathophysiologic basis for the angiographic signs of vascular ectasias of the colon. Radiology 125:615–621, 1977 Google Scholar 9. [link.springer.com]
Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. Vol 1. 8th ed. Philadelphia, Pennsylvania: Saunders; 2006:767-769. 10. hatia P, Hendy MS, Li-Kam-Wa E, Bowyer PK. [gastroenterologyandhepatology.net]
Prevention
Technically, successful embolization requires the catheter be placed in a precise position to prevent injuring normal tissue. [radiologyinfo.org]
A dose-reponse effect was noted in the prevention of gastric, but not duodenal, ulcer. [uwgi.org]
However, our patient received surgery because the number and the location of the lesions—10 polypoid lesions between the proximal and distal jejunum—prevented endoscopic treatment. [e-sciencecentral.org]
One is also advised to refrain from using nonsteroidal anti-inflammatory drugs in this case to prevent the condition to aggravate. [primehealthchannel.com]