1/10. Duodenal ulceration into the cystic artery with massive hemorrhage.This is a case presentation of a unique cause of intestinal bleeding. A duodenal ulcer eroded into the superficial branch of the cystic artery, causing massive intestinal hemorrhage. The patient, a 76-year-old woman, presented with left upper abdominal and left back pain secondary to cystic lesions in the pancreas body and tail. Stress after operation and complication of leakage of pancreatic juice after distal pancreatectomy with splenectomy and diclofenac sodium administration may have caused a deep peptic ulcer to erode the cystic artery. We performed a transfixing ligation of the bleeding vessel, serosal suture of ulcer of the gallbladder, and simple closure of the duodenal ulcer with covering greater omentum. There were no serious complications after the operation, and the patient made an uneventful recovery.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/10. Recurrent gastric hemorrhaging with large submucosal hematomas in a patient with primary AL systemic amyloidosis: endoscopic and histopathological findings.A 64-year-old woman who suffered intractable gastric ulcers with hemorrhaging showed huge submucosal hematomas in her stomach on the endoscopic examination. Since gastric mucosal biopsy revealed amyloid deposition and IgG lambda type M protein was detectable in her serum, she was diagnosed as having primary AL systemic amyloidosis. The gastric hemorrhages did not improve despite intensive medication, so total gastrectomy was performed, resulting in an unfavorable outcome. Massive deposition of amyloid with A lambda immunoreactivity was seen on the submucosal vessels in her stomach. This is a rare primary AL systemic amyloidosis case showing recurrent and fatal gastric submucosal hematomas.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/10. A case of successful embolotherapy for gastric ulcer bleeding from the intercostal artery after oesophagectomy and gastric reconstruction.We report a successful treatment with coil embolisation of an intercostal artery for ulcer bleeding in a gastric tube in a 70-year-old man who underwent a total oesophagectomy and gastric tube reconstruction for oesophageal cancer. This case teaches us to search aberrant feeding vessels when active bleeding is suspected in reconstructed gastric tube in the patient with oesophagectomy and oesophagogastrostomy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/10. Gastric and splenic infarction: a complication of intraarterial vasopressin infusion.Gastric and splenic infarction following intraarterial infusion of vasopressin in a patient's left gastric artery is reported. None of the previously described factors predisposing to infarction were present and the cause appears to have been hyperconstriction of vessels in response to vasopressin. Computed tomography (CT) scanning was used to confirm the extent of involvement.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/10. Endoscopic treatment of bleeding peptic ulcers.Since June, 1979, patients with upper gastrointestinal bleeding, other than of the varices, have been subjected to the procedure of endoscopic hemostasis with injection of absolute ethanol. This method is based on the principle of tissue dehydration and fixation with absolute ethanol. In this procedure, the bleeding vessels are dehydrated and fixed with consequent vasoconstriction and necrosis of the vascular wall, including its endothelial lining, thereby facilitating thrombogenesis and hemostasis. We have applied this method in 147 cases of upper gastrointestinal bleeding, obtaining a successful temporary hemostasis in all cases. Rebleeding from the same site occurred in 5 cases and new bleeding from another site occurred in 6 cases; however, in these cases, hemostasis was successfully obtained by reinjecting ethanol. After hemostasis, 6 patients received elective surgery and another 2 were operated on due to perforation of the stomach. Of the patients treated by this method, 11 died due to causes unrelated to gastrointestinal bleeding. After the hemostatic procedure, cure of the ulcer by conservative treatment was attained in the remaining 136 cases. Therefore, the local injection of absolute ethanol is an effective hemostatic method for upper gastrointestinal bleeding.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/10. Endoscopic local injection of hypertonic saline-epinephrine solution to arrest hemorrhage from the upper gastrointestinal tract.For the purpose of arresting hemorrhage from the upper gastrointestinal tract we developed a method of endoscopic local injection of hypertonic saline-epinephrine solution, consisting of 3.6% or 7.1% sodium chloride with 0.005% epinephrine, which was locally injected around the base of the bleeding vessel under endoscopy. During the period between October 1978 and September 1983, a total of 158 patients underwent treatment for hemostasis by this method. The major causes of bleeding in our study consisted of gastric ulcers (114) and duodenal ulcers (15). The overall effective rate of hemostasis was 98.1%. By applying this method, the rate of emergency operation for patients with bleeding from the upper gastrointestinal tract was significantly reduced from 21.7% (15/69) to 0.8% (1/128).- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/10. Conservative surgery for bleeding duodenal ulcer--vagotomy and pyloroplasty.50 unselected cases of bleeding duodenal ulcer were treated by vagotomy and pyloroplasty with suturing of the bleeding vessels. The operative mortality was 8% of which recurrent haemorrhage accounted for 6% of the patients. The operative mortality was related to advanced age, severity of bleed and associated medical illnesses. vagotomy-pyloroplasty with suture ligation is technically easy to perform for bleeding duodenal ulcer and has a low incidence of recurrent haemorrhage.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/10. Endoscopic ethanol injection for treatment of bleeding peptic ulcer.We treated three children aged 10, 11 and 13 years with actively bleeding ulcers using local endoscopic injection of pure ethanol. ethanol was injected into several sites around a visible vessel with or without bleeding. Haemostasis following ethanol injection therapy was confirmed by endoscopy performed the day after treatment. No rebleeding was observed. There were no complications related to the procedure. Injection therapy is technically simple and inexpensive. Conclusion Our results suggest that endoscopic ethanol injection is safe and may be the treatment of choice for control of bleeding from peptic ulcers in children.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/10. Bleeding from gastric ulcer halted by laparoscopic suture ligation.In a 48-year-old Japanese man there was an uncontrollable and recurrent bleeding from a gastric ulcer and laparoscopic surgery was done. Two cannulae were placed in the gastric cavity through the abdominal wall and suture ligation of the bleeding vessel at the posterior wall of the stomach was done under video-visual control with endoscopic guidance. The bleeding ceased, complications were nil, and he remains well. This article reports on surgery done to repair uncontrollable, recurrent bleeding from a gastric ulcer. Two cannulae were placed in the gastric cavity through the abdominal wall and suture of the vessel at the posterior wall of the stomach was done with videovisual control and endoscopic guidance. This approach is concluded to have supplied minimal-access surgery, cost effectiveness, early discharge, less pain, and doctor-patient satisfaction.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
10/10. Endoscopic hemostasis of bleeding duodenal ulcer in a child with Henoch-Schonlein purpura.A 9-year-old boy with Henoch-Schonlein purpura had a duodenal ulcer. Endoscopic injection with pure ethanol was performed on a pulsating visible vessel in the third part of the duodenum, resulting in complete hemostasis. A bleeding ulcer, although rare, may be a serious gastrointestinal complication of Henoch-Schonlein purpura and may require aggressive intervention.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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