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Balloon assisted endoscopy

Emanuele Rondonotti, Cristiano Spada, Samuel Adler, Andrea May, Edward J Despott, Anastasios Koulaouzidis, Simon Panter, Dirk Domagk, Ignacio Fernandez-Urien, Gabriel Rahmi, Maria Elena Riccioni, Jeanin E van Hooft, Cesare Hassan, Marco Pennazio
SMALL-BOWEL CAPSULE ENDOSCOPY (SBCE): 1: ESGE recommends that prior to SBCE patients ingest a purgative (2 L of polyethylene glycol [PEG]) for better visualization.Strong recommendation, high quality evidence.However, the optimal timing for taking purgatives is yet to be established. 2: ESGE recommends that SBCE should be performed as an outpatient procedure if possible, since completion rates are higher in outpatients than in inpatients.Strong recommendation, moderate quality evidence...
March 14, 2018: Endoscopy
Takeshi Yamashina, Yoshikazu Hayashi, Hirotsugu Sakamoto, Tomonori Yano, Yoshimasa Miura, Satoshi Shinozaki, Keijiro Sunada, Alan Kawarai Lefor, Hironori Yamamoto
BACKGROUND:  Colorectal endoscopic submucosal dissection (ESD) can be technically difficult in some situations, such as paradoxical movement of the proximal colon. The double-balloon endoscope provides stable endoscopic maneuvering, even in the small intestine. The aim of this study was to assess the outcomes of balloon-assisted endoscopic submucosal dissection (BAESD) of colonoscopically difficult superficial proximal colon tumors. METHODS:  We retrospectively reviewed the records of patients who underwent BAESD of superficial proximal colon tumors where colonoscopic difficulties were encountered, from January 2011 to September 2016...
February 12, 2018: Endoscopy
Kyung Hwan Song, Beom Jae Lee
No abstract text is available yet for this article.
January 2018: Clinical Endoscopy
Emmanuel Ofori, Daryl Ramai, Charilaos Papafragkakis, Kinesh Changela, Mahesh Krishnaiah
Small intestinal tumors are rare with adenocarcinoma of the small intestine accounting for less than 2% of all gastrointestinal cancers. Primary jejunal adenocarcinoma constitutes a minute portion of small intestine adenocarcinomas. Clinically, this cancer presents at latter stages of its progression, mainly due to vague and non-specific symptoms, and the difficulty encountered in accessing the jejunum on upper endoscopy. Diagnosis of jejunal adenocarcinoma is usually inconclusive with the use of computed tomography (CT) scan, small bowel series, or upper endoscopy...
December 2017: Gastroenterology Research
Ernst Eber, Juan L Antón-Pacheco, Jacques de Blic, Iolo Doull, Al Faro, Raffaella Nenna, Thomas Nicolai, Petr Pohunek, Kostas N Priftis, Paola Serio, Courtney Coleman, Sarah Masefield, Thomy Tonia, Fabio Midulla
Paediatric airway endoscopy is accepted as a diagnostic and therapeutic procedure, with an expanding number of indications and applications in children. The aim of this European Respiratory Society task force was to produce a statement on interventional bronchoscopy in children, describing the evidence available at present and current clinical practice, and identifying areas deserving further investigation. The multidisciplinary task force panel performed a systematic review of the literature, focusing on whole lung lavage, transbronchial and endobronchial biopsy, transbronchial needle aspiration with endobronchial ultrasound, foreign body extraction, balloon dilation and occlusion, laser-assisted procedures, usage of airway stents, microdebriders, cryotherapy, endoscopic intubation, application of drugs and other liquids, and caregiver perspectives...
December 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Tomonori Aoki, Atsuo Yamada, Yoshihiro Hirata, Hirobumi Suzuki, Ayako Nakada, Ryota Niikura, Motoko Seto, Makoto Okamoto, Kazuhiko Koike
BACKGROUND: Among patients with obscure gastrointestinal bleeding (OGIB), endoscopic ulcerative lesions in the small bowel have diverse etiologies and often cause rebleeding. Certain characteristics of patients or ulcerations may be reasonable indications for diagnostic balloon-assisted endoscopy (BAE) to assess etiology and may be risks of rebleeding; however, these characteristics are unclear. We aimed to elucidate appropriate indications for diagnostic BAE and predictors of long-term rebleeding in patients with small bowel ulcerative lesions...
December 12, 2017: Journal of Gastroenterology and Hepatology
C Römmele, A Ebigbo, M Schrempf, H Messmann, S K Gölder
Background and Aims: Balloon-assisted enteroscopy (BAE) is a well-established tool in the diagnosis and therapy of small bowel diseases. Ink tattooing of the small bowel is used to mark pathologic lesions or the depth of small bowel insertion. The purpose of this study was to determine the safety, the detection rate, and the clinical relevance of ink tattooing during BAE. Methods: We performed a retrospective analysis of all 81 patients who received an ink tattooing during BAE between 2010 and 2015...
