Dieulafoy’s Lesion as An Important Cause of Obscure GI Bleeding: A Case Report | Chapter 11 | Medical Science: Updates and Prospects Vol. 7

 

Dieulafoy's lesion is a rare but serious cause of gastrointestinal bleeding, typically affecting older adults. It involves an aberrant arteriole eroding the gastric mucosa, resulting in severe, recurrent bleeding that poses diagnostic and management challenges. A review of the literature revealed that, since the original description of Dieulafoy’s lesion over 100 years ago, only 280 cases had been reported worldwide up to 2010. From Bangladesh, only two cases have been reported, both described recently. This study reported the case of a female in her mid-sixties who presented with melena. She had coexisting left heart failure and chronic kidney disease. Initial and repeat upper GI endoscopies were negative, but a subsequent emergency endoscopy revealed bleeding from two sites near the gastroesophageal junction. Hemostasis was achieved with argon plasma coagulation, and Dieulafoy’s lesion was identified as the cause of her recurrent GI bleeding. This case highlights the importance of considering Dieulafoy’s lesion (DL) in the differential diagnosis of gastrointestinal haemorrhage, as it can cause significant morbidity, weight loss, and may be missed during initial investigations. Therefore, DL should be emphasised in postgraduate medical curricula and always considered in patients presenting with GI bleeding.

 

 

Author(s) Details

Mamun Al Mahtab
Department of Hepatology, Bangladesh Medical University, Dhaka, Bangladesh.

 

Sheikh Mohammad Fazle Akbar
Oita University, Oita / Miyakawa Memorial Research Foundation, Tokyo, Japan.

 

Musarrat Mahtab
Clinical Research Organization, Dhaka, Bangladesh.

 

Please see the book here :- https://doi.org/10.9734/bpi/msup/v7/7281

An Overview of Therapeutic Options between Proton Pump Inhibitors (PPI) and Fundoplication in Gastroesophageal Reflux Disease (GERD) Management | Chapter 4 | An Overview of Disease and Health Research Vol. 3

Introduction: Gastroesophageal reflux disease (GERD) is a prevalent, chronic condition characterised by the retrograde flow of gastric contents into the oesophagus, resulting in symptoms such as heartburn, regurgitation, and chest discomfort. The disease imposes a substantial burden on healthcare systems and significantly affects patients’ quality of life. First-line therapy for GERD typically includes lifestyle modifications and acid suppression with proton pump inhibitors (PPIs). While PPIs are effective in the majority of patients, a significant proportion report persistent symptoms or develop concerns about long-term use, including risks of nutrient malabsorption, renal complications, and infections. Surgical options, particularly laparoscopic Nissen fundoplication, provide symptomatic relief but carry the potential for adverse outcomes such as dysphagia, gas bloat, and surgical failure over time.

 

Aim: This review aimed to clarify the role of Stretta, transoral incisionless fundoplication (TIF), endoscopic full-thickness plication (EFTP), LINX® magnetic sphincter augmentation system, laparoscopic electrical stimulation (EndoStim®), and the RefluxStop™ implant in modern GERD management and define their potential in bridging the gap between conservative and surgical therapies.

 

Methods: This review evaluated current data on the emerging therapies, as well as techniques such as endoscopic mucosal resection and ablation seek to augment the anti-reflux barrier through mucosal remodelling.

 

Results: Evidence from multiple clinical studies and meta-analyses supports Stretta’s role in improving GERD-related quality of life, reducing oesophageal acid exposure, and, in many cases, lowering dependence on proton pump inhibitors. Moreover, both TIF and EFTP offer significant benefits as less invasive alternatives to traditional GERD surgery, with the potential for improved patient outcomes and quicker recovery times. While TIF is less invasive and focuses on reshaping the gastroesophageal junction to restore LES function, EFTP offers a more robust structural intervention, which may be preferable in patients with more severe GERD. As these therapies continue to evolve, understanding their efficacy, safety, and appropriate indications is critical. Minimally invasive and endoscopic therapies represent a significant advancement in the treatment of GERD, offering alternatives to conventional pharmacologic and surgical strategies. While data supporting these interventions are promising, particularly in terms of symptom relief and reduced acid exposure, most studies to date are limited by short follow-up periods, heterogeneity in study design, and variability in patient selection. Stretta, TIF, and EFTP show utility in enhancing lower oesophagal sphincter function with a favourable safety profile, particularly in patients with mild to moderate disease. Similarly, device-based interventions such as LINX® and EndoStim® offer innovative mechanisms of action with growing clinical support. More recently, anatomical solutions like the RefluxStop™ implant and endoscopic mucosal remodelling have opened new avenues for intervention, though they remain in earlier stages of evaluation.

