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Results for “Melena”

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At least 19 recordsLinked to original sources
PubMed1991

A case of melena caused by a hepatic aneurysm ruptured into the intrahepatic bile duct in a patient with allergic granulomatous angiitis.

A 46 year old woman was admitted to our institute in June, 1987 with an attack of asthma, as well as remittent fever and leukocytosis accompanied by hypereosinophilia. She was found to have melena from an unknown source upon gastrointestinal examination. Four low-density areas were found in the liver on computed tomography and one of the intrahepatic foci formed a large extrahepatic abscess communicating with the intrahepatic duct on tubography. Resection of the four hepatic segments, including the large abscess, and cholecystectomy were performed. Healed necrotizing arteritis was histopathologically observed in the resected liver specimen, with the four low-density areas on CT scan having all been necrotic foci. One of them formed an intrahepatic biliary fistula and rupture of a hepatic aneurysm into a biliary duct was found to be the cause of melena. Although eosinophil infiltration and extravascular granuloma were not observed, a diagnosis of allergic granulomatous angiitis was made from the characteristic clinical course, systemic vasculitis and peripheral blood eosinophilia. To the best of our knowledge, this is the first report of intrahepatic duct perforation most probably being caused by hepatic aneurysm rupture in a patient with allergic granulomatous angiitis.

Aneurysm↗
PubMed1991

[Campylobacter enterocolitis complaining of melena].

A 38-year-old man was admitted to our hospital complaining of 5 episodes of melena without abdominal pain or diarrhea. No abnormalities were noted through an upper gastrointestinal endoscopy, but a proctoscopy revealed a large amount of coagulated blood within the rectum immediately before his admission. A colonoscopy revealed spotty redness with dark-red coagulation in the region from the splenic flexure down to the rectum except oral colon beyond the transverse colon. A presumptive diagnosis of campylobacter enterocolitis was made by a microscopy performed on the stool specimen, then an oral administration of erythromycin was started. A colonoscopy done on the 5th hospital day proved improvement on the mucosal changes. The final diagnosis of campylobacter enterocolitis was made by the stool culture. The patient took a satisfactory course of hospitalization and was discharged on the 10th day. Bacteriological examination of stool specimen together with endoscopy has been confirmed to be useful for the diagnosis of melena cases without manifestation of infectious enterocolitis.

Adult↗
PubMed1992

Effectiveness of high-dose intravenous immunoglobulin in a case of acquired von Willebrand syndrome with chronic melena not responsive to desmopressin and factor VIII concentrate.

A patient with benign monoclonal IgG lambda paraproteinemia, acquired von Willebrand syndrome (AVWS), and chronic melena successfully responding to high-dose intravenous immunoglobulin (lvlg) is reported. Coagulation parameters at admission were APTT (ratio) 1.68; VIII:C 11 IU/dL; vWF:Ag 7 IU/dL:Ricof less than 3 IU/dl. RIPA was greater than 1.8 mg/ml, and bleeding time (BT) was prolonged (18 min). No evidence for an in vitro inhibitor against the VIII/vWF complex was observed. VIII/vWF measurements showed a short-lived increase after both DDAVP and Hemate P, and BT was transiently normalized. After intravenous Ig (1 g/kg for 2 days), VIII/vWF measurements, hemostatic parameters and multimeric pattern were completely corrected (VIII/C 106 IU/dl, vWF:Ag 168 IU/dl, RiCof 147 IU/dl, APTT ratio 0.89, BT 5'), with a return to pre-infusion values after 15 days. Hemoccult test became negative and packed red cell transfusions, of which 130 units were administered during the last year, were no longer required. After 18 months the patient is on maintenance treatment with repeated courses of Ig, at 3 to 4-week intervals based on VIII/vWF and BT monitoring.

Bleeding Time↗
PubMed1991

Frank melena in a patient with fallopian tube pregnancy.

We present herein a case of a young woman who experienced lower intestinal hemorrhage caused by ischemic necrosis of the small intestine induced by the compression of a Fallopian tube hematoma in an ectopic pregnancy. All accessible preoperative attempts to clear the site of the bleeding were unsuccessful and an exploratory laparotomy was indicated seventeen days after the development of melena. An ileocecal resection and right salpingectomy finally had to be performed.

Adult↗
PubMed1990

Intractable diarrhea and melena in an AIDS patient.

A young Arab male, clinically suspected to have ulcerative colitis, was operated upon for fulminant intractable diarrhea with melena. The colon showed severe necrotizing and hemorrhagic colitis which was attributed to an opportunistic infection, viz cytomegalovirus infection. The patient's immunocompromised state was a consequence of AIDS, proved by ELISA and Western Blot test. He subsequently developed multiple brain abscesses and succumbed to uncontrolled infection.

Acquired Immunodeficiency Syndrome↗