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All Journal The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy
Hasan Maulahela, Hasan
Unknown Affiliation
Health Professions Medicine & Pharmacology

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Small Bowel Malignancy in Patient with Obscure Gastrointestinal Bleeding in Cipto Mangunkusumo Hospital, Diagnosed Using Double Balloon Enteroscopy: A Case Series Maulahela, Hasan; Fauzi, Achmad
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 2 (2017): VOLUME 18, NUMBER 2, August 2017
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (788.631 KB) | DOI: 10.24871/1822017118-121

Abstract

Small bowel malignancy is still a rare case as a cause of gastrointestinal bleeding. The symptoms of small bowel malignancy are not specific.  One of the symptoms is obscure gastrointestinal bleeding.  Obscure gastrointestinal bleeding (OGIB) is defined as recurrent or persistent gastrointestinal bleeding when the result esophagogastroduodenoscopy and colonic endoscopy is negative. OGIB accounts for approximately 5% of all gastrointestinal bleeding events. Most OGIB events are attributable to small bowel disease. Double-balloon enteroscopy, also known as push-and-pull enteroscopy is an endoscopic technique for visualization of the small bowel. Here we present 5 cases of small bowel tumours in patient with obscure gastrointestinal bleeding who underwent double balloon enteroscopy at Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Three patients had confirmed gastrointestinal stromal tumour (GIST) from the histopathology examination, while 2 patients were diagnosed with adenocarcinoma.
Colorectal Cancer: Epidemiological Trends, Screening, and Inheritability Paramita, Isabela Andhika; Maulahela, Hasan; Winston, Kevin
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 3 (2018): VOLUME 19, NUMBER 3, December 2018
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (144.723 KB) | DOI: 10.24871/1932018163-169

Abstract

Colorectal cancer is one of the most common cancer worldwide. The incidence and mortality trend in different areas of the world varies. Colorectal cancer incidence and mortality are increasing in some countries. There are also epidemiological shift towards younger age  (below 40). Most common non-invasive screening tests are fecal immunochemistry test (FIT) and fecal occult blood test (FOBT). Both have good sensitivity. The best invasive method for colorectal screening is still colonoscopy. Hereditary colorectal cancer is an important factor in younger age colorectal cancer. Familial adenomatous polyposis and Lynch syndrome are most common hereditary CRC. In familial or hereditary CRC, the chance of developing the cancerous form of the disease is nearly inevitable. Genetic testing may benefit the patients and their future progenies.
Unusual Case of Massive Obscure Gastrointestinal Bleeding: Ectopic Varices in Jejunum Caused by Arteriovenous Malformation Syam, Ari Fahrial; Maulahela, Hasan; Renaldi, Kaka
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 1 (2018): VOLUME 19, NUMBER 1, April 2018
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (542.682 KB) | DOI: 10.24871/191201856-58

Abstract

Small bowel ectopic varices is a rare etiology for obscure gastrointestinal bleeding. Ectopic varices in the absence of portal hypertension can be caused by congenital or familial conditions (e.g. malformation of vessel). Bleeding caused by ectopic varices can be massive and life threatening. Single Balloon Enteroscopy (SBE) is one of diagnostic modalities for obscure gastrointestinal bleeding. We report one case of obscure overt gastrointestinal bleeding with sub-acute onset. Previous esophagogastroduodenoscopy and colonoscopy cannot found the source of bleeding. On the enteroscopy we found varices at proximal jejunum with active bleeding during procedure. We applied hemostatic powder to stop the bleeding and proceed to surgery. Surgery was performed by enteroscopy guide. The jejunum section with varices was resected and the pathology confirmed the malformation of arteriovenous. Currently there is no available guideline or randomized study for the treatment of ectopic varices. Treatment options include ligation, sclerotherapy, surgery and interventional radiology. In this patient we choose surgery because of massive gastrointestinal bleeding.
Co-Authors Achmad Fauzi Amanda P Utari, Amanda P Ari F Syam Ari Fahrial Syam Dadang Makmun Gurmeet Singh Kaka Renaldi Marcellus Simadibrata Murdani Abdullah Nur Atikah Paramita, Isabela Andhika Rahmat Cahyanur Winston, Kevin