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Gastrointestinal Endoscopy Clinics of North America

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https://www.readbyqxmd.com/read/29933784/prevention-of-recurrent-lower-gastrointestinal-hemorrhage
#1
REVIEW
Shivani Gupta, David A Greenwald
This article summarizes current knowledge regarding the incidence of and risk factors associated with recurrent lower gastrointestinal hemorrhage. The literature regarding medical, endoscopic, and surgical methods to prevent rebleeding from diverticulosis, angioectasia, and chronic hemorrhagic radiation proctopathy is reviewed. In addition, the evidence for endoscopic clipping as primary prophylaxis against postpolypectomy bleeding is explored.
July 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29933783/the-role-of-endoscopic-hemostasis-therapy-in-acute-lower-gastrointestinal-hemorrhage
#2
REVIEW
Roy Soetikno, Naoki Ishii, Jennifer M Kolb, Hazem Hammad, Tonya Kaltenbach
Acute severe lower gastrointestinal bleeding (LGIB) can be treated by endoscopy safely and effectively. At present, the data on the efficacy of endoscopy in the treatment of patients with LGIB are still being collected. Thus, guidelines to manage patients with LGIB are still in development. Herein, based on the recent literature and their twenty year experience in their units in the US and in Japan, the authors summarize the role of endoscopic hemostasis therapy in acute severe LGIB with a focus on how to perform the hemostasis techniques...
July 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29933782/colonoscopy-in-acute-lower-gastrointestinal-bleeding-diagnosis-timing-and-bowel-preparation
#3
REVIEW
Kendall R Beck, Amandeep K Shergill
Lower gastrointestinal bleeding is bleeding from a colonic source. Rapid colon purge using 4 to 6 L of polyethylene glycol followed by early colonoscopy, within 24 hours of presentation, is recommended to optimize the detection and management of bleeding sources. Although the data are mixed, early colonoscopy seems to be associated with higher detection of bleeding lesions and therapeutic interventions. There is no clear benefit for early colonoscopy in terms of reduced duration of stay, rebleeding, transfusion requirement, or surgery compared with patients undergoing elective colonoscopy...
July 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29933781/patient-presentation-risk-stratification-and-initial-management-in-acute-lower-gastrointestinal-bleeding
#4
REVIEW
Majid A Almadi, Alan N Barkun
The approach to lower gastrointestinal bleeding (LGIB) has evolved over the last few years to incorporate a multidisciplinary management strategy. Although the causes of LGIB vary depending on the age and comorbid conditions of patients, the initial resuscitation and principles of optimizing patients' condition before endoscopic evaluation, when appropriate, are the cornerstones to clinical care. The role of risk stratification is to triage patients as well as to mobilize health care resources based on predicted outcomes...
July 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29933780/managing-antithrombotic-agents-in-the-setting-of-acute-gastrointestinal-bleeding
#5
REVIEW
Moe H Kyaw, Francis K L Chan
The incidence of antithrombotic-associated gastrointestinal (GI) bleeding is increasing due to the growing advanced age population. There is consensus on ceasing anticoagulant and antiplatelet agents during an acute GI bleeding episode but clearer guidance is needed on resumption of these agents. This article reviews evidence for optimal management of antithrombotics in the setting of acute GI bleeding and highlights areas in which future studies are needed.
July 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29933779/the-role-of-transcatheter-arterial-embolization-in-the-management-of-nonvariceal-upper-gastrointestinal-bleeding
#6
REVIEW
Dan E Orron, Allan I Bloom, Ziv Neeman
Nearly 50 years ago, catheter angiography was introduced as a means of both diagnosing and treating nonvariceal upper gastrointestinal bleeding. Technological advances and innovations have resulted in the introduction of microcatheters that, using a coaxial technique, are capable of selecting third-order arterial branches and of delivering a wide array of embolic agents. This article reviews the imaging diagnosis of nonvariceal upper gastrointestinal bleeding, the techniques of diagnostic and therapeutic angiography, the angiographic appearance of the various etiologies of nonvariceal upper gastrointestinal bleeding, the rationale behind case-specific selection of embolic agents as well as the anticipated outcome of transcatheter arterial embolization...
