Sample records for gastrointestinal endoscopy asge

  1. Gastrointestinal endoscopy in pregnancy

    PubMed Central

    Savas, Nurten

    2014-01-01

    Gastrointestinal endoscopy has a major diagnostic and therapeutic role in most gastrointestinal disorders; however, limited information is available about clinical efficacy and safety in pregnant patients. The major risks of endoscopy during pregnancy include potential harm to the fetus because of hypoxia, premature labor, trauma and teratogenesis. In some cases, endoscopic procedures may be postponed until after delivery. When emergency or urgent indications are present, endoscopic procedures may be considered with some precautions. United States Food and Drug Administration category B drugs may be used in low doses. Endoscopic procedures during pregnancy may include upper gastrointestinal endoscopy, percutaneous endoscopic gastrostomy, sigmoidoscopy, colonoscopy, enteroscopy of the small bowel or video capsule endoscopy, endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography. All gastrointestinal endoscopic procedures in pregnant patients should be performed in hospitals by expert endoscopists and an obstetrician should be informed about all endoscopic procedures. The endoscopy and flexible sigmoidoscopy may be safe for the fetus and pregnant patient, and may be performed during pregnancy when strong indications are present. Colonoscopy for pregnant patients may be considered for strong indications during the second trimester. Although therapeutic endoscopic retrograde cholangiopancreatography may be considered during pregnancy, this procedure should be performed only for strong indications and attempts should be made to minimize radiation exposure. PMID:25386072

  2. Gastrointestinal endoscopy: infection and disinfection.

    PubMed Central

    O'Connor, H J; Axon, A T

    1983-01-01

    The past decade has seen the development of an array of complex flexible fibreoptic instruments for gastrointestinal (GI) endoscopy, and an increasing use of these for diagnostic and therapeutic purposes. It has been recognised more recently that the use of contaminated endoscopic equipment can lead to serious and occasionally fatal infections. Infection with a wide variety of micro-organisms has been reported following oesophago-gastroduodenoscopy (OGD) and endoscopic retrograde cholangio-pancreatography (ERCP). PMID:6414894

  3. Spectroscopic Applications in Gastrointestinal Endoscopy

    PubMed Central

    ROY, HEMANT K.; BACKMAN, VADIM

    2013-01-01

    One of the major frontiers in biomedical optics has been as an adjunct to gastrointestinal endoscopy. In particular, spectroscopy of elastic light scattering has the potential of addressing many of the vexing challenges confronting endoscopists. This review discusses the principles of spectroscopy and critically evaluates performance in clinically significant scenarios. One of the best established applications is optical biopsy (in situ histological determination), and a number of techniques such as elastic scattering spectroscopy have demonstrated the ability to discriminate between neoplastic and non-neoplastic polyps. For flat dysplasia detection in Barrett’s esophagus, some of the most promising spectroscopic technologies are angle-resolved low-coherence interferometry and endoscopic polarized scanning spectroscopy (the next generation light scattering spectroscopy). A new and exciting biological approach involves optical detection of field carcinogenesis. This can be exploited to reduce colonoscopic adenoma miss rate by assessing microcirculatory augmentation in the mucosa in the vicinity of the polyp using polarization-gatedspectroscopy. Furthermore, there are nano/micro-architectural correlates with diffuse field carcinogenesis throughout the colon. Indeed, technologies such as low coherence enhanced backscattering spectroscopy and partial wave spectroscopic microscopy have demonstrated that the detection of the nano-architectural alterations in the rectal mucosa can accurately sense advanced adenomas elsewhere in the colon. This may lend itself to a minimally intrusive risk stratification to identify patients who are most likely to harbor neoplasia and thus benefit from colonoscopy. Bridging these advances into the endoscopy suite requires pragmatic future development. Future studies need to focus on efficacy, cost, practicality (time required, etc), and particularly developing the paradigms that will impact upon clinical decision making. PMID:23059052

  4. Therapeutic endoscopy for acute upper gastrointestinal bleeding

    Microsoft Academic Search

    Mitchell S. Cappell

    2010-01-01

    Endoscopy is the primary diagnostic and therapeutic tool for upper gastrointestinal bleeding (UGIB). The performance of endoscopic therapy depends on findings of stigmata of recent hemorrhage (SRH). For peptic ulcer disease—the most common etiology of UGIB—endoscopic therapy is indicated for findings of major SRH, such as active bleeding, oozing, or the presence of a nonbleeding visible vessel, but not indicated

  5. Endoscopy for Nonvariceal Upper Gastrointestinal Bleeding

    PubMed Central

    Kim, Ki Bae; Youn, Sei Jin

    2014-01-01

    Endoscopy for acute nonvariceal upper gastrointestinal bleeding plays an important role in primary diagnosis and management, particularly with respect to identification of high-risk stigmata lesions and to providing endoscopic hemostasis to reduce the risk of rebleeding and mortality. Early endoscopy, defined as endoscopy within the first 24 hours after presentation, improves patient outcome and reduces the length of hospitalization when compared with delayed endoscopy. Various endoscopic hemostatic methods are available, including injection therapy, mechanical therapy, and thermal coagulation. Either single treatment with mechanical or thermal therapy or a treatment that combines more than one type of therapy are effective and safe for peptic ulcer bleeding. Newly developed methods, such as Hemospray powder and over-the-scope clips, may provide additional options. Appropriate decisions and specific treatment are needed depending upon the conditions. PMID:25133117

  6. Gastrointestinal endoscopy in the pregnant woman

    PubMed Central

    Friedel, David; Stavropoulos, Stavros; Iqbal, Shahzad; Cappell, Mitchell S

    2014-01-01

    About 20000 gastrointestinal endoscopies are performed annually in America in pregnant women. Gastrointestinal endoscopy during pregnancy raises the critical issue of fetal safety in addition to patient safety. Endoscopic medications may be potentially abortifacient or teratogenic. Generally, Food and Drug Administration category B or C drugs should be used for endoscopy. Esophagogastroduodenoscopy (EGD) seems to be relatively safe for both mother and fetus based on two retrospective studies of 83 and 60 pregnant patients. The diagnostic yield is about 95% when EGD is performed for gastrointestinal bleeding. EGD indications during pregnancy include acute gastrointestinal bleeding, dysphagia > 1 wk, or endoscopic therapy. Therapeutic EGD is experimental due to scant data, but should be strongly considered for urgent indications such as active bleeding. One study of 48 sigmoidoscopies performed during pregnancy showed relatively favorable fetal outcomes, rare bad fetal outcomes, and bad outcomes linked to very sick mothers. Sigmoidoscopy should be strongly considered for strong indications, including significant acute lower gastrointestinal bleeding, chronic diarrhea, distal colonic stricture, suspected inflammatory bowel disease flare, and potential colonic malignancy. Data on colonoscopy during pregnancy are limited. One study of 20 pregnant patients showed rare poor fetal outcomes. Colonoscopy is generally experimental during pregnancy, but can be considered for strong indications: known colonic mass/stricture, active lower gastrointestinal bleeding, or colonoscopic therapy. Endoscopic retrograde cholangiopancreatography (ERCP) entails fetal risks from fetal radiation exposure. ERCP risks to mother and fetus appear to be acceptable when performed for ERCP therapy, as demonstrated by analysis of nearly 350 cases during pregnancy. Justifiable indications include symptomatic or complicated choledocholithiasis, manifested by jaundice, cholangitis, gallstone pancreatitis, or dilated choledochus. ERCP should be performed by an expert endoscopist, with informed consent about fetal radiation risks, minimizing fetal radiation exposure, and using an attending anesthesiologist. Endoscopy is likely most safe during the second trimester of pregnancy. PMID:24891928

  7. Gastrointestinal endoscopy in the pregnant woman.

    PubMed

    Friedel, David; Stavropoulos, Stavros; Iqbal, Shahzad; Cappell, Mitchell S

    2014-05-16

    About 20000 gastrointestinal endoscopies are performed annually in America in pregnant women. Gastrointestinal endoscopy during pregnancy raises the critical issue of fetal safety in addition to patient safety. Endoscopic medications may be potentially abortifacient or teratogenic. Generally, Food and Drug Administration category B or C drugs should be used for endoscopy. Esophagogastroduodenoscopy (EGD) seems to be relatively safe for both mother and fetus based on two retrospective studies of 83 and 60 pregnant patients. The diagnostic yield is about 95% when EGD is performed for gastrointestinal bleeding. EGD indications during pregnancy include acute gastrointestinal bleeding, dysphagia > 1 wk, or endoscopic therapy. Therapeutic EGD is experimental due to scant data, but should be strongly considered for urgent indications such as active bleeding. One study of 48 sigmoidoscopies performed during pregnancy showed relatively favorable fetal outcomes, rare bad fetal outcomes, and bad outcomes linked to very sick mothers. Sigmoidoscopy should be strongly considered for strong indications, including significant acute lower gastrointestinal bleeding, chronic diarrhea, distal colonic stricture, suspected inflammatory bowel disease flare, and potential colonic malignancy. Data on colonoscopy during pregnancy are limited. One study of 20 pregnant patients showed rare poor fetal outcomes. Colonoscopy is generally experimental during pregnancy, but can be considered for strong indications: known colonic mass/stricture, active lower gastrointestinal bleeding, or colonoscopic therapy. Endoscopic retrograde cholangiopancreatography (ERCP) entails fetal risks from fetal radiation exposure. ERCP risks to mother and fetus appear to be acceptable when performed for ERCP therapy, as demonstrated by analysis of nearly 350 cases during pregnancy. Justifiable indications include symptomatic or complicated choledocholithiasis, manifested by jaundice, cholangitis, gallstone pancreatitis, or dilated choledochus. ERCP should be performed by an expert endoscopist, with informed consent about fetal radiation risks, minimizing fetal radiation exposure, and using an attending anesthesiologist. Endoscopy is likely most safe during the second trimester of pregnancy. PMID:24891928

  8. Guidelines for Safety in the Gastrointestinal Endoscopy Unit

    PubMed Central

    Calderwood, Audrey H.; Chapman, Frank J.; Cohen, Jonathan; Cohen, Lawrence B.; Collins, James; Day, Lukejohn W.; Early, Dayna S.

    2014-01-01

    EXECUTIVE SUMMARY Historically, safety in the gastrointestinal (GI) endoscopy unit has focused on infection control, particularly around the reprocessing of endoscopes. Two highly publicized outbreaks where the transmission of infectious agents were related to GI endoscopy have highlighted the need to address potential gaps along the endoscopy care continuum that could impact patient safety. PMID:24485393

  9. Risk Management for Gastrointestinal Endoscopy in Elderly Patients: Questionnaire for Patients Undergoing Gastrointestinal Endoscopy

    PubMed Central

    Umegaki, Eiji; Abe, Shinya; Tokioka, Satoshi; Takeuchi, Nozomi; Takeuchi, Toshihisa; Yoda, Yukiko; Murano, Mitsuyuki; Higuchi, Kazuhide

    2010-01-01

    More elderly patients now undergo gastrointestinal endoscopy following recent advances in endoscopic techniques. In this study, we conducted a high-risk survey of endoscopies in Japan, using a questionnaire administered prior to upper gastrointestinal tract endoscopy (UGITE), and identified anticholinergic agents and glucagon preparations as high-risk premedication. We also evaluated the cardiovascular effects of anticholinergic agents and glucagon through measurements of plasma levels of human atrial natriuretic peptide (hANP) and human brain natriuretic peptide (hBNP). The subjects were 1480 patients who underwent UGITE. Nurses administered a pre-endoscopy questionnaire, questioning subjects regarding heart disease, hypertension, glaucoma, and urinary difficulties as risk factors for anticholinergic agents, and Diabetes mellitus as a risk factor for glucagon preparations. Evaluation of subjects divided into under 65 and over 65 age groups revealed that in subjects aged 65 and over, risk factors for anticholinergic agents were significantly more high than those for glucagon. Analysis of the cardiovascular effects of anticholinergic agents and glucagon, in the elderly patients showed that hANP levels were significantly higher following administration of anticholinergic agents, but the change was not significant for glucagon premedication. Taking a detailed history before UGITE with the aid of a questionnaire at the same time as informed consent is obtained, is extremely useful in terms of risk management and selection of the appropriate premedication. PMID:20104268

  10. Propofol alternatives in gastrointestinal endoscopy anesthesia

    PubMed Central

    Goudra, Basavana Gouda; Singh, Preet Mohinder

    2014-01-01

    Although propofol has been the backbone for sedation in gastrointestinal endoscopy, both anesthesiologists and endoscopists are faced with situations where an alternative is needed. Recent national shortages forced many physicians to explore these options. A midazolam and fentanyl combination is the mainstay in this area. However, there are other options. The aim of this review is to explore these options. The future would be, invariably, to move away from propofol. The reason is not in any way related to the drawbacks of propofol as a sedative. The mandate that requires an anesthesia provider to administer propofol has been a setback in many countries. New sedative drugs like Remimazolam might fill this void in the future. In the meantime, it is important to keep an open eye to the existing alternatives. PMID:25422614

  11. Sedation and monitoring for gastrointestinal endoscopy

    PubMed Central

    Amornyotin, Somchai

    2013-01-01

    The safe sedation of patients for diagnostic or therapeutic procedures requires a combination of properly trained physicians and suitable facilities. Additionally, appropriate selection and preparation of patients, suitable sedative technique, application of drugs, adequate monitoring, and proper recovery of patients is essential. The goal of procedural sedation is the safe and effective control of pain and anxiety as well as to provide an appropriate degree of memory loss or decreased awareness. Sedation practices for gastrointestinal endoscopy (GIE) vary widely. The majority of GIE patients are ambulatory cases. Most of this procedure requires a short time. So, short acting, rapid onset drugs with little adverse effects and improved safety profiles are commonly used. The present review focuses on commonly used regimens and monitoring practices in GIE sedation. This article is to discuss the decision making process used to determine appropriate pre-sedation assessment, monitoring, drug selection, dose of sedative agents, sedation endpoint and post-sedation care. It also reviews the current status of sedation and monitoring for GIE procedures in Thailand. PMID:23424050

  12. Wireless capsule endoscopy: perspectives beyond gastrointestinal bleeding.

    PubMed

    Redondo-Cerezo, Eduardo; Sánchez-Capilla, Antonio Damián; De La Torre-Rubio, Paloma; De Teresa, Javier

    2014-11-14

    Wireless capsule endoscopy (CE) is a technology developed for the endoscopic exploration of the small bowel. The first capsule model was approved by the Food and Drug Administration in 2001, and its first and essential indication was occult gastrointestinal (GI) bleeding. Over subsequent years, this technology has been refined to provide superior resolution, increased battery life, and capabilities to view different parts of the GI tract. Indeed, cases for which CE proved useful have increased significantly over the last few years, with new indications for the small bowel and technical improvements that have expanded its use to other parts of the GI tract, including the esophagus and colon. The main challenges in the development of CE are new devices with the ability to provide therapy, air inflation for a better vision of the small bowel, biopsy sampling systems attached to the capsule and the possibility to guide and move the capsule with an external motion control. In this article we review the current and new indications of CE, and the evolving technological changes shaping this technology, which has a promising potential in the coming future of gastroenterology. PMID:25400450

  13. Sedation in Gastrointestinal Endoscopy: An Anesthesiologist’s Perspective

    Microsoft Academic Search

    Philippe Van der Linden

    2010-01-01

    Sedation is required to treat an ever increasing number of patients for medical diagnostic or therapeutic procedures, in particular in gastrointestinal endoscopy. Due to the apparent ease of administration of sedative techniques, and due to the shortage of anesthetic staff in many Western countries, sedation is being carried out more and more frequently by non-anesthesiologist doctors or even paramedical staff.

  14. Sedation in gastrointestinal endoscopy: Current issues

    PubMed Central

    Triantafillidis, John K; Merikas, Emmanuel; Nikolakis, Dimitrios; Papalois, Apostolos E

    2013-01-01

    Diagnostic and therapeutic endoscopy can successfully be performed by applying moderate (conscious) sedation. Moderate sedation, using midazolam and an opioid, is the standard method of sedation, although propofol is increasingly being used in many countries because the satisfaction of endoscopists with propofol sedation is greater compared with their satisfaction with conventional sedation. Moreover, the use of propofol is currently preferred for the endoscopic sedation of patients with advanced liver disease due to its short biologic half-life and, consequently, its low risk of inducing hepatic encephalopathy. In the future, propofol could become the preferred sedation agent, especially for routine colonoscopy. Midazolam is the benzodiazepine of choice because of its shorter duration of action and better pharmacokinetic profile compared with diazepam. Among opioids, pethidine and fentanyl are the most popular. A number of other substances have been tested in several clinical trials with promising results. Among them, newer opioids, such as remifentanil, enable a faster recovery. The controversy regarding the administration of sedation by an endoscopist or an experienced nurse, as well as the optimal staffing of endoscopy units, continues to be a matter of discussion. Safe sedation in special clinical circumstances, such as in the cases of obese, pregnant, and elderly individuals, as well as patients with chronic lung, renal or liver disease, requires modification of the dose of the drugs used for sedation. In the great majority of patients, sedation under the supervision of a properly trained endoscopist remains the standard practice worldwide. In this review, an overview of the current knowledge concerning sedation during digestive endoscopy will be provided based on the data in the current literature. PMID:23382625

  15. Sedation in gastrointestinal endoscopy: current issues.

    PubMed

    Triantafillidis, John K; Merikas, Emmanuel; Nikolakis, Dimitrios; Papalois, Apostolos E

    2013-01-28

    Diagnostic and therapeutic endoscopy can successfully be performed by applying moderate (conscious) sedation. Moderate sedation, using midazolam and an opioid, is the standard method of sedation, although propofol is increasingly being used in many countries because the satisfaction of endoscopists with propofol sedation is greater compared with their satisfaction with conventional sedation. Moreover, the use of propofol is currently preferred for the endoscopic sedation of patients with advanced liver disease due to its short biologic half-life and, consequently, its low risk of inducing hepatic encephalopathy. In the future, propofol could become the preferred sedation agent, especially for routine colonoscopy. Midazolam is the benzodiazepine of choice because of its shorter duration of action and better pharmacokinetic profile compared with diazepam. Among opioids, pethidine and fentanyl are the most popular. A number of other substances have been tested in several clinical trials with promising results. Among them, newer opioids, such as remifentanil, enable a faster recovery. The controversy regarding the administration of sedation by an endoscopist or an experienced nurse, as well as the optimal staffing of endoscopy units, continues to be a matter of discussion. Safe sedation in special clinical circumstances, such as in the cases of obese, pregnant, and elderly individuals, as well as patients with chronic lung, renal or liver disease, requires modification of the dose of the drugs used for sedation. In the great majority of patients, sedation under the supervision of a properly trained endoscopist remains the standard practice worldwide. In this review, an overview of the current knowledge concerning sedation during digestive endoscopy will be provided based on the data in the current literature. PMID:23382625

  16. Emergency diagnosis of upper gastrointestinal bleeding by fiberoptic endoscopy.

    PubMed Central

    Villar, H V; Roberts Fender, H; Watson, L C; Thompson, J C

    1977-01-01

    Emergency esophagogastroduodenoscopy has been performed in 192 consecutive patients admitted with massive gastrointestinal bleeding. Accurate endoscopic diagnosis was made in 184 or 96%; 58 patients underwent emergency operations to control bleeding with an overall operative mortality of 26%. Excluding 16 patients who underwent emergency portacaval shunting, the operative mortality was 7%. In 6 patients, the bleeding was controlled by endoscopic electrocoagulation. There were no complications. Emergency endoscopy should be done routinely as the primary diagnostic approach in the diagnosis of upper gastrointestinal bleeding. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. Fig. 5. PMID:300236

  17. Transmission of Infection by Flexible Gastrointestinal Endoscopy and Bronchoscopy

    PubMed Central

    Peters, Frans T. M.; van der Mei, Henny C.; Degener, John E.

    2013-01-01

    SUMMARY Flexible endoscopy is a widely used diagnostic and therapeutic procedure. Contaminated endoscopes are the medical devices frequently associated with outbreaks of health care-associated infections. Accurate reprocessing of flexible endoscopes involves cleaning and high-level disinfection followed by rinsing and drying before storage. Most contemporary flexible endoscopes cannot be heat sterilized and are designed with multiple channels, which are difficult to clean and disinfect. The ability of bacteria to form biofilms on the inner channel surfaces can contribute to failure of the decontamination process. Implementation of microbiological surveillance of endoscope reprocessing is appropriate to detect early colonization and biofilm formation in the endoscope and to prevent contamination and infection in patients after endoscopic procedures. This review presents an overview of the infections and cross-contaminations related to flexible gastrointestinal endoscopy and bronchoscopy and illustrates the impact of biofilm on endoscope reprocessing and postendoscopic infection. PMID:23554415

  18. Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.

    PubMed

    van Hooft, Jeanin E; van Halsema, Emo E; Vanbiervliet, Geoffroy; Beets-Tan, Regina G H; DeWitt, John M; Donnellan, Fergal; Dumonceau, Jean-Marc; Glynne-Jones, Robert G T; Hassan, Cesare; Jiménez-Perez, Javier; Meisner, Søren; Muthusamy, V Raman; Parker, Michael C; Regimbeau, Jean-Marc; Sabbagh, Charles; Sagar, Jayesh; Tanis, Pieter J; Vandervoort, Jo; Webster, George J; Manes, Gianpiero; Barthet, Marc A; Repici, Alessandro

    2014-11-01

    This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). This Guideline was also reviewed and endorsed by the Governing Board of the American Society for Gastrointestinal Endoscopy (ASGE). 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 The following recommendations should only be applied after a thorough diagnostic evaluation including a contrast-enhanced computed tomography (CT) scan. 1 Prophylactic colonic stent placement is not recommended. Colonic stenting should be reserved for patients with clinical symptoms and imaging evidence of malignant large-bowel obstruction, without signs of perforation (strong recommendation, low quality evidence). 2 Colonic self-expandable metal stent (SEMS) placement as a bridge to elective surgery is not recommended as a standard treatment of symptomatic left-sided malignant colonic obstruction (strong recommendation, high quality evidence). 3 For patients with potentially curable but obstructing left-sided colonic cancer, stent placement may be considered as an alternative to emergency surgery in those who have an increased risk of postoperative mortality, I. e. American Society of Anesthesiologists (ASA) Physical Status ? III and/or age > 70 years (weak recommendation, low quality evidence). 4 SEMS placement is recommended as the preferred treatment for palliation of malignant colonic obstruction (strong recommendation, high quality evidence), except in patients treated or considered for treatment with antiangiogenic drugs (e. g. bevacizumab) (strong recommendation, low quality evidence). PMID:25325682

  19. Sedation in gastrointestinal endoscopy: Where are we at in 2014?

    PubMed

    Ferreira, Alexandre Oliveira; Cravo, Marília

    2015-02-16

    Gastrointestinal endoscopies are invasive and unpleasant procedures that are increasingly being used worldwide. The importance of high quality procedures (especially in colorectal cancer screening), the increasing patient awareness and the expectation of painless examination, increase the need for procedural sedation. The best single sedation agent for endoscopy is propofol which, due to its' pharmacokinetic/dynamic profile allows for a higher patient satisfaction and procedural quality and lower induction and recovery times, while maintaining the safety of traditional sedation. Propofol is an anesthetic agent when used in higher doses than those needed for endoscopy. Because of this important feature it may lead to cardiovascular and respiratory depression and, ultimately, to cardiac arrest and death. Fueled by this argument, concern over the safety of its administration by personnel without general anesthesia training has arisen. Propofol usage seems to be increasing but it's still underused. It is a safe alternative for simple endoscopic procedures in low risk patients even if administered by non-anesthesiologists. Evidence on propofol safety in complex procedures and high risk patients is less robust and in these cases, the presence of an anesthetist should be considered. We review the existing evidence on the topic and evaluate the regional differences on sedation practices. PMID:25685266

  20. Highlights from the 50th seminar of the korean society of gastrointestinal endoscopy.

    PubMed

    Kim, Eun Young; Choi, Il Ju; Kwon, Kwang An; Ryu, Ji Kon; Dong, Seok Ho; Hahm, Ki Baik

    2014-07-01

    The July issue of Clinical Endoscopy deals with selected articles covering the state-of-the-art lectures delivered during the 50th seminar of the Korean Society of Gastrointestinal Endoscopy (KSGE) on March 30, 2014, highlighting educational contents pertaining to either diagnostic or therapeutic gastrointestinal (GI) endoscopy, which contain fundamental and essential points in GI endoscopy. KSGE is very proud of its seminar, which has been presented twice a year for the last 25 years, and hosted more than 3,500 participants at the current meeting. KSGE seminar is positioned as one of premier state-of-the-art seminars for endoscopy, covering topics for novice endoscopists and advanced experts, as well as diagnostic and therapeutic endoscopy. The 50th KSGE seminar consists of more than 20 sessions, including a single special lecture, concurrent sessions for GI endoscopy nurses, and sessions exploring new technologies. Nine articles were selected from these prestigious lectures, and invited for publication in this special issue. This introductory review, prepared by the editors of Clinical Endoscopy, highlights core contents divided into four sessions: upper GI tract, lower GI tract, pancreatobiliary system, and other specialized topic sessions, including live demonstrations and hands-on courses. PMID:25133113

  1. Highlights from the 50th Seminar of the Korean Society of Gastrointestinal Endoscopy

    PubMed Central

    Kim, Eun Young; Choi, Il Ju; Kwon, Kwang An; Ryu, Ji Kon; Dong, Seok Ho

    2014-01-01

    The July issue of Clinical Endoscopy deals with selected articles covering the state-of-the-art lectures delivered during the 50th seminar of the Korean Society of Gastrointestinal Endoscopy (KSGE) on March 30, 2014, highlighting educational contents pertaining to either diagnostic or therapeutic gastrointestinal (GI) endoscopy, which contain fundamental and essential points in GI endoscopy. KSGE is very proud of its seminar, which has been presented twice a year for the last 25 years, and hosted more than 3,500 participants at the current meeting. KSGE seminar is positioned as one of premier state-of-the-art seminars for endoscopy, covering topics for novice endoscopists and advanced experts, as well as diagnostic and therapeutic endoscopy. The 50th KSGE seminar consists of more than 20 sessions, including a single special lecture, concurrent sessions for GI endoscopy nurses, and sessions exploring new technologies. Nine articles were selected from these prestigious lectures, and invited for publication in this special issue. This introductory review, prepared by the editors of Clinical Endoscopy, highlights core contents divided into four sessions: upper GI tract, lower GI tract, pancreatobiliary system, and other specialized topic sessions, including live demonstrations and hands-on courses. PMID:25133113

  2. Comparison of a novel bedside portable endoscopy device with nasogastric aspiration for identifying upper gastrointestinal bleeding

    PubMed Central

    Choi, Jong Hwan; Choi, Jae Hyuk; Lee, Yoo Jin; Lee, Hyung Ki; Choi, Wang Yong; Kim, Eun Soo; Park, Kyung Sik; Cho, Kwang Bum; Jang, Byoung Kuk; Chung, Woo Jin; Hwang, Jae Seok

    2014-01-01

    AIM: To compare outcomes using the novel portable endoscopy with that of nasogastric (NG) aspiration in patients with gastrointestinal bleeding. METHODS: Patients who underwent NG aspiration for the evaluation of upper gastrointestinal (UGI) bleeding were eligible for the study. After NG aspiration, we performed the portable endoscopy to identify bleeding evidence in the UGI tract. Then, all patients underwent conventional esophagogastroduodenoscopy as the gold-standard test. The sensitivity, specificity, and accuracy of the portable endoscopy for confirming UGI bleeding were compared with those of NG aspiration. RESULTS: In total, 129 patients who had GI bleeding signs or symptoms were included in the study (age 64.46 ± 13.79, 91 males). The UGI tract (esophagus, stomach, and duodenum) was the most common site of bleeding (81, 62.8%) and the cause of bleeding was not identified in 12 patients (9.3%). Specificity for identifying UGI bleeding was higher with the portable endoscopy than NG aspiration (85.4% vs 68.8%, P = 0.008) while accuracy was comparable. The accuracy of the portable endoscopy was significantly higher than that of NG in the subgroup analysis of patients with esophageal bleeding (88.2% vs 75%, P = 0.004). Food material could be detected more readily by the portable endoscopy than NG tube aspiration (20.9% vs 9.3%, P = 0.014). No serious adverse effect was observed during the portable endoscopy. CONCLUSION: The portable endoscopy was not superior to NG aspiration for confirming UGI bleeding site. However, this novel portable endoscopy device might provide a benefit over NG aspiration in patients with esophageal bleeding. PMID:25009396

  3. [Emergency endoscopy after operation of the upper gastro-intestinal tract: problems and risks (author's transl)].

    PubMed

    Daniels, V; Grönniger, J; Dzieniszewski, G P; Kempf, P

    1980-10-17

    Upper gastro-intestinal bleeding or other complications after operations on this tract can lead to grave additional risk for the patient, especially in the early postoperative phase. Because of its high degree of diagnostic accuracy, emergency endoscopy is in most cases of decisive importance in planning the type (conservative or surgical) and timing of any necessary treatment. Special investigative techniques as well as the early use of endoscopy in 97 patients achieved a high rate of success at a low risk to the patients. Indications, results and risks of emergency endoscopy of the upper gastro-intestinal tract in the late postoperative phase are similar to those for the non-operated patient. PMID:6970119

  4. Studying and Incorporating Efficiency into Gastrointestinal Endoscopy Centers

    PubMed Central

    Day, Lukejohn W.; Belson, David

    2015-01-01

    Efficiency is defined as the use of resources in such a way as to maximize the production of goods and services. Improving efficiency has been the focus of management in many industries; however, it has not been until recently that incorporating efficiency models into healthcare has occurred. In particular, the study and development of improvement projects aimed at enhancing efficiency in GI have been growing rapidly in recent years. This focus on improving efficiency in GI has been spurred by the dramatic rise in the demand for endoscopic procedures as well as the rising number of insured patients requiring GI care coupled at the same time with limited resources in terms of staffing and space in endoscopy centers. This paper will critically review the history of efficiency in endoscopy centers, first by looking at other healthcare industries that have extensively studied and improved efficiency in their fields, examine a number of proposed efficiency metrics and benchmarks in endoscopy centers, and finally discuss opportunities where endoscopy centers could improve their efficiency.

  5. Perception of Gastrointestinal Endoscopy by Patients and Examiners with and without Background Music

    Microsoft Academic Search

    Janek Binek; Markus Sagmeister; Jan Borovicka; Matthias Knierim; Bernhard Magdeburg; Christa Meyenberger

    2003-01-01

    Background\\/Aims: Several studies have reported improved patient comfort with music in the preoperative setting, however music has seldom been assessed during gastrointestinal endoscopy. We aimed to assess how background music may influence the perception of patients and examiners involved in endoscopic examinations. Methods: 301 patients (128 females, 173 males; mean age 59 years) were included in the study (EGD and

  6. Follicular lymphoma with extensive gastrointestinal tract involvement: follow-up by capsule endoscopy.

    PubMed

    Sapoznikov, Boris; Morgenstern, Sarah; Raanani, Pia; Aviram, Adina; Rabizadeh, Esther; Prokocimer, Miron; Niv, Yaron

    2007-04-01

    Follicular lymphoma with gastrointestinal tract involvement is rare. We describe the case of a young woman with follicular lymphoma with multiple nodular lesions involving segments of the proximal jejunum and terminal ileum. The presenting symptom was chronic diarrhea. The diagnosis was made by endoscopy with histologic examination of the mucosal lesions of the proximal and distal small intestine, immunohistochemical staining, and molecular analysis. The initial spread and pattern of the small bowel involvement, as well as treatment response, were evaluated by videocapsule endoscopy. The application of molecular analysis along with immunophenotypic evaluation has made it possible to precisely diagnose follicular lymphoma. In the present case, the use of capsule endoscopy improved the evaluation of the extent of small bowel involvement prior to and following treatment. PMID:17353993

  7. Role of endoscopy in management of gastrointestinal complications of portal hypertension.

    PubMed

    Luigiano, Carmelo; Iabichino, Giuseppe; Judica, Antonino; Virgilio, Clara; Peta, Valentina; Abenavoli, Ludovico

    2015-01-16

    The management of patients with gastrointestinal complications of portal hypertension is often complex and challenging. The endoscopy plays an important role in the management of these patients. The role of endoscopy is both diagnostic and interventional and in the last years the techniques have undergone a rapid expansion with the advent of different and novel endoscopic modalities, with consequent improvement of investigation and treatment of these patients. The choice of best therapeutic strategy depends on many factors: baseline disease, patient's clinical performance and the timing when it is done if in emergency or a prophylactic approaches. In this review we evaluate the endoscopic management of patients with the gastrointestinal complications of portal hypertension. PMID:25610530

  8. Role of endoscopy in management of gastrointestinal complications of portal hypertension

    PubMed Central

    Luigiano, Carmelo; Iabichino, Giuseppe; Judica, Antonino; Virgilio, Clara; Peta, Valentina; Abenavoli, Ludovico

    2015-01-01

    The management of patients with gastrointestinal complications of portal hypertension is often complex and challenging. The endoscopy plays an important role in the management of these patients. The role of endoscopy is both diagnostic and interventional and in the last years the techniques have undergone a rapid expansion with the advent of different and novel endoscopic modalities, with consequent improvement of investigation and treatment of these patients. The choice of best therapeutic strategy depends on many factors: baseline disease, patient’s clinical performance and the timing when it is done if in emergency or a prophylactic approaches. In this review we evaluate the endoscopic management of patients with the gastrointestinal complications of portal hypertension. PMID:25610530

  9. Should Capsule Endoscopy Be the First Test for Every Obscure Gastrointestinal Bleeding?

    PubMed Central

    Tae, Chung Hyun

    2014-01-01

    Obscure gastrointestinal bleeding (OGIB) refers to gastrointestinal (GI) bleeding of unclear origin that persists or recurs after negative findings on esophagogastroduodenoscopy and colonoscopy. OGIB accounts for approximately 5% of all types of GI bleeding. More than 80% of OGIB cases originate in the small bowel. The ability to detect OGIB in the small bowel has significantly advanced and been revolutionized since the introduction of the capsule endoscopy and double-balloon enteroscopy techniques in 2000 and 2001, respectively. With these new methods for small-bowel evaluation, new guidelines have been proposed for the diagnosis and management of OGIB. However, some issues remain unsolved. The purpose of this article is to review the various modalities used for evaluating OGIB, including capsule endoscopy and double-balloon enteroscopy, and to help guide clinicians in their decisions on which modality will be the most effective. PMID:25324999

  10. Narrow-band imaging with magnifying endoscopy for the evaluation of gastrointestinal lesions

    PubMed Central

    Boeriu, Alina; Boeriu, Cristian; Drasovean, Silvia; Pascarenco, Ofelia; Mocan, Simona; Stoian, Mircea; Dobru, Daniela

    2015-01-01

    Narrow band imaging (NBI) endoscopy is an optical image enhancing technology that allows a detailed inspection of vascular and mucosal patterns, providing the ability to predict histology during real-time endoscopy. By combining NBI with magnification endoscopy (NBI-ME), the accurate assessment of lesions in the gastrointestinal tract can be achieved, as well as the early detection of neoplasia by emphasizing neovascularization. Promising results of the method in the diagnosis of premalignant and malignant lesions of gastrointestinal tract have been reported in clinical studies. The usefulness of NBI-ME as an adjunct to endoscopic therapy in clinical practice, the potential to improve diagnostic accuracy, surveillance strategies and cost-saving strategies based on this method are summarized in this review. Various classification systems of mucosal and vascular patterns used to differentiate preneoplastic and neoplastic lesions have been reviewed. We concluded that the clinical applicability of NBI-ME has increased, but standardization of endoscopic criteria and classification systems, validation in randomized multicenter trials and training programs to improve the diagnostic performance are all needed before the widespread acceptance of the method in routine practice. However, published data regarding the usefulness of NBI endoscopy are relevant in order to recommend the method as a reliable tool in diagnostic and therapy, even for less experienced endoscopists. PMID:25685267

  11. Narrow-band imaging with magnifying endoscopy for the evaluation of gastrointestinal lesions.

    PubMed

    Boeriu, Alina; Boeriu, Cristian; Drasovean, Silvia; Pascarenco, Ofelia; Mocan, Simona; Stoian, Mircea; Dobru, Daniela

    2015-02-16

    Narrow band imaging (NBI) endoscopy is an optical image enhancing technology that allows a detailed inspection of vascular and mucosal patterns, providing the ability to predict histology during real-time endoscopy. By combining NBI with magnification endoscopy (NBI-ME), the accurate assessment of lesions in the gastrointestinal tract can be achieved, as well as the early detection of neoplasia by emphasizing neovascularization. Promising results of the method in the diagnosis of premalignant and malignant lesions of gastrointestinal tract have been reported in clinical studies. The usefulness of NBI-ME as an adjunct to endoscopic therapy in clinical practice, the potential to improve diagnostic accuracy, surveillance strategies and cost-saving strategies based on this method are summarized in this review. Various classification systems of mucosal and vascular patterns used to differentiate preneoplastic and neoplastic lesions have been reviewed. We concluded that the clinical applicability of NBI-ME has increased, but standardization of endoscopic criteria and classification systems, validation in randomized multicenter trials and training programs to improve the diagnostic performance are all needed before the widespread acceptance of the method in routine practice. However, published data regarding the usefulness of NBI endoscopy are relevant in order to recommend the method as a reliable tool in diagnostic and therapy, even for less experienced endoscopists. PMID:25685267

  12. Prevalence of celiac disease and its endoscopic markers among patients having routine upper gastrointestinal endoscopy

    Microsoft Academic Search

    William Dickey; Dermot Hughes

    1999-01-01

    OBJECTIVE:The aim of this study was to determine the prevalence of duodenal villous atrophy (VA) among patients undergoing routine upper gastrointestinal (GI) endoscopy and the value of endoscopic markers for VA in selecting patients for duodenal biopsy.METHODS:One hundred and fifty adult patients with upper GI symptoms or iron-deficiency anemia had inspection and biopsy of the second part of the duodenum

  13. Follicular Lymphoma with Extensive Gastrointestinal Tract Involvement: Follow-up by Capsule Endoscopy

    Microsoft Academic Search

    Boris Sapoznikov; Sarah Morgenstern; Pia Raanani; Adina Aviram; Esther Rabizadeh; Miron Prokocimer; Yaron Niv

    2007-01-01

    Follicular lymphoma with gastrointestinal tract involvement is rare. We describe the case of a young woman with follicular\\u000a lymphoma with multiple nodular lesions involving segments of the proximal jejunum and terminal ileum. The presenting symptom\\u000a was chronic diarrhea. The diagnosis was made by endoscopy with histologic examination of the mucosal lesions of the proximal\\u000a and distal small intestine, immunohistochemical staining,

  14. Evaluation of Infliximab Effects on Gastrointestinal Bleeding in Crohn's Disease Using Double-Balloon Endoscopy

    PubMed Central

    Chowdhury, Manzurul; Kudara, Norihiko; Chiba, Toshimi; Endo, Masaki; Akasaka, Risaburo; Tomita, Kazumitsu; Fujiwara, Saori; Mizutani, Tomomi; Sugai, Tamotsu; Takikawa, Yasuhiro; Suzuki, Kazuyuki

    2009-01-01

    Tumor necrosis factor ? plays an important role in the pathogenesis of Crohn's disease (CD). The effects of infliximab on gastrointestinal bleeding in CD have not yet been fully evaluated. Herein we describe three CD cases who presented with gastrointestinal bleeding and received infliximab treatment. In case 1, double-balloon endoscopy showed a large ulcer with several irregularly shaped ulcers in the terminal ileum; 8 weeks after infliximab administration, complete healing of all lesions was observed. In case 2, double-balloon endoscopy showed linear ulcers and mucosal edema in the jejunum and ileum; 5 weeks after infliximab administration, all lesions were decreased in size and were healed. In case 3, double-balloon endoscopy revealed ulcerations and stenosis in the terminal ileum; 12 weeks after infliximab administration, ulcer healing and an increased diameter of the ileal stenosis were observed. These three cases have been receiving ongoing infliximab maintenance therapy and are currently symptom-free. Infliximab thus appears to be useful for treatment of gastrointestinal bleeding in CD patients. PMID:21103274

  15. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.

    PubMed

    Pennazio, Marco; Spada, Cristiano; Eliakim, Rami; Keuchel, Martin; May, Andrea; Mulder, Chris J; Rondonotti, Emanuele; Adler, Samuel N; Albert, Joerg; Baltes, Peter; Barbaro, Federico; Cellier, Christophe; Charton, Jean Pierre; Delvaux, Michel; Despott, Edward J; Domagk, Dirk; Klein, Amir; McAlindon, Mark; Rosa, Bruno; Rowse, Georgina; Sanders, David S; Saurin, Jean Christophe; Sidhu, Reena; Dumonceau, Jean-Marc; Hassan, Cesare; Gralnek, Ian M

    2015-04-01

    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). 2 In patients with overt obscure gastrointestinal bleeding, ESGE recommends performing small-bowel capsule endoscopy as soon as possible after the bleeding episode, optimally within 14 days, in order to maximize the diagnostic yield (strong recommendation, moderate quality evidence). 3 ESGE does not recommend the routine performance of second-look endoscopy prior to small-bowel capsule endoscopy; however whether to perform second-look endoscopy before capsule endoscopy in patients with obscure gastrointestinal bleeding or iron-deficiency anaemia should be decided on a case-by-case basis (strong recommendation, low quality evidence). 4 In patients with positive findings at small-bowel capsule endoscopy, ESGE recommends device-assisted enteroscopy to confirm and possibly treat lesions identified by capsule endoscopy (strong recommendation, high quality evidence). 5 ESGE recommends ileocolonoscopy as the first endoscopic examination for investigating patients with suspected Crohn's disease (strong recommendation, high quality evidence). In patients with suspected Crohn's disease and negative ileocolonoscopy findings, ESGE recommends small-bowel capsule endoscopy as the initial diagnostic modality for investigating the small bowel, in the absence of obstructive symptoms or known stenosis (strong recommendation, moderate quality evidence).ESGE does not recommend routine small-bowel imaging or the use of the PillCam patency capsule prior to capsule endoscopy in these patients (strong recommendation, low quality evidence). In the presence of obstructive symptoms or known stenosis, ESGE recommends that dedicated small bowel cross-sectional imaging modalities such as magnetic resonance enterography/enteroclysis or computed tomography enterography/enteroclysis should be used first (strong recommendation, low quality evidence). 6 In patients with established Crohn's disease, based on ileocolonoscopy findings, ESGE recommends dedicated cross-sectional imaging for small-bowel evaluation since this has the potential to assess extent and location of any Crohn's disease lesions, to identify strictures, and to assess for extraluminal disease (strong recommendation, low quality evidence). In patients with unremarkable or nondiagnostic findings from such cross-sectional imaging of the small bowel, ESGE recommends small-bowel capsule endoscopy as a subsequent investigation, if deemed to influence patient management (strong recommendation, low quality evidence). When capsule endoscopy is indicated, ESGE recommends use of the PillCam patency capsule to confirm functional patency of the small bowel (strong recommendation, low quality evidence). 7 ESGE strongly recommends against the use of small-bowel capsule endoscopy for suspected coeliac disease but suggests that capsule endoscopy could be used in patients unwilling or unable to undergo conventional endoscopy (strong recommendation, low quality evidence). PMID:25826168

  16. Evaluation of dyspeptic symptoms in patients with and without Helicobacter pylori infection and normal upper gastrointestinal endoscopy

    Microsoft Academic Search

    L Marzio; G Cappello; E Ballone

    2003-01-01

    Background. A relationship between Helicobacter pylori infection and dyspeptic symptoms has not yet been demonstrated.Aim. To evaluate any possible difference in symptom score between dyspeptic patients with and without H. pylori infection who have normal upper gastrointestinal endoscopy and no other appreciable gastrointestinal or systemic disease.Patients. A series of consecutive patients affected by upper abdominal disturbances completed a symptoms questionnaire

  17. Oxygen desaturation and tachycardia during upper gastrointestinal endoscopy are transient and benign.

    PubMed

    Mistry, F P; Abraham, P; Bhatia, S J

    1992-08-01

    We continuously monitored the arterial oxygen saturation (SaO2) and pulse rate by pulse oximetry in 46 patients undergoing upper gastrointestinal endoscopy for diagnosis (21 cases) or variceal sclerotherapy (25). No premedication or prior topical anaesthesia was used. Significant hypoxaemia (percent drop in SaO2 > 2) occurred in 24 (52%) patients during the procedure; in 16 of these it occurred during introduction of the endoscope. Twenty seven (59%) patients had hypoxaemia during recovery, 25 of these immediately after withdrawal of the endoscope. All these episodes were short-lived and were probably due to gagging; basal levels were reached within 1 to 5 min. Tachycardia (> 100 beats/min) occurred in 41 (89%) patients. Sclerotherapy and history of smoking did not affect the incidence and magnitude of hypoxaemia and tachycardia. Transient cardio-respiratory changes occur during and immediately after endoscopy, but these appear to be clinically benign. PMID:1308490

  18. INTEGRATED OPTICAL TOOLS FOR MINIMALLY INVASIVE DIAGNOSIS AND TREATMENT AT GASTROINTESTINAL ENDOSCOPY.

    PubMed

    Rodriguez-Diaz, Eladio; Bigio, Irving J; Singh, Satish K

    2011-04-01

    Over the past two decades, the bulk of gastrointestinal (GI) endoscopic procedures has shifted away from diagnostic and therapeutic interventions for symptomatic disease toward cancer prevention in asymptomatic patients. This shift has resulted largely from a decrease in the incidence of peptic ulcer disease in the era of antisecretory medications coupled with emerging evidence for the efficacy of endoscopic detection and eradication of dysplasia, a histopathological biomarker widely accepted as a precursor to cancer. This shift has been accompanied by a drive toward minimally-invasive, in situ optical diagnostic technologies that help assess the mucosa for cellular changes that relate to dysplasia. Two competing but complementary approaches have been pursued. The first approach is based on broad-view targeting of "areas of interest" or "red flags." These broad-view technologies include standard white light endoscopy (WLE), high-definition endoscopy (HD), and "electronic" chromoendoscopy (narrow-band-type imaging). The second approach is based on multiple small area or point-source (meso/micro) measurements, which can be either machine (spectroscopy) or human-interpreted (endomicroscopy, magnification endoscopy), much as histopatholgy slides are. In this paper we present our experience with the development and testing of a set of familiar but "smarter" standard tissue-sampling tools that can be routinely employed during screening/surveillance endoscopy. These tools have been designed to incorporate fiberoptic probes that can mediate spectroscopy or endomicroscopy. We demonstrate the value of such tools by assessing their preliminary performance from several ongoing clinical studies. Our results have shown promise for a new generation of integrated optical tools for a variety of screening/surveillance applications during GI endoscopy. Integrated devices should prove invaluable for dysplasia surveillance strategies that currently result in large numbers of benign biopsies, which are of little clinical consequence, including screening for colorectal polyps and surveillance of "flat" dysplasia such as Barrett's esophagus and chronic colitis due to inflammatory bowel diseases. PMID:21152112

  19. How commonly is upper gastrointestinal cancer missed at endoscopy? A meta-analysis

    PubMed Central

    Menon, Shyam; Trudgill, Nigel

    2014-01-01

    Background and study aims: Upper gastrointestinal (UGI) cancer in the Western world usually presents at an advanced stage, when opportunities for curative therapy are limited. The failure to detect subtle, early-stage UGI cancer at endoscopy may contribute to a poor prognosis. We undertook a meta-analysis of studies of endoscopic miss rates for UGI cancer to quantify how often opportunities to diagnose cancer at an earlier stage are missed. Patients and methods: A MEDLINE search was conducted to identify relevant studies, and a meta-analysis was conducted. “Missed” UGI cancer was defined as cancer that had not been diagnosed by UGI endoscopy performed within 3 years before the diagnosis. Random effects meta-analysis was used to determine the event rate of missed UGI cancer. Results: Ten studies were identified that included 3,787 patients with UGI cancer. Four hundred eighty-seven UGI cancers were missed at endoscopy within 3 years before diagnosis. Marked heterogeneity was observed between studies (I 2, 94.4?%; P?endoscopy up to 3 years before diagnosis. To ameliorate the poor prognosis of patients with UGI cancer in the Western world, efforts should be made to improve the quality of UGI endoscopy and create opportunities for earlier diagnosis.

  20. INTEGRATED OPTICAL TOOLS FOR MINIMALLY INVASIVE DIAGNOSIS AND TREATMENT AT GASTROINTESTINAL ENDOSCOPY

    PubMed Central

    Rodriguez-Diaz, Eladio; Bigio, Irving J.; Singh, Satish K.

    2010-01-01

    Over the past two decades, the bulk of gastrointestinal (GI) endoscopic procedures has shifted away from diagnostic and therapeutic interventions for symptomatic disease toward cancer prevention in asymptomatic patients. This shift has resulted largely from a decrease in the incidence of peptic ulcer disease in the era of antisecretory medications coupled with emerging evidence for the efficacy of endoscopic detection and eradication of dysplasia, a histopathological biomarker widely accepted as a precursor to cancer. This shift has been accompanied by a drive toward minimally-invasive, in situ optical diagnostic technologies that help assess the mucosa for cellular changes that relate to dysplasia. Two competing but complementary approaches have been pursued. The first approach is based on broad-view targeting of “areas of interest” or “red flags.” These broad-view technologies include standard white light endoscopy (WLE), high-definition endoscopy (HD), and “electronic” chromoendoscopy (narrow-band-type imaging). The second approach is based on multiple small area or point-source (meso/micro) measurements, which can be either machine (spectroscopy) or human-interpreted (endomicroscopy, magnification endoscopy), much as histopatholgy slides are. In this paper we present our experience with the development and testing of a set of familiar but “smarter” standard tissue-sampling tools that can be routinely employed during screening/surveillance endoscopy. These tools have been designed to incorporate fiberoptic probes that can mediate spectroscopy or endomicroscopy. We demonstrate the value of such tools by assessing their preliminary performance from several ongoing clinical studies. Our results have shown promise for a new generation of integrated optical tools for a variety of screening/surveillance applications during GI endoscopy. Integrated devices should prove invaluable for dysplasia surveillance strategies that currently result in large numbers of benign biopsies, which are of little clinical consequence, including screening for colorectal polyps and surveillance of “flat” dysplasia such as Barrett’s esophagus and chronic colitis due to inflammatory bowel diseases. PMID:21152112

  1. Urgent double balloon endoscopy provides higher yields than non-urgent double balloon endoscopy in overt obscure gastrointestinal bleeding

    PubMed Central

    Aniwan, Satimai; Viriyautsahakul, Vichai; Rerknimitr, Rungsun; Angsuwatcharakon, Phonthep; Kongkam, Pradermchai; Treeprasertsuk, Sombat; Kullavanijaya, Pinit

    2014-01-01

    Background and study aims: In overt obscure gastrointestinal bleeding (OV), double balloon endoscopy (DBE) is recommended as one of the most important investigations as it can provide both diagnosis and treatment. However, there is no set standard on the timing of DBE in OV. The aim of this study was to compare the diagnostic and therapeutic yields between urgent and non-urgent DBE in patients with OV. Patients and methods: Between January 2006 and February 2013, 120 patients with OV who underwent DBE were retrospectively reviewed. An urgent DBE was defined as DBE performed within 72?h from the last visible gastrointestinal bleeding (n?=?74) whereas a non-urgent DBE was defined as DBE performed after 72?h (n?=?46). Diagnostic yields, therapeutic impact and clinical outcomes were evaluated. Results: Diagnostic yield in urgent DBE was significantly higher than that in non-urgent DBE (70?% versus 30?%; P?

