Unusual Causes of Upper Gastrointestinal Bleeding

Parikh, Keyur; Ali, Meer; Wong, Richard C.K.

doi:10.1016/j.giec.2015.02.009

Cited by 18 publications

(17 citation statements)

References 88 publications

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“…2 PAEF is a rare entity and the reported incidence of PAEF is 0.007 per million 3 and it is associated with a high mortality. Its occurrence is usually due to erosion of an abdominal aortic aneurysm into the intestinal tract.…”

Section: Discussionmentioning

confidence: 99%

The cause of intestinal bleeding cannot be missed: the case of primary aortic-enteric fistula

2016

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Primary aortoenteric fistula (PAEF) is a rare condition of intestinal hemorrhage. We herein report a case of this condition initially suspected by ultrasonographic evaluation and subsequently confirmed by computed tomography. PAEF should be considered a possible cause in patients with gastrointestinal bleeding of uncertain etiology and especially in patients with known aortic aneurysms. The rapid recognition of this condition may save the life of these patients because in untreated subjects the mortality is 100%, frequently due to hypovolemic shock.

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Section: Discussionmentioning

confidence: 99%

The cause of intestinal bleeding cannot be missed: the case of primary aortic-enteric fistula

2016

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“…Variceal bleeding and esophagitis are common causes of upper GI bleeding while vascular lesions are a relatively uncommon cause [1, 2]. Bleeding from periesophageal pseudoaneurysms, however, has not been reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Periesophageal Pseudoaneurysms: Rare Cause of Refractory Bleeding Treated with Transarterial Embolization

Kohli

Shah

Komorowski

et al. 2016

Case Reports in Gastrointestinal Medicine

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A 43-year-old female with history of systemic lupus erythematosus, prior cytomegalovirus esophagitis treated with ganciclovir, and long segment Barrett's esophagus (Prague class C8 M9) with high grade dysplasia treated with radiofrequency ablation presented to the hospital with hematemesis. An upper gastrointestinal endoscopy showed multiple esophageal ulcers with active arterial spurting which could not be controlled with endoscopic interventions including placement of hemostatic clips. An emergent angiogram demonstrated actively bleeding saccular dilations (pseudoaneurysms) in the esophageal branches of the lower thoracic aorta as well as left gastric artery for which gelfoam and coil embolization was initially successful. Due to recurrence of massive bleeding, she subsequently underwent emergent esophagectomy and bipolar exclusion. Pathology demonstrated submucosal hemorrhage, esophagitis with dysplastic Barrett's mucosa, and an ulcer containing cytomegaloviral inclusions. We report the first case of arterial bleeding from periesophageal pseudoaneurysms as well as use of angiographic embolization for arterial bleeding in the esophagus.

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“…Magnetic resonance imaging (MRI) is the first choice in suspected cases of hemobilia, especially in childhood. Magnetic resonance cholangiopancreatography (MRCP) findings demonstrate gallbladder hemobilia as a mixed signal intensity that is consistent with blood products in various stages of breakdown [42][43][44][45][46] . A radionuclide "tagged" red cell scan will be positive for a biliary source if the hemorrhage is brisk.…”

Section: Diagnosismentioning

confidence: 94%

“…A radionuclide "tagged" red cell scan will be positive for a biliary source if the hemorrhage is brisk. [46] However, bleeding scans typically entail a delay of several hours, which is problematic when the patient is unstable.…”

Section: Diagnosismentioning

confidence: 99%

Massive hemobilia in childhood

Celayir¹

2018

Haydarpasa Numune Med J

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Hemobilia is very rare in the pediatric population, and so it continues to be a diagnostic challenge. Hemobilia is an abnormal communication between a vessel of the splanchnic circulation and the biliary system. Treatment planning for hemobilia in children should be performed; therefore, the differential diagnosis is very important in order to find the cause of the upper gastrointestinal bleeding. Awareness of potential causes and the management of upper gastrointestinal bleeding and hemobilia should enable physicians to treat their patients more effectively. This study is a review of potential etiologies of hemobilia and the challenges involved in the diagnosis and surgical management of massive hemobilia, especially in children.

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Unusual Causes of Upper Gastrointestinal Bleeding

Cited by 18 publications

References 88 publications

The cause of intestinal bleeding cannot be missed: the case of primary aortic-enteric fistula

The cause of intestinal bleeding cannot be missed: the case of primary aortic-enteric fistula

Periesophageal Pseudoaneurysms: Rare Cause of Refractory Bleeding Treated with Transarterial Embolization

Massive hemobilia in childhood

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