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A Study of Mallory-Weiss Syndrome Secondary to Upper Gastrointestinal Bleeding

Open Journal of Clinical Diagnostics 2014年第3期4卷 130-136页

作者： Yoshihiro Inoue Yasuhisa Fujino Makoto Onodera Satoshi Kikuchi Masayuki Sato Hisaho Sato hironobu noda Masahiro Kojika Yasushi Suzuki Shigeatsu Endo Department of Critical Care Medicine School of Medicine Iwate Medical University Morioka-shi Japan

Background: In Mallory-Weiss Syndrome (MWS), vomiting causes the mucous membrane and submucosa near the esophagogastric mucosal junction to tear and bleed. Thus, MWS can arise after heavy drinking and as a complication of endoscopic upper gastrointestinal examinations or procedures. However, there has been no report of MWS secondary to upper gastrointestinal bleeding thus far. Case Subjects: Of 79 MWS cases over a 10-year period from 2002 to 2011, we identified and studied 6 cases, in which MWS was probably caused by another lesion causing upper gastrointestinal bleeding. Results: There were 2 cases, each of gastric ulcers, duodenal ulcers, and varicose veins. In 3 cases, MWS was discovered during treatment of the primary lesion and was simultaneously treated. In the other 3 cases, patients were treated for MWS according to endoscopic diagnosis, and the primary lesion was overlooked;in these cases, the primary lesion was identified and treated after the bleeding recurred. One patient with cirrhosis died of hepatic failure. Conclusion: Care should be taken when dealing with MWS because it can occur as a result of vomiting caused by hematemesis or as a complication of endoscopic examination and treatment. When assessing MWS, other hemorrhagic lesions may be overlooked.

关键词： Mallory-Weiss Syndrome Upper Gastrointestinal Bleeding Endoscopic Hemostasis

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The East Japan Great Earthquake and Three Cases of Near-Drowning with Tsunami Due to the Earthquake

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Open Journal of Clinical Diagnostics 2014年第3期4卷 145-151页

作者： Yoshihiro Inoue Yasuhisa Fujino Makoto Onodera Satoshi Kikuchi Masayuki Sato Hisaho Sato hironobu noda Masahiro Kojika Yasushi Suzuki Shigeatu Endo Department of Critical Care Medicine School of Medicine Iwate Medical University Morioka-shi Japan

We encountered the Great East Japan Earthquake on March 11, 2011. The magnitude of the earthquake is 9.0 and it is one of the greatest from A.D. 1900 to now. The earthquake developed large tsunami and many people living on the pacific coast of east Japan died from lung disorder caused by near drowning with tsunami. We also encountered three cases of lung disorders caused by near drowning. All three were females, and two of them were old elderly. All segments of both lungs were involved in all the three patients, necessitating ICU admission and endotracheal intubation and mechanical ventilation. All three died within three weeks. In at least two cases, misswallowing of oil was suspected from the features noted at the time of the detection. Many bacteria were detected from the phlegm of two cases.

关键词： Tsunami Drowning Pneumonia

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A Case of Multiple Hemorrhagic Gastric Ulcers Developed via a Mechanism Similar to Water-Immersion Restraint Stress

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Open Journal of Clinical Diagnostics 2015年第4期5卷 136-140页

作者： Yoshihiro Inoue Yasuhisa Fujino Makoto Onodera Satoshi Kikuchi Masayuki Sato Hisaho Sato hironobu noda Masahiro Kkojika Yasushi Suzuki Shigeatsu Endo Department of Critical Care Medicine School of Medicine Iwate Medical University Morioka-Shi Japan

In rats, water-immersion restraint stress is a model of experimental ulceration. We encountered a case in which multiple hemorrhagic gastric ulcers formed in the stomach in a setting similar to water-immersion restraint stress. The patient was a 54-year-old man who was found wet on a riverbank and transported by ambulance. Because of hypothermia and renal failure, hemodialysis was performed. Tarry stools were noted and endoscopy revealed the presence of multiple hemorrhagic gastric ulcers;thus, hemostasis was performed end oscopically. During the course, pseudo membranous colitis also developed and was ameliorated with vancomycin. Further, the renal failure and gastric ulcers improved, and the patient was discharged from hospital 25 days later. The reason why he survived more than 2 weeks was the hot summer season and he was not soaked in the river water throughout.

关键词： Water-Immersion Restraint Stress Acute Gastric Mucosal Legion Endoscopic Hemostasis

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