Mary Ann and J. Milburn Smith Child Health Research Program, Children's Memorial Hospital and Children's Memorial Research Center, Department of Pediatrics, Feinberg School of Medicine, Northwestern University, 2300 Children's Plaza, Box 157, Chicago, IL 60614.
American journal of obstetrics and gynecology (Impact Factor: 4.7). 02/2010; DOI: 10.1016/j.ajog.2009.12.015
Source: PubMed
Download full-text


Available from: Xiaobin Wang, Oct 03, 2014
9 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Antral vascular ectasia ("watermelon stomach") has recently been defined and characterized. This condition may be a source of significant bleeding from the stomach. Although steroids have been useful in some patients, antrectomy has been advocated as definitive therapy. We have treated 12 patients who were bleeding from this lesion with the Olympus HeatProbe Unit and have eliminated further hemorrhage. All presented with gastrointestinal bleeding, iron-deficiency anemia, and compatible antral biopsies. Using the large probe, vascular streaks were treated until the endoscopic appearance returned to normal (average four treatment sessions). No further bleeding was evident from the antral vascular ectasia over an average follow-up period of 20.9 months. Eight of 10 patients who had required transfusion prior to therapy no longer needed transfusion, but two received blood for other conditions. We conclude that antral vascular ectasia can be successfully treated with the HeatProbe Unit and this should be the initial modality of therapy for this condition.
    Gastrointestinal Endoscopy 07/1989; 35(4):324-8. DOI:10.1016/S0016-5107(89)72802-9 · 5.37 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The effect of Yag laser photocoagulation on the course of bleeding of gastrointestinal vascular malformations was studied in 59 patients, with a total of 482 lesions. The lesions were located in the upper gastrointestinal tract alone in 25 patients, in the lower tract alone in 31 patients and in both the lower and the upper gastrointestinal tract in three patients. In the month before laser therapy the number of bleeding episodes averaged 1.09 +/- 0.6 (SD) per patient (n = 57) and the transfusion requirements 2.4 +/- 2.6 red blood cells units per patient, while in the month after treatment the bleeding incidence averaged 0.16 +/- 0.5 and the transfusion requirements 0.21 +/- 0.8 (both p less than 0.001). Long term results were analysed considering for each patient an equally long pretreatment and follow up period. After a mean follow up period of 11.5 months (1-48 months), 17 of the 57 patients available for follow up rebled. The reduction of the bleeding rate was statistically significant at one, six, 12, and 18 months of follow up, while transfusion rate was significantly decreased at one, six, and 12 months. The results were disappointing in patients with Osler-Weber-Rendu (n = 4) and in patients with angiomas associated with Von Willebrand's disease (n = 3), who all rebled. In angiodysplasia the treatment was successful in 82% of the 49 patients. The more numerous the lesions, the less effective the reduction in bleeding rate by laser treatment was. Histological studies showed that the haemostatic effect of Yag laser photocoagulation was obtained by destruction of the lesion. Rebleeding was due to lesions missed at the first treatment, incompletely treated lesions and recurrence of new lesions. In two patients a free caecal perforation necessitated a right hemicolectomy. In both patients numerous or very large lesions had been treated in the caecum.
    Gut 07/1985; 26(6):586-93. DOI:10.1136/gut.26.6.586 · 14.66 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Fifty-six patients who presented with non-steroidal anti-inflammatory drug-associated duodenal ulcers received maintenance treatment with ranitidine. Forty-eight of these patients stopped treatment with non-steroidal anti-inflammatory drugs. The cumulative symptomatic remission at the end of 5 years of maintenance treatment was 97.7%. While half the patients had presented with haemorrhage from the ulcer, only one patient bled during maintenance treatment, giving a cumulative risk of 2.3% in 5 years of maintenance treatment. We conclude that maintenance treatment with ranitidine effectively and safely keeps patients with non-steroidal anti-inflammatory drug-associated ulcers symptom- and risk-free.
    Alimentary Pharmacology & Therapeutics 11/1989; 3(5):499-503. DOI:10.1111/j.1365-2036.1989.tb00241.x · 5.73 Impact Factor

Similar Publications