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<a href="http://doi.org/10.1016/j.ijscr.2020.10.094" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.ijscr.2020.10.094</a>
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Pages
15-17
Volume
77
ISSN
2210-2612 2210-2612 2210-2612
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Update Year & Number
October 2020 List
NEOMED College
NEOMED College of Medicine Student
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NEOMED Student Publications
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Title
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Report of a case involving novel use of a post-operative esophagogastroduodenoscopy to re-evaluate a duodenal ulcer bleed.
Publisher
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International Journal of Surgery Case Reports
Date
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2020
2020-10-23
Subject
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Surgery; Endoscopy; Case report; Bleeding; Duodenum; Repair; Ulcer
Creator
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DeVito R;Shoukry S;Arif A;Fullmer R;Simpson M;Kimyaghalam A
Description
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INTRODUCTION: Acute gastrointestinal (GI) bleeding can be a life-threatening condition. This is usually diagnosed and managed by an upper GI tract endoscopy. When treating actively bleeding duodenal ulcers, surgical intervention, or arterial embolization by Interventional Radiology (IR) is warranted in the event of failed initial management. We present a patient with a significant GI bleed and failure of management through endoscopy, necessitating emergent surgical intervention. PRESENTATION OF CASE: An 87-year-old female presented to the emergency department after a fall. Her hemoglobin level dropped significantly and an esophagogastroduodenoscopy (EGD) revealed a large pool of blood in the stomach but had a limited view of an active bleed. The patient was taken emergently to the operating room (OR) where she underwent an exploratory laparotomy, gastroduodenostomy, suture ligation, and pyloroplasty. The following day, she had increased sanguineous output from her nasogastric (NG) tube. Re-evaluation was done with an EGD in the OR. The patient tolerated all procedures well and was transferred to a facility with IR capabilities for further management. DISCUSSION: An EGD hours after gastroduodenostomy runs a high risk for perforation and is not the typical course of action. Given the lack of IR availability and concern for rebleeding, this procedure was performed in the OR to minimize risk. CONCLUSION: A favorable outcome was achieved with this patient and hemostasis was confirmed with the post-operative EGD. Further studies will determine whether this approach is a viable option for facilities without IR until the patient can be transferred.
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<a href="http://doi.org/10.1016/j.ijscr.2020.10.094" target="_blank" rel="noreferrer noopener">10.1016/j.ijscr.2020.10.094</a>
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journalArticle
2020
Arif A
bleeding
Case report
DeVito R
duodenum
Endoscopy
Fullmer R
International Journal Of Surgery Case Reports
journalArticle
Kimyaghalam A
NEOMED College of Medicine Student
NEOMED Student Publications
October 2020 List
repair
Shoukry S
Simpson M
Surgery
ulcer