  2. Applying LED in full-field optical coherence tomography for gastrointestinal endoscopy

    NASA Astrophysics Data System (ADS)

    Yang, Bor-Wen; Wang, Yu-Yen; Juan, Yu-Shan; Hsu, Sheng-Jie

    2015-05-01

    Optical coherence tomography (OCT) has become an important medical imaging technology due to its non-invasiveness and high resolution. Full-field optical coherence tomography (FF-OCT) is a scanning scheme especially suitable for en face imaging as it employs a CMOS/CCD device for parallel pixels processing. FF-OCT can also be applied to high-speed endoscopic imaging. Applying cylindrical scanning and a right-angle prism, we successfully obtained a 360° tomography of the inner wall of an intestinal cavity through an FF-OCT system with an LED source. The 10-?m scale resolution enables the early detection of gastrointestinal lesions, which can increase detection rates for esophageal, stomach, or vaginal cancer. All devices used in this system can be integrated by MOEMS technology to contribute to the studies of gastrointestinal medicine and advanced endoscopy technology.

  3. Nonvariceal upper gastrointestinal tract bleeding – risk factors and the value of emergency endoscopy

    PubMed Central

    Dabrowiecki, Stanislaw; Szczesny, Wojciech; Szmytkowski, Jakub

    2013-01-01

    Introduction Upper gastrointestinal tract bleeding (UGIB) remains a valid issue of modern medicine. The mortality and recurrence rates remain high and have not decreased as expected over the past decades. Aim of the study: to assess the treatment outcomes of nonvariceal UGIB depending on the timing of endoscopy (urgent vs. elective) and to perform an analysis of risk factors for death in patients with nonvariceal UGIB. Material and methods Comparative evaluation of treatment outcomes in two groups of patients. Group A consisted of patients undergoing elective endoscopy (n = 187). Group B consisted of patients undergoing emergency endoscopy (n = 295). Moreover, the influence of selected factors on the risk of death and bleeding recurrence was analyzed in the combined population of the two groups. This was done by constructing a logistic regression model and testing dependence hypotheses. Results In group A the mortality rate was 9.1%, and the recurrence rate was 18.2%. In group B the values were 6.8% and 12.2%, respectively. No statistically significant difference was found (p = NS). In group B the number of surgical interventions, blood transfusions and intensive care admissions was significantly lower (p < 0.05). An analysis of the combined material showed that the factors which correlated with an elevated risk of death included: old age, hemodynamic state (shock), elevated Charlson Comorbidity Index score, hemoglobin concentration, bleeding from a malignant lesion, recurrent bleeding and the need for surgery (p < 0.05). Conclusions The use of emergency endoscopy improves the treatment outcomes in patients with UGIB, although no statistically significant decrease in the mortality and recurrence rates could be observed. PMID:24273567

  4. Urgent endoscopy in elderly patients with non-variceal upper gastrointestinal bleeding

    PubMed Central

    D?browiecki, Stanis?aw; Szcz?sny, Wojciech

    2012-01-01

    Introduction Age of the patient is an important prognostic factor in patients with non-variceal upper gastrointestinal bleeding (UGIB). Despite that fact, current treatment algorithms do not differentiate UGIB management according to the patient's age. Aim To compare treatment outcomes in patients below and above 75 years of age, treated for UGIB with urgent endoscopy. Material and methods Prospective analysis of treatment outcomes in 295 patients with non-variceal UGIB divided into two age groups (group A < 75 years of age, group B > 75 years of age). Urgent endoscopy (up to 3 h since admission) was performed in 292 patients. The groups were compared in regards to the duration of symptoms, previous UGIB, presence of factors predisposing to UGIB (NSAIDs, peptic ulcer disease, liver cirrhosis, and previous gastrointestinal surgery), haemodynamic state and haemoglobin (Hb) levels on admission. We analysed the causes of UGIB, severity of UGIB on the Forrest scale, type of endoscopic bleeding control method, and co-morbidities with use of the Charlson Co-morbidity Index (CCI). Treatment outcomes were assessed in regard of mortality rate, UGIB-recurrence rate, duration of hospital stay, amount of transfused blood products and the requirement of intensive therapy unit (ITU) or other departments’ admissions. Patients were followed until their discharge home. Results Mortality rate was 6.8% (group A vs. B: 3.5% vs. 18.7%; p = 0.001). Upper gastrointestinal bleeding recurrence was noted in 12.2% of patients (group A vs. B: 12.5% vs. 10.9%; p = 0.73). 2.4% of patients required surgery for UGIB (group A vs. B: 1.7% vs. 4.7%; p = 0.16). Patients in group B required ITU admission more frequently (group A vs. B: 1% vs. 4.7%; p < 0.01). The mean hospital stay (4.3 days) and the mean number of transfused packed red blood cells (PRBCs) (2.35 Units) did not differ between the groups. Patients in group B used NSAIDS much more frequently, more often had hypovolaemic shock and had a higher CCI score. Conclusions Urgent endoscopy is an important and broadly accepted method of treatment of UGIB. Despite strict adherence to the modern UGIB-treatment algorithms, mortality remains high in the elderly. Thus, these patients need particular attention. The presented study indicates that the standard management might not be sufficient in elderly patients. PMID:23362423

  5. Sex differences in dreaming during short propofol sedation for upper gastrointestinal endoscopy.

    PubMed

    Xu, Guanghong; Liu, Xuesheng; Sheng, Qiying; Yu, Fengqiong; Wang, Kai

    2013-10-01

    Previous reports suggest that sex differences may exist in dreaming under anesthesia, but their results were inconclusive. The current study explored sex differences in the incidence and content of dreams during short propofol sedation for upper gastrointestinal endoscopy and investigated whether sex differences or dream content affect patient satisfaction with sedation. A total of 200 patients (100 men and 100 women) undergoing upper gastrointestinal endoscopy participated in this study. Patients were interviewed with the modified Brice questionnaire about the incidence and the content of dreams, and satisfaction with sedation was assessed. The results showed that the incidence of dreaming was significantly higher in men (31%) than in women (17%) (P=0.02), but recovery time was similar. In men, 45% (14/31) of dreamers reported positive emotional content and only 6% (2/31) reported negative emotional content. In contrast, in women, 18% (3/17) reported positive and 29% (5/17) reported negative content (P=0.04). Men reported dreams that were more vivid, meaningful, familiar, and memorable (P<0.01). No significant sex differences were observed in the emotional intensity of dreams, and emotional content did not influence patients' satisfaction. In sum, sex differences existed in dreaming during short propofol sedation despite similar recovery time and matching in terms of age. Men reported dreaming more frequently and had a higher incidence of recall for their dream narratives. In particular, men reported significantly more positive emotional content, less negative emotional content, and more meaningful content. Dreamer satisfaction with sedation was not influenced by sex or dream content. PMID:23863717

  6. Small-bowel endoscopy core curriculum.

    PubMed

    Rajan, Elizabeth A; Pais, Shireen A; Degregorio, Barry T; Adler, Douglas G; Al-Haddad, Mohammad; Bakis, Gennadiy; Coyle, Walter J; Davila, Raquel E; Dimaio, Christopher J; Enestvedt, Brintha K; Jorgensen, Jennifer; Lee, Linda S; Mullady, Daniel K; Obstein, Keith L; Sedlack, Robert E; Tierney, William M; Faulx, Ashley L

    2013-01-01

    This is one of a series of documents prepared by the ASGE Training Committee. This curriculum document contains recommendations for training, intended for use by endoscopy training directors, endoscopists involved in teaching endoscopy, and trainees in endoscopy. It was developed as an overview of techniques currently favored for the performance and training of small-bowel endoscopy and to serve as a guide to published references, videotapes, and other resources available to the trainer. By providing information to endoscopy trainers about the common practices used by experts in performing the technical aspects of the procedure, the ASGE hopes to improve the teaching and performance of small-bowel endoscopy. PMID:23261090

  7. H. pylori May Not Be Associated with Iron Deficiency Anemia in Patients with Normal Gastrointestinal Tract Endoscopy Results

    PubMed Central

    Saler, Tayyibe; Ke?kek, ?akir Özgür; K?rk, Sibel; Ahbab, Süleyman; Orto?lu, Gülay

    2014-01-01

    Background. The aim of this study was to investigate the association between iron deficiency anemia and H. pylori in patients with normal gastrointestinal tract endoscopy results. Materials and Methods. A total of 117 male patients with normal gastrointestinal tract endoscopy results were included in this retrospective study. The study and control groups included 69 and 48 patients with and without iron deficiency anemia, respectively. The prevalence of H. pylori, the number of RBCs, and the levels of HGB, HTC, MCV, iron, and ferritin were calculated and compared. Results. There was no statistically significant difference found between the groups according to the prevalence of H. pylori (65.2% versus 64.6%, P = 0.896). Additionally, the levels of RBCs, HGB, HTC, MCV, iron, and ferritin in the patients in the study group were lower than those in the control group (P < 0.05). Finally, there was no association between iron deficiency anemia and H. pylori (OR 1.02, Cl 95% 0.47–2.22, and P = 0.943). Conclusion. H. pylori is not associated with iron deficiency anemia in male patients with normal gastrointestinal tract endoscopy results. PMID:25610466

  8. Appropriate use of endoscopy in the diagnosis and treatment of gastrointestinal diseases: up-to-date indications for primary care providers

    PubMed Central

    Nguyen, Vien X; Le Nguyen, Vi Thuy; Nguyen, Cuong C

    2010-01-01

    The field of endoscopy has revolutionized the diagnosis and treatment of gastrointestinal (GI) diseases in recent years. Besides the ‘traditional’ endoscopic procedures (esophagogastroduodenoscopy, colonoscopy, flexible sigmoidoscopy, and endoscopic retrograde cholangiopancreatography), advances in imaging technology (endoscopic ultrasonography, wireless capsule endoscopy, and double balloon enteroscopy) have allowed GI specialists to detect and manage disorders throughout the digestive system. This article reviews various endoscopic procedures and provides up-to-date endoscopic indications based on the recommendations of American Society for Gastrointestinal Endoscopy and American Cancer Society for primary care providers in order to achieve high-quality and cost-effective care. PMID:21116340

  9. Ketodex, a combination of dexmedetomidine and ketamine for upper gastrointestinal endoscopy in children: a preliminary report.

    PubMed

    Goyal, Rakhee; Singh, Shivinder; Shukla, R N; Patra, Arun Kumar; Bhargava, D V

    2013-06-01

    A combination of dexmedetomidine and ketamine for upper gastrointestinal endoscopies (UGIE) was studied in 46 children aged 2-12 years over a 6-month period. Dexmedetomidine 1 ?g/kg and ketamine 2 mg/kg were given as a bolus over 5 min. Heart rate (HR), mean arterial pressure (MAP), oxygen saturation (SpO2), and sedation scores were noted before induction as baseline and then every 5 min until recovery. The duration and ease of the procedure, time to recovery, and adverse effects, if any, were also recorded. UGIE could be performed with ease in 41 of the 46 cases. The HR, MAP, and SpO2 did not change significantly from the baseline. No airway intervention was required in any patient. There was no laryngospasm or shivering in any of the children, and one, four, and 11 children had hiccup, vomiting, and increased salivation, respectively. The Pediatric Anesthesia Emergence Delirium score was <4 in all except for two cases. The results of this case series show that this drug combination not only promises to be clinically effective but also safe for UGIE in children. Further randomized controlled trials with standard sedation protocols will be required to draw definite conclusions. PMID:23223916

  10. Biochromoendoscopy: Molecular Imaging with Capsule Endoscopy for Detection of Adenomas of the Gastrointestinal Tract

    PubMed Central

    Zhang, Howard; Morgan, Douglas; Cecil, Gerald; Burkholder, Adam; Ramocki, Nicole; Scull, Brooks; Kay Lund, P.

    2009-01-01

    Background Current capsule endoscopy (CE) provides minimally invasive technology for gastrointestinal imaging, but has limited ability to discriminate different polyp types. Near Infrared Fluorescent (NIRF) probes activated by biomarkers upregulated in adenomas (e.g., cathepsin B) are potentially powerful tools to distinguish premalignant or malignant lesions from benign or inflammatory lesions. Objectives To examine whether CE can be integrated with NIRF probes to detect adenomas, and whether cathepsin B activated NIRF probes are activated by benign or inflammatory ones. Design and Setting Mouse models of adenomas, hyperplastic/lymphoid polyps, and acute or chronic intestinal inflammation were injected intravenously with a cathepsin B activated probe (Prosense™ 680). Dissected intestine was imaged with CE under white or NIRF light. For NIRF, excitation (680 nm), dichroic and emission (700 nm) filters were combined with CE when images were recorded. Prosense™ 680 samples with or without protease were used as positive and negative controls. CE based imaging data was verified using an independent imaging system (Xenogen IVIS system). Main Outcome Measurements Proof of principle that CE integrated with NIRF probes can detect and discriminate adenomas from other lesions. Results CE based NIRF imaging with Prosense™ 680 readily visualized adenomas, including in the colitis model. NIRF signals of different intensities were detected. Prosense™ 680 was not activated by benign or inflammatory lesions. Limitations Optical filters external to capsule were used. Conclusions We demonstrate proof of principle of biochromoendoscopy, CE combined with molecular probes, provides a novel approach that differentiates adenomas from benign polyps and inflammatory lesions. PMID:18499106

  11. Risk of transmission of carbapenem-resistant Enterobacteriaceae and related "superbugs" during gastrointestinal endoscopy.

    PubMed

    Muscarella, Lawrence F

    2014-10-16

    To evaluate the risk of transmission of carbapenem-resistant Enterobacteriaceae (CRE) and their related superbugs during gastrointestinal (GI) endoscopy. Reports of outbreaks linked to GI endoscopes contaminated with different types of infectious agents, including CRE and their related superbugs, were reviewed. Published during the past 30 years, both prior to and since CRE's emergence, these reports were obtained by searching the peer-reviewed medical literature (via the United States National Library of Medicine's "MEDLINE" database); the Food and Drug Administration's Manufacturer and User Facility Device Experience database, or "MAUDE"; and the Internet (via Google's search engine). This review focused on an outbreak of CRE in 2013 following the GI endoscopic procedure known as endoscopic retrograde cholangiopancreatography, or ERCP, performed at "Hospital X" located in the suburbs of Chicago (IL; United States). Part of the largest outbreak of CRE in United States history, the infection and colonization of 10 and 28 of this hospital's patients, respectively, received considerable media attention and was also investigated by the Centers for Disease Control and Prevention (CDC), which published a report about this outbreak in Morbidity and Mortality Weekly Report (MMWR), in 2014. This report, along with the results of an independent inspection of Hospital X's infection control practices following this CRE outbreak, were also reviewed. While this article focuses primarily on the prevention of transmissions of CRE and their related superbugs in the GI endoscopic setting, some of its discussion and recommendations may also apply to other healthcare settings, to other types of flexible endoscopes, and to other types of transmissible infectious agents. This review found that GI endoscopy is an important risk factor for the transmission of CRE and their related superbugs, having been recently associated with patient morbidity and mortality following ERCP. The CDC reported in MMWR that the type of GI endoscope, known as an ERCP endoscope, that Hospital X used to perform ERCP in 2013 on the 38 patients who became infected or colonized with CRE might be particularly challenging to clean and disinfect, because of the complexity of its physical design. If performed in strict accordance with the endoscope manufacturer's labeling, supplemented as needed with professional organizations' published guidelines, however, current practices for reprocessing GI endoscopes, which include high-level disinfection, are reportedly adequate for the prevention of transmission of CRE and their related superbugs. Several recommendations are provided to prevent CRE transmissions in the healthcare setting. CRE transmissions are not limited to contaminated GI endoscopes and also have been linked to other reusable flexible endoscopic instrumentation, including bronchoscopes and cystoscopes. In conclusion, contaminated GI endoscopes, particularly those used during ERCP, have been causally linked to outbreaks of CRE and their related superbugs, with associated patient morbidity and mortality. Thorough reprocessing of these complex reusable instruments is necessary to prevent disease transmission and ensure patient safety during GI endoscopy. Enhanced training and monitoring of reprocessing staffers to verify the proper cleaning and brushing of GI endoscopes, especially the area around, behind and near the forceps elevator located at the distal end of the ERCP endoscope, are recommended. If the ERCP endoscope features a narrow and exposed channel that houses a wire connecting the GI endoscope's control head to this forceps elevator, then this channel's complete reprocessing, including its flushing with a detergent using a procedure validated for effectiveness, is also emphasized. PMID:25324917

  12. Sedation in gastrointestinal endoscopy: a prospective study comparing nonanesthesiologist-administered propofol and monitored anesthesia care

    PubMed Central

    de Paulo, Gustavo Andrade; Martins, Fernanda P.B.; Macedo, Erika P.; Gonçalves, Manoel Ernesto P.; Mourão, Carlos Alberto; Ferrari, Angelo P.

    2015-01-01

    Introduction: Adequate sedation is one of the cornerstones of good quality gastrointestinal endoscopy (GIE). Propofol sedation has increased significantly but there has been much debate over whether it can be administered by endoscopists. The aim of this prospective trial was to compare nonanesthesiologist-administered propofol (NAAP) and monitored anesthesia care (MAC). Methods: A total of 2000 outpatients undergoing GIE at Hospital Albert Einstein (São Paulo, Brazil), a tertiary-care private hospital, were divided into two matched groups: NAAP (n?=?1000) and MAC (n?=?1000). In NAAP, propofol doses were determined by the endoscopist. A second physician stayed in the room during the entire procedure, according to local regulations. In MAC, the anesthesiologist administered propofol. Results: In total, 1427 patients (71.3?%) were ASA (American Society of Anesthesiologists) class I and 573 were ASA class II. In NAAP, patients received more propofol?+?fentanyl (61.1?% vs. 50.5?%; P?

  13. The Evaluation of Premenopausal Women with Anemia: What Is the Yield of Gastrointestinal Endoscopy?

    Microsoft Academic Search

    Kristen Robson; Amy Barto; Rebecca F. Liberman

    2009-01-01

    Anemia is not uncommon in premenopausal women. The purpose of this study was to determine the yield of endoscopy in premenopausal\\u000a women with anemia. We identified and reviewed the medical records of 168 premenopausal women who underwent upper endoscopy\\u000a and\\/or colonoscopy for the indication of iron deficiency anemia (IDA) during the years 1996 through 2005. Of the 168 patients,\\u000a 100

  14. Effects of nasal cleansing and topical decongestants on patient tolerance during upper gastrointestinal endoscopy: a prospective randomized study

    PubMed Central

    Akbaba, Soner; Köseo?lu, Hüseyin; Bozk?rl?, Bahad?r Osman; Ak?n, Fatma Ebru; Gündo?du, R?za Haldun; Ersoy, Osman; Karakaya, Jale; Ersoy, Pamir Eren

    2014-01-01

    Adequate patient tolerance is essential for successful completion of safe endoscopic examination. Although there are many reported methods to increase patient tolerance, none of these fully resolve this problem. The aim of this study was to investigate whether relaxing the nasal airways increase patient tolerance to upper gastrointestinal endoscopy (UGE). A total of 300 patients scheduled for diagnostic UGE were randomized into three separate groups. Prior to the UGE procedure the first group was administered intranasal cortisone spray following nasal cleansing (INC). Patients in the second group were administered intranasal saline after nasal cleansing (INSP). The patients in the third group were treated with the standard endoscopic procedure alone (SEP). After the UGE procedure, both endoscopists and patients were asked to evaluate the ease of performing the procedure. Furthermore, patients who had undergone endoscopy before were asked to compare their current experience to their most recent endoscopy. Results shown that INC and INSP groups had significantly better tolerance than the SEP group. When comparing their current experience with the previous one, INC and INSP groups reported that the current experience was better. Conclusions: Taking measures to relax the nasal airways makes breathing more comfortable and increase patient tolerance during UGE. PMID:24995106

  15. Endoscopy – 40 Years since Fiber Optics

    Microsoft Academic Search

    Basil I. Hirschowitz

    2000-01-01

    Since the presentation of the first prototype fiber optic endoscope to the ASGE (or the American Gastroscopic Club as it was then known) in Colorado Springs 40 years ago [1], there has been unimaginable growth and development in endoscopy and gastroenterology, little of which could have been anticipated from the state of gastroenterology in general and of GI endoscopy in

  16. ASGE Technology Committee systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting real-time endoscopic assessment of the histology of diminutive colorectal polyps.

    PubMed

    Abu Dayyeh, Barham K; Thosani, Nirav; Konda, Vani; Wallace, Michael B; Rex, Douglas K; Chauhan, Shailendra S; Hwang, Joo Ha; Komanduri, Sri; Manfredi, Michael; Maple, John T; Murad, Faris M; Siddiqui, Uzma D; Banerjee, Subhas

    2015-03-01

    In vivo real-time assessment of the histology of diminutive (?5 mm) colorectal polyps detected at colonoscopy can be achieved by means of an "optical biopsy" by using currently available endoscopic technologies. This systematic review and meta-analysis was performed by the American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee to specifically assess whether acceptable performance thresholds outlined by an ASGE Preservation and Incorporation of Valuable endoscopic Innovations (PIVI) document for clinical adoption of these technologies have been met. We conducted direct meta-analyses calculating the pooled negative predictive value (NPV) for narrow-band imaging (NBI), i-SCAN, and Fujinon Intelligent Color Enhancement (FICE)-assisted optical biopsy for predicting adenomatous polyp histology of small/diminutive colorectal polyps. We also calculated the pooled percentage agreement with histopathology when assigning postpolypectomy surveillance intervals based on combining real-time optical biopsy of colorectal polyps 5 mm or smaller with histopathologic assessment of polyps larger than 5 mm. Random-effects meta-analysis models were used. Statistical heterogeneity was evaluated by means of I(2) statistics. Our meta-analyses indicate that optical biopsy with NBI, exceeds the NPV threshold for adenomatous polyp histology, supporting a "diagnose-and-leave" strategy for diminutive predicted nonneoplastic polyps in the rectosigmoid colon. The pooled NPV of NBI for adenomatous polyp histology by using the random-effects model was 91% (95% confidence interval [CI], 88-94). This finding was associated with a high degree of heterogeneity (I(2) = 89%). Subgroup analysis indicated that the pooled NPV was greater than 90% for academic medical centers (91.8%; 95% CI, 89-94), for experts (93%; 95% CI, 91-96), and when the optical biopsy assessment was made with high confidence (93%; 95% CI, 90-96). Our meta-analyses also indicate that the agreement in assignment of postpolypectomy surveillance intervals based on optical biopsy with NBI of diminutive colorectal polyps is 90% or greater in academic settings (91%; 95% CI, 86-95), with experienced endoscopists (92%; 95% CI, 88-96) and when optical biopsy assessments are made with high confidence (91%; 95% CI, 88-95). Our systematic review and meta-analysis confirms that the thresholds established by the ASGE PIVI for real-time endoscopic assessment of the histology of diminutive polyps have been met, at least with NBI optical biopsy, with endoscopists who are expert in using this advanced imaging technology and when assessments are made with high confidence. PMID:25597420

  17. Capturing and stitching images with a large viewing angle and low distortion properties for upper gastrointestinal endoscopy

    NASA Astrophysics Data System (ADS)

    Liu, Ya-Cheng; Chung, Chien-Kai; Lai, Jyun-Yi; Chang, Han-Chao; Hsu, Feng-Yi

    2013-06-01

    Upper gastrointestinal endoscopies are primarily performed to observe the pathologies of the esophagus, stomach, and duodenum. However, when an endoscope is pushed into the esophagus or stomach by the physician, the organs behave similar to a balloon being gradually inflated. Consequently, their shapes and depth-of-field of images change continually, preventing thorough examination of the inflammation or anabrosis position, which delays the curing period. In this study, a 2.9-mm image-capturing module and a convoluted mechanism was incorporated into the tube like a standard 10- mm upper gastrointestinal endoscope. The scale-invariant feature transform (SIFT) algorithm was adopted to implement disease feature extraction on a koala doll. Following feature extraction, the smoothly varying affine stitching (SVAS) method was employed to resolve stitching distortion problems. Subsequently, the real-time splice software developed in this study was embedded in an upper gastrointestinal endoscope to obtain a panoramic view of stomach inflammation in the captured images. The results showed that the 2.9-mm image-capturing module can provide approximately 50 verified images in one spin cycle, a viewing angle of 120° can be attained, and less than 10% distortion can be achieved in each image. Therefore, these methods can solve the problems encountered when using a standard 10-mm upper gastrointestinal endoscope with a single camera, such as image distortion, and partial inflammation displays. The results also showed that the SIFT algorithm provides the highest correct matching rate, and the SVAS method can be employed to resolve the parallax problems caused by stitching together images of different flat surfaces.

  18. Medical malpractice litigation related to gastrointestinal endoscopy in Japan: A two-decade review of civil court cases

    PubMed Central

    Hiyama, Toru; Tanaka, Shinji; Yoshihara, Masaharu; Fukuhara, Tatsuma; Mukai, Shinichi; Chayama, Kazuaki

    2006-01-01

    AIM: To examine the allegations in malpractice litigations related to gastrointestinal endoscopy in Japan. METHODS: A retrospective review of cases tried in the civil court system during the 21-year period from 1985 to 2005, identified in a computerized legal database, was undertaken. RESULTS: Eighteen malpractice litigations and a total of 30 allegations were identified. Of the 18 (44%) malpractice litigations, 8 (44%) were related to eso-phagogastroduodenoscopy, 4 (22%) to colonoscopy, 4 (22%) to endoscopic sphincterotomy, and 2 (11%) to endoscopic retrograde cholangiopancreatography. Seventeen (94%) cases pertained to complications, and the remaining (6%) case pertained to misdiagnosis. In 10 cases, the patient died of the complications. Allegations were categorized as: (1) performance error during the endoscopic procedure (n = 12, 40%); (2) lack of informed consent (n = 9, 30%); (3) performance error during the treatment after the endoscopic procedure (n = 4, 13%); (4) premedication error (n = 3, 10%); (5) diagnostic error (n = 1, 3%); and (6) indication error for the endoscopic procedure (n = 1, 3%). CONCLUSION: These data may aid in the design of risk prevention strategies to be used by gastrointestinal endoscopists. PMID:17106936

  19. Upper gastrointestinal endoscopy in the patient population of Kumasi, Ghana: Indications and findings

    PubMed Central

    Gyedu, Adam; Yorke, Joseph

    2014-01-01

    Introduction Characteristics of patients undergoing Upper GI endoscopy (UGIE) in Kumasi, Ghana are largely unknown. This paper reviews the work of three endoscopy units in Kumasi. Methods A review of the records of patients undergoing diagnostic UGIE in the three centers from October 2006 to December 2011 was undertaken. Results 3110 completed UGIE were performed over the period. In 80% of the patients the primary indication for UGIE was dyspepsia occurring without any other symptom. In 50% of patients UGIE findings were normal. Peptic ulcer disease, the most common positive finding, was diagnosed in 27.4% of patients. The odds ratio (O.R) of yielding a positive endoscopic finding for patients presenting with recurrent vomiting, dyspepsia associated with weight loss and UGI bleeding were 3.87 (95% C.I: 2.23-6.69), 1.72 (95% C.I: 1.03-2.87) and 1.81 (95% C.I: 1.03-3.16) respectively. Dyspepsia without any other symptom, on the other hand, yielded a positive endoscopic finding with O.R of 0.67 (95% CI: 0.57-0.80). Alarm symptoms (UGI bleeding, recurrent vomiting, dysphagia or weight loss associated with dyspepsia) yielded a positive endoscopic finding with an O.R of 2.34 (95% C.I: 1.74-3.13). Conclusion Most patients in Kumasi underwent UGIE because of dyspepsia in the absence of any other symptom. These patients were more likely to have normal endoscopic findings. The opposite was true for those presenting with alarm symptoms. Our results suggest that initial UGIE may be preferentially offered to patients presenting with alarm symptoms especially in resource-poor settings such as ours. PMID:25478048

  20. Virtual gastrointestinal colonoscopy in combination with large bowel endoscopy: Clinical application

    PubMed Central

    He, Qing; Rao, Ting; Guan, Yong-Song

    2014-01-01

    Although colorectal cancer (CRC) has no longer been the leading cancer killer worldwide for years with the exponential development in computed tomography (CT) or magnetic resonance imaging, and positron emission tomography/CT as well as virtual colonoscopy for early detection, the CRC related mortality is still high. The objective of CRC screening is to reduce the burden of CRC and thereby the morbidity and mortality rates of the disease. It is believed that this goal can be achieved by regularly screening the average-risk population, enabling the detection of cancer at early, curable stages, and polyps before they become cancerous. Large-scale screening with multimodality imaging approaches plays an important role in reaching that goal to detect polyps, Crohn’s disease, ulcerative colitis and CRC in early stage. This article reviews kinds of presentative imaging procedures for various screening options and updates detecting, staging and re-staging of CRC patients for determining the optimal therapeutic method and forecasting the risk of CRC recurrence and the overall prognosis. The combination use of virtual colonoscopy and conventional endoscopy, advantages and limitations of these modalities are also discussed. PMID:25320519

  1. Comprehensive management of full-thickness luminal defects: The next frontier of gastrointestinal endoscopy

    PubMed Central

    Winder, Joshua S; Pauli, Eric M

    2015-01-01

    Full thickness gastrointestinal defects such as perforations, leaks, and fistulae are a relatively common result of many of the endoscopic and surgical procedures performed in modern health care. As the number of these procedures increases, so too will the number of resultant defects. Historically, these were all treated by open surgical means with the associated morbidity and mortality. With the recent advent of advanced endoscopic techniques, these defects can be treated definitively while avoiding an open surgical procedure. Here we explore the various techniques and tools that are currently available for the treatment of gastrointestinal defects including through the scope clips, endoscopic suturing devices, over the scope clips, sealants, endoluminal stents, endoscopic suction devices, and fistula plugs. As fistulae represent the most recalcitrant of defects, we focus this editorial on a multimodal approach of treatment. This includes optimization of nutrition, treatment of infection, ablation of tracts, removal of foreign bodies, and treatment of distal obstructions. We believe that by addressing all of these factors at the time of attempted closure, the patient is optimized and has the best chance at long-term closure. However, even with all of these factors addressed, failure does occur and in those cases, endoscopic therapies may still play a role in that they allow the patient to avoid a definitive surgical therapy for a time while nutrition is optimized, and infections are addressed.

  2. Proton pump inhibitors therapy vs H2 receptor antagonists therapy for upper gastrointestinal bleeding after endoscopy: A meta-analysis

    PubMed Central

    Zhang, Ying-Shi; Li, Qing; He, Bo-Sai; Liu, Ran; Li, Zuo-Jing

    2015-01-01

    AIM: To compare the therapeutic effects of proton pump inhibitors vs H2 receptor antagonists for upper gastrointestinal bleeding in patients after successful endoscopy. METHODS: We searched the Cochrane library, MEDLINE, EMBASE and PubMed for randomized controlled trials until July 2014 for this study. The risk of bias was evaluated by the Cochrane Collaboration’s tool and all of the studies had acceptable quality. The main outcomes included mortality, re-bleeding, received surgery rate, blood transfusion units and hospital stay time. These outcomes were estimated using odds ratios (OR) and mean difference with 95% confidence interval (CI). RevMan 5.3.3 software and Stata 12.0 software were used for data analyses. RESULTS: Ten randomized controlled trials involving 1283 patients were included in this review; 678 subjects were in the proton pump inhibitors (PPI) group and the remaining 605 subjects were in the H2 receptor antagonists (H2RA) group. The meta-analysis results revealed that after successful endoscopic therapy, compared with H2RA, PPI therapy had statistically significantly decreased the recurrent bleeding rate (OR = 0.36; 95%CI: 0.25-0.51) and receiving surgery rate (OR = 0.29; 95%CI: 0.09-0.96). There were no statistically significant differences in mortality (OR = 0.46; 95%CI: 0.17-1.23). However, significant heterogeneity was present in both the numbers of patients requiring blood transfusion after treatment [weighted mean difference (WMD), -0.70 unit; 95%CI: -1.64 - 0.25] and the time that patients remained hospitalized [WMD, -0.77 d; 95%CI: -1.87 - 0.34]. The Begg’s test (P = 0.283) and Egger’s test (P = 0.339) demonstrated that there was no publication bias in our meta-analysis. CONCLUSION: In patients with upper gastrointestinal bleeding after successful endoscopic therapy, compared with H2RA, PPI may be a more effective therapy. PMID:26034370

  3. Autofluorescence endoscopy.

    PubMed

    Falk, Gary W

    2009-04-01

    Autofluorescence endoscopy is a wide area imaging technique, with the ability to rapidly examine a large surface area of gastrointestinal mucosa to detect small areas of dysplasia or cancer. It has potential in diseases such as Barrett's esophagus, ulcerative colitis, and gastric cancer, in which large areas of mucosa may harbor areas of dysplasia or superficial cancer not visible on conventional or high-definition white-light endoscopy. Autofluorescence endoscopy technology has evolved from fiberoptic to video technology with a marked improvement in image quality. Although fiberoptic autofluorescence endoscopy seems to provide no advantage over conventional white-light imaging, videobased technology, especially if combined with narrow band imaging, offers great promise for enhancing endoscopic surveillance of Barrett's esophagus. However, for this technology to have future clinical applications, image quality still needs to be improved and the false positive rate needs to be decreased further. Autofluorescence technology detects indirect measures of dysplasia and carcinoma, and is nonspecific, so additional enhancements are clearly desirable. PMID:19423019

  4. Detection of malignant lesions in vivo in the upper gastrointestinal tract using image-guided Raman endoscopy

    NASA Astrophysics Data System (ADS)

    Bergholt, Mads Sylvest; Zheng, Wei; Lin, Kan; Ho, Khek Yu; Yeoh, Khay Guan; Teh, Ming; So, Jimmy Bok Yan; Huang, Zhiwei

    2012-01-01

    Raman spectroscopy is a vibrational analytic technique sensitive to the changes in biomolecular composition and conformations occurring in tissue. With our most recent development of near-infrared (NIR) Raman endoscopy integrated with diagnostic algorithms, in vivo real-time Raman diagnostics has been realized under multimodal wide-field imaging (i.e., white- light reflectance (WLR), narrow-band imaging (NBI), autofluorescence imaging (AFI)) modalities. A selection of 177 patients who previously underwent Raman endoscopy (n=2510 spectra) was used to render two robust models based on partial least squares - discriminant analysis (PLS-DA) for esophageal and gastric cancer diagnosis. The Raman endoscopy technique was validated prospectively on 4 new gastric and esophageal patients for in vivo tissue diagnosis. The Raman endoscopic technique could identify esophageal cancer in vivo with a sensitivity of 88.9% (8/9) and specificity of 100.0% (11/11) and gastric cancers with a sensitivity of 77.8% (14/18) and specificity of 100.0% (13/13). This study realizes for the first time the image-guided Raman endoscopy for real-time in vivo diagnosis of malignancies in the esophagus and gastric at the biomolecular level.

  5. Comparison of weight, depth, and diagnostic adequacy of specimens obtained with 16 different biopsy forceps designed for upper gastrointestinal endoscopy.

    PubMed Central

    Danesh, B J; Burke, M; Newman, J; Aylott, A; Whitfield, P; Cotton, P B

    1985-01-01

    The influence of endoscopic forceps variables (size, design, and make) on biopsy specimen weight, depth, and diagnostic adequacy has been studied in vitro on normal human stomach, and in vivo at endoscopy in dog and in patients. Greater pressure during the biopsy procedure yielded significantly heavier, deeper, and histologically more acceptable specimens. Standard sized forceps (diameter 2.4 mm) and those with ellipsoid cups consistently produced larger specimens than the smaller 'paediatric' forceps (1.8 mm) and those with round cups. Deeper specimens were also obtained using the standard forceps. In vitro and in vivo in the dog, the standard sized forceps also produced specimens of greater diagnostic adequacy than the paediatric forceps. At endoscopy in patients, however, we could not detect any influence of the size, shape, and presence of forceps spike or fenestration on the diagnostic adequacy of the specimens. PMID:3972269

  6. Initial experience of wireless-capsule endoscopy for evaluating occult gastrointestinal bleeding and suspected small bowel pathology

    Microsoft Academic Search

    Eitan Scapa; Harold Jacob; Shlomo Lewkowicz; Michal Migdal; Daniel Gat; Arkady Gluckhovski; Nurit Gutmann; Zvi Fireman

    2002-01-01

    OBJECTIVE:Small bowel pathology can be diagnosed using enteroscopy (which has limitations) and by x-ray (which is not sensitive for flat lesions). For the first time ever, we used a new technique, wireless-capsule video endoscopy, to diagnose small bowel pathology. Our aim was to prove the effectiveness and safety of this technology.METHODS:We used the Given (M2A) system in 35 patients, aged

  7. Current status of core and advanced adult gastrointestinal endoscopy training in Canada: Survey of existing accredited programs

    PubMed Central

    Xiong, Xin; Barkun, Alan N; Waschke, Kevin; Martel, Myriam

    2013-01-01

    OBJECTIVE: To determine the current status of core and advanced adult gastroenterology training in Canada. METHODS: A survey consisting of 20 questions pertaining to core and advanced endoscopy training was circulated to 14 accredited adult gastroenterology residency program directors. For continuous variables, median and range were analyzed; for categorical variables, percentage and associated 95% CIs were analyzed. RESULTS: All 14 programs responded to the survey. The median number of core trainees was six (range four to 16). The median (range) procedural volumes for gastroscopy, colonoscopy, percutaneous endoscopic gastrostomy and sigmoidoscopy, respectively, were 400 (150 to 1000), 325 (200 to 1500), 15 (zero to 250) and 60 (25 to 300). Eleven of 13 (84.6%) programs used endoscopy simulators in their curriculum. Eight of 14 programs (57%) provided a structured advanced endoscopy training fellowship. The majority (88%) offered training of combined endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasonography. The median number of positions offered yearly for advanced endoscopy fellowship was one (range one to three). The median (range) procedural volumes for ERCP, endoscopic ultrasonography and endoscopic mucosal resection, respectively, were 325 (200 to 750), 250 (80 to 400) and 20 (10 to 63). None of the current programs offered training in endoscopic submucosal dissection or natural orifice transluminal endoscopic surgery. CONCLUSION: Most accredited adult Canadian gastroenterology programs met the minimal procedural requirements recommended by the Canadian Association of Gastroenterology during core training. However, a more heterogeneous experience has been observed for advanced training. Additional studies would be required to validate and standardize evaluation tools used during gastroenterology curricula. PMID:23712301

  8. Combined endobronchial and esophageal endosonography for the diagnosis and staging of lung cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline, in cooperation with the European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS).

    PubMed

    Vilmann, Peter; Frost Clementsen, Paul; Colella, Sara; Siemsen, Mette; De Leyn, Paul; Dumonceau, Jean-Marc; Herth, Felix J; Larghi, Alberto; Vazquez-Sequeiros, Enrique; Hassan, Cesare; Crombag, Laurence; Korevaar, Daniël A; Konge, Lars; Annema, Jouke T

    2015-07-01

    This is an official guideline of the European Society of Gastrointestinal Endoscopy (ESGE), produced in cooperation with the European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS). It addresses the benefit and burden associated with combined endobronchial and esophageal mediastinal nodal staging of lung cancer. The Scottish Intercollegiate Guidelines Network (SIGN) approach was adopted to define the strength of recommendations and the quality of evidence.The article has been co-published with permission in Endoscopy and the European Respiratory Journal. PMID:26034060

  9. A randomized trial of topical anesthesia comparing lidocaine versus lidocaine plus xylometazoline for unsedated transnasal upper gastrointestinal endoscopy

    PubMed Central

    Cheung, Justin; Goodman, Karen J; Bailey, Robert; Fedorak, Richard N; Morse, John; Millan, Mario; Guzowski, Tom; van Zanten, Sander Veldhuyzen

    2010-01-01

    BACKGROUND: The optimal topical anesthesia regimen for unsedated transnasal endoscopy is unknown. The addition of a nasal decongestant, such as xylometazoline (X), to a topical anesthestic may improve patient comfort. OBJECTIVE: To determine the effectiveness of lidocaine (L) versus L plus X (LX) for anesthesia in unsedated transnasal endoscopy. METHODS: Consecutive participants of the Aklavik Helicobacter pylori project were prospectively randomly assigned to receive LX or L for unsedated transnasal 4.9 mm ultrathin endoscopy. The primary outcome was overall procedure discomfort on a validated 10-point visual analogue scale (1 = no discomfort, 10 = severe discomfort). Secondary outcomes included pain, endoscope insertion difficulty, gagging, adverse events and encounter times. Results were presented as mean ± SD, difference in mean, 95% CI. RESULTS: A total of 181 patients were randomly assigned to receive LX (n=94) and L (n=87). Baseline characteristics between the two groups were similar (mean age 40 years, 59% women). Overall, patient procedural discomfort with LX and L were 4.2±2.4 versus 3.9±2.1, respectively (0.29; 95% CI ?0.39 to 0.96). Transnasal insertion difficulty was significantly lower with LX than with L (2.4±2.1 versus 3.2±2.8, respectively [?0.80; 95% CI ?1.54 to ?0.06]). Compared with L, the use of LX was associated with significantly less time needed to apply anesthesia (2.4±1.8 min versus 3.5±2.2 min, respectively [?1.10; 95% CI ?1.71 min to ?0.50 min]) and less time for insertion (3.2±1.8 min versus 3.9±2.2 min, respectively [?0.70 min; 95% CI ?1.30 min to ?0.10 min]). Epistaxis was rare but occurred less frequently with LX (1.1%) than with L (4.6%) (P=0.19). CONCLUSIONS: LX did not improve patient comfort for transnasal endoscopy compared with L alone. However, LX was associated with less difficulty with endoscope transnasal insertion and reduced insertion time. Further studies on the optimal regimen and dosing of anesthesia are required. PMID:20485707

  10. Clinical validation of the European Panel on the Appropriateness of Gastrointestinal Endoscopy (EPAGE) II criteria in an open-access unit: a prospective study

    PubMed Central

    Garcia, AZ Gimeno; Gonzalez, Y; Quintero, E; Nicolas-Perez, D; Adrian, Z; Romero, R; Fernandez, O Alarcon; Hernandez, M; Carrillo, M; Felipe, V; Diaz, J; Ramos, L; Moreno, M; Jimenez-Sosa, A

    2013-01-01

    Background and study aims The European Panel on the Appropriateness of Gastrointestinal Endoscopy (EPAGE I) criteria were recently updated (EPAGE II), but no prospective studies have used these criteria in clinical practice. The aim of the current study was to validate the EPAGE II criteria in an open-access endoscopy unit. Patients and methods A prospective observational study was conducted in an open-access endoscopy unit at the tertiary care referral center. Consecutive outpatients (n = 1004; mean age 58.9 ± 13.1 years; 45% men) were referred for diagnostic colonoscopy between September 2009 and February 2010. The appropriateness of colonoscopy was assessed based on EPAGE II criteria, and the relationship between appropriateness and both referral doctor and detection of significant lesions was examined. The effectiveness of EPAGE II criteria in assessing appropriateness was measured by means of sensitivity, specificity, and positive and negative predictive values for detecting significant lesions. Results Colonoscopic cecal intubation was achieved in 956 patients (95.2%). Most referral doctors were gastroenterologists (58.0%) and the most common indication was colorectal cancer (CRC) screening (35.2%). EPAGE II criteria were applicable in 968 patients (96.4%); of these patients, the indication was appropriate in 778 (80.4%), inappropriate in 102 (10.5%), and uncertain in 88 (9.1%). Patients with appropriate or uncertain indications based on EPAGE II criteria had more relevant endoscopic findings than those with inappropriate indications (38.8% vs. 24.5%; OR 1.95, 95% CI 1.22–3.13; P<0.005). Sensitivity and negative predictive value of EPAGE II criteria for detecting significant lesions were 93.1% (95% CI 90%–96%) and 75.5% (95% CI 67%–84%), respectively, whereas for advanced neoplastic lesions these values were 98.0% (95% CI 95%–100%) and 98.0% (95% CI 95%–100%), respectively. Adherence to EPAGE II recommendations was an independent predictor of finding a significant lesion (OR 1.93, 95% CI 1.20–3.11; P = 0.007). Conclusions EPAGE II is a simple, valid score for detecting inappropriate colonoscopies in clinical practice. PMID:22109649

  11. Gastrointestinal endoscopy biopsy derived proteomic patterns predict indeterminate colitis into ulcerative colitis and Crohn’s colitis

    PubMed Central

    Ballard, Billy Ray; M’Koma, Amosy Ephreim

    2015-01-01

    Patients with indeterminate colitis (IC) are significantly younger at diagnosis with onset of symptoms before the age of 18 years with significant morbidity in the interim. The successful care of IC is based on microscopic visual predict precision of eventual ulcerative colitis (UC) or Crohn’s colitis (CC) which is not offered in 15%-30% of inflammatory bowel disease (IBD) patients even after a combined state-of-the-art classification system of clinical, visual endoscopic, radiologic and histologic examination. These figures have not changed over the past 3 decades despite the introduction of newer diagnostic modalities. The patient outcomes after restorative proctocolectomy and ileal pouch-anal anastomosis may be painstaking if IC turns into CC. Our approach is aiming at developing a single sensitive and absolute accurate diagnostic test tool during the first clinic visit through endoscopic biopsy derived proteomic patterns. Matrix-assisted-laser desorption/ionization mass spectrometry (MS) and/or imaging MS technologies permit a histology-directed cellular test of endoscopy biopsy which identifies phenotype specific proteins, as biomarker that would assist clinicians more accurately delineate IC as being either a UC or CC or a non-IBD condition. These novel studies are underway on larger cohorts and are highly innovative with significances in differentiating a UC from CC in patients with IC and could lend mechanistic insights into IBD pathogenesis.

  12. Functional imaging and endoscopy

    PubMed Central

    Zhang, Jian-Guo; Liu, Hai-Feng

    2011-01-01

    The emergence of endoscopy for the diagnosis of gastrointestinal diseases and the treatment of gastrointestinal diseases has brought great changes. The mere observation of anatomy with the imaging mode using modern endoscopy has played a significant role in this regard. However, increasing numbers of endoscopies have exposed additional deficiencies and defects such as anatomically similar diseases. Endoscopy can be used to examine lesions that are difficult to identify and diagnose. Early disease detection requires that substantive changes in biological function should be observed, but in the absence of marked morphological changes, endoscopic detection and diagnosis are difficult. Disease detection requires not only anatomic but also functional imaging to achieve a comprehensive interpretation and understanding. Therefore, we must ask if endoscopic examination can be integrated with both anatomic imaging and functional imaging. In recent years, as molecular biology and medical imaging technology have further developed, more functional imaging methods have emerged. This paper is a review of the literature related to endoscopic optical imaging methods in the hopes of initiating integration of functional imaging and anatomical imaging to yield a new and more effective type of endoscopy. PMID:22090783

  13. Advanced Technologies for Gastrointestinal Endoscopy

    E-print Network

    Simaan, Nabil

    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 422 1. INTRODUCTION Each reader of this review is likely to know someone who has experienced a disease, Tennessee 37235; email: p.valdastri@vanderbilt.edu 2 The Biorobotics Institute, Scuola Superiore Sant on the potential of these new technologies to address the limitations of current endoscopes in mass cancer

  14. American Society for Gastrointestinal Endoscopy

    MedlinePLUS

    ... discounts end July 9 Improving Quality and Safety September 18, 2015, San Antonio, TX Early reg. discounts end August 20 EndoFest ® 2015 September 25-27, 2015, Chicago, IL Early reg. discounts end August 20 ...

  15. [Bowel imaging--capsule endoscopy].

    PubMed

    Riemann, J F; Rosenbaum, A

    2006-12-13

    The small bowel has ever since been the "black box" of endoscopy. The long distance from mouth to anus limits the use of conventional endoscopy for the multiple complex looped configurations. For some years now the new technology of wireless capsule endoscopy allows the endoscopic imaging of the complete small bowel. After ingestion of a small pill-size video capsule a continuous series of images is transmitted to an external recorder, whose data can be reviewed after completion of the examination. Compared to other diagnostic tools like push-enteroscopy, capsule endoscopy proves higher diagnostic yield for the detection of bleeding sources in obscure gastrointestinal bleeding. Its results for this task seem to be comparable to those of intraoperative endoscopy, so far considered as gold standard. Capsule endoscopy also opens up new horizons in diagnosing different small-bowel affections like Crohn's disease and polyposis syndromes. Complication rate is low, the main problem being the entrapment of the capsule in a previous unknown stricture which limits its use in Crohn's disease considerably. To date capsule endoscopy needs further evaluation in respect to outcome and cost-effectiveness in order to confirm its role as an important diagnostic tool for the small bowel. PMID:17256278

  16. Nasal endoscopy

    MedlinePLUS

    ... nose and sinuses. Remove polyps, mucus, or other masses from the nose or sinuses. ... surgeries to remove polyps, excess mucus, or other masses Your health care provider may recommend nasal endoscopy ...