2017: Gastroenterology Research and Practice
Tsung-Chun Lee, Yi-Chen Huang, Yen-Zhen Lu, Yu-Chang Yeh, Linda Chia-Hui Yu
KEY POINTS: Balloon-assisted enteroscopy (BAE) is an emerging standard procedure by utilizing distensible balloons to facilitate deep endoscopy in the small and large intestine. Sporadic cases of bacteraemia were found after BAE. Balloon distension by BAE caused gut tissue hypoxia. The impact of balloon distension-induced hypoxia on intestinal barriers remains unclear. Murine models of BAE by colonic balloon distension showed that short- and long-term hypoxia evoked opposite effects on epithelial tight junctions (TJs)...
November 27, 2017: Journal of Physiology
Shinji Okabayashi, Taku Kobayashi, Tomohisa Sujino, Ryo Ozaki, Satoko Umeda, Takahiko Toyonaga, Eiko Saito, Masaru Nakano, Maria Carla Tablante, Shojiroh Morinaga, Toshifumi Hibi
Extracolonic involvement of the gastrointestinal tract is extremely uncommon in ulcerative colitis (UC) and rarely found in the upper gastrointestinal tract or in postoperative cases since it typically responds to steroids. Here we report a case of UC complicated by extensive ileal inflammation that was refractory to steroids. A 20-year-old man was diagnosed with UC of typical pancolitis without ileal involvement and started treatment with pH-dependent mesalazine and oral prednisolone. Although his symptoms transiently resolved, the condition flared when the steroid dose was tapered down...
October 2017: Intestinal Research
Thomas A Zikos, Jennifer Pan, Berkeley Limketkai, Dipanjan Banerjee, Nielsen Fernandez-Becker
Background: Continuous flow left ventricular assist device (CF-LVAD) patients have a high prevalence of gastrointestinal bleeding from the small bowel. Video capsule endoscopy (VCE) is often used for diagnosis in these patients, but efficacy has yet to be determined. In this study, we evaluated the efficacy of VCE in the management of CF-LVAD patients with suspected small bowel bleeding by comparing to a non-VCE CF-LVAD control group. Methods: We retrospectively reviewed the charts of all patients with CF-LVADs implanted at Stanford Hospital from January 2010 to October 2015...
October 2017: Gastroenterology Research
Hsu-Heng Yen, Chen-Wang Chang, Jen-Wei Chou, Shu-Chen Wei
Inflammatory bowel diseases are idiopathic inflammatory diseases of two main types, Crohn's disease and ulcerative colitis. Crohn's disease can affect the entire gastrointestinal tract, and the distal ileum is involved in up to 70% of patients. Moreover, Crohn's disease in one-quarter to one-third of patients involves isolation of the small bowel. Due to the nonspecific symptoms and anatomical location of the disease, small bowel Crohn's disease is a phenotype that is particularly difficult to manage. Since the introduction of capsule endoscopy in 2000 and balloon-assisted enteroscopy in the 21st century, it is now possible to directly inspect for small bowel Crohn's disease...
September 2017: Clinical Endoscopy
Gregory Pajot, Gerardo Calderon, Andrés Acosta
Purpose of review Endoscopic bariatric therapy (EBT) is a rapidly developing area that has now seen FDA approval of six endoscopic bariatric devices and procedures and there are a number of other novel EBTs progressing through various stages of development with newly published findings. This paper aims to assist readers in either selecting an appropriate therapy for their patient or deciding to incorporate these therapies into their practice. This paper provides an updated review of the available data on EBTs, both FDA approved and not, with a particular focus on effectiveness and safety, as well as guidance for discussing with your patient the decision to use endoscopic therapies...
December 2017: Current Treatment Options in Gastroenterology
Gian Eugenio Tontini, Helmut Neumann
Since 2001, small bowel capsule endoscopy (SBCE) has been widely implemented into clinical practice as a minimal-invasive diagnostic approach for diagnosing small bowel diseases. Currently, SBCE is moreover recognized as the first-line procedure for the diagnostic work-up of obscure gastrointestinal bleeding (OGIB) and for a variety of SB disorders including Crohn's disease, inherited polyposis syndromes, suspected small bowel tumors or refractory celiac disease [1,2]. In addition, capsule endoscopy is used to guide the decision whether device assisted enteroscopy (i...
