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Therapeutic endoscopy

Wen-Guo Chen, Guo-Dong Shan, Hong Zhang, Ming Yang, Lin L, Min Yue, Guang-Wu Chen, Qing Gu, Hua-Tuo Zhu, Guo-Qiang Xu, Li-Hua Chen
The aim of the study was to evaluate the diagnostic and therapeutic value of double-balloon entoroscopy (DBE) in small bowel diseases (SBDs) in China.A retrospective review of 674 consecutive patients who underwent DBE between January 2007 and November 2015 was conducted. Patients were divided into 3 groups by age, young group (<45 years), middle-aged group (45-65 years), and elderly group (>65 years). Data were collected with regard to demographics, clinical, endoscopic findings, complications, diagnostic yield, and management...
October 2016: Medicine (Baltimore)
Takaki Emura, Kenji Hosoda, Shota Harai, Noboru Oyachi, Takeyuki Suzuki, Ken Takada, Koji Kobayashi, Hisatake Ikeda
BACKGROUND: Massive gastrointestinal bleeding in children, mostly caused by esophageal varices secondary to chronic liver disease, is uncommon. Dieulafoy lesion in the gastrointestinal tract is a rare but important cause of gastrointestinal bleeding; massive bleeding from this lesion can be fatal unless adequate treatment is promptly initiated. We report a case of gastric Dieulafoy lesion in a 2-year old successfully treated with endoscopic hemoclipping. CASE PRESENTATION: A 2-year-old Japanese boy was admitted to our department with sudden massive hematemesis...
October 19, 2016: Journal of Medical Case Reports
Julian Panes, Vipul Jairath, Barrett G Levesque
Crohn's disease and ulcerative colitis are heterogeneous inflammatory bowel disease (IBD), and therapeutic requirements vary among patients. We have a limited capacity to predict disease progression for individual patients, so it is important that they are evaluated for presence of active disease when symptoms are mild or even absent, when patients are more likely to respond to new treatment interventions. It is then important to monitor responses to treatment, to quickly identify those therapies that are ineffective, modify or change therapy, and avoid disease complications...
October 14, 2016: Gastroenterology
Mohammad Minakari, Shervin Badihian, Pooyan Jalalpour, Vahid Sebghatollahi
BACKGROUND AND AIM: Upper gastrointestinal bleeding (UGIB) is a threatening condition leading to urgent hospitalization. This study aims to investigate etiology and outcome in UGIB patients in Iran. METHODS: Medical records of GIB patients admitted to Alzahra referral hospital (in Isfahan) during 2010-2015 were retrospectively reviewed for demographic data, comorbidities, history of smoking and taking non-steroidal anti-inflammatory drugs (NSAIDs), presenting symptoms, endoscopic findings, therapeutic endoscopy, blood products' infusion, surgical intervention and mortality...
October 17, 2016: Journal of Gastroenterology and Hepatology
Marlene Aagaard Hansen, Helle Ø Kristensen, Lars Maagaard Andersen
A 60-year-old male was admitted with acute abdominal pain and fever. Computed tomography (CT) of the abdomen revealed free air. Diagnostic laparoscopy showed a toothpick perforating the ventricle, and the toothpick was removed successfully. This condition is severe with a reported mortality of 9.6%. A practical guideline based on 136 cases was presented in 2014. Endoscopy was found to be superior to CT in identifying toothpicks as well as offering therapeutic intervention, rendering endoscopy the first choice in diagnostic and treatment...
October 17, 2016: Ugeskrift for Laeger
Yusuke Watanabe, Amin Madani, Elif Bilgic, Katherine M McKendy, Gada Enani, Iman Ghaderi, Gerald M Fried, Liane S Feldman, Melina C Vassiliou
BACKGROUND: General surgery residency may not adequately prepare residents for independent practice. It is unclear; however, if non-ACGME-accredited fellowships are better meeting training needs. The purpose of this mixed-method study was to determine perceived preparedness for practice and to identify gaps in fellowship training. METHODS: A survey was developed using an iterative qualitative methodology based on interviews and focus groups of graduated fellows and program directors...
October 14, 2016: Surgical Endoscopy
Kuk Hui Son, Chang-Hyu Choi, Jae-Ik Lee, Kun Woo Kim, Ji Sung Kim, So Young Lee, Kook Yang Park, Chul Hyun Park
BACKGROUND: Guidelines for esophagogastroduodenoscopy (EGD) in the West allow the continued use of warfarin under therapeutic international normalized ratio (INR) level. In Korea, no guidelines have been issued regarding warfarin treatment before EGD. The authors surveyed Korean cardiac surgeons about how Korean cardiac surgeons handle warfarin therapy before EGD using a questionnaire. Participants were requested to make decisions regarding the continuation of warfarin therapy in two hypothetical cases...
