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Esophageal Varices-II: Clinical Features and Management01:28

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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
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Inflammatory Bowel Disease I: Ulcerative Colitis01:27

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Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
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Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
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Gastritis III: Clinical Manifestations and Management01:23

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The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
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Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
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Gastrointestinal Bleeding in COVID-19-Infected Patients.

Mitchell S Cappell1, David M Friedel2

  • 1Division of Gastroenterology, Department of Medicine, Aleda E. Lutz Veterans Hospital at Saginaw, Main Building, Room 3212, 1500 Weiss Street, Saginaw, MI 48602, USA.

Gastroenterology Clinics of North America
|February 22, 2023
PubMed
Summary

Gastrointestinal bleeding in COVID-19 patients often stems from mucosal inflammation, stress gastritis, or ischemic colitis. Endoscopic procedures are increasingly safe for these patients with proper precautions.

Keywords:
COVID-19ColonoscopyEndoscopy safetyEsophagogastroduodenoscopyGastrointestinal bleedingPandemicSARSTherapeutic endoscopy

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Internal Medicine

Background:

  • COVID-19 pandemic causes significant global morbidity and mortality.
  • Gastrointestinal (GI) manifestations are common in COVID-19 patients, impacting morbidity and mortality.
  • GI bleeding is a frequent complication, often occurring post-hospital admission.

Purpose of the Study:

  • To review the current literature on gastrointestinal bleeding in COVID-19 patients.
  • To elucidate the causes and characteristics of GI bleeding in the context of COVID-19 infection.
  • To assess the safety and evolving practices of GI endoscopy in COVID-19 patients.

Main Methods:

  • Literature review of studies concerning GI bleeding in COVID-19 patients.
  • Analysis of the reported causes of upper and lower GI bleeding.
  • Evaluation of the risks and safety measures associated with GI endoscopy during the pandemic.

Main Results:

  • Mild GI bleeding often results from COVID-19-induced mucosal inflammation and erosions.
  • Severe upper GI bleeding is frequently linked to peptic ulcer disease (PUD) or stress gastritis secondary to COVID-19 pneumonia.
  • Lower GI bleeding is commonly associated with ischemic colitis, stemming from hypercoagulopathy and thrombosis in COVID-19 patients.

Conclusions:

  • GI bleeding in COVID-19 patients has diverse etiologies, including mucosal erosions, PUD, stress gastritis, and ischemic colitis.
  • The risk of COVID-19 transmission during GI endoscopy is considered low, especially with personal protective equipment (PPE) and vaccination.
  • GI endoscopy is a feasible and increasingly safe procedure for COVID-19-infected patients, aiding in the management of GI bleeding.