July 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29933778/the-cutting-edge-doppler-probe-in-guiding-endoscopic-hemostasis
#7
REVIEW
Kevin A Ghassemi, Dennis M Jensen
This article examines use of the Doppler endoscopic probe (DEP) for risk stratification and as a guide to definitive hemostasis of nonvariceal upper gastrointestinal (NVUGI) bleeding and colonic diverticular hemorrhage. Studies report that lesions with high-risk stigmata of recent hemorrhage (SRH) have a higher rate of a positive DEP signal compared with those without such SRH. Lesions with a persistently positive DEP signal after endoscopic hemostasis have a higher 30-day rebleeding rate. Studies document arterial blood flow underneath stigmata of recent hemorrhage as a risk factor for rebleeding of focal nonvariceal gastrointestinal lesions...
July 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29933777/emerging-endoscopic-treatments-for-nonvariceal-upper-gastrointestinal-hemorrhage
#8
REVIEW
Alvaro Martínez-Alcalá, Klaus Mönkemüller
Despite major improvements in endoscopic devices and therapeutic endoscopy, rebleeding rates and mortality have remained the same for several decades. Therefore, much interest has been paid to emerging therapeutic devices, such as the over-the-scope clip and hemostatic sprays. Other emerging technologies, such as radiofrequency ablation, endoscopic suturing devices, and ultrasound-guided angiotherapy, are also being investigated to improve therapeutic outcomes in specific situations. This narrative review details the technical aspects, clinical applications, outcomes, and potential limitations of these devices in the context of nonvariceal upper gastrointestinal hemorrhage...
July 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29933776/endoscopic-management-of-nonvariceal-nonulcer-upper-gastrointestinal-bleeding
#9
REVIEW
Michael A Chang, Thomas J Savides
Nonvariceal, nonulcer upper gastrointestinal hemorrhage (UGIH) is a less common cause for acute upper gastrointestinal bleeding. However, nonvariceal, nonulcer UGIH is an important entity to identify and treat appropriately to prevent bleeding-related morbidity and mortality. Over the past 40 years, there has been a revolution in gastrointestinal endoscopy and a similar revolution in the management of UGIH. The aim of this article is to focus on the endoscopic management of nonvariceal, nonulcer UGIH, with a focus on the newer diagnostic and treatment modalities currently available...
July 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29933775/endotherapy-of-peptic-ulcer-bleeding
#10
REVIEW
Debbie Troland, Adrian Stanley
Peptic ulcer bleeding is common and associated with significant morbidity and mortality. We discuss the endoscopic assessment of peptic ulcers and the rationale for treatment. We also review the evidence for the available endoscopic therapies, both individually and in combination, to draw conclusions on the optimum endoscopic management of peptic ulcer bleeding.
July 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29933774/initial-assessment-risk-stratification-and-early-management-of-acute-nonvariceal-upper-gastrointestinal-hemorrhage
#11
REVIEW
Jennifer X Cai, John R Saltzman
Inhospital mortality from nonvariceal upper gastrointestinal bleeding has improved with advances in medical and endoscopy therapy. Initial management includes resuscitation, hemodynamic monitoring, proton pump inhibitor therapy, and restrictive blood transfusion. Risk stratification scores help triage bleeding severity and provide prognosis. Upper endoscopy is recommended within 24 hours of presentation; select patients at lowest risk may be effectively treated as outpatients. Emergent endoscopy within 12 hours does not improve clinical outcomes, including mortality, rebleeding, or need for surgery, despite an increased use of endoscopic treatment...
July 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29519338/lumen-apposing-stents-an-important-step-forward
#12
EDITORIAL
Jacques Van Dam
No abstract text is available yet for this article.
April 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29519337/lumen-apposing-metal-stents-an-important-new-tool-for-interventional-endoscopy-comes-of-age
#13
EDITORIAL
Charles J Lightdale
No abstract text is available yet for this article.
