11/20. hemobilia secondary to metastatic liver disease.hemobilia has previously been reported only in association with primary hepatic tumors. A patient with metastatic liver disease is described who presented with melena, abdominal pain, and jaundice. Bleeding from the ampullary papilla was observed at endoscopy. jaundice resulted from biliary obstruction by blood clots containing foci of tumor cells identical to those of the hemorrhagic hepatic tumor nodules. hemobilia from metastatic liver disease may occur more commonly than reported.- - - - - - - - - - ranking = 1keywords = obstruction (Clic here for more details about this article) |
12/20. splenic vein obstruction: a cause of upper gastrointestinal bleeding.Isolated splenic vein obstruction may lead to bleeding from gastric varices. The condition is rare, the varices may be difficult to demonstrate and therefore the diagnosis often is delayed. This is illustrated by an example of a 79-year-old man who had intermittent melena for two years before the diagnosis was made. Following splenectomy there was no bleeding.- - - - - - - - - - ranking = 5keywords = obstruction (Clic here for more details about this article) |
13/20. Intestinal neurofibromatosis. Multiple complications in a single case.The use of radionuclide gastrointestinal scanning with 99mTc sulfur colloid, supplementing angiography, is described in the diagnosis of the source of bleeding in a 60-year-old woman with neurofibromatosis. These two procedures succeeded in locating the origin of bleeding from neurofibroma in the jejunum, which was corrected by surgery. To our knowledge, this case report is the first description of a patient with neurofibromatosis, with all the reported gastrointestinal symptoms: intermittent abdominal pains, palpable abdominal mass, gastrointestinal bleeding and small bowel obstruction.- - - - - - - - - - ranking = 1keywords = obstruction (Clic here for more details about this article) |
14/20. Recurrent intestinal haemorrhages caused by a lipoma in the ileocaecal valve in a patient with Von Willebrand's disease.Lipomas of the digestive tract are rare and may give rise to obstruction, intussusception or haemorrhage. In a 74-year old woman with Von Willebrand's disease, a lipoma in the ileocaecal valve caused frequent intestinal haemorrhages and chronic anaemia over a period of more than 15 years. diagnosis and therapy are discussed on the basis of the case history.- - - - - - - - - - ranking = 1keywords = obstruction (Clic here for more details about this article) |
15/20. Chronic anemia secondary to side-to-side distal small bowel anastomosis.Occult intestinal bleeding was diagnosed in a patient who underwent a distal small bowel resection. The resection was required for small bowel obstruction. She developed iron deficiency anemia four years later. Clinically she presented with melena. colonoscopy, gastroscopy were unsuccessful in making the diagnosis. But a 99 mass technetium (99m Tc) Labeled Red Blood Cell (RBC) scintigraphy, established the bleeding site in the gastrointestinal tract. laparotomy identified an ulcerative lesion at the surgical side-to-side anastomosis. histology demonstrated focal ulceration with chronic inflammation but did not show crypt abscesses, or granulomata. Medical therapy, including iron and histamine-antagonists were ineffective. She was treated with resection of the anastomosis. Gastrointestinal bleeding due to anastomotic ulceration appears to be a late complication of small bowel resection with side-to-side anastomosis.- - - - - - - - - - ranking = 1keywords = obstruction (Clic here for more details about this article) |
16/20. fibromuscular dysplasia of the visceral arteries.fibromuscular dysplasia (FMD) commonly involves the renal and carotid arteries. However, visceral arterial involvement is rare. We report a 39-yr-old male who developed ischemic bowel disease twice (once in the jejunal artery and once in the sigmoid artery) as a result of FMD. First ischemic change occurred in the sigmoid colon with manifestation of melena and abdominal pain, and the second occurred in the jejunum, with severe abdominal pain and intestinal stenosis. angiography revealed the "string of beads" appearance, characteristic of FMD, in those two arteries responsible for the ischemic lesions. fasting therapy with intravenous hyperalimentation improved both lesions, but secondary stenosis caused by ischemia occurred in the jejunum. Surgical resection of the stenotic jejunum was required. Although the abnormal arteries that had been imaged as a "string of beads" on angiography were not resected, the postoperative course has been uneventful and satisfactory.- - - - - - - - - - ranking = 1.9081543561673keywords = artery (Clic here for more details about this article) |
17/20. Complicated jejunal diverticulosis: report of a case.The authors report a case of complicated multiple jejunal diverticulosis and review the data from the literature on this pathology. A 74-year-old man was admitted to our unit presenting with symptoms of intestinal obstruction. He had previously experienced three episodes of the same symptomatology with melena. endoscopy excluded gastroduodenal or colonic bleeding; an X-ray of the small bowel detected multiple large jejunal diverticula. The patient underwent surgery: a jejunal resection was performed just below the Treitz angle extending about 60-70 cm. The postoperative course was uneventful and the patient was discharged on the 8th postoperative day. At present, the patient is doing well and has not since demonstrated any symptoms of either intestinal obstruction or melena.- - - - - - - - - - ranking = 2keywords = obstruction (Clic here for more details about this article) |
18/20. hemobilia associated with a traumatic arteriovenous fistula.Although there have been many reports of hemobilia, its association with an arteriovenous fistula within the liver is extremely rare, only two cases having been reported in the world literature. The authors describe a third case in which a gunshot injury to the liver of a 19-year-old man resulted in the development of hemobilia demonstrated radiologically to be associated with an arteriovenous fistula. The condition was successfully managed by ligation of the proximal hepatic artery.- - - - - - - - - - ranking = 0.95407717808363keywords = artery (Clic here for more details about this article) |
19/20. Colonic variceal bleeding in a patient with mesenteric venous obstruction due to an ileal carcinoid tumour.Colonic varices are a recognized cause of rectal bleeding in portal hypertension. We report here a patient who presented with melaena several months after resection of an ileal carcinoid tumour. Subsequent colonoscopy for continued episodes of rectal bleeding demonstrated extensive colonic varices. In the absence of portal hypertension, the varices appeared to be related to mesenteric venous obstruction. The management of bleeding colonic varices, in these circumstances, is discussed.- - - - - - - - - - ranking = 5keywords = obstruction (Clic here for more details about this article) |
20/20. Case report: life-threatening haematochezia from a jejunal leiomyoma.leiomyoma is a common benign intestinal tumour. Melaena is not rare in this tumour. Recently, rectal haematochezia has been considered as one of the very rare manifestations of leiomyoma. We report a case of jejunal leiomyoma showing life-threatening rectal bleeding. This 76-year-old man was admitted to hospital because of continuous rectal bleeding for 2 days. Haemorrhagic shock occurred and transfusion of 27 units of packed red blood cells failed to correct the shock. Emergent superior mesenteric angiography revealed a distal jejunal tumour showing evidence of active oozing. Segmental intestinal resection was performed to remove this jejunal tumour. Final pathological examination disclosed a jejunal leiomyoma with a ruptured artery responsible for the life-threatening bleeding. The patient recovered after tumour resection. Our presenting case was probably the second case of jejunal leiomyoma showing haematochezia. The diagnostic priority is discussed.- - - - - - - - - - ranking = 0.95407717808363keywords = artery (Clic here for more details about this article) |
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