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Surgical treatments of recurrent small intestine metastatic melanoma manifesting with gastrointestinal hemorrhage and intussusception:A case report

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World Journal of gastrointestinal Oncology 2023年第1期15卷 205-214页

作者： Wen-Juan Fan Heng-Hui Cheng Wang Wei Department of Gastroenterology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina Hubei Key Laboratory of Hepato-Pancreato-Biliary Diseases Wuhan 430030Hubei ProvinceChina Institution of Pathology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina

BACKGROUND Melanoma is the most aggressive form of skin cancer,with a tendency to metastasize to any *** melanoma is the most frequent cause of skin cancer-related deaths *** intestine cancers especially small intestine metastases are relatively *** intestine metastases are seldom described and likely *** is most common in pediatric age,and in adults are almost 5%of all *** SUMMARY A 75-year-old man with a history of acral malignant melanoma was admitted to the Gastroenterology Department of our hospital,complaining of intermittent melena for 1 *** resonance enterography showed partial thickening of the jejunal wall and formation of a soft tissue mass,indicating a neoplastic lesion with jejunojejunal *** patient underwent partial small bowel *** findings and immunohistochemical staining indicated small intestine metastatic *** patient refused further anti-tumor treatment after the *** months after the first surgery,the patient presented with melena *** tomography enterography showed the anastomotic stoma was normal without thickening of the intestinal wall,and routine conservative treatment was *** months later,the patient developed melena *** patient underwent a second surgery,and multiple metastatic melanoma lesions were *** patient refused adjuvant anti-tumor treatment and was alive at the latest *** Small intestine metastatic melanoma should be suspected in any patient with a history of malignant melanoma and gastrointestinal symptoms.

关键词： Melanoma Metastasis gastrointestinal hemorrhage Intussusception Small bowel resection Case report

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Crohn's disease presenting as acute gastrointestinal hemorrhage

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World Journal of Gastroenterology 2016年第16期22卷 4073-4078页

作者： Amareshwar Podugu Kanwarpreet Tandon Fernando J Castro Department of Gastroenterology Cleveland Clinic Florida

Severe gastrointestinal (GI) hemorrhage is a rare complication of Crohn’s disease (CD). Although several surgical and non-surgical approaches have been described over the last 2 decades this complication still poses significant diagnostic and therapeutic challenges. Given the relative infrequency of severe bleeding in CD, available medical literature on this topic is mostly in the form of retrospective case series and reports. In this article we review the risk factors, diagnostic modalities and treatment options for the management of CD presenting as GI hemorrhage.

关键词： Crohn’ s disease Recurrence gastrointestinal hemorrhage Biologic agents Risk factors

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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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Ileal Lymphangioma Presenting with gastrointestinal hemorrhage： A Case Report

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Clinical oncology and cancer researeh 2010年第1期7卷 67-68页

作者： Hong-qun ZHENG Ming LIU Bei-qiu HAN Qi-fan ZHANG Department of Oncology the Fourth AffiliatedHospital of Harbin Medical University HarbinHeilongjiang Province China.

Introduction Lymphangioma is a rare benign tumor of lymphatic vessel origin. The tumor often appears in the head and neck region at a young age and can occasionally be found in the abdomen of adults with protean degrees of symptoms depending on the tumor size and location. How- ever, lymphangioma of the small intestine is extremely rare with only a few cases reported in the literature. As the tumor is not well-recog- nized, many patients with small intestine lymphangioma have been given an incorrect preoperative diagnosis. The ideal treatment for the disease is surgical excision, and the prognosis is comparatively good. In this paper, we report a rare case of ileal lymphangioma with gas- trointestinal hemorrhage preoperatively diagnosed using enteroscopy and treated with surgery.

关键词： lymphangioma gastrointestinal hemorrhage treatment.

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Inverted Meckel's diverticulum as a cause of occult lower gastrointestinal hemorrhage

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World Journal of Gastroenterology 2012年第42期18卷 6155-6159页

作者： Omar M Rashid Joseph K Ku Masayuki Nagahashi Akimitsu Yamada Kazuaki Takabe Department of Surgery Virginia Commonwealth UniversityRichmondVA 23220United States Precision Plastic Surgery RiversideCA 92506United States

