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3.
Säo Paulo med. j ; 132(3): 184-188, 14/abr. 2014. tab, graf
Article in English | LILACS | ID: lil-710423

ABSTRACT

CONTEXT: Button battery ingestion is a frequent pediatric complaint. The serious complications resulting from accidental ingestion have increased significantly over the last two decades due to easy access to gadgets and electronic toys. Over recent years, the increasing use of lithium batteries of diameter 20 mm has brought new challenges, because these are more detrimental to the mucosa, compared with other types, with high morbidity and mortality. The clinical complaints, which are often nonspecific, may lead to delayed diagnosis, thereby increasing the risk of severe complications. CASE REPORT: A five-year-old boy who had been complaining of abdominal pain for ten days, was brought to the emergency service with a clinical condition of hematemesis that started two hours earlier. On admission, he presented pallor, tachycardia and hypotension. A plain abdominal x-ray produced an image suggestive of a button battery. Digestive endoscopy showed a deep ulcerated lesion in the esophagus without active bleeding. After this procedure, the patient presented profuse hematemesis and severe hypotension, followed by cardiorespiratory arrest, which was reversed. He then underwent emergency exploratory laparotomy and presented a new episode of cardiorespiratory arrest, which he did not survive. The battery was removed through rectal exploration. CONCLUSION: This case describes a fatal evolution of button battery ingestion with late diagnosis and severe associated injury of the digestive mucosa. A high level of clinical suspicion is essential for preventing this evolution. Preventive strategies are required, as well as health education, with warnings to parents, caregivers and healthcare professionals. .


CONTEXTO: A ingestão de bateria em disco é queixa frequente em pediatria. As complicações graves decorrentes de ingestão acidental têm aumentado significativamente nas últimas duas décadas, devido ao fácil acesso aos aparelhos e brinquedos eletrônicos. Nos últimos anos, o aumento do uso de baterias de lítio com diâmetro de 20 mm trouxe novos desafios, por serem mais prejudiciais para a mucosa em comparação com outros tipos, com elevada morbidade e mortalidade. As queixas clínicas, muitas vezes inespecíficas, podem levar ao atraso no diagnóstico, aumentando o risco de complicação grave. RELATO DE CASO: Menino de cinco anos, com queixa de dor abdominal há 10 dias, é trazido ao serviço de emergência com quadro clínico de hematêmese há duas horas. Na admissão, apresentava palidez, taquicardia e hipotensão. Imagem sugestiva de bateria em disco foi visualizada na radiografia simples de abdome. A endoscopia digestiva demonstrou lesão ulcerada profunda no esôfago sem sangramento ativo. Após o procedimento, o paciente apresentou hematêmese profusa e hipotensão grave, seguidos de parada cardiorrespiratória (PCR), revertida. Submetido a laparotomia exploradora de urgência, apresentou novo episódio de PCR, sem reversão. A bateria foi removida por exploração retal. CONCLUSÃO: Este caso descreve a evolução fatal de ingestão da bateria em disco com diagnóstico tardio e associação com lesão grave de mucosa digestiva. Alto nível de suspeita clínica é obrigatório para evitar tal evolução. As estratégias de prevenção são necessárias, bem como a educação em saúde, com alerta aos pais, cuidadores e profissionais de saúde. .


Subject(s)
Child, Preschool , Humans , Male , Colon , Delayed Diagnosis/adverse effects , Electric Power Supplies , Foreign Bodies/complications , Shock, Hemorrhagic/etiology , Emergencies , Esophagus/injuries , Fatal Outcome , Foreign Bodies , Foreign Bodies/surgery , Heart Arrest/etiology , Hematemesis/etiology
4.
Rev. chil. cir ; 64(1): 68-71, feb. 2012. ilus
Article in Spanish | LILACS | ID: lil-627080

ABSTRACT

The most common presentation of esophageal hematoma is pain, dysphagia and hematemesis. We report two patients with the condition. A 77 years old female presenting with retrosternal pain and odynophagia after ingesting a pig bone. An upper gastrointestinal endoscopy showed a lineal hematoma, protruding to the lumen in the upper portion of the esophagus. The patient was managed with nil per os (NPO) and parenteral hydration and discharged 72 hours later. An 87 years old male presenting with two episodes of hematemesis and weight loss, an upper gastrointestinal endoscopy showed a dissecting hematoma involving the entire esophageal wall. The patient was managed with NPO and hydration and discharged in good conditions 11 days after admission.


