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Gastrointestinal hemorrhage in the setting of gastrointestinal cancer: Anatomical prevalence, predictors, and interventions

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World Journal of Gastrointestinal Endoscopy 2021年第9期13卷 391-406页

作者： Mohamad A Minhem ahmad nakshabandi Rabia Mirza Mohd Amer Alsamman Mark C Mattar Internal Medicine Loyola University Medical CenterMaywoodIL 60153United States Department of Gastroenterology Medstar Georgetown University HospitalWashingtonDC 20007United States School of Medicine Georgetown UniversityWashingtonDC 20007United States

BACKGROUND Gastrointestinal hemorrhage(GIH)is a common complication with gastrointestinal cancers(GIC).There is no comprehensive research that examines GIH in different types of *** To study the prevalence,predictors,and interventions of GIH based on the anatomical location of *** This is a retrospective analysis of the 2016-2018 National Inpatient Sample database,the largest inpatient care database in the United *** adult inpatients(≥18-year-old)were ***-10-CM codes were used to identify patients with GIH and *** of GIH was obtained based on the anatomical location of *** of GIH in the GIC population were studied using multivariate *** including endoscopy were compared to the non-intervention group to determine the differences in inpatient *** Out of a total of 18173885 inpatients,321622(1.77%)cases had a diagnosis of *** GIC patients,30507(9.5%)inpatients had GIH,which was significantly(P<0.001)more than the prevalence of GIH in patients without GIC(3.4%).The highest to lowest GIH rates are listed in the following order:Stomach cancer(15.7%),liver cancer(13.0%),small bowel cancer(12.7%),esophageal cancer(9.1%),colorectal cancer(9.1%),pancreatic cancer(7.2%),bile duct cancer(6.0%),and gallbladder cancer(5.1%).Within gastric cancer,the GIH rate ranged from 14.8%in cardia cancer to 25.5%in fundus *** small bowel cancers,duodenal cancers had a higher GIH rate(15.6%)than jejunal(11.1%)and ileal cancers(5.7%).Within esophageal cancers,lower third cancers had higher GIH(10.7%)than the middle third(8.0%)or upper third cancers(6.2%).When studying the predictors of GIH in GIC,socioeconomic factors such as minority race and less favorable insurances(Medicaid and self-pay)were associated with significantly higher GIH on multivariate analysis(P<0.01).Chemotherapy and immunotherapy were also identified to have a lower risk for GIH[odds ratios(OR)=0.74(0.72-0.77),P<0.001].Out of 3

关键词： Gastrointestinal hemorrhage Gastrointestinal cancer Anatomy Risk factors Gastrointestinal endoscopy

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Role of colonoscopy in diagnosis of capecitabine associated ileitis:Two case reports

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World Journal of Gastrointestinal Endoscopy 2019年第5期11卷 383-388页

作者： Alexander E Dao Angela Hsu ahmad nakshabandi Rohan Mandaliya Sandeep Nadella Anita Sivaraman Mark Mattar Aline Charabaty Department of Gastroenterology Medstar Georgetown University Hospital Department of Gastroenterology Johns Hopkins University at Sibley Memorial Hospital

BACKGROUND Capecitabine is considered a first line agent in adjuvant therapy for breast and colorectal cancer. However,cases of severe diarrhea have been reported with increasing frequency in recent years. When diarrhea is severe and prolonged,capecitabine associated ileitis should be considered as a possible *** SUMMARY Herein,we present two cases of capecitabine ileitis,specifically involving the terminal ileum and ascending colon. We will demonstrate the disease course and treatment modalities applied to alleviate this condition,as well as discuss the merits of using colonoscopy to aid in *** Ultimately our cases demonstrate that symptomatic management with traditional anti-diarrheal medications is largely ineffective. Prompt recognition and discontinuation of capecitabine is an imperative step in proper management of this condition and colonoscopy with biopsy can be helpful when the diagnosis is unclear.

关键词： Capecitabine Xeloda 5-Fluorouracil Ileitis Ileocolitis Colonoscopy Case report

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