  17. Highlights of International Digestive Endoscopy Network 2013

    PubMed Central

    Kwon, Kwang An; Choi, Il Ju; Kim, Eun Young; Dong, Seok Ho

    2013-01-01

    Rapid advances in the technology of gastrointestinal endoscopy as well as the evolution of science have made it necessary for us to continue update in either various endoscopic techniques or state of art lectures relevant to endoscopy. International Digestive Endoscopy Network (IDEN) 2013 was held in conjunction with Korea-Japan Joint Symposium on Gastrointestinal Endoscopy (KJSGE) during June 8 to 9, 2013 at Seoul, Korea. Two days of impressive scientific program dealt with a wide variety of basic concerns from upper gastrointestine (GI), lower GI, pancreaticobiliary endoscopy to advanced knowledge including endoscopic submucosal dissection forum. IDEN seems to be an excellent opportunity to exchange advanced information of the latest issues on endoscopy with experts from around the world. In this special issue of Clinical Endoscopy, we prepared state of art review articles from contributing authors and the current highlights will skillfully deal with very hot spots of each KJSGE, upper GI, lower GI, and pancreaticobiliary sessions by associated editors of Clinical Endoscopy. PMID:24143297

  18. Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED)

    PubMed Central

    Dinis-Ribeiro, M.; Areia, M.; de Vries, A. C.; Marcos-Pinto, R.; Monteiro-Soares, M.; O'Connor, A.; Pereira, C.; Pimentel-Nunes, P.; Correia, R.; Ensari, A.; Dumonceau, J. M.; Machado, J. C.; Macedo, G.; Malfertheiner, P.; Matysiak-Budnik, T.; Megraud, F.; Miki, K.; O'Morain, C.; Peek, R. M.; Ponchon, T.; Ristimaki, A.; Rembacken, B.; Carneiro, F.; Kuipers, E. J.

    2012-01-01

    Atrophic gastritis, intestinal metaplasia, and epithelial dysplasia of the stomach are common and are associated with an increased risk for gastric cancer. In the absence of guidelines, there is wide disparity in the management of patients with these premalignant conditions. The European Society of Gastrointestinal Endoscopy (ESGE), the European Helicobacter Study Group (EHSG), the European Society of Pathology (ESP) and the Sociedade Portuguesa de Endoscopia Digestiva (SPED) have therefore combined efforts to develop evidence-based guidelines on the management of patients with precancerous conditions and lesions of the stomach (termed MAPS). A multidisciplinary group of 63 experts from 24 countries developed these recommendations by means of repeat online voting and a meeting in June 2011 in Porto, Portugal. The recommendations emphasize the increased cancer risk in patients with gastric atrophy and metaplasia, and the need for adequate staging in the case of high grade dysplasia, and they focus on treatment and surveillance indications and methods. PMID:22198778

  19. Asymptomatic Gallstones (AsGS) - To Treat or Not to?

    PubMed

    Behari, Anu; Kapoor, V K

    2012-02-01

    With ready availability of abdominal ultrasound, asymptomatic gallstones (AsGS) are being diagnosed with increasing frequency. Management decisions need to take into account the natural history of AsGS as well as the risks of cholecystectomy. Long-term follow up studies from the West have consistently shown that only a small minority of asymptomatic gallstones lead to development of symptoms or complications. Some sub-groups of patients (eg those with chronic hemolytic syndromes) have been shown to be at a higher risk of developing symptoms and complications and prophylactic cholecystectomy has been advised for them. Clear division of patients into low or high risk categories is still far from ideal and better identification of risk factors and risk stratification is needed. Overall, both open and laparoscopic cholecystectomy, are generally safe procedures. However, the incidence of bile duct injury (with all its serious consequences) continues to be higher with laparoscopic cholecystectomy and this should receive due consideration before offering prophylactic cholecystectomy to an asymptomatic patient who is not expected to receive any clinical benefit from it. Gallbladder cancer is rare in most of the developed world and prophylactic cholecystectomy has generally not been recommended to prevent development of GBC. Considering the wide geographical/ethnic variation in incidence of GBC across the world and the strong association of GBC with gallstones, it may not be prudent to extrapolate the results of studies of natural history of AsGS from one part of the world to another. Since northern India has one of the highest incidences of GBC in the world, it is imperative to have data on natural history of AsGS in patients from this area to allow formulation of precise guidelines for management of AsGs. PMID:23372301

  20. Aspirin and Gastrointestinal Bleeding

    Microsoft Academic Search

    J. Faivre; M. Faivre; N. Lery; R. Ducluzeau; B. Moulinier; P. Paliard

    1979-01-01

    From history-taking and from analysis of plasma salicylate levels it is shown that a link exists between aspirin and gastrointestinal bleeding in 68% of cases. Salicylate levels alone indicate that aspirin has been taken in 22% of cases. Plasma salicylate measurement and endoscopy allow a better understanding of haemorrhagic lesions due to aspirin. Aspirin is responsible especially for haemorrhage from

  1. Capsule endoscopy: Future horizons

    PubMed Central

    Fireman, Zvi

    2010-01-01

    Capsule endoscopy (CE) was launched at the beginning of this millennium and has since become a well established methodology for evaluating the entire small bowel for manifold pathologies. CE far exceeded early expectations by providing a tool for establishing the correct diagnosis for elusive gastrointestinal (GI) conditions such as obscure GI bleeding, Crohn’s disease, polyposis syndrome and others. Contemporary CE, like radiology, gives results that can only be read, unlike conventional endoscopic procedures which enable concomitant biopsy when indicated. This is one of the major limitations of the technique. The ideal CE should improve the quality of the image and have a faster frame rate than the currently available one. There should be a therapeutic capsule capable of performing a biopsy, aspirating fluid, delivering drugs as well as measuring the motility of the small bowel wall. Another major leap forward would be the capability of remote control of the capsule’s movement in order to navigate it to reach designated anatomical areas for carrying out a variety of therapeutic options. Technology for improving the capability of the future generation capsule is almost within grasp and it would not be surprising to witness the realization of these giant steps within the coming decade. PMID:21160761

  2. A cross-sectional study to assess the feasibility of a short message service to improve adherence of outpatients undergoing sedation gastrointestinal endoscopy in the People’s Republic of China

    PubMed Central

    Deng, Xiaoqian; Ye, Ling; Wang, Yuting; Zhu, Tao

    2014-01-01

    Background Adherence to the prescribed preparation regimen for patients scheduled for sedation gastrointestinal endoscopy (SGIE) often fails to meet health care providers’ expectations. Therefore, the feasibility of using mobile phones to improve the adherence of outpatients was assessed among outpatients scheduled for SGIE. Methods The study was designed as a cross-sectional study using survey questionnaires. Outpatients who would be undergoing SGIE were enrolled. The main outcomes included proportions of outpatients who have access to mobile phones, and the use of text-messaging among outpatients. Willingness to receive text messages and personal opinions about short message service (SMS) were also investigated. Characteristics of outpatients, including socio-demographic factors, with a mobile phone (or those who could receive and read messages) compared with those without a mobile phone (or those who could not receive and read messages) were compared using the chi-square test. Logistic regression was used to analyze significant contributing factors associated with mobile phone ownership and the use of text messages. Results A large majority of outpatients owned personal mobile phones (94.9%) and could receive and read the messages (78.9%). Most of the outpatients were willing to receive a pre-procedure education via text message (81.9%). Outpatients aged 16–39 years old and those with a college education or higher were more likely to use mobile phones and read SMS than outpatients aged 60–80 years old and those with only a primary education level (P<0.0001). Outpatients who lived in an urban setting were more likely to own a mobile phone than outpatients who lived in a rural setting (P=0.002). Conclusion The accessibility of mobile phones and the frequent use of message functions on mobile phones provide support for the initiation of an SMS reminder system for outpatients who will undergo SGIE in the People’s Republic of China. In addition, the characteristics of the target study population should be considered when carrying out an SMS intervention. PMID:25278748

  3. UEG Week 2014 highlights: putting endoscopy into perspective.

    PubMed

    Papanikolaou, Ioannis S; Siersema, Peter D

    2015-02-01

    The 22nd United European Gastroenterology (EUG) Week took place in Vienna in October 2014. The meeting offered a great opportunity to all those interested in gastrointestinal (GI) endoscopy to exchange clinical experiences, research trends, and scientific progress from all over the world. This report will highlight some of the most interesting topics of GI endoscopy that were presented over the 3 days, and will briefly comment on them in light of the latest bibliographic data. PMID:25635730

  4. Combined endobronchial and esophageal endosonography for the diagnosis and staging of lung cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline, in cooperation with the European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS).

    PubMed

    Vilmann, Peter; Clementsen, Paul Frost; Colella, Sara; Siemsen, Mette; De Leyn, Paul; Dumonceau, Jean-Marc; Herth, Felix J; Larghi, Alberto; Vasquez-Sequeiros, Enrique; Hassan, Cesare; Crombag, Laurence; Korevaar, Daniël A; Konge, Lars; Annema, Jouke T

    2015-06-01

    This is an official guideline of the European Society of Gastrointestinal Endoscopy (ESGE), produced in cooperation with the European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS). It addresses the benefit and burden associated with combined endobronchial and esophageal mediastinal nodal staging of lung cancer. The Scottish Intercollegiate Guidelines Network (SIGN) approach was adopted to define the strength of recommendations and the quality of evidence.The article has been co-published with permission in the European Journal of Cardio-Thoracic Surgery and the European Respiratory Journal. Recommendations 1 For mediastinal nodal staging in patients with suspected or proven non-small-cell lung cancer (NSCLC) with abnormal mediastinal and/or hilar nodes at computed tomography (CT) and/or positron emission tomography (PET), endosonography is recommended over surgical staging as the initial procedure (Recommendation grade A). The combination of endobronchial ultrasound with real-time guided transbronchial needle aspiration (EBUS-TBNA) and endoscopic (esophageal) ultrasound with fine needle aspiration, with use of a gastrointestinal (EUS-FNA) or EBUS (EUS-B-FNA) scope, is preferred over either test alone (Recommendation grade C). If the combination of EBUS and EUS-(B) is not available, we suggest that EBUS alone is acceptable (Recommendation grade C).Subsequent surgical staging is recommended, when endosonography does not show malignant nodal involvement (Recommendation grade B). 2 For mediastinal nodal staging in patients with suspected or proven non-small-cell peripheral lung cancer without mediastinal involvement at CT or CT-PET, we suggest that EBUS-TBNA and/or EUS-(B)-FNA should be performed before therapy, provided that one or more of the following conditions is present: (i) enlarged or fluorodeoxyglucose (FDG)-PET-avid ipsilateral hilar nodes; (ii) primary tumor without FDG uptake; (iii) tumor size ??3?cm (Fig.?3a?-?c) (Recommendation grade C). If endosonography does not show malignant nodal involvement, we suggest that mediastinoscopy is considered, especially in suspected N1 disease (Recommendation grade C).If PET is not available and CT does not reveal enlarged hilar or mediastinal lymph nodes, we suggest performance of EBUS-TBNA and/or EUS-(B)-FNA and/or surgical staging (Recommendation grade C). 3 In patients with suspected or proven?

  5. Microscopic imaging in endoscopy: endomicroscopy and endocytoscopy.

    PubMed

    Goetz, Martin; Malek, Nisar P; Kiesslich, Ralf

    2014-01-01

    Performing real-time microscopy has been a vision of endoscopists since the very early phases of gastrointestinal endoscopy. Confocal endomicroscopy, an adaption of confocal laser scanning microscopy, and endocytoscopy, an adaption of white-light microscopy, have been introduced into the endoscopic armamentarium in the past decade. Both techniques yield on-site histological information. Multiple trials have demonstrated the ability of gastroenterologists to obtain and interpret microscopic images from the upper and lower gastrointestinal tract, and also the hepatobiliary-pancreatic system, during endoscopy. Such microscopic information has been successfully used in expert hands to minimize sampling error by 'smart', microscopically targeted biopsies and to guide endoscopic interventions. However, endomicroscopy is also unique in its ability to dynamically visualize cellular processes in their native environment free of artefacts. This ability enables fundamental insights into mechanisms of human diseases in clinical and translational science. PMID:23897286

  6. Sedation for Pediatric Endoscopy

    PubMed Central

    2014-01-01

    It is more difficult to achieve cooperation when conducting endoscopy in pediatric patients than adults. As a result, the sedation for a comfortable procedure is more important in pediatric patients. The sedation, however, often involves risks and side effects, and their prediction and prevention should be sought in advance. Physicians should familiarize themselves to the relevant guidelines in order to make appropriate decisions and actions regarding the preparation of the sedation, patient monitoring during endoscopy, patient recovery, and hospital discharge. Furthermore, they have to understand the characteristics of the pediatric patients and different types of endoscopy. The purpose of this article is to discuss the details of sedation in pediatric endoscopy. PMID:24749082

  7. Capsule endoscopy in patients refusing conventional endoscopy

    PubMed Central

    Romero-Vázquez, Javier; Argüelles-Arias, Federico; García-Montes, Josefa Maria; Caunedo-Álvarez, Ángel; Pellicer-Bautista, Francisco Javier; Herrerías-Gutiérrez, Juan Manuel

    2014-01-01

    Capsule endoscopy is nowadays the diagnostic technique of choice in the study of small bowel pathologies, allowing the non-invasive study of the entire mucosa. This has led, together with new technical advances, to the creation of two new models (PillCam ESO and PillCam Colon) for the study of esophageal and colonic diseases. These two new capsules offer an interesting alternative to conventional endoscopy in the study of the upper and lower digestive tracts, because traditional endoscopy is often unpleasant and uncomfortable for the patient, can be painful, often requires moderate or deep sedation and is not without complications (hemorrhage, perforation, etc.). PillCam Colon is particularly important for its usefulness in the diagnosis of colonic polyps, and is a potentially useful tool in cases of incomplete colonoscopy or in colorectal cancer screening, even more when most patients are reluctant to undergo screening programs due to the said disadvantages of conventional colonoscopy. This article discusses the advantages of capsule endoscopy over conventional endoscopy, its current application possibilities and indications in routine clinical practice. In the various sections of the work, we assess the application of endoscopic capsule in different sections of the digestive tract (esophagus, stomach, and colon) and finally the potential role of panendoscopy with PillCam Colon. PMID:24966612

  8. The Myxococcus xanthus asgA gene encodes a novel signal transduction protein required for multicellular development.

    PubMed Central

    Plamann, L; Li, Y; Cantwell, B; Mayor, J

    1995-01-01

    The Myxococcus xanthus asgA gene is one of three known genes necessary for the production of extracellular A-signal, a cell density signal required early in fruiting body development. We determined the DNA sequence of asgA. The deduced 385-amino-acid sequence of AsgA was found to contain two domains: one homologous to the receiver domain of response regulators and the other homologous to the transmitter domain of histidine protein kinases. A kanamycin resistance (Kmr) gene was inserted at various positions within or near the asgA gene to determine the null phenotype. Those strains with the Kmr gene inserted upstream or downstream of asgA are able to form fruiting bodies, while strains containing the Kmr gene inserted within asgA fail to develop. The nature and location of the asgA476 mutation were determined. This mutation causes a leucine-to-proline substitution within a conserved stretch of hydrophobic residues in the N-terminal receiver domain. Cells containing the insertion within asgA and cells containing the asgA476 substitution have similar phenotypes with respect to development, colony color, and expression of an asg-dependent gene. An analysis of expression of a translational asgA-lacZ fusion confirms that asgA is expressed during growth and early development. Finally, we propose that AsgA functions within a signal transduction pathway that is required to sense starvation and to respond with the production of extracellular A-signal. PMID:7721694

  9. New aspects of modern endoscopy

    PubMed Central

    Rey, Johannes Wilhelm; Kiesslich, Ralf; Hoffman, Arthur

    2014-01-01

    The prognosis for patients with malignancies of the gastrointestinal-tract is strictly dependent on early detection of premalignant and malignant lesions. However, small, flat or depressed neoplastic lesions remain difficult to detect with these technologies thereby limiting their value for polyp and cancer screening. At the same time computer and chip technologies have undergone major technological changes which have greatly improved endoscopic diagnostic investigation. New imaging modalities and techniques are very notable aspects of modern endoscopy. Chromoendoscopy or filter-aided colonoscopy (virtual chromoendoscopy) with high definition endoscopes is able to enhance the detection and characterization of lesions. Finally, confocal laser endomicroscopy provides histological confirmation of the presence of neoplastic changes. The developing techniques around colonoscopy such as the retro-viewing colonoscope, the balloon-colonoscope or the 330-degrees-viewing colonoscope try to enhance the efficacy by reducing the adenoma miss rate in right-sided, non-polypoid lesions. Colon capsule endoscopy is limited to identifying cancer and not necessarily small adenomas. Preliminary attempts have been made to introduce this technique in clinical routine. PMID:25132916

  10. The ambulatory endoscopy center (AEC): what it can do for your gastroenterology practice.

    PubMed

    Frakes, James T

    2006-10-01

    Endoscopy accounts for most of the gastroenterologist's professional time and revenue. The thoughtful gastroenterologist in practice must understand the potential sites of service for endoscopy, including either the hospital endoscopy unit or an ambulatory endoscopy center (whether an office endoscopy suite or a licensed, certified, and accredited ambulatory surgery center). Out-of-hospital endoscopy centers have advantages for patients, including convenience, efficiency, economy, and more pleasant surroundings than the hospital. Payers appreciate improved access and reduced costs. For gastrointestinal practices, ambulatory endoscopy centers, particularly ambulatory surgery centers, provide significant advantages, including enhanced reimbursement and cost management, control, efficiency and convenience, quality control, opportunities for clinical research, and marketing and competitive strengths. PMID:17098615

  11. Gastrointestinal hemorrhage: evaluation with MDCT.

    PubMed

    Soto, Jorge A; Park, Seong Ho; Fletcher, Joel G; Fidler, Jeff L

    2015-06-01

    Gastrointestinal (GI) bleeding is a common medical problem, with high associated morbidity and mortality. The clinical presentation of gastrointestinal hemorrhage varies with the location of the bleeding source, the intensity of the bleed, and the presence of comorbidities that affect the ability to tolerate blood loss. Conventional endoscopic examinations are usually the initial diagnostic tests in patients presenting with overt gastrointestinal hemorrhage. However, implementation of upper tract endoscopy and colonoscopy in the emergency setting can be challenging due to inconsistent availability of the service and difficulties in achieving adequate colonic cleansing in emergent situations. Thus, imaging tests are often relied upon to establish the location and the cause of bleeding, either for initial diagnosis or after non-revealing upper and lower tract endoscopies ("obscure" bleeding). This article discusses the imaging evaluation of patients with gastrointestinal bleeding and reviews the imaging appearance of the most common causes, taking into account the two most relevant clinical presentations: overt bleeding and obscure bleeding. PMID:25637128

  12. Management of gastrointestinal hemorrhage.

    PubMed Central

    Hilsden, R. J.; Shaffer, E. A.

    1995-01-01

    Acute gastrointestinal hemorrhage is a common problem that requires prompt recognition and management to prevent serious morbidity and mortality. Management goals are stabilization of the patient with vigorous fluid resuscitation followed by investigation and definitive treatment of the bleeding source. Endoscopy is often the initial diagnostic test and allows therapeutic measures to be performed at the same time. Images Figure 1 Figure 2 PMID:8563510

  13. Molecular characterization of AsgA, an unusual signal transduction protein required for multicellular development in Myxococcus xanthus 

    E-print Network

    Li, Yonghui

    1995-01-01

    (or part of it) to export A-signal outside the cell; III. The asg genes encode regulators for I. and/or II. (46, 48, 55, ). To test these hypotheses, we cloned and characterized the asg genes, and have purified the AsgA and AsgB proteins in order... as CIT agar without the Casitone). DNA manipulations. Standard procedures for restriction endonuclease digestions, agarose gel electrophoresis, purification of DNA from agarose gels, DNA ligations, and other cloning-related techniques were used...

  14. Sedation for Your Endoscopy

    MedlinePLUS

    ... blood” such as Coumadin, Lovenox, Heparin, and Plavix yes | no Any type of medicine that is used for diabetes ( ... the past? yes | no Are you allergic to any medicines? yes | no If you had an endoscopy before, were ...

  15. Ultra high magnification endoscopy: Is seeing really believing?

    PubMed Central

    Arya, Aman V; Yan, Brian M

    2012-01-01

    Endoscopy is an indispensible diagnostic and therapeutic instrument for gastrointestinal diseases. Endocytoscopy and confocal endomicroscopy are two types of ultra high magnification endoscopy techniques. Standard endoscopy allows for 50 × magnification, whereas endocytoscopy can magnify up to 1400 × and confocal endomicroscopy can magnify up to 1000 ×. These methods open the realm of real time microscopic evaluation of the GI tract, including cellular and subcellular structures. Confocal endomicroscopy has the additional advantage of being able to visualize subsurface structures. The use of high magnification endoscopy in conjunction with standard endoscopy allows for a real-time microscopic assessment of areas with macroscopic abnormalities, providing “virtual biopsies” with valuable information about cellular and subcellular changes. This can minimize the number of biopsies taken at the time of endoscopy. The use of this technology may assist in detecting pre-malignant or malignant changes at an earlier state, allowing for earlier intervention and treatment. High magnification endoscopy has shown promising results in clinical trials for Barrett’s esophagus, esophageal adenocarcinoma, esophageal squamous cell cancer, gastric cancer, celiac disease, colorectal cancer, and inflammatory bowel disease. As the use of high magnification endoscopy techniques increases, the clinical applications will increase as well. Of the two systems, only confocal endomicroscopy is currently commercially available. Like all new technologies there will be an initial learning curve before operators become proficient in obtaining high quality images and discerning abnormal from normal pathology. Validated criteria for the diagnosis of the various gastrointestinal diseases will need to be developed for each method. In this review, the basic principles of both modalities are discussed, along with their clinical applicability and limitations. PMID:23189217

  16. Endoscopy reporting standards

    PubMed Central

    Beaulieu, Daphnée; Barkun, Alan N; Dubé, Catherine; Tinmouth, Jill; Hallé, Pierre; Martel, Myriam

    2013-01-01

    OBJECTIVES: The Canadian Association of Gastroenterology (CAG) recently published consensus recommendations for safety and quality indicators in digestive endoscopy. The present article focuses specifically on the identification of key elements that should be found in all electronic endoscopy reports detailing recommendations adopted by the CAG consensus group. METHODS: A committee of nine individuals steered the CAG Safety and Quality Indicators in Endoscopy Consensus Group, which had a total membership of 35 voting individuals with knowledge on the subject relating to endoscopic services. A comprehensive literature search was performed with regard to the key elements that should be found in an electronic endoscopy report. A task force reviewed all published, full-text, adult and human studies in French or English. RESULTS: Components to be entered into the standardized report include identification of procedure, timing, procedural personnel, patient demographics and history, indication(s) for procedure, comorbidities, type of bowel preparation, consent for the procedure, pre-endoscopic administration of medications, type and dose of sedation used, extent and completeness of examination, quality of bowel preparation, relevant findings and pertinent negatives, adverse events and resulting interventions, patient comfort, diagnoses, endoscopic interventions performed, details of pathology specimens, details of follow-up arrangements, appended pathology report(s) and, when available, management recommendations. Summary information should be provided to the patient or family. CONCLUSION: Continuous quality improvement should be the responsibility of every endoscopist and endoscopy facility to ensure improved patient care. Appropriate documentation of endoscopic procedures is a critical component of such activities. PMID:23712304

  17. Towards CARS Endoscopy Franois Lgar*

    E-print Network

    Xie, Xiaoliang Sunney

    Towards CARS Endoscopy François Légaré* Center for Nanoscale Systems and Department of Chemistry provide a proof-of-principle demonstration of CARS endoscopy. The design utilizes a single mode optical characteristics at intensities needed for endoscopy. CARS endoscopic images are recorded by collecting the epi-CARS

  18. Electronic imaging in endoscopy

    Microsoft Academic Search

    George Berci; Margaret Paz-Partlow

    1988-01-01

    Endoscopy evolved from a hollow tube view of visually restricted areas into an expansive, distal representation of the anatomy. Rod lens telescopes, improved coherent imaging bundles, superior light sources, and other optical advances enhanced endoscopic observations. Yet complicated endoscopic procedures remained visible to the endoscopist alone, relegating assistance and consultation toverbal description of sophisticatedvisual observation. Instrumentational advances alone did not

  19. Recent advances in photoacoustic endoscopy

    PubMed Central

    Yoon, Tae-Jong; Cho, Young-Seok

    2013-01-01

    Imaging based on photoacoustic effect relies on illuminating with short light pulses absorbed by tissue absorbers, resulting in thermoelastic expansion, giving rise to ultrasonic waves. The ultrasonic waves are then detected by detectors placed around the sample. Photoacoustic endoscopy (PAE) is one of four major implementations of photoacoustic tomography that have been developed recently. The prototype PAE was based on scanning mirror system that deflected both the light and the ultrasound. A recently developed mini-probe was further miniaturized, and enabled simultaneous photoacoustic and ultrasound imaging. This PAE-endoscopic ultrasound (EUS) system can offer high-resolution vasculature information in the gastrointestinal (GI) tract and display differences between optical and mechanical contrast compared with single-mode EUS. However, PAE for endoscopic GI imaging is still at the preclinical stage. In this commentary, we describe the technological improvements in PAE for possible clinical application in endoscopic GI imaging. In addition, we discuss the technical details of the ultrasonic transducer incorporated into the photoacoustic endoscopic probe. PMID:24255745

  20. Capsule endoscopy: Current practice and future directions

    PubMed Central

    Hale, Melissa F; Sidhu, Reena; McAlindon, Mark E

    2014-01-01

    Capsule endoscopy (CE) has transformed investigation of the small bowel providing a non-invasive, well tolerated means of accurately visualising the distal duodenum, jejunum and ileum. Since the introduction of small bowel CE thirteen years ago a high volume of literature on indications, diagnostic yields and safety profile has been presented. Inclusion in national and international guidelines has placed small bowel capsule endoscopy at the forefront of investigation into suspected diseases of the small bowel. Most commonly, small bowel CE is used in patients with suspected bleeding or to identify evidence of active Crohn’s disease (CD) (in patients with or without a prior history of CD). Typically, CE is undertaken after upper and lower gastrointestinal flexible endoscopy has failed to identify a diagnosis. Small bowel radiology or a patency capsule test should be considered prior to CE in those at high risk of strictures (such as patients known to have CD or presenting with obstructive symptoms) to reduce the risk of capsule retention. CE also has a role in patients with coeliac disease, suspected small bowel tumours and other small bowel disorders. Since the advent of small bowel CE, dedicated oesophageal and colon capsule endoscopes have expanded the fields of application to include the investigation of upper and lower gastrointestinal disorders. Oesophageal CE may be used to diagnose oesophagitis, Barrett’s oesophagus and varices but reliability in identifying gastroduodenal pathology is unknown and it does not have biopsy capability. Colon CE provides an alternative to conventional colonoscopy for symptomatic patients, while a possible role in colorectal cancer screening is a fascinating prospect. Current research is already addressing the possibility of controlling capsule movement and developing capsules which allow tissue sampling and the administration of therapy. PMID:24976712

  1. Endoscopy in screening for digestive cancer

    PubMed Central

    Lambert, René

    2012-01-01

    The aim of this study is to describe the role of endoscopy in detection and treatment of neoplastic lesions of the digestive mucosa in asymptomatic persons. Esophageal squamous cell cancer occurs in relation to nutritional deficiency and alcohol or tobacco consumption. Esophageal adenocarcinoma develops in Barrett’s esophagus, and stomach cancer in chronic gastric atrophy with Helicobacter pylori infection. Colorectal cancer is favoured by a high intake in calories, excess weight, low physical activity. In opportunistic or individual screening endoscopy is the primary detection procedure offered to an asymptomatic individual. In organized or mass screening proposed by National Health Authorities to a population, endoscopy is performed only in persons found positive to a filter selection test. The indications of primary upper gastrointestinal endoscopy and colonoscopy in opportunistic screening are increasingly developing over the world. Organized screening trials are proposed in some regions of China at high risk for esophageal cancer; the selection test is cytology of a balloon or sponge scrapping; they are proposed in Japan for stomach cancer with photofluorography as a selection test; and in Europe, America and Japan; for colorectal cancer with the fecal occult blood test as a selection test. Organized screening trials in a country require an evaluation: the benefit of the intervention assessed by its impact on incidence and on the 5 year survival for the concerned tumor site; in addition a number of bias interfering with the evaluation have to be controlled. Drawbacks of screening are in the morbidity of the diagnostic and treatment procedures and in overdetection of none clinically relevant lesions. The strategy of endoscopic screening applies to early cancer and to benign adenomatous precursors of adenocarcinoma. Diagnostic endoscopy is conducted in 2 steps: at first detection of an abnormal area through changes in relief, in color or in the course of superficial capillaries; then characterization of the morphology of the lesion according to the Paris classification and prediction of the risk of malignancy and depth of invasion, with the help of chromoscopy, magnification and image processing with neutrophil bactericidal index or FICE. Then treatment decision offers 3 options according to histologic prediction: abstention, endoscopic resection, surgery. The rigorous quality control of endoscopy will reduce the miss rate of lesions and the occurrence of interval cancer. PMID:23293721

  2. Characterization of Follicular Lymphoma in the Small Intestine Using Double-Balloon Endoscopy

    PubMed Central

    Chowdhury, Manzurul; Endo, Masaki; Chiba, Toshimi; Kudara, Norihiko; Oana, Shuhei; Sato, Kunihiko; Akasaka, Risaburo; Tomita, Kazumitsu; Fujiwara, Saori; Mizutani, Tomomi; Sugai, Tamotsu; Takikawa, Yasuhiro; Suzuki, Kazuyuki

    2009-01-01

    Follicular lymphomas occur rarely in the gastrointestinal tract, representing only 1–3% of all gastrointestinal tract B-cell non-Hodgkin lymphomas. We describe endoscopic analysis of 3 cases of follicular lymphoma in the small intestine using double-balloon endoscopy. Double-balloon endoscopy revealed multiple nodular lesions and elevated white patches, multiple polypoid lesions, and scattered white polypoid and nodular lesions in the duodenum and small intestine. Fuji Intelligent Chromo Endoscopy demonstrated small, whitish nodules, and narrow-band imaging showed a coiled, elongated vascular pattern within the elevated lesions. These cases are the first follicular lymphomas in the small intestine evaluated using narrow-band imaging or Fuji Intelligent Chromo Endoscopy to be reported. PMID:19901998

  3. [Use of spasmolytic agent otilonium bromide (spasmomen) in digestive endoscopy: a prospective study in 63 patients].

    PubMed

    Gómez, N A; León, C J; Gutiérrez, J

    1997-01-01

    Otilonium bromide is a calcium antagonist with a direct myolytic effect, that is indicated in spastic conditions and functional dyskinesias of the gastroenteric apparatus (irritable bowel syndrome) and as a premedication for gastrointestinal endoscopic procedures. The present study assessed otilonium bromide 40 mg PO the night before and 40 mg PO the morning in 49 upper and 14 lower flexible endoscopies in 63 patients, to determine the presence or absence of peristalsis and relaxation of the pylorus. No side effects were observed due to the medication. In 46 (93.8%) upper endoscopies marked relaxation of the gastrointestinal tract and also pylorus relaxation were observed. In 13 (92.8%) lower endoscopies, marked relaxation of the colonic tract was also seen. All patients tolerated well the endoscopies. Otilonium bromide was useful as premedication in order to enable upper and lower endoscopic explorations, because of its spasmolytic effect. PMID:9412140

  4. Screening for Precancerous Lesions of Upper Gastrointestinal Tract: From the Endoscopists' Viewpoint

    PubMed Central

    Chung, Chen-Shuan; Wang, Hsiu-Po

    2013-01-01

    Upper gastrointestinal tract cancers are one of the most important leading causes of cancer death worldwide. Diagnosis at late stages always brings about poor outcome of these malignancies. The early detection of precancerous or early cancerous lesions of gastrointestinal tract is therefore of utmost importance to improve the overall outcome and maintain a good quality of life of patients. The desire of endoscopists to visualize the invisibles under conventional white-light endoscopy has accelerated the advancements in endoscopy technologies. Nowadays, image-enhanced endoscopy which utilizes optical- or dye-based contrasting techniques has been widely applied in endoscopic screening program of gastrointestinal tract malignancies. These contrasting endoscopic technologies not only improve the visualization of early foci missed by conventional endoscopy, but also gain the insight of histopathology and tumor invasiveness, that is so-called optical biopsy. Here, we will review the application of advanced endoscopy technique in screening program of upper gastrointestinal tract cancers. PMID:23573079

  5. Endoscopy in sharks.

    PubMed

    Murray, Michael J

    2010-05-01

    The importance of the shark species as ambassadors for the ocean ecosystems within public aquariums, and an ever increasing understanding of their importance as keystone species in those ecosystems, has resulted in more and more opportunities for the veterinary profession to interact with these charismatic fish. Although still in its infancy in aquatic medicine, endoscopy has the potential to be a valuable tool in the management of captive and free-ranging sharks. When contemplating an endoscopic procedure in a shark, the clinician must consider the unique anatomy of the species, the nature of the immobilization planned, and the performance of the procedure itself. Endoscopy should be considered as an adjunct procedure in the clinical management of captive sharks, and may have an important role in the scientific monitoring of free-ranging shark populations. PMID:20381779

  6. Extra-articular hip endoscopy

    PubMed Central

    Verhelst, L.; Guevara, V.; De Schepper, J.; Van Melkebeek, J.; Pattyn, C.; Audenaert, E. A.

    2012-01-01

    The aim of this review is to evaluate the current available literature evidencing on peri-articular hip endoscopy (the third compartment). A comprehensive approach has been set on reports dealing with endoscopic surgery for recalcitrant trochanteric bursitis, snapping hip (or coxa-saltans; external and internal), gluteus medius and minimus tears and endoscopy (or arthroscopy) after total hip arthroplasty. This information can be used to trigger further research, innovation and education in extra-articular hip endoscopy. PMID:23610664

  7. Capsule endoscopy in neoplastic diseases

    PubMed Central

    Pennazio, Marco; Rondonotti, Emanuele; de Franchis, Roberto

    2008-01-01

    Until recently, diagnosis and management of small-bowel tumors were delayed by the difficulty of access to the small bowel and the poor diagnostic capabilities of the available diagnostic techniques. An array of new methods has recently been developed, increasing the possibility of detecting these tumors at an earlier stage. Capsule endoscopy (CE) appears to be an ideal tool to recognize the presence of neoplastic lesions along this organ, since it is non-invasive and enables the entire small bowel to be visualized. High-quality images of the small-bowel mucosa may be captured and small and flat lesions recognized, without exposure to radiation. Recent studies on a large population of patients undergoing CE have reported small-bowel tumor frequency only slightly above that reported in previous surgical series (range, 1.6%-2.4%) and have also confirmed that the main clinical indication to CE in patients with small-bowel tumors is obscure gastrointestinal (GI) bleeding. The majority of tumors identified by CE are malignant; many were unsuspected and not found by other methods. However, it remains difficult to identify pathology and tumor type based on the lesion’s endoscopic appearance. Despite its limitations, CE provides crucial information leading in most cases to changes in subsequent patient management. Whether the use of CE in combination with other new diagnostic (MRI or multidetector CT enterography) and therapeutic (Push-and-pull enteroscopy) techniques will lead to earlier diagnosis and treatment of these neoplasms, ultimately resulting in a survival advantage and in cost savings, remains to be determined through carefully-designed studies. PMID:18785274

  8. Electronic imaging in endoscopy.

    PubMed

    Berci, G; Paz-Partlow, M

    1988-01-01

    Endoscopy evolved from a hollow tube view of visually restricted areas into an expansive, distal representation of the anatomy. Rod lens telescopes, improved coherent imaging bundles, superior light sources, and other optical advances enhanced endoscopic observations. Yet complicated endoscopic procedures remained visible to the endoscopist alone, relegating assistance and consultation to verbal description of sophisticated visual observation. Instrumentational advances alone did not promote three crucial elements: participation, cooperation and documentation. The importance of these elements has increased with the need for coordinated assistance in complex operative endoscopic manipulations, as well as in a visual record for improved documentation and consultation. New imaging technologies are supplanting the unwieldy, often daunting equipment once required for photodocumentation. The charged couple device (CCD) 2/3 and 1/2 in. "chip" video camera miniaturization provides nearly weightless TV coobservation. Distal chip placement has created the "video endoscope". Combined with the 8 mm tape format, the chip has created a lightweight, single unit camera, monitor, and recorder. A recent advantage, magnetic disc recording, permits still video storage of up to 25 images. An electronic printer produces a hard color copy (4 x 5), which is inserted in the chart before the patient leaves the endoscopy room. The cost of the equipment can be shared in multidisciplinary institutions. PMID:3071869

  9. Endoscopy of Nasopharyngeal Cancer

    PubMed Central

    Ossoff, Robert H.

    1994-01-01

    Nasopharyngeal cancer (NPC) is a unique disease with increasing interest for many physicians due to its unusual etiology, histology, and epidemiology. The recent era of fiberoptic endoscopy now provides the clinician with better tools for the screening, diagnosis, staging, and follow-up of NPC. The use of high resolution flexible and rigid nasopharyngoscopy gives the physician an opportunity for a more sensitive examination in a higher proportion of patients. Ultimately, this will allow for earlier diagnosis of NPC, and improved prognosis and better quality of life for the patients with this disease. Also, by allowing the clinician to perform directed biopsies of the nasopharynx under local anesthesia, fiberoptic nasopharyngoscopy allows a less morbid and more cost-effective approach towards this disease, including screening protocols in certain high risk regions of the world. PMID:18493343

  10. Role of endoscopy in the bariatric surgery of patients.

    PubMed

    De Palma, Giovanni D; Forestieri, Pietro

    2014-06-28

    Obesity is an increasingly serious health problem in nearly all Western countries. It represents an important risk factor for several gastrointestinal diseases, such as gastroesophageal reflux disease, erosive esophagitis, hiatal hernia, Barrett's esophagus, esophageal adenocarcinoma, Helicobacter pylori infection, colorectal polyps and cancer, non-alcoholic fatty liver disease, cirrhosis, and hepatocellular carcinoma. Surgery is the most effective treatment to date, resulting in sustainable and significant weight loss, along with the resolution of metabolic comorbidities in up to 80% of cases. Many of these conditions can be clinically relevant and have a significant impact on patients undergoing bariatric surgery. There is evidence that the chosen procedure might be changed if specific pathological upper gastrointestinal findings, such as large hiatal hernia or Barrett's esophagus, are detected preoperatively. The value of a routine endoscopy before bariatric surgery in asymptomatic patients (screening esophagogastroduodenoscopy) remains controversial. The common indications for endoscopy in the postoperative bariatric patient include the evaluation of symptoms, the management of complications, and the evaluation of weight loss failure. It is of critical importance for the endoscopist to be familiar with the postoperative anatomy and to work in close collaboration with bariatric surgery colleagues in order to maximize the outcome and safety of endoscopy in this setting. The purpose of this article is to review the role of the endoscopist in a multidisciplinary obesity center as it pertains to the preoperative and postoperative management of bariatric surgery patients. PMID:24976715

  11. The effectiveness of clinical hypnosis in the digestive endoscopy: a multiple case report.

    PubMed

    Domínguez-Ortega, Luis; Rodríguez-Muñoz, Sarbelio

    2010-10-01

    The aim of this study is to evaluate the efficacy and viability of hypnosis before and during a gastrointestinal endoscopy. Six Gastroscopies and 22 colonoscopies were carried out under hypnosis in a group of patients. The patients ranged in age from 20 and 67 years and have a history of previously incomplete and poorly tolerated examinations or expressed an active demand for sedation. For 6 of the patients who underwent a gastroscopy under hypnosis, the procedure was successfully completed, reaching the second part of the duodenum without difficulty for the endoscopist. Colonoscopy of the cecum was completed in 19 of 20 patients. All patients, except 1, considered their tolerance level as "good." Hypnosis facilitated an adequate endoscopy intervention without any discomfort in 85% of the cases examined. Avoidance of anaesthesia reduces risk to the patient. Hence, hypnosis for gastrointestinal endoscopy appears to provide a promising strategy. PMID:21049743

  12. Capsule Endoscopy versus Standard Tests in Influencing Management of Obscure Digestive Bleeding: Results from a German Multicenter Trial

    Microsoft Academic Search

    Bruno Neu; Christian Ell; Andrea May; Elke Schmid; Jürgen-Ferdinand Riemann; Friedrich Hagenmüller; Martin Keuchel; Nib Soehendra; Uwe Seitz; Alexander Meining; Thomas Rösch

    2005-01-01

    BACKGROUND:Capsule endoscopy (CE) is a new modality for obscure digestive bleeding (OBD), but little is known about its influence on management and outcome.PATIENTS AND METHODS:Fifty-six patients (male\\/female 26\\/30; mean age 63 yr) with ODB, and negative upper and lower gastrointestinal (GI) endoscopy were included in this multicenter study. The diagnostic yield of CE was compared to three other tests (OT:

  13. Swallowable Wireless Capsule Endoscopy: Progress and Technical Challenges

    PubMed Central

    Pan, Guobing; Wang, Litong

    2012-01-01

    Wireless capsule endoscopy (WCE) offers a feasible noninvasive way to detect the whole gastrointestinal (GI) tract and revolutionizes the diagnosis technology. However, compared with wired endoscopies, the limited working time, the low frame rate, and the low image resolution limit the wider application. The progress of this new technology is reviewed in this paper, and the evolution tendencies are analyzed to be high image resolution, high frame rate, and long working time. Unfortunately, the power supply of capsule endoscope (CE) is the bottleneck. Wireless power transmission (WPT) is the promising solution to this problem, but is also the technical challenge. Active CE is another tendency and will be the next geneion of the WCE. Nevertheless, it will not come true shortly, unless the practical locomotion mechanism of the active CE in GI tract is achieved. The locomotion mechanism is the other technical challenge, besides the challenge of WPT. The progress about the WPT and the active capsule technology is reviewed. PMID:22253621

  14. Small bowel capsule endoscopy in 2007: Indications, risks and limitations

    PubMed Central

    Rondonotti, Emanuele; Villa, Federica; Mulder, Chris JJ; Jacobs, Maarten AJM; de Franchis, Roberto

    2007-01-01

    Capsule endoscopy has revoluzionized the study of the small bowel by providing a reliable method to evaluate, endoscopically, the entire small bowel. In the last six years several papers have been published exploring the possible role of this examination in different clinical conditions. At the present time capsule endoscopy is generally recommended as a third examination, after negative bidirectional endoscopy, in patients with obscure gastrointestinal bleeding. A growing body of evidence suggests also an important role for this examination in other clinical conditions such as Crohn’s disease, celiac disease, small bowel polyposis syndromes or small bowel tumors. The main complication of this examination is the retention of the device at the site of a previously unknown small bowel stricture. However there are also some other open issues mainly due to technical limitations of this tool (which is not driven from remote control, is unable to take biopsies, to insufflate air, to suck fluids or debris and sometimes to correctly size and locate lesions).The recently developed double balloon enteroscope, owing to its capability to explore a large part of the small bowel and to take targeted biopsies, although being invasive and time consuming, can overcome some limitations of capsule endoscopy. At the present time, in the majority of clinical conditions (i.e. obscure GI bleeding), the winning strategy seems to be to couple these two techniques to explore the small bowel in a painless, safe and complete way (with capsule endoscopy) and to define and treat the lesions identified (with double balloon enteroscopy). PMID:18069752

  15. Management of iatrogenic colorectal perforation: From surgery to endoscopy

    PubMed Central

    Cai, Shi-Lun; Chen, Tao; Yao, Li-Qing; Zhong, Yun-Shi

    2015-01-01

    Iatrogenic colon perforation is one the most pernicious complications for patients undergoing endoscopic screening or therapy. It is a serious but rare complication of colonoscopy. However, with the expansion of the indications for endoscopic therapies for gastrointestinal diseases, the frequency of colorectal perforation has increased. The management of iatrogenic colorectal perforation is still a challenge for many endoscopists. The methods for treating this complication vary, including conservative treatment, surgical treatment, laparoscopy and endoscopy. In this review, we highlight the etiology, recognition and treatment of colorectal iatrogenic perforation. Specifically, we shed light on the endoscopic management of this rare complication.

  16. Endoscopy in the Diagnosis and Management of Motility Disorders

    Microsoft Academic Search

    Yael Kopelman; George Triadafilopoulos

    2011-01-01

    Background  Gastrointestinal illness may result from either an underlying structural abnormality (e.g. neoplastic obstruction), or a functional\\u000a disorder (e.g. motor diarrhea), or both (e.g. achalasia with squamous esophageal cancer).\\u000a \\u000a \\u000a \\u000a \\u000a Aims  The purpose of this study was to highlight the potential value and role of endoscopy in the recognition and management of\\u000a patients with functional and motility disorders.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We performed a literature review

  17. Room-temperature electroluminescence from germanium in an Al0.3Ga0.7As/Ge heterojunction

    E-print Network

    Kolner, Brian H.

    Room-temperature electroluminescence from germanium in an Al0.3Ga0.7As/Ge heterojunction light systems. In this study, we demonstrate room-temperature electroluminescence from germanium in an Al0.3Ga0 material properties of germanium. Electroluminescence peaks were observed near 1550 nm and the energy

  18. Gastrointestinal angiodysplasia in chronic renal failure.

    PubMed

    Kaaroud, H; Fatma, L Ben; Beji, S; Boubaker, K; Hedri, H; Hamida, F Ben; El Younsi, F; Abdallah, T Ben; Maiz, H Ben; Kheder, A

    2008-09-01

    Gastrointestinal (GI) hemorrhage is a frequent and sometimes life-threatening complication of end-stage renal failure. Angiodysplasia (AD), vascular malformation, is the most common cause of recurrent lower-intestinal hemorrhage in patients with renal failure. We report four chronic hemodialysis patients with AD. All patients presented with severe anemia requiring transfusion. GI hemorrhage ceased spontaneously in three cases and after treatment with argon plasma coagulation in another. Diagnosis of AD is usually challenging, since its cause is still unknown, and its clinical presentation is variable. Lesions are multiple in 40-75% of cases, often located in the stomach and duodenum but can affect the colon and the jejunum. Diagnosis is improved by endoscopy which has a much higher sensitivity compared to angiography. Capsular endoscopy may reveal the hemorrhage site in the small intestine when regular endoscopy fails, and therapeutic intervention usually include argon plasma coagulation. PMID:18711303

  19. The endoscopy Global Rating Scale – Canada: Development and implementation of a quality improvement tool

    PubMed Central

    MacIntosh, Donald; Dubé, Catherine; Hollingworth, Roger; van Zanten, Sander Veldhuyzen; Daniels, Sandra; Ghattas, George

    2013-01-01

    BACKGROUND: Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality highlight the need for endoscopy facilities to review the quality of the service they offer. OBJECTIVE: To adapt the United Kingdom Global Rating Scale (UK-GRS) to develop a web-based and patient-centred tool to assess and improve the quality of endoscopy services provided. METHODS: Based on feedback from 22 sites across Canada that completed the UK endoscopy GRS, and integrating results of the Canadian consensus on safety and quality indicators in endoscopy and other Canadian consensus reports, a working group of endoscopists experienced with the GRS developed the GRS-Canada (GRS-C). RESULTS: The GRS-C mirrors the two dimensions (clinical quality and quality of the patient experience) and 12 patient-centred items of the UK-GRS, but was modified to apply to Canadian health care infrastructure, language and current practice. Each item is assessed by a yes/no response to eight to 12 statements that are divided into levels graded D (basic) through A (advanced). A core team consisting of a booking clerk, charge nurse and the physician responsible for the unit is recommended to complete the GRS-C twice yearly. CONCLUSION: The GRS-C is intended to improve endoscopic services in Canada by providing endoscopy units with a straightforward process to review the quality of the service they provide. PMID:23472242

  20. [Possibilities of energy augmentation of pellets shot from ASG replicas and gunshot wounds].

    PubMed

    Golema, Wojciech; Jurek, Tomasz; Thannhäuser, Agata; Kawecki, Jerzy; Trnka, Jakub

    2011-01-01

    In this paper, the authors review the types of air soft gun replicas depending on the type of drive and ammunition, showing the possibilities of altering the M4A1 rifle replica's technical parameters and the effect of such modifications on initial energy of the projectile. A PJ4 CQB NAVY replica's inner barrel, spring, motor and cylinder kit were replaced. Subsequently, the muzzle velocity was determined and compared to the initial muzzle velocity. This example showed that amateur modifications can greatly increase the initial energy of the pellet. The authors suggest that especially in terms of determining the exposure to direct danger of death or grave detriment to health, the manufacturer's data about pellet energy should not be taken without question, but one should strive for an individual assessment of the ASG replica constituting the evidence. PMID:22715674

  1. The Effectiveness of Intravenous Sedation in Diagnostic Upper Gastrointestinal Endoscopy

    Microsoft Academic Search

    Narong Lertakayamanee; Viyada Chalayonnavin BN

    Background: Topical pharyngeal anesthesia is required to perform a technically adequate esophago- gastroduodenoscopy (EGD), but does not improve patient satisfaction, comfort, and willingness to repeat, particularly in the elderly and those with increased pharyngeal sensitivity. The comparative effectiveness of intravenous sedation versus no sedation remains poorly characterized. Objective: To compare the effectiveness of diagnostic EGD with and without intravenous sedation

  2. Advances in interventional gastrointestinal endoscopy in colon and rectum

    Microsoft Academic Search

    Uwe Seitz; Stefan Seewald; Sabine Bohnacker; Nib Soehendra

    2003-01-01

    Background. Instrumental and procedural advances particularly in the therapeutic field have been achieved. Review. Endoscopes with larger working channel, additional jet-channel, or variable stiffness allow more sophisticated interventional procedures. Higher resolution in endoscopic image quality helps to identify early lesions that can be treated endoscopically at this stage. Polypectomy and mucosectomy are no longer limited by the size of the

  3. The Dawning of a New Sedative: Propofol in Gastrointestinal Endoscopy

    Microsoft Academic Search

    Ludwig T. Heuss; Werner Inauen

    2004-01-01

    Background: Using gentler endoscopes and improved sedation, great strides have been made in enhancing patients’ comfort and acceptance of endoscopic procedures. Because morbidity and mortality have been associated with benzodiazepines in endoscopic sedation, safer alternatives were sought. Propofol (2,6-diisopropylphenol), a rapid and short-acting anesthetic, initially used in the 1980’s for general anesthesia induction and maintenance, is a promising candidate. Methods:

  4. Blood detection in wireless capsule endoscopy using expectation maximization clustering

    NASA Astrophysics Data System (ADS)

    Hwang, Sae; Oh, JungHwan; Cox, Jay; Tang, Shou Jiang; Tibbals, Harry F.