 

Conclusion: In conclusion, while emerging GERD therapies do not yet replace conventional treatment, they significantly expand the therapeutic toolkit. Collaboration between gastroenterologists, surgeons, and patients is essential to select the most appropriate treatment strategy, balancing innovation with evidence-based care. With ongoing refinement and validation, these approaches have the potential to address unmet needs and reshape the standard of care for GERD. Future directions should focus on long-term outcomes, head-to-head comparative trials, and defining patient subgroups most likely to benefit from each therapy. Importantly, successful GERD management increasingly depends on a multidisciplinary approach that incorporates patient-specific factors such as motility patterns, anatomical features, symptom phenotype, and treatment preferences.

 

Author(s) Details

Harald Rosen
Centre of Surgery, Sigmund Freud Private University, A-1020 Vienna, Austria.

 

Christian Günther Sebesta
Science Center Donaustadt, Langobardenstrasse 122, A-1220 Vienna, Austria.

 

Marie Christine Sebesta
Science Center Donaustadt, Langobardenstrasse 122, A-1220 Vienna, Austria.

 

Christian Sebesta
Science Center Donaustadt, Langobardenstrasse 122, A-1220 Vienna, Austria and Department of Internal Medicine, Clinic Donaustadt, SMZ-Ost, Langobardenstrasse 122, A-1220 Vienna, Austria.

 

Please see the book here:- https://doi.org/10.9734/bpi/aodhr/v3/5540

Chronic Renal Failure and Bleeding Due to Dieulafoy Lesion: Two Case Reports and Literature Review | Chapter 10 | Medicine and Medical Research: New Perspectives Vol. 4

Dieulafoy’s lesions are rare vascular malformations of the gastrointestinal tract. Dieulafoy’s lesion was first reported by Gallard in 1884 and then described in detail by Georges Dieulafoy in 1898. A Dieulafoy’s lesion is an aberrant vessel that does not reduce in caliber when it extends from the submucosa to the mucosa. Damage to this artery can cause severe and intermittent arterial bleeding from small vascular stumps that are difficult to visualize. Multiple factors have been proposed that increase the risk of upper gastrointestinal bleeding in end-stage renal disease patients including platelet dysfunction due to uremia, high prevalence of arteriovenous malformations, various co-morbidities like cardiovascular disease, diabetes mellitus, liver cirrhosis and old age. Furthermore, these catastrophic bleeding episodes frequently result in hemodynamic instability and the need for transfusion of multiple blood products. Recently, uremic syndrome has been identified as a risk factor for gastric mucosal lesions. We present two clinical cases of acute digestive bleeding due to the Dielafoy lesion with chronic kidney disease as the main cause, where two different therapies were performed endoscopically. Endoscopic therapy is still the first-line diagnostic and/or treatment option for Dieulafoy’s lesion. This study concluded with the results of the patients that the best therapy was the application of the hemostatic hemoclip on the injury vs. the injection with adrenaline on the wound site. Uremia is identified as a risk factor for upper gastrointestinal bleeding in patients with pre-existing Dieulafoy lesions, as well as a higher incidence of new bleeding.

 

Author (s) Details

 

Gustavo Adolfo Hernández Valdez
Department of Internal Medicine, ISSSTE APP General Hospital of Tepic, Tepic, Nayarit, Mexico.

 

Diana Estefanía Ibarra García
Department of Internal Medicine, ISSSTE APP General Hospital of Tepic, Tepic, Nayarit, Mexico.