Meckel's diverticulum is a common asymptomatic congenital gastrointestinal anomaly,but rarely it can present with *** the last few years inverted Meckel's diverticulum has been reported in the literature with increasing frequency as an occult source of lower gastrointestinal ***,we report a case of a 54-year-old male,who was referred for surgical evaluation with persistent anemia and occult blood per rectum after a work up which failed to localize the source over 12 mo,including upper and capsule endoscopy,colonoscopy,enteroclysis,Meckel scan,and tagged nuclear red blood cell *** abdominal computed tomography scan showed a possible mid-ileal intussusception and intraluminal *** the abdominal exploration,inverted Meckel's diverticulum was diagnosed and *** review the literature,discuss the forms in which the disease presents,the diagnostic modalities utilized,pathological findings,and *** less than 40 cases have been reported in the English literature from 1978 to 2005,19 cases have been reported in the last 6 years alone(2006-2012) due to improved diagnostic *** diagnosis and treatment of this disease requires a high index of clinical suspicion,which is becoming increasingly relevant to general gastroenterologists.

关键词： Inverted Meckel's diverticulum gastrointestinal hemorrhage Lower gastrointestinal bleeding Intussusceptions

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Clinical features of AMPAR2 antibody-positive autoimmune encephalitis with gastrointestinal hemorrhage: a case report

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Journal of Translational Neuroscience 2023年第3期8卷 28-32页

作者： Yi Bao Zhixuan Chen Yong Liu Jun Chen Department of Neurology Taihe Hospital of ShiyanAffiliated Hospital of Hubei University of MedicineShiyan 442000China

Objective:To describe the clinical features of autoimmune encephalitis complicated with gastrointestinal ***:The clinical data of one patient whose initial symptom was mental abnormality were collected and the related examinations,such as cerebrospinal fluid and magnetic resonance imaging (MRI),were ***: Cerebrospinal fluid examination found that anti-α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor(AMPAR)2 antibody was strongly positive,although the patient had repeated gastrointestinal hemorrhage but,after hormone combined with immunoglobulin treatment,the symptoms gradual-ly ***:Mental disorders are not all psychosis,and autoimmune encephalitis should not be *** is very important to perform anti-AMPAR encephalitis antibody test;accurate diagnosis and timely treatment can improve the prognosis.

关键词： gastrointestinal hemorrhage autoim-mune encephalitis α-Amino-3-hydroxy-5-methylisox-azole-4-propionic acid subtype glutamate receptor(AM-PAR) cerebrospinal fluid

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Early and accurate diagnosis and selection of appropriate treatment plans are crucial for patients with gastrointestinal hemangiomas

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World Journal of gastrointestinal Surgery 2025年第2期17卷 303-307页

作者： Zhou Chen Liang Wang Peng-Jie Yu Department of Emergency Medicine The Second Affiliated Hospital of Guangdong UniversityZhanjiang 524000Guangdong ProvinceChina Department of gastrointestinal Oncology Surgery Affiliated Hospital of Qinghai UniversityXining 810000Qinghai ProvinceChina Department of Anorectal Surgery The Affiliated Hospital of Qinghai UniversityXining 810000Qinghai ProvinceChina

gastrointestinal hemangioma(GIH)is clinically rare,accounting for 7%-10%of benign gastrointestinal tumors and 0.5%of systemic *** can occur as either solitary or multiple lesions,with gastrointestinal bleeding as a significant clinical *** the clinical and endoscopic features of GIH is essential for improving diagnostic accuracy,particularly through endoscopy and selective arteriography,which are highly effective in diagnosing GIH and preventing misdiagnosis and inappropriate *** confirmed diagnosis,it is essential to thoroughly evaluate the patient's condition to determine the most suitable treatment modality—whether surgical,endoscopic,or minimally invasive *** minimally invasive interventional partial embolization therapy using polyvinyl alcohol particles,proposed and implemented by Pospisilova et al,has achieved excellent clinical *** approach reduces surgical trauma and the inherent risks of traditional surgical treatments.

关键词： Hemangioma gastrointestinal hemangioma gastrointestinal hemorrhage Minimally invasive interventional treatment Selective embolization

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Application of endoscopic hemoclips for nonvariceal bleeding in the upper gastrointestinal tract

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World Journal of Gastroenterology 2009年第34期15卷 4322-4326页

作者： Shi-Bin Guo Ai-Xia Gong Jing Leng Jing Ma Lin-Mei Ge Department of Gastroenterology the Affiliated First Hospital of Dalian Medical University Dalian 116001 Liaoning Province China