    2006-03-01

    Wireless Capsule Endoscopy (WCE) is a relatively new technology (FDA approved in 2002) allowing doctors to view most of the small intestine. Other endoscopies such as colonoscopy, upper gastrointestinal endoscopy, push enteroscopy, and intraoperative enteroscopy could be used to visualize up to the stomach, duodenum, colon, and terminal ileum, but there existed no method to view most of the small intestine without surgery. With the miniaturization of wireless and camera technologies came the ability to view the entire gestational track with little effort. A tiny disposable video capsule is swallowed, transmitting two images per second to a small data receiver worn by the patient on a belt. During an approximately 8-hour course, over 55,000 images are recorded to a worn device and then downloaded to a computer for later examination. Typically, a medical clinician spends more than two hours to analyze a WCE video. Research has been attempted to automatically find abnormal regions (especially bleeding) to reduce the time needed to analyze the videos. The manufacturers also provide the software tool to detect the bleeding called Suspected Blood Indicator (SBI), but its accuracy is not high enough to replace human examination. It was reported that the sensitivity and the specificity of SBI were about 72% and 85%, respectively. To address this problem, we propose a technique to detect the bleeding regions automatically utilizing the Expectation Maximization (EM) clustering algorithm. Our experimental results indicate that the proposed bleeding detection method achieves 92% and 98% of sensitivity and specificity, respectively.

  5. Capsule endoscopy: Present status and future expectation

    PubMed Central

    Goenka, Mahesh K; Majumder, Shounak; Goenka, Usha

    2014-01-01

    Video capsule endoscopy (CE) since its introduction 13 years back, has revolutionized our approach to small intestinal diseases. Obscure gastrointestinal bleed (OGIB) continues to be the most important indication for CE with a high sensitivity, specificity as well as positive and negative predictive values. It is best performed during ongoing bleed or immediately thereafter. Overt OGIB has a higher diagnostic yield than occult OGIB. However, even in iron deficiency anemia, CE is emerging as important investigation after initial negative work up. In suspected Crohn’s disease (CD), CE has been shown superior to traditional imaging and endoscopic technique and should be considered after a negative ileocolonoscopy. Although CE has also been used for evaluating established CD, a high capsule retention rate precludes its use ahead of cross-sectional imaging. Celiac disease, particularly where gastro-duodenoscopy cannot be performed or is normal, can also be investigated by CE. Small bowel tumor, hereditary polyposis syndrome, and non-steroidal anti-inflammatory drugs induced intestinal damage are other indications for CE. Capsule retention is the only significant adverse outcome of CE and occurs mostly in presence of intestinal obstruction. This can be prevented by use of Patency capsule prior to CE examination. Presence of cardiac pacemaker and intracardiac devices continue to be relative contraindications for CE, though data do not suggest interference of CE with these devices. Major limitations of CE today include failure to control its movement from outside, inability of CE to acquire tissue for diagnosis, and lack of therapeutic help. With ongoing interesting and exciting developments taking place in these areas, these issues would be solved in all probability in near future. CE has the potential to become one of the most important tools in diagnostic and possibly in the therapeutic field of gastrointestinal disorder. PMID:25110430

  6. Role of over the scope clips in the management of iatrogenic gastrointestinal perforations.

    PubMed

    Changela, Kinesh; Virk, Muhhamad A; Patel, Niravkumar; Duddempudi, Sushil; Krishnaiah, Mahesh; Anand, Sury

    2014-08-28

    Advances in endoscopic and surgical techniques have increased the frequency and complexity of these procedures and associated complications such as gastrointestinal perforation. With the advancements in the field of gastroenterology, the promising use of an over the scope clips (OTSC) has fulfilled the unmet need for a reliable endoscopic devise in approximation of gastrointestinal perforation. This novel approach has raised the level of confidence in endoscopist in dealing with this serious complication during endoscopy. Here we have shared our experience with OTSC to evaluate its efficacy and safety in managing iatrogenic gastrointestinal perforations during endoscopy. PMID:25170237

  7. Intraoperative bowel cleansing tool in active locomotion capsule endoscopy.

    PubMed

    Ciuti, G; Tognarelli, S; Verbeni, A; Menciassi, A; Dario, P

    2013-01-01

    Capsule endoscopy (CE) can be considered an example of "disruptive technology" since it represents a bright alternative to traditional diagnostic methodologies. If compared with traditional endoscopy, bowel cleansing procedure in CE becomes of greater importance, due to the impossibility to intraoperatively operate on unclean gastrointestinal tract areas. Considering the promising results and benefits obtained in the field of CE for gastrointestinal diagnosis and intervention, the authors approached the bowel cleansing issue with the final aim to propose an innovative and easy-to-use intraoperative cleansing system to be applied to an active locomotion softly-tethered capsule device, already developed by the authors. The system, that has to be intended as an additional tool for intraoperatively cleansing procedure of the colonic tract, is composed by a flexible tube with a metallic deflector attached to the distal end; it can be headed to the target area through the capsule operating channel. Performances of the colonoscopic capsule and intraoperative cleansing capabilities were successfully confirmed both in an in-vitro and ex-vivo experimental session. The innovative intraoperative cleansing system demonstrated promising results in terms of water injection, colonic wall cleansing procedure and subsequent water suction, thus guaranteeing to reduce the risk of inadequate visualization of the mucosa in endoscopic procedures. PMID:24110819

  8. Recent advances in targeted endoscopic imaging: Early detection of gastrointestinal neoplasms

    PubMed Central

    Kwon, Yong-Soo; Cho, Young-Seok; Yoon, Tae-Jong; Kim, Ho-Shik; Choi, Myung-Gyu

    2012-01-01

    Molecular imaging has emerged as a new discipline in gastrointestinal endoscopy. This technology encompasses modalities that can visualize disease-specific morphological or functional tissue changes based on the molecular signature of individual cells. Molecular imaging has several advantages including minimal damage to tissues, repetitive visualization, and utility for conducting quantitative analyses. Advancements in basic science coupled with endoscopy have made early detection of gastrointestinal cancer possible. Molecular imaging during gastrointestinal endoscopy requires the development of safe biomarkers and exogenous probes to detect molecular changes in cells with high specificity anda high signal-to-background ratio. Additionally, a high-resolution endoscope with an accurate wide-field viewing capability must be developed. Targeted endoscopic imaging is expected to improve early diagnosis and individual therapy of gastrointestinal cancer. PMID:22442742

  9. The advancing art and science of endoscopy.

    PubMed

    Vitale, Gary C; Davis, Brian R; Tran, Tin C

    2005-08-01

    Flexible endoscopy continues to advance encompassing treatment of a variety of diseases traditionally managed surgically. This review describes and evaluates many of these new endoscopic approaches with an eye toward the future. Gastroesophageal reflux disease is now treated with several endoscopic, non-operative techniques. A procedure using radiofrequency energy delivered by a peroral catheter with small needles inserted into the wall of the esophagus causes collagen deposition and ablates transient lower esophageal sphincter relaxation, both of which reduce reflux. With this treatment, >80% of patients will reduce or stop their medication for reflux. Trials involving new injectable materials show promise with a 75-80% improvement in heartburn-related quality-of-life scores and reduced medication use. Endoscopic suture and stapling devices restore the antireflux barrier with sutures that create a pleat or plication at the gastroesophageal junction. Early results indicated that 62-74% of patients had significant improvement. Long-term results are not available for any of these new techniques and there seems to be a drop off in effectiveness over time. Gastrointestinal bleeding has been more effectively managed with the recent introduction of small clips and detachable snares to control bleeding vessels. Banding and sclerotherapy for variceal bleeding has all but eliminated urgent operation for that diagnosis. In the biliary-pancreas realm, endoscopic management of pancreatic pseudocysts, stenting of pancreatic or biliary strictures and fistulae have reduced operative indications in those disease processes. Pseudocyst drainage involves creation of a transenteric communication between the pseudocyst and the stomach or duodenum. Complete cyst resolution without recurrence can be expected in 85% of patients. While endoscopic palliation of malignant biliary strictures has been accepted for years, experience with endoscopic management of iatrogenic strictures indicates that it may serve as an alternative option without surgery in many patients. Enteric stenting using metallic self-expanding stents in the esophagus, duodenum, and colon allows alleviation of obstruction without surgery for palliantation and in the colon may relieve obstruction to avoid colostomy prior to an elective resection. On the horizon stands the flexible endoscopic route to the abdominal cavity via the transgastric route and the promise of combined endoscopic-laparoscopic approaches to complex abdominal problems. General surgeons should rekindle their interest in flexible endoscopy or risk losing entire categories of disease to other specialties or to a small specialized group of endoscopic surgeons. PMID:16023436

  10. Digestive endoscopy in five decades.

    PubMed

    Cotton, Peter B

    2005-01-01

    The world of gastroenterology changed forever when flexible endoscopes became available in the 1960s. Diagnostic and therapeutic techniques proliferated and entered the mainstream of medicine, not without some controversy. Success resulted in a huge service demand, with the need to train more endoscopists and to organise large endoscopy units and teams of staff. The British health service struggled with insufficient numbers of consultants, other staff and resources, and British endoscopy fell behind that of most other developed countries. This situation is now being addressed aggressively, with many local and national initiatives aimed at improving access and choice, and at promoting and documenting quality. Many more consultants are needed and some should be relieved of their internal medicine commitment to focus on their specialist skills. New instruments and procedures are stretching the diagnostic boundaries and changing the interface with sister disciplines like radiology, surgery and pathology. The old distinctions, particularly between gastroenterology and surgery, are increasingly irrelevant and unhelpful. The future is bright for gastroenterology and for endoscopy, but unpredictable. In this fast-changing world it will be essential to remain flexible, with our goals firmly focused on the best interests of our patients. PMID:16411358

  11. Flexible Endoscopy in the Management of Patients Undergoing Roux-en-Y Gastric Bypass

    Microsoft Academic Search

    Bruce Schirmer; Cengiz Erenoglu; Anna Miller

    2002-01-01

    Background: Flexible upper endoscopy (FUE) is an important diagnostic and therapeutic tool in the management of upper gastrointestinal\\u000a diseases. We examined the role of FUE in the management of patients undergoing Roux-en-Y gastric bypass (RYGBP). Methods:\\u000a All patients undergoing RYGBP at a single institution from 1986 to 2001 were studied. Preoperative FUE was performed by the\\u000a surgeon to assess the

  12. Update of endoscopy in liver disease: More than just treating varices

    PubMed Central

    Krystallis, Christoforos; Masterton, Gail S; Hayes, Peter C; Plevris, John N

    2012-01-01

    The management of complications in liver disease is often complex and challenging. Endoscopy has undergone a period of rapid expansion with numerous novel and specialized endoscopic modalities that are of increasing value in the investigation and management of the patient with liver disease. In this review, relevant literature search and expert opinions have been used to provide a brief overview and update of the current endoscopic management of patients with liver disease and portal hypertension. The main areas covered are safety of endoscopy in patients with liver disease, the use of standard endoscopy for the treatment of varices and the role of new endoscopic modalities such as endoscopic ultrasound, esophageal capsule, argon plasma coagulation, spyglass and endomicroscopy in the investigation and treatment of liver-related gastrointestinal and biliary pathology. It is clear that the role of the endoscopy in liver disease is well beyond that of just treating varices. As the technology in endoscopy expands, so does the role of the endoscopist in liver disease. PMID:22346246

  13. Assessment of regional ionosphere model supporting precise positioning for ASG-EUPOS network

    NASA Astrophysics Data System (ADS)

    Krypiak-Gregorczyk, Anna; Wielgosz, Pawel; Jarmo?owski, Wojciech

    2015-04-01

    Since 2008 the Head Office of Geodesy and Cartography in Poland operates a dense active GNSS network - ASG-EUPOS - consisting of over 100 stations. Currently over 60 stations are equipped with GPS+GLONASS receivers, including almost 30 stations with Galileo capability. This greatly improves IPP coverage over Poland and neighboring areas and offers excellent opportunity of providing high resolution and accurate ionosphere model for positioning purposes. In this paper we show performance assessment of a multi-GNSS ionospheric TEC model derived from precise carrier phase GNSS data. The model is based on processing of 170 GNSS stations located in Poland and neighboring countries. In the first step, carrier phase biases are estimated for each satellite arc. In the second step, theses biases are used together with multi-frequency, multi-GNSS carrier phase observations to calculate TEC at IPP locations. Then, the least squares collocation method is applied to provide vertical TEC grid - the TEC model. The TEC grid is used to calculate ionospheric delay corrections. The corrections are then verified by comparison to double differences ionospheric residual derived from GNSS data at selected test baselines. Our results show that the multi-GNSS regional ionospheric TEC model is capable of providing ionospheric corrections that may satisfy precise GNSS positioning requirements.

  14. Nurse endoscopy in a district general hospital.

    PubMed Central

    Goodfellow, P. B.; Fretwell, I. A.; Simms, J. M.

    2003-01-01

    INTRODUCTION: This study describes the first full year of independent practice by a newly appointed nurse endoscopist in a district general hospital. PATIENTS AND METHODS: Patients underwent either 'one stop' flexible sigmoidoscopy and barium enema or flexible sigmoidoscopy alone. Barium enema results, video photography, clinical follow-up, and histology were used to validate the results of the flexible sigmoidoscopy. One stop clinic: 161 endoscopies were performed, with 104 female patients (65%), and a mean age of 64 years. There was one failed endoscopy due to poor bowel preparation. Abnormalities were identified in 84% of endoscopies. Flexible sigmoidoscopy detected abnormalities not seen on the barium enema in 28 cases, all of which were polyps (18%). Barium enema identified one abnormality within reach of the flexible sigmoidoscope not identified at endoscopy (small polyp in sigmoid; 1%). Elective flexible sigmoidoscopy list: 121 endoscopies were performed, with 65 female patients (54%), and a mean age of 59 years. There were two failed endoscopy procedures, both attributed to poor bowel preparation. Two-thirds of patients had an abnormality on investigation. There were no complications in either group of patients. CONCLUSIONS: The nurse-led endoscopy service has been successfully initiated with a high completion rate for flexible sigmoidoscopies. All significant conditions were identified with 99% sensitivity. Nurse endoscopy is a safe, useful and practical procedure in the setting of this district general hospital. PMID:12831491

  15. Wireless capsule endoscopy of the small intestine in children.

    PubMed

    Zevit, Noam; Shamir, Raanan

    2015-06-01

    Wireless capsule endoscopy (CE) for the diagnosis of small-bowel disease has been in clinical use for more than a decade, and is no longer an emerging technology, but rather one that has reached fruition. This noninvasive technology has been readily embraced by both physicians and patients. Used in the diagnosis of inflammatory bowel disease, for locating sources of obscure gastrointestinal bleeding, and for assessing small-bowel polyp burden in polyposis syndromes as well as for less common indications, CE has transformed the diagnostic algorithms of small-bowel investigations. Although already in widespread use, the technology incorporated into the various CE platforms continues to improve and expand. Here, we briefly review the indications, limitations, and advances in video capsule technology, with an emphasis on its use in pediatrics. PMID:25782661

  16. Recent advances in capsule endoscopy: development of maneuverable capsules.

    PubMed

    Keller, Jutta; Fibbe, Christiane; Rosien, Ulrich; Layer, Peter

    2012-09-01

    One important disadvantage of modern capsule endoscopy is its lack of maneuverability. Thus, clinically available systems depend on transportation by spontaneous gastrointestinal motility. Even in subjects with normal motility, transit time for different intestinal segments may vary considerably, and relevant segments may be passed too quickly. This probably explains why approximately 10% of all pathologies are overlooked during small bowel investigations. Moreover, without maneuverable capsule endoscopes, the large inner surface of the stomach cannot be investigated properly. The most advanced approaches, which try to develop maneuverable systems for targeted inspection of the GI tract, use magnetic fields for steering of a videocapsule with magnetic inclusions. With such systems, preliminary clinical studies have already been performed. Other projects try to develop biologically inspired steering mechanisms such as capsules that can move on legs or they use electrical stimulation of the intestinal wall in order to induce contractions for propulsion of the videocapsule. PMID:23061707

  17. Endoscopic diagnosis of follicular lymphoma with small-bowel involvement using video capsule endoscopy and double-balloon endoscopy: a case series.

    PubMed

    Nakamura, M; Ohmiya, N; Hirooka, Y; Miyahara, R; Ando, T; Watanabe, O; Itoh, A; Kawashima, H; Ohno, E; Kinoshita, T; Goto, H

    2013-01-01

    The aims of this study were to compare the detection rates of gastrointestinal follicular lymphoma lesions by video capsule endoscopy (VCE) and double-balloon endoscopy (DBE), and to determine the pathologic diagnostic yields of DBE-directed biopsies. A total of 27 consecutive patients were enrolled. No significant difference in detection rates was observed in 12 patients who underwent total enteroscopy at both VCE and DBE. Pathologic diagnostic yields stratified by location were 91?% in the proximal duodenum at esophagogastroduodenoscopy, 88?% in the jejunum at antegrade DBE, 52?% in the ileum at retrograde DBE, and 57?% in the terminal ileum at colonoscopy. VCE and DBE were helpful in determining treatment in 44?% of patients. PMID:23208779

  18. Recent advancement of therapeutic endoscopy in the esophageal benign diseases.

    PubMed

    Bechara, Robert; Inoue, Haruhiro

    2015-05-16

    Over the past 30 years, the field of endoscopy has witnessed several advances. With the advent of endoscopic mucosal resection, removal of large mucosal lesions have become possible. Thereafter, endoscopic submucosal resection was refined, permitting en bloc removal of large superficial neoplasms. Such techniques have facilitated the development of antireflux mucosectomy, a promising novel treatment for gastroesophageal reflux. The introduction and use of over the scope clips has allowed for endoscopic closure of defects in the gastrointestinal tract, which were traditionally treated with surgical intervention. With the development of per-oral endoscopic myotomy (POEM), the treatment of achalasia and spastic disorders of the esophagus have been revolutionized. From the submucosal tunnelling technique developed for POEM, Per oral endoscopic tumor resection of subepithelial tumors was made possible. Simultaneously, advances in biotechnology have expanded esophageal stenting capabilities with the introduction of fully covered metal and plastic stents, as well as biodegradable stents. Once deemed a primarily diagnostic tool, endoscopy has quickly transcended to a minimally invasive intervention and therapeutic tool. These techniques are reviewed with regards to their application to benign disease of the esophagus. PMID:25992187

  19. Endoscopy

    MedlinePLUS

    ... It uses an instrument called an endoscope, or scope for short. Scopes have a tiny camera attached to a long, ... or opening to see inside an organ. Sometimes scopes are used for surgery, such as for removing ...

  20. Gastrointestinal involvement in systemic mastocytosis.

    PubMed Central

    Ammann, R W; Vetter, D; Deyhle, P; Tschen, H; Sulser, H; Schmid, M

    1976-01-01

    Four consecutive patients with systemic mastocytosis were studied. One patient had a malabsorption syndrome with only minor histological changes of the intestinal mucosa. Another patient with ulcer diathesis had a gastric secretory pattern resembling Zollinger-Ellison syndrome. Serum gastrin and histamine levels were consistently normal in all patients. Endoscopy of stomach and colon disclosed urticaria-like papulae either spontaneously or after topical provocation in all patients. No increase of mast cells was found in multiple mucosal biopsies. A markedly increased gastric tissue content of histamine was found, however, in the three patients studied. The findings suggest that urticaria-like lesions associated with a high tissue content of histamine may be more important that hyperhistaminaemia in causing the various gastrointestinal symptoms. PMID:1261881

  1. Optical Molecular Imaging in the Gastrointestinal Tract

    PubMed Central

    Carns, Jennifer; Keahey, Pelham; Quang, Timothy; Anandasabapathy, Sharmila; Richards-Kortum, Rebecca

    2013-01-01

    Recent developments in optical molecular imaging allow for real-time identification of morphological and biochemical changes in tissue associated with gastrointestinal neoplasia. This review summarizes widefield and high resolution imaging modalities currently in pre-clinical and clinical evaluation for the detection of colorectal cancer and esophageal cancer. Widefield techniques discussed include high definition white light endoscopy, narrow band imaging, autofluoresence imaging, and chromoendoscopy; high resolution techniques discussed include probe-based confocal laser endomicroscopy, high-resolution microendoscopy, and optical coherence tomography. Finally, new approaches to enhance image contrast using vital dyes and molecular-specific targeted contrast agents are evaluated. PMID:23735112

  2. Coeliac disease and malignancy of the duodenum: diagnosis by endoscopy, successful treatment of the malignancy, and response to a gluten free diet

    Microsoft Academic Search

    M J Hall; B T Cooper; N Rooney; H Thompson; A E Read

    1991-01-01

    A patient presented with subtotal villous atrophy and a malignant duodenal tumour of uncertain histogenesis. He was successfully treated by resection and chemotherapy and the small bowel mucosa recovered on a gluten free diet. The tumour was diagnosed at upper gastrointestinal endoscopy when barium studies and abdominal computed tomography were normal, thus making this one of the earliest coeliac malignancies

  3. Can the presence of endoscopic high-risk stigmata be predicted before endoscopy? A multivariable analysis using the RUGBE database

    PubMed Central

    Chen, Yen-I; Wyse, Jonathan; Barkun, Alan; Bardou, Marc; Gralnek, Ian M; Martel, Myriam

    2014-01-01

    BACKGROUND: Many aspects in the management of acute upper gastrointestinal bleeding rely on pre-esophagogastroduodenoscopy (EGD) stratification of patients likely to exhibit high-risk stigmata (HRS); however, data predicting the presence of HRS are lacking. OBJECTIVE: To determine clinical and laboratory predictors of HRS at the index EGD in patients presenting with acute upper gastrointestinal bleeding using retrospective data from a validated national database – the Canadian Registry in Upper Gastrointestinal Bleeding and Endoscopy registry. METHODS: Relevant clinical and laboratory parameters were evaluated. HRS was defined as spurting, oozing, nonbleeding visible vessel or adherent clot after vigorous irrigation. Multivariable modelling was used to identify predictors of HRS including age, sex, hematemesis, use of antiplatelet agents, American Society of Anesthesiologists (ASA) classification, nasogastric tube aspirate, hemoglobin level and elapsed time from the onset of bleeding to EGD. RESULTS: Of the 1677 patients (mean [± SD] age 66.2±16.8 years; 38.3% female), 28.7% had hematemesis, 57.8% had an ASA score of 3 to 5, and the mean hemoglobin level was 96.8±27.3 g/L. The mean time from presentation to endoscopy was 22.2±37.5 h. The best fitting multivariable model included the following significant predictors: ASA score 3 to 5 (OR 2.16 [95% CI 1.71 to 2.74]), a shorter time to endoscopy (OR 0.99 [95% CI 0.98 to 0.99]) and a lower initial hemoglobin level (OR 0.99 [95% CI 0.99 to 0.99]). CONCLUSION: A higher ASA score, a shorter time to endoscopy and lower initial hemoglobin level all significantly predicted the presence of endoscopic HRS. These criteria could be used to improve the optimal selection of patients requiring more urgent endoscopy. PMID:24945183

  4. Light-induced fluorescence endoscopy (LIFE) imaging system for early cancer detection

    NASA Astrophysics Data System (ADS)

    Zeng, Haishan; MacAulay, Calum E.; Lam, Stephen; Palcic, Branko

    1999-09-01

    This paper summarizes our experiences on the development of a Light Induced Fluorescence Endoscopy (LIFE) imaging system for early cancer detection in the respiratory and gastrointestinal tract. The system utilizes tissue autofluorescence to provide real time video imaging of the examined organ. No exogenous fluorescent tumor markers are needed. It is used by a physician in adjunct to conventional white-light endoscopy. Suspicious areas are identified in pseudo color to guide biopsy. A multi- center clinical trial has demonstrated that in the lung, the relative sensitivity of white-light imaging + LIFE imaging vs. white-light imaging alone was 6.3 for intraepithelial neoplastic lesion detection and 2.71 when invasive carcinomas were also included. The following issues will be discussed: (1) spectroscopy study design for imaging system development; (2) architecture of the imaging systems; (3) different imaging modalities (white-light imaging, dual channel fluorescence imaging, and combined fluorescence/reflectance imaging); and (4) clinical applications.

  5. Conventional Nuclear Medicine in the Evaluation of Gastrointestinal and Genitourinary Tract Disorders

    Microsoft Academic Search

    Ariane Boubaker

    \\u000a Conventional nuclear medicine investigations of the gastrointestinal (GI) tract are not commonly performed in routine clinical\\u000a practice, although prevalence of disorders affecting the upper gastrointestinal tract is quite high ranging from 15% to 40%\\u000a in European countries. Most diagnostic tests used to differentiate organic from nonorganic cause are invasive (endoscopy,\\u000a manometry, pH monitoring) and may be not well tolerated by

  6. Gastrointestinal complications of systemic sclerosis

    PubMed Central

    Tian, Xin-Ping; Zhang, Xuan

    2013-01-01

    Systemic sclerosis is an autoimmune disease characterized by progressive skin thickening and tightness. Pulmonary interstitial fibrosis and kidney damage are the most important indicators for mortality; however, the gastrointestinal tract is the most commonly damaged system. Virtually all parts of the gastrointestinal (GI) tract can be involved, although the esophagus is the most frequently reported. The mechanisms that cause such extensive damage are generally unclear, but vascular changes, immunological abnormalities, excessive accumulation of collagen in the submucosa, smooth muscle atrophy and neuropathy may participate because these are the most common histological findings in biopsies and autopsies. Most patients with GI tract involvement complain about dyspepsia, nausea, vomiting, abdominal bloating/distension, and fecal incontinence. These symptoms are generally mild during the early stage of the disease and are likely ignored by physicians. As the disease becomes more advanced, however, patient quality of life is markedly influenced, whereby malnutrition and shortened survival are the usual consequences. The diagnosis for systemic sclerosis is based on manometry measurements and an endoscopy examination. Supportive and symptomatic treatment is the main therapeutic strategy; however, an early diagnosis is critical for successful management. PMID:24222949

  7. Surveillance for gastrointestinal malignancies

    PubMed Central

    Tiwari, Ashish K; Laird-Fick, Heather S; Wali, Ramesh K; Roy, Hemant K

    2012-01-01

    Gastrointestinal (GI) malignancies are notorious for frequently progressing to advanced stages even in the absence of serious symptoms, thus leading to delayed diagnoses and dismal prognoses. Secondary prevention of GI malignancies through early detection and treatment of cancer-precursor/premalignant lesions, therefore, is recognized as an effective cancer prevention strategy. In order to efficiently detect these lesions, systemic application of screening tests (surveillance) is needed. However, most of the currently used non-invasive screening tests for GI malignancies (for example, serum markers such as alpha-fetoprotein for hepatocellular carcinoma, and fecal occult blood test, for colon cancer) are only modestly effective necessitating the use of highly invasive endoscopy-based procedures, such as esophagogastroduodenoscopy and colonoscopy for screening purposes. Even for hepatocellular carcinoma where non-invasive imaging (ultrasonography) has become a standard screening tool, the need for repeated liver biopsies of suspicious liver nodules for histopathological confirmation can’t be avoided. The invasive nature and high-cost associated with these screening tools hinders implementation of GI cancer screening programs. Moreover, only a small fraction of general population is truly predisposed to developing GI malignancies, and indeed needs surveillance. To spare the average-risk individuals from superfluous invasive procedures and achieve an economically viable model of cancer prevention, it’s important to identify cohorts in general population that are at substantially high risk of developing GI malignancies (risk-stratification), and select suitable screening tests for surveillance in these cohorts. We herein provide a brief overview of such high-risk cohorts for different GI malignancies, and the screening strategies that have commonly been employed for surveillance purpose in them. PMID:22969223

  8. GASTROINTESTINAL BLEEDING AFTER LIVER TRANSPLANTATION1

    PubMed Central

    Tabasco-Minguillán, Javier; Jain, Ashok; Naik, Mangala; Weber, Kelly M.; Irish, William; Fung, John J.; Rakela, Jorge; Starzl, Thomas E.

    2010-01-01

    To investigate the causes of gastrointestinal bleeding (GIB) and its impact on patient and graft survival after liver transplantation (OLTx), adult patients among the first 1000 consecutive OLTx under Tacrolimus comprised our study population. Of 834 patients who comprised our population, 74 had at least one bleeding episode, and 760 patients had no GIB. Patients with GIB had their bleeding episodes analyzed and those without GIB were used as controls. The mean age, gender, and UNOS status were similar in both groups. Endoscopy was done in 73 patients with GIBand yielded a diagnosis in 60 (82.2%) who had a single (n=39) or multiple (n=21) GIB episodes. In the remaining 13 (17.8%) patients, the bleeding source was not identified. Ulcers (25) were the most common diagnosis, followed by enteritis (23), portal hypertensive lesions (15), RY bleeds (6), and miscellaneous (25). The majority (73%) of the GIB episodes occurred during the first postoperative trimester. The patient and graft survival were statistically lower in the GIB group compared with the rest. The adjusted relative risk of mortality and graft failure were increased by bleeding. In summary, endoscopy identified the source of GIB after OLTx in most cases. The cumulative incidence of GIB was 8.9% for the study period. Ulcers were the most common cause of GIB. The onset of gastrointestinal bleeding after liver transplantation carried a decreased patient and graft survival. PMID:9000662

  9. Recurrent lower gastrointestinal bleeding due to primary colonic Kaposi's sarcoma in a patient with AIDS.

    PubMed

    Ling, Jie; Coron, Roger; Basak, Prasanta; Jesmajian, Stephen

    2013-11-01

    Epidemic Kaposi's sarcoma remains the most common cancer in patients with human immunodeficiency virus and is associated with significant morbidity and mortality in AIDS patients. Primary visceral Kaposi's sarcoma (Kaposi's sarcoma without cutaneous lesions) presenting with lower gastrointestinal bleeding (LGIB) has rarely been reported. Though Kaposi's sarcoma can occur anywhere in gastrointestinal tract, gastrointestinal symptoms are often non-specific such as chronic blood loss anaemia, vomiting, diarrhoea, intestinal obstruction. In these patients, severe gastrointestinal bleeding requiring repeated blood transfusions is extremely rare. Clinicians should be aware of gastrointestinal tract Kaposi's sarcoma since visceral Kaposi's sarcoma can present in the absence of cutaneous involvement. Endoscopy with biopsy is useful in the diagnosis for severe LGIB in patients with AIDS. Furthermore, gastrointestinal Kaposi's sarcoma should be considered in the differential diagnosis of GI bleeding. We report a case of primary colonic KS who presented with recurrent GI bleeding which was eventually diagnosed by sigmoidoscopy and confirmed pathologically. PMID:23970616

  10. Capsule endoscopy—A mechatronics perspective

    NASA Astrophysics Data System (ADS)

    Lin, Lin; Rasouli, Mahdi; Kencana, Andy Prima; Tan, Su Lim; Wong, Kai Juan; Ho, Khek Yu; Phee, Soo Jay

    2011-03-01

    The recent advances in integrated circuit technology, wireless communication, and sensor technology have opened the door for development of miniature medical devices that can be used for enhanced monitoring and treatment of medical conditions. Wireless capsule endoscopy is one of such medical devices that has gained significant attention during the past few years. It is envisaged that future wireless capsule endoscopies replace traditional endoscopy procedures by providing advanced functionalities such as active locomotion, body fluid/tissue sampling, and drug delivery. Development of energy-efficient miniaturized actuation mechanisms is a key step toward achieving this goal. Here, we review some of the actuators that could be integrated into future wireless capsules and discuss the existing challenges.

  11. Gastrointestinal system

    PubMed Central

    Cheng, Leo K.; O’Grady, Gregory; Du, Peng; Egbuji, John U.; Windsor, John A.; Pullan, Andrew J.

    2014-01-01

    The functions of the gastrointestinal (GI) tract include digestion, absorption, excretion, and protection. In this review, we focus on the electrical activity of the stomach and small intestine, which underlies the motility of these organs, and where the most detailed systems descriptions and computational models have been based to date. Much of this discussion is also applicable to the rest of the GI tract. This review covers four major spatial scales: cell, tissue, organ, and torso, and discusses the methods of investigation and the challenges associated with each. We begin by describing the origin of the electrical activity in the interstitial cells of Cajal, and its spread to smooth muscle cells. The spread of electrical activity through the stomach and small intestine is then described, followed by the resultant electrical and magnetic activity that may be recorded on the body surface. A number of common and highly symptomatic GI conditions involve abnormal electrical and/or motor activity, which are often termed functional disorders. In the last section of this review we address approaches being used to characterize and diagnose abnormalities in the electrical activity and how these might be applied in the clinical setting. The understanding of electrophysiology and motility of the GI system remains a challenging field, and the review discusses how biophysically based mathematical models can help to bridge gaps in our current knowledge, through integration of otherwise separate concepts. PMID:20836011

  12. Esophageal adenocarcinoma with white opaque substance observed by magnifying endoscopy with narrow band imaging.

    PubMed

    Yoshii, Shunsuke; Kato, Motohiko; Honma, Keiichiro; Fujinaga, Tetsuji; Tsujii, Yoshiki; Maekawa, Akira; Inoue, Takuya; Hayashi, Yoshito; Akasaka, Tomofumi; Shinzaki, Shinichiro; Nishida, Tsutomu; Iijima, Hideki; Tsujii, Masahiko; Morii, Eiichi; Takehara, Tetsuo

    2015-03-01

    White opaque substance (WOS) is observed in the gastric neoplasia of 0-IIa type using magnifying endoscopy with narrow band imaging (NBI-ME). Colonic and duodenal neoplasms with WOS have also been reported. Immunohistochemical examination with adipophilin reveals WOS in gastric neoplasms as lipid droplets, and WOS is specific for neoplasm with intestinal or gastrointestinal phenotype. We herein report a case of adenocarcinoma of the esophagogastric junction with WOS. A male patient in his sixties was found by esophagogastroduodenoscopy to have an esophageal elevated lesion. NBI-ME showed whitish deposits that looked similar to WOS in gastric neoplasms. The patient underwent endoscopic submucosal dissection and the lesion was resected in a single piece. This tumor had diffuse positivity for adipophilin and gastrointestinal phenotype. PMID:25041337

  13. Virtual endoscopy in neurosurgery: a review.

    PubMed

    Neubauer, André; Wolfsberger, Stefan

    2013-01-01

    Virtual endoscopy is the computerized creation of images depicting the inside of patient anatomy reconstructed in a virtual reality environment. It permits interactive, noninvasive, 3-dimensional visual inspection of anatomical cavities or vessels. This can aid in diagnostics, potentially replacing an actual endoscopic procedure, and help in the preparation of a surgical intervention by bridging the gap between plain 2-dimensional radiologic images and the 3-dimensional depiction of anatomy during actual endoscopy. If not only the endoscopic vision but also endoscopic handling, including realistic haptic feedback, is simulated, virtual endoscopy can be an effective training tool for novice surgeons. In neurosurgery, the main fields of the application of virtual endoscopy are third ventriculostomy, endonasal surgery, and the evaluation of pathologies in cerebral blood vessels. Progress in this very active field of research is achieved through cooperation between the technical and the medical communities. While the technology advances and new methods for modeling, reconstruction, and simulation are being developed, clinicians evaluate existing simulators, steer the development of new ones, and explore new fields of application. This review introduces some of the most interesting virtual reality systems for endoscopic neurosurgery developed in recent years and presents clinical studies conducted either on areas of application or specific systems. In addition, benefits and limitations of single products and simulated neuroendoscopy in general are pointed out. PMID:23254819

  14. Value of Ear Endoscopy in Cholesteatoma Surgery

    Microsoft Academic Search

    M. Badr-el-Dine

    2002-01-01

    Objective: The purpose of this study was to assess the value of ear endoscopy in cholesteatoma surgery and to demonstrate its consequence in improving surgical outcome. Materials and Methods: A total of 92 ears with acquired cholesteatoma (primary or secondary) were operated on. In this prospective study, 82 cases were operated on by using canal wall up (CWU) technique, and

  15. Zoonotic Ancylostoma ceylanicum infection detected by endoscopy.

    PubMed

    Ngui, Romano; Lim, Yvonne A L; Ismail, Wan Hafiz Wan; Lim, Kie Nyok; Mahmud, Rohela

    2014-07-01

    We report a case of Ancylostoma ceylanicum infection detected by endoscopy. It was diagnosed and confirmed using polymerase chain reaction (PCR) and DNA sequencing. The patient is a 58-year-old Malaysian woman who lives in a rural area, where uncontrolled populations of stray and semidomesticated dogs live in close proximity with humans. PMID:24891471

  16. Juvenile polyposis of the stomach causing recurrent upper gastrointestinal bleeding.

    PubMed

    Winkler, Alexandra; Hinterleitner, Thomas A; Högenauer, Christoph; Hauser, Hubert; Langner, Cord

    2007-01-01

    We present the case of a 42-year-old man who suffered from recurrent severe upper gastrointestinal bleeding starting from February 2003. Endoscopy showed multiple glassy polyps in the stomach, which corresponded to a diffuse mucosal thickening detected by endosonography. The duodenum was normal. In February 2006, life-threatening acute gastrointestinal bleeding prompted total gastrectomy. The resection specimen showed the gastric mucosa carpeted by numerous glassy pedunculated polyps, measuring 2 cm in largest diameter. Histologically, the polyps were characterized by an abundant loose stroma and by elongated, twisting foveolae, covered by hyperplastic epithelium. Colonoscopy including the terminal ileum revealed a single tubulovillous adenoma, but no hamartomatous polyps, rendering a final diagnosis of juvenile polyposis of the stomach. This case represents the first description of juvenile polyposis causing life-threatening gastric haemorrhage. Thus, although rare, the disease has to be considered in the differential diagnosis of patients with acute upper gastrointestinal tract bleeding. PMID:17206083

  17. A modular and programmable development platform for capsule endoscopy system.

    PubMed

    Khan, Tareq Hasan; Shrestha, Ravi; Wahid, Khan A

    2014-06-01

    The state-of-the-art capsule endoscopy (CE) technology offers painless examination for the patients and the ability to examine the interior of the gastrointestinal tract by a noninvasive procedure for the gastroenterologists. In this work, a modular and flexible CE development system platform consisting of a miniature field programmable gate array (FPGA) based electronic capsule, a microcontroller based portable data recorder unit and computer software is designed and developed. Due to the flexible and reprogrammable nature of the system, various image processing and compression algorithms can be tested in the design without requiring any hardware change. The designed capsule prototype supports various imaging modes including white light imaging (WLI) and narrow band imaging (NBI), and communicates with the data recorder in full duplex fashion, which enables configuring the image size and imaging mode in real time during examination. A low complexity image compressor based on a novel color-space is implemented inside the capsule to reduce the amount of RF transmission data. The data recorder contains graphical LCD for real time image viewing and SD cards for storing image data. Data can be uploaded to a computer or Smartphone by SD card, USB interface or by wireless Bluetooth link. Computer software is developed that decompresses and reconstructs images. The fabricated capsule PCBs have a diameter of 16 mm. An ex-vivo animal testing has also been conducted to validate the results. PMID:24859846

  18. Combination of Age and Sex Improves the Ability to Predict Upper Gastrointestinal Malignancy in Patients with Uncomplicated Dyspepsia: A Prospective Multicentre Database Study

    Microsoft Academic Search

    Riccardo Marmo; Gianluca Rotondano; Roberto Piscopo; Maria Antonia Bianco; Paola Russo; Paola Capobianco; Livio Cipolletta

    2005-01-01

    BACKGROUND AND AIMS:Current guidelines recommend endoscopy for dyspeptic patients >45 yr of age and\\/or with “alarm” symptoms. The management of younger patients with uncomplicated dyspepsia is controversial. The objective of the study was to identify any risk factors predictive of upper gastrointestinal malignancy in patients with uncomplicated dyspepsia and validate their ability in refining indications for endoscopy.METHODS:Prospective database study of

  19. New optical technologies for earlier endoscopic diagnosis of premalignant gastrointestinal lesions.

    PubMed

    Dacosta, Ralph S; Wilson, Brian C; Marcon, Norman E

    2002-02-01

    Gastrointestinal malignancies continue to be the second leading cause of cancer-related deaths in the developed world. The early detection and treatment of gastrointestinal preneoplasms has been demonstrated to significantly improve patient survival. Conventional screening tools include standard white light endoscopy (WLE) and frequent surveillance with biopsy. Well-defined endoscopic surveillance biopsy protocols aimed at early detection of dysplasia and malignancy have been undertaken for groups at high risk. Unfortunately, the poor sensitivity associated with WLE is a significant limitation. In this regard, major efforts continue in the development and evaluation of alternative diagnostic techniques. This review will focus on notable developments made at the forefront of research in modern gastrointestinal endoscopy based on novel optical endoscopic modalities, which rely on the interactions of light with tissues. Here we present the 'state-of-the-art' in fluorescence endoscopic imaging and spectroscopy, Raman spectroscopy, optical coherence tomography, light scattering spectroscopy, chromoendoscopy, confocal fluorescence endoscopy, and immunofluorescence endoscopy. These new developments may offer significant improvements in the diagnosis of early lesions by allowing for targeted mucosal excisional biopsies, and perhaps may even provide 'optical biopsies' of equivalent histological accuracy. This enhancement of the endoscopist's ability to detect subtle preneoplastic changes in the gastrointestional mucosa in real time and improved staging of lesions could lead to curative endoscopic ablation of these lesions and, in the long term, improve patient survival and quality of life. PMID:12000596

  20. Diagnosing small bowel Crohn’s disease with wireless capsule endoscopy

    PubMed Central

    Fireman, Z; Mahajna, E; Broide, E; Shapiro, M; Fich, L; Sternberg, A; Kopelman, Y; Scapa, E

    2003-01-01

    Background: The small bowel is the most commonly affected site of Crohn’s disease (CD) although it may involve any part of the gastrointestinal tract. The current methodologies for examining the small bowel are x ray and endoscopy. Aims: To evaluate, for the first time, the effectiveness of wireless capsule endoscopy in patients with suspected CD of the small bowel undetected by conventional modalities, and to determine the diagnostic yield of the M2A Given Capsule. Patients: Seventeen patients (eight males, mean age 40 (15) years) with suspected CD fulfilled study entry criteria: nine had iron deficiency anaemia (mean haemoglobin 10.5 (SD 1.8) g%), eight had abdominal pain, seven had diarrhoea, and three had weight loss. Small bowel x ray and upper and lower gastrointestinal endoscopic findings were normal. Mean duration of symptoms before diagnosis was 6.3 (SD 2.2) years. Methods: Each subject swallowed an M2A Given Capsule containing a miniature video camera, batteries, a transmitter, and an antenna. Recording time was approximately eight hours. The capsule was excreted naturally in the patient’s bowel movement, and the data it contained were retrieved and interpreted the next day. Results: Of the 17 study participants, 12 (70.6%, six males, mean age 34.5 (12) years) were diagnosed as having CD of the small bowel according to the findings of the M2A Given Capsule. Conclusions: Wireless capsule endoscopy diagnosed CD of the small bowel (diagnostic yield of 71%). It was demonstrated as being an effective modality for diagnosing patients with suspected CD undetected by conventional diagnostic methodologies. PMID:12584221

  1. A new approach to blue rubber bleb nevus syndrome: the role of capsule endoscopy and intra-operative enteroscopy.

    PubMed

    Kopácová, Marcela; Tachecí, Ilja; Koudelka, Jaroslav; Králová, Miroslava; Rejchrt, Stanislav; Bures, Jan

    2007-07-01

    Blue rubber bleb nevus syndrome (BRBNS) is a rare vascular malformation disorder with cutaneous and visceral lesions frequently associated with serious, even fatal bleeding and anemia. The syndrome is considered to be autosomaly predominantly inherited. Intra-operative enteroscopy (IOE) is the best method of identification of all lesions (particularly the small ones, less than 3 mm) and treatment by endoscopic electro-coagulation or surgical excision. Capsule wireless endoscopy is optimal for screening before the IOE and for monitoring the effect of therapy (in patients with BRBNS). We report two cases of BRBNS. Anemia, gastrointestinal bleeding, gastrointestinal malformations and multifocal venous malformations of the skin were present in both of our cases. Gastrointestinal lesions were identified by gastroscopy, colonoscopy and capsule endoscopy. The multiple venous malformations were treated partly by endoscopic electro-coagulation (lesions up to 4 mm in diameter) and by wedge resection. Both of our patients were 12-year-old girls at the time of operation. In the first patient 31 venous malformations of the small bowel were coagulated, two were resected by the surgeon. In the second patient 20 lesions were coagulated endoscopically and another 31 nevi were resected during an 8 h procedure. The first girl is doing fine 4 years after the procedure, the second was allowed home 2 weeks after the procedure in excellent condition. IOE is a unique method of small bowel investigation and concurrently provides a solution for pathological findings. Capsule endoscopy is a feasible non-invasive screening procedure. We believe that a radical eliminatory approach by means of combined surgery and IOE is indicated for the BRBNS to prevent ongoing gastrointestinal bleeding. PMID:17205297

  2. Zinc and gastrointestinal disease

    PubMed Central

    Skrovanek, Sonja; DiGuilio, Katherine; Bailey, Robert; Huntington, William; Urbas, Ryan; Mayilvaganan, Barani; Mercogliano, Giancarlo; Mullin, James M

    2014-01-01

    This review is a current summary of the role that both zinc deficiency and zinc supplementation can play in the etiology and therapy of a wide range of gastrointestinal diseases. The recent literature describing zinc action on gastrointestinal epithelial tight junctions and epithelial barrier function is described. Zinc enhancement of gastrointestinal epithelial barrier function may figure prominently in its potential therapeutic action in several gastrointestinal diseases. PMID:25400994

  3. Double-clad fiber coupler for endoscopy.

    PubMed

    Lemire-Renaud, Simon; Rivard, Maxime; Strupler, Mathias; Morneau, Dominic; Verpillat, Frédéric; Daxhelet, Xavier; Godbout, Nicolas; Boudoux, Caroline

    2010-05-10

    We present a double-clad fiber coupler (DCFC) for use in endoscopy to reduce speckle contrast, increase signal collection and depth of field. The DCFC is made by fusing and tapering two all silica double-clad fiber (DCF) and allows achromatic transmission of >95% of core illumination (1265nm - 1325nm) as well as collection of >42% of inner cladding diffuse light. Its potential for endoscopy is demonstrated in a spectrally encoded imaging setup which shows speckle reduction by a factor 5, increased signal collection by a factor 9 and enhanced depth of field by 1.8 times. Separation by the DCFC of single- and multi-mode signals allows combining low-speckle reflectance images (25.5 fps) with interferometrically measured depth profiles (post-processed) for of small three-dimensional (3D) features through an all-fiber low loss instrument. PMID:20588826

  4. Proposal of a Formal Gynecologic Endoscopy Curriculum

    Microsoft Academic Search

    Vadim Morozov; Ceana Nezhat

    2009-01-01

    As minimally invasive surgery becomes the standard of care in the United States and around the world, the formal training of endoscopic surgeons is an issue of growing concern. With the implementation of the American Association of Gynecologic Laparoscopists\\/Society of Reproductive Surgeons (AAGL\\/SRS)–sponsored fellowship training in gynecologic endoscopy and a growing number of hands-on courses, we have the challenge of

  5. Aspects of computer vision in surgical endoscopy

    NASA Astrophysics Data System (ADS)

    Rodin, Vincent; Ayache, Alain; Berreni, N.

    1993-09-01

    This work is related to a project of medical robotics applied to surgical endoscopy, led in collaboration with Doctor Berreni from the Saint Roch nursing-home in Perpignan, France). After taking what Doctor Berreni advises, two aspects of endoscopic color image processing have been brought out: (1) The help to the diagnosis by the automatic detection of the sick areas after a learning phase. (2) The 3D reconstruction of the analyzed cavity by using a zoom.

