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J Gastroenterol Dig Dis 2017 | Volume 2, Issue 3
World Gastroenterological &
Gastroenterology and Endoscopy
October 30-31, 2017 | Toronto, Canada
World Congress on
Combined endoscopic and surgical treatment of severe GI bleeding in a patient with heart assist
device under therapeutic anticoagulation
Mohamed Bounnah
1
, Edris Wedi
2, 3
, Riccardo Memeo
4, 5
and
Carlo Jung
2,3
1
Public Hospital Establishment Mohamed Boudiaf, Algeria
2
University Hospitals, France
3
Goettingen University Hospital, Germany
4
University Hospitals, France
5
Ospedale Regionale F Miulli, Italy
G
I bleeding is a common complication in patients
with heart assist device. Reasons for bleeding are
multifactorial. In general endoscopic therapy is the
treatment of choice whereas more invasive procedures
are avoided in these critically ill patients. We present a 65-
year old male patient suffering from severe gastrointestinal
bleeding after left and right ventricular assist device
placement with therapeutic anticoagulation. Endoscopically,
multiple gastric bleeding sources were found but couldn’t be
treated effectively because of a large blood clot. Therefore,
a combined multimodal endoscopical and surgical approach
was applied, including gastrotomy for removal of the blood
clot, surgical transgastrical suturing, and luminal endoscopic
over-the-scope clip (OTSC) placement as well as hemospray
application. Postoperative endoscopic visualization showed
effective bleeding control. The patient unfortunately died
due to causes unrelated to endoscopic/surgical treatment.
This case shows that a combination of endoscopic and
surgical techniques as a minimal invasive option can be an
alternative for the treatment of severe upper GI bleeding in
critically ill and anticoagulated patients unfit for gastrectomy.
Speaker Biography
Mohamed Bounnah has possessed his expertise in digestive endoscopy of the passion
he feels for this field and the different international exchanges that he may have had
during his training, the approach of endoscopy and surgery leaves immersed new
techniques in endoscopy and opens new perspectives for the care of the patients
who other times were in surgery this border between the two domains all arouses its
interest to implement a new approach and technique with the different teams with
whom he has already worked.
e:
dr.bounnah@gmail.com