Cause Of GI Bleeding Research Articles

Spontaneous intramural rupture of the esophagus: Clinical presentation and endoscopic findings

Laceration of the esophagus occurs most frequently at the gastroesophageal junction and is a common cause of GI bleeding. Referred to as Mallory-Weiss tears, this mucosal laceration usually arises as a result of vigorous coughing, vomiting, or rapid increases in intra-abdominal pressure. Deeper injury involving the muscularis propria can lead to perforation of the esophagus, also known as Boerhaave's syndrome.1 Spontaneous intramural esophageal rupture (SIER), or incomplete perforation, is a deeper injury than the Mallory-Weiss tear but it does not extend through the entire muscle layer as in Boerhaave's syndrome.

Massive gastrointestinal bleeding as the initial manifestation of pancreatic carcinoma.

Pancreatic carcinoma is a rare cause of GI bleeding. We have studied eight patients in whom major digestive hemorrhage was the first sign of a subsequently proven pancreatic malignancy. Bleeding was characteristically severe and unremitting, including hematochezia (four), melena (three), and hematemesis (one). In seven cases, direct tumor invasion into a contiguous portion of the GI tract was present. Tumor erosion occurred into the third portion of the duodenum (three) descending (two), stomach (one), and transverse colon (one). In one patient, a metastatic bleeding lesion was present in the sigmoid colon. The four patients who required urgent laparotomy for control of major hemorrhage died during the initial hospitalization. Conventional diagnostic evaluation by endoscopic and roentgenographic techniques was commonly unsuccessful. Our retrospective analysis suggested that a more aggressive approach, including early angiography in unrelenting and undiagnosed bleeding, might have aided diagnosis and averted laparotomy in a population with dismal prospects for a surgical solution. Clinicians should be aware that pancreatic malignancy may present with a varying spectrum of GI bleeding ranging from occult to potentially exsanguinating hematemesis, hematochezia, or melena.

GASTROINTESTINAL BLEEDING IN INFANCY AND CHILDHOOD

In summary, the causes of GI bleeding in infancy and childhood are varied, ranging from congenital and hereditary disorders to those more commonly seen in the adult population. Many causes of GI bleeding in the pediatric population are restricted to a narrow range regarding age of onset, frequently enabling the physician to narrow the differential diagnosis before proceeding with invasive investigation; however, GI bleeding may involve any portion of the intestinal tract, from mouth to anus, as in adulthood, and many causes common to the adult population also must be considered.

Acute gastric changes and gastrointestinal bleeding in patients with cerebrovascular accidents (author's transl)

Pathogenesis of gastrointestinal bleeding (GI bleeding) following cerebrovascular accidents (CVA) was studied by gastroendoscopy. Gastroendoscopic examinations were performed in patients with acute cerebrovascular accidents. These patients were operated on except for 2 cases. The gastroendoscopic examination was performed under general anesthesia just before or after the operation. Forty seven patients were examined (35 cerebral hemorrhages, nine subarachnoid hemorrhages, two infarctions, one moyamoya). The gastroscopy was performed in 25 cases within 24 hours from the onset of the CVA. Acute gastric changes within 24 hours were mainly gastric petechiae (GP). These findings were classified as follows: GP(1), petechiae localized in the fundal region; GP(2), petechiae observed diffusely and mainly in the fundal region; and GP(3), petechiae observed on the whole gastric wall with bleeding. GI bleeding and the degree of petechiae were closely related. GI bleeding was noticed in 25% of GP(1), 89% of GP(2) and 100% of GP(3). No fresh ulcerative findings were noted within 24 hours in our cases. Acute gastric changes were related to the level of consciousness. CT scans showed that cerebral hemorrhage frequently involved the hypothalamic region in cases of GP (2) or GP(3). It is concluded that characteristic acute gastroendoscopic findings within 24 hours from the onest of CVA are petechiae and the main cause of GI bleeding are these petechiae. Mucosal ulceration of the stomache and duodenum are secondary changes following petechiae.