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device assisted enteroscopy

Uri Kopylov, Dan Carter, Abraham Rami Eliakim
In approximately one-third of Crohn's disease patients, the disease is confined to the small bowel, inaccessible to the reach of standard endoscopy. Thorough and complete evaluation of the small bowel is crucial in such patients for the initial diagnosis, prognostication, and disease monitoring. Video capsule endoscopy and device-assisted enteroscopy have revolutionized the ability to visualize the small-bowel mucosa. This article reviews the literature pertaining to the use of capsule endoscopy and deep enteroscopy in established Crohn's disease, including the major indications, applications, and safety issues...
October 2016: Gastrointestinal Endoscopy Clinics of North America
Anne Marie Jelsig
Hamartomatous polyps (HPs) in the gastrointestinal (GI) tract are rare compared to other types of GI polyps, yet they are the most common type of polyp in children. The symptoms are usually rectal bleeding, abdominal pain, obstipation, anaemia, and/or small bowel obstruction. The polyps are typically removed concurrently with endoscopy when located in the colon, rectum, or stomach, whereas polyps in the small bowel are removed during push-enteroscopy, device-assisted enteroscopy, or by surgery. HPs can be classified as juvenile polyps or Peutz-Jeghers polyps based on their histopathological appearance...
August 2016: Danish Medical Journal
Mikang Kim, Hyun Joo Jang
Endoscopy has a crucial role in the diagnosis, management, and surveillance of inflammatory bowel disease (IBD). It contributes in supporting the diagnosis of IBD with the clinical history, physical examination, laboratory findings, and targeted biopsies. Furthermore, endoscopy has a significant role in assessing disease activity and distribution in treatment efficacy evaluation, post-surgical recurrence risk, and cancer surveillance in patients with long-lasting illness. Endoscopy also provides therapeutic potential for the treatment of IBD, especially with stricture dilatation and treatment of bleeding...
July 2016: Intestinal Research
Joanna K Law
PURPOSE OF REVIEW: Endoscopic technology has evolved such that device-assisted enteroscopes (DAEs) are readily available and utilized to diagnose and treat patients with small bowel disease. In this review, we briefly discuss the DAE platforms and the expanding role for small bowel enteroscopy. RECENT FINDINGS: The indications for small bowel endoscopy are rapidly increasing with new diagnostic and therapeutic maneuvers that are allowing patients to obtain treatments that would have otherwise required more invasive or higher risk procedures...
July 13, 2016: Current Opinion in Gastroenterology
Daniel L Raines, Kellen T Jex, Mark J Nicaud, Douglas G Adler
BACKGROUND AND AIMS: The source of gastrointestinal bleeding (GIB) may elude us despite exhaustive testing in some cases. Bleeding in these cases is often related to a vascular lesion that is discernible only when actively bleeding. The objective of this study was to determine the efficacy and safety of endoscopy combined with the administration of anti-platelet and/or anti-coagulant agents to stimulate bleeding in order to define a source. METHODS: A retrospective review of a database of device-assisted enteroscopy (DAE) procedures was completed to identify cases in which provocation with antiplatelet or anticoagulant agents was used as part of a GIB evaluation...
June 22, 2016: Gastrointestinal Endoscopy
Jae Hyun Kim, Won Moon
While the domain of gastrointestinal endoscopy has made great strides over the last several decades, endoscopic assessment of the small bowel continues to be challenging. Recently, with the development of new technology including video capsule endoscopy, device-assisted enteroscopy, and computed tomography/magnetic resonance enterography, a more thorough investigation of the small bowel is possible. In this article, we review the systematic approach for patients with suspected small bowel disease based on these advanced endoscopic and imaging systems...
July 2016: Clinical Endoscopy
Pier Alberto Testoni, Alberto Mariani, Lars Aabakken, Marianna Arvanitakis, Erwan Bories, Guido Costamagna, Jacques Devière, Mario Dinis-Ribeiro, Jean-Marc Dumonceau, Marc Giovannini, Tibor Gyokeres, Michael Hafner, Jorma Halttunen, Cesare Hassan, Luis Lopes, Ioannis S Papanikolaou, Tony C Tham, Andrea Tringali, Jeanin van Hooft, Earl J Williams
This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It provides practical advice on how to achieve successful cannulation and sphincterotomy at minimum risk to the patient. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations 1 ESGE suggests that difficult biliary cannulation is defined by the presence of one or more of the following: more than 5 contacts with the papilla whilst attempting to cannulate; more than 5 minutes spent attempting to cannulate following visualization of the papilla; more than one unintended pancreatic duct cannulation or opacification (low quality evidence, weak recommendation)...