El hematoma intramural esofágico es infrecuente, existiendo pocos casos registrados en la literatura. Generalmente se presenta posterior a un trauma, por ejemplo asociado a procedimientos endoscópicos (escleroterapia), o en forma espontánea. La presentación clínica más frecuente es la tríada de dolor torácico, odinofagia/disfagia y/o hematemesis. Generalmente el tratamiento consiste en un manejo expectante con medidas de soporte habitual. Se exponen 2 casos clínicos presentados en nuestro centro durante el año 2009 y se realiza una revisión de la literatura.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Esophageal Diseases/diagnosis , Esophageal Diseases/therapy , Hematoma/diagnosis , Hematoma/therapy , Esophageal Diseases/complications , Hematemesis/etiology , Deglutition Disorders/etiology
5.
Indian J Pediatr ; 2009 June; 76(6): 635-638
Article in English | IMSEAR | ID: sea-142302

ABSTRACT

Objective. To find out whether the causes of upper GI bleeding in our center in a developing country differed from developed countries. Methods. Children presenting to our center with upper GI bleeding from March 2002 to March 2007, were retrospectively evaluated. Informations were retrieved from patient’s history and physical examination and results of upper GI endoscopy regarding etiology of bleeding, managements, use of medications which might predispose patient to bleeding, and the mortality rate. Results. From 118 children (67 boys; with age of 7.7±4.7 yrs) who underwent upper GI endoscopies, 50% presented with hematemesis, 14% had melena and 36% had both. The most common causes of upper GI bleeding among all patients were gastric erosions (28%), esophageal varices (16%), duodenal erosions (10%), gastric ulcer (8.5%), Mallory Weiss syndrome tear (7.8%), duodenal ulcer (6.8%), esophagitis (1.7%) and duodenal ulcer with gastric ulcer (0.8%). The causes of bleeding could not be ascertained in 20.5% of cases. No significant pre-medication or procedure related complications were observed. Endoscopic therapy was performed in 13.5% of patients. In 14.4% of patients, there was a history of consumption of medications predisposing them to upper GI bleeding. Two deaths occurred (1.7%) too. Conclusion. The findings in the present study showed that half of upper GI bleedings in pediatric patients from south of Iran, were due to gastric and duodenal erosions and ulcers. This study concludes that the causes of upper GI bleeding in children in our center of a developing country, are not different from those in developed ones.


Subject(s)
Adolescent , Child , Child, Preschool , Developed Countries/statistics & numerical data , Developing Countries/statistics & numerical data , Duodenal Diseases/complications , Duodenal Diseases/diagnosis , Duodenal Diseases/epidemiology , Duodenal Ulcer/complications , Duodenal Ulcer/diagnosis , Duodenal Ulcer/epidemiology , Endoscopy, Gastrointestinal , Female , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/epidemiology , Gastrointestinal Hemorrhage/etiology , Hematemesis/diagnosis , Hematemesis/epidemiology , Hematemesis/etiology , Humans , Infant , Iran/epidemiology , Male , Melena/diagnosis , Melena/epidemiology , Melena/etiology , Retrospective Studies , Stomach Diseases/complications , Stomach Diseases/diagnosis , Stomach Diseases/epidemiology , Stomach Ulcer/complications , Stomach Ulcer/diagnosis , Stomach Ulcer/epidemiology
6.
JSP-Journal of Surgery Pakistan International. 2009; 14 (2): 99-100
in English | IMEMR | ID: emr-93701

ABSTRACT

Hemorrhoids in children are not common. The most common cause of hemorrhoids in the young children is portal hypertension. A 3 year old boy with history of hematemsis and external hemorrhoids is being reported. Patient had associated varices for which he was put on proparnolol


Subject(s)
Humans , Male , Child , Hematemesis/etiology , Varicose Veins , Propranolol
7.
Article in English | IMSEAR | ID: sea-124254

ABSTRACT

Jejunogastric intussusception is a known complication following gastrojejunostomy. However, only occasionally have they presented with haematemesis and we are unaware of any case where it led to recurrent haematemesis. We describe a case where the patient developed recurrent upper gastrointestinal bleeding due to recurrent episodes of jejunogastric intussusception following gastrojejunostomy performed 12 years earlier for duodenal ulcer disease.


