ABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Fibroma/diagnostic imaging , Fibroma/surgery , Gastrointestinal Stromal Tumors/diagnostic imaging , Endoscopy , Immunohistochemistry/methodsABSTRACT
No disponible
Subject(s)
Aged , Humans , Male , Colonoscopy/adverse effects , Hemoperitoneum/diagnosis , Hemoperitoneum/etiology , Colorectal Neoplasms , Abdominal Pain , PneumoperitoneumSubject(s)
Colonoscopy/adverse effects , Hematoma/etiology , Hemoperitoneum/etiology , Aged , Colon/blood supply , Diagnosis, Differential , Hematoma/diagnostic imaging , Hematoma/surgery , Hemoperitoneum/diagnostic imaging , Hemoperitoneum/surgery , Hemorrhoids/complications , Hemorrhoids/diagnostic imaging , Hemostasis, Surgical , Humans , Male , Mesentery/blood supply , Pneumoperitoneum/diagnosis , Stress, Mechanical , Tomography, X-Ray ComputedABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Colitis/microbiology , Aeromonas hydrophila/isolation & purification , Colonic Neoplasms/diagnosis , Gram-Negative Bacterial Infections/epidemiologySubject(s)
Adenocarcinoma/complications , Aeromonas hydrophila/isolation & purification , Colitis/etiology , Colonic Neoplasms/complications , Gram-Negative Bacterial Infections/etiology , Abdominal Pain/etiology , Adenocarcinoma/diagnosis , Adenocarcinoma/diagnostic imaging , Aged , Colitis/microbiology , Colonic Neoplasms/diagnosis , Colonic Neoplasms/diagnostic imaging , Diabetes Mellitus, Type 2/complications , Dyslipidemias/complications , Female , Gram-Negative Bacterial Infections/microbiology , Humans , Sigmoid Neoplasms/complications , Sigmoid Neoplasms/diagnosis , Sigmoid Neoplasms/pathology , Tomography, X-Ray Computed , Ulcer/etiologySubject(s)
Colitis/chemically induced , Enema/adverse effects , Hydrogen Peroxide/adverse effects , Aged , Humans , MaleABSTRACT
Se presenta el caso de una mujer de 81 años con accidentes vasculares cerebrales (ACV) recurrentes con doble antiagregación y hemorragia digestiva de origen oscuro. No se encontró el origen del sangrado con cápsula endoscópica, enteroscopia de doble balón, laparotomía exploradora y enteroscopia intraoperatoria bidireccional desde boca a ano. La paciente requirió la transfusión de 117 concentrados de hematíes durante 2 años pese a suspensión de la medicación antiagregante y tratamiento con análogos de la somatostatina. Por ello, se inició terapia con dosis crecientes de talidomida, hasta 300mg, asociadas a profilaxis tromboembólica durante 3 meses, sin respuesta. Al suspender la heparina, la hemorragia se controló durante 3 meses, pero se retiró la talidomida por efectos secundarios. Dado que la hemorragia recidivó al mes de la suspensión, se realizó un segundo ciclo de 3 meses de tratamiento con talidomida. Durante un año de seguimiento, la paciente no ha precisado transfusión de hemoderivados (AU)
We report the challenging case of an 81-year-old woman on dual antiplatelet therapy with recurrent strokes, who presented with severe obscure gastrointestinal bleeding. A thorough diagnostic work-up, including capsule endoscopy, double balloon enteroscopy, arteriography, exploratory laparotomy and mouth-to-anus intraoperative enteroscopy, failed to reveal the source of the bleeding. During a 2-year period, the patient required 117 packed red blood cell units, despite withdrawal of antiplatelet drugs and empirical therapy with high-dose somatostatin analogues. The patient was administered an increasing dosage of thalidomide, up to 300mg/day, with thromboembolism prophylaxis for 3 months, with no clinical response. The bleeding stopped for 3 months after heparin was discontinued, but thalidomide had to be withdrawn owing to adverse effects. Since bleeding recurred a month later, the patient underwent another 3-month course of thalidomide. The patient has not required further blood transfusion after a 1-year follow-up (AU)
Subject(s)
Humans , Female , Aged, 80 and over , Thalidomide/administration & dosage , Gastrointestinal Hemorrhage/drug therapy , Risk Factors , Thrombosis/prevention & control , Melena/drug therapyABSTRACT
We report the challenging case of an 81-year-old woman on dual antiplatelet therapy with recurrent strokes, who presented with severe obscure gastrointestinal bleeding. A thorough diagnostic work-up, including capsule endoscopy, double balloon enteroscopy, arteriography, exploratory laparotomy and mouth-to-anus intraoperative enteroscopy, failed to reveal the source of the bleeding. During a 2-year period, the patient required 117 packed red blood cell units, despite withdrawal of antiplatelet drugs and empirical therapy with high-dose somatostatin analogues. The patient was administered an increasing dosage of thalidomide, up to 300 mg/day, with thromboembolism prophylaxis for 3 months, with no clinical response. The bleeding stopped for 3 months after heparin was discontinued, but thalidomide had to be withdrawn owing to adverse effects. Since bleeding recurred a month later, the patient underwent another 3-month course of thalidomide. The patient has not required further blood transfusion after a 1-year follow-up.