 

Juan Antonio Contreras Escamilla
Department of Internal Medicine, ISSSTE APP General Hospital of Tepic, Tepic, Nayarit, Mexico.

 

Janette Alejandra Gamiño Gutierrez
Hospital Civil de Guadalajara Fray, Mexico.

 

Francisco Manuel Tonatiuh Carrillo Beltran
Department of Internal Medicine, ISSSTE APP General Hospital of Tepic, Tepic, Nayarit, Mexico.

 

Ulises Solis Gomez
Department of Internal Medicine, ISSSTE APP General Hospital of Tepic, Tepic, Nayarit, Mexico.

Jocelyn Nataly Quintero Meléndez
Department of Internal Medicine, ISSSTE APP General Hospital of Tepic, Tepic, Nayarit, Mexico.

 

Ivan Alejandro Medina Jimenez
Department of Internal Medicine, ISSSTE APP General Hospital of Tepic, Tepic, Nayarit, Mexico.

 

Marco Antonio González Villar
Department of Internal Medicine, ISSSTE APP General Hospital of Tepic, Tepic, Nayarit, Mexico.

 

Jorge Rojas Morales
Department of Internal Medicine, ISSSTE APP General Hospital of Tepic, Tepic, Nayarit, Mexico.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v4/2410

Identification of Polyps and Tumors from Endoscopy Images with Deep Belief Network | Chapter 5 | Research and Applications Towards Mathematics and Computer Science Vol. 6

 It has existed demonstrated that a successful figure processing approach can process real-time endoscopic videos to assist specialists in making critical conclusions about cancer patients. An productive diagnostic measure in gastrointestinal area is endoscopy, which us an endoscope with a camcorder and a transmitter which sends television frames. Using the existing software, the representations are taken from original-time endoscopic videos and fed into MATLAB for figure processing. The treated videos' output is then provided back into the host program. Image processing techniques have happened used to identify and advance the visualization of polyps in the gastro intestinal plan, which assists experts in making decisions. The system's goal search out let the specialist or medical practitioner visualize and recognize problematic constructions such as polyps and bleeding spots all the while endoscopic operations. This submitted approach is tested on a recorded gastrointestinal dataset that has ten series videos of 7894 frames.

Author(s) Details:

Nagesh B. S.,
Department of CSE, R. N. S. Institute of Technology, Bengaluru, India.

N. P. Kavya,
Department of CSE, R. N. S. Institute of Technology, Bengaluru, India.

Please see the link here: https://stm.bookpi.org/RATMCS-V6/article/view/12524

A Case Report on Gastroduodenal Strongyloidiasis Causing Protein Losing Enteropathy | Chapter 11 | New Horizons in Medicine and Medical Research Vol. 5

 

Strongyloidiasis is a contagious disease with a complex life cycle that infects humans through the skin. We talk about a 46-year-old woman who came in with stomach pain and distention. She was taking a proton pump inhibitor (PPI) for recurrent gastritis. She also talks about how she uses steroid to treat joint discomfort. An abdominal USG indicated substantial ascites. Endoscopy of the upper gastrointestinal tract revealed edematous duodenal mucosa with patchy erythema, as well as diffuse erythematous gastric mucosa with a minor mosaic pattern. During a histological examination of a gastric sample, Strongyloides stercoralis was discovered infected in the stomach mucosal glands. The patient was completely recovered after a course of antihelmintic treatment. This is a case report of gastroduodenal strongyloidiasis with abdominal discomfort and ascites as the presenting symptoms.


Author(S) Details

S. Bharti
Department of Pathology, All India Institute of Medical Sciences, Patna, Bihar, India.

A. Singh
Department of Pathology, All India Institute of Medical Sciences, Patna, Bihar, India.

R. Kirti
Department of General Medicine, All India Institute of Medical Sciences, Patna, Bihar, India.

. Navneet
Department of Pathology, All India Institute of Medical Sciences, Patna, Bihar, India.