  6. Upper gastrointestinal bleeding: predictors of outcome.

    PubMed

    Larson, G; Schmidt, T; Gott, J; Bond, S; O'Connor, C A; Richardson, J D

    1986-10-01

    We reviewed the records of 115 patients treated for upper gastrointestinal (UGI) bleeding on a general surgical and trauma service from January 1981 to June 1984. Clinical variables were analyzed with regard to three outcome criteria: mortality rate, blood transfusion requirements, and need for operation. Endoscopy was performed in all patients, usually within 24 hours of detection of bleeding. Thirty-six patients required greater than or equal to 5 U of blood, 27 patients required an operation for bleeding, and 26 patients (23%) died in the hospital. In 19 patients, death was attributed to the patient's underlying disease; in seven patients, death was due to bleeding or operation. Significant predictors of death were: age greater than or equal to 60 years old (p less than or equal to 0.02), disease in three organ systems (p less than 0.05), 5 U transfusion requirement (p less than 0.001), operation for bleeding necessary (p less than 0.03), lung/liver disease (p less than 0.03), and recent stress of major operation, trauma, or sepsis. Mortality rates were highest for bleeding varices (36%) and lowest for duodenal ulcers (7.7%) and gastric ulcers (15.8%). Endoscopy accurately determined the cause of UGI bleeding in most patients. The data suggest that the unchanging mortality rate for UGI bleeding is largely due to underlying disease or injury for which the success of current treatment is limited. PMID:3490003

  7. Endoscopy in Canada: Proceedings of the National Roundtable.

    PubMed

    Switzer, Noah; Dixon, Elijah; Tinmouth, Jill; Bradley, Nori; Vassiliou, Melina; Schwaitzberg, Steve; Gomes, Tony; Ellsmere, James; de Gara, Chris

    2015-01-01

    This 2014 roundtable discussion, hosted by the Canadian Association of General Surgeons, brought together general surgeons and gastroenterologists with expertise in endoscopy from across Canada to discuss the state of endoscopy in Canada. The focus of the roundtable was the evaluation of the competence of general surgeons at endoscopy, reviewing quality assurance parameters for high-quality endoscopy, measuring and assessing surgical resident preparedness for endoscopy practice, evaluating credentialing programs for the endosuite and predicting the future of endoscopic services in Canada. The roundtable noted several important observations. There exist inadequacies in both resident training and the assessment of competency in endoscopy. From these observations, several collaborative recommendations were then stated. These included the need for a formal and standardized system of both accreditation and training endoscopists. PMID:25886520

  8. High-level disinfection of gastrointestinal endoscope reprocessing.

    PubMed

    Chiu, King-Wah; Lu, Lung-Sheng; Chiou, Shue-Shian

    2015-02-20

    High level disinfection (HLD) of the gastrointestinal (GI) endoscope is not simply a slogan, but rather is a form of experimental monitoring-based medicine. By definition, GI endoscopy is a semicritical medical device. Hence, such medical devices require major quality assurance for disinfection. And because many of these items are temperature sensitive, low-temperature chemical methods, such as liquid chemical germicide, must be used rather than steam sterilization. In summarizing guidelines for infection prevention and control for GI endoscopy, there are three important steps that must be highlighted: manual washing, HLD with automated endoscope reprocessor, and drying. Strict adherence to current guidelines is required because compared to any other medical device, the GI endoscope is associated with more outbreaks linked to inadequate cleaning or disinfecting during HLD. Both experimental evaluation on the surveillance bacterial cultures and in-use clinical results have shown that, the monitoring of the stringent processes to prevent and control infection is an essential component of the broader strategy to ensure the delivery of safe endoscopy services, because endoscope reprocessing is a multistep procedure involving numerous factors that can interfere with its efficacy. Based on our years of experience in the surveillance of culture monitoring of endoscopic reprocessing, we aim in this study to carefully describe what details require attention in the GI endoscopy disinfection and to share our experience so that patients can be provided with high quality and safe medical practices. Quality management encompasses all aspects of pre- and post-procedural care including the efficiency of the endoscopy unit and reprocessing area, as well as the endoscopic procedure itself. PMID:25699232

  9. Gastrointestinal disorders - resources

    MedlinePLUS

    Digestive disease - resources; Resources - gastrointestinal disorders ... org American Liver Foundation - www.liverfoundation.org National Digestive Diseases Information Clearinghouse - http://digestive.niddk.nih.gov

  10. Doppler imaging using spectrally-encoded endoscopy

    PubMed Central

    Yelin, Dvir; Bouma, B. E.; Rosowsky, J. J.; Tearney, G. J.

    2009-01-01

    The capability to image tissue motion such as blood flow through an endoscope could have many applications in medicine. Spectrally encoded endoscopy (SEE) is a recently introduced technique that utilizes a single optical fiber and miniature diffractive optics to obtain endoscopic images through small diameter probes. Using spectral-domain interferometry, SEE is furthermore capable of three-dimensional volume imaging at video rates. Here we show that by measuring relative spectral phases, this technology can additionally measure Doppler shifts. Doppler SEE is demonstrated in flowing Intralipid phantoms and vibrating middle ear ossicles. PMID:18795020

  11. Continuing challenges in the diagnosis and management of obscure gastrointestinal bleeding.

    PubMed

    Baptista, Veronica; Marya, Neil; Singh, Anupam; Rupawala, Abbas; Gondal, Bilal; Cave, David

    2014-11-15

    The diagnosis and management of obscure gastrointestinal bleeding (OGIB) have changed dramatically since the introduction of video capsule endoscopy (VCE) followed by deep enteroscopy and other imaging technologies in the last decade. Significant advances have been made, yet there remains room for improvement in our diagnostic yield and treatment capabilities for recurrent OGIB. In this review, we will summarize the latest technologies for the diagnosis of OGIB, limitations of VCE, technological enhancement in VCE, and different management options for OGIB. PMID:25400996

  12. Continuing challenges in the diagnosis and management of obscure gastrointestinal bleeding

    PubMed Central

    Baptista, Veronica; Marya, Neil; Singh, Anupam; Rupawala, Abbas; Gondal, Bilal; Cave, David

    2014-01-01

    The diagnosis and management of obscure gastrointestinal bleeding (OGIB) have changed dramatically since the introduction of video capsule endoscopy (VCE) followed by deep enteroscopy and other imaging technologies in the last decade. Significant advances have been made, yet there remains room for improvement in our diagnostic yield and treatment capabilities for recurrent OGIB. In this review, we will summarize the latest technologies for the diagnosis of OGIB, limitations of VCE, technological enhancement in VCE, and different management options for OGIB. PMID:25400996

  13. Nafcillin Implicated in A Case of Cutaneous and Gastrointestinal Leukocytoclastic Vasculitis

    PubMed Central

    Xie, Changqing; Pancholi, Suchita S

    2015-01-01

    Leukocytoclastic vasculitis (LV) is a rare hypersensitive reaction involving the small vessels, which is usually mediated by drugs. Very few cases of nafcillin -associated LV have been reported. Here, we reported a case of LV with the presentation of skin rashes and gastrointestinal bleeding after receiving nafcillin, evidenced by endoscopy and skin biopsy. The symptoms resolved after withdrawal of nafcillin and the addition of prednisone treatment. LV should be considered in the differential diagnosis of erythematous rash, especially with gastrointestinal symptoms after the exposure.

  14. Registered nurse-administered sedation for gastrointestinal endoscopic procedure

    PubMed Central

    Amornyotin, Somchai

    2015-01-01

    The rising use of nonanesthesiologist-administered sedation for gastrointestinal endoscopy has clinical significances. Most endoscopic patients require some forms of sedation and/or anesthesia. The goals of this sedation are to guard the patient’s safety, minimize physical discomfort, to control behavior and to diminish psychological responses. Generally, moderate sedation for these procedures has been offered by the non-anesthesiologist by using benzodiazepines and/or opioids. Anesthesiologists and non-anesthesiologist personnel will need to work together for these challenges and for safety of the patients. The sedation training courses including clinical skills and knowledge are necessary for the registered nurses to facilitate the patient safety and the successful procedure. However, appropriate patient selection and preparation, adequate monitoring and regular training will ensure that the use of nurse-administered sedation is a feasible and safe technique for gastrointestinal endoscopic procedures.

  15. Esophageal involvement of pemphigus vulgaris associated with upper gastrointestinal bleeding.

    PubMed

    Chang, Sooyun; Park, Soo Jung; Kim, Sun Wook; Jin, Moo-Nyun; Lee, Jung-Hee; Kim, Hyun Ju; Hong, Sung Pil; Kim, Tae Il

    2014-09-01

    Esophageal involvement of pemphigus vulgaris is rare, and when present, the most common presenting symptoms reported in the medical literature are odynophagia and dysphagia. Here, we present two cases of pemphigus vulgaris presenting with upper gastrointestinal hemorrhage because of esophageal involvement of the disease. In case 1, a 41-year-old female patient with a prior diagnosis of pemphigus vulgaris presented with hematemesis. Esophagogastroduodenoscopy showed diffuse mucosal exfoliation and oozing bleeding of the oropharynx and esophagus. The patient recovered after the administration of high-dose corticosteroids and immunosuppressants. In case 2, a 30-year-old female patient with known pemphigus vulgaris also presented with hematemesis, showing similar endoscopic findings to the first case. She also responded to the same treatment. Esophageal involvement of pemphigus vulgaris responds to high-dose corticosteroids and immunosuppressants. Thus, in patients with pemphigus vulgaris with signs or symptoms of upper gastrointestinal bleeding, an early endoscopy for the evaluation of esophageal involvement is beneficial. PMID:25325007

  16. Detection of Neoplastic Gastric Lesions Using Capsule Endoscopy: Pilot Study

    PubMed Central

    Lee, Wook Hyun; Kim, Jin Su; Park, Jae Myung; Lee, In Seok; Kim, Sang Woo; Choi, Myung-Gyu

    2013-01-01

    Objectives. Capsule endoscopy is relatively noninvasive method and its use extends from the small bowel to the esophagus and colon. The aim of this study was to evaluate the feasibility and acceptability of capsule endoscopy for neoplastic gastric lesions. Methods. Capsule endoscopy (Pillcam ESO) was performed within 48 hours of esophagogastroduodenoscopy for eight patients who were diagnosed with gastric cancers, the size of which were less than 4?cm and who presented written consent. Patients changed position in a specified designed sequence every 30 seconds after capsule ingestion. Position change was repeated with ingestion of an effervescent agent. The rate of detection of intragastric lesions, observation of normal gastric anatomy and patient satisfaction between capsule endoscopy and esophagogastroduodenoscopy were compared. Results. Capsule endoscopy found four out of eight gastric lesions. The gastroesophageal junction was observed in seven of the eight cases, pyloric ring in five of the eight cases, and gastric angle in four of the eight cases. The patient satisfaction assessment questionnaire rated capsule endoscopy significantly higher than upper endoscopy in all categories. Conclusions. Capsule endoscopy was less effective than esophagogastroduodenoscopy and showed limited value in this feasibility study. PMID:23762039

  17. Use of capsule endoscopy to diagnose colon diseases

    Microsoft Academic Search

    Bing-Zhou Wang; Ling-Fei Wu; Guo-Ping Li; Wei-Ang Yang

    AIM: To explore the use of capsule endoscopy to detect colon disorders following the completion of small intestine disease diagnosis on the basis of implementation of energy consumption control for the endoscope, body position adjustment and food serving. METHODS: Seventy-six patients who received capsule endoscopy examination to exclude ileus were divided into two study groups: Group 1 (n = 39)

  18. Endoscopy training in Canadian general surgery residency programs

    PubMed Central

    Bradley, Nori L.; Bazzerelli, Amy; Lim, Jenny; Ying, Valerie Wu Chao; Steigerwald, Sarah; Strickland, Matt

    2015-01-01

    Summary Currently, general surgeons provide about 50% of endoscopy services across Canada and an even greater proportion outside large urban centres. It is essential that endoscopy remain a core component of general surgery practice and a core competency of general surgery residency training. The Canadian Association of General Surgeons Residents Committee supports the position that quality endoscopy training for all Canadian general surgery residents is in the best interest of the Canadian public. However, the means by which quality endoscopy training is achieved has not been defined at a national level. Endoscopy training in Canadian general surgery residency programs requires standardization across the country and improved measurement to ensure that competency and basic credentialing requirements are met. PMID:26011848

  19. Global-constrained hidden Markov model applied on wireless capsule endoscopy video segmentation

    NASA Astrophysics Data System (ADS)

    Wan, Yiwen; Duraisamy, Prakash; Alam, Mohammad S.; Buckles, Bill

    2012-06-01

    Accurate analysis of wireless capsule endoscopy (WCE) videos is vital but tedious. Automatic image analysis can expedite this task. Video segmentation of WCE into the four parts of the gastrointestinal tract is one way to assist a physician. The segmentation approach described in this paper integrates pattern recognition with statiscal analysis. Iniatially, a support vector machine is applied to classify video frames into four classes using a combination of multiple color and texture features as the feature vector. A Poisson cumulative distribution, for which the parameter depends on the length of segments, models a prior knowledge. A priori knowledge together with inter-frame difference serves as the global constraints driven by the underlying observation of each WCE video, which is fitted by Gaussian distribution to constrain the transition probability of hidden Markov model.Experimental results demonstrated effectiveness of the approach.

  20. Small bowel capsule endoscopy: Where are we after almost 15 years of use?

    PubMed Central

    Van de Bruaene, Cedric; De Looze, Danny; Hindryckx, Pieter

    2015-01-01

    The development of capsule endoscopy (CE) in 2001 has given gastroenterologists the opportunity to investigate the small bowel in a non-invasive way. CE is most commonly performed for obscure gastrointestinal bleeding, but other indications include diagnosis or follow-up of Crohn’s disease, suspicion of a small bowel tumor, diagnosis and surveillance of hereditary polyposis syndromes, Nonsteroidal anti-inflammatory drug-induced small bowel lesions and celiac disease. Almost fifteen years have passed since the release of the small bowel capsule. The purpose of this review is to offer the reader a brief but complete overview on small bowel CE anno 2014, including the technical and procedural aspects, the possible complications and the most important indications. We will end with some future perspectives of CE. PMID:25610531

  1. Small bowel capsule endoscopy: Where are we after almost 15 years of use?

    PubMed

    Van de Bruaene, Cedric; De Looze, Danny; Hindryckx, Pieter

    2015-01-16

    The development of capsule endoscopy (CE) in 2001 has given gastroenterologists the opportunity to investigate the small bowel in a non-invasive way. CE is most commonly performed for obscure gastrointestinal bleeding, but other indications include diagnosis or follow-up of Crohn's disease, suspicion of a small bowel tumor, diagnosis and surveillance of hereditary polyposis syndromes, Nonsteroidal anti-inflammatory drug-induced small bowel lesions and celiac disease. Almost fifteen years have passed since the release of the small bowel capsule. The purpose of this review is to offer the reader a brief but complete overview on small bowel CE anno 2014, including the technical and procedural aspects, the possible complications and the most important indications. We will end with some future perspectives of CE. PMID:25610531

  2. A Review of Machine-Vision-Based Analysis of Wireless Capsule Endoscopy Video

    PubMed Central

    Chen, Yingju; Lee, Jeongkyu

    2012-01-01

    Wireless capsule endoscopy (WCE) enables a physician to diagnose a patient's digestive system without surgical procedures. However, it takes 1-2 hours for a gastroenterologist to examine the video. To speed up the review process, a number of analysis techniques based on machine vision have been proposed by computer science researchers. In order to train a machine to understand the semantics of an image, the image contents need to be translated into numerical form first. The numerical form of the image is known as image abstraction. The process of selecting relevant image features is often determined by the modality of medical images and the nature of the diagnoses. For example, there are radiographic projection-based images (e.g., X-rays and PET scans), tomography-based images (e.g., MRT and CT scans), and photography-based images (e.g., endoscopy, dermatology, and microscopic histology). Each modality imposes unique image-dependent restrictions for automatic and medically meaningful image abstraction processes. In this paper, we review the current development of machine-vision-based analysis of WCE video, focusing on the research that identifies specific gastrointestinal (GI) pathology and methods of shot boundary detection. PMID:23197930

  3. [Design of extracorporeal apparatus of capsule endoscopy based on ARM+FPGA].

    PubMed

    Wang, Shenghua; Zhang, Sijie; Wang, Yue; Wang, Zhenxing

    2011-10-01

    Considering that the patients would bear the annoyance of fixed posture for long time when they are examined with gastrointestinal wireless endoscopy, even though portable devices have been developed, the treatments still depend on PC so much, we proposed an embedded solution based on ARM + FPGA. It used embedded ARM9 S3C2440 as processor core, collected images from digestive tract through capsule endoscopy which can be swallowed down there, and wirelessly transferred these images to the receiving system, then used video decoder chip SAA7114H for analog of NTSC video image decode. And under FPGA's logic controlling, effective digital video signal was transferred to S3C2440 for further treatment. Finally within the embedded Linux environment, we programmed the visual user interfaces using the QT/Embedded, realizing the offline record of the real-time video images of digestive tract portable and preferences. It can make patients move more freely and even without PC when examining. In addition, the method greatly improves the efficiency of the doctor, and is more intelligent and with more humane nature. PMID:22097259

  4. Application of Wireless Power Transmission Systems in Wireless Capsule Endoscopy: An Overview

    PubMed Central

    Basar, Md Rubel; Ahmad, Mohd Yazed; Cho, Jongman; Ibrahim, Fatimah

    2014-01-01

    Wireless capsule endoscopy (WCE) is a promising technology for direct diagnosis of the entire small bowel to detect lethal diseases, including cancer and obscure gastrointestinal bleeding (OGIB). To improve the quality of diagnosis, some vital specifications of WCE such as image resolution, frame rate and working time need to be improved. Additionally, future multi-functioning robotic capsule endoscopy (RCE) units may utilize advanced features such as active system control over capsule motion, drug delivery systems, semi-surgical tools and biopsy. However, the inclusion of the above advanced features demands additional power that make conventional power source methods impractical. In this regards, wireless power transmission (WPT) system has received attention among researchers to overcome this problem. Systematic reviews on techniques of using WPT for WCE are limited, especially when involving the recent technological advancements. This paper aims to fill that gap by providing a systematic review with emphasis on the aspects related to the amount of transmitted power, the power transmission efficiency, the system stability and patient safety. It is noted that, thus far the development of WPT system for this WCE application is still in initial stage and there is room for improvements, especially involving system efficiency, stability, and the patient safety aspects. PMID:24949645

  5. Laser-induced fluorescence spectroscopy at endoscopy

    NASA Astrophysics Data System (ADS)

    Qu, Jianan Y.; MacAulay, Calum E.; Lam, Stephen; Palcic, Branko

    1994-07-01

    A spectrofluorometry system has been developed for the collection of laser induced fluorescense spectra of tissue during endoscopy. In this system, a catheter with seven optical fibers was used to deliver the excitation light and collect the emitted fluorescence. The system enables one to switch from regular endoscopy into fluorescence measurement in 50 ms using a computerized shutter system. The fluorescence spectra can be recorded in 100 ms. This spectrofluorometry system has been used to obtain spectra from bronchial, larynx and nasopharyngeal tissues when employed with the appropriate endoscopes. The results demonstrate that laser induced fluorescence can be used to differentiate abnormal tissue from normal tissue. The illumination and fluorescence collection patterns of this system have been modeled using a Monte Carlo simulation. The Monte Carlo simulation data shows that the spectra recorded by our collection pattern is very close to the intrinsic spectra of tissue. The experimental results and the Monte Carlo simulation suggest that changes in fluorescence intensity are more robust for the detection of early cancers than the differences in spectral characteristics.

  6. Upper gastrointestinal bleeding in patients with liver cirrhosis.

    PubMed Central

    Odelowo, Olajide O.; Smoot, Duane T.; Kim, Kyungsook

    2002-01-01

    Patients with liver cirrhosis may develop upper gastrointestinal hemorrhage from a variety of lesions, which include those that arise by virtue of portal hypertension, namely gastroesophageal varices and portal hypertensive gastropathy and other lesions seen in the general population. Do patients with liver cirrhosis, hemorrhage from varices and other lesions equally, or are they more likely to bleed from varices? The aim of this study is to determine predominant causes of bleeding in patients with liver cirrhosis and upper gastrointestinal bleeding. PATIENTS AND METHODS: A retrospective review of 40 patients with liver cirrhosis based on the clinical and biochemical parameters of the Child-Pugh score, and upper gastrointestinal bleeding was carried out at an inner city hospital. Endoscopy diagnoses were documented. RESULTS: Of 40 patients, 38 patients had cirrhosis associated with alcohol consumption. Twelve of the above 38 patients who consumed alcohol also had hepatitis C virus (HCV) infection. Eleven patients had only varices on endoscopic examination, 17 had varices plus coexisting lesions. From these 17 patients, nine were found to have bled from varices, and eight were found to have bled from coexisting lesions. Twelve patients who had no varices bled from other lesions. Of 40 patients, 28 had varices, and 20 actually bled from varices. In this study there was no correlation between severity of liver cirrhosis as determined by the Child-Pugh score and the absence or presence of varices. CONCLUSION: Patients with liver cirrhosis and upper gastrointestinal bleeding hemorrhage from a variety of lesions. In this study of 40 patients, (70%) had gastroesophageal varices diagnosed at upper endoscopy, while 50% actually bled from varices. PMID:12152928

  7. Endoscopic Evaluation and Management of Gastrointestinal Bleeding in Patients with Ventricular Assist Devices

    PubMed Central

    Meyer, Marty M.; Young, Scott D.; Sun, Benjamin; Azzouz, Maher; Firstenberg, Michael S.

    2012-01-01

    The optimal diagnostic approach and yield for gastrointestinal bleeding (GIB) in patients with ventricular assist devices (VAD) are unknown. We explored the etiology of bleeding and yield of upper and lower endoscopy, balloon-assisted enteroscopy, and video capsule endoscopy in the evaluation of GIB in patients with VADs. Methods. All VAD patients with overt gastrointestinal bleeding and drop in hematocrit from April 1, 2000 to July 31, 2008 were retrospectively reviewed. The endoscopic evaluation of each episode was recorded. Overall yield of EGD, colonoscopy, balloon-assisted, and video capsule endoscopy were evaluated. Results. Thirty-six bleeding episodes occurred involving 20 patients. The site of GIB was identified in 32/36 episodes (88.9%), and the etiology of bleeding was determined in 30/36 cases (83.3%). Five VAD patients underwent VCE. The VCE exams demonstrated a high yield with 80% of exams identifying the etiology of GIB. Endoscopic intervention was successful in 8/9 attempts. No adverse events were recorded. Two patients required surgical intervention for GIB. Conclusion. Upper, lower, video capsule, and balloon-assisted enteroscopies are safe and demonstrate a high yield in the investigation of gastrointestinal bleeding in VAD patients. Medical centers caring for VAD patients should employ a standardized protocol to optimize endoscopic evaluation and intervention. PMID:22474445

  8. Endoscopic evaluation and management of gastrointestinal bleeding in patients with ventricular assist devices.

    PubMed

    Meyer, Marty M; Young, Scott D; Sun, Benjamin; Azzouz, Maher; Firstenberg, Michael S

    2012-01-01

    The optimal diagnostic approach and yield for gastrointestinal bleeding (GIB) in patients with ventricular assist devices (VAD) are unknown. We explored the etiology of bleeding and yield of upper and lower endoscopy, balloon-assisted enteroscopy, and video capsule endoscopy in the evaluation of GIB in patients with VADs. Methods. All VAD patients with overt gastrointestinal bleeding and drop in hematocrit from April 1, 2000 to July 31, 2008 were retrospectively reviewed. The endoscopic evaluation of each episode was recorded. Overall yield of EGD, colonoscopy, balloon-assisted, and video capsule endoscopy were evaluated. Results. Thirty-six bleeding episodes occurred involving 20 patients. The site of GIB was identified in 32/36 episodes (88.9%), and the etiology of bleeding was determined in 30/36 cases (83.3%). Five VAD patients underwent VCE. The VCE exams demonstrated a high yield with 80% of exams identifying the etiology of GIB. Endoscopic intervention was successful in 8/9 attempts. No adverse events were recorded. Two patients required surgical intervention for GIB. Conclusion. Upper, lower, video capsule, and balloon-assisted enteroscopies are safe and demonstrate a high yield in the investigation of gastrointestinal bleeding in VAD patients. Medical centers caring for VAD patients should employ a standardized protocol to optimize endoscopic evaluation and intervention. PMID:22474445

  9. Primary gastrointestinal lymphoma

    PubMed Central

    Ghimire, Prasanna; Wu, Guang-Yao; Zhu, Ling

    2011-01-01

    Gastrointestinal tract is the most common extranodal site involved by lymphoma with the majority being non-Hodgkin type. Although lymphoma can involve any part of the gastrointestinal tract, the most frequent sites in order of its occurrence are the stomach followed by small intestine and ileocecal region. Gastrointestinal tract lymphoma is usually secondary to the widespread nodal diseases and primary gastrointestinal tract lymphoma is relatively rare. Gastrointestinal lymphomas are usually not clinically specific and indistinguishable from other benign and malignant conditions. Diffuse large B-cell lymphoma is the most common pathological type of gastrointestinal lymphoma in essentially all sites of the gastrointestinal tract, although recently the frequency of other forms has also increased in certain regions of the world. Although some radiological features such as bulky lymph nodes and maintenance of fat plane are more suggestive of lymphoma, they are not specific, thus mandating histopathological analysis for its definitive diagnosis. There has been a tremendous leap in the diagnosis, staging and management of gastrointestinal lymphoma in the last two decades attributed to a better insight into its etiology and molecular aspect as well as the knowledge about its critical signaling pathways. PMID:21390139

  10. Gastrointestinal Tract Mesenchymal Lesions

    Microsoft Academic Search

    Dora Lam-Himlin

    2011-01-01

    This article reviews the most common and characteristic mesenchymal lesions found in the gastrointestinal tract and intraabdominal location in a pattern-based approach: spindle and epithelioid tumors (gastrointestinal stromal tumor, schwannoma, glomus tumor, leiomyoma and leiomyosarcoma, inflammatory fibroid polyp, perineurioma, melanoma, calcifying fibrous tumor, sclerosing mesenteritis, mesenteric fibromatosis, and inflammatory myofibroblastic tumor), and clear and granular tumors (clear cell sarcoma, granular

  11. The Gastrointestinal Tumor Microenvironment

    PubMed Central

    Quante, Michael; Varga, Julia; Wang, Timothy C.; Greten, Florian R.

    2013-01-01

    Over the past decade, the microenvironment of gastrointestinal tumors has gained increasing attention because it is required for tumor initiation, progression, and metastasis. The tumor microenvironment has many components and has been recognized as one of the major “hallmarks” of epithelial cancers. Although therapeutic strategies for gastrointestinal cancer have previously focused on the epithelial cell compartment, there is increasing interest in reagents that alter the microenvironment, based on reported interactions among gastrointestinal epithelial, stromal, and immune cells during gastrointestinal carcinogenesis. We review the different cellular components of the gastrointestinal tumor microenvironment and their functions in carcinogenesis, and discuss how improving our understanding of the complex stromal network could lead to new therapeutic strategies. PMID:23583733

  12. Effect of endoscopy screening on stage at gastric cancer diagnosis: results of the National Cancer Screening Programme in Korea

    PubMed Central

    Choi, K S; Jun, J K; Suh, M; Park, B; Noh, D K; Song, S H; Jung, K W; Lee, H-Y; Choi, I J; Park, E-C

    2015-01-01

    Background: Although gastric cancer screening is common among countries with a high prevalence of gastric cancer, there is little data to support the effectiveness of this screening. This study was designed to determine the differences in stage at diagnosis of gastric cancer according to the screening history and screening method (upper gastrointestinal series (UGIS) vs endoscopy). Methods: The study population was derived from the National Cancer Screening Programme (NCSP), a nationwide organised screening programme in Korea. The study cohort consisted of 19?168 gastric cancer patients who had been diagnosed in 2007 and who were invited to undergo gastric cancer screening via the NCSP between 2002 and 2007. Results: Compared with never-screened patients, the odds ratios for being diagnosed with localised gastric cancer in endoscopy-screened patients and UGIS-screened patients were 2.10 (95% CI=1.90–2.33) and 1.24 (95% CI=1.13–1.36), respectively. Conclusions: Screening by endoscopy was more strongly associated with a diagnosis of localised stage gastric cancer compared with screening by UGIS. PMID:25490528

  13. Management of anticoagulation in patients with acute gastrointestinal bleeding.

    PubMed

    Radaelli, Franco; Dentali, Francesco; Repici, Alessandro; Amato, Arnaldo; Paggi, Silvia; Rondonotti, Emanuele; Dumonceau, Jean Marc

    2015-08-01

    Acute gastrointestinal bleeding represents the most common adverse event associated with the use of oral anticoagulant therapy. Due to increasing prescription of anticoagulants worldwide, gastroenterologists are more and more called to deal with bleeding patients taking these medications. Their management is challenging because several issues have to be taken into account, such as the severity of bleeding, the intensity of anticoagulation, the patient's thrombotic risk and endoscopy findings. The recent introduction into the marketplace of new direct oral anticoagulants, for whom specific reversal agents are still lacking, further contributes to make the decision-making process even more demanding. Available evidence on this topic is limited and practice guidelines by gastroenterology societies only marginally address key issues for clinicians, including when and how to reverse coagulopathy, the optimal timing of endoscopy and when and how to resume anticoagulation thereafter. The present paper reviews the evidence in the literature and provides practical algorithms to support clinicians in the management of patients on anticoagulants who present with acute gastrointestinal bleeding. PMID:25935464

  14. Enhanced magnification endoscopy: A new technique to identify specialized intestinal metaplasia in Barrett's esophagus

    Microsoft Academic Search

    Moises Guelrud; Idamys Herrera; Harold Essenfeld; Julio Castro

    2001-01-01

    Background: Specialized intestinal metaplasia (SIM) in Barrett's esophagus (BE) is not identifiable by standard endoscopy. Acetic acid instillation enhances the ability to detect columnar epithelium at the squamocolumnar union. Enhanced magnification endoscopy involves the combined use of magnification endoscopy with acetic acid. This study assessed the value of enhanced magnification endoscopy in detecting SIM in patients with BE. Methods: Patients

  15. Recent Advances in Image-enhanced Endoscopy

    PubMed Central

    Cho, Won Young; Lee, Don Haeng

    2011-01-01

    The desire to better recognized such malignancies, which may be difficult to distinguish from inflammation or trauma, has accelerated the development of endoscopy with new optical technologies. Narrow-band imaging is a novel endoscopic technique that may enhance the accuracy of diagnosis using narrow-bandwidth filters in a red-green-blue sequential illumination system. Autofluorescence imaging is based on the detection of natural tissue fluorescence emitted by endogenous molecules. I-scan technology using a digital filter that modifies normal images through software functions, is the newly developed image-enhanced endoscopic technology from PENTAX. Flexible spectral imaging color enhancement enhances the visualization of mucosal structure and microcirculation by the selection of spectral transmittance with a dedicated wavelength. Confocal laser endomicroscopy images were collected with an argon beam with a scanning depth of 0 (epithelium) to 250 µm (lamina propria) and analyzed using the reflected light. PMID:22741116

  16. Miniature Grating for Spectrally-Encoded Endoscopy

    PubMed Central

    Kang, Dongkyun; Martinez, Ramses V.; Whitesides, George M.

    2013-01-01

    Spectrally-encoded endoscopy (SEE) is an ultraminiature endoscopy technology that acquires high-definition images of internal organs through a sub-mm endoscopic probe. In SEE, a grating at the tip of the imaging optics diffracts the broadband light into multiple beams, where each beam with a distinctive wavelength is illuminated on a unique transverse location of the tissue. By encoding one transverse coordinate with the wavelength, SEE can image a line of the tissue at a time without using any beam scanning devices. This feature of the SEE technology allows the SEE probe to be miniaturized to sub-mm dimensions. While previous studies have shown that SEE has the potential to be utilized for various clinical imaging applications, the translation of SEE for medicine has been hampered by challenges in fabricating the miniature grating inherent to SEE probes. This paper describes a new fabrication method for SEE probes. The new method uses a soft lithographic approach to pattern a high-aspect-ratio grating at the tip of the miniature imaging optics. Using this technique, we have constructed a 500-?m-diameter SEE probe. The miniature grating at the tip of the probe had a measured diffraction efficiency of 75%. The new SEE probe was used to image a human finger and formalin fixed mouse embryos, demonstrating the capability of this device to visualize key anatomic features of tissues with high image contrast. In addition to providing high quality imaging SEE optics, the soft lithography method allows cost-effective and reliable fabrication of these miniature endoscopes, which will facilitate the clinical translation of SEE technology. PMID:23503940

  17. Integrated optical tools for minimally invasive diagnosis and treatment at gastrointestinal endoscopy

    E-print Network

    Bigio, Irving J.

    in the incidence of peptic ulcer disease in the era of antisecretory medications coupled with emerging evidence for colorectal polyps and surveillance of ``flat'' dysplasia such as Barrett's esophagus and chronic colitis due

  18. Incidental findings of thickening luminal gastrointestinal organs on computed tomography: an absolute indication for endoscopy

    Microsoft Academic Search

    Qiang Cai; Deborah A. Baumgarten; John P. Affronti; J. Patrick Waring

    2003-01-01

    OBJECTIVE:Incidental findings of thickened luminal GI organs (LGIO) on CT are not uncommon. However, the significance of these findings is unclear. Because of the lack of scientific data, there are no clinical guidelines for the evaluation of these radiologic abnormalities. Our objective was to determine whether endoscopic evaluation of these findings revealed significant abnormalities.METHODS:This study evaluated all incidental findings of

  19. Incidental findings of thickening luminal gastrointestinal organs on computed tomography: an absolute indication for endoscopy

    Microsoft Academic Search

    Qiang Cai; Deborah A Baumgarten; John P Affronti; J. Patrick Waring

    2003-01-01

    ObjectiveIncidental findings of thickened luminal GI organs (LGIO) on CT are not uncommon. However, the significance of these findings is unclear. Because of the lack of scientific data, there are no clinical guidelines for the evaluation of these radiologic abnormalities. Our objective was to determine whether endoscopic evaluation of these findings revealed significant abnormalities.

  20. Interventional Endoscopy Database for Pancreatico-biliary, Gastrointestinal and Esophageal Disorders

    ClinicalTrials.gov

    2015-06-01

    Ampullary Cancer; Duodenal Cancer; Bile Duct Cancer; Bile Duct Disorders; Gallstones; Obstructive Jaundice; Pancreatic Disorders (Noncancerous); Colorectal Cancer; Esophageal Cancer; Barrett's Esophagus; Gastric Malignancies; Pancreatic Cancer; Pediatric Gastroenterology; Cholangiocarcinoma; Pancreatic Pseudocysts; Acute and Chronic Pancreatitis; Recurrent Pancreatitis; Cholangitis; Bile Leak; Biliary Strictures; Pancreatic Divisum; Biliary and Pancreatic Stones; Choledocholithiasis

  1. Effect of longer battery life on small bowel capsule endoscopy

    PubMed Central

    Ou, George; Shahidi, Neal; Galorport, Cherry; Takach, Oliver; Lee, Terry; Enns, Robert

    2015-01-01

    AIM: To determine if longer battery life improves capsule endoscopy (CE) completion rates. METHODS: A retrospective study was performed at a tertiary, university-affiliated hospital in Vancouver, Canada. Patients who underwent CE with either PillCam™ SB2 or SB2U between 01/2010 and 12/2013 were considered for inclusion. SB2 and SB2U share identical physical dimensions but differ in their battery lives (8 h vs 12 h). Exclusion criteria included history of gastric or small bowel surgery, endoscopic placement of CE, interrupted view of major landmarks due to technical difficulty or significant amount of debris, and repeat CE using same system. Basic demographics, comorbidities, medications, baseline bowel habits, and previous surgeries were reviewed. Timing of major landmarks in CE were recorded, and used to calculate gastric transit time, small bowel transit time, and total recording time. A complete CE study was defined as visualization of cecum. Transit times and completion rates were compared. RESULTS: Four hundred and eight patients, including 208 (51.0%) males, were included for analysis. The mean age was 55.5 ± 19.3 years. The most common indication for CE was gastrointestinal bleeding (n = 254, 62.3%), followed by inflammatory bowel disease (n = 86, 21.1%). There was no difference in gastric transit times (group difference 0.90, 95%CI: 0.72-1.13, P = 0.352) and small bowel transit times (group difference 1.07, 95%CI: 0.95-1.19, P = 0.261) between SB2U and SB2, but total recording time was about 14% longer in the SB2U group (95%CI: 10%-18%, P < 0.001) and there was a corresponding trend toward higher completion rate (88.2% vs 93.2%, OR = 1.78, 95%CI 0.88-3.63, P = 0.111). There was no statistically significant difference in the rates of positive findings (OR = 0.98, 95%CI: 0.64-1.51, P = 0.918). CONCLUSION: Extending the operating time of CE may be a simple method to improve completion rate although it does not affect the rate of positive findings. PMID:25759536

  2. Application and limitations of endoscopy in anthropological and archaeological research.

    PubMed

    Beckett, Ronald G

    2015-06-01

    The use of endoscopy in anthropological and archaeological research was been well documented in the literature. This article explores the varied settings in which endoscopy is beneficial in gathering visual data for interpretation related to cultural remains and artifacts. Endoscopic data may be used to assist in the pursuit of answering such bioanthropological questions as sex, age at death, presence of paleopathologies, dental conditions, and cultural practices. Endoscopy is often used to guide and document biopsy procedures as well as the retrieval of artifacts from within poorly accessible locations such as body cavities, coffins, or tombs. In addition, endoscopic data is used to examine such archaeological features as tomb structure and design. A contrast between the medical and anthropological approach is described. Endoscopic research is enhanced when applied in conjunction with additional varied imaging modalities. While invasive, endoscopy is a nondestructive methodological approach. As with all methods, endoscopy has application and interpretational limitations, which can be described as limitations resulting from instrumentation, and those arising from personnel less familiar with the various approaches to endoscopy in both field and laboratory settings. Anat Rec, 298:1125-1134, 2015. © 2015 Wiley Periodicals, Inc. PMID:25998646

  3. Creation of a therapeutic digestive endoscopy suite in Senegal: renovation, training and university certification. Results of a Belgian-Senegalese inter-university project.

    PubMed

    Le Moine, O; Diouf, M L; Mbengue, M; Mbaye, P S; Diop, P M; Balme, F; Brihay, J; Le Moine-Pauwels, A; Le Moine, M; Moreira-Diop, T

    2012-02-01

    Therapeutic digestive endoscopy did not exist in sub-Saharan Africa before 2005. However, the prevalence of digestive diseases that could potentially benefit from basic endoscopic treatment is very high in this region. Portal hypertension with variceal bleeding and severe dysphagia associated with benign or malignant upper gastrointestinal tract diseases are prominent in these countries. The aim of the Project described in this report was to create a digestive endoscopy facility in Dakar (Senegal, West Africa), that would also provide local training in therapeutic endoscopy to doctors and nurses and facilitate regional autonomy with the opening of a University Certification in Gastroenterology. It took about 10 years to achieve these targets - 5 years to prepare realistic aims that took into account local needs, available local resources, and funding, and 4 years for the Project itself (2005-2009). At the present time, Senegalese colleagues and nurses are autonomous for basic therapeutic procedures in the upper and lower gastrointestinal tract. Two years after the end of funding, the rate of therapeutic activity has increased from 0% in 2005 to 12 % of digestive endoscopic activity in 2011. Key points of success were preparation, confidence of medical personnel, university involvement, shared funding, local multidisciplinary training, and facilitation of autonomy. Belgian healthcare workers were present on-site in Dakar for a total of about 6 months over the 4-year Project period, with an annual budget of less than € 80000. The Project has enabled an efficient North-South collaboration with a minimal budget, which has changed the healthcare provision of digestive endoscopy in Senegal, and has also provided autonomy, and facilitated the development of South-South cooperation. PMID:22271028

  4. Confocal laser endomicroscopy and immunoendoscopy for real-time assessment of vascularization in gastrointestinal malignancies

    PubMed Central

    Gheonea, Dan Ionu?; Câr?ân?, Tatiana; Ciurea, Tudorel; Popescu, Carmen; B?d?r?u, Anca; S?ftoiu, Adrian

    2011-01-01

    Gastrointestinal cancers represent a major cause of morbidity and mortality, with incomplete response to chemotherapy in the advanced stages and poor prognosis. Angiogenesis plays a crucial part in tumor growth and metastasis, with most gastrointestinal cancers depending strictly on the development of a new and devoted capillary network. Confocal laser endomicroscopy is a new technology which allows in vivo microscopic analysis of the gastrointestinal mucosa and its microvascularization during ongoing endoscopy by using topically or systemically administered contrast agents. Targeting markers of angiogenesis in association with confocal laser endomicroscopic examination (immunoendoscopy), as a future challenge, will add functional analysis to the morphological aspect of the neoplastic process. This review describes previous experience in endomicroscopic examination of the upper and lower digestive tract with emphasis on vascularization, resulting in a broad spectrum of potential clinical applications, and also preclinical research that could be translated to human studies. PMID:21218080

  5. Confocal laser endomicroscopy and immunoendoscopy for real-time assessment of vascularization in gastrointestinal malignancies.

    PubMed

    Gheonea, Dan Ionu?; Câr?ân?, Tatiana; Ciurea, Tudorel; Popescu, Carmen; B?d?r?u, Anca; S?ftoiu, Adrian

    2011-01-01

    Gastrointestinal cancers represent a major cause of morbidity and mortality, with incomplete response to chemotherapy in the advanced stages and poor prognosis. Angiogenesis plays a crucial part in tumor growth and metastasis, with most gastrointestinal cancers depending strictly on the development of a new and devoted capillary network. Confocal laser endomicroscopy is a new technology which allows in vivo microscopic analysis of the gastrointestinal mucosa and its microvascularization during ongoing endoscopy by using topically or systemically administered contrast agents. Targeting markers of angiogenesis in association with confocal laser endomicroscopic examination (immunoendoscopy), as a future challenge, will add functional analysis to the morphological aspect of the neoplastic process. This review describes previous experience in endomicroscopic examination of the upper and lower digestive tract with emphasis on vascularization, resulting in a broad spectrum of potential clinical applications, and also preclinical research that could be translated to human studies. PMID:21218080

  6. Commonly used gastrointestinal drugs.

    PubMed

    Aggarwal, Annu; Bhatt, Mohit

    2014-01-01

    This chapter reviews the spectrum and mechanisms of neurologic adverse effects of commonly used gastrointestinal drugs including antiemetics, promotility drugs, laxatives, antimotility drugs, and drugs for acid-related disorders. The commonly used gastrointestinal drugs as a group are considered safe and are widely used. A range of neurologic complications are reported following use of various gastrointestinal drugs. Acute neurotoxicities, including transient akathisias, oculogyric crisis, delirium, seizures, and strokes, can develop after use of certain gastrointestinal medications, while disabling and pervasive tardive syndromes are described following long-term and often unsupervised use of phenothiazines, metoclopramide, and other drugs. In rare instances, some of the antiemetics can precipitate life-threatening extrapyramidal reactions, neuroleptic malignant syndrome, or serotonin syndrome. In contrast, concerns about the cardiovascular toxicity of drugs such as cisapride and tegaserod have been grave enough to lead to their withdrawal from many world markets. Awareness and recognition of the neurotoxicity of gastrointestinal drugs is essential to help weigh the benefit of their use against possible adverse effects, even if uncommon. Furthermore, as far as possible, drugs such as metoclopramide and others that can lead to tardive dyskinesias should be used for as short time as possible, with close clinical monitoring and patient education. PMID:24365343

  7. Acute Upper Gastro-Intestinal Bleeding in Morocco: What Have Changed?

    PubMed Central

    Timraz, A.; Khannoussi, W.; Ajana, F. Z.; Essamri, W.; Benelbarhdadi, I.; Afifi, R.; Benazzouz, M.; Essaid, A.

    2011-01-01

    Objective. In the present study, we aimed to investigate epidemiological, clinical, and etiological characteristics of acute upper gastro-intestinal bleeding. Materials and Methods. This retrospective study was conducted between January 2003 and December 2008. It concerned all cases of acute upper gastroduodenal bleeding benefited from an urgent gastro-intestinal endoscopy in our department in Morocco. Characteristics of patients were evaluated in terms of age, gender, medical history, presenting symptoms, results of rectal and clinical examinations, and endoscopy findings. Results. 1389 cases were registered. As 66% of the patients were male, 34% were female. Mean age was 49. 12% of patients had a history of previous hemorrhage, and 26% had a history of NSAID and aspirin use. Endoscopy was performed in 96%. The gastroduodenal ulcer was the main etiology in 38%, followed by gastritis and duodenitis in 32.5%. Conclusion. AUGIB is still a frequent pathology, threatening patients' life. NSAID and aspirin are still the major risk factors. Their impact due to peptic ulcer remains stable in our country. PMID:21991509

  8. Gastrointestinal bleeding from Dieulafoy’s lesion: Clinical presentation, endoscopic findings, and endoscopic therapy

    PubMed Central

    Nojkov, Borko; Cappell, Mitchell S

    2015-01-01

    Although relatively uncommon, Dieulafoy’s lesion is an important cause of acute gastrointestinal bleeding due to the frequent difficulty in its diagnosis; its tendency to cause severe, life-threatening, recurrent gastrointestinal bleeding; and its amenability to life-saving endoscopic therapy. Unlike normal vessels of the gastrointestinal tract which become progressively smaller in caliber peripherally, Dieulafoy’s lesions maintain a large caliber despite their peripheral, submucosal, location within gastrointestinal wall. Dieulafoy’s lesions typically present with severe, active, gastrointestinal bleeding, without prior symptoms; often cause hemodynamic instability and often require transfusion of multiple units of packed erythrocytes. About 75% of lesions are located in the stomach, with a marked proclivity of lesions within 6 cm of the gastroesophageal junction along the gastric lesser curve, but lesions can also occur in the duodenum and esophagus. Lesions in the jejunoileum or colorectum have been increasingly reported. Endoscopy is the first diagnostic test, but has only a 70% diagnostic yield because the lesions are frequently small and inconspicuous. Lesions typically appear at endoscopy as pigmented protuberances from exposed vessel stumps, with minimal surrounding erosion and no ulceration (visible vessel sans ulcer). Endoscopic therapy, including clips, sclerotherapy, argon plasma coagulation, thermocoagulation, or electrocoagulation, is the recommended initial therapy, with primary hemostasis achieved in nearly 90% of cases. Dual endoscopic therapy of epinephrine injection followed by ablative or mechanical therapy appears to be effective. Although banding is reportedly highly successful, it entails a small risk of gastrointestinal perforation from banding deep mural tissue. Therapeutic alternatives after failed endoscopic therapy include repeat endoscopic therapy, angiography, or surgical wedge resection. The mortality has declined from about 30% during the 1970’s to 9%-13% currently with the advent of aggressive endoscopic therapy. PMID:25901208

  9. Genetics Home Reference: Gastrointestinal stromal tumor

    MedlinePLUS

    ... cells in the gastrointestinal tract and patches of dark skin on various areas of the body. Some ... Cancer Society: Treating Gastrointestinal Stromal Tumor (GIST) Cancer.Net: Gastrointestinal Stromal Tumor--Diagnosis Genetic Testing Registry: Gastrointestinal ...

  10. Review of Musculoskeletal Injuries and Prevention in the Endoscopy Practitioner

    PubMed Central

    2014-01-01

    Practitioners of endoscopy often experience musculoskeletal pain and injury (most often in the back, neck, shoulders, hands, wrists, and thumbs) that are associated with the minute and repetitive strain that is placed on these areas during endoscopic procedures. This review of the current documentation of endoscopy-related pain and injuries among practitioners finds that such problems are widespread and specific in kind as well as strongly correlated with high procedure volume and procedure duration. Research on the nature and impact of cumulative trauma and overuse syndromes in other professions such as dentistry, pianists, production labor, and athletics is brought to bear on the work of the endoscopist. A more thorough understanding of the nature and prevalence of work-related pain and injury sustained by endoscopists should inform further development of ergonomic practices and equipment design. This article reviews current recommendations for ergonomic design in the endoscopy procedure space and finds that reported compliance with those recommendations is quite low. Strategies for the management of the risk of musculoskeletal injuries related to the practice of endoscopy include compliance with currently recommended ergonomic practices, education of trainees in ergonomic technique when practicing endoscopy, and research toward the modification and development of more ergonomic endoscopes and procedure spaces. PMID:24798940

  11. Apollo gastrointestinal analysis

    NASA Technical Reports Server (NTRS)

    Nichols, B. L.; Huang, C. T. L.

    1975-01-01

    Fecal bile acid patterns for the Apollo 17 flight were studied to determine the cause of diarrhea on the mission. The fecal sterol analysis gave no indication of an infectious diarrhea, or specific, or nonspecific etiology occurring during the entire flight. It is assumed that the gastrointestinal problems encountered are the consequences of altered physiology, perhaps secondary to physical or emotional stress of flight.

  12. Aspirin and gastrointestinal bleeding

    Microsoft Academic Search

    R. H. Salter

    1968-01-01

    The evidence for the association of aspirin ingestion with occult and overt bleeding from the gastrointestinal tract is reviewed, as is the concept that an acute superficial erosive lesion of the gastric mucosa may be a consequence of taking aspirin. The possible mechanisms concerned in the pathogenesis of the aspirin-induced mucosal lesion are discussed.