Subject(s)
Duodenal Ulcer/surgery , Gastric Bypass/adverse effects , Hematemesis/etiology , Humans , Intussusception/etiology , Jejunal Diseases/etiology , Male , Middle Aged , Stomach Diseases/etiology
8.
Article in English | IMSEAR | ID: sea-124977

ABSTRACT

Portal hypertension with variceal bleed and a well functioning liver is an indication for shunt surgery. The commonly performed procedure is the lieno-renal shunt. When the left adrenal vein is long enough, and of healthy diameter a spleno-adrenal shunt is possible. Most of the reported cases are of distal spleno-adrenal type. A case of proximal spleno-adrenal patent shunt with a follow-up two years is presented along with review of literature.


Subject(s)
Adolescent , Adrenal Glands/blood supply , Hematemesis/etiology , Humans , Hypertension, Portal/complications , Male , Splenorenal Shunt, Surgical/methods , Treatment Outcome
9.
Article in English | IMSEAR | ID: sea-134748

ABSTRACT

On 30.08.2003, a 20-year-old boy met with a vehicular accident and sustained spinal injury and left upper limb fracture. He was immediately hospitalized and seemed to recover well after treatment for a period of 15 days, when just before discharge he suddenly had hematemesis and bleeding per rectum and succumbed within another 24 hours. The case is discussed in detail.


Subject(s)
Accidents, Traffic/complications , Accidents, Traffic/mortality , Fatal Outcome , Gastrointestinal Hemorrhage/drug therapy , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/mortality , Hematemesis/drug therapy , Hematemesis/etiology , Hematemesis/mortality , Humans , Male , Quadriplegia/etiology , Spinal Injuries/complications , Spinal Injuries/etiology , Steroids/therapeutic use , Young Adult
11.
Salud pública Méx ; 47(3): 193-200, mayo-jun. 2005. tab
Article in English | LILACS | ID: lil-412238

ABSTRACT

OBJETIVO: El dengue hemorrágico en México es una enfermedad emergente desde 1994. La circulación de los cuatro serotipos incrementa el riesgo de epidemias de dengue hemorrágico. MATERIAL Y MÉTODOS: Se reportan los datos clínicos y epidemiológicos de los casos de dengue hemorrágico confirmados y notificados por el IMSS de 1995 a 2003. Se analizaron las características clínicas y epidemiológicas entre grupos. Para el control y la evaluación final de las variables se utilizó un modelo multivariado. RESULTADOS: Los casos fueron asignados en dos grupos: 438 con dengue clásico, que incluye 109 casos con manifestaciones hemorrágicas sin trombocitopenia, y 977 casos de dengue hemorrágico con 79 defunciones. Los factores de riesgo asociados a las defunciones fueron: hematemesis (RR 2.6; IC 95 por ciento 1.4-4.6) y melena (RR 2.2; IC 95 por ciento 1.2-3.7). CONCLUSIONES: El cuadro clínico descrito para la población del Instituto Mexicano del Seguro Social permite identificar factores pronósticos que ayuden al clínico a prevenir y manejar adecuadamente los casos severos de dengue hemorrágico.


Subject(s)
Adult , Female , Humans , Male , Severe Dengue/epidemiology , Ascites/epidemiology , Ascites/etiology , Disease Progression , Severe Dengue/complications , Severe Dengue/diagnosis , Severe Dengue/mortality , Dengue/complications , Dengue/diagnosis , Dengue/epidemiology , Dengue/mortality , Follow-Up Studies , Hematemesis/epidemiology , Hematemesis/etiology , Incidence , Melena/epidemiology , Melena/etiology , Mexico/epidemiology , Prognosis , Retrospective Studies , Risk , Risk Factors , Serologic Tests , Thrombocytopenia/epidemiology
12.
Annals of King Edward Medical College. 2005; 11 (3): 346-347
in English | IMEMR | ID: emr-69671

ABSTRACT

A case of unknown bullet trauma to the lung, in remote past, presented with hemoptysis which was mislabeled as hematemesis. Once labeled, a number of physicians, one after the other, kept on treating her for that symptom. She also consulted a number of specialties and was treated for reflux esophagitis, tuberculosis etc. Meanwhile her x-ray chest revealed a foreign body which was treated as an artifact first, and proved to be a bullet on CT scan. Thoracotomy had to be performed to remove the pathologic right lower lobe of lung