View Book:- https://stm.bookpi.org/NHMMR-V5/article/view/6489

Management of Patient with Simultaneous Overt Gastrointestinal Bleeding and Myocardial Infarction with ST Segment Elevation: A Case Report | Chapter 03 | Emerging Trends in Disease and Health Research Vol. 3

 Background: The current ERC recommendations have resulted in a number of favourable outcomes, including a decrease in mortality, a shorter stay in the hospital, and a better prognosis for STEMI patients. A little modification in guidelines, on the other hand, would lower in-hospital mortality and hospitalisation expenses even more for a small group of patients. Patients with a STEMI infarction and gastrointestinal bleeding fall into this category.

Two treatment approaches were examined in patients with concurrent gastrointestinal bleeding and ST segment elevation myocardial infarction. The first is a standard method that follows ESC rules, whereas the second is more innovative and places a higher priority on endoscopy.

The patient who received endoscopy prior to PCI was released without difficulties, despite the new method. Prior to a gastroenterological diagnosis, a patient who underwent coronary intervention and was started on normal antiplatelet medication died as a result of significant bleeding.

Conclusion: For ethical considerations and in accordance with cardiological recommendations for the therapy of ACS, a study of patients with ASC who have a high risk of intestinal bleeding, in which endoscopy is prioritised and PCI is performed only later, will almost certainly never be conducted. However, as illustrated by the stated scenario, such behaviour is fully possible despite surpassing the 90-minute time limit for implementing PCI (120-minutes).

Author(S) Details

Jakub Nozewski
Faculty of Health Sciences, Emergency Department, Nicolaus Copernicus University, Bydgoszcz, Poland.

Grzegorz Grzesk
Faculty of Health Sciences, Department of Cardiology and Clinical Pharmacology, Nicolaus Copernicus University, Bydgoszcz, Poland.

Maria Klopocka
Faculty of Health Science, Vice-dean for education and development, Department of Gastroenterology, Nicolaus Copernicus University, Bydgoszcz, Poland.

Michal Wicinski
Faculty of Medicine, Vice-dean for students affairs, Department of Pharmacology and Therapy, Nicolaus Copernicus University, Bydgoszcz, Poland.

Klara Nicpon-Nozewska
Faculty of Health Sciences, Department and Clinic of Geriatrics, Nicolaus Copernicus University, Bydgoszcz, Poland.

Jakub Konieczny
Clinic of Emergency, Biziel’s Hospital, Bydgoszcz, Poland.

Adam Wlodarczyk
Faculty of Medicine, Department of Psychiatry, Medical University of Gdansk, Poland.

View Book:- https://stm.bookpi.org/ETDHR-V3/article/view/5870

Evaluation of Adenoidal Obstruction in Children: Endoscopic Findings in Relation to Radiographic Assessment | Chapter 22 | Issues and Developments in Medicine and Medical Research Vol. 3

 Background: Adenoids are one of the most frequent clinical diseases that afflict children. Parents frequently report snoring, hyponasal speaking, nasal blockage, recurring colds, and sleep apnea in their children. One of the most prevalent items encountered by an otorhinolaryngologist in day-to-day practise is adenoid hypertrophy and its complications.

Aims and Objectives: The purpose of this study is to assess the role of endoscopic examination of the nose and nasopharynx in cases with adenoidal hypertrophy and mouth breathing in children.

Materials and Methods: Between October 2017 and October 2018, a prospective study of 100 patients aged 2 to 25 years was undertaken in the Department of Otorhinolaryngology, MGM Medical College, Indore. Patients were evaluated clinically, as well as endoscopic and radiologically, before receiving medicinal treatment with corticosteroid nasal spray.

The researchers looked at 100 cases of persistent mouth breathing and snoring in this study.

The age range of 6-15 years accounted for 73 percent of the total. Only 8% of the instances were detected in people above the age of 15. 17 percent of the children were under the age of five. In this series, the male-to-female ratio was roughly 2.4:1 in 71 and 29 patients, respectively, with considerable improvement in adenoid size and endoscopic image following 4 weeks of steroid nasal spray use.

Conclusion: A method for determining the size, shape, and position of adenoids has been established using radiological assessment of the nasopharynx. The optimal tool for investigating chronic mouth breathing and snoring is diagnostic rigid endoscopy of the nose. For cautious control of adenoid enlargement, steroid nasal spray is a very efficient therapeutic technique.