  13. Lens-free endoscopy probe for optical coherence tomography.

    PubMed

    Moon, Sucbei; Piao, Zhonglie; Kim, Chang-Seok; Chen, Zhongping

    2013-06-15

    We present an ultrathin fiber-optic endoscopy probe for optical coherence tomography (OCT), which is made of a series of fused optical fibers instead of the conventional scheme based on an objective lens. The large-core fiber with a core diameter of 20 ?m was utilized for the probe, while a single-mode fiber of core diameter 8.2 ?m mainly delivered the OCT light. Those fibers were spliced with a bridge fiber of an intermediate core size. The guided light was stepwise converted to a beam of a large mode-field diameter to be radiated with a larger depth of focus. We obtained a 125 ?m thick all-fiber endoscopy probe with a side-viewing capability implemented by an angled fiber end. Successful OCT imaging was demonstrated with a swept-source OCT system and showed the practical applicability of our lens-free endoscopy probe. PMID:23938961

  14. Gastrointestinal bleeding with continuous-flow left ventricular assist devices.

    PubMed

    Amer, Syed; Shah, Parth; Hassan, Syed

    2015-04-01

    Continuous-flow left ventricular assist device (CF-LVAD) insertion is a life-saving procedure that is being increasingly used in patients with advanced heart failure. However, patients with CF-LVADs are at an increased risk of gastrointestinal bleeding (GIB). Bleeding can occur anywhere in the GI tract with lesions being more prevalent in the upper GI tract than in the lower GI tract. The pathophysiology of GIB in patients with CF-LVADs is unique and likely involves three synergistic mechanisms-coagulopathy, acquired von Willebrand disease and continuous non-pulsatile blood flow. Management strategies vary depending on the presentation and site of bleeding. Prevention strategies to prevent GIB in these patients include low pump speed, close hemodynamic monitoring and a low threshold for endoscopy. We aim to review in detail the pathophysiology, management, complications and preventive strategies in patients with CF-LVAD who present with GIB. PMID:25614135

  15. Bridging bronchus: Importance of recognition on airway endoscopy.

    PubMed

    Gainor, Danielle; Kinzinger, Michael; Carl, John; Anne, Samantha

    2015-07-01

    Bridging bronchus is an anomalous bronchus, which crosses the mediastinum from the contralateral mainstem bronchus and it is commonly associated with congenital great vessel abnormalities. This is a case report of an infant that underwent airway endoscopy and attempt at cannulation of a mainstem bronchus with supposed bronchial cast after cardiac surgery in the intensive care unit. After multiple failed attempts, further workup was completed which revealed a bridging bronchus. A bridging bronchus must be suspected in a patient with abnormal appearing endoscopy in presence of great vessel anomalies to prevent accidental injury to the tracheobronchial tree. PMID:25980374

  16. Gastrointestinal stromal tumor

    PubMed Central

    Yue, Changjun

    2012-01-01

    Gastrointestinal stromal tumor has received a lot of attention over the last 10 years due to its unique biologic behavior, clinicopathological features, molecular mechanisms, and treatment implications. GIST is the most common mesenchymal neoplasm in the gastrointestinal tract and has emerged from a poorly understood and treatment resistant neoplasm to a well-defined tumor entity since the discovery of particular molecular abnormalities, KIT and PDGFRA gene mutations. The understanding of GIST biology at the molecular level promised the development of novel treatment modalities. Diagnosis of GIST depends on the integrity of histology, immunohistochemistry and molecular analysis. The risk assessment of the tumor behavior relies heavily on pathological evaluation and significantly impacts clinical management. In this review, historic review, epidemiology, pathogenesis and genetics, diagnosis, role of molecular analysis, prognostic factor and treatment strategies have been discussed. PMID:22943011

  17. Assessment of Antigenemia Assay for the Diagnosis of Cytomegalovirus Gastrointestinal Diseases in HIV-Infected Patients

    PubMed Central

    Hamada, Yohei; Shimbo, Takuro; Igari, Toru; Nakashima, Ryo; Asayama, Naoki; Nishimura, So; Yazaki, Hirohisa; Teruya, Katsuji; Gatanaga, Hiroyuki; Kikuchi, Yoshimi; Akiyama, Junichi; Ohmagari, Norio; Uemura, Naomi; Oka, Shinichi

    2013-01-01

    Abstract We conducted a single-center prospective study to evaluate the utility of cytomegalovirus (CMV) antigenemia assay for the diagnosis of CMV-gastrointestinal disease (GID). The study subjects were HIV-infected patients with CD4 count ?200??L/cells who had undergone endoscopy. A definite diagnosis of CMV-GID was made by histological examination of endoscopic biopsied specimen. CMV antigenemia assay (C10/C11 monoclonal antibodies), CD4 count, HIV viral load, history of HAART, and gastrointestinal symptoms as measured by 7-point Likert scale, were assessed on the same day of endoscopy. One hundred cases were selected for analysis, which were derived from 110 cases assessed as at high-risk for CMV-GID after endoscopy screening of 423 patients. Twelve patients were diagnosed with CMV-GID. Among the gastrointestinal symptoms, mean bloody stool score was significantly higher in patients with CMV-GID than in those without (2.5 vs. 1.7, p=0.02). The area under the receiver-operating characteristic curve of antigenemia was 0.80 (95%CI 0.64–0.96). The sensitivity, specificity, positive likelihood ratio (LR), and negative LR of antigenemia were 75.0%, 79.5%, 3.7, and 0.31, respectively, when the cutoff value for antigenemia was ?1 positive cell per 300,000 granulocytes, and 50%, 92.0%, 5.5, and 0.55, respectively, for ?5 positive cells per 300,000 granulocytes. In conclusion, CMV antigenemia seems a useful diagnostic test for CMV-GID in patients with HIV infection. The use of ?5 positive cells per 300,000 granulocytes as a cutoff value was associated with high specificity and high positive LR. Thus, a positive antigenemia assay with positive endoscopic findings should allow the diagnosis of CMV-GID without biopsy. PMID:23799239

  18. Splenic Pseudoaneursym as the Cause of Recurrent Gastrointestinal Bleeding in a Woman With Diffuse Scleroderma

    PubMed Central

    Hartman, Joshua; Protano, Marion-Anna

    2015-01-01

    A 67-year-old woman with a 15-year history of intestinal scleroderma presented with recurrent melena. Upper endoscopies revealed a healing, non-bleeding, large gastric ulcer. After the third bleed, angiography demonstrated bleeding from a splenic artery pseudoaneurysm adjacent to the gastric ulcer. Scleroderma patients are at risk of bleeding from esophagitis or gastric arteriovenous malformations, while splenic artery pseudoaneurysms are primarily attributed to pancreatitis and trauma. This is the first reported case of gastrointestinal bleeding from a splenic artery pseudoaneurysm in a patient with intestinal scleroderma and a large gastric ulcer.

  19. Screening for gastric cancer: the usefulness of endoscopy.

    PubMed

    Choi, Kui Son; Suh, Mina

    2014-11-01

    Gastric cancer screening is common in countries with high prevalence rates of gastric cancer. However, data supporting the effectiveness of gastric cancer screening are lacking. Thus, the aim of this review was to examine the current evidence on gastric cancer screening. Herein, we reviewed radiographic and endoscopic tests as methods of gastric cancer screening. Previous cohort studies and case-control studies have demonstrated reduced gastric cancer mortality in study populations that had undergone gastric cancer screening with radiographic tests. Recently, a case-control study in Japan reported a 30% reduction in gastric cancer mortality when screening was undertaken via endoscopy. Also, endoscopic screening for gastric cancer exhibited higher sensitivity and specificity than radiographic screening. Moreover, most cost-effectiveness analyses on the best strategy for detecting early gastric cancer have generally concluded that endoscopy is more cost-effective than radiographic testing. Although data on the impact of endoscopy screening programs on gastric cancer mortality are limited, recent study results suggest that gastric cancer screening by endoscopy in average-risk populations performs better than radiography screening. Further evaluation of the impact of these screening methods should take into account cost and any associated reduction in gastric cancer mortality. PMID:25505713

  20. A fiber optic optoacoustic ultrasound sensor for photoacoustic endoscopy

    Microsoft Academic Search

    Clay Sheaff; Shai Ashkenazi

    2010-01-01

    Photoacoustic Endoscopy (PE) is a new imaging modality that can provide high-resolution vascular imaging in vivo. Optoacoustic sensing (optical detection of ultrasound) is a good candidate for PE due to its enhanced sensitivity, wide bandwidth, and miniaturizability in comparison to piezoelectric, PVDF, and capacitive transducers. In this work we present the fabrication and testing of a fiber optic optoacoustic ultrasound

  1. VirEn: A Virtual Endoscopy System Anna Vilanova

    E-print Network

    for educational pur­ poses like endoscopists training (e.g. sinus surgery). ffl Special parts of the human body, which are impossi­ ble to access with a real endoscope (e.g. blood ves­ sels, thoracic aorta). ffl A special field of application is the usage of virtual endoscopy for surgery planning. Several virtual

  2. Palliative intubation of oesophagogastric neoplasms at fibreoptic endoscopy

    Microsoft Academic Search

    A L Ogilvie; M W Dronfield; R Ferguson; M Atkinson

    1982-01-01

    Of one hundred and twenty-one patients with neoplastic obstruction of the oesophagus or cardia 118 underwent palliative intubation at fibreoptic endoscopy on a total of 135 occasions. Sixty had adenocarcinoma, 49 had squamous carcinoma, and in nine the oesophagus was involved by a growth arising elsewhere. Satisfactory swallowing ws restored in 112 patients. Thirteen patients died in hospital shortly after

  3. Overview LS ABV K Three perspectives on endoscopy

    E-print Network

    Nevins, Monica

    Overview LS ABV K Three perspectives on endoscopy Paul Mezo Carleton University #12;Overview LS ABV;Overview LS ABV K The three perspectives by abbreviation LS ? ? ABV ? K #12;Overview LS ABV K Character endoscopic group given by s Sad · s : WR LH · Spectral transfer: s = H s H (s, ) #12;Overview LS ABV K

  4. Low Power and Low Complexity Compressor for Video Capsule Endoscopy

    Microsoft Academic Search

    Tareq Hasan Khan; Khan A. Wahid

    2011-01-01

    The main challenge in video capsule endoscopic system is to reduce the area and power consumption while maintaining acceptable video reconstruction. In this paper, a subsample-based data compressor for video endoscopy applica- tion is presented. The algorithm is developed around the special features of endoscopic images that consists of a differential pulse- coded modulation (DPCM) followed by Golomb-Rice coding. Based

  5. Automatic Classification of Digestive Organs in Wireless Capsule Endoscopy Videos

    E-print Network

    Lee, Jeongkyu

    .00. A human digestive system consists of a series of several different organs including the esophagus, stomach such as gastroscopy, push enteroscopy colonoscopy have been used for the visualization of digestive system. HoweverAutomatic Classification of Digestive Organs in Wireless Capsule Endoscopy Videos Jeongkyu Lee1

  6. Klippel-Trenaunay syndrome with gastrointestinal bleeding, splenic hemangiomas and left inferior vena cava

    PubMed Central

    Wang, Zhen-Kai; Wang, Fang-Yu; Zhu, Ren-Min; Liu, Jiong

    2010-01-01

    Klippel-Trenaunay syndrome is a congenital vascular anomaly characterized by a triad of varicose veins, cutaneous capillary malformation, and hypertrophy of bone and (or) soft tissue. Gastrointestinal vascular malformations in Klippel-Trenaunay syndrome may present with gastrointestinal bleeding. The majority of patients with spleenic hemangiomatosis and/or left inferior vena cava are asymptomatic. We herein report a case admitted to the gastroenterology clinic with life-threatening hematochezia and symptomatic iron deficiency anemia. Due to the asymptomatic mild intermittent hematochezia, splenic hemangiomas and left inferior vena cava, the patient did not seek any help for gastrointestinal bleeding until his admittance to our department for evaluation of massive gastrointestinal bleeding. He was referred to angiography because of his serious pathogenetic condition and inefficiency of medical therapy. The method showed that hemostasis was successfully achieved in the hemorrhage site by embolism of corresponding vessels. Further endoscopy revealed vascular malformations starting from the stomach to the descending colon. On the other hand, computed tomography revealed splenic hemangiomas and left inferior vena cava. To the best of our knowledge, this is the first Klippel-Trenaunay syndrome case presenting with gastrointestinal bleeding, splenic hemangiomas and left inferior vena cava. The literature on the evaluation and management of this case is reviewed. PMID:20333801

  7. Survey of symptoms, respiratory function, and immunology and their relation to glutaraldehyde and other occupational exposures among endoscopy nursing staff

    Microsoft Academic Search

    A Vyas; C A C Pickering; L A Oldham; H C Francis; A M Fletcher; T Merrett; R McL Niven

    2000-01-01

    OBJECTIVESTo find the nature and incidence of symptoms experienced by a large sample of hospital endoscopy nurses. To find whether nurses in endoscopy units develop asthma under current working conditions in endoscopy units. To obtain analytically reliable data on exposure concentrations of glutaraldehyde (GA) vapour in endoscopy units, and to relate them to individual hygiene and work practices. To characterise

  8. Endoscopic evaluation and biopsy collection of the gastrointestinal tract in the green moray eel (Gymnothorax funebris): application in a case of chronic regurgitation with gastric mucus gland hyperplasia.

    PubMed

    Meegan, Jenny; Sidor, Inga F; Field, Cara; Roddy, Nicole; Sirpenski, Gayle; Dunn, J Lawrence

    2012-09-01

    A green moray eel (Gymnothorax funebris) was evaluated for chronic regurgitation. By using flexible endoscopy, the gastrointestinal tract was evaluated and revealed multifocal proliferative gastric masses and an intestinal ulcer. Biopsy specimens revealed gastric mucus gland hyperplasia, intestinal nematodiasis, and mild enteritis. Esophagoscopy and gastroscopy were performed by using a larger endoscope (length, 200 cm). A smaller endoscope (length, 100 cm) facilitated entering the intestinal tract in normograde or retrograde directions. A control eel was also evaluated, and no gross or histologic abnormalities were detected. The case eel was treated with metoclopramide and fenbendazole, responded well to therapy, and regurgitation decreased. A year later, the animal died of unrelated causes. Necropsy revealed coelomic gastric adhesions. The gastric proliferative lesions were associated with degeneration and necrosis of gastric pit mucosa without significant inflammation; etiology was unknown. Gastrointestinal endoscopy proved a useful diagnostic tool for evaluation and biopsy collection in this eel species. PMID:23082527

  9. [A case of gastrointestinal stromal tumor of the duodenum with a huge abscess].

    PubMed

    Okamoto, Nobuhiko; Yamafuji, Kazuo; Takeshima, Kaoru; Hayashi, Noritaka; Baba, Hideo

    2011-11-01

    A 36-year-old man admitted for upper abdominal pain and fever. Enhanced abdominal computed tomography showed a cystic tumor with an air fluid level, measuring 140mm in size, along the side of the first and second portions of the duodenum. The common bile duct, portal vein, and proper hepatic artery were displaced by the tumor. Upper gastrointestinal endoscopy showed duodenal ulcer, but fistula was not confirmed. Combining all imaging and clinical findings, it was clinically diagnosed as duodenal submucosal tumor with abscess, and elective surgery was performed. There was a huge mass in the Morrison pouch, with severe adhesion to the second portion of the duodenum, gall bladder, common bile duct, and transverse colon. Subtotal stomach-preserving pancreaticoduodenectomy with transverse colectomy was performed. A fistula from the second portion of the duodenum to the tumor was confirmed on the resected specimen. Histological examination showed gastrointestinal stromal tumor originating in the duodenum. PMID:22056710

  10. In Vivo Endoscopic Imaging of Ancylostomiasis-Induced Gastrointestinal Bleeding: Clinical and Biological Profiles

    PubMed Central

    Barakat, Maha; Ibrahim, Naglaa; Nasr, Ahmed

    2012-01-01

    Little data are available regarding the association of ancylostomiasis with overt gastrointestinal bleeding. This 6-year retrospective study describes the clinical and biological profiles of unexpectedly identified ancylostomiasis in a 4-month-old baby and four adults; they presented with melena and were referred for urgent diagnostic gastrointestinal endoscopy, which confirmed numerous small intestine injuries with surrounding blood pools caused by Ancylostoma duodenale worms. Gastric erosions were also encountered in one patient. Uniquely, worm biological activities were recorded live in vivo, including mucosal invasion through a vigorous, rapid piercing process, repeated bloodsucking habits, and gut appearance during the stages of feeding, digestion, and excretion in male and female worms. In conclusion, ancylostomiasis-induced melena may occur in all ages from infants to the elderly. Worm bloodfeeding occurs after quick mucosal piercing, with blood loss being aggravated by a repeated feeding behavior. After treatment is started, bleeding stops rapidly in response to anthelmintic therapy. PMID:22869629

  11. Alcohol, Aspirin, and Gastrointestinal Bleeding

    Microsoft Academic Search

    Kerry Goulston; Allan R. Cooke

    1968-01-01

    In 20 healthy male subjects faecal blood loss was measured by means of a chromium-51-labelled red blood cell technique. Mean daily faecal blood loss associated with unbuffered aspirin ingestion was significantly increased by alcohol in the 13 subjects studied. In seven others alcohol alone did not cause gastrointestinal bleeding. These findings suggest that alcohol may accentuate gastrointestinal blood loss associated

  12. Endoscopy in inflammatory bowel disease when and why

    PubMed Central

    Rameshshanker, Rajaratnam; Arebi, Naila

    2012-01-01

    Endoscopy plays an important role in the diagnosis and management of inflammatory bowel disease (IBD). It is useful to exclude other aetiologies, differentiate between ulcerative colitis (UC) and Crohn’s disease (CD), and define the extent and activity of inflammation. Ileocolonoscopy is used for monitoring of the disease, which in turn helps to optimize the management. It plays a key role in the surveillance of UC for dysplasia or neoplasia and assessment of post operative CD. Capsule endoscopy and double balloon enteroscopy are increasingly used in patients with CD. Therapeutic applications relate to stricture dilatation and dysplasia resection. The endoscopist’s role is vital in the overall management of IBD. PMID:22720120

  13. Capsule Endoscopy in Inflammatory Bowel Disease: Current Applications.

    PubMed

    Singeap, Ana-Maria; Stanciu, Carol; Cojocariu, Camelia; Sfarti, Catalin; Trifan, Anca

    2015-06-01

    Since its introduction to clinical practice in 2001, small-bowel capsule endoscopy (SBCE) has become an important investigation procedure in many small bowel pathologies, including both suspected and known Crohn's disease (CD). SBCE has higher diagnostic yield than other radiologic and endoscopic modalities used in evaluation of patients with suspected CD. In addition, SBCE has proved useful, in a non-invasive and safe manner, as a monitoring method for evaluating the severity and extent of lesions, postoperative recurrence, and mucosal healing in patients with known CD. Monitoring of colonic inflammation in patients with ulcerative colitis (UC) using second-generation of colon capsule endoscopy (CCE-2) has also been reported. Besides its advantages, CE also has several limitations such as the inability to obtain biopsies and lack of therapeutic capabilities, hopefully to be overcome in the near future by advances in modern technologies. PMID:26058935

  14. Diagnosis of colorectal tumorous lesions by magnifying endoscopy

    Microsoft Academic Search

    Shin-ei Kudo; Satoru Tamura; Takashi Nakajima; Hiro-o Yamano; Hisashi Kusaka; Hidenobu Watanabe

    1996-01-01

    Background: The magnifying colonoscope allows 100-fold magnified viewing of the colonic surface. Methods: We examined 2050 colorectal tumorous lesions by magnifying endoscopy, stereomicroscopy, and histopathology and classified these lesions according to pit pattern. Based on stereomicroscopy, lesions with a type 1 or 2 pit pattern were nontumors, whereas lesions with types 3s, 3L, 4, and\\/or 5 pit patterns were neoplastic

  15. Risk factors for complications associated with upper gastrointestinal foreign bodies

    PubMed Central

    Hong, Kyong Hee; Kim, Yoon Jae; Kim, Jae Hak; Chun, Song Wook; Kim, Hee Man; Cho, Jae Hee

    2015-01-01

    AIM: To investigate predictive risk factors associated with complications in the endoscopic removal of foreign bodies from the upper gastrointestinal tract. METHODS: We retrospectively reviewed the medical records of 194 patients with a diagnosis of foreign body impaction in the upper gastrointestinal tract, confirmed by endoscopy, at two university hospital in South Korea. Patient demographic data, including age, gender, intention to ingestion, symptoms at admission, and comorbidities, were collected. Clinical features of the foreign bodies, such as type, size, sharpness of edges, number, and location, were analyzed. Endoscopic data those were analyzed included duration of foreign body impaction, duration of endoscopic performance, endoscopic device, days of hospitalization, complication rate, 30-d mortality rate, and the number of operations related to foreign body removal. RESULTS: The types of upper gastrointestinal foreign bodies included fish bones, drugs, shells, meat, metal, and animal bones. The locations of impacted foreign bodies were the upper esophagus (57.2%), mid esophagus (28.4%), stomach (10.8%), and lower esophagus (3.6%). The median size of the foreign bodies was 26.2 ± 16.7 mm. Among 194 patients, endoscopic removal was achieved in 189, and complications developed in 51 patients (26.9%). Significant complications associated with foreign body impaction and removal included deep lacerations with minor bleeding (n = 31, 16%), ulcer (n = 11, 5.7%), perforation (n = 3, 1.5%), and abscess (n = 1, 0.5%). Four patients underwent operations because of incomplete endoscopic foreign body extraction. In multivariate analyses, risk factors for endoscopic complications and failure were sharpness (HR = 2.48, 95%CI: 1.07-5.72; P = 0.034) and a greater than 12-h duration of impaction (HR = 2.42, 95%CI: 1.12-5.25, P = 0.025). CONCLUSION: In cases of longer than 12 h since foreign body ingestion or sharp-pointed objects, rapid endoscopic intervention should be provided in patients with ingested foreign bodies. PMID:26185385

  16. Analysis of cardiopulmonary stress during endoscopy: Is unsedated transnasal esophagogastroduodenoscopy appropriate for elderly patients?

    PubMed Central

    Uchiyama, Kazuhiko; Ishikawa, Takeshi; Sakamoto, Naoyuki; Kajikawa, Hirokazu; Takagi, Tomohisa; Handa, Osamu; Tatsumi, Yoshihide; Yagi, Nobuaki; Naito, Yuji; Itoh, Yoshito; Takemura, Shuhei

    2014-01-01

    BACKGROUND: Transnasal esophagogastroduodenoscopy (EGD) without sedation has been reported to be safe and tolerable. It has recently been used widely in Japan for the detection of upper gastrointestinal disease. Alternatively, transoral examination using a thin endoscope has also been reported to be highly tolerable. OBJECTIVE: To examine the cardiocirculatory effects of transoral versus transnasal EGD in an attempt to determine the most suitable endoscopic methods for patients ?75 years of age. METHODS: Subjects who underwent monitoring of respiratory and circulatory dynamics without sedation during endoscopic screening examinations were enrolled at the New Ooe Hospital (Kyoto, Japan) between April 2008 and March 2009. A total of 165 patients (age ?75 years) provided written informed consent and were investigated in the present study. Patients were randomly divided into three subgroups: UO group – thin endoscope; SO group – standard endoscope; and UT group – transnasal EGD. Percutaneous arterial blood oxygen saturation, heart rate and blood pressure were evaluated just before EGD and at five time points during EGD. After transnasal EGD, patients who had previously been examined using transoral EGD with a standard endoscope were asked about preferences for their next examination. RESULTS: There were no statistical differences in the characteristics among the groups. Percutaneous oxygen saturation in the UT group showed a transient drop compared with the SO and UO groups at the beginning of the endoscopic procedure. Heart rate showed no significant differences among the SO, UO and UT groups; Systolic blood pressure in the UO group was lower immediately after insertion compared with the SO and UT groups. The rate pressure product in the UO group was comparable with that in the UT group during endoscopy, and the SO group showed a continuously higher level than the UO and UT groups. More than one-half (54.4%) of patients were ‘willing to choose transnasal EGD for next examination’. CONCLUSIONS: For elderly patients, unsedated transnasal EGD failed to show an advantage over unsedated standard endoscopy. Transoral thin EGD was estimated to be safe and tolerable. PMID:24288691

  17. Combined optical resolution photoacoustic and fluorescence micro-endoscopy

    NASA Astrophysics Data System (ADS)

    Shao, Peng; Shi, Wei; Hajireza, Parsin; Zemp, Roger J.

    2012-02-01

    We present a new micro-endoscopy system combining real-time C-scan optical-resolution photoacoustic micro-endoscopy (OR-PAME), and a high-resolution fluorescence micro-endoscopy system for visualizing fluorescently labeled cellular components and optically absorbing microvasculature simultaneously. With a diode-pumped 532-nm fiber laser, the OR-PAM sub-system is capable of imaging with a resolution of ~ 7?m. The fluorescence sub-system consists of a diode laser with 445 nm-centered emissions as the light source, an objective lens and a CCD camera. Proflavine, a FDA approved drug for human use, is used as the fluorescent contrast agent by topical application. The fluorescence system does not require any mechanical scanning. The scanning laser and the diode laser light source share the same light path within an optical fiber bundle containing 30,000 individual single mode fibers. The absorption of Proflavine at 532 nm is low, which mitigates absorption bleaching of the contrast agent by the photoacoustic excitation source. We demonstrate imaging in live murine models. The system is able to provide cellular morphology with cellular resolution co-registered with the structural and functional information given by OR-PAM. Therefore, the system has the potential to serve as a virtual biopsy technique, helping researchers and clinicians visualize angiogenesis, effects of anti-cancer drugs on both cells and the microcirculation, as well as aid in the study of other diseases.

  18. Dual modality optoacoustic and laser ultrasound endoscopy system

    NASA Astrophysics Data System (ADS)

    Tsyboulski, Dmitri; Conjusteau, André; Oraevsky, Alexander

    2014-03-01

    Ultrasound endoscopy has been proven effective in identifying and staging relatively advanced tumors in esophageal or colon wall lining. When combined with optoacoustic imaging modality, the endoscopy examination may prove beneficial in detecting also early stage tumors as well as more accurate staging of advanced tumors based on functional - anatomical maps. Here we present a prototype of a dual-modality optoacoustic - laser ultrasound (OA-LUS) endoscopy system with enhanced imaging capabilities. The system consists of a rotating 90° off-axis parabolic reflector which is acoustically coupled to a flat 8-element transducer array. A parabolic mirror serves dual purpose of directing light towards a sample and reflecting incoming optically generated ultrasound signals towards a detector. LUS modality is enabled by placing an optically absorbing and acoustically transparent polymeric membrane in the path of laser light to generate broadband and non-reverberating transient ultrasound waves propagating towards the sample. Focused system detects ultrasound signals and reconstructs the image similar to optoacoustic mode. Presence of a delay between optically generated and reflected acoustic signals allows concurrent image acquisition in OA and LUS modalities.

  19. Fulminant gastrointestinal bleeding caused by EBV-triggered hemophagocytic lymphohistiocytosis: report of a case.

    PubMed

    Klein, S; Schmidt, C; La Rosée, P; Pletz, M; Harz, S; Dirsch, O; Fritzenwanger, M; Stallmach, A

    2014-04-01

    Hemophagocytic lymphohistiocytosis (HLH) is a rare and often fatal hyperinflammatory syndrome characterized by fever, cytopenia, dramatically increased ferritin and hepatosplenomegaly. Here, we describe a previously healthy 39 year old pregnant woman in 30th week of her pregnancy with diarrhoea, intermittent gastrointestinal bleeding and fever of unknown focus. After cesarean section of twins in the 31st week she deteriorated with fulminant upper and lower gastrointestinal bleeding and disseminated intravascular coagulation. Gastro-, ileocolonoscopy and capsule endoscopy identified multiple bleeding punched ulcerations in the stomach, the entire small bowel and in parts of the colon. Emergency surgery with intraoperative endoscopy for uncontrolled hemorrhagic shock resulted in the resection of actively bleeding ulcers in the jejunum which temporally stabilized the critically ill patient. Jejunal histology and in situ hybridisation showed extensive ulcerations, focal lymphohistiocytic infiltration and EBV-positive immunoblasts. The diagnosis fulminant EBV-related HLH was confirmed based on the HLH-2004 diagnostic criteria and through detection of a reactivated EBV infection (up to 3?×?10(7) DNA copies/mL serum). Despite immunosuppressive therapy with steroids, cyclosporine A and etoposide in combination with Rituximab, the patient died from this sepsis-like, hyper-inflammatory syndrome in multiorgan failure with uncontrolled bleeding. PMID:24718941

  20. Obesity and gastrointestinal diseases.

    PubMed

    Fujimoto, Ai; Hoteya, Shu; Iizuka, Toshiro; Ogawa, Osamu; Mitani, Toshifumi; Kuroki, Yuichiro; Matsui, Akira; Nakamura, Masanori; Kikuchi, Daisuke; Yamashita, Satoshi; Furuhata, Tsukasa; Yamada, Akihiro; Nishida, Noriko; Arase, Koji; Hashimoto, Mitsuyo; Igarashi, Yoshinori; Kaise, Mitsuru

    2013-01-01

    The prevalence of obesity in the Japanese population has been increasing dramatically in step with the Westernization of lifestyles and food ways. Our study demonstrated significant associations between obesity and a number of gastrointestinal disorders in a large sample population in Japan. We demonstrated that reflux esophagitis and hiatal hernia were strongly related to obesity (BMI > 25) in the Japanese. In particular, obesity with young male was a high risk for these diseases. On the other hand, it has been reported that obesity is also associated with Barrett's esophagus and colorectal adenoma; however, obesity was not a risk factor for these diseases in our study. The difference of ethnicity of our subjects may partly explain why we found no data to implicate obesity as a risk factor for Barrett's esophagus. Arterial sclerosis associated with advanced age and hyperglycemia was accompanied by an increased risk of colorectal adenoma. PMID:23781242

  1. Obesity and Gastrointestinal Diseases

    PubMed Central

    Fujimoto, Ai; Hoteya, Shu; Iizuka, Toshiro; Ogawa, Osamu; Mitani, Toshifumi; Kuroki, Yuichiro; Matsui, Akira; Nakamura, Masanori; Kikuchi, Daisuke; Yamashita, Satoshi; Furuhata, Tsukasa; Yamada, Akihiro; Nishida, Noriko; Arase, Koji; Hashimoto, Mitsuyo; Igarashi, Yoshinori; Kaise, Mitsuru

    2013-01-01

    The prevalence of obesity in the Japanese population has been increasing dramatically in step with the Westernization of lifestyles and food ways. Our study demonstrated significant associations between obesity and a number of gastrointestinal disorders in a large sample population in Japan. We demonstrated that reflux esophagitis and hiatal hernia were strongly related to obesity (BMI > 25) in the Japanese. In particular, obesity with young male was a high risk for these diseases. On the other hand, it has been reported that obesity is also associated with Barrett's esophagus and colorectal adenoma; however, obesity was not a risk factor for these diseases in our study. The difference of ethnicity of our subjects may partly explain why we found no data to implicate obesity as a risk factor for Barrett's esophagus. Arterial sclerosis associated with advanced age and hyperglycemia was accompanied by an increased risk of colorectal adenoma. PMID:23781242

  2. Development of radiation hard Ga0.50In0.50P\\/Ga0.99In0.01As\\/Ge space solar cells with multi quantum wells

    Microsoft Academic Search

    René Kellenbenz; Raymond Hoheisel; Peter Kailuweit; Wolfgang Guter; Frank Dimroth; Andreas W. Bett

    2010-01-01

    The efficiency of today's Ga0.5In0.5P\\/Ga0.99In0.01As\\/Ge triple-junction space solar cells can be improved by the incorporation of multi-quantum wells to extend the absorption of the GaInAs middle cell. In this paper, the effect of high energy electron irradiation on the device performance of quantum well single- and triple-junction devices was investigated. For GaAs single-junction solar cells it could be shown that

  3. Supratherapeutic anticoagulation at presentation is associated with reduced mortality in nonvariceal upper gastrointestinal hemorrhage

    PubMed Central

    Irwin, James; Ferguson, Reid; Weilert, Frank; Smith, Anthony

    2014-01-01

    Introduction: Warfarin is a widely used and easily reversible anticoagulant. Although bleeding is more likely in warfarin users, it may also be more readily treated. This retrospective observational case-control study compares the outcome of acute nonvariceal upper gastrointestinal hemorrhage in warfarin users with a supratherapeutic international normalized ratio (INR) and outcome in non?–?warfarin users. Patients and methods: Clinical and endoscopic data for patients presenting with overt upper gastrointestinal hemorrhage were collected between 23rd February 2001 and 12 October 2010.?Patients with variceal hemorrhage were excluded. Warfarin users with a supratherapeutic INR (??3.0) at presentation (supratherapeutic anticoagulation [SA] group) were matched to a cohort with upper gastrointestinal hemorrhage not taking warfarin at presentation (control group). Patients were matched by age, sex, Rockall score, year of endoscopy, inpatient or outpatient status, and the presence of disseminated cancer at presentation. The incidence rates of major outcomes in the two groups were compared. Results: A total of 128 patients (SA group) were matched to 135 control patients. The SA group patients were less likely to die within 30 days (6.25?% vs. 15.5?%, odds ratio?=?0.36, P?=?0.028 by Test for Equality of Proportions). There was a trend toward more surgery in the control group (5?% vs. 2?%), and rates of blood transfusion (77?% vs. 70?%) were similar in the two groups. Conclusion: In patients presenting with nonvariceal upper gastrointestinal hemorrhage, a supratherapeutic INR at presentation due to warfarin use is associated with reduced mortality.

  4. Gastrointestinal Manifestations of Cystic Fibrosis.

    PubMed

    Kelly, Thomas; Buxbaum, James

    2015-07-01

    Gastrointestinal symptoms of cystic fibrosis are the most important non-pulmonary manifestations of this genetic illness. Pancreatic manifestations include acute and chronic pancreatitis as well as pancreas insufficiency resulting in malnutrition. Complications in the gastrointestinal lumen are diverse and include distal intestinal obstruction syndrome (DIOS), meconium ileus, intussusception, and constipation; biliary tract complications include focal biliary cirrhosis and cholangiectasis. The common pathophysiology is the inspissation of secretions in the hollow structures of the gastrointestinal tract. Improved survival of CF patients mandates that the adult gastroenterologist be aware of the presentation and treatment of pancreatic, luminal, and hepatobiliary CF complications. PMID:25648641

  5. Gastrointestinal Motility Disorders in Children

    PubMed Central

    Ambartsumyan, Lusine

    2014-01-01

    The most common and challenging gastrointestinal motility disorders in children include gastroesophageal reflux disease (GERD), esophageal achalasia, gastroparesis, chronic intestinal pseudo-obstruction, and constipation. GERD is the most common gastrointestinal motility disorder affecting children and is diagnosed clinically and treated primarily with acid secretion blockade. Esophageal achalasia, a less common disorder in the pediatric patient population, is characterized by dysphagia and treated with pneumatic balloon dilation and/or esophagomyotomy. Gastroparesis and chronic intestinal pseudo-obstruction are poorly characterized in children and are associated with significant morbidity. Constipation is among the most common complaints in children and is associated with significant morbidity as well as poor quality of life. Data on epidemiology and outcomes, clinical trials, and evaluation of new diagnostic techniques are needed to better diagnose and treat gastrointestinal motility disorders in children. We present a review of the conditions and challenges related to these common gastrointestinal motility disorders in children. PMID:24799835

  6. The chicken gastrointestinal microbiome.

    PubMed

    Oakley, Brian B; Lillehoj, Hyun S; Kogut, Michael H; Kim, Woo K; Maurer, John J; Pedroso, Adriana; Lee, Margie D; Collett, Stephen R; Johnson, Timothy J; Cox, Nelson A

    2014-11-01

    The domestic chicken is a common model organism for human biological research and of course also forms the basis of a global protein industry. Recent methodological advances have spurred the recognition of microbiomes as complex communities with important influences on the health and disease status of the host. In this minireview, we provide an overview of the current state of knowledge of the chicken gastrointestinal microbiome focusing on spatial and temporal variability, the presence and importance of human pathogens, the influence of the microbiota on the immune system, and the importance of the microbiome for poultry nutrition. Review and meta-analysis of public data showed cecal communities dominated by Firmicutes and Bacteroides at the phylum level, while at finer levels of taxonomic resolution, a phylogenetically diverse assemblage of microorganisms appears to have similar metabolic functions that provide important benefits to the host as inferred from metagenomic data. This observation of functional redundancy may have important implications for management of the microbiome. We foresee advances in strategies to improve gut health in commercial operations through management of the intestinal microbiota as an alternative to in-feed subtherapeutic antibiotics, improvements in pre- and probiotics, improved management of polymicrobial poultry diseases, and better control of human pathogens via colonization reduction or competitive exclusion strategies. PMID:25263745

  7. Capsule endoscopy compared with conventional colonoscopy for detection of colorectal neoplasms.

    PubMed

    Sieg, Andreas

    2011-05-16

    Colon capsule endoscopy (CCE) may be a means to overcome the low adherence to colorectal cancer screening. The device is an ingestible capsule with a video camera at both ends that can take photographs as it progresses through the gastrointestinal tract. PillCam colon (PCC1) may be used for structural evaluation of the large bowel following an adequate cleaning procedure. PCC1 measures 11 mm × 31 mm and has dual cameras that enable the device to acquire video images from both ends with a wide coverage area, automatic light control and a frame rate of four frames per second. The system includes a sensor array and data recorder connected to the patient during the procedure. The recorded data are downloaded to the Given Imaging Rapid workstation for review of the colon video. The second generation of PillCam Colon (PCC2) is similar to PCC1 and incorporates new developments. The angle of view has been increased to 172 degrees. It has an adaptive frame rate, alternating from 35 frames per second while in motion to 4 images when virtually stationary. The new RAPID(®) software now includes a simple graphic interface tool for polyp size estimation. The procedure of bowel cleansing until capsule ingestion is similar to that used for traditional colonoscopy. However it is more rigorous as the bowel cleanliness for capsule colonoscopy has to be excellent or at least good to result in an adequate sensitivity of the method. Briefly, it consists of 3.5-4 L of split dose polyethylene glycol. Oral NaP boosters are administered after 1-2 h if the capsule has entered the small bowel. Sodium phosphate (NaP) seems to be a necessary adjunct to the regimen because the total transit time is doubled without NaP. The cleansing level was considered to be good to excellent in 72%-88% in studies with PCC1. The sensitivity for significant polyps (> 6 mm or more than 3 polyps >3 mm) ranged from 63%-88% with specificities between 64%-94%. PCC2 showed an improved sensitivity of 89% and a specificity of 76%. CCE seems to be a safe and effective method of visualizing the colonic mucosa through colon fluids without the need for sedation or insufflation of air. The sensitivity of CCE to detect polyps, advanced adenomas and cancer is lower compared to optical colonoscopy but improvements will be made in the near future. With an increased recording duration, even a panenteric examination of the whole gastrointestinal tract may be possible. PMID:21772938

  8. A low prevalence of H pylori and endoscopic fi ndings in HIV positive Chinese patients with gastrointestinal symptoms

    Microsoft Academic Search

    Fu-Jing Lv; Xiao-Lan Luo; Xin Meng; Rui Jin; Hui-Guo Ding; Shu-Tian Zhang

    2007-01-01

    Abstract AIM: To compare the prevalence of H pylori infection, peptic ulcer, cytomegalovirus (CMV) infection and Candida esophagitis,in human,immunodeficiency virus,(HIV)- positive and HIV-negative patients, and evaluate the impact of CD4 lymphocyte,on H pylori and,opportunistic infections. METHODS:A total of 151 patients (122 HIV-positive and 29HIV-negative) with,gastrointestinal symptoms,were examined,by upper,endoscopy,and biopsy. Samples were assessed to determine the prevalence of H pylori infection,

  9. Alternative Agents to Prevent Fogging in Head and Neck Endoscopy

    PubMed Central

    Piromchai, Patorn; Kasemsiri, Pornthep; Thanaviratananich, Sanguansak

    2011-01-01

    Background: The essential factor for diagnosis and treatment of diseases in head and neck endoscopy is the visibility of the image. An anti-fogging agent can reduce this problem by minimizing surface tension to prevent the condensation of water in the form of small droplets on a surface. There is no report on the use of hibiscrub® or baby shampoo to reduce fogging in the literature. The objective of this study was to compare the efficacy between commercial anti-fogging agent, hibiscrub® and baby shampoo to reduce fogging for the use in head and neck endoscopy. Methods: The study was conducted at the Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University in August 2010. Commercial anti-fogging agent, baby shampoo and hibiscrub® were applied on rigid endoscope lens before putting them into a mist generator. The images were taken at baseline, 15 seconds, 30 seconds and 1 minute. The images’ identifiers were removed before they were sent to two evaluators. A visual analogue scale (VAS) was used to rate the image quality from 0 to 10. Results: The difference in mean VAS score between anti-fogging agent, baby shampoo and hibiscrub® versus no agent were 5.46, 4.45 and 2.1 respectively. The commercial anti-fogging agent and baby shampoo had most protective benefit and performed significantly better than no agent (P = 0.05). Conclusions: Baby shampoo is an effective agent to prevent fogging during head and neck endoscopy and compares favourably with commercial anti-fogging agent. PMID:24179399

  10. Colon capsule endoscopy: Current status and future directions

    PubMed Central

    Tal, Andrea O; Vermehren, Johannes; Albert, Jörg G

    2014-01-01

    Colon capsule endoscopy (CCE; PillCam Colon; Given Imaging; Yoqneam, Israel) is a minimally invasive wireless technique for the visualization of the colon. With the recent introduction of the second generation colon capsule the diagnostic accuracy of CCE for polyp detection has significantly improved and preliminary data suggest it may be useful to monitor mucosal inflammation in patients with inflammatory bowel disease. Limitations include the inability to take biopsies and the procedural costs. However, given the potentially higher acceptance within an average risk colorectal cancer (CRC) screening population, its usefulness as a screening tool with regard to CRC prevention should be further evaluated. PMID:25469027

  11. The role of barium esophagography in an endoscopy world.

    PubMed

    Katzka, David A

    2014-10-01

    Barium esophagography, although an old test, remains important to the understanding of esophageal physiology and diagnosis of esophageal disorders. It provides additive and/or confirmatory information to endoscopy and is the more accurate means of yielding diagnosis. Barium esophagography allows correlation of symptoms with barium findings and with varied textures substances. It allows, particularly for oropharyngeal dysfunction, implementation therapeutic maneuvers and instructions while testing. The caveat to maintaining the benefits of barium esophagography is continuing to promote and support expertise from our radiologists in performing these studies, which has been challenged by our cost-efficient and high-tech medical society. PMID:25216903

  12. State of the art in advanced endoscopic imaging for the detection and evaluation of dysplasia and early cancer of the gastrointestinal tract

    PubMed Central

    Coda, Sergio; Thillainayagam, Andrew V

    2014-01-01

    Ideally, endoscopists should be able to detect, characterize, and confirm the nature of a lesion at the bedside, minimizing uncertainties and targeting biopsies and resections only where necessary. However, under conventional white-light inspection – at present, the sole established technique available to most of humanity – premalignant conditions and early cancers can frequently escape detection. In recent years, a range of innovative techniques have entered the endoscopic arena due to their ability to enhance the contrast of diseased tissue regions beyond what is inherently possible with standard white-light endoscopy equipment. The aim of this review is to provide an overview of the state-of-the-art advanced endoscopic imaging techniques available for clinical use that are impacting the way precancerous and neoplastic lesions of the gastrointestinal tract are currently detected and characterized at endoscopy. The basic instrumentation and the physics behind each method, followed by the most influential clinical experience, are described. High-definition endoscopy, with or without optical magnification, has contributed to higher detection rates compared with white-light endoscopy alone and has now replaced ordinary equipment in daily practice. Contrast-enhancement techniques, whether dye-based or computed, have been combined with white-light endoscopy to further improve its accuracy, but histology is still required to clarify the diagnosis. Optical microscopy techniques such as confocal laser endomicroscopy and endocytoscopy enable in vivo histology during endoscopy; however, although of invaluable assistance for tissue characterization, they have not yet made transition between research and clinical use. It is still unknown which approach or combination of techniques offers the best potential. The optimal method will entail the ability to survey wide areas of tissue in concert with the ability to obtain the degree of detailed information provided by microscopic techniques. In this respect, the challenging combination of autofluorescence imaging and confocal endomicroscopy seems promising, and further research is awaited. PMID:24868168

  13. Childhood functional gastrointestinal disorders

    PubMed Central

    Rasquin-Weber, A; Hyman, P; Cucchiara, S; Fleisher, D; Hyams, J; Milla, P; Staiano, A

    1999-01-01

    This is the first attempt at defining criteria for functional gastrointestinal disorders (FGIDs) in infancy, childhood, and adolescence. The decision-making process was as for adults and consisted of arriving at consensus, based on clinical experience. This paper is intended to be a quick reference. The classification system selected differs from the one used in the adult population in that it is organized according to main complaints instead of being organ-targeted. Because the child is still developing, some disorders such as toddler's diarrhea (or functional diarrhea) are linked to certain physiologic stages; others may result from behavioral responses to sphincter function acquisition such as fecal retention; others will only be recognizable after the child is cognitively mature enough to report the symptoms (e.g., dyspepsia). Infant regurgitation, rumination, and cyclic vomiting constitute the vomiting disorders. Abdominal pain disorders are classified as: functional dyspepsia, irritable bowel syndrome (IBS), functional abdominal pain, abdominal migraine, and aerophagia. Disorders of defecation include: infant dyschezia, functional constipation, functional fecal retention, and functional non-retentive fecal soiling. Some disorders, such as IBS and dyspepsia and functional abdominal pain, are exact replications of the adult criteria because there are enough data to confirm that they represent specific and similar disorders in pediatrics. Other disorders not included in the pediatric classification, such as functional biliary disorders, do occur in children; however, existing data are insufficient to warrant including them at the present time. For these disorders, it is suggested that, for the time being, clinicians refer to the criteria established for the adult population.???Keywords: infant vomiting; cyclic vomiting syndrome; functional dyspepsia in children; irritable bowel syndrome in children; functional abdominal pain in children; functional diarrhea in children; functional constipation in children; Rome II PMID:10457047

  14. Computer-aided diagnosis in endoscopy: a novel application toward automatic detection of abnormal lesions on magnifying narrow-band imaging endoscopy in the stomach.

    PubMed

    Lee, Tsung-Chun; Lin, Yu-Huei; Uedo, Noriya; Wang, Hsiu-Po; Chang, Hsuan-Ting; Hung, Chung-Wen

    2013-01-01

    Gastric cancer is the fourth common cancer and the second major cause of cancer death worldwide. Early detection of gastric cancer by endoscopy surveillance is actively investigated to improve patient survival, especially using the newly developed magnifying narrow-band imaging endoscopy in the stomach. However, meticulous examination of the aforementioned images is both time and experience demanding and interpretation could be variable among different doctors, which hindered its widespread application. In this study, we developed a new image analysis system by adopting local binary pattern and vector quantization to perform pattern comparison between known training abnormal images and testing images of magnifying narrow band endoscopy images in the stomach. Our preliminary results demonstrated promising potential for automatically labeled region of interest for endoscopy doctors to focus on abnormal lesions for subsequent targeted biopsy, with the rates of recall 0.46-1.00 and precision 0.39-0.87. PMID:24110716

  15. Narrow-band imaging system with magnifying endoscopy for superficial esophageal lesions

    Microsoft Academic Search

    Tatsuya Yoshida; Haruhiro Inoue; Shinsuke Usui; Hitoshi Satodate; Norio Fukami; Shin-ei Kudo

    2004-01-01

    BackgroundBy assessing the intrapapillary capillary loop in esophageal mucosa, magnifying endoscopy can play an important role in the evaluation of superficial esophageal lesions. A newly developed narrow-band imaging system was applied to magnifying endoscopy in a clinical setting; the benefit of the narrow-band imaging system was evaluated.

  16. Interactive Dynamic Navigation for Virtual Endoscopy Krishnan Ramaswamy 1;2 and William E. Higgins 2

    E-print Network

    Higgins, William

    provides a virtual copy of the anatomy. Complex anatomical information can be obtained by interactiveInteractive Dynamic Navigation for Virtual Endoscopy Krishnan Ramaswamy 1;2 and William E. Higgins Navigation for Virtual Endoscopy Krishnan Ramaswamy 1;2 and William E. Higgins 2 1 Radionics Software

  17. Treatment of Gastrointestinal Carcinoid Tumors by Stage

    MedlinePLUS

    ... with endoscopy, or treated with a medicine like octreotide (Sandostatin) or lanreotide (Somatuline) that will lower both gastrin ... t causing symptoms, some doctors recommend treatment with octreotide or lanreotide because it may slow tumor growth. ...

  18. Use of confocal laser endomicroscopy to assess the adequacy of endoscopic treatment of gastrointestinal neoplasia: a systematic review and meta-analysis.

    PubMed

    Ypsilantis, Efthymios; Pissas, Dimitrios; Papagrigoriadis, Savvas; Haji, Amyn

    2015-02-01

    Evaluation of the adequacy of endoscopic mucosal resection (EMR) of gastrointestinal lesions remains challenging by use of conventional endoscopy. Confocal laser endomicroscopy (CLE) is a novel imaging technique, designed to provide in vivo histology, and facilitate diagnosis with real-time intervention. We undertook a systematic review of the available literature, exploring the role of CLE in assuring completeness of EMR of gastrointestinal lesions. The number of pertinent studies is very limited, including only 1 randomized controlled study and 2 prospective comparative case series. Per-lesion meta-analysis showed that the sensitivity of CLE for detection of residual neoplasia was 91% (95% confidence interval, 82.5%-96%) with specificity of 69% (95% confidence interval, 61%-77%), with significant heterogeneity noted in all outcomes. In conclusion, the evidence underpinning the usefulness of CLE in ensuring adequate EMR of gastrointestinal neoplasia is currently very weak, with limited promising results related to gastric and colorectal polyp resections. PMID:24910941

  19. Flexor Digitorum Accessorius Longus: Importance of Posterior Ankle Endoscopy

    PubMed Central

    Batista, Jorge Pablo; del Vecchio, Jorge Javier; Golanó, Pau; Vega, Jordi

    2015-01-01

    Endoscopy for the posterior region of the ankle through two portals is becoming more widespread for the treatment of a large number of conditions which used to be treated with open surgery years ago. The tendon of the flexor hallucis longus (FHL) travels along an osteofibrous tunnel between the posterolateral and posteromedial tubercles of the talus. Chronic inflammation of this tendon may lead to painful stenosing tenosynovitis. The aim of this report is to describe two cases depicting an accessory tendon which is an anatomical variation of the flexor hallucis longus in patients with posterior friction syndrome due to posterior ankle impingement and associated with a posteromedial osteochondral lesion of the talus. The anatomical variation (FDAL) described was a finding during an endoscopy of the posterior region of the ankle, and we have spared it by sectioning the superior flexor retinaculum only. The accessory flexor digitorum longus is an anatomical variation and should be taken into account when performing an arthroscopy of the posterior region of the ankle. We recommend this treatment on this type of injury although we admit this does not make a definite conclusion.

  20. Bowel preparation regimens for colon capsule endoscopy: a review

    PubMed Central

    Nigar, Sofia; Paleti, Vani; Lane, Devin; Duddempudi, Sushil

    2014-01-01

    Colon capsule endoscopy (CCE) is being actively evaluated as an emerging complementary or alternative procedure for evaluation of the colon. The yield of CCE is significantly dependent on the quality of bowel preparation. In addition to achieving a stool-free colon the bowel preparation protocols need to decrease bubble effect and aid propulsion of the capsule. An extensive English literature search was done using PubMed with search terms of colon capsule endoscopy, PillCam and bowel preparation. Full-length articles which met the criteria were included for review. A total of 12 studies including 1149 patients were reviewed. There was significant variability in the type of bowel preparation regimens. Large-volume (3–4 liters) polyethylene glycol (PEG) was the most widely used laxative. Lower volumes of PEG showed comparable results but larger studies are needed to determine efficacy. Sodium phosphate was used as an effective booster in most studies. Magnesium citrate and ascorbic acid are emerging as promising boosters to replace sodium phosphate when it is contraindicated. The potential benefit of prokinetics needs further evaluation. Over the past decade there has been significant improvement in the bowel preparation regimens for CCE. Further experience and studies are likely to standardize the bowel preparation regimens before CCE is adopted into routine clinical practice. PMID:24790642

  1. [Upper digestive tract endoscopy in rural Africa: Togo].