Subject(s)
Humans , Female , Wounds, Gunshot , Forensic Ballistics , Lung/injuries , Hemoptysis/etiology , Hematemesis/etiology , Tuberculosis/diagnosis , Thoracotomy , Esophagitis, Peptic/diagnosis , Thoracotomy , Tomography, X-Ray Computed , Radiography, Thoracic , Pneumonectomy
13.
Journal of the Royal Medical Services. 2005; 12 (1): 47-49
in English | IMEMR | ID: emr-72225

ABSTRACT

This article present a case of hematemesis caused by a leech infesting the floor of the mouth, which was managed in Princess Haya Hospital in Aqaba/Jordan in October-2003. This pathological condition is extremely rare in urban areas but is frequent in endemic rural areas. We also highlighted some very interesting features of Leech due to chemicals they possess and their medicinal use


Subject(s)
Humans , Male , Hematemesis/etiology , Hematemesis/parasitology , Hematemesis/therapy , Gastrointestinal Hemorrhage
14.
Article in English | IMSEAR | ID: sea-63656

ABSTRACT

We report a 28-year-old man who presented with hematemesis due to choricarcinoma of testis metastatic to the stomach. Gastroscopy showed a polypoidal lesion. Testicular wedge biopsy confirmed mixed germ cell tumor, the choriocarcinomatous portion alone getting metastasized to the stomach. He was initiated on chemotherapy with actinomycin-D, etoposide and methotrexate, but died due to multiple metastases to the lung and brain.


Subject(s)
Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Brain Neoplasms/secondary , Choriocarcinoma/drug therapy , Fatal Outcome , Hematemesis/etiology , Humans , Male , Stomach Neoplasms/complications , Testicular Neoplasms/drug therapy
15.
Article in English | IMSEAR | ID: sea-64441

ABSTRACT

We report a 62-year-old man with cardiac failure and acute renal failure, who had massive hematemesis. Upper GI endoscopy showed a large gastric lesser curvature ulcer. Billroth II gastrectomy specimen showed fungal invasion. He received amphotericin B postoperatively, and recovered uneventfully.


Subject(s)
Amphotericin B/therapeutic use , Follow-Up Studies , Gastrectomy/methods , Gastric Mucosa/pathology , Gastroenterostomy , Gastroscopy/methods , Hematemesis/etiology , Humans , Male , Middle Aged , Postoperative Care , Risk Assessment , Severity of Illness Index , Stomach Ulcer/etiology , Treatment Outcome , Zygomycosis/complications
16.
Asian Pac J Allergy Immunol ; 2003 Dec; 21(4): 211-6
Article in English | IMSEAR | ID: sea-36623

ABSTRACT

This study was conducted in order to analyze the clinical manifestations, the endoscopic findings, the histology of the gastrointestinal mucosa, the treatments and the clinical course in infants who had hematemesis induced by cow milk allergy. The medical records were reviewed retrospectively. The criteria for the diagnosis of CMA included elimination of cow milk formula resulting in improvement of symptoms, specific endoscopic and histologic findings as well as the exclusion of other causes. Twenty-three infants with a diagnosis of hematemesis were analyzed, which included 20 infants with CMA and 3 infants with gastroesophageal reflux disease (GERD). In the CMA group were 12 girls and 8 boys whose ages were 4.3 +/- 1.4 months. The onset of vomiting after starting cow milk formulas was 70.6 +/- 48.9 days. Gastroduodenoscopy was performed on 15 patients showing erythema, erosion and friability of the gastric mucosa in all patients and lymphoid hyperplasia in the duodenal bulb in 7 patients. Eight patients had mild to moderate eosinophilic infiltration and 5 patients had eosinophilia. Cow milk formulas were changed to other formulas: two children were initially given extensively hydrolyzed casein formulas and later followed by a soy formula, 14 were given a soy formula and 4 were given partially whey hydrolyzed formulas. All patients showed clinical signs of improvement a few days later. Patients that were able to tolerate cow milk were 1.5 +/- 0.9 years old. During the follow-up period (2.6 +/- 1.8 years after treatment) 4 patients were diagnosed with asthma, 4 patients with chronic respiratory symptoms, 4 patients with constipation and 2 others with food allergies. CMA induced gastritis in infancy may not be classified as eosinophilic gastritis because of the low level of eosinophilic infiltration. The elimination of cow milk and subsequent substitution with a soy formula is the proper management.


