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The Digestive (Gastrointestinal) System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Surgical intervention most commonly would involve colectomy and ileostomy for inflammatory bowel disease, vagotomy or antrectomy for peptic ulcer disease, cholecystectomy for inflammation of the gallbladder, appendectomy for inflammation of the appendix, and repair of inguinal hernias by herniorrhaphy. Paracentesis or abdominocentesis (centesis = puncture) is a procedure done to remove fluid from the abdomen or peritoneal cavity.
Gastric antral vascular ectasia (GAVE)
Published in Mohammad Ibrarullah, Atlas of Diagnostic Endoscopy, 2019
Gastric antral vascular ectasia (GAVE) accounts for nearly 4% of non-variceal UGI bleeding. The entity commonly occurs in association with chronic liver disease, chronic renal failure, autoimmune connective tissue disorder, bone marrow transplantation, ischemic or valvular heart disease, hypertension, familial Mediterranean anemia and acute myeloid anemia. The pathogenesis of the entity is not clearly understood. The presentation ranges from occult to frank GI bleeding. Two types of lesions have been identified on endoscopy: punctuate or striped. Because of similarity in appearance, the striped variety is also known as “watermelon” stomach. Though the antral region shows predominant involvement, occasionally it may extend to the gastric fundus as well. In chronic liver disease, it must be differentiated from portal hypertensive gastropathy as the treatment modalities for both are quite different. Unlike PHG, reduction in portal pressure has no effect on GAVE. Argon plasma coagulation, laser photocoagulation and heater probe application are the accepted modalities of treatment. Rarely, antrectomy may be required for uncontrolled hemorrhage.
Dyspepsia
Published in Andrew Stevens, James Raftery, Jonathan Mant, Sue Simpson, Health Care Needs Assessment, 2018
Brendan C. Delaney, Paul Moayyedi
The success of H. pylori eradication therapy in preventing long-term recurrence of peptic ulcer disease means that ulcer surgery is now rarely performed. Operations that have been recommended include an antrectomy with a gastro-duodenal anastomosis (Billroth I), an antrectomy with gastro-jejunal anastomosis (Billroth II), a vagotomy and pyloroplasty or a highly selective vagotomy.
Peritoneal patch in vascular reconstruction during pancreaticoduodenectomy for pancreatic cancer: a single Centre experience
Published in Acta Chirurgica Belgica, 2023
Vincent De Pauw, Martina Pezzullo, Maria Antonietta Bali, Imad El Moussaoui, Marie-Lucie Racu, Nicky D’haene, Christelle Bouchart, Jean Closset, Jean-Luc Van Laethem, Julie Navez
Tumour resections were performed by laparotomy and involved standard PD with antrectomy and en bloc SMV/PV resection. Specimen was removed under vascular clamping, either mesenteric in case of venous resection inferior to SMV/PV confluence, or porto-mesenteric in case of SMV/PV confluence involvement requiring splenic and portal veins clamping. Venous reconstruction (Figure 1) was performed using a PP sewn with continuous suture of non-resorbable monofilament (5/0). The PP was harvested through the same surgical incision either from the parietal peritoneum of the left lumbar region or from the falciform ligament. The intraperitoneal side of the parietal patch was placed on the intraluminal side of the vein. All patients underwent digestive reconstruction either by pancreaticojejunostomy or by pancreaticogastrostomy according to the surgeon’s choice (except in case of total pancreatectomy), completed by hepaticojejunostomy and gastrojejunostomy in antecolic position. The abdominal cavity was drained with either a multichannel silicone drain or two closed-suction tubes.
Upper gastrointestinal vascular ectasia: an under-recognized complication of systemic sclerosis
Published in Scandinavian Journal of Rheumatology, 2021
R Shukla, R Warner, P Whorwell, AL Herrick
If GAVE is recognized early, local therapy in the form of endoscopic haemostatic procedures such as argon plasma has been highly effective in patients with bleeding gastric vascular ectasia (4). Nd-YAG laser therapy has also been used successfully but relapses have been reported requiring retreatment (5). Other treatment modalities include cryotherapy, gastric antrum banding, and, rarely, gastric antrectomy, which carries a significant risk of mortality (6). More recently, intravenous cyclophosphamide and autologous haematopoietic stem cell transplantation have both been associated with improvement and resolution of GAVE-SSc in refractory cases (7, 8).
The cost-effectiveness of radiofrequency ablation for treating patients with gastric antral vascular ectasia refractory to first line endoscopic therapy
Published in Current Medical Research and Opinion, 2020
Cormac Magee, David Graham, Catherine Leonard, Jessica McMaster, Heather Davies, Maria Skotchko, Laurence Lovat, Charles Murray, Stuart Mealing, Howard Smart, Rehan Haidry
Surgical treatment can be definitive for GAVE with antrectomy to remove the affected mucosa15,16, but in some cases the surgical mortality and morbidity can outweigh any potential benefit17.