October 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Rebecca J Critchley-Thorne, Jon M Davison, Jeffrey W Prichard, Lia M Reese, Yi Zhang, Kathleen A Repa, Jinhong Li, David L Diehl, Nirag C Jhala, Gregory Ginsberg, Maureen DeMarshall, Tyler Foxwell, Blair A Jobe, Ali H Zaidi, Lucas C Duits, Jacques J G H M Bergman, Anil K Rustgi, Gary W Falk
BACKGROUND: There is a need for improved tools to detect high grade dysplasia (HGD) and esophageal adenocarcinoma (EAC) in patients with Barrett's esophagus (BE). In previous work, we demonstrated that a 3-tier classifier predicted risk of incident progression in BE. Our aim was to determine if this risk classifier could detect a field effect in non-dysplastic (ND), indefinite for dysplasia (IND) or low-grade dysplasia (LGD) biopsies from BE patients with prevalent HGD/EAC. METHODS: We performed a multi-institutional case-control study to evaluate a previously developed risk classifier that is based upon quantitative image features derived from 9 biomarkers and morphology, and predicts risk for HGD/EAC in BE patients...
October 11, 2016: Cancer Epidemiology, Biomarkers & Prevention
William L Hasler
Chronic unexplained nausea and vomiting (CUNV) refers to a symptom complex defined by nausea and/or vomiting with normal diagnostic testing, including anatomic assessments (including upper endoscopy) and measures of upper gut function (e.g., gastric emptying testing). Nausea and vomiting in this condition are postulated to result from aberrant peripheral or central neurohumoral activity. A substantial subset of patients satisfies this diagnosis as more than half of individuals referred for scintigraphic testing exhibit normal gastric emptying rates...
October 10, 2016: Current Treatment Options in Gastroenterology
Václav Hejda
Cirrhosis is the end stage of progressive development of different liver diseases and is associated with significant morbidity and mortality rates. Cirrhosis is associated with a number of potential complications, in particular with development of portal hypertension. Portal hypertension with the production of ascites, hepatic and gastric varices bleeding in the upper part of the gastrointestinal tract, presents the breakpoint in the natural course of cirrhosis, and it is associated with a considerably worse prognosis of patients, with a dramatically increased risk of mortality...
2016: Vnitr̆ní Lékar̆ství
Robert N Lopez, Steven T Leach, Daniel A Lemberg, Gilles Duvoisin, Richard B Gearry, Andrew S Day
Over the last two decades knowledge on faecal biomarkers has substantially increased. Nowadays these non-invasive markers of inflammation have significant clinical utility in the management of inflammatory bowel disease (IBD). Their use informs the decision to perform endoscopy before diagnosis is made right through to influencing therapeutic choices and the need for interval endoscopic assessment. In this review, the roles of two S100 proteins, calprotectin and S100A12 are described along with that of lactoferrin, in the context of IBD...
October 10, 2016: Journal of Gastroenterology and Hepatology
Nikhil Sonthalia, Samit S Jain, Ravindra G Surude, Vinay B Pawar, Suhas Udgirkar, Pravin M Rathi
Esophageal squamous cell carcinoma (ESCC) is the commonest primary malignant esophageal tumor, which typically presents as endoscopically visible surface mucosal ulcerations, irregularities, or polyploidal masses. We here report a rare case of primary ESCC with completely intramural growth under a normal looking intact nondysplastic surface squamous epithelium disguising as a submucosal tumor. Upper gastrointestinal endoscopy-guided mucosal biopsy was negative for malignancy. Endoscopic ultrasound (EUS) revealed a heteroechoic solid mass originating from the muscularis propria of the distal esophagus...
2016: Clinical Medicine Insights. Gastroenterology
Everson L A Artifon, Mauro E Ramirez, José C Ardengh, Maria Cristina Sartor, Gabriel M Favaro, Emilio Belmonte, Julio Lobo, Djalma Coelho, Julio Pereira-Lima, Cesar V Lopez, Sergio E Matuguma, Carlos K Furuya, Julio Pisani, Spencer Cheng, Marco A Buch, Tomazo Franzini, Tiago F Vilela, Ricardo Pessoa, Eduardo Bonin, Marcos Lera, Thaisa S Nakadomari, Leandro Y Kashiwagui, Marlus T Gerber, Ramiro Mascarenhas
Teaching models in endoscopy are important tools to minimize risks derived from endoscopic procedures, taking into account that therapeutic endoscopy, also known as surgical endoscopy, has greatly developed during the last decade. This results from the fact that minimally invasive procedures present relevant contributions and promote more comfort to patients. In this context, ex vivo teaching models and virtual simulators are important tools to the safe acquisition of abilities. In this article, the Brazilian Society of Digestive Endoscopy presents and describes its first course of therapeutic ERCP and EUS in models of laboratory teaching...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Rinaldo Pellicano, Davide G Ribaldone, Sharmila Fagoonee, Marco Astegiano, Giorgio M Saracco, Francis Mégraud
The discovery that the bacterium Helicobacter pylori (H. pylori) lives in the stomach has rendered out-of-date the concept of inhospitality of the gastric environment. H. pylori is able to survive in this organ through mechanisms of acid resistance and colonization factors. The prevalence of H. pylori infection varies depending on age, socioeconomic class, and country. Currently, in the context of a decreased trend in H. pylori prevalence, it is estimated that about 50% of the world's human population are carriers of the microorganism, with a higher rate in developing countries than in developed countries...
