Abstract:
:Diagnostic angiography still plays an essential role in the diagnosis of patients,particularly those with acute lower GI bleeding. Transcatheter therapy appears to be a viable treatment alternative in selected patients with GI bleeding. Many interventionists today believe embolotherapy to be more effective initially and to have better long-term results, specifically less rebleeding, than vasopressin infusion with at least equal complication rates. Unfortunately, direct comparison of the two techniques in a randomized, controlled fashion has not been performed. Small patient series, such as those summarized here, suggest that the results of the two techniques are essentially equal, and ischemic complications appear more prevalent with embolotherapy. The use of embolotherapy--either empirically based on endoscopic or surgical findings or directed against a site found to have contrast extravasation-represents the current intervention of choice in the case of upper GI bleeding refractory to endoscopic intervention. Head-to-head studies directly comparing the efficacy, morbidity, and mortality associated with endovascular or surgical correction of bleeding from the upper GI tract is needed. Although the current tide favors embolotherapy in the lower GI tract, infusion of vasoconstricting agents deserves more attention. To that end, there is a great need for scientific data regarding the safety and efficacy of transcatheter therapy for upper and lower GI bleeding.
journal_name
Gastroenterol Clin North Amjournal_title
Gastroenterology clinics of North Americaauthors
Miller M Jr,Smith TPdoi
10.1016/j.gtc.2005.09.001subject
Has Abstractpub_date
2005-12-01 00:00:00pages
735-52issue
4eissn
0889-8553issn
1558-1942pii
S0889-8553(05)00082-8journal_volume
34pub_type
杂志文章abstract::Swallowed fluticasone and oral viscous budesonide are effective first-line therapies for eosinophilic esophagitis in children. Side effects are minimal without evidence of Cushing syndrome, as seen in treatment with systemic corticosteroids. New studies on alternative delivery systems and different corticosteroids (eg...
journal_title:Gastroenterology clinics of North America
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journal_title:Gastroenterology clinics of North America
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journal_title:Gastroenterology clinics of North America
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journal_title:Gastroenterology clinics of North America
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journal_title:Gastroenterology clinics of North America
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journal_title:Gastroenterology clinics of North America
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journal_title:Gastroenterology clinics of North America
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journal_title:Gastroenterology clinics of North America
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doi:10.1016/j.gtc.2003.12.003
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journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
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journal_title:Gastroenterology clinics of North America
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journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
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journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
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abstract::Acute acalculous cholecystitis (ACC) can develop with or without gallstones after surgery and in critically ill or injured patients. Diabetes mellitus, malignant disease, abdominal vasculitis, congestive heart failure, cholesterol embolization, shock, and cardiac arrest also have been associated with AAC. The pathogen...
journal_title:Gastroenterology clinics of North America
pub_type: 杂志文章,评审
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journal_title:Gastroenterology clinics of North America
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journal_title:Gastroenterology clinics of North America
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journal_title:Gastroenterology clinics of North America
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journal_title:Gastroenterology clinics of North America
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journal_title:Gastroenterology clinics of North America
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journal_title:Gastroenterology clinics of North America
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journal_title:Gastroenterology clinics of North America
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journal_title:Gastroenterology clinics of North America
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journal_title:Gastroenterology clinics of North America
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abstract::Despite the availability of a protective vaccine for over 3 decades, the number of persons with chronic hepatitis B virus (HBV) infection remains high. These persons are at risk for cirrhosis and hepatocellular carcinoma. Current treatment is effective at inhibiting viral replication and reducing complications of chro...
journal_title:Gastroenterology clinics of North America
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