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gastric outlet obstruction

Maitham A Moslim, Gavin A Falk, Federico G Seifarth
Background: Temporary or long-term nutritional support through gastrojejunal (GJ) feeding tubes is a safe and common means of enteral feeding in adults and children. It is indicated in patients with severe gastroesophageal reflux disease, gastric outlet obstruction, or severe gastric dysfunction or gastroparesis. Several techniques for GJ feeding tube placement have been reported. The most technically challenging part of GJ tube placement is the advancement and optimal positioning of the jejunal extension into the proximal jejunum...
January 2018: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Alexander D Jobrack, Suman Goel, Alvin M Cotlar
Introduction: Granular cell tumors (GCTs) are of neuroectodermal origin and account for 0.5% of soft tissue tumors. They are most prevalent in African-Americans in the fourth to sixth decades, with a predilection for the head and neck regions. GCTs usually resemble more common lesions and hence are difficult to diagnose preoperatively. The tumor is readily identified on needle biopsy. Although usually benign with a malignancy rate of only 2-3%, the malignant form has a reported 3-yr mortality of 60%...
March 14, 2018: Military Medicine
Yen-I Chen, Theodore James, Amol Agarwal, Todd H Baron, Takao Itoi, Rastislav Kunda, Jose Nieto, Majidah Bukhari, Olaya Brewer Gutierrez, Omid Sanaei, Robert Moran, Lea Fayad, Mouen A Khashab
Background and study aims:  Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) in malignant gastric outlet obstruction (GOO) appears to be promising; however, its role in benign GOO is unclear. The aim of this study was to ascertain the clinical efficacy and safety of EUS-GE in benign GOO. Patients and methods : This was an international retrospective series involving 5 tertiary centers. Consecutive patients who underwent EUS-GE between 1/2013 - 10/2016 for benign GOO were included...
March 2018: Endoscopy International Open
Ashish Joshi, Sushil Falodia, Naveen Kumar, R L Solanki
Strictures of the small intestine have been attributed many causes of Crohn's disease, nonsteroidal anti-inflammatory drugs, neoplastic, post-surgical, and corrosive ingestion. Opium as a cause of small intestine strictures has not been described. Six cases of opium addicts diagnosed with small intestine strictures were selected after excluding the possible etiology of strictures. Investigations like upper gastrointestinal endoscopy, colonoscopy (in patients with small intestinal obstruction), barium meal follow-through, and histopathology of strictures were done in all patients...
March 7, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Jamil Shah, Tagore Sunkara, Krishna Sowjanya Yarlagadda, Prashanth Rawla, Vinaya Gaduputi
Percutaneous endoscopic gastrostomy (PEG) is a well-recognized procedure for providing enteral feeding and long-term enteral nutritional support. Although it is mostly well tolerated, complications, sometimes mechanical in nature, do occur. Rare, and often initially unrecognized, late complications of PEG tube placement are gastric outlet obstruction and duodenal obstruction. Simple adjustment of the gastrostomy tube will lead to the improvement of the patient's clinical condition and prevent further complications...
February 2018: Gastroenterology Research
Kelly M Caldwell, Seeyuen J Lee, Phillip L Leggett, Kulvinder S Bajwa, Sheilendra S Mehta, Shinil K Shah
Bouveret syndrome is a rare complication of cholelithiasis that usually presents with signs and symptoms of gastric outlet obstruction. Given the relative rarity of this condition, there are no standardized guidelines for the management of this condition. In this paper, we review the diagnosis and management options (endoscopic, laparoscopic, and open approaches) of patients with Bouveret syndrome, including a report of one case to illustrate some of the endoscopic and surgical principles of management.
2018: Clinical and Experimental Gastroenterology
B Krishnaraj, B Dhanapal, G Shankar, S C Sistla, I Galidevara, A Suresh
Gastric lipomas are rare benign tumours of the stomach, representing less than 3% of all benign gastric neoplasms. They are usually asymptomatic but larger lesions can present with abdominal pain, gastric outlet obstruction and haematemesis. Malignant transformation is extremely rare. Accurate preoperative diagnosis can be established with computed tomography. Being benign, extensive surgery is not necessary and simple excision of the lesion is adequate. Small asymptomatic lesions can be followed up. We present a case of 80-year-old woman with gastric submucosal lipoma who presented with haematemesis...
February 27, 2018: Annals of the Royal College of Surgeons of England
Bradley MacDonald, Sarah Rumore, Ajay Sharma, Zubin Grover
No abstract text is available yet for this article.
February 7, 2018: Archives of Disease in Childhood
Takahiro Yukimoto, Tomohito Morisaki, Sho Komukai, Hisako Yoshida, Daisuke Yamaguchi, Nanae Tsuruoka, Koichi Miyahara, Yasuhisa Sakata, Shinichi Shibasaki, Seiji Tsunada, Takahiro Noda, Seiji Yunotani, Kazuma Fujimoto
Objective Endoscopic self-expandable metallic stent (SEMS) placement and gastrojejunostomy (GJY) are palliative treatments for malignant gastric outlet obstruction (GOO). The aim of the present study was to compare the palliative effects of these treatments and identify predictors of a poor oral intake after treatment. Methods and Patients In total, 65 patients with GOO at multiple centers in Saga, Japan, were evaluated. Thirty-eight patients underwent SEMS placement, and 27 underwent GJY from January 2010 to December 2016...
