1/36. Acute upper gastrointestinal bleed: a case study.Upper gastrointestinal (UGI) bleeding on a presenting symptom is of major significance for nurse practitioners in any clinical setting. Bleeding in the upper gastric tract is a symptom of a disease process rather than a disease in itself. UGI bleeding accounts for 300,000 hospitalizations annually. An astute knowledge of the pathophysiology and clinical presentations of UGI bleeding enables swift intervention and a reduction in morbidity and mortality rates. This article presents a case report of a white male in his fifties diagnosed with metastatic colon cancer and acute UGI bleeding and emphasizes the need for early screening and detection, disease education, and prompt interventions to minimize associated complications.- - - - - - - - - - ranking = 1keywords = disease (Clic here for more details about this article) |
2/36. Intramural duodenal hematoma presenting as a complication of peptic ulcer disease.We report the first case in the English literature of an intramural duodenal hematoma presenting as a complication of helicobacter pylori-induced peptic ulcer disease. Intramural duodenal hematomas have been previously described in patients-usually in the setting of blunt trauma, postendoscopic biopsy, gastrostomy placement, and hemostatic therapy and in patients with a coagulopathy or bleeding diathesis-but not as a presentation of peptic ulcer disease. It is important to recognize this complication, as surgical management may benefit patients with a duodenal hematoma.- - - - - - - - - - ranking = 2keywords = disease (Clic here for more details about this article) |
3/36. liver penetration by a duodenal ulcer in a young woman.liver penetration is a rare but serious complication of peptic ulcer disease. We report a case of a 33-year-old woman who took large doses of nonsteroidal antiinflammatory drugs and developed a giant duodenal ulcer that penetrated into her liver. The diagnosis was based on histologic examination of endoscopic biopsies. She was initially treated with a proton pump inhibitor, but, within 5 weeks, she developed a symptomatic postbulbar stricture that required surgical correction. We also review 11 other reported cases of endoscopically and histologically diagnosed peptic ulcer penetration into the liver.- - - - - - - - - - ranking = 0.33333333333333keywords = disease (Clic here for more details about this article) |
4/36. porphyria cutanea tarda associated with an acute gastrointestinal bleed: the roles of supplemental iron and blood transfusion.We describe a case of porphyria cutanea tarda (PCT) induced by blood transfusion and oral iron supplementation in an 80-year-old white woman. The patient experienced acute blood loss from 2 duodenal ulcers 2 months prior to presentation. During her hospitalization for the gastrointestinal bleed, her anemia was treated with blood transfusion, iron supplementation, and erythropoietin. Multiple blistering lesions developed on her skin 2 months after hospital discharge. Clinical and laboratory findings were consistent with a diagnosis of porphyria cutanea tarda. Treatment included discontinuation of iron therapy, local skin care, and phlebotomy, which prevented the development of more lesions. The roles of iron overload and chronic renal disease in the pathogenesis of the porphyria are discussed.- - - - - - - - - - ranking = 0.33333333333333keywords = disease (Clic here for more details about this article) |
5/36. Metastatic choriocarcinoma presenting as a bleeding duodenal ulcer.We report a case of a young man with a rare disease, a choriocarcinoma of the gastrointestinal tract presenting as a common entity, a bleeding duodenal ulcer. Pathological findings and strongly positive immunostains of tissue specimens for beta human chorionic gonadotrophin confirmed the entire tumor to be a choriocarcinoma ruling out the possibility of an adenocarcinoma with focal components of choriocarcinoma or a beta human chorionic gonadotrophin producing adenocarcinoma. The pattern of tumor invasion in this case is more suggestive of metastatic than primary involvement of the gastrointestinal tract. The diagnosis of primary gastrointestinal choriocarcinoma is difficult because of the need to meticulously rule out the occurrence of a primary in other organs, which at times regresses spontaneously, a diagnosis made more difficult in this case in which no autopsy was performed.- - - - - - - - - - ranking = 0.33333333333333keywords = disease (Clic here for more details about this article) |
6/36. Management of massive upper gastrointestinal haemorrhage from multiple sites of peptic ulceration with somatostatin and octreotide--a report of five cases.Surgical management of massive upper gastrointestinal bleeding after failed medical treatment may be hazardous because of diffuse bleeding from several sites, further complicated in some patients by intercurrent disease, age, or previous surgery. Experience with combined somatostatin and octreotide therapy in five such patients is described. All were treated initially with either intravenous somatostatin (250 micrograms/hour) or octreotide (Sandostatin) (50 micrograms/hour) for periods ranging from three to five days, after which they were given subcutaneous octreotide (50 or 100 micrograms three times daily). Bleeding was controlled by this regimen in all cases. The patients were all discharged from hospital on either ranitidine (n = 4) or omeprazole (n = 1). Repeat endoscopy at the end of the treatment period with somatostatin and octreotide (n = 1) or four weeks after discharge (n = 3) showed complete healing of the bleeding sites. somatostatin and octreotide may be of value in controlling severe upper gastrointestinal bleeding in patients in whom surgery is hazardous because of bleeding from several peptic lesions further complicated in some by intercurrent disease or age.- - - - - - - - - - ranking = 0.66666666666667keywords = disease (Clic here for more details about this article) |
7/36. gastrointestinal hemorrhage due to complicated gastroduodenal ulcer disease in liver transplant patients taking sirolimus.sirolimus is emerging as a popular immunosuppressive agent for patients undergoing solid organ and pancreatic cell transplantation. Here, we report the clinical courses of three patients receiving sirolimus who developed aggressive gastroduodenal ulcer disease. One patient died from massive gastrointestinal bleeding, and ulcers in the other two patients healed only after discontinuation of sirolimus. We propose that the mechanism underlying this severe ulcer diathesis, and poor ulcer healing, was linked to the well-known inhibitory effects of sirolimus on wound healing. We propose that sirolimus should be used carefully (or even withheld) in patients with known or previous ulcer disease, and further that it should be used prudently and/or in conjunction with aggressive prophylaxis therapy in those at risk for ulcer disease.- - - - - - - - - - ranking = 2.3333333333333keywords = disease (Clic here for more details about this article) |
8/36. Steroid therapy and duodenal ulcer in infants.Two infants with acute life-threatening complications of duodenal ulcer following steroid administration are described. Although the possible association between steroid therapy and peptic ulcer disease is well known, the need for ulcer prophylaxis during such therapy in infants is not unanimously accepted. The case for ulcer prophylaxis in this setting is presented.- - - - - - - - - - ranking = 0.33333333333333keywords = disease (Clic here for more details about this article) |
9/36. cimetidine and ranitidine may not cross-react to cause thrombocytopenia.We report the case of a patient with peptic ulcer disease who developed cimetidine-induced thrombocytopenia. The thrombocytopenia resolved spontaneously following discontinuation of cimetidine, and did not recur with ranitidine. We concluded that cimetidine and ranitidine do not necessarily cross-react to induce thrombocytopenia. Thus the exclusion of both H2-blockers in the event that one has caused thrombocytopenia may not be justified.- - - - - - - - - - ranking = 0.33333333333333keywords = disease (Clic here for more details about this article) |
10/36. Cushing disease presenting as atypical psychosis followed by sudden death.The authors report a case of Cushing's disease that first presented as a diagnostically confusing Atypical Psychosis. Sudden death occurred secondary to unexpected gastrointestinal bleed. Pathological findings confirmed the diagnosis. Neurochemical mechanisms for the behavioral aberrations are explored.- - - - - - - - - - ranking = 1.3333333333333keywords = disease (Clic here for more details about this article) |
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