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Ayad Ahmad Mohammed, Sardar Hasan Arif, Abdulwahid M Salih, Fahmi Hussein Kakamad
Intestinal obstruction resulted from balloon migration is an extremely rare but serious late complication of the intragastric balloon (IGB). The aim of this study is to report a case of small bowel obstruction occurring in a middle age corpulent female following embedding of IGB. A 47-year-old obese female presented with abdominal pain, nausea, and vomiting for two days. She had a history of an endoscopically placed IGB nine months before presentation. Physical examination showed an obese woman with mild distress, and the right upper abdomen was tender...
November 2018: Annals of Medicine and Surgery
Kazuhiro Ota, Satoshi Kikutani, Yuka Kawasaki, Noriaki Sugawara, Satoshi Harada, Yuichi Kojima, Sadaharu Nouda, Toshihisa Takeuchi, Hiroshi Akutagawa, Kazuhide Higuchi
Herein, we report for the first time a case of a surficial superficial non-ampullary duodenal cancer causing obscure intestinal bleeding that was identified by small-bowel capsule endoscopy and treated by endoscopic mucosal resection. A 73-year-old man underwent upper gastrointestinal endoscopy to identify the cause of anemia. Although conventional duodenoscopy revealed a flat, elevated 5-mm lesion with a central recess and "milk-white mucosa" at the inferior duodenal angulus, capsule endoscopy revealed a white nodular 5-mm lesion with central recess at the duodenum slightly to the anal side from the major duodenal papilla...
September 26, 2018: Clinical Journal of Gastroenterology
Xiaobo Cai, Haiyun Zhang, Shenzheng Luo, Li Baiwen, Jing Ma, Lungen Lu, Xinjian Wan
BACKGROUND AND AIM: Endoscopic biliary drainage is difficult in patients with biliary obstruction combined with gastric outlet stricture (GOS). Endoscopic ultrasound is useful for such patients, but needs advanced technique and sophisticated equipment. This study aimed to evaluate the efficacy and safety of conventional endoscopic retrograde cholangiopancreatography (ERCP) in patients with GOS and biliary obstruction without the assistance of endoscopic ultrasound. PATIENTS AND METHODS: Seventy-four patients with GOS proximal to the ampulla and biliary obstruction, including 27 with benign GOS and 47 with malignant GOS, were retrospectively enrolled...
November 2018: European Journal of Gastroenterology & Hepatology
Duygu Kara, Nevzat Aykut Bayrak, Burcu Volkan, Cihat Uçar, Mehmet Nuri Cevizci, Sedat Yılmaz
OBJECTIVES: Esophagogastroduodenoscopy (EGD) can cause fear and anxiety in children. Cortisol, which is the most important glucocorticoid hormone in humans, can increase under physiological stress. The purpose of this study was to measure the salivary cortisol level (SCL) and anxiety level in patients undergoing EGD and evaluate their effects on the procedure. METHODS: Children undergoing EGD under sedoanalgesia with propofol for various reasons were included. Their basal SCLs were compared with those of healthy age- and sex-matched controls...
August 30, 2018: Journal of Pediatric Gastroenterology and Nutrition
Chad Bisambar, Andrew Collier, Fraser Duthie, Carron Meney
A 40-year-old Caucasian female presented with hyperglycaemia, polyuria, polydipsia and weight loss of 6 kg over a 1-month period. There was no personal or family history of malignancy or diabetes mellitus. On examination, she was jaundiced with pale mucous membranes and capillary glucose was 23.1 mmol/L. Initial investigations showed iron deficiency anaemia and obstructive pattern of liver function tests. HbA1c was diagnostic of diabetes mellitus at 79 mmol/mol. Malignancy was suspected and CT chest, abdomen and pelvis showed significant dilatation of intra- and extra-hepatic biliary tree including pancreatic duct, with periampullary 30 mm mass lesion projecting into lumen of duodenum...
2018: Endocrinology, Diabetes & Metabolism Case Reports
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
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
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
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)
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
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...
September 2018: Obesity Surgery
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
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
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
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
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
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
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
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
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
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