July 2016: Endoscopy
Elizabeth E Bollinger, Melissa A Spera, Daniel L Raines
BACKGROUND: Current guidelines recommend suspending thienopyridine therapy 5 to 7 days before therapeutic endoscopy to reduce the risk of bleeding-related complication. However, interruption of antiplatelet therapy may increase the risk of a cardiovascular event. The aim of this study was to evaluate the safety and diagnostic yield of device-assisted enteroscopy (DAE) with endoscopic therapy in patients receiving thienopyridine antiplatelet therapy. MATERIALS AND METHODS: A retrospective chart review was performed for patients treated in the LSU Health Sciences Gastroenterology Clinics between the dates of October 4, 2007 and February 15, 2015...
April 30, 2016: Journal of Clinical Gastroenterology
Rolando Pinho, Miguel Mascarenhas-Saraiva, Susana Mão-de-Ferro, Sara Ferreira, Nuno Almeida, Pedro Figueiredo, Adélia Rodrigues, Hélder Cardoso, Margarida Marques, Bruno Rosa, José Cotter, Germano Vilas-Boas, Carla Cardoso, Marta Salgado, Ricardo Marcos-Pinto
BACKGROUND: Device-assisted enteroscopies (DAEs) are recent endoscopic techniques that enable direct endoscopic small-bowel evaluation. OBJECTIVE: The objective of this article is to evaluate the implementation of DAEs in Portugal and assess the main indications, diagnoses, diagnostic yield, therapeutic yield and complication rate. METHODS: We conducted a multicenter retrospective series using a national Web-based survey on behalf of the Portuguese Small-Bowel Study Group...
April 2016: United European Gastroenterology Journal
Dejan Micic, Carol E Semrad
The small bowel is a challenging area for endoscopic evaluation and therapy due to its length and angulated configuration. A small lumen diameter and segmental peristalsis made it a perfect fit for examination by a novel ingestible wireless camera in a capsule. The development of capsule endoscopy changed the diagnosis and management of bleeding lesions, ulcers, and tumors deep in the small bowel, allowing earlier diagnosis with excellent patient acceptance. Device-assisted enteroscopy revolutionized small bowel therapy, particularly management of bleeding, Peutz-Jeghers polyposis, and tumor marking for minimally invasive surgery...
June 2016: Current Treatment Options in Gastroenterology
Dae Young Cheung, Jin Su Kim, Ki-Nam Shim, Myung-Gyu Choi
Video capsule endoscopy (VCE) has expanded the range of endoscopic examination of the small bowel. The clinical application of VCE is mainly for obscure gastrointestinal bleeding (OGIB) and small bowel tumor is one of the clinically significant diagnoses of VCE, often requiring subsequent invasive interventions. Small bowel tumors are detected with a frequency of around 4% with VCE in indications of OGIB, iron deficiency anemia, unexplained abdominal pain, and others. Protruding mass with bleeding, mucosal disruption, irregular surface, discolored area, and white villi are suggested as the VCE findings of small bowel tumor...
January 2016: Clinical Endoscopy
Rolando Pinho, Ana Ponte, Adélia Rodrigues, Teresa Pinto-Pais, Carlos Fernandes, Iolanda Ribeiro, Joana Silva, Jaime Rodrigues, Miguel Mascarenhas-Saraiva, João Carvalho
BACKGROUND AND AIMS: The effectiveness of endoscopic therapy of small-bowel vascular lesions (SBVL) remains unclear as recent studies report high recurrence rates after 2 years of follow-up. This study aimed to evaluate the long-term rebleeding risk after endoscopic therapy of SBVL and to identify predictive factors of rebleeding. METHODS: This was a retrospective single-center series of patients with SBVL treated endoscopically between July 2007 and February 2015...
April 2016: European Journal of Gastroenterology & Hepatology
Carola Haapamäki, Marianne Udd, Leena Kylänpää
INTRODUCTION: Surgically altered anatomy complicates endoscopic procedures of the pancreaticobiliary tree. Biliary strictures have been managed using percutaneous transhepatic techniques. MATERIALS AND METHODS: In recent years device-assisted enteroscopy (e.g., double balloon enteroscope [DBE]) has been used to gain access to the common bile duct. The length of the scope and its narrow, 2.8-mm working channel limit the use of standard endoscopic retrograde cholangiopancreatography (ERCP) devices...