Author(S) Details

Jagram Verma
Department of ENT and Head and Neck Surgery, MGMMC and MYH, Indore (M.P), India.

Aparaajita U. Mundra
M.G.M. Medical College, Indore, M.P, India.

Lokesh Bhalot
M.G.M. Medical College, Indore, M.P, India.

R. K. Mundra
M.G.M. Medical College, Indore, M.P, India.

View Book:- https://stm.bookpi.org/IDMMR-V3/article/view/5483

A Comparative Approach on Intra-operative Microscope-integrated Indocyanine Green Angiography | Chapter 12 | Recent Developments in Medicine and Medical Research Vol. 12

 Intraoperative vascular assessment during cerebral aneurysms, cerebral AVM/AVF, spinal AVM/AVF, brain tumours, and vascular bypass using a microscope integrated Indocyanine green (ICG) video angiography with colour mapping and graphic representation is a safe, easy, simple, real-time, cost-effective procedure.

It has certain drawbacks, so a combination of microvascular doppler, endoscopy, electrophysiology, and intraoperative DSA may be beneficial.

This research looks into ICG angiography and how it's used in different procedures by different centres, as well as how it compares to other intraoperative vascular status monitoring methods.

Author(S) Details

Amit K. Ghosh
Institute of Neurosciences, Kolkata, India.

View Book:- https://stm.bookpi.org/RDMMR-V12/article/view/4678

A Rare Case of Lateral Nasal Wall Haemangioma in a Young Female| Chapter 17 | Highlights on Medicine and Medical Science Vol. 10

 Hemangiomas are benign tumours that arise from the body's circulatory systems. They are classified as capillary, cavernous, or mixed histologically. Although it is frequent in the head and neck area, it is uncommon in the nasal cavity, nasopharynx, and paranasal sinuses, accounting for only 10% of all head and neck haemangiomas. The haemangioma in this patient originated from the right nasal cavity's lateral nasal wall. So yet, just a handful similar examples have been described in the literature. This case was described since it had the potential to be misdiagnosed due to radiological abnormalities, as well as to highlight the benefits of embolization in the treatment of such highly vascular nasal tumours.

Author (S) Details

Dr. Ashfaque Ansari
Department of E.N.T, MGM Medical College and Hospital, Aurangabad, India.

Dr. Sanjana U. Nair
Department of E.N.T, MGM Medical College and Hospital, Aurangabad, India.

View Book :- https://stm.bookpi.org/HMMS-V10/article/view/2265

Butterfly Gastric Bypass | Chapter 2 | Highlights on Medicine and Medical Science Vol. 7

 Perforation, haemorrhage, and cancer of the bypassed stomach, duodenum, and biliary tree are significant problems that can be deadly if not detected early, which is difficult with RYGBP and micro bypass procedures. Butterfly gastroplasty is an option for patients who are suitable for bariatric surgery. When comorbidities are present, the BMI should be greater than 30 or greater than 25. The success of butterfly gasroplasty as a laparoscopic restrictive technique, as evidenced by the fact that over 1000 cases have been performed (since 2008) in numerous centres and the Ahmed Maher teaching hospital in Cairo, Egypt. We recommend laparoscopic butterfly gastric bypass (BB) as the treatment of choice for morbid obesity because it combines all of the benefits of a mini gastric bypass with the added benefit of a gastro-gastric banded outlet that allows for easy endoscopic and radiological diagnosis and treatment of the bypassed stomach.

Author (S) Details

Essam Abdel-Galil
Department of Surgery, Ahmed MAHER Teaching Hospital, Cairo, Egypt.