AIM： To investigate acute nonvariceal bleeding in the upper gastrointestinal （GI） tract and evaluate the effects of endoscopic hemoclipping. METHODS： Sixty-eight cases of acute nonvariceal bleeding in the upper GI tract were given endoscopic treatment with hemoclip application. Clinical data, endoscopic findings, and the effects of the therapy were evaluated. RESULTS： The 68 cases （male：female = 42：26, age from 9 to 70 years, average 54.4） presented with hernatemesis in 26 cases （38.2%）, melena in nine cases （13.3%）, and both in 33 cases （48.5%）. The causes of the bleeding included gastric ulcer （29 cases）, duodenal ulcer （11 cases）, Dieulafoy＇s lesion （11 cases）, Mallory-Weiss syndrome （six cases）, post-operative （three cases）, post-polypectomy bleeding （five cases）, and post-sphincterotomy bleeding （three cases）; 42 cases had active bleeding. The mean number of hemoclips applied was four. Permanent hemostasis was obtained by hemoclip application in 59 cases; 6 cases required emergent surgery （three cases had peptic ulcers, one had Dieulafoy＇s lesion, and two were caused by sphincterotomy）; three patients died （two had Dieulafoy＇s lesion and one was caused by sphincterotomy）; and one had recurrent bleeding with Dieulafoy＇s lesion 10 mo later, but in a different location. CONCLUSION： Endoscopic hemoclip application was an effective and safe method for acute nonvariceal bleeding in the upper GI tract with satisfactory outcomes.

关键词： gastrointestinal hemorrhage Endoscopy Hemoclip Hemostasis

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Serum prealbumin as an effective prognostic indicator for determining clinical status and prognosis in patients with hemorrhagic stroke

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Neural Regeneration Research 2017年第7期12卷 1097-1102页

作者： Shen-qi Zhang Bin Peng Creed M.Stary Zhi-hong Jian Xiao-xing Xiong Qian-xue Chen Department of Neurosurgery Renmin Hospital of Wuhan University Wuhan Hubei Province China Department of Neurology Renmin Hospital of Wuhan University Wuhan Hubei Province China Department of Anesthesiology Stanford University School of Medicine Palo Alto CA USA

Serum prealbumin is a recognized marker of malnutrition,but its prognostic role in patients with hemorrhagic stroke remains *** this study,we retrospectively reviewed the records of 105 patients with hemorrhagic stroke admitted to Renmin Hospital of Wuhan University,China,from January to December *** collected demographic and radiological data,and recorded serum prealbumin levels at admission and on days 1,3,6,9,and *** existence of infections and gastrointestinal hemorrhage,and clinical condition at discharge were also *** prealbumin levels during hospitalization were significantly lower in patients with infections compared with those without infections,and also significantly lower in patients with gastrointestinal hemorrhage compared with those *** prealbumin levels at discharge were significantly higher in patients with good recovery than in those with poor *** conclude that regular serum prealbumin measurements in patients with hemorrhagic stroke may be a useful indicator for determining clinical status and prognosis,which may therefore help to guide clinical decision-making.

关键词： nerve regeneration prealbumin hemorrhagic stroke infection gastrointestinal hemorrhage prognostic indicator prognosis neural regeneration

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Secondary aortoesophageal fistula initially presented with empyema after thoracic aortic stent grafting:A case report

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World Journal of Clinical Cases 2021年第29期9卷 8938-8945页

作者： De-Qiong Wang Mei Liu Wen-Juan Fan Department of Gastroenterology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina

BACKGROUND Massive upper gastrointestinal(GI)bleeding is usually urgent and severe,and is mostly caused by GI *** fistula(AEF)after thoracic aortic stent grafting is a rare cause of this condition,and has a poor prognosis with a high mortality *** clinical symptoms of AEF are usually nonspecific,and the diagnosis is often difficult,especially when upper GI bleeding is *** identification,early diagnosis,and early treatment are very important for improving *** SUMMARY A 74-year-old man was admitted to the infectious disease department with>10-d fever and 10-mo prior history of thoracic aortic stent grafting for thoracic aortic penetrating *** tests revealed elevated inflammatory indicators and *** computed tomography(CT)showed postoperative changes of the aorta after endovascular stent graft implantation,pulmonary infection and pleural *** effusion tests showed *** 1 wk of anti-infective treatment,temperature returned to normal and chest CT indicated improvement in pulmonary infection and reduction of pleural *** endoscopy was performed because of epigastric discomfort,and showed a large ulcer with blood clot in the middle ***,on day 11,hematemesis and melena developed *** stopped temporarily after hemostatic treatment and bedside endoscopic *** and abdominal aortic CT angiography confirmed *** that day,he suffered massive hemorrhage and hemorrhagic ***,his family elected to discontinue *** AEF should be strongly considered in patients with a history of aortic intervention who present with fever,especially with empyema.

关键词： gastrointestinal hemorrhage Esophageal fistula Esophageal perforation Thoracic aorta Empyema Case report

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