December 2016: Panminerva Medica
Piotr Eder, Liliana Łykowska-Szuber, Katarzyna Katulska, Kamila Stawczyk-Eder, Iwona Krela-Kaźmierczak, Katarzyna Klimczak, Aleksandra Szymczak, Marek Stajgis, Krzysztof Linke
INTRODUCTION: Objective assessment of Crohn's disease (CD) activity in patients treated with anti-tumour necrosis factor (anti-TNF) antibodies is crucial for the prediction of its long-term results. Mucosal healing estimated endoscopically has a strong predictive value; however, only combined assessment together with transmural healing in magnetic resonance enterography (MRE) gives full information about the whole spectrum of inflammatory lesions in CD. AIM: To assess the usefulness of intestinal healing phenomenon in CD, defined as improvement both in endoscopy and MRE, after anti-TNF induction therapy, in predicting long-term results of 1-year treatment...
2016: Przegla̜d Gastroenterologiczny
Furkan U Ertem, Wenqian Zhang, Kyle Chang, Wan Mohaiza Dashwood, Praveen Rajendran, Deqiang Sun, Ala Abudayyeh, Eduardo Vilar, Maen Abdelrahim, Roderick H Dashwood
Intervention strategies in familial adenomatous polyposis (FAP) patients and other high-risk colorectal cancer (CRC) populations have highlighted a critical need for endoscopy combined with safe and effective preventive agents. We performed transcriptome profiling of colorectal adenomas from FAP patients and the polyposis in rat colon (Pirc) preclinical model, and prioritized molecular targets for prevention studies in vivo. At clinically relevant doses in the Pirc model, the drug Clotam (tolfenamic acid, TA) was highly effective at suppressing tumorigenesis both in the colon and in the small intestine, when administered alone or in combination with Sulindac...
October 5, 2016: International Journal of Cancer. Journal International du Cancer
T Stuber, B Schmitz, H J Brambs
Introduction: Portal hypertension may lead to severe esophageal or rectal variceal bleeding. Case report: We present a case of a 67-year-old patient presenting with recurrent rectal variceal bleeding who was non-responsive to endoscopic treatment. We are reporting on an interventional therapeutic approach found in interdisciplinary consensus. Discussion: Endoscopy, surgery or TIPS (transjugular intrahepatic portosystemic shunt) can be performed in patients with gastrointestinal bleeding due to portal hypertension in liver cirrhosis...
October 5, 2016: Zeitschrift Für Gastroenterologie
G Di Nardo, C Di Lorenzo, A Lauro, V Stanghellini, N Thapar, T B Karunaratne, U Volta, R De Giorgio
BACKGROUND: Chronic intestinal pseudo-obstruction (CIPO) represents the most severe form of gastrointestinal dysmotility with debilitating and potentially lethal consequences. Symptoms can be non-specific, and result in this condition being diagnosed incorrectly or too late with consequences for morbidity and even mortality. PURPOSE: The present article aims to provide pediatric and adult gastroenterologists with an up to date review about clinical features, diagnosis and therapeutic options for CIPO...
September 29, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Monjur Ahmed
As the number of diagnostic and therapeutic gastrointestinal endoscopies is increasing, and there is an increase in number of patients taking blood thinners, we are seeing more and more patients on blood thinners prior to endoscopic procedures. Gastrointestinal bleeding or thromboembolism can occur in this category of patients in the periendoscopic period. To better manage these patients, endoscopists should have a clear concept about the various blood thinners in the market. Patients' risk of thromboembolism off anticoagulation, and the risk of bleeding from endoscopic procedures should be assessed prior to endoscopy...
September 16, 2016: World Journal of Gastrointestinal Endoscopy
Marisol Luján-Sanchis, Laura Sanchis-Artero, Laura Larrey-Ruiz, Laura Peño-Muñoz, Paola Núñez-Martínez, Génesis Castillo-López, Lara González-González, Carlos Boix Clemente, Cecilia Albert Antequera, Ana Durá-Ayet, Javier Sempere-Garcia-Argüelles
Capsule endoscopy (CE) currently plays an important role in Crohn's disease (CD). It is a noninvasive technique that has led to a breakthrough in the endoscopic diagnosis of diseases of the small intestine. Its superior diagnostic performance and excellent safety profile lead to its considerable acceptance on the part of the patient. This paper reviews current indications of CE in three stages of clinical practice: Suspected CD, unclassified colitis and its extensive role in diagnosed CD. The diagnostic and therapeutic impact of the results of CE on the monitoring of this disease is also reviewed...
September 16, 2016: World Journal of Gastrointestinal Endoscopy
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