August 20, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Mihai Rimbas, Alberto Larghi, Guido Costamagna
Interventional endoscopic ultrasonography (EUS) is currently becoming the less invasive therapeutic approach for the drainage of pancreatic fluid collections, of acute cholecystitis in patients unfit for surgery and for biliary drainage after failed endoscopic retrograde cholangiopancreatography. In addition, EUS-guided gastroenterostomy (EUS-GE) has recently emerged as a feasible procedure to treat patients with gastric outlet obstruction, as an alternative to surgery or to standard endoscopy when endoscopic stent placement is not possible...
July 2017: Endoscopic Ultrasound
Yu Nishida, Shuhei Hosomi, Hirokazu Yamagami, Tomomi Yukawa, Yasuaki Nagami, Fumio Tanaka, Noriko Kamata, Tetsuya Tanigawa, Masatsugu Shiba, Toshio Watanabe, Kazunari Tominaga, Yasuhiro Fujiwara, Tetsuo Arakawa
Objective Balloon-assisted endoscopy enables access to and treatment of strictures in the small intestine using endoscopic balloon dilation (EBD); however, the long-term outcomes of EBD have not been sufficiently evaluated. This study evaluated the long-term outcomes of EBD in Crohn's disease to identify the risk factors associated with the need for subsequent surgical intervention. Methods We retrospectively analyzed patients with Crohn's disease who had undergone EBD with double-balloon endoscopy (DBE) for small intestinal strictures at a single center between 2006 and 2015...
September 1, 2017: Internal Medicine
Jinsu Kim
The balloon-assisted enteroscope has been regarded as the standard device for direct visualization of deep small bowels and allows for the diagnosis and treatment of small bowel disease. At the beginning, its application was focused on the diagnosis of obscure gastrointestinal bleeding, inflammatory bowel disease, and small bowel tumor. However, the indications are being expanded to various therapeutic procedures, not only confined to bleeding control. With the expansion of the indications, the need to perform enteroscopy effectively and safely is increasing...
July 2017: Clinical Endoscopy
Valérie Deslauriers, Amélie Beauchamp, Fabio Garofalo, Henri Atlas, Ronald Denis, Pierre Garneau, Radu Pescarus
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is the most popular bariatric surgery worldwide. Gastric sleeve stenosis is the most common postoperative complication, occurring in up to 3.9% of the cases. Current treatment options include endoscopic treatments, such as dilatations and stent placement as well as surgical revisions such as laparoscopic Roux-en-Y gastric bypass (LRYGB), wedge gastrectomy or seromyotomy. METHODS: A retrospective analysis of our prospectively collected therapeutical endoscopy database was performed between January 2014 and February 2017...
July 19, 2017: Surgical Endoscopy
Tom G Moreels
The present review provides an update of the currently available (proto-) types of device-assisted enteroscopy (DAE). In recent years, newly designed double- and single-balloon enteroscopes have emerged. They aim to improve insertion depth into the small bowel, and they also allow more efficient endoscopic interventions. Nowadays, almost all conventional endoscopic procedures are feasible using DAE, opening the door to new indications. Recently, more data have become available on pediatric DAE, DAE-assisted colonoscopy, and DAE in patients with altered anatomy, including DAE-assisted endoscopic retrograde cholangiopancreatography and direct cholangioscopy...
July 14, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Jasmijn F Haanstra, Abdul Al-Toma, Evelien Dekker, Steven A L W Vanhoutvin, Fokko M Nagengast, Elisabeth M Mathus-Vliegen, Monique E van Leerdam, Wouter H de Vos Tot Nederveen Cappel, Roeland A Veenendaal, Annemieke Cats, Silvia Sanduleanu, Hans F A Vasen, Jan H Kleibeuker, Jan J Koornstra
BACKGROUND AND STUDY AIMS : Lynch syndrome (LS) patients have an increased risk of small bowel cancer. The question is whether surveillance will lead to early detection of (pre)malignant lesions. We recently reported on prevalence of small bowel neoplasia (SBN) in LS patients as assessed by video capsule endoscopy (VCE). The aim of this prospective study was to determine the incidence of SBN. PATIENTS AND METHODS : Asymptomatic LS patients who underwent a VCE were invited to undergo a second VCE procedure 2 years later...
July 2017: Endoscopy International Open
Divyanshoo R Kohli, Marlon F Levy, George B Smallfield
A 54-year old male liver transplant recipient with Roux-en-Y choledochojejunostomy was admitted for symptomatic anemia. Despite endoscopies and a bleeding scan, active bleeding was not visualized. Angiography and abdominal computed tomography demonstrated possible jejunal varices at the choledochojejunal anastomosis. Double-balloon enteroscopy demonstrated varices with overlying clots in the Roux limb at the anastomosis. Due to the extensive loop formation and unstable position of the endoscope, therapeutic intervention could not be performed...
2017: ACG Case Reports Journal
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