February 9, 2018: Internal Medicine
Hirokazu Honda, Takashi Ikeya, Erika Kashiwagi, Shuichi Okada, Katsuyuki Fukuda
Gastric bezoars are rare and are usually found incidentally. They can sometimes cause severe complications, including gastric outlet obstruction (GOO) or gastric pneumatosis (GP). In cases of bezoars with GP, the optimal treatment strategy has not yet been defined. We report the case of an 89-year-old man with a history of type 2 diabetes mellitus and hypertension who presented to our emergency room with a 2-day history of upper abdominal pain, nausea, and vomiting. Physical examination revealed no rebound tenderness or guarding, and laboratory values revealed no elevation of the serum lactate level...
September 2017: Case Reports in Gastroenterology
Judith Staub, Ali Siddiqui, Linda Jo Taylor, David Loren, Tom Kowalski, Douglas G Adler
BACKGROUND AND AIMS: ERCP (endoscopic retrograde cholangiopancreatography) performed through previously placed enteral stents is an uncommon procedure without a significant amount of supporting literature, and with a wide reported range of technical success. The purpose of this study was to evaluate and better define the technical feasibility and safety of performing ERCP through enteral stents in patients with combined malignant biliary and gastric outlet obstruction (GOO). METHODS: We conducted a multicenter, retrospective study on 71 patients with combined gastric outlet and biliary obstruction who underwent ERCP through a previously placed enteral stent at 2 tertiary care centers...
February 6, 2018: Gastrointestinal Endoscopy
Ioannis D Kostakis, Zoe Garoufalia, Themistoklis Feretis, Stylianos Kykalos, Dimitrios Mantas
Bouveret's syndrome is a rare cause of proximal gallstone ileus with obstruction of duodenum or gastric outlet. We report a case of an 87-year-old female patient presented with 1 week history of vomiting whose plain radiograms showed ileus and pneumobilia. The abdominal computed tomography confirmed pneumobilia and revealed free air and leakage of oral contrast agent in the hepatic hilum and subhepatic space and an impacted gallstone in the third portion of the duodenum. The patient underwent exploratory laparotomy, which showed that the duodenal perforation was circumvallated, and a side-to-side retrocolic gastrojejunal anastomosis was performed in order to surpass the impacted gallstone...
October 2017: Journal of Surgical Case Reports
Bradley Anderson, David Johnson, Seth Sweetser
No abstract text is available yet for this article.
January 31, 2018: Clinical Gastroenterology and Hepatology
Craig A Munroe, Elizabeth Ross, Beverly Bolinger
No abstract text is available yet for this article.
January 31, 2018: Gastroenterology
Naomi M Sell, Zhi Ven Fong, Carlos Fernandez Del Castillo, Motaz Qadan, Andrew L Warshaw, David Chang, Keith D Lillemoe, Cristina R Ferrone
BACKGROUND: Approximately 20-40% of patients with "resectable" pancreatic adenocarcinoma (PDAC) by imaging criteria have metastatic disease on exploration. Our aim was to assess the potential impact of staging laparoscopy versus upfront laparotomy in "resectable" patients found to have metastatic PDAC. METHODS: Clinicopathologic data was retrospectively collected for all patients with PDAC undergoing an operation with curative intent between 2001-2015 at a single institution...
January 31, 2018: Annals of Surgical Oncology
Zaim Gashi, Aida Ferri Polloshka, Arber Veliu, Fisnik Kurshumliu, Elton Bahtiri
The patient, a 40-year-old male, was referred to our clinic with intermittent nausea, vomiting and symptomatic anemia for 4 months. Notable hematological indices were low hemoglobin levels of 9.6 g/dl and hematocrit levels of 35.8%, while after receiving two units of concentrated red blood cells, at discharge; they achieved levels of 15.2 g/dl and 42.3%, respectively. Esophagogastroduodenoscopy revealed a 3 cm antral pedunculated polyp, prolapsing into pylorus thus causing intermittent pyloric obstruction and anemia...
December 15, 2017: Open Access Macedonian Journal of Medical Sciences
Amanda Ricciuto, Bairbre L Connolly, Tanja Gonska
No abstract text is available yet for this article.
February 2018: Journal of Pediatric Gastroenterology and Nutrition
Rabea Hasadia, Yael Kopelman, Oded Olsha, Ricardo Alfici, Itamar Ashkenazi
PURPOSE: We evaluated the short-term and long-term outcomes of emergency operations for peptic ulcer (PUD) complications in a period of time in which the need for surgery is infrequent. METHODS: Retrospective review of operated patients (2007-2015) in one medical center. RESULTS: 81 patients were included (8.9 patients/year): 70 (86.4%) male; 11 (13.6%) female. Indications for operation were hemorrhage in 18 (22.2%), perforation in 62 (76...
January 22, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Jayalaxmi S Aihole, M Narendra Babu, Vinay Jadhav, Deepak Javaregowda
The gastric teratoma is a rare tumor that usually presents as an abdominal mass, with or without features of gastric outlet obstruction. We report two cases of gastric teratoma; one - mature in a male neonate and another - ruptured immature gastric teratoma in a female neonate.
October 2017: Indian Journal of Medical and Paediatric Oncology
Christine Jackman, Ryan Waddell, Leon Fisher, Michael Ben-Meir, Gabriel Blecher, Gerard S Goh, Katie Walker
No abstract text is available yet for this article.
January 12, 2018: Emergency Medicine Australasia: EMA
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