Meckel’s diverticulum
Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven in Succeeding in Paediatric Surgery Examinations, 2017
Most patients with Meckel’s diverticulum are asymptomatic. Approximately 4%–16% of patients have related symptoms. The most common signs and symptoms of Meckel’s diverticulum are bleeding, obstruction and inflammation. The type of presentation correlates with age. Intestinal obstruction due to volvulus or intussusception is the most typical presentation in newborns. In older infants and younger children, painless lower gastrointestinal bleeding is common. Older children usually present with inflammation mimicking appendicitis. Children are more likely to be symptomatic than adults. In adults, inflammation and obstructive symptoms are common. Bleeding is generally painless, episodic and sometimes massive, and is mainly due to ectopic gastric mucosa, which is found in 60%–85% of cases. Occult bleeding with anaemia is rare.
The adrenal glands and other abdominal endocrine disorders
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie in Bailey & Love's Short Practice of Surgery, 2018
Symptoms that lead to the diagnosis are caused by either the primary tumour or its lymph node metastases. Acute or chronic, recurrent or persistent abdominal pain, ileus or, rarely, lower gastrointestinal bleeding may occur. Symptoms may be due to liver metastases, such as sudden painful reddening of the face and chest (‘flushing’), diarrhoea or bronchospasm. These symptoms constitute ‘carcinoid’ syndrome. About 60% of patients eventually develop cardiac symptoms because of stenosis and insufficiency of the pulmonary and, more rarely, the tricuspid valve, with enlargement and thickening of the wall of the right atrium. The aetiology is unknown but local effects of serotonin and kinins may contribute.
Process Delivery in Colorectal Surgical Practice
Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams in Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Similarly, the majority of patients with diverticular disease present with sepsis or obstruction. At least a third of all inflammatory bowel disease present to the front door with acute symptoms. A small number of patients will lower gastrointestinal bleeding will require urgent admission and investigation. Civil violence when it affects the large bowel will also need to be managed through the emergency admission unit.
Predictive factors of therapeutic intervention in on-call endoscopy for suspected gastrointestinal bleeding
Published in Scandinavian Journal of Gastroenterology, 2018
Chan Hyung Lee, Hyuk Yoon, Yoon Jin Choi, Eun Sun Jang, Jaihwan Kim, Cheol Min Shin, Young Soo Park, Jin-Hyeok Hwang, Jin-Wook Kim, Sook-Hayng Jeong, Nayoung Kim, Dong Ho Lee, Joo Sung Kim
In this study, gastroduodenal ulcer (45.9%) was the most frequent cause of upper gastrointestinal bleeding, which is concordant with previous reports [1,4,7,26,27]. However, the most frequent cause of lower gastrointestinal bleeding was procedure-related bleeding (40.0%), such as that in polypectomy and endoscopic mucosal resection, instead of diverticular disease. which is not compatible with the findings of previous studies [2,3,28]. Although the reason is not clear, this phenomenon can be explained in part by the selected study population, who underwent endoscopy out of hours. In our present study, patients who were discharged after polypectomy or endoscopic mucosal resection in regular working hours visited the hospital because of symptoms of bleeding. On-call endoscopy was likely to be performed in these patients who were strongly considered to require hemostasis.
Incidence of diverticular bleeding: a population-based study
Published in Scandinavian Journal of Gastroenterology, 2019
G. D. Olafsson, J. P. Hreinsson, E. S. Björnsson
The current study was a retrospective, population-based study. Electronic medical records including reports on endoscopies have been stored at the National University Hospital of Iceland since 2006. Lists of electronic colonoscopy reports of all patients that were admitted to the National University Hospital of Iceland between the 1st of January 2006 and the 31st of December 2016 were reviewed manually. Data on patients that underwent colonoscopy between 2010 and 2013 had been collected previously, used in other studies, and had already been reviewed manually [2–4]. Only patients that were residents in the Reykjavik metropolitan area were included in the incidence calculations. The average population of the Reykjavík metropolitan area during the study period was 202,251. Acute lower gastrointestinal bleeding (ALGIB) was defined as the passage of bright red blood per rectum leading to hospitalization or occurring in a hospitalized patient.
Out of sight for the endoscopist? Gastrointestinal bleeding after aortic repair
Published in Scandinavian Journal of Gastroenterology, 2022
Markus Busch, Klaus Stahl, Jan Fuge, Claudia Schrimpf, Nina RIttgerodt, Mark Greer, Young-Seon Mederacke, Axel Haverich, Heiner Wedemeyer, Benjamin Heidrich, Andrea Schneider, Henrike Lenzen, Ingmar Mederacke
Acute gastrointestinal bleeding is a frequent cause of emergency department attendance. The most common causes of upper gastrointestinal bleeding (UGIB) being peptic ulcer disease, followed by esophagitis, gastritis, duodenitis and variceal bleeding [1]. Lower gastrointestinal bleeding (LGIB) is commonly due to diverticular disease, hemorrhoids, colonics polyps or colitis [1]. The mainstay of bleeding remains upper and/or lower endoscopy, as recommended in various international [2–6] and national guidelines [7]. Using these approaches, GI bleeds are usually reliably identified. In the most recent ESGE guideline however, CT angiography prior to endoscopy has been recommended in patients with lower GI bleeding resulting in hemodynamic instability [2]. This may be particularly relevant in the context of aortoenteric fistulas (AEF), which represent a rare but important cause of both upper and lower gastrointestinal hemorrhage following aortic surgery, resulting in mortality rates of 50%−70% [8–10].
Related Knowledge Centers
- Gastrointestinal Bleeding
- Gastrointestinal Tract
- Upper Gastrointestinal Bleeding
- Jejunum
- Rectum
- Large Intestine
- Ileocecal Valve
- Anus
- Suspensory Muscle of Duodenum
- Duodenum