IDDF2020-ABS-0194 Timing of endoscopy for acute upper gastrointestinal bleeding: a territory-wide cohort study

Abstract

Methods Borderline advanced malignancy patient underwent diagnostic workup and was found to have adenocarcinoma uncinate. He underwent palliative double bypass and NACT. Post-NACT reassessment was done, which showed a resectable uncinate mass with the dilated pancreatic duct. Curative resection -Whipple's pancreaticioduodenectomy was done. Biopsy showed -complete response.The postsurgery-controlled pancreatic fistula was managed conservatively, but afferent loop of GJ and leakage developed which was treated initially with prolonged conservative treatment. After the failure of conservative TT it was operated and adhesions lysed with jejunojejunal bypass was done. Still patient had 10 ml leakage from drain site pancreaticojejunostomy or gastrojejunostomy leak. Again conservative TTT was done but failed. Fistula was located by percutaneous tube and fibrin glue injection was done to heal the fistula tract which succeeded, but later again, 5 ml occasional discharge lead to exploration and fistula finally healed. The patient remained in follow up to 2.5 yrs since diagnosis and 1.5 yrs since the curative surgery, without any recurrence.Results The patient remained disease-free for 1.5 yrs post curative surgery and 2.5 yrs since diagnosis.The gastrojejunaula healed after multiple interventions. Conclusions The multispecialty approach gives the best results in borderline advanced uncinate malignancy Persistence leads to the cure of any GI surgical issues in patients Prolonged survival can be expected in curative surgery of post-NACT carcinoma uncinate A complete response can be seen in uncinate malignancy cases.

Efficacy and safety of tranexamic acid in the treatment of gastric cancer complicated with upper gastrointestinal bleeding

“…Upper GI bleeding refers to bleeding above the duodenal ligament, which is a typical clinical emergency and one of the most common complications of gastric cancer [3]. The incidence of acute GI bleeding in upper digestive tract malignant tumors is about 5% [4]. About 30% of patients with inoperable gastric cancer have neoplastic GI bleeding [5].…”