    PubMed

    Djibril, M A; M'Ba, K B; Kaaga, Y L; Bagny, A; Edou, K A; Redah, D; Agbetra, A

    2009-02-01

    The purpose of this report was to describe the profile of esogastroduodenal disease diagnosed by upper digestive tract endoscopy (UDTE) in a rural area of Togo. This prospective study combines data collected during two two-week screening campaigns carried out in the Kara region. Patients were informed of the presence of the endoscopy team by means of a bulletin on a rural radio station. All male and female patients 15 years or older were included. A total of 220 UDTE procedure reports were recorded and analyzed including 107 men and 113 women with a mean age of 37.7 years (range: 15-84 years). Disease was detected in 72 procedures mainly in the 21 to 41 year age group (47.2 %) with a higher proportion of men than women: 38% versus 27% respectively. The most frequent indications for UDTE were epigastralgia (47.7 %) including 39% of procedures leading to the discovery of disease and diffuse abdominal pain (21.8 %). The procedure was carried out for follow-up purposes in 19.1% of cases. The most common lesions were peptic ulcer (34.2%), inflammatory disease including esophagitis, gastritis, and bulboduodenitis (32.4%), gastroduodenal bile reflux (9.3%), pylorobulbar stenosis (5.5%), tumoral disease (3.7%), and esophageal varicosities (3.7%). This study based on UDTE diagnostic procedures provided insight into the profile of esogastroduodenal disease in rural Africa. These screening campaigns required special organization using appropriate equipment and personnel. PMID:19499733

  2. Pulmonary aspiration of gastric contents during routine endoscopy

    SciTech Connect

    La France, N.D.; Cole, P.; Wolfe, E.; Giardello, F.; Wagner, H.N.

    1985-05-01

    Radioactive tracer studies are a sensitive means to detect occult pulmonary aspiration of gastric contents. A complication of diagnostic endoscopy is aspiration of contents even in fasted patients. The authors have studied 21 hospitalized patients who underwent elective endoscopy (END) for suspected UGI pathology. Fifteen minutes before END, and prior to pharygeal anesthesia, 1 mCi Tc-99m-sulfur colloid, added to the usual 30cc of simethicone routinely administered before END, was given orally. END was performed as usual and 2 hours later anterior 100,000 count images of the chest were obtained. All the studies were interpreted without history or clinical information. Fever developed within 24 hours (and septic shock in 1) in both patients with positive studies while no fever occurred in the remaining patients with negative studies (rho<.001). The authors conclude that oral radionuclide pulmonary aspiration studies may; detect aspiration not recognized by the endoscopist, reveal evidence of aspiration that preceeds adverse clinical signs and symptoms, and be influenced by systemic pre-END drugs known to affect GI secretions and motility.

  3. Diagnostic Accuracy of the Initial Endoscopy for Ampullary Tumors

    PubMed Central

    Lee, Hee Seung; Jang, Jong Soon; Lee, Seungho; Yeon, Myeong Ho; Kim, Ki Bae; Park, Jae Geun; Lee, Joo Young; Kim, Mi Jin; Han, Joung-Ho; Sung, Rohyun

    2015-01-01

    Background/Aims Ampullary tumors come in a wide variety of malignant forms. We evaluated the diagnostic accuracy of endoscopy for ampullary tumors, and analyzed the causes of misdiagnosis. Methods We compared endoscopic imaging and biopsy results to final diagnoses. Types of endoscope, numbers of biopsy specimens taken, and final diagnoses were evaluated as possible factors influencing diagnostic accuracy. Results Final diagnoses were 19 adenocarcinomas, 18 normal or papillitis, 11 adenomas, two adenomyomas, one paraganglioma, and one neuroendocrine tumor. The diagnostic accuracy of endoscopic imaging or the initial biopsy was identical (67.3%). At least one test was concordant with the final diagnosis in all except two cases. Compared with the final diagnosis, endoscopic imaging tended to show more advanced tumors, whereas the initial biopsy revealed less advanced lesions. The diagnostic accuracy of the initial biopsy was influenced by the type of endoscope used and the final diagnosis, but not by the number of biopsies taken. Conclusions Endoscopy has limited accuracy in the diagnosis of ampullary tumors. However, most cases with concordant endoscopic imaging and biopsy results are identical to the final diagnosis. Therefore, in cases where both of these tests disagree, re-evaluation with a side-viewing endoscope after resolution of papillitis is required.

  4. Gastrointestinal Amyloidosis Presenting with Multiple Episodes of Gastrointestinal Bleeding

    SciTech Connect

    Kim, Sang Hyeon, E-mail: g4439@naver.com; Kang, Eun Ju; Park, Jee Won; Jo, Jung Hyun [Dong-A University Hospital, Department of Diagnostic Radiology (Korea, Republic of); Kim, Soo Jin [College of Medicine, Dong-A University, Department of Pathology (Korea, Republic of); Cho, Jin Han; Kang, Myong Jin; Park, Byeong Ho [Dong-A University Hospital, Department of Diagnostic Radiology (Korea, Republic of)

    2009-05-15

    Amyloidosis is characterized by the extracellular deposition of amyloid protein in various organs. Gastrointestinal involvement in amyloidosis is common, but a diagnosis of amyloidosis is often delayed. Severe gastrointestinal hemorrhage in amyloidosis is rare but can be fatal in some cases. We experienced a case of a 49-year-old man who presented with recurrent massive hematochezia. Although embolization was performed eight times for bleeding from different sites of the small intestine, hematochezia did not cease. We report the case, with a review of the literature.

  5. Gastrointestinal Bleeding as a Complication of Serial Transverse Enteroplasty

    PubMed Central

    Fisher, Jeremy G.; Stamm, Danielle A.; Modi, Biren P.; Duggan, Christopher; Jaksic, Tom

    2015-01-01

    Purpose Serial transverse enteroplasty (STEP) lengthens and tapers bowel in patients with intestinal failure and has a generally low complication profile. Evaluation and treatment of serious gastrointestinal bleeding (GIB) in three STEP patients is described. Methods Records of patients participating in an interdisciplinary intestinal rehabilitation program were reviewed to identify those who underwent STEP and had GIB necessitating red blood cell transfusion. Results Of 296 patients, 23 underwent STEP and 3 (13%) had subsequent GIB requiring transfusion. Underlying diagnoses were multiple atresias/intrauterine volvulus, gastroschisis, and gastroschisis with volvulus. STEP was performed at ages ranging from 3–5 months, using 3–8 stapler firings with an increase in mean bowel length from 23 to 45 cm. GIB was noted at 10–33 months post-op and resulted in 2–7 transfusions per patient over a period of 3–16 months. Gastrointestinal endoscopic evaluation demonstrated ulcers adjacent to the staple lines in two patients. Both had improvement of GIB with enteral antibiotics, sulfasalazine, topical enteral steroids and, ultimately, a period of bowel rest. The third patient had histological evidence of eosinophilic enteritis and was treated sequentially with antibiotics, sulfasalazine, enteral steroids, and an elemental diet. In all three, hemoglobin levels improved despite persistent occult bleeding. Conclusions Significant GIB is a potential late complication of STEP. Endoscopy identified the underlying source of GIB in all three patients. A combination of enteral antibiotics, anti-inflammatory medications, and bowel rest was effective in the treatment of post-STEP GIB, without the need for additional bowel resection. PMID:24851761

  6. Predictive Clinical Factors in the Diagnosis of Gastrointestinal Kaposi's Sarcoma and Its Endoscopic Severity

    PubMed Central

    Nagata, Naoyoshi; Shimbo, Takuro; Yazaki, Hirohisa; Asayama, Naoki; Akiyama, Junichi; Teruya, Katsuji; Igari, Toru; Ohmagari, Norio; Oka, Shinichi; Uemura, Naomi

    2012-01-01

    Background The diagnosis of gastrointestinal (GI) involvement in Kaposi's sarcoma (KS) is important to make because the need for treatment depends on the extent of the disease. Moreover, severe GI lesions can cause serious complications. Endoscopy with biopsy is an extremely useful method to diagnose GI-KS. However, determining the indications for endoscopy is difficult because KS can occur without GI symptoms or cutaneous KS. This study sought to clarify predictive clinical factors for GI-KS and its severity on endoscopy. Methodology/Principal Findings A total of 1,027 HIV-infected patients who underwent endoscopy were analyzed. Sexual behavior, CD4 count, HIV RNA, history of highly active antiretroviral therapy (HAART), GI symptoms, and cutaneous KS were assessed. Endoscopic severity including bulky tumor, ulceration, and number of lesions were evaluated. Thirty-three patients had GI-KS and 46 patients cutaneous KS. Among the GI-KS patients, 78.8% (26/33) had no GI symptoms and 24.2% (8/33) had no cutaneous KS. Univariate analysis identified men who have sex with men (MSM), CD4 <100 cells/µL, HIV RNA ?10,000 copies/mL, no history of HAART, and cutaneous KS were significantly associated with GI-KS. Among these factors, cutaneous KS was closely related to GI-KS on multivariable analysis. Among patients without cutaneous KS, MSM and CD4 count <100 cells/µL were the only independent clinical factors related to GI-KS. Bulky tumor was significantly associated with CD4 <100 cells/µL and large number of lesions was significantly associated with HIV-RNA ?10,000 copies/mL. Conclusions To diagnose GI-KS, clinical factors need to be considered before endoscopy. The presence of GI symptoms is not useful in predicting GI-KS. MSM and CD4 count <100 cells/µL are predictive factors among patients without cutaneous KS. Caution should be exercised especially in patients with low CD4 counts or high HIV viral loads as they are more likely to develop severe GI-KS lesions. PMID:23226197

  7. Gastrointestinal Symptoms of Marathon Runners

    PubMed Central

    Keeffe, Emmet B.; Lowe, Daniel K.; Goss, J. Richard; Wayne, Robert

    1984-01-01

    A survey of 707 participants in the 13th Annual Trail's End Marathon in Seaside, Oregon, showed a high incidence of gastrointestinal disturbances, predominantly of the lower tract, associated with long-distance running. The urge to defecate, both during and immediately after running, occurred in over a third of runners. Bowel movements (35%) and diarrhea (19%) were relatively common after running, and runners occasionally interrupted hard runs or races for bowel movements (18%) or diarrhea (10%). Lower gastrointestinal disturbances were more frequent in women than in men and in younger than in older runners. Awareness of the frequency and nature of gastrointestinal symptoms documented by this survey will assist physicians in evaluating abdominal complaints in runners. PMID:6506684

  8. Gastrointestinal symptoms of marathon runners.

    PubMed

    Keeffe, E B; Lowe, D K; Goss, J R; Wayne, R

    1984-10-01

    A survey of 707 participants in the 13th Annual Trail's End Marathon in Seaside, Oregon, showed a high incidence of gastrointestinal disturbances, predominantly of the lower tract, associated with long-distance running. The urge to defecate, both during and immediately after running, occurred in over a third of runners. Bowel movements (35%) and diarrhea (19%) were relatively common after running, and runners occasionally interrupted hard runs or races for bowel movements (18%) or diarrhea (10%). Lower gastrointestinal disturbances were more frequent in women than in men and in younger than in older runners. Awareness of the frequency and nature of gastrointestinal symptoms documented by this survey will assist physicians in evaluating abdominal complaints in runners. PMID:6506684

  9. Therapeutic Vaccines for Gastrointestinal Cancers

    PubMed Central

    Rahma, Osama E.

    2011-01-01

    Despite progress in the management of gastrointestinal malignancies, these diseases remain devastating maladies. Conventional treatment with chemotherapy and radiation is still only partially effective and highly toxic. In the era of increasing knowledge of the molecular biology of tumors and the interaction between the tumor and immune system, the development of targeted agents, including cancer vaccines, has emerged as a promising modality. In this paper, we discuss the principals of vaccine development, and we review most of the published trials on gastrointestinal cancer vaccines that have been conducted over the last decade. Many antigens and various treatment approaches have already been tested in colon, pancreatic, and other cancers. Some of these approaches have already shown some clinical benefit. In this paper, we discuss these different strategies and some of the future directions for targeting gastrointestinal malignancies with vaccines. PMID:22298988

  10. Development of a fluorescence video endoscopy imaging system for the early detection of cancer in the gastrointestinal tract

    NASA Astrophysics Data System (ADS)

    Zeng, Haishan; Weiss, Alan; MacAulay, Calum E.; MacKinnon, Nick; Cline, Richard W.; Dawson, Remy

    1997-06-01

    The utility of autofluorescence imaging for the early detection of lung cancer has been previously demonstrated. The aim of this work is to extend the use of real time autofluorescence imaging to the early detection of cancer of the esophagus, stomach, and colon. A prototype fluorescence imaging system was developed which produces real time video images of tissue autofluorescence. The system consist of a filtered blue light source, two intensified CCD cameras, a fiber optic endoscope, and a computer based control center. The system produces a real time pseudo color display based on images acquired from two fluorescence bands. These bands were selected based on in vivo fluorescence spectroscopic studies. The generated pseudo image clearly delineates the abnormal tissue areas for biopsy. Early cancer sties missed under conventional white light examination became visible under fluorescence imaging. A further development allows the fluorescence imaging system to be used in an alternate fashion. The system captures a fluorescence image in the green and a reflectance image in the red-near IR. Different spectral information was exploited in the two imaging modes.

  11. Dexmedetomidine-ketamine sedation during upper gastrointestinal endoscopy and biopsy in a patient with Duchenne muscular dystrophy and egg allergy

    PubMed Central

    Raman, Vidya; Yacob, Desale; Tobias, Joseph D

    2012-01-01

    Sedation during invasive procedures provides appropriate humanitarian care as well as facilitating the completion of procedure. Although generally safe and effective, adverse effects may occur especially in patients with co-morbid diseases. In many cases, given its rapid onset and offset, propofol is chosen to provide sedation during various invasive procedures. We present a nine-year-old, 45 kg child with Duchenne muscular dystrophy (DMD) who presented for esophagogastroduodenoscopy (EGD). Given the egg allergy, which was a relative contraindication to the use of propofol, and the potential risk of malignant hyperthermia due to DMD, a combination of dexmedetomidine and ketamine was used for procedural sedation. Dexmedetomidine was administered as a loading dose of 1 ?g/kg along with a single bolus dose of ketamine (1 mg/kg). This was followed by a dexmedetomidine infusion at 0.5 ?g/kg/hour. The patient tolerated the procedure well and was discharged to home. Previous reports regarding the use of dexmedetomidine and ketamine for procedural sedation are reviewed and the potential efficacy of this combination is discussed. PMID:22624101

  12. Motion management in gastrointestinal cancers.

    PubMed

    Abbas, Hassan; Chang, Bryan; Chen, Zhe Jay

    2014-06-01

    The presence of tumor and organ motions complicates the planning and delivery of radiotherapy for gastrointestinal cancers. Without proper accounting of the movements, target volume could be under-dosed and the nearby normal critical organs could be over-dosed. This situation is further exacerbated by the close proximity of abdominal tumors to many normal organs at risk (OARs). A number of strategies have been developed to deal with tumor and organ motions in radiotherapy. This article presents a review of the techniques used in the evaluation, quantification, and management of tumor and organ motions for radiotherapy of gastrointestinal cancers. PMID:24982771

  13. Gastrointestinal stromal tumour in pregnancy

    PubMed Central

    Stubbs, Benjamin Michael; Desai, Ankit; Singh, Seema; Seddon, Beatrice; Khan, Farrukh

    2011-01-01

    Gastrointestinal stromal tumour (GIST) in pregnancy is rare. There have been only three previously reported cases, all of which have been diagnosed on postoperative histology. The authors present the first case of a preoperatively diagnosed GIST arising in a 31-year-old pregnant woman. With a suspected diagnosis, the patient was managed through a combined obstetric and upper gastrointestinal multidisciplinary team meeting, resulting in planned early caesarean section and surgical removal of the tumour. This case emphasises the fact that early and effective multidisciplinary discussion allows for proper treatment planning and more informed patient decisions. PMID:22689595

  14. Review of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography using several endoscopic methods in patients with surgically altered gastrointestinal anatomy

    PubMed Central

    Shimatani, Masaaki; Takaoka, Makoto; Tokuhara, Mitsuo; Miyoshi, Hideaki; Ikeura, Tsukasa; Okazaki, Kazuichi

    2015-01-01

    The endoscopic approach for biliary diseases in patients with surgically altered gastrointestinal anatomy (SAGA) had been generally deemed impractical. However, it was radically made feasible by the introduction of double balloon endoscopy (DBE) that was originally developed for diagnosis and treatments for small-bowel diseases. Followed by the subsequent development of single-balloon endoscopy (SBE) and spiral endoscopy (SE), interventions using several endoscopes for biliary disease in patients with SAGA widely gained an acceptance as a new modality. Many studies have been made on this new technique. Yet, some problems are to be solved. For instance, the mutual unavailability among devices due to different working lengths and channels, and unestablished standardization of procedural techniques can be raised. Additionally, in an attempt to standardize endoscopic procedures, it is important to evaluate biliary cannulating methods by case with existence of papilla or not. A full comprehension of the features of respective scope types is also required. However there are not many papers written as a review. In our manuscript, we would like to evaluate and make a review of the present status of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography applying DBE, SBE and SE for biliary diseases in patients with SAGA for establishment of these modalities as a new technology and further improvement of the scopes and devices. PMID:26078830

  15. Development of enterohepatic fistula after embolization in ileal gastrointestinal stromal tumor: a case report.

    PubMed

    Lee, Yun Ho; Koo, Ja Seol; Jung, Chang Ho; Chung, Sang Yoon; Lee, Jae Joong; Kim, Seung Young; Hyun, Jong Jin; Jung, Sung Woo; Choung, Rok Seon; Lee, Sang Woo; Choi, Jai Hyun

    2013-11-21

    Gastrointestinal stromal tumor (GIST) is a rare mesenchymal tumor of the gastrointestinal tract that has been associated with the formation of fistulas to adjacent organs in few case reports. However, GIST with enterohepatic fistula has not been reported. Here we report the case of an enterohepatic fistula that occurred after embolization of a liver mass originating in the distal ileum. An 87-year-old woman was hospitalized for melena. On initial conventional endoscopy, a bleeding focus in the gastrointestinal tract was not found. Because of massive hematochezia, enteroscopy was performed through the anus. A protruding, ulcerative mass was found in the distal ileum that was suspected to be the source of the bleeding; a biopsy sample was taken. Electrocoagulation was not successful in controlling the bleeding; therefore, embolization was performed. After embolization, the patient developed a high fever and severe abdominal tenderness with rebound tenderness. Follow-up abdominopelvic computed tomography revealed an enterohepatic fistula between the liver and distal ileum. The fistula was treated surgically by segmental resection of the distal ileum and unlooping of the liver mass. PMID:24282371

  16. [Gastrointestinal manifestations of acquired immunodeficiency syndrome; case studies of 14 patients].

    PubMed

    Bengoa, J M; Widgren, S

    1986-10-01

    The gastrointestinal manifestations seen in acquired immune deficiency syndrome (AIDS) are discussed based on the observation of 14 patients with a positive serology for LAV/HTLV III antibody. AIDS was confirmed in 8 cases and AIDS related complex (ARC) in 6 cases. Risk groups included 6 homosexuals, 6 drug abusers and 2 patients from Zaïre. All the AIDS cases underwent gastrointestinal endoscopy and biopsy; in 5 patients a necropsy was performed. Evaluation of the immune status showed lymphopenia and a decreased ratio of OKT4/OKT8. Clinical and pathological observations are discussed sequentially. Acute esophagitis includes cases of Candida albicans super-infection, cytomegalovirus and herpes simplex. Acute enteritis and colitis were seen in association with cryptosporidium, Isospora belli and CMV. 3 cases were found to have chronic duodenitis and malabsorption. Digestive lesions of Kaposi's sarcoma were seen in 3 cases. Diagnosis and treatment of gastrointestinal infections in AIDS is important in view of the high morbidity and serious secondary complications. PMID:3775342

  17. Caustic injury of the upper gastrointestinal tract: A comprehensive review

    PubMed Central

    Contini, Sandro; Scarpignato, Carmelo

    2013-01-01

    Prevention has a paramount role in reducing the incidence of corrosive ingestion especially in children, yet this goal is far from being reached in developing countries, where such injuries are largely unreported and their true prevalence simply cannot be extrapolated from random articles or personal experience. The specific pathophysiologic mechanisms are becoming better understood and may have a role in the future management and prevention of long-term consequences, such as esophageal strictures. Whereas the mainstay of diagnosis is considered upper gastrointestinal endoscopy, computed tomography and ultrasound are gaining a more significant role, especially in addressing the need for emergency surgery, whose morbidity and mortality remains high even in the best hands. The need to perform emergency surgery has a persistent long-term negative impact both on survival and functional outcome. Medical or endoscopic prevention of stricture is debatable, yet esophageal stents, absorbable or not, show promising data. Dilatation is the first therapeutic option for strictures and bougies should be considered especially for long, multiple and tortuous narrowing. It is crucial to avoid malnutrition, especially in developing countries where management strategies are influenced by malnutrition and poor clinical conditions. Late reconstructive surgery, mainly using colon transposition, offers the best results in referral centers, either in children or adults, but such a difficult surgical procedure is often unavailable in developing countries. Possible late development of esophageal cancer, though probably overemphasized, entails careful and long-term endoscopic screening. PMID:23840136

  18. Time-resolved spectrofluorometer for clinical tissue characterization during endoscopy

    NASA Astrophysics Data System (ADS)

    Glanzmann, Thomas; Ballini, Jean-Pierre; van den Bergh, Hubert; Wagnières, Georges

    1999-10-01

    Time-resolved fluorescence spectroscopy has the potential to provide more information for the detection of early cancer than continuous wave spectroscopy. A new optical fiber-based spectrofluorometer for time-resolved fluorescence spectroscopy of biological tissue during clinical endoscopy is presented. The apparatus is based on a nitrogen laser pumping a dye laser as excitation source and a streak camera coupled with a spectrograph as time-resolved spectrometer. The excitation and fluorescence light is carried by an optical fiber to the tissue under investigation and back to the detector, respectively. This optical fiber can be inserted into the biopsy channel of a conventional endoscope. Hence, the apparatus can be used to perform in situ tissue characterization during endoscopy. The instrument enables the measurement of the decays of entire fluorescence spectra within 15 s with a dynamic range of the spectro-temporal images of up to three orders of magnitude. Luminescence lifetimes from the sub ns up to the ms range can be measured. Spectral and temporal resolution, sensitivity, and dynamic range of the instrumentation were determined. The accuracy of the apparatus was checked by the measurement of the fluorescence lifetimes of various fluorophores with known lifetimes. For the first time, two-dimensional time-resolved spectra with sub-ns temporal resolution of tissue fluorescence of the human bladder, the bronchi, and the esophagus taken during endoscopy are presented as a demonstration of performance of the instrumentation. The excitation wavelengths were 337 nm in the case of the bladder and the esophagus and 480 nm in the case of the bronchi. Lifetime contrasts between normal and neoplastic tissue were found in all three organs. The spectral analysis of the fluorescence decays showed that the fluorescence between 370 and 490 nm, excited at 337 nm, consisted in several overlapping spectra. In the case of the esophagus, the contrast between normal and tumoral tissue was inverse in two different spectral bands proving the importance of the choice of the appropriate spectral range for time-resolved autofluorescence measurements for an optimal contrast. The in vivo fluorescence decay of the photosensitizers 5-aminolevulinic acid hexylester hydrochloride-induced protoporphyrin IX was measured in the human bladder and found to be mono-exponential with a lifetime of 15.9 (±1.2) ns. An in vivo fluorescence lifetime of 8.5 (±0.8) ns was found in the case of the photosensitizer 5, 10, 15, 20-tetra(m-hydroxyphenyl)chlorin (mTHPC) in the esophagus.

  19. Automatic detection of small bowel tumors in capsule endoscopy based on color curvelet covariance statistical texture descriptors.

    PubMed

    Barbosa, Daniel J C; Ramos, Jaime; Correia, José Higino; Lima, Carlos S

    2009-01-01

    Traditional endoscopic methods do not allow the visualization of the entire Gastrointestinal (GI) tract. Wireless Capsule Endoscopy (CE) is a diagnostic procedure that overcomes this limitation of the traditional endoscopic methods. The CE video frames possess rich information about the condition of the stomach and intestine mucosa, encoded as color and texture patterns. It is known for a long time that human perception of texture is based in a multi-scale analysis of patterns, which can be modeled by multi-resolution approaches. Furthermore, modeling the covariance of textural descriptors has been successfully used in classification of colonoscopy videos. Therefore, in the present paper it is proposed a frame classification scheme based on statistical textural descriptors taken from the Discrete Curvelet Transform (DCT) domain, a recent multi-resolution mathematical tool. The DCT is based on an anisotropic notion of scale and high directional sensitivity in multiple directions, being therefore suited to characterization of complex patterns as texture. The covariance of texture descriptors taken at a given detail level, in different angles, is used as classification feature, in a scheme designated as Color Curvelet Covariance. The classification step is performed by a multilayer perceptron neural network. The proposed method has been applied in real data taken from several capsule endoscopic exams and reaches 97.2% of sensitivity and 97.4% specificity. These promising results support the feasibility of the proposed method. PMID:19964706

  20. Endoscopy and the Risk of Venous Thromboembolism: A Case-Control Study

    PubMed Central

    Venkatachalapathy, S. V.; Evans, G.; Muller, A. F.

    2014-01-01

    Background and Study Aims To assess whether there was an association between endoscopy and the risk of venous thromboembolism (VTE). Patients and Methods Retrospective case?–?control study of patients diagnosed with VTE over a 3-year period. Each was age- and sex-matched to one of three controls who attended an outpatient appointment on the same date as that of the diagnosis of VTE in the patients. Patients who had undergone endoscopy within 90 days of VTE were included. On a second analysis, patients who were hospitalized and those with inflammatory bowel disease or malignancy were excluded. The difference in occurrence of endoscopy between cases and controls was examined using the McNemar test. The risk of VTE occurring following endoscopy was quantified by means of odds ratios. Results Forty-five of 436 patients (10.3?%) had undergone an endoscopy in the VTE group compared with 14?/436 controls (3.2?%; P?endoscopy as for controls (2.92 [95?% CI 1.51, 5.62]; P?=?0.001). When patients with inflammatory bowel disease or malignancy were also excluded, no difference was found between patients undergoing endoscopy and controls (1.92 [0.95, 3.85]; P?=?0.07). Ten percent of patients with VTE underwent endoscopy in the 3 months before the diagnosis compared with 3?% of controls (P?endoscopy performed and VTE risk. Conclusions When those with known risk factors for VTE were excluded, no significant increased risk of VTE was found.

  1. Cannabinoids and the gastrointestinal tract

    Microsoft Academic Search

    R G PERTWEE

    2001-01-01

    The enteric nervous system of several species, including the mouse, rat, guinea pig and humans, contains cannabinoid CB1receptors that depress gastrointestinal motility, mainly by inhibiting ongoing contractile transmitter release. Signs of this depressant effect are, in the whole organism, delayed gastric emptying and inhibition of the transit of non-absorbable markers through the small intestine and, in isolated strips of ileal

  2. Anthrax of the Gastrointestinal Tract

    Microsoft Academic Search

    Thira Sirisanthana; Arthur E. Brown

    When swallowed, anthrax spores may cause lesions from the oral cavity to the cecum. Gastrointestinal anthrax is greatly underreported in rural disease-endemic areas of the world. The apparent paucity of this form of anthrax reflects the lack of facilities able to make the diagnosis in these areas. The spectrum of disease, ranging from subclinical infection to death, has not been

  3. [Motility and functional gastrointestinal disorders].

    PubMed

    Mearin, Fermín; Rey, Enrique; Balboa, Agustín

    2014-09-01

    This article discusses the studies on functional and motor gastrointestinal disorders presented at the 2014 Digestive Diseases Week conference that are of greatest interest to us. New data have been provided on the clinical importance of functional gastrointestinal disorders, with recent prevalence data for irritable bowel syndrome and fecal incontinence. We know more about the pathophysiological mechanisms of the various functional disorders, especially irritable bowel syndrome, which has had the largest number of studies. Thus, we have gained new data on microinflammation, genetics, microbiota, psychological aspects, etc. Symptoms such as abdominal distension have gained interest in the scientific community, both in terms of patients with irritable bowel syndrome and those with constipation. From the diagnostic point of view, the search continues for a biomarker for functional gastrointestinal disorders, especially for irritable bowel syndrome. In the therapeutic area, the importance of diet for these patients (FODMAP, fructans, etc.) is once again confirmed, and data is provided that backs the efficacy of already marketed drugs such as linaclotide, which rule out the use of other drugs such as mesalazine for patients with irritable bowel syndrome. This year, new forms of drug administration have been presented, including metoclopramide nasal sprays and granisetron transdermal patches for patients with gastroparesis. Lastly, a curiosity that caught our attention was the use of a vibrating capsule to stimulate gastrointestinal transit in patients with constipation. PMID:25294261

  4. Gastrointestinal manifestations of HIV infection

    Microsoft Academic Search

    D Sharpstone; B Gazzard

    1996-01-01

    Most of the morbidity and mortality of late AIDS is associated with gastrointestinal disease. Whilst oesophageal candidosis responds readily to treatment and cytomegalovirus enteritis may be cleared by antiviral agents, the two commonest protozoal pathogens— Microsporidia and Cryptosporidia—cannot be eradicated. These protozoa cause disruption of small-bowel villus architecture by unknown mechanisms and severe malabsorption, maldigestion, and diarrhoea. Weight loss is

  5. Gastrointestinal pathology in South America.

    PubMed

    Rolón, P A

    1979-04-01

    Non-neoplastic gastrointestinal disease in South America is largely related to environmental conditions. Parasitic disorders, including Chagas' disease with megacolon, predominate in endemic regions. Common enteritides of various etiologie are frequent, whereas appendicits, diverticulosis of the colon, ulcerative colitis and Crohn's disease are extremely rare. There was no appendicitis in native Indians of Paraguay. PMID:109417

  6. Cutaneous manifestations of gastrointestinal diseases

    Microsoft Academic Search

    Erin E. Boh; Raed Mahmoud

    There are a myriad of dermatologic disorders asso- ciated with gastrointestinal (GI) diseases. This article covers the common dermatologic conditions that may be associated with underlying GI diseases and several uncommon conditions that the dermatologist should recognize as being associated with GI disor- ders. Table 1 presents an outline of the diseases that are covered. Inflammatory bowel diseases Inflammatory disorders

  7. Single Nanowire Probe for Single Cell Endoscopy and Sensing

    NASA Astrophysics Data System (ADS)

    Yan, Ruoxue

    The ability to manipulate light in subwavelength photonic and plasmonic structures has shown great potentials in revolutionizing how information is generated, transformed and processed. Chemically synthesized nanowires, in particular, offers a unique toolbox not only for highly compact and integrated photonic modules and devices, including coherent and incoherent light sources, waveguides, photodetectors and photovoltaics, but also for new types of nanoscopic bio-probes for spot cargo delivery and in-situ single cell endoscopy and sensing. Such nanowire probes would enable us to carry out intracellular imaging and probing with high spatial resolution, monitor in-vivo biological processes within single living cells and greatly improve our fundamental understanding of cell functions, intracellular physiological processes, and cellular signal pathways. My work is aimed at developing a material and instrumental platform for such single nanowire probe. Successful optical integration of Ag nanowire plasmonic waveguides, which offers deep subwavelength mode confinement, and conventional photonic waveguides was demonstrated on a single nanowire level. The highest plasmonic-photonic coupling efficiency coupling was found at small coupling angles and low input frequencies. The frequency dependent propagation loss was observed in Ag nanowire and was confirmed by quantitative measurement and in agreement with theoretical expectations. Rational integration of dielectric and Ag nanowire waveguide components into hybrid optical-plasmonic routing devices has been demonstrated. This capability is essential for incorporating sub-100nm Ag nanowire waveguides into optical fiber based nanoprobes for single cell endoscopy. The nanoprobe system based on single nanowire waveguides was demonstrated by optically coupling semiconductor or metal nanowire with an optical fiber with tapered tip. This nanoprobe design requires minimal instrumentation which makes it cost efficient and readily adaptable to average bio-lab environment. These probes are mechanically robust and flexible and can withstand repeated bending and deformation without significant deterioration in optical performance, which offers an ideal instrumental platform for out subsequent effort of using these nanoprobes in chemical sensing as well as single cell endoscopy and spot delivery. Parameters affecting the coupling efficiency and output power of the nanoprobe were studied and chemical etched of single mode fiber with small cone angle was established to be optimized for highly effective optical nanoprobes. The versatility of the nanoprobe design was first tested by transforming the nanowire probe into a pH sensor with near-field photopolymerization of a copolymer containing pH sensitive dye on the tip of the nanowire. The pH-sensitive nanoprobe was able to report the pH difference in micro-droplets containing buffer solution with the excitation of light waveguided on the nanoprobe with internal calibration, fast response time and good photostability and reversibility. Such nanoprobe sensors are ideal for high definition spatial and temporal sensing of concentration profile, especially for the kinetic processes in single cell studies for which chemical probes of minute sizes and fast response are desired. The nanoprobe was then applied into spot cargo delivery and in-situ single cell endoscopy. It was demonstrated that nanowire-based optical probe can deliver payloads into the cell with a high spatiotemporal precision, guide and confine visible light into intracellular compartments selectively and detect optical signals from the subcellular regions with high spatial resolution. The nanoprobe was proven to be biocompatible and non-invasive. The effective optical coupling between the fiber optics and the nanowire enables highly localized excitation and detection, limiting the probe volume to the close proximity of the nanowire. None the less, this versatile technique does not rely on any expensive or bulky instrumentation, and relies only on micromanipulator and optical microscope th

  8. Electromechanical performance of piezoelectric scanning mirrors for medical endoscopy

    PubMed Central

    Gilchrist, Kristin H.; Dausch, David E.; Grego, Sonia

    2012-01-01

    The electromechanical performance of piezoelectric scanning mirrors for endoscopy imaging is presented. The devices are supported by a single actuating cantilever to achieve a high fill factor, the ratio of mirror area to the combined mirror and actuator area. The largest fill factor devices (74%) achieved 10° mechanical scan range at +/?10V with a 300 ?m long cantilever. The largest angular displacement of 30° mechanical scan range was obtained with a 500 ?m long cantilever device with a 63% fill factor driven at 40 Vpp. A systematic investigation of device performance (displacement and speed) as a function of fabrication and operational parameters including the stress balance in the cantilever revealed unexpectedly large displacements with lack of inversion at the coercive field. An interpretation of the results is presented based on piezoelectric film domain orientation and clamping with supporting piezoelectric film characterization measurements. PMID:22773894

  9. Wireless capsule endoscopy as a tool in diagnosing autoimmune enteropathy.

    PubMed

    Gram-Kampmann, Eva-Marie; Lillevang, Søren T; Detlefsen, Sönke; Laursen, Stig Borbjerg

    2015-01-01

    Autoimmune enteropathy (AE) is an immune mediated illness of the intestinal mucosa. The cause is unknown, and the diagnosis is based on typical characteristics displayed. There is no gold standard for treatment. We present two adult cases of AE and demonstrate the challenges in establishing the diagnosis. The extensive diagnostic work up excluded other more common causes of protracted diarrhoea. Wireless capsule endoscopy (WCE) displayed universal small intestinal mucosal damage with shortened villi that led to the suspicion of AE in both patients. The diagnosis was confirmed with microscopy, showing shortened villi, villous blunting and hyperplasia of crypts in both patients. In one patient, deep crypt lymphocytosis with minimal intraepithelial lymphocytosis was found as well. Both patients were successfully treated with high-dose immunosuppressant therapy to induce and maintain remission. Use of WCE as a diagnostic tool was invaluable in establishing the diagnosis of AE. PMID:26150615

  10. PDE-based three dimensional path planning for virtual endoscopy.

    PubMed

    Hassouna, M Sabry; Farag, A A

    2005-01-01

    Three dimensional medial paths or curve skeletons (CS) are an essential component of any virtual endoscopy (VE) system, because they serve as flight paths for a virtual camera to navigate the human organ and to examine its internal structures. In this paper, we propose a novel framework for computing flight paths of tubular structures for VE using partial differential equation (PDE). The method works in two passes. In the first pass, the overall topology of the organ is analyzed and its important topological nodes are identified, while in the second pass, the actual flight paths are computed by tracking them starting from each identified node. The proposed framework is robust, fully automatic, computationally efficient, and computes CS that are centered, connected, thin, and less sensitive to boundary noise. We have extensively validated the robustness of the proposed method both quantitatively and qualitatively against several synthetic phantoms and clinical datasets. PMID:17354723

  11. Obstructive sleep apnea and sedation in the endoscopy suite.

    PubMed

    Moos, Daniel D

    2006-01-01

    Patients with obstructive sleep apnea are at risk of mortality and morbidity related to the administration of sedatives, anesthetics, and opioids. Commonly employed sedatives and analgesics promote pharyngeal collapse and alter normal respiratory responses to obstruction and apnea. Literature concerning patients with obstructive sleep apnea undergoing moderate and deep sedation in the endoscopy suite is lacking. The purpose of this article is to provide the reader with a review of normal airway patency, the effects of obstructive sleep apnea on airway patency, and the impact that analgesics and sedatives may impart on the airway of patients with obstructive sleep apnea. The goal of this article is to increase awareness, stimulate discussions within the gastroenterological community, and encourage research regarding sedation in this at-risk population. PMID:17273012

  12. Diagnosis of Adult Chronic Rhinosinusitis: Can Nasal Endoscopy Predict Intrasinus Disease?

    PubMed Central

    Kolethekkat, Arif Ali; Paul, Roshna Rose; Kurien, Mary; Kumar, Shyam; Al Abri, Rashid; Thomas, Kurien

    2013-01-01

    Objectives To define the role of endoscopic evaluation of middle meatus in adult patients clinically diagnosed to have chronic rhino-sinusitis and its ability to predict intra-sinus mucosal involvement as compared to CT scan. Methods This prospective analytical study was conducted on consecutive patients with diagnosis of chronic rhino-sinusitis who were symptomatic and fulfilled the American Academy of Otolaryngology - Head and Neck Surgery Task Force criteria. The patients were enrolled prospectively and were subjected to rigid diagnostic nasal endoscopy and classified as defined by the revised Sinus Allergy Health Partnership Task Force criteria. The patients then underwent non contrast CT sinuses on the same day. Results were analyzed as a diagnostic test evaluation using CT as a gold standard. Results Among the 75 study patients with symptom based chronic rhino-sinusitis, nasal endoscopy was abnormal in 65 patients (87%). Of these patients, 60/65 (92%) showed positive findings on CT scan. Ten patients had normal endoscopy, of these 6/10 (60%) had abnormal CT scan. Sensitivity and specificity of diagnostic nasal endoscopy against CT scan were 91% (95% CI: 81-97) and 44% (95% CI: 14-79), respectively. The likelihood ratio for positive nasal endoscopy to diagnose chronic rhino-sinusitis was 1.6 and the likelihood ratio to rule out chronic rhino-sinusitis when endoscopy was negative was 0.2. Conclusion Nasal endoscopy is a valid and objective diagnostic tool in the work up of patients with symptomatic chronic rhino-sinusitis. When clinical suspicion is low (<50%) and endoscopy is negative, the probability of rhino-sinusitis is very low (<17%) and there is no need to perform a CT scan to reconfirm this finding routinely. Endoscopy alone is able to diagnose chronic rhino-sinusitis in >90% of patients when clinical suspicion is high (88%) as defined in this study by AAO-HNS Task Force criteria. Negative endoscopy, however, does not totally exclude the sinus disease in patients fulfilling task force criteria. CT scan may be needed on follow-up if there is clinical suspicion in 10% of these patients who are negative on endoscopy if symptoms persists. It is thus possible to reduce the number of CT scans if patients are carefully selected based on clinical criteria and endoscopy is done initially as part of their evaluation. PMID:24223247

  13. Hepatic Portal Venous Gas: An Unusual Complication Following Upper Endoscopy and Dilation

    PubMed Central

    Seeger, Kristina

    2014-01-01

    Hepatic portal venous gas (HPVG), a rare condition in which gas accumulates in the portal venous circulation, is often associated with a significant underlying pathology, such as intestinal ischemia, sepsis, and trauma. HPVG after endoscopy or dilation is an unusual complication. We report a case of HPVG following upper endoscopy and dilation for an esophageal stricture in a 34-year-old patient with eosinophilic esophagitis (EoE). The patient was treated conservatively, and his symptoms resolved. Follow-up computed tomography (CT) scan showed resolution of HPVG. This case highlights a rare and potentially ominous complication of upper endoscopy and dilation and underscores the role of conservative management.

  14. Management of non-variceal upper gastrointestinal tract hemorrhage: Controversies and areas of uncertainty

    PubMed Central

    Trawick, Eric P; Yachimski, Patrick S

    2012-01-01

    Upper gastrointestinal tract hemorrhage (UGIH) remains a common presentation requiring urgent evaluation and treatment. Accurate assessment, appropriate intervention and apt clinical skills are needed for proper management from time of presentation to discharge. The advent of pharmacologic acid suppression, endoscopic hemostatic techniques, and recognition of Helicobacter pylori as an etiologic agent in peptic ulcer disease (PUD) has revolutionized the treatment of UGIH. Despite this, acute UGIH still carries considerable rates of morbidity and mortality. This review aims to discuss current areas of uncertainty and controversy in the management of UGIH. Neoadjuvant proton pump inhibitor (PPI) therapy has become standard empiric treatment for UGIH given that PUD is the leading cause of non-variceal UGIH, and PPIs are extremely effective at promoting ulcer healing. However, neoadjuvant PPI administration has not been shown to affect hard clinical outcomes such as rebleeding or mortality. The optimal timing of upper endoscopy in UGIH is often debated. Upon completion of volume resuscitation and hemodynamic stabilization, upper endoscopy should be performed within 24 h in all patients with evidence of UGIH for both diagnostic and therapeutic purposes. With rising healthcare cost paramount in today’s medical landscape, the ability to appropriately triage UGIH patients is of increasing value. Upper endoscopy in conjunction with the clinical scenario allows for accurate decision making concerning early discharge home in low-risk lesions or admission for further monitoring and treatment in higher-risk lesions. Concomitant pharmacotherapy with non-steroidal anti-inflammatory drugs (NSAIDs) and antiplatelet agents, such as clopidogrel, has a major impact on the etiology, severity, and potential treatment of UGIH. Long-term PPI use in patients taking chronic NSAIDs or clopidogrel is discussed thoroughly in this review. PMID:22468078

  15. Massive upper gastrointestinal bleeding from an accessory splenic artery mimicking isolated gastric varices.

    PubMed

    Kervancioglu, S; Yilmaz, F G; Gulsen, M; Kervancioglu, P; Kervancioglu, R

    2013-11-01

    Knowledge of anatomical variations of coeliac trunk and its branches is important for surgeons and interventional radiologists planning surgical and radiological interventions. We describe a case of a 42-year-old male with an accessory splenic artery (ASA) originating from the left gastric artery (LGA) running in the wall of gastric fundus and mimicking isolated gastric varices, which was observed during endoscopy. Bleeding from this artery was massive and was managed with endovascular coil embolisation. Coeliac angiography of the patient with upper gastrointestinal bleeding showed that the coeliac trunk divided into 3 arteries: the LGA, the splenic artery, and the right hepatic artery. Additionally, the variations of ASA and the left hepatic artery arising from LGA, and the left and right inferior phrenic arteries arising from ASA were identified. This case is the first to be presented in the literature with ASA originating from LGA that was situated in the gastric wall where inferior phrenic arteries arose from the ASA. PMID:24402761

  16. [Approach to the diagnosis and treatment of chronic anemia secondary to gastrointestinal diseases].

    PubMed

    Rodríguez-Moranta, Francisco; Rodríguez-Alonso, Lorena; Guardiola Capón, Jordi

    2014-12-01

    Iron deficiency anemia is the most common type of anemia and can cause asthenia, cognitive and functional impairment, and decompensation of underlying diseases. Iron deficiency anemia is not a disease but is the result of a potentially serious medical problem. Consequently, patients should always undergo investigation of the underlying cause. In men and postmenopausal women, the condition is caused by gastrointestinal loss and malabsorption of iron. In this group, recommended procedures are gastroscopy, colonoscopy and serological testing for celiac disease. If the results of these tests are negative, repeat examinations and iron therapy should be considered. In treatment-refractory or recurrent anemia, the small intestine should be investigated. In this case, the procedure of choice is capsule endoscopy. Iron deficiency anemia should always be treated until iron deposits have returned to normal levels. A wide variety of preparations are available, in both oral and parental formulations. PMID:25443541

  17. Molecular confocal laser endomicroscopy: A novel technique for in vivo cellular characterization of gastrointestinal lesions

    PubMed Central

    Karstensen, John Gásdal; Klausen, Pia Helene; Saftoiu, Adrian; Vilmann, Peter

    2014-01-01

    While flexible endoscopy is essential for macroscopic evaluation, confocal laser endomicroscopy (CLE) has recently emerged as an endoscopic method enabling visualization at a cellular level. Two systems are currently available, one based on miniprobes that can be inserted via a conventional endoscope or via a needle guided by endoscopic ultrasound. The second system has a confocal microscope integrated into the distal part of an endoscope. By adding molecular probes like fluorescein conjugated antibodies or fluorescent peptides to this procedure (either topically or systemically administered during on-going endoscopy), a novel world of molecular evaluation opens up. The method of molecular CLE could potentially be used for estimating the expression of important receptors in carcinomas, subsequently resulting in immediate individualization of treatment regimens, but also for improving the diagnostic accuracy of endoscopic procedures by identifying otherwise invisible mucosal lesions. Furthermore, studies have shown that fluorescein labelled drugs can be used to estimate the affinity of the drug to a target organ, which probably can be correlated to the efficacy of the drug. However, several of the studies in this research field have been conducted in animal facilities or in vitro, while only a limited number of trials have actually been carried out in vivo. Therefore, safety issues still needs further evaluations. This review will present an overview of the implications and pitfalls, as well as future challenges of molecular CLE in gastrointestinal diseases. PMID:24976717

  18. Ingestion of strong corrosive alkalis: spectrum of injury to upper gastrointestinal tract and natural history.

    PubMed

    Zargar, S A; Kochhar, R; Nagi, B; Mehta, S; Mehta, S K

    1992-03-01

    We have prospectively studied 31 patients who ingested strong alkalis for location, extent, severity, and outcome of the injury to the upper gastrointestinal tract. Alkalis ingested were sodium hydroxide (n = 28) and potassium hydroxide (n = 3). The injury was assessed within 36 h of alkali intake by endoscopy or surgery, or at autopsy. Symptoms and signs did not give a reliable forecast of the extent and severity of injury. The corrosive burns were classified as grade 2a in six patients, grade 2b in eight, and grade 3 in 17. The esophagus was injured in all patients, the stomach in 93.5%, and the duodenum in 29.6%. Acute complications occurred in 32.3% of the patients and death in 12.9%; all but one of such patients had grade 3 burns. All patients with 2a injury recovered without sequelae. Four of the eight patients with grade 2b injury and all survivors of grade 3 injury developed esophageal or gastric cicatrization, or both, which needed endoscopic or surgical treatment. We find endoscopy is not only a safe and reliable tool for diagnosis in such patients, but also is of importance in treatment and prognosis. We conclude that ingestion of strong alkalis is a very serious condition that inflicts severe contiguous injury to the esophagus and stomach and results in high morbidity and mortality. PMID:1539568

  19. Is the anesthesiologist necessary in the endoscopy suite? A review of patients, payers and safety.

    PubMed

    Birk, John; Bath, Roopjeet Kaur

    2015-07-01

    The use of propofol for sedation during endoscopy has been increasing, particularly given its association with superior patient satisfaction. Propofol sedation may also allow for higher quality endoscopy exams, increased efficiency of endoscopy suites and most particularly, permit better patient compliance with colonoscopy for colorectal cancer screening. However, propofol is typically provided by anesthesia specialists via monitored anesthesia care, and is associated with significant economic burden. Given the increasing use of monitored anesthesia care, which adds significant costs to endoscopy, payers are likely to react with changes in payer policies. One alternative to monitored anesthesia care is non-anesthesiologist administered propofol, which due to safety concerns and a lack of reimbursement has not been widely adopted in the US. PMID:25979248

  20. A randomized trial of peroral versus transnasal unsedated endoscopy using an ultrathin videoendoscope

    Microsoft Academic Search

    Atif Zaman; Martin Hahn; Ronald Hapke; Kandice Knigge; M. Brian Fennerty; Ronald M. Katon

    1999-01-01

    Background: Potential advantages of unsedated endoscopy include the prevention of side effects or morbidity related to the use of sedative drugs, less intensive patient monitoring, and less expense. We compared transnasal (T-EGD) with peroral (P-EGD) unsedated endoscopy by using an ultrathin video instrument with respect to patient tolerance and acceptance. Method: Patients were randomized to T-EGD or P-EGD. If the

  1. Lanthanum-Induced Gastrointestinal Histiocytosis

    PubMed Central

    Araya, Hiwot; Longacre, Teri A.; Pasricha, Pankaj J.

    2015-01-01

    A patient with end-stage renal disease (ESRD) on hemodialysis presented with fever, anorexia, and nausea shortly after starting oral lanthanum carbonate for phosphate control. Gastric and duodenal biopsies demonstrated diffuse histiocytosis with intracellular aggregates of basophilic foreign material. Transmission electron microscopy, an underutilized diagnostic test, revealed the nature of the aggregates as heavy metal particles, consistent with lanthanum. Symptoms and histiocytosis improved after discontinuation of lanthanum. Lanthanum may be an underdiagnosed cause of gastrointestinal histiocytosis.