View Book :- https://stm.bookpi.org/HMMS-V7/article/view/2030

A Case Study of Migrating Gossypioma: Unforeseen Challenges | Chapter 13 | Highlights on Medicine and Medical Science Vol. 3

 Gossypioma is a medical term that refers to the retention of a sponge or other surgical device after an intra-abdominal surgery. It is one of the most common medico-legal issues. Clinical symptoms of intra-abdominal Gossypioma range from mild abdominal pain to serious complications such as bowel or visceral perforation and obstruction. The illness can manifest itself in a number of ways, ranging from asymptomatic to severe gastrointestinal consequences such as vomiting, abdominal pain, obstruction, perforation, peritonitis, and even death. Transmural migration of a gossypioma is a very rare occurrence that can result in bowel or visceral perforation. Formation of a fistula or obstruction Transmural migration of an intra-abdominal Gossypioma has been reported in the stomach, ileum, colon, bladder, vagina, and diaphragm. There have only been a few cases reported in the medical literature. We do, however, report the first case of the world's largest Gossypioma, a surgical mop measuring 26 x 23 cm that was removed endoscopically. Six months ago, a 60-year-old man underwent an open cholecystectomy for symptomatic gall stones. He became symptomatic two weeks after the operation, complaining of abdominal pain and recurrent vomiting. Transmural Gossypioma migration into the stomach should be considered in the differential diagnosis. Endoscopy can be used to diagnose as well as treat patients. Surgery may be recommended in cases of endoscopic failure or incomplete migration of Gossypioma into the stomach.

Author (S) Details

Dr. Parveen Malhotra
Department of Medical Gastroenterology, Anesthesiology, Gynecology and Obstetrics, PGIMS Rohtak, India.

Vani Malhotra
Department of Medical Gastroenterology, Anesthesiology, Gynecology and Obstetrics, PGIMS Rohtak, India.

Naveen Malhotra
Department of Medical Gastroenterology, Anesthesiology, Gynecology and Obstetrics, PGIMS Rohtak, India.

Yogesh Sanwariya
Department of Medical Gastroenterology, Anesthesiology, Gynecology and Obstetrics, PGIMS Rohtak, India.

Isha Pahuja
Department of Medical Gastroenterology, Anesthesiology, Gynecology and Obstetrics, PGIMS Rohtak, India.

Akshay
Department of Medical Gastroenterology, Anesthesiology, Gynecology and Obstetrics, PGIMS Rohtak, India.

View Book :- https://stm.bookpi.org/HMMS-V3/article/view/1604

Research on Gastric Ulcer Model in Mini-Pig |Chapter 9 | Current Research in Agriculture and Veterinary Sciences Vol. 3

 The mini-pig has been in high demand in the basic and clinical research fields due to its ease of handling, small size, and analytical and physiological similarities to humans. It has been used in numerous clinical studies to mimic a variety of diseases, including cardiovascular disease, diabetes, metabolic syndrome, bone abnormalities, skin infections, and gastrointestinal ailments. It has the potential to be the most useful animal model for studying gastrointestinal diseases such as gastric ulcers. Materials and Procedures: Sus scrofa female mini-pigs weighing around 30 kg were used in this experiment. After a week of acclimation, the animals were fasted for 48 hours with free access to drinking water, followed by an endoscopic intra-gastric acetic acid injection. Mini-pigs were divided into two groups. It has the potential to be the most useful animal model for studying gastrointestinal diseases such as gastric ulcers. Materials and Procedures: Sus scrofa female mini-pigs weighing around 30 kg were used in this experiment. After a week of acclimation, the animals were fasted for 48 hours with free access to drinking water, followed by an endoscopic intra-gastric acetic acid injection. Mini-pigs were divided into two groups. two groups of two mini-pigs each Endoscopy was used to investigate the process of gastric ulcer development at the time of injection, on the 7th and 14th days. An autopsy was performed 14 days after the drug injection, followed by a stomach tissue analysis. Gastric ulcer was successfully induced in mini-pig animals, with clearly visible signs of necrosis, inflammation, and mineralization. Famotidine's therapeutic properties were demonstrated when illness symptoms were significantly reduced. Conclusion: We discovered that mini-pigs, which have a high resemblance to humans, can be an effective and practical species for inducing gastric ulcers and can be used in a variety of preclinical research. The use of animal models in the study of digestive diseases is critical for understanding the pathogenesis of these disorders and testing new therapies.

Author(s) Details

Woon Kyu Lee
Department of Biomedical Sciences, School of Medicine, Inha University, Incheon, South Korea.

View Book :- https://stm.bookpi.org/CRAVS-V3/article/view/1588