April 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29519336/how-the-experts-do-it-step-by-step-guide
#14
REVIEW
Ji Young Bang, Shyam Varadarajulu
Lumen-apposing metal stents are integrated in a single-step delivery system for draining intra-abdominal fluid collections. The theoretic advantage of lumen-apposing stents is the ability to approximate the wall of the drained cavity or organ to the gastrointestinal tract lumen. The use of lumen-apposing stents now includes drainage of organs adjacent to the stomach/duodenum and creation of anastomosis between the stomach and jejunum. The lumen-apposing stents may also serve as a conduit for accessing the remnant stomach for performing biliary tract interventions...
April 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29519335/endoscopic-closure-of-gastrointestinal-fistulae-and-leaks
#15
REVIEW
Jaehoon Cho, Ara B Sahakian
The development of new endoscopic techniques, such as gastrointestinal (GI) stenting, full-thickness suturing, clip application, and use of tissue adhesives, has had a significant impact on management of GI fistulae. These techniques have shown promising results, but further study is needed to optimize the efficacy of long-term closure. The advancement of endoscopic techniques, including the use of the lumen apposing metal stent (LAMS), has allowed for the deliberate creation of fistula tracts to apply endoscopic therapy that previously could not be achieved...
April 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29519334/avoidance-recognition-and-management-of-complications-associated-with-lumen-apposing-metal-stents
#16
REVIEW
Stuart K Amateau, Martin L Freeman
The lumen-apposing metal stent has evolved endoscopic transluminal therapies, although it has potential complications, including maldeployment, bleeding, perforation, migration, and several risks specific to necrotizing pancreatitis. Careful planning and technique mitigate these inherent risks of lumen-apposing metal sent deployment; however, setbacks occur even in the most experienced of hands. Therefore, early recognition and management of these complications are critical to alleviating morbidity and avoiding mortality...
April 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29519333/lumen-apposing-metal-stents-which-one-and-why
#17
REVIEW
Matthew W Stier, Irving Waxman
Numerous lumen-apposing metal stents (LAMS) have been designed for transluminal applications, including complex pancreatic fluid collections (PFCs) and difficult biliary access. Limited high-quality data exist directly comparing the various LAMS models, and their use remains largely dependent on availability and operator expertise. LAMS placement has been streamlined by the addition of electrocautery, allowing for single-step or modified "hot" approach, if desired. Therapeutic endoscopists continue to explore the application of this technology in a variety of clinical scenarios, and future innovations will be needed to meet these evolving clinical demands...
April 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29519332/novel-uses-of-lumen-apposing-metal-stents
#18
REVIEW
Monica Saumoy, Clark Yarber, Michel Kahaleh
The lumen apposing metal stent (LAMS) has historically been used for drainage of pancreatic fluid collections. The unique design of this stent has allowed endoscopists to develop novel uses, including drainage of abscesses adjacent to gastrointestinal lumens, maintaining patency in gastrointestinal strictures, and creating a fistulous tract to bypass altered or compromised anatomy. These alternative uses for the LAMS take advantage of its ability to form a sealed, well-approximated anastomosis. Future applications of the LAMS are continuously being developed as clinicians provide minimally invasive approaches for management of these disease processes...
April 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29519331/endoscopic-ultrasound-guided-gallbladder-drainage
#19
REVIEW
Ryan Law, Todd H Baron
Recent literature has demonstrated effectiveness and safety of endoscopic ultrasound-guided gallbladder drainage, both as a primary intervention in patients with cholecystitis who are unfit for urgent surgical intervention and as a secondary intervention to internalize biliary drainage after initial placement of a percutaneous cholecystostomy catheter.
April 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29519330/endoscopic-ultrasound-guided-biliary-drainage
#20
REVIEW
Brian R Boulay, Simon K Lo
Endoscopic ultrasound (EUS)-guided biliary drainage is an emerging technique that combines the advantages of the endoscopic and percutaneous approaches, without the inconveniences and discomfort of an indwelling external catheter. There has been growing interest and experience in EUS-biliary drainage. Several different EUS-guided techniques have been developed to access the obstructed biliary tree from either the stomach or duodenum, according to the location of the stricture, the anatomy of the patient, and the experience of the endoscopist...
April 2018: Gastrointestinal Endoscopy Clinics of North America
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