  2. Lanthanum-Induced Gastrointestinal Histiocytosis.

    PubMed

    Rothenberg, Michael E; Araya, Hiwot; Longacre, Teri A; Pasricha, Pankaj J

    2015-04-01

    A patient with end-stage renal disease (ESRD) on hemodialysis presented with fever, anorexia, and nausea shortly after starting oral lanthanum carbonate for phosphate control. Gastric and duodenal biopsies demonstrated diffuse histiocytosis with intracellular aggregates of basophilic foreign material. Transmission electron microscopy, an underutilized diagnostic test, revealed the nature of the aggregates as heavy metal particles, consistent with lanthanum. Symptoms and histiocytosis improved after discontinuation of lanthanum. Lanthanum may be an underdiagnosed cause of gastrointestinal histiocytosis. PMID:26157959

  3. NSAIDs and the gastrointestinal tract

    Microsoft Academic Search

    Maneesh Gupta; Glenn M. Eisen

    2009-01-01

    NSAIDs incur significant gastrointestinal (GI) side effects. The complication risk increases with history of peptic ulcer\\u000a or older age. Helicobacter pylori infection and cardioprotective aspirin have independent and additive risks in the presence of NSAID use. NSAID enteropathy\\u000a is increasingly recognized. Cardiovascular and GI risk stratification and H. pylori infection testing should be done before initiating NSAIDs. An NSAID combined

  4. Role of wireless capsule endoscopy in the follow-up of inflammatory bowel disease.

    PubMed

    Mitselos, Ioannis V; Christodoulou, Dimitrios K; Katsanos, Konstantinos H; Tsianos, Epameinondas V

    2015-06-10

    The introduction of wireless capsule endoscopy in 2000 has revolutionized our ability to visualize parts of the small bowel mucosa classically unreached by the conventional endoscope, and since the recent introduction of colon capsule endoscopy, a promising alternative method has been available for the evaluation of large bowel mucosa. The advantages of wireless capsule endoscopy include its non-invasive character and its ability to visualize proximal and distal parts of the intestine, while important disadvantages include the procedure's inability of tissue sampling and significant incompletion rate. Its greatest limitation is the prohibited use in cases of known or suspected stenosis of the intestinal lumen due to high risk of retention. Wireless capsule endoscopy plays an important role in the early recognition of recurrence, on Crohn's disease patients who have undergone ileocolonic resection for the treatment of Crohn's disease complications, and in patients' management and therapeutic strategy planning, before obvious clinical and laboratory relapse. Although capsule endoscopy cannot replace traditional endoscopy, it offers valuable information on the evaluation of intestinal disease and has a significant impact on disease reclassification of patients with a previous diagnosis of ulcerative colitis or inflammatory bowel disease unclassified/indeterminate colitis. Moreover, it may serve as an effective alternative where colonoscopy is contraindicated and in cases with incomplete colonoscopy studies. The use of patency capsule maximizes safety and is advocated in cases of suspected small or large bowel stenosis. PMID:26078832

  5. Is the Environment of the Endoscopy Unit a Reservoir of Pathogens?

    PubMed Central

    Choi, Eun Sung; Choi, Jae Hyuk; Lee, Jung Min; Lee, Sang Min; Lee, Yoo Jin; Kang, Yu Jin; Cho, Kwang Bum; Park, Kyung Sik; Jang, Byoung Kuk; Hwang, Jae Seok; Chung, Woo Jin; Ryoo, Nam Hee; Jeon, Seong Woo; Jung, Min Kyu

    2014-01-01

    Background/Aims Given the characteristic procedures involved in the endoscopy unit, the spread of pathogens is much more frequent in this unit than in other environments. However, there is a lack of data elucidating the existence of pathogens in the endoscopy unit. The aim of this study was to detect the presence of possible pathogens in the endoscopy unit. Methods We performed environmental culture using samples from the endoscopy rooms of 2 tertiary hospitals. We used sterile cotton-tipped swabs moistened with sterile saline to swab the surfaces of 197 samples. Then, we cultured the swab in blood agar plate. Samples from the colonoscopy room were placed in thioglycollate broth to detect the presence of anaerobes. After 2 weeks of culture period, we counted the colony numbers. Results The most commonly contaminated spots were the doctor's keyboard, nurse's cart, and nurse's mouse. The common organisms found were non-pathogenic bacterial microorganisms Staphylococcus, Micrococcus, and Streptococcus spp.. No definite anaerobe organism was detected in the colonoscopy room. Conclusions Although the organisms detected in the endoscopy unit were mainly non-pathogenic organisms, they might cause opportunistic infections in immunocompromised patients. Therefore, the environment of the endoscopy room should be managed appropriately; moreover, individual hand hygiene is important for preventing possible hospital-acquired infections. PMID:25374497

  6. Role of wireless capsule endoscopy in the follow-up of inflammatory bowel disease

    PubMed Central

    Mitselos, Ioannis V; Christodoulou, Dimitrios K; Katsanos, Konstantinos H; Tsianos, Epameinondas V

    2015-01-01

    The introduction of wireless capsule endoscopy in 2000 has revolutionized our ability to visualize parts of the small bowel mucosa classically unreached by the conventional endoscope, and since the recent introduction of colon capsule endoscopy, a promising alternative method has been available for the evaluation of large bowel mucosa. The advantages of wireless capsule endoscopy include its non-invasive character and its ability to visualize proximal and distal parts of the intestine, while important disadvantages include the procedure’s inability of tissue sampling and significant incompletion rate. Its greatest limitation is the prohibited use in cases of known or suspected stenosis of the intestinal lumen due to high risk of retention. Wireless capsule endoscopy plays an important role in the early recognition of recurrence, on Crohn’s disease patients who have undergone ileocolonic resection for the treatment of Crohn’s disease complications, and in patients’ management and therapeutic strategy planning, before obvious clinical and laboratory relapse. Although capsule endoscopy cannot replace traditional endoscopy, it offers valuable information on the evaluation of intestinal disease and has a significant impact on disease reclassification of patients with a previous diagnosis of ulcerative colitis or inflammatory bowel disease unclassified/indeterminate colitis. Moreover, it may serve as an effective alternative where colonoscopy is contraindicated and in cases with incomplete colonoscopy studies. The use of patency capsule maximizes safety and is advocated in cases of suspected small or large bowel stenosis. PMID:26078832

  7. Pancreatic cystogastrostomy by combined upper endoscopy and percutaneous transgastric instrumentation.

    PubMed

    Atabek, U; Mayer, D; Amin, A; Camishion, R C

    1993-10-01

    Minimally invasive endoscopic and radiologic techniques have been reported for internal gastric drainage of pancreatic pseudocysts but these have significant technical limitations. A purely endoscopic approach to cystogastrostomy provides limited access for instrumentation and hemostasis. Radiologically-guided percutaneous techniques cannot regularly provide an adequately wide cystogastrostomy opening. Reported is a patient who had a pancreatic cystogastrostomy performed using a minimally invasive surgical approach combining upper endoscopy and percutaneous transgastric surgical instrumentation. The upper endoscope essentially served as a camera. A percutaneous endoscopic gastrostomy tube served as a port for inserting laparoscopic instruments into the stomach. The laparoscopic instruments were used to create a 1.5 cm cystogastrostomy opening similar in size to what could be created by an open abdominal approach. The laparoscopy instruments provided good tactile feedback and excellent hemostatic control. Avoiding an open abdominal procedure shortened postoperative recovery and reduced patient discomfort. Although the pseudocyst recurred once, the same procedure was performed again and there has not been a recurrence for 10 months. The authors conclude that this minimally invasive surgical procedure provides an excellent alternative approach for internal drainage of selected pancreatic pseudocysts. PMID:8251667

  8. Gastrointestinal Tract Cancer Screening Using Fecal Carcinoembryonic Antigen

    Microsoft Academic Search

    Yonggoo Kim; Seong Lee; Haemyung Jeon; Wonbae Lee; Jae Kwang Kim; Myungok Cho; Myungshin Kim; Jihyang Lim; Chang Suk Kang; Kyungja Han

    There is a great need to detect gastrointestinal tract cancer at an early stage. It is well known that most carcinoma tissues of the gastrointestinal tract contain carcinoembryonic antigen (CEA). Stools are a rich source of cells derived from the gastrointestinal tract. We analyzed total fecal CEA in 60 gastrointestinal tract cancer patients, 20 benign gastrointestinal tract disorder patients, and

  9. Prognostic factors in upper gastrointestinal bleeding

    Microsoft Academic Search

    Bettina Katschinski; Richard Logan; Jackie Davies; Gail Faulkner; Jim Pearson; Michael Langman

    1994-01-01

    In this study we examined factors of possible prognostic value about outcome in a consecutive series of 2217 patients with hematemesis and melena. Death occurred in 189 (8.5%) patients, and 243 (11%) patients experienced rebleeding. Death was significantly associated with rebleeding, age over 60 years, and the finding of blood in the stomach at endoscopy. Rebleeding was significantly associated with

  10. Poor endoscopic findings in children with non variceal upper gastrointestinal bleeding: is biopsy necessary?

    PubMed Central

    Giannakopoulos, A; Logothetis, A; Panayiotou, J; Van-Vliet, K; Orfanou, I; Roma-Giannikou, E

    2010-01-01

    Background: Gastrointestinal bleeding in infants and children is a potentially serious condition in the practice of general pediatrics that requires investigation. The objective of this study is to describe the endoscopic and histopathological findings in children with upper gastrointestinal (UGI) bleeding of non variceal origin. Patients and Methods: We performed a retrospective study of the medical records of 181 children, aged 1 month to 15.2 years, with non variceal UGI bleeding, who were admitted in our department over the period 1988-2008 and underwent upper GI endoscopy accompanied by histology. Patients were divided in 4 groups according to their age (=0-1 years, = 1-6 years, C=6-12 years, D= 12-16 years). Results: An endoscopically evident bleeding source was detected in only 5% of all patients. Histological examination revealed increased incidence of eosinophilic infiltration in infants, in contrast to all other age groups, where non-specific or H. pylori related inflammation predominated. Peptic ulcer was found in 4.4% of all patients. Conclusion: Although an evident bleeding source was detected in only a small percentage of patients, the accompanying histological examination provided additional information regarding possible underlying diseases and contributed to the subsequent therapeutic management. PMID:21311634

  11. Nodular lymphoid hyperplasia in the gastrointestinal tract in adult patients: A review.

    PubMed

    Albuquerque, Andreia

    2014-11-16

    Nodular lymphoid hyperplasia of the gastrointestinal tract is characterized by the presence of multiple small nodules, normally between between 2 and 10 mm in diameter, distributed along the small intestine (more often), stomach, large intestine, or rectum. The pathogenesis is largely unknown. It can occur in all age groups, but primarily in children and can affect adults with or without immunodeficiency. Some patients have an associated disease, namely, common variable immunodeficiency, selective IgA deficiency, Giardia infection, or, more rarely, human immunodeficiency virus infection, celiac disease, or Helicobacter pylori infection. Nodular lymphoid hyperplasia generally presents as an asymptomatic disease, but it may cause gastrointestinal symptoms like abdominal pain, chronic diarrhea, bleeding or intestinal obstruction. A diagnosis is made at endoscopy or contrast barium studies and should be confirmed by histology. Its histological characteristics include markedly hyperplasic, mitotically active germinal centers and well-defined lymphocyte mantles found in the lamina propria and/or in the superficial submucosa, distributed in a diffuse or focal form. Treatment is directed towards associated conditions because the disorder itself generally requires no intervention. Nodular lymphoid hyperplasia is a risk factor for both intestinal and, very rarely, extraintestinal lymphoma. Some authors recommend surveillance, however, the duration and intervals are undefined. PMID:25400867

  12. Role of hemostatic powders in the endoscopic management of gastrointestinal bleeding

    PubMed Central

    Bustamante-Balén, Marco; Plumé, Gema

    2014-01-01

    Acute gastrointestinal bleeding (AGIB) is a prevalent condition with significant influence on healthcare costs. Endoscopy is essential for the management of AGIB with a pivotal role in diagnosis, risk stratification and management. Recently, hemostatic powders have been added to our endoscopic armamentarium to treat gastrointestinal (GI) bleeding. These substances are intended to control active bleeding by delivering a powdered product over the bleeding site that forms a solid matrix with a tamponade function. Local activation of platelet aggregation and coagulation cascade may be also boosted. There are currently three powders commercially available: hemostatic agent TC-325 (Hemospray®), EndoClot™ polysaccharide hemostatic system, and Ankaferd Bloodstopper®. Although the available evidence is based on short series of cases and there is no randomized controlled trial yet, these powders seem to be effective in controlling GI bleeding from a variety of origins with a very favorable side effects profile. They can be used either as a primary therapy or a second-line treatment, and they seem to be especially indicated in cases of cancer-related bleeding and lesions with difficult access. In this review, we will comment on the mechanism of action, efficacy, safety and technical challenges of the use of powders in several clinical scenarios and we will try to define the main current indications of use and propose new lines of research in this area. PMID:25133029

  13. Upper Gastrointestinal Mucosal Injury and Symptoms in Elderly Low-Dose Aspirin Users

    PubMed Central

    Shimada, Yuji; Nagahara, Akihito; Hojo, Mariko; Asaoka, Daisuke; Ueyama, Hiroya; Matsumoto, Kenshi; Watanabe, Sumio

    2015-01-01

    Background. We investigated the prevalence, symptoms, and QOL impact of esophageal (EI), gastric (GI), and duodenal mucosal injury (DI) individually between low-dose aspirin (LDA) users and nonusers to reveal the clinical features of LDA-related mucosal injury. Methods. Data were extracted from the records of subjects who underwent upper gastrointestinal endoscopy at our department between April 2008 and December 2013. Responses from 3162 elderly patients on Frequency Scale for Symptoms of GERD (FSSG) and SF-8 QOL questionnaires (SF-8) were analyzed. FSSG items were classified into total score (TS), reflux score (RS), and dyspepsia score (DS). The SF-8 questionnaire consisted of the physical component summary (PCS) and mental component summary (MCS). Results. Prevalence among LDA users and nonusers, respectively, was 9.6% and 10.0% (P = 0.83) for EI, 35.9% and 27.5% (P = 0.0027) for GI, 3.3% and 3.4% (P = 0.84) for DI, and 8.2% and 5.2% (P = 0.036) for mucosal injury in 2 or more organs. LDA users diagnosed with EI had significantly lower PCS, LDA users diagnosed with GI had significantly lower DS, and LDA users diagnosed with DI had significantly lower RS and significantly lower MCS. Conclusion. These results provide important clinical information indicating that symptom-based management is not appropriate in LDA users regarding upper gastrointestinal mucosal injury. PMID:25691897

  14. What's New in Gastrointestinal Stromal Tumor Research and Treatment?

    MedlinePLUS

    ... Topic Additional resources for gastrointestinal stromal tumor What’s new in gastrointestinal stromal tumor research and treatment? There ... GIST) Talking With Your Doctor After Treatment What`s New in Gastrointestinal Stromal Tumor (GIST) Research? Other Resources ...

  15. What Are the Key Statistics about Gastrointestinal Stromal Tumors?

    MedlinePLUS

    ... for gastrointestinal stromal tumors? What are the key statistics about gastrointestinal stromal tumors? Gastrointestinal stromal tumors (GISTs) ... They are slightly more common in men. Survival statistics for GIST are discussed in the section, “ Survival ...

  16. Cholangiocarcinoma and malignant bile duct obstruction: A review of last decades advances in therapeutic endoscopy

    PubMed Central

    Bertani, Helga; Frazzoni, Marzio; Mangiafico, Santi; Caruso, Angelo; Manno, Mauro; Mirante, Vincenzo Giorgio; Pigò, Flavia; Barbera, Carmelo; Manta, Raffaele; Conigliaro, Rita

    2015-01-01

    In the last decades many advances have been achieved in endoscopy, in the diagnosis and therapy of cholangiocarcinoma, however blood test, magnetic resonance imaging, computed tomography scan may fail to detect neoplastic disease at early stage, thus the diagnosis of cholangiocarcinoma is achieved usually at unresectable stage. In the last decades the role of endoscopy has moved from a diagnostic role to an invaluable therapeutic tool for patients affected by malignant bile duct obstruction. One of the major issues for cholangiocarcinoma is bile ducts occlusion, leading to jaundice, cholangitis and hepatic failure. Currently, endoscopy has a key role in the work up of cholangiocarcinoma, both in patients amenable to surgical intervention as well as in those unfit for surgery or not amenable to immediate surgical curative resection owing to locally advanced or advanced disease, with palliative intention. Endoscopy allows successful biliary drainage and stenting in more than 90% of patients with malignant bile duct obstruction, and allows rapid reduction of jaundice decreasing the risk of biliary sepsis. When biliary drainage and stenting cannot be achieved with endoscopy alone, endoscopic ultrasound-guided biliary drainage represents an effective alternative method affording successful biliary drainage in more than 80% of cases. The purpose of this review is to focus on the currently available endoscopic management options in patients with cholangiocarcinoma. PMID:26078827

  17. Serotonin in the Gastrointestinal Tract

    PubMed Central

    Camilleri, Michael

    2009-01-01

    Purpose of review To assess the role of serotonin and its control in the manifestations and treatment of lower functional gastrointestinal disorders (FGID). Recent literature has explored several novel concepts in the association of serotonin and symptoms, alterations in tissue levels of serotonin and its reuptake protein (SERT), aspects of the genetic determinants of serotonergic function (particularly 5-HTTLPR) and its relationship to gastrointestinal motor and sensory functions, and novel serotonergic agents used in therapy of lower FGID. The most consistent findings are the increase in plasma 5-HT in diarrheal diseases and reduction in constipation. The SERT in platelets impacts on the circulating level of 5-HT. Meta-analysis shows that 5-HTTLPR genotype is not significantly associated with IBS in Caucasians or Asians. New 5-HT3 antagonists and 5-HT4 agonists are efficacious and promise to provide relief for patients if they can pass regulatory hurdles. Summary While the most relevant implication for clinical practice remains the evidence that serotonergic agents are efficacious in the treatment of chronic constipation, chronic diarrhea and irritable bowel syndrome, the role of genetic control of 5-HT and its receptors is the subject of ongoing research, and is likely to enhance understanding of the mechanisms and treatment of these diseases. PMID:19115522

  18. Histopathology of gastrointestinal neuroendocrine neoplasms

    PubMed Central

    Hirabayashi, Kenichi; Zamboni, Giuseppe; Nishi, Takayuki; Tanaka, Akira; Kajiwara, Hiroshi; Nakamura, Naoya

    2013-01-01

    Gastrointestinal neuroendocrine neoplasms (GI-NENs) arise from neuroendocrine cells distributed mainly in the mucosa and submucosa of the gastrointestinal tract. In 2010, the World Health Organization (WHO) classification of NENs of the digestive system was changed, categorizing these tumors as grade 1 neuroendocrine tumor (NET), grade-2NET, neuroendocrine carcinoma (large- or small-cell type), or mixed adenoneuroendocrine carcinoma (MANEC). Such a classification is based on the Ki-67 index and mitotic count in histological material. For the accurate pathological diagnosis and grading of NENs, it is important to clearly recognize the characteristic histological features of GI-NENs and to understand the correct method of counting Ki-67 and mitoses. In this review, we focus on the histopathological features of GI-NENs, particularly regarding biopsy and cytological diagnoses, neuroendocrine markers, genetic and molecular features, and the evaluation of the Ki-67 index and mitotic count. In addition, we will address the histological features of GI-NEN in specific organs. PMID:23346552

  19. Gastrointestinal citrate absorption in nephrolithiasis

    NASA Technical Reports Server (NTRS)

    Fegan, J.; Khan, R.; Poindexter, J.; Pak, C. Y.

    1992-01-01

    Gastrointestinal absorption of citrate was measured in stone patients with idiopathic hypocitraturia to determine if citrate malabsorption could account for low urinary citrate. Citrate absorption was measured directly from recovery of orally administered potassium citrate (40 mEq.) in the intestinal lavage fluid, using an intestinal washout technique. In 7 stone patients citrate absorption, serum citrate levels, peak citrate concentration in serum and area under the curve were not significantly different from those of 7 normal subjects. Citrate absorption was rapid and efficient in both groups, with 96 to 98% absorbed within 3 hours. The absorption of citrate was less efficient from a tablet preparation of potassium citrate than from a liquid preparation, probably due to a delayed release of citrate from wax matrix. However, citrate absorption from solid potassium citrate was still high at 91%, compared to 98% for a liquid preparation. Thus, hypocitraturia is unlikely to be due to an impaired gastrointestinal absorption of citrate in stone patients without overt bowel disease.

  20. Gastrointestinal Behçet's disease: a review.

    PubMed

    Skef, Wasseem; Hamilton, Matthew J; Arayssi, Thurayya

    2015-04-01

    Behçet's disease (BD) is an idiopathic, chronic, relapsing, multi-systemic vasculitis characterized by recurrent oral and genital aphthous ulcers, ocular disease and skin lesions. Prevalence of BD is highest in countries along the ancient silk road from the Mediterranean basin to East Asia. By comparison, the prevalence in North American and Northern European countries is low. Gastrointestinal manifestations of Behçet's disease are of particular importance as they are associated with significant morbidity and mortality. Although ileocecal involvement is most commonly described, BD may involve any segment of the intestinal tract as well as the various organs within the gastrointestinal system. Diagnosis is based on clinical criteria - there are no pathognomonic laboratory tests. Methods for monitoring disease activity on therapy are available but imperfect. Evidence-based treatment strategies are lacking. Different classes of medications have been successfully used for the treatment of intestinal BD which include 5-aminosalicylic acid, corticosteroids, immunomodulators, and anti-tumor necrosis factor alpha monoclonal antibody therapy. Like inflammatory bowel disease, surgery is reserved for those who are resistant to medical therapy. A subset of patients have a poor disease course. Accurate methods to detect these patients and the optimal strategy for their treatment are not known at this time. PMID:25852265

  1. Gastrointestinal Behçet's disease: A review

    PubMed Central

    Skef, Wasseem; Hamilton, Matthew J; Arayssi, Thurayya

    2015-01-01

    Behçet’s disease (BD) is an idiopathic, chronic, relapsing, multi-systemic vasculitis characterized by recurrent oral and genital aphthous ulcers, ocular disease and skin lesions. Prevalence of BD is highest in countries along the ancient silk road from the Mediterranean basin to East Asia. By comparison, the prevalence in North American and Northern European countries is low. Gastrointestinal manifestations of Behçet’s disease are of particular importance as they are associated with significant morbidity and mortality. Although ileocecal involvement is most commonly described, BD may involve any segment of the intestinal tract as well as the various organs within the gastrointestinal system. Diagnosis is based on clinical criteria - there are no pathognomonic laboratory tests. Methods for monitoring disease activity on therapy are available but imperfect. Evidence-based treatment strategies are lacking. Different classes of medications have been successfully used for the treatment of intestinal BD which include 5-aminosalicylic acid, corticosteroids, immunomodulators, and anti-tumor necrosis factor alpha monoclonal antibody therapy. Like inflammatory bowel disease, surgery is reserved for those who are resistant to medical therapy. A subset of patients have a poor disease course. Accurate methods to detect these patients and the optimal strategy for their treatment are not known at this time. PMID:25852265

  2. Purinergic receptors in gastrointestinal inflammation.

    PubMed

    Kolachala, Vasantha L; Bajaj, Rahul; Chalasani, Meghana; Sitaraman, Shanthi V

    2008-02-01

    Purinergic receptors comprise a family of transmembrane receptors that are activated by extracellular nucleosides and nucleotides. The two major classes of purinergic receptors, P1 and P2, are expressed widely in the gastrointestinal tract as well as immune cells. The purinergic receptors serve a variety of functions from acting as neurotransmitters, to autocoid and paracrine signaling, to cell activation and immune response. Nucleosides and nucleotide agonist of purinergic receptors are released by many cell types in response to specific physiological signals, and their levels are increased during inflammation. In the past decade, the advent of genetic knockout mice and the development of highly potent and selective agonists and antagonists for the purinergic receptors have significantly advanced the understanding of purinergic receptor signaling in health and inflammation. In fact, agonist/antagonists of purinergic receptors are emerging as therapeutic modalities to treat intestinal inflammation. In this article, the distribution of the purinergic receptors in the gastrointestinal tract and their physiological and pathophysiological role in intestinal inflammation will be reviewed. PMID:18063703

  3. Effect of aspirin cessation before endoscopy in Japanese patients with low-dose-aspirin-associated gastroduodenal mucosal injury

    PubMed Central

    Ito, Yoshitsugu; Noguchi, Seiji; Yamaguchi, Sumiharu; Okaniwa, Noriko; Tanabe, Atsushi; Noda, Hisatsugu; Yanamoto, Kenichiro; Tamura, Yasuhiro; Kondo, Yoshihiro; Masui, Ryuta; Izawa, Shinya; Iida, Akihito; Mizuno, Mari; Ogasawara, Naotaka; Funaki, Yasushi; Kasugai, Kunio

    2013-01-01

    Background The incidence of upper gastrointestinal injury by low-dose aspirin (LDA) has increased. Objective We aimed to clarify the risk factors and prevention strategies associated with LDA-induced gastroduodenal ulcer in Japanese patients. Methods A retrospective study involving 284 LDA users who underwent oesophagogastroduodenoscopy between January and December 2010 were included. We investigated the patients’ clinical characteristics and endoscopic findings. Results Of 284 patients, 29 (10.2%) had gastro and/or duodenal ulcers. Male gender, peptic ulcer history, abdominal symptoms, half-dose proton pump inhibitors (PPIs), complete-dose PPIs, and nonsteroidal anti-inflammatory drugs were significantly associated with LDA-induced gastro and/or duodenal ulcers: odds ratio (95% confidence interval) 3.62 (1.06–12.27), 6.60 (1.84–23.62), 3.06 (1.12–8.40), 0.16 (0.03–0.94), 0.07 (0.01–0.61), and 9.68 (1.64–57.18), respectively. PPI significantly reduced gastric ulcers and/or duodenal ulcers (p?=?0.03). The modified Lanza score for gastric mucosal lesion in the LDA cessation group was significantly lower than in the LDA noncessation group (0.53 vs. 1.02; p?=?0.008). Conclusions Half-dose PPIs as well as complete-dose PPIs were effective for preventing LDA-induced gastric and/or duodenal ulcers. The cessation of LDA before endoscopy may lead to an underestimation of LDA-induced gastric injury. PMID:24917970

  4. Use of small bowel capsule endoscopy in patients with chronic kidney disease: experience from a University Referral Center

    PubMed Central

    Docherty, Emily; Koulaouzidis, Anastasios; Douglas, Sarah; Plevris, John N.

    2015-01-01

    Background There are only few reports on the diagnostic yield (DY) of small bowel capsule endoscopy (SBCE) in patients with chronic kidney disease (CKD). We aim to report our SBCE experience in patients with CKD. Methods Retrospective study; case notes of patients with low estimated glomerular filtration rate (eGFR) who underwent SBCE (March 2005-August 2012) for anemia and/or obscure gastrointestinal bleeding (OGIB) were retrieved and abstracted. Severity of CKD was defined according to Renal Association recommendations as: stage 3 (eGFR: 30-59); stage 4 (eGFR: 15-29); and stage 5 (eGFR <15 or on dialysis). Results In the aforementioned period, 69 patients with CKD [stage 3: 65/69 (92.8%), stage 4 or 5:4/69 (7.2%)] had SBCE. 51/65 (78.5%) patients with stage 3 CKD had SBCE due to unexplained anemia and/or OGIB [43 (66.1%) and 8 (12.3%), respectively]. In 25/51 (49%), the SBCE was normal and in 17/51 (33.3%) showed small-bowel angiectasias. Other findings were active bleeding (n=2), fold edema (n=2), ileal erosions (n=1), adenocarcinoma (n=1), and inconclusive/videos not available (n=3). All patients (n=4) with CKD grade 4 or 5 were referred due to unexplained anemia; 3/4 (75%) had angiectasias and 1 normal SBCE. Fecal calprotectin (FC) was measured in 12 patients with CKD stage 3 and unexplained anemia prior to their SBCE; no significant small-bowel inflammation was found in this subgroup. Conclusion SBCE has limited DY in CKD patients referred for unexplained anemia. Sinister SB pathology is rare, while the most common finding is angiectasias. Furthermore, FC measurement prior to SBCE -in this cohort of patients- is not associated with increased DY. PMID:25608445

  5. Analysis of bias voltage dependent spectral response in Ga{sub 0.51}In{sub 0.49}P/Ga{sub 0.99}In{sub 0.01}As/Ge triple junction solar cell

    SciTech Connect

    Sogabe, Tomah, E-mail: Sogabe@mbe.rcast.u-tokyo.ac.jp; Ogura, Akio; Okada, Yoshitaka [Research Center for Advanced Science and Technology (RCAST), The University of Tokyo 4-6-1 Komaba, Meguro-ku, Tokyo 153-8504 (Japan)

    2014-02-21

    Spectral response measurement plays great role in characterizing solar cell device because it directly reflects the efficiency by which the device converts the sunlight into an electrical current. Based on the spectral response results, the short circuit current of each subcell can be quantitatively determined. Although spectral response dependence on wavelength, i.e., the well-known external quantum efficiency (EQE), has been widely used in characterizing multijunction solar cell and has been well interpreted, detailed analysis of spectral response dependence on bias voltage (SR ?V{sub bias}) has not been reported so far. In this work, we have performed experimental and numerical studies on the SR??V{sub bias} for Ga{sub 0.51}In{sub 0.49}P/Ga{sub 0.99}In{sub 0.01}As/Ge triple junction solar cell. Phenomenological description was given to clarify the mechanism of operation matching point variation in SR??V{sub bias} measurements. The profile of SR?V{sub bias} curve was explained in detail by solving the coupled two-diode current-voltage characteristic transcend formula for each subcell.

  6. Diagnostic and therapeutic role of endoscopy in gastroenteropancreatic neuroendocrine neoplasms.

    PubMed

    Attili, Fabia; Capurso, Gabriele; Vanella, Giuseppe; Fuccio, Lorenzo; Delle Fave, Gianfranco; Costamagna, Guido; Larghi, Alberto

    2014-01-01

    Gastroenteropancreatic neuroendocrine neoplasms have substantially increased over the last decades. Because of the indolent clinical course of the disease even in advance stages and the rise in the incidental diagnosis of small asymptomatic lesions, the prevalence of gastroenteropancreatic neuroendocrine neoplasms is higher than that of pancreatic, gastric and oesophageal adenocarcinomas, making them the second most prevalent cancer type of the gastrointestinal tract. This increase in the overall prevalence of gastroenteropancreatic neuroendocrine neoplasms has been paralleled by a growth in the importance of the endoscopist in the care of these patients, who usually require a multidisciplinary approach. In this manuscript the diagnostic and therapeutic role of endoscopic for gastroenteropancreatic neuroendocrine neoplasms will be reviewed. PMID:23731843

  7. Pediatric and Adolescent Gastrointestinal Motility & Pain Program

    E-print Network

    Pediatric and Adolescent Gastrointestinal Motility & Pain Program Department of Pediatrics% of visits to the pediatric gastroenterologist. Constipation is a problem for about 1 in 6 children at some pediatric functional gastrointestinal disorders that prompt parents to bring their child to the doctor

  8. The Nervous System and Gastrointestinal Function

    ERIC Educational Resources Information Center

    Altaf, Muhammad A.; Sood, Manu R.

    2008-01-01

    The enteric nervous system is an integrative brain with collection of neurons in the gastrointestinal tract which is capable of functioning independently of the central nervous system (CNS). The enteric nervous system modulates motility, secretions, microcirculation, immune and inflammatory responses of the gastrointestinal tract. Dysphagia,…

  9. Gastrointestinal cancer: recent developments in medical oncology

    Microsoft Academic Search

    G. Chong; D. Cunningham

    2005-01-01

    BackgroundProgress in the medical oncological treatment of gastrointestinal cancer has resulted from advances in tumour biology as well as randomised clinical trials. This review updates oncologists on developments in perioperative therapy for gastrointestinal tumours, optimal use of chemotherapy for colorectal cancer, and novel targeted monoclonal antibodies (mAbs).

  10. Gastrointestinal stem cells in development and cancer

    Microsoft Academic Search

    S Brabletz; O Schmalhofer; T Brabletz

    2008-01-01

    An enormous body of knowledge about the biology of stem cells and their role in development, tissue homeostasis and cancer formation has been gained in the last 20 years. This review gives a comprehensive overview on knowledge about localization and regulation of normal gastrointestinal stem cells and links it to our understanding of gastrointestinal tumourigenesis and malignant progression in the

  11. GASTROINTESTINAL ANTHRAX: REVIEW OF NINE PATIENTS

    Microsoft Academic Search

    Shohreh Beheshti; Gholam-Reza Rezaian; Sasan Afifi; Sheema Rezaian

    2003-01-01

    Background - Gastrointestinal anthrax is quite rare and often fatal. Here we report the clinical presentation and outcome of nine patients with this disease. Methods - The medical records of all patients with documented anthrax admitted to our university hospitals from 1975 to 2000 were reviewed. Nine patients were found to have gastrointestinal anthrax. Data regarding the clinical presentation, incubation

  12. Computed tomography of the gastrointestinal tract

    SciTech Connect

    Fishman, E.K.; Jones, B.

    1988-01-01

    This book contains 11 chapters and five case studies. Some of the chapter titles are: CT of the Stomach; CT and Other Inflammatory Bowel Disease; Evaluation of Crohn's Disease; Periotoneal Metastasis; CT and MRI Correlation of the Gastrointestinal Tract; CT of Acute Gastrointestinal Abnormlities; and CT of Colorectal Cancer.

  13. Bench to Bedside Primer: The Gastrointestinal System and Gastrointestinal Disease

    NSDL National Science Digital Library

    Katie Anderson (Dakota Middle School)

    2011-10-07

    This bench-to-bedside is a four-page Â?primerÂ? (a booklet of basic principles) that highlights gastrointestinal (GI) physiology. This primer should be readable by your students or the general public to help inform them about the organ system, diseases that affect it, and basic and clinical research being done on it. It could also be used as a teaching model your students could follow in creating their own bench-to-beside primer.This teaching resource was developed by a K-12 science teacher in the American Physiological SocietyÂ?s 2011 Frontiers Online in Physiology Program. For more information on this program, please visit www.frontiersinphys.org.

  14. Gastrointestinal Manifestations in Systemic Autoimmune Diseases

    PubMed Central

    COJOCARU, M.; COJOCARU, Inimioara Mihaela; SILOSI, Isabela; VRABIE, Camelia Doina

    2011-01-01

    ABSTRACT In an autoimmune disease, the immune system attacks and harms the body's own tissues. The systemic autoimmune diseases include collagen vascular diseases, the systemic vasculitides, Wegener granulomatosis, and Churg-Strauss syndrome. These disorders can involve any part of the gastrointestinal tract, hepatobiliary system and pancreas. They can cause a variety of gastrointestinal manifestations that are influenced by the pathophysiologic characteristics of the underlying disease process. There is a wide variation of gastrointestinal manifestations from these autoimmune disorders including, but not limited to: oral ulcers, dysphagia, gastroesophageal reflux disease, abdominal pain, constipation, diarrhea, fecal incontinence, pseudo-obstruction, perforation and gastrointestinal bleeding. Clinical workup should be initiated by the patient's subjective complaints. In this review, we analyze the effects of autoimmune diseases on the gastrointestinal tract. PMID:21977190

  15. Is there a role for colon capsule endoscopy beyond colorectal cancer screening? A literature review

    PubMed Central

    Triantafyllou, Konstantinos; Beintaris, Iosif; Dimitriadis, George D

    2014-01-01

    Colon capsule endoscopy is recommended in Europe alternatively to colonoscopy for colorectal cancer screening in average risk individuals. The procedure has also been proposed to complete colon examination in cases of incomplete colonoscopy or when colonoscopy is contraindicated or refused by the patient. As tissue samples cannot be obtained with the current capsule device, colon capsule endoscopy has no place in diagnosing ulcerative colitis or in dysplasia surveillance. Nevertheless, data are accumulating regarding its feasibility to examine ulcerative colitis disease extent and to monitor disease activity and mucosal healing, even though reported results on the capsule’s performance in this field vary greatly. In this review we present the currently available evidence for the use of colon capsule endoscopy to complement colonoscopy failure to reach the cecum and its use to evaluate ulcerative colitis disease activity and extent. Moreover, we provide an outlook on issues requiring further investigation before the capsule becomes a mainstream alternative to colonoscopy in such cases. PMID:25278694

  16. Capsule endoscopy for the small bowel in juvenile polyposis syndrome: a case series.

    PubMed

    Postgate, A J; Will, O C; Fraser, C H; Fitzpatrick, A; Phillips, R K S; Clark, S K

    2009-11-01

    Juvenile polyposis syndrome is one of the hamartomatous polyposis syndromes and demonstrates phenotypic heterogeneity. All patients with juvenile polyposis develop colorectal polyps and are at risk of colorectal cancer. Small-bowel involvement is variably described. Small-intestinal cancer is reported but is rare and there is no evidence-based protocol for small-intestinal surveillance. This case series reports the small-bowel capsule endoscopy findings and genetic mutational analyses of ten adults (7-male; median age 39.2 years, interquartile range 37.4 - 42.0 years) with documented juvenile polyposis syndrome. Two patients had small-bowel polyps beyond the range of standard gastroscopy identified at capsule endoscopy: a 6-mm ileal polyp in one, and 10-mm and 6-mm ileal polyps in the second (histology unknown). Duodenal polyps were detected in a third patient at capsule endoscopy. Three further patients had previously documented duodenal polyps at surveillance gastroscopy. A SMAD4 mutation was identified in seven patients but there was no obvious association with gastric/small-bowel polyp burden. In conclusion, capsule endoscopy provided information additional to conventional endoscopy in patients with juvenile polyposis syndrome and was well tolerated. However, no lesions requiring clinical intervention were identified and polyp numbers were small. Capsule endoscopy may appropriately be used as a baseline investigation for the identification of patients with large or dense small-bowel polyps for whom ongoing small-bowel investigation would be recommended. Patients in whom polyps are confined to the colon are unlikely to require ongoing small-bowel review. PMID:19816839

  17. Virtual endoscopy of the nasopharynx in the evaluation of its normal anatomy and alterations due to lymphoid hyperplasia: preliminary report

    Microsoft Academic Search

    Ignazio Pandolfo; Silvio Mazziotti; Giorgio Ascenti; Sergio Vinci; Ignazio Salamone; Giovanni Colletti; Alfredo Blandino

    2004-01-01

    The purpose of this study was to evaluate the diagnostic usefulness of virtual endoscopy in establishing the anatomic appearance of nasopharynx, both normal and affected by lymphoid hyperplasia. Thirty-seven patients affected by chronic rhinosinusal and otomastoid pathology, all studied by rhinoscopy, were examined with multislice computed tomography (CT) and virtual endoscopy of the nasopharynx. Rhinoscopy showed a completely normal nasopharynx

  18. Endoprobe: A system for radionuclide-guided endoscopy

    SciTech Connect

    Raylman, Raymond R.; Srinivasan, Amarnath [Center for Advanced Imaging, Department of Radiology, West Virginia University, Morgantown, West Virginia 26506-9236 (United States)

    2004-12-01

    Methods to guide the surgical treatment of cancer utilizing handheld beta-sensitive probes in conjunction with tumor-avid radiopharmaceuticals [such as {sup 18}F-fluorodeoxyglucose (FDG)] have previously been developed. These technologies could also potentially be used to assist in minimally invasive techniques for the diagnosis of cancer. The goal of this project is to develop and test a system for performing radionuclide-guided endoscopies. This system (called Endoprobe) has four major subsystems: beta detector, position tracker, endoscope, and user interface. The beta detection unit utilizes two miniaturized solid state detectors to preferentially detect beta particles. The position tracking system allows real-time monitoring of the unit's location. The beta detector and position tracking system's receiver are mounted on the tip of an endoscope. Information from the beta detector and tracking system, in addition to the video signal from the endoscope, are combined and presented to the user via a computer interface. The system was tested in a simulated search for radiotracer-avid areas of esophageal cancer. The search for esophageal cancer was chosen because this type of cancer is often diagnosed with endoscopic procedures and has been reported to have good affinity for FDG. Accumulations of FDG in the normal organs of the abdomen were simulated by an anthropomorphic torso phantom filled with the appropriate amounts of radioactivity. A 1.5-mm-thick gelatin film containing FDG was used to simulate radiotracer uptake in the lining of normal esophagus. Esophageal lesions (both benign and malignant) were simulated by thin disks of gelatin (diameters=3.5-12 mm) containing appropriate concentrations of FDG embedded in the gelatin film simulating normal esophagus. Endoprobe facilitated visual identification and examination of the simulated lesions. The position tracking system permitted the location of the Endoprobe tip to be monitored and plotted in real time on a previously acquired positron emission tomography-computed tomography (PET-CT) image of the phantom. The detection system successfully acquired estimates of the beta flux emitted from areas chosen by the user. Indeed, Endoprobe was able to assist in distinguishing simulated FDG-avid areas as small as 3.5 mm in diameter from normal esophagus (p value <0.025). In addition to FDG, Endoprobe can be used with other positron or electron-emitting radionuclides such as {sup 11}C or {sup 131}I. The next phase of this project will focus on modification of the prototype to make it more suitable for clinical use.

  19. Microbial biofilms and gastrointestinal diseases

    PubMed Central

    von Rosenvinge, Erik C.; O’May, Graeme A.; Macfarlane, Sandra; Macfarlane, George T.; Shirtliff, Mark E.

    2014-01-01

    The majority of bacteria live not planktonically, but as residents of sessile biofilm communities. Such populations have been defined as ‘matrix-enclosed microbial accretions, which adhere to both biological and nonbiological surfaces’. Bacterial formation of biofilm is implicated in many chronic disease states. Growth in this mode promotes survival by increasing community recalcitrance to clearance by host immune effectors and therapeutic antimicrobials. The human gastrointestinal (GI) tract encompasses a plethora of nutritional and physicochemical environments, many of which are ideal for biofilm formation and survival. However, little is known of the nature, function, and clinical relevance of these communities. This review summarizes current knowledge of the composition and association with health and disease of biofilm communities in the GI tract. PMID:23620117

  20. Pathology of Gastrointestinal Stromal Tumors

    PubMed Central

    Foo, Wai Chin; Liegl-Atzwanger, Bernadette; Lazar, Alexander J.

    2012-01-01

    Gastrointestinal stromal tumor (GIST) is a well recognized and relatively well understood soft tissue tumor. Early events in GIST development are activating mutations in KIT or PDGFRA, which occur in most GISTs and encode for mutated tyrosine receptor kinases that are therapeutic targets for tyrosine kinase inhibitors, including imatinib and sunitinib. A small minority of GISTs possessing neither KIT nor PDGFRA mutations may have germline mutations in SDH, suggesting a potential role of SDH in the pathogenesis. Immunohistochemical detection of KIT, and more recently DOG1, has proven to be reliable and useful in the diagnosis of GISTs. Because current and future therapies depend on pathologists, it is important that they recognize KIT-negative GISTs, GISTs in specific clinical contexts, GISTs with unusual morphology, and GISTs after treatment. This review focuses on recent developments in the understanding of the biology, immunohistochemical diagnosis, the role of molecular analysis, and risk assessment of GISTs. PMID:22855636

  1. Antimicrobial Peptides in Gastrointestinal Inflammation

    PubMed Central

    Jäger, Simon; Stange, Eduard F.; Wehkamp, Jan

    2010-01-01

    Acute and chronic inflammations of mucosal surfaces are complex events in which the effector mechanisms of innate and adaptive immune systems interact with pathogenic and commensal bacteria. The role of constitutive and inducible antimicrobial peptides in intestinal inflammation has been investigated thoroughly over the recent years, and their involvement in various disease states is expanded ever more. Especially in the intestines, a critical balance between luminal bacteria and the antimicrobial peptides is essential, and a breakdown in barrier function by impaired production of defensins is already implicated in Crohn's disease. In this paper, we focus on the role of antimicrobial peptides in inflammatory processes along the gastrointestinal tract, while considering the resident and pathogenic flora encountered at the specific sites. The role of antimicrobial peptides in the primary events of inflammatory bowel diseases receives special attention. PMID:21151692

  2. Gastrointestinal bleeding after cold biopsy.

    PubMed

    Vu, C K; Korman, M G; Bejer, I; Davis, S

    1998-07-01

    Cold biopsy of the gastric mucosa is useful in many gastroduodenal disorders. Antral biopsies are done with increasing frequency to confirm Helicobacter pylori infection and to determine the type and content of gastritis. Gastrointestinal bleeding after gastric cold biopsy is rare. We report two patients who developed melena after cold biopsy of the gastric antrum. Repeat gastroscopies excluded lesions other than the biopsied sites as the source of bleeding. Colonoscopies in both cases did not reveal any evidence of lower GI bleed. Relevant medications include amlodipine, in case 1, and brufen, which was used in case 2 but discontinued before biopsy. Literature review has shown the rarity of clinically significant hemorrhage resulting from gastric cold biopsy. Nevertheless, all patients undergoing gastroscopy should be informed of this potential complication. PMID:9672346

  3. Image-enhanced endoscopy is critical in the surveillance of patients with colonic IBD.

    PubMed

    Subramanian, Venkataraman; Bisschops, Raf

    2014-07-01

    Cancer risk in patients with inflammatory bowel disease (IBD) involving the colon is high and increases with time. The quality and efficacy of colonoscopic surveillance is variable. Chromoendoscopy with targeted biopsies is superior to standard white light endoscopy with random biopsies. Although commonly practiced, the technique of random colonic biopsies has poor yield for dysplasia and has little clinical consequence. Studies have shown a limited role for electronic-based image-enhanced endoscopy, including narrow band imaging, in detecting IBD dysplasia. Efforts should focus on the dissemination of the technique of chromoendoscopy in routine clinical practice through training and quality metrics. PMID:24975530

  4. Solitary fibrous tumor of the greater omentum, mimicking gastrointestinal stromal tumor of the small intestine: a case report.

    PubMed

    Urabe, Masayuki; Yamagata, Yukinori; Aikou, Susumu; Mori, Kazuhiko; Yamashita, Hiroharu; Nomura, Sachiyo; Shibahara, Junji; Fukayama, Masashi; Seto, Yasuyuki

    2015-05-01

    Solitary fibrous tumor (SFT) is one of the mesenchymal tumors, which rarely arises in the abdominal space. We report a very rare case of abdominal SFT, mimicking another mesenchymal tumor. A 52-year-old Japanese man was referred to our hospital for further evaluation and treatment of gallbladder polyp. Contrast-enhanced computed tomography (CT) showed an enhanced nodule within the gallbladder, and incidentally, also showed a well-circumscribed mass adjacent to the small intestine. The mass was depicted as slightly high density in plain CT, and with contrast-enhancement, the mass was partially stained in early phase and the stained area spread heterogeneously in delayed phase. Magnetic resonance imaging showed that the abdominal mass was depicted as slightly high intensity on T2-weighted imaging and low intensity on T1-weighted imaging. With double-balloon endoscopy and capsule endoscopy, we did not find any tumor inside the small intestine. These visual findings lead us to diagnose it as gastrointestinal stromal tumor of the small intestine with extraluminal growth. We planned to resect both the gallbladder polyp and the intraperitoneal tumor at the same time for pathologic diagnosis and treatment. When the operation was performed, we found a milk-white lobulated tumor on the greater omentum and the tumor was entirely resected. Microscopically, the gallbladder polyp was diagnosed as tubular adenoma, and the omental tumor was diagnosed as SFT. It is important to bear in mind that omental SFTs sometimes mimic other mesenchymal tumors and should be included in the differential diagnosis of abdominal tumor not revealed by endoscopy. PMID:26011203

  5. Neuroplasticity and dysfunction after gastrointestinal inflammation.

    PubMed

    Brierley, Stuart M; Linden, David R

    2014-10-01

    The gastrointestinal tract is innervated by several distinct populations of neurons, whose cell bodies either reside within (intrinsic) or outside (extrinsic) the gastrointestinal wall. Normally, most individuals are unaware of the continuous, complicated functions of these neurons. However, for patients with gastrointestinal disorders, such as IBD and IBS, altered gastrointestinal motility, discomfort and pain are common, debilitating symptoms. Although bouts of intestinal inflammation underlie the symptoms associated with IBD, increasing preclinical and clinical evidence indicates that infection and inflammation are also key risk factors for the development of other gastrointestinal disorders. Notably, a strong correlation exists between prior exposure to gut infection and symptom occurrence in IBS. This Review discusses the evidence for neuroplasticity (structural, synaptic or intrinsic changes that alter neuronal function) affecting gastrointestinal function. Such changes are evident during inflammation and, in many cases, long after healing of the damaged tissues, when the nervous system fails to reset back to normal. Neuroplasticity within distinct populations of neurons has a fundamental role in the aberrant motility, secretion and sensation associated with common clinical gastrointestinal disorders. To find appropriate therapeutic treatments for these disorders, the extent and time course of neuroplasticity must be fully appreciated. PMID:25001973

  6. Different roles of capsule endoscopy and double-balloon enteroscopy in obscure small intestinal diseases

    PubMed Central

    Zhang, Zhi-Hong; Qiu, Chun-Hua; Li, Yi

    2015-01-01

    AIM: To compare the roles of capsule endoscopy (CE) and double-balloon enteroscopy (DBE) in the diagnosis of obscure small bowel diseases. METHODS: From June 2009 to December 2014, 88 patients were included in this study; the patients had undergone gastroscopy, colonoscopy, radiological small intestinal barium meal, abdominal computed tomography or magnetic resonance imaging scan and mesenteric angiography, but their diagnoses were still unclear. The patients with gastrointestinal obstructions, fistulas, strictures, or cardiac pacemakers, as well as pregnant women, and individuals who could not accept the capsule-retention or capsule-removal surgery were excluded. Patients with heart, lung and other vital organ failure diseases were also excluded. Everyone involved in this study had undergone CE and DBE. The results were divided into: (1) the definite diagnosis (the diagnosis was confirmed at least by one of the biopsy, surgery, pathology or the drug treatment effects with follow-up for at least 3 mo); (2) the possible diagnosis (a possible diagnosis was suggested by CE or DBE, but not confirmed by the biopsy, surgery or follow-up drug treatment effects); and (3) the unclear diagnosis (no exact causes were provided by CE and DBE for the disease). The detection rate and the diagnostic yield of the two methods were compared. The difference in the etiologies between CE and DBE was estimated, and the different possible etiologies caused by the age groups were also investigated. RESULTS: CE exhibited a better trend than DBE for diagnosing scattered small ulcers (P = 0.242, Fisher’s test), and small vascular malformations (?2 = 1.810, P = 0.179, Pearson ?2 test), but with no significant differences, possible due to few cases. However, DBE was better than CE for larger tumors (P = 0.018, Fisher’s test) and for diverticular lesions with bleeding ulcers (P = 0.005, Fisher’s test). All three hemangioma cases diagnosed by DBE in this study (including sponge hemangioma, venous hemangioma, and hemangioma with hamartoma lesions) were all confirmed by biopsy. Two parasite cases were found by CE, but were negative by DBE. This study revealed no obvious differences in the detection rates (DR) of CE (60.0%, 53/88) and DBE (59.1%, 52/88). However, the etiological diagnostic yield (DY) difference was apparent. The CE diagnostic yield was 42.0% (37/88), and the DBE diagnostic yield was 51.1% (45/88). Furthermore, there were differences among the age groups (?2 = 22.146, P = 0.008, Kruskal Wallis Test). Small intestinal cancer (5/6 cases), vascular malformations (22/29 cases), and active bleeding (3/4 cases) appeared more commