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Duodenoscopy

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https://www.readbyqxmd.com/read/30032885/determination-of-the-median-effective-dose-of-propofol-in-combination-with-different-doses-of-ketamine-during-gastro-duodenoscopy-in-children-a-randomised-controlled-trial
#1
J Hayes, C Matava, C Pehora, H El-Beheiry, S Jarvis, Y Finkelstein
BACKGROUND: Propofol is used to induce deep sedation or general anaesthesia for procedures in children. Adjuvants, such as ketamine, are routinely added to reduce the dose of propofol required and propofol-related adverse events. We conducted a randomised controlled trial to determine the effective bolus dose of propofol in combination with ketamine that induces adequate depth of anaesthesia in 50% of children (ED50 ) undergoing gastro-duodenoscopy. METHODS: Children were randomised to one of four doses of ketamine: 0 (control), 0...
August 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29971260/improving-the-mucosal-visualization-at-gastroscopy-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials-reporting-the-role-of-simethicone-%C3%A2-n-acetylcysteine
#2
Muhammad Shafique Sajid, Saad Rehman, Fergus Chedgy, Krishna K Singh
Background: The objective of this article is to study the role of Simethicone ± N-acetylcysteine in improving the mucosal visualization during oesophago-gastro-duodenoscopy (OGD). Methods: The data retrieved from the published randomized controlled trials (RCTs) reporting the role of Simethicone ± N-acetylcysteine during OGD was analysed using the principles of meta-analysis. The summated outcome of continuous variables was expressed as standardized mean difference (SMD) and dichotomous data was presented in odds ratio (OR)...
2018: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29940643/a-rare-case-of-signet-ring-cell-carcinoma-associated-with-poorly-differentiated-adenocarcinoma-of-the-non-ampullary-duodenum
#3
Cosmin Caraşca, George Simion, Adela Corina Nechifor-Boilă, Alina Mioara Boeriu, Ecaterina Daniela Dobru
Primary duodenal cancer is a rare entity accounting for only 0.3% of all gastrointestinal cancers. Histopathologically, most duodenal cancers are mucin-producing adenocarcinomas, 34% being poorly differentiated. Signet-ring cell (SRC) carcinoma is extremely uncommon in the duodenum. Herein, we report a rare case of SRC carcinoma associated with poorly differentiated adenocarcinoma of the non-ampullary duodenum in a 74-year-old woman. The patient was admitted to the hospital for persistent epigastric pain, significant weight loss and hypochromic microcytic anemia...
2018: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/29742689/total-robotic-surgery-for-pancreaticoduodenectomy-combined-with-rectal-cancer-anterior-resection-a-case-report-and-literature-review
#4
QunGuang Jiang, TaiYuan Li, DongNing Liu, Cheng Tang
RATIONALE: Synchronous double malignancies, including carcinoma of the ampulla of Vater and rectal carcinoma, are generally uncommon occurrences in the gastrointestinal tract. PATIENT CONCERNS: The present study report a case of a 37-year-old man who was incidentally found to suffer from carcinoma of the ampulla of Vater and rectal carcinoma. DIAGNOSES: The duodenoscopy was performed and revealed an ulcerated and bulky ampulla of Vater, the biopsy from which revealed a moderate-differentiated adenocarcinoma, A local hospital colonoscopy confirmed a tumor located in rectal 7 cm from the anal margin and biopsy-confirmed poorly differentiated adenocarcinoma...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29684421/duodenoscopy-an-amplifier-of-cross-transmission-during-a-carbapenemase-producing-enterobacteriaceae-outbreak-in-a-gastroenterology-pathway
#5
C Bourigault, F Le Gallou, N Bodet, N Musquer, M-E Juvin, S Corvec, N Ferronnière, S Wiesel, J Gournay, G Birgand, M Le Rhun, D Lepelletier
Carbapenemase-producing Klebsiella pneumoniae (OXA-48 CPE) were identified in five patients who underwent an endoscopy with the same duodenoscope in October 2015. The endoscope was the only epidemiological link between these cases. A transient contamination of the duodenoscope following a failure in the disinfection process may have been the cause of transmission.
August 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29681019/high-percentage-pathological-findings-in-obese-patients-suggest-that-esophago-gastro-duodenoscopy-should-be-made-mandatory-prior-to-bariatric-surgery
#6
Mizelle D'Silva, Aparna Govil Bhasker, Nimisha S Kantharia, Muffazal Lakdawala
ᅟ: Obesity is a global epidemic and will soon become the number one priority in healthcare management. Bariatric surgery causes a significant improvement in obesity and its related complications. Pre-operative esophago-gastro-duodenoscopy (EGD) is done by several bariatric surgical teams across the world but is still not mandatory. AIM: To study the percentage of symptomatic and asymptomatic pathological EGD findings in obese patients undergoing bariatric surgery and to analyze whether these findings influence the eventual choice of bariatric surgery...
April 21, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29526961/choledochoduodenal-fistula-during-chemotherapy-with-brentuximab-vedotin-for-methotrexate-associated-lymphoproliferative-disorder
#7
Yuji Eso, Norimitsu Uza, Kotaro Shirakawa, Kenji Sawada, Kentaro Katsuragi, Minoru Matsuura, Hiroshi Seno
We herein report a patient with a history of rheumatoid arthritis treated with methotrexate, which caused methotrexate-associated lymphoproliferative disorder and obstructive jaundice due to an enlarged lymph node. The obstructive jaundice was treated with endoscopic biliary stenting. A histopathological examination revealed features of Hodgkin's lymphoma, and chemotherapy with brentuximab vedotin was administered. Cholangiography and duodenoscopy after four rounds of chemotherapy revealed a choledochoduodenal fistula that developed in response to chemotherapy...
August 1, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29488595/-chronic-and-severe-anemia-caused-by-ancylostoma-duodenale-in-ecuador-diagnosis-by-duodenoscopy
#8
Manuel Calvopiña, Jessica Flores, Isabel Guaman, Gabriela Lara, Jeyson Abarca
For 11 years, a 38-year-old male residing in a subtropical region of Ecuador, was repeatedly diagnosed with chronic anemia, and treated with blood transfusions in a hospital of province of Cotopaxi, Ecuador. He was transferred to Quito for severe anemia, having hemoglobin of 4 g/dL. Duodenoscopy was performed and adult nematodes, identified later as Ancylostoma duodenale, were observed. The patient was successfully treated with albendazole for five consecutive days and given blood transfusions. In the control visit at eight months, without anemia and no hookworm ova in the stool examined were found...
October 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/29484072/percutaneous-transgastric-interventional-radiology-operated-duodenoscopy-for-the-identification-of-duodenal-perforation-and-graham-patch-dehiscence
#9
Ravi Nara Srinivasa, Matthew L Osher, Douglas A Murrey, Jordan Bruce Fenlon, Charles Brewerton, Wael E Saad, Jeffrey Forris Beecham Chick
Patients with a Roux-en-Y gastric bypass may be challenging diagnostic and therapeutic dilemmas for gastroenterologists and endoscopists due to anatomic considerations. Pancreaticobiliary limb pathology is particularly difficult to diagnose from standard endoscopic approaches as it often requires double balloon enteroscopy. Percutaneous access and gastrostomy placement into the gastric remnant, however, is a commonly performed procedure by interventional radiology. This report describes the identification of duodenal perforation and Graham patch dehiscence in the pancreaticobiliary limb of a patient with a prior Roux-en-Y gastric bypass who had failed traditional endoscopic measures, using transgastric remnant interventional duodenoscopy and confirmed with methylene blue injection into a periduodenal abscess...
December 2017: Radiology Case Reports
https://www.readbyqxmd.com/read/29352618/point-shear-wave-elastography-of-the-spleen-its-role-in-patients-with-portal-hypertension
#10
Natalie Lucchina, Chiara Recaldini, Monica Macchi, Valeria Molinelli, Mario Montanari, Sergio Segato, Raffaele Novario, Carlo Fugazzola
The goals of the study described here were to evaluate the feasibility and reproducibility of measuring spleen stiffness (SS) using point shear wave elastography in a series of cirrhotic patients and to investigate whether SS, liver stiffness (LS) and other non-invasive parameters are correlated with the presence of esophagogastric varices (EVs). Fifty-four cirrhotic patients with low-grade EVs or without EVs at esophago-gastro-duodenoscopy were enrolled. They underwent abdominal ultrasound and Doppler ultrasound of hepatic vessels simultaneously with p-SWE of the liver and spleen...
April 2018: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/29327262/risk-of-neoplastic-progression-among-patients-with-an-irregular-z-line-on-long-term-follow-up
#11
David Itskoviz, Zohar Levi, Doron Boltin, Alex Vilkin, Yifat Snir, Rachel Gingold-Belfer, Yaron Niv, Iris Dotan, Ram Dickman
BACKGROUND: Barrett's esophagus (BE) is a known complication of gastroesophageal reflux disease. In a previous study, we described a high prevalence of intestinal metaplasia (IM) in patients with an irregular Z line. However, the clinical importance of this finding is unclear. GOALS: To evaluate the long-term development of BE and relevant complications in patients diagnosed with an irregular Z line, with or without IM, on routine esophago-gastro-duodenoscopy (EGD)...
June 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29280782/management-of-acute-pancreatitis-in-the-pediatric-population-a-clinical-report-from-the-north-american-society-for-pediatric-gastroenterology-hepatology-and-nutrition-pancreas-committee
#12
Maisam Abu-El-Haija, Soma Kumar, Jose Antonio Quiros, Keshawadhana Balakrishnan, Bradley Barth, Samuel Bitton, John F Eisses, Elsie Jazmin Foglio, Victor Fox, Denease Francis, Alvin Jay Freeman, Tanja Gonska, Amit S Grover, Sohail Z Husain, Rakesh Kumar, Sameer Lapsia, Tom Lin, Quin Y Liu, Asim Maqbool, Zachary M Sellers, Flora Szabo, Aliye Uc, Steven L Werlin, Veronique D Morinville
BACKGROUND: Although the incidence of acute pancreatitis (AP) in children is increasing, management recommendations rely on adult published guidelines. Pediatric-specific recommendations are needed. METHODS: The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pancreas committee performed a MEDLINE review using several preselected key terms relating to management considerations in adult and pediatric AP. The literature was summarized, quality of evidence reviewed, and statements of recommendations developed...
January 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29181158/serum-pepsinogen-and-gastrin-17-as-potential-biomarkers-for-pre-malignant-lesions-in-the-gastric-corpus
#13
Tan Han Loong, Ngiu Chai Soon, Nik Ritza Kosai Nik Mahmud, Jeevinesh Naidu, Rafiz Abdul Rani, Nazefah Abdul Hamid, Marjanu Hikmah Elias, Isa Mohamed Rose, Azmi Tamil, Norfilza M Mokhtar, Raja Affendi Raja Ali
There is a lack of non-invasive screening modalities to diagnose chronic atrophic gastritis (CAG) and intestinal metaplasia (IM). Thus, the aim of the present study was to determine the sensitivity and specificity of serum pepsinogen I (PGI), PGI:II, the PGI:II ratio and gastrin-17 (G-17) in diagnosing CAG and IM, and the correlations between these serum biomarkers and pre-malignant gastric lesions. A cross-sectional study of 72 patients (82% of the calculated sample size) who underwent oesophageal-gastro-duodenoscopy for dyspepsia was performed in the present study...
November 2017: Biomedical Reports
https://www.readbyqxmd.com/read/29151478/low-incidence-of-esophageal-lesions-after-pulmonary-vein-isolation-using-contact-force-sensing-catheter-without-esophageal-temperature-probe
#14
Christian Blockhaus, Patrick Müller, Stephan Vom Dahl, Silke Leonhardt, Dieter Häussinger, Shqipe Gerguri, Lucas Clasen, Jan Schmidt, Muhammed Kurt, Christoph Brinkmeyer, Malte Kelm, Dong-In Shin, Hisaki Makimoto
Pulmonary vein isolation (PVI) is a cornerstone therapy for atrial fibrillation (AF). Although severe complications are rather rare, the development of an atrio-esophageal fistula (AEF) is a fatal complication with a very high mortality even after surgical treatment. The use of esophageal temperature probes (ETP) during PVI may protect the esophagus but it is still under debate since the ETP may also lead to esophageal lesions. The aim of this study was to evaluate the clinical safety of PVI using contact-force (CF) sensing catheter without esophageal temperature monitoring...
November 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29127130/eosinophilic-oesophagitis-and-coeliac-disease-is-there-an-association
#15
Ana Margarida Vaz, Antonio Jesus Cadilla, Diamantino Sousa, Horácio Guerreiro
A 25-year-old man was seen in outpatient clinic for progressive solid food dysphagia. He was already medicated with a proton pump inhibitor with no improvement. His blood tests showed a slight microcytic anaemia and peripheral eosinophilia. The oesophago-gastro-duodenoscopy showed longitudinal furrows in the distal two-thirds of the oesophagus and a concentric distal stenosis. The biopsies taken showed eosinophilic infiltrates consistent with eosinophilic oesophagitis. There was no improvement with topical fluticasone, so the patient was started on a systemic corticosteroid with resolution of dysphagia and of the oesophageal stenosis...
