Angiodysplasia of the gastrointestinal (GI) tract consists of ectasia of the submucosal vessels of the bowel. The evaluation of such patients needs proctoscopy, colonoscopy, small bowel enema, enteroscopy, capsule enteroscopy and angiography. Capsule enteroscopy has come up as an alternative to GI enteroscopy and colonoscopy in patients with occult GI bleeding; up to 52% cases of small bowel angiodysplasia in patients with occult GI bleed with negative upper GI and colonoscopy have been reported. The use of capsule enteroscopy potentially limits the hazard of radiation exposure from angiography and is less invasive than double balloon endoscopy. The treatment options for angiodysplasias include intra-arterial vasopressin injection, selective gel foam embolisation, endoscopic electrocoagulation and injection of sclerosants, with each of these being technically demanding, and requiring centres with good access to enteroscopy technology and trained gastroenterologists. Operative intervention has been indicated for refractory bleeding or lesions in sites not accessible to endoscopic interventions.

Background/Aim: The thoracic injury and related complications are responsible for upto 25% of blunt trauma mortality. This study is designed to compare these two popular ventilation modes in traumatic flail chest. Materials and Method: A total of 30 patients with thoracic trauma, aged 18–60 years, were enrolled in this study for a period of 1 year. The Thoracic Trauma Severity Score (TTSS) was used for assessing the severity of chest injury. Patients were divided into two treatment groups: one recieved endotracheal intubation with mechanical ventilation (ET group, n = 15) and another recieved noninvasive ventilation (NIV group, n = 15). All patients were observed for the duration of ventilatory days, complications such as pneumonia and sepsis, length of the stay in ICU, and mortality. Statistical analysis was done using statistical software SPSS for windows (Version 16.0). Results: There were no significant differences in age, sex, weight, and length of the stay in ICU in between the two groups. Rate of complications was significantly higher in ET group. Oxygenation was significantly improved in NIV group within 24 hr, later it become equivalent to the ET group patients while the pCO 2 level was significantly lower in ET group compared with NIV group. Analgesia in both the groups is maintained to keep the visual analog scale (VAS) score below 2 and was comparable in both the groups. Conclusions: The endotracheal intubation is also associated with serious complications as compared to NIV. The use of NIV in appropriate patients decreases complications, mortality, length of the stay in ICU, the use of resources, and cost.

Hypo-perfusion is usual in patients suffering from traumatic injury that may be indicated by serum lactate elevation. This study was performed to analyze the relation of the lactate value with trauma mortality and its clearance. The research included a total of 202 trauma patients admitted into ICU. Study parameters such as patient demography, injury mechanism, Blood Pressure (BP), heart rate (HR), Glasgow Coma Scale (GCS) and level of lactate in the blood. All these parameters were documented in the first 3 hours of hospitalization, and lactate clearance was recorded between 3 and 9 hours afterwards. For the study point; death up to 7 days was considered as a direct impact of trauma and considered in study. The study was divided into two subgroups, either expired (n=79) or survivors (n=123) according to the final outcome. The mean age, mean body weight, sex ratio, HR, Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) in both groups were comparable. The difference in lactate at admission, lactate at 6 hours and lactate clearance in between survivors and deaths were found to be insignificant statistically. Among trauma patients there is no significant relationship between lactate admission or lactate clearance and mortality. Higher sample size may be appropriate for definitive proof to be reached.

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