Subject(s)
Animals , Duodenoscopy , Female , Gastric Mucosa/pathology , Gastroesophageal Reflux/etiology , Gastrointestinal Diseases/etiology , Gastroscopy , Hematemesis/etiology , Humans , Infant , Male , Milk Hypersensitivity/complications
18.
Article in English | WPRIM | ID: wpr-65044

ABSTRACT

Aortoesophageal fistula is a rare and lethal disorder that may result from primary diseases of aorta or esophagus, aortic bypass graft, ingestion of foreign body, trauma, surgical procedure or instrumentation. Tuberculous fistula is extremely rare. We present a 27-yr-old female patient with aortoesophageal fistula associated with tuberculous mediastinitis. The patient experienced massive hematemesis and esophagoscopy revealed a small mucosal defect with exudate-coated blood vessel like Dieulafoy 's lesion on about 25 cm from the incisor teeth. Despite two sessions of endoscopic hemostatic procedures, active massive hemorrhage recurred and was controlled effectively with a prompt insertion of Sengstaken-Blakemore tube. The patient underwent open thoracotomy, which revealed aortoesophageal fistula. Numerous white-yellowish, millet seed-like tubercles were scattered in pleural and abdominal cavity. Division of fistular tract and esophageal resection with Ivor-Lewis anastomosis were performed. Histopathologic study confirmed tuberculous pleuritis and peritonitis. The patient died of postoperative pulmonary complication.


Subject(s)
Adult , Aorta, Thoracic/pathology , Aortic Diseases/etiology , Esophageal Fistula/etiology , Esophagus/pathology , Fatal Outcome , Female , Hematemesis/etiology , Humans , Mediastinitis/pathology , Tuberculosis, Miliary/complications
19.
Article in English | IMSEAR | ID: sea-90741

ABSTRACT

Leiomyoma of the duodenum is a rare tumour. Small intestinal tumours contributing to upper gastrointestinal bleed is still rare. They usually present with malena and anaemia, rarely hematemesis. We report a case of leiomyoma of duodenum diagnosed on endoscopic ultrasound that presented with massive haematemesis.


Subject(s)
Adult , Biopsy, Needle , Duodenal Neoplasms/complications , Endosonography , Follow-Up Studies , Hematemesis/etiology , Humans , Laparotomy , Leiomyoma/complications , Male
20.
JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2001; 11 (6): 379-382
in English | IMEMR | ID: emr-57058

ABSTRACT

To determine the independent predictors of morbidity, mortality and survival after the first episode of acute variceal bleeding in patients with liver cirrhosis. Design: A longitudinal study done on 115 cases. Place and Duration of Study: It was conducted in Hayatabad Medical Complex, Peshawar, from January, 1996 to December, 1998 and followed-up till June, 2000. Subjects and One hundred and fifteen cirrhotic patients, 88 men and 27 women, having a mean [' SD] age of 52.4'5.4 years [range 37- 67 years], with first episode of acute variceal bleeding and admitted to the hospital, were studied. All the patients were positive for the virological markers i.e. 73[63.48%] for anti-HCV and 42[36.52%] HBsAg. The mean follow-up was 41 ' 4.3 months with the range of 30 to 54 months. Forty-three [39.81%] patients developed complications during the hospitalization period. These included encephalopathy [n =16], progression of a pre-existent hepatic encephalopathy [n =21] and renal failure [n = 6]. Seven [6.08%] patients died within 48 hours despite therapy. Causes of death included hypovolemic shock in six patients and unsuccessful control of bleeding in one patient. Age, hepatic encephalopathy, renal failure, hepatocellular carcinoma and Child's grade were the independent factors that predicted prognosis at 6 weeks. At the end of observation period, 88[92.63%] patients were alive while 7[7.37%] had died. Conclusions: We conclude that occurrence of a first episode of acute variceal bleeding alters the natural history of liver cirrhosis because it is associated with high morbidity and the frequent development of life-threatening complications especially during the first 6 weeks. Long-term survival in such cases needs to be determined in prolonged studies


Subject(s)
Humans , Male , Female , Liver Cirrhosis/complications , Hemorrhage/etiology , Hematemesis/etiology , Esophageal and Gastric Varices/etiology , Hemorrhage/mortality , Endoscopy, Gastrointestinal
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