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Query: UNIPROT:P01185 (
vasopressin
)
23,126
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
A series of 23 patients with intractible gastrointestinal (GI) bleeding were managed by the transcatheter method. The series included 5 with hemobilia, 8 with upper GI (UGI) bleeding, 5 with lower GI (LGI) bleeding and 5 with variceal bleeding. The etiology of the hemobilia was surgery, or percutaneous transhepatic cholangiography and drainage (PTCD) complicated by various degrees of biliary tract infection. The causes of UGI bleeding included erosive gastritis, gastric and duodenal ulcers, and traumatic duodenal laceration. All 5 LGI bleedings were due to
ischemic colitis
and all 5 variceal bleedings were due to hyperdynamic portal hypertension from arterio-portal (A-P) shunting for hepatocellular carcinomas (HCC). Intra-arterial
vasopressin
infusion was performed on 17 (4, hemobilia; 8, UGI; and 5 LGI bleeding) of these 23 cases as initial management. The success rate for
vasopressin
in hemobilia, UGI and LGI bleeding was 75% (3/4), 38% (3/8), and 60% (3/5), respectively. The overall initial success rate of
vasopressin
was 52% (9/17). The relatively poor success rate of
vasopressin
infusion for UGI bleeding was due to ulcers and laceration. The incidence of rebleeding for
vasopressin
infusion was 22% (2/9) including one case each of UGI and LGI bleeding. Three patients (1 hemobilia and 2 UGI bleeding) among these 17 cases underwent transarterial embolization (TAE) after failure of intra-arterial
vasopressin
infusion. One of these 23 cases with hemobilia underwent TAE for initial transcatheter control of the GI bleeding. Five cases of active esophageal variceal bleeding, caused by A-P shunting in HCC, were all successfully controlled by TAE.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Transcatheter control of intractible gastrointestinal bleeding. 167 14
Drug-induced constipation is mostly caused by changes in gut motility, whilst diarrhoea is more frequently caused by an increase in intestinal fluid secretion. In both instances the drug has to reach the enteric nervous system or the enterocyte, either via the blood or from the lumen, in sufficient concentrations to affect the mediators that regulate motility and fluid transport. Diarrhoea and constipation are frequently mentioned as side-effects of drugs, and therapeutic agents for almost all organ systems have been implicated. However, both these side-effects are usually mild or moderate, and rarely necessitate interruption of drug treatment. An exception to this rule is the antibiotic-associated colitis seen in patients treated with antibiotics such as lincomycin or clindamycin; in principle almost all antibiotics may cause this severe and potentially life-threatening complication. Other rare forms of severe, drug-induced colitis and diarrhoea result from toxic or anaphylactic reactions against gold preparations, cytostatic agents and sulphonamides.
Ischaemic colitis
due to vascular complications has been described in some women taking oral contraceptives, and in patients treated with
vasopressin
or digitalis.
...
PMID:Diarrhoea and constipation. 304 67
This paper reports a case of
ischaemic colitis
observed in a male patient with acute oesophageal variceal bleeding treated with Glypressin (triglycyl lysine
vasopressin
). The therapeutic effect of this substance depends on the lowering of the portal vein pressure brought about by a vasoconstriction of the vessels of the splanchnic region. The undesired complication of
ischaemic colitis
occurred as a result of a reduction in blood flow to the colonic mucosa.
...
PMID:Ischaemic colitis in a patient treated with glypressin for bleeding oesophageal varices. 349 79
The mesenteric hemodynamic response to circulatory shock is characteristic and profound; this vasoconstrictive response disproportionately affects both the mesenteric organs and the organism as a whole. Vasoconstriction of post-capillary mesenteric venules and veins, mediated largely by the alpha-adrenergic receptors of the sympathetic nervous system, can effect an "autotransfusion" of up to 30% of the total circulating blood volume, supporting cardiac filling pressures ("preload"), and thereby sustaining cardiac output at virtually no cost in nutrient flow to the mesenteric organs. Under conditions of decreased cardiac output caused by cardiogenic or hypovolemic shock, selective vasoconstriction of the afferent mesenteric arterioles serves to sustain total systemic vascular resistance ("afterload"), thereby maintaining systemic arterial pressure and sustaining the perfusion of non-mesenteric organs at the expense of mesenteric organ perfusion (Cannon's "flight or fight" response). This markedly disproportionate response of the mesenteric resistance vessels is largely independent of the sympathetic nervous system and variably related to
vasopressin
, but mediated primarily by the renin-angiotensin axis. The extreme of this response can lead to gastric stress erosions, nonocclusive mesenteric ischemia,
ischemic colitis
, ischemic hepatitis, ischemic cholecystitis, and/or ischemic pancreatitis. Septic shock can produce decreased or increased mesenteric perfusion, but is characterized by an increased oxygen consumption that exceeds the capacity of mesenteric oxygen delivery, resulting in net ischemia and consequent tissue injury. Mesenteric organ injury from ischemia/reperfusion due to any form of shock can lead to a triggering of systemic inflammatory response syndrome, and ultimately to multiple organ dysfunction syndrome. The mesenteric vasculature is therefore a major target and a primary determinant of the systemic response to circulatory shock.
...
PMID:The mesenteric hemodynamic response to circulatory shock: an overview. 1133 91
Early attempts of using embolization for lower gastrointestinal hemorrhage were fraught with complications, most notably
ischemic colitis
or bowel infarction. Embolotherapy was eventually abandoned in favor of catheter-directed vasoconstriction (i.e.,
vasopressin
infusion). This latter therapy is time and labor intensive. With the advent of microcatheter technology, superselective embolization emerged and is rapidly becoming the endovascular therapy of choice for patients with severe lower gastrointestinal hemorrhage refractory to medical management. Numerous studies on the subject have consistently reported high clinical success with low ischemic complications. This article will review the current status of co-axial microcatheter embolization with an emphasis on the technical aspects of the procedure.
...
PMID:Microcatheter embolization of lower gastrointestinal hemorrhage: an old idea whose time has come. 1557 34
Acute lower gastrointestinal bleeding (LGIB), defined as hemorrhage into the gastrointestinal tract distal to the ligament of Treitz, is a major cause of morbidity and mortality among adults. Overall, mortality rates are estimated between 2.4% and 3.9%. The most common etiology for LGIB is diverticulosis, implicated in approximately 30% of cases, with other causes including hemorrhoids,
ischemic colitis
, and postpolypectomy bleeding. Transcatheter visceral angiography has begun to play an increasingly important role in both the diagnosis and treatment of LGIB. Historically, transcatheter visceral angiography has been used to direct
vasopressin
infusion with embolization reserved for treatment of upper gastrointestinal bleeding. However, advances in microcatheter technology and embolotherapy have enabled super-selective embolization to emerge as the treatment of choice for many cases of LGIB.
...
PMID:Management of Acute Lower Gastrointestinal Bleeding. 2922 58