December 2015: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Wiley D Truss, Frederick Weber, Salpy V Pamboukian, Arvind Tripathi, Shajan Peter
Gastrointestinal bleeding (GIB) is a frequent challenge encountered in patients implanted with a left ventricular assist device (LVAD), affecting approximately 25% of this population. Many patients have no identifiable source of bleeding after routine esophagogastroduodenoscopy and colonoscopy and are labeled as obscure GIB (OGIB). Significant costs and invasive procedures are required to investigate and stop the source of bleeding in these patients. We performed a retrospective analysis at a single tertiary referral center to investigate the diagnostic yield and overall effectiveness of video capsule enteroscopy (VCE) in this population...
January 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Nikhil Banerjee, Michael Presta, Matthew Charous, Neil Gupta
BACKGROUND/AIMS: Resource-intensive endoscopic procedures have shown to generate more costs than revenue under the current reimbursement system in the USA. Single-balloon enteroscopy (SBE), a resource-intensive procedure, has never been evaluated for its financial impact at tertiary care hospitals, and thus, our aim was to determine the sources of revenue that SBE procedures generate. METHODS: Retrospective review of all procedures performed using the SBE system during the first year of implementation at a single tertiary referral center...
April 2016: Surgical Endoscopy
Rabia Ali, Daniel Wild, Frederick Shieh, David L Diehl, Monika Fischer, Wataru Tamura, David T Rubin, Vivek Kumbhari, Patrick Okolo, Andrew Storm, Zamir Halpern, Helmut Neumann, Harshit S Khara, Mark B Pochapin, Seth A Gross
BACKGROUND AND AIMS: The advent of capsule endoscopy has revolutionized evaluation of the small bowel. Capsule endoscopy has become the criterion standard as the initial examination to diagnose small-bowel abnormalities, but does not allow for tissue sampling or therapeutic intervention. Deep enteroscopy can be performed by using a balloon-assisted device or a spiral overtube for both diagnostic and therapeutic interventions of the small bowel. Deep enteroscopy is time-consuming and requires special endoscopes and accessories to perform the examination...
November 2015: Gastrointestinal Endoscopy
Parambir S Dulai, Barrett G Levesque, Brian G Feagan, Geert D'Haens, William J Sandborn
BACKGROUND AND AIMS: Mucosal healing is an important treatment end-point in inflammatory bowel disease, and achieving mucosal healing has been demonstrated to improve disease-related outcomes. Considerable uncertainty exists, however, regarding the optimal approach for the assessment of mucosal healing. AIMS: To compare currently available diagnostic tools for the assessment of mucosal healing and outline the ideal approach to integrating these tools into clinical trials and clinical practice...
August 2015: Gastrointestinal Endoscopy
Tetsuo Tamura, Daisuke Kikuchi, Tsunao Imamura, Yuko Koizumi, Rikako Koyama, Mitsuru Kaise, Kazuo Takeuchi
No abstract text is available yet for this article.
2015: Endoscopy
Marco Pennazio, Cristiano Spada, Rami Eliakim, Martin Keuchel, Andrea May, Chris J Mulder, Emanuele Rondonotti, Samuel N Adler, Joerg Albert, Peter Baltes, Federico Barbaro, Christophe Cellier, Jean Pierre Charton, Michel Delvaux, Edward J Despott, Dirk Domagk, Amir Klein, Mark McAlindon, Bruno Rosa, Georgina Rowse, David S Sanders, Jean Christophe Saurin, Reena Sidhu, Jean-Marc Dumonceau, Cesare Hassan, Ian M Gralnek
This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). The Guideline was also reviewed and endorsed by the British Society of Gastroenterology (BSG). It addresses the roles of small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders. Main recommendations 1 ESGE recommends small-bowel video capsule endoscopy as the first-line investigation in patients with obscure gastrointestinal bleeding (strong recommendation, moderate quality evidence)...
April 2015: Endoscopy
Majed El Zouhairi, James B Watson, Svetang V Desai, David K Swartz, Alejandra Castillo-Roth, Mahfuzul Haque, Paul S Jowell, Malcolm S Branch, Rebecca A Burbridge
AIM: To evaluate the success rates of performing therapy utilizing a rotational assisted enteroscopy device in endoscopic retrograde cholangiopancreatography (ERCP) in surgically altered anatomy patients. METHODS: Between June 1, 2009 and November 8, 2012, we performed 42 ERCPs with the use of rotational enteroscopy for patients with altered anatomy (39 with gastric bypass Roux-en-Y, 2 with Billroth II gastrectomy, and 1 with hepaticojejunostomy associated with liver transplant)...
March 16, 2015: World Journal of Gastrointestinal Endoscopy
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