November 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29030368/iron-deficiency-anaemia-in-a-coeliac-a-cause-for-concern
#16
Niamh Peters, Donal Tighe
A 70-year-old woman with a 15-year history of coeliac disease was admitted for treatment and investigation of symptomatic anaemia. Of note, she was recently commenced on aspirin therapy for retinal artery occlusion. This followed a normal gastro-duodenoscopy, colonoscopy and CT abdomen as workup for iron deficiency anaemia. On this occasion, the patient was further investigated with small bowel capsule endoscopy. This revealed an ulcerated lesion in her proximal jejunum suspicious for malignancy, namely lymphoma...
October 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29026595/time-trend-occurrence-of-duodenal-intraepithelial-lymphocytosis-and-celiac-disease-in-an-open-access-endoscopic-population
#17
Gloria Galli, Flaminia Purchiaroni, Edith Lahner, Maria Carlotta Sacchi, Emanuela Pilozzi, Vito Domenico Corleto, Emilio Di Giulio, Bruno Annibale
BACKGROUND: Duodenal intraepithelial lymphocytosis (DIL) is a histological finding characterized by the increase of intraepithelial CD3T-lymphocytes over the normal value without villous atrophy, mostly associated to coeliac disease (CD), Helicobacter pylori (Hp) gastritis and autoimmune diseases. OBJECTIVE: To assess the occurrence of DIL, CD and Hp gastritis in an endoscopic population over a 13 year period. METHODS: From 2003 to 2015 we included adult patients who consecutively underwent oesophago-gastro-duodenoscopy (OGD) with duodenal biopsies assessing the overall and annual occurrence of DIL and CD and the prevalence of Hp gastritis...
October 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28975884/anaesthesia-in-patients-undergoing-esophago-gastro-duodenoscopy-for-suspected-bleeding
#18
Ida Helsø, Martin Risom, Therese Risom Vestergaard, Nicolai Bang Foss, Steffen Rosenstock, Morten Hylander Møller, Lars Hyldborg Lundstrøm, Nicolai Lohse
INTRODUCTION: Upper gastrointestinal bleeding (UGIB) is a common emergency. Currently, there are no agreed guidelines on the level of anaesthetic support required in patients undergoing acute esophago-gastro-duodendoscopy (EGD). METHODS: An online questionnaire comprising 19 questions was distributed to all members of the Danish Association of Anaesthesiology and Intensive Care (n = 1,418) and the Danish Society of Anaesthesiologists in Training (n = 566). The questions concerned clinical practice for anaesthesia care to patients undergoing EGD for suspected UGIB and availability of local guidelines...
October 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28943567/a-rare-case-of-ureteral-carcinoma-with-recurrence-in-the-duodenum-requiring-double-stenting
#19
Hiroyuki Matsubayashi, Hirotoshi Ishiwatari, Masaki Tanaka, Tomohiro Iwai, Toru Matsui, Shinya Fujie, Naomi Kakushima, Sayo Ito, Ryo Yamashita, Masato Abe, Keiko Sasaki, Hiroyuki Ono
A 61-year-old man who had undergone total nephrouretectomy eight months earlier for right ureteral carcinoma was referred for the investigation of elevated serum hepatobiliary enzymes. Computed tomography revealed a small mass invading the lower bile duct. Duodenoscopy revealed a central ulcerative tumor near the major papilla, and a biopsy histologically confirmed metastatic ureteral carcinoma. Endoscopic biliary stenting ameliorated the cholangitis, and gemcitabine-based chemotherapy was initiated. The patient was stable for a year until a duodenal stenosis developed and required duodenal stenting...
November 15, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28877814/limited-resection-of-the-duodenum-for-nonampullary-duodenal-tumors-with-review-of-the-literature
#20
REVIEW
Daisuke Hashimoto, Kota Arima, Akira Chikamoto, Katsunobu Taki, Risa Inoue, Takayoshi Kaida, Takaaki Higashi, Katsunori Imai, Toru Beppu, Hideo Baba
The surgical management of duodenal pathology is challenging because of its retroperitoneal position and shared blood supply with the pancreas. We present three types of limited resection of the duodenum for the removal of superficial or small nonampullary duodenal (NADL) lesions, and also a review of the English literature regarding management, such as endoscopic resection and limited duodenal resection. Ten cases underwent limited resections of the duodenum for superficial or small NADL lesions from 2011 to 2015...
November 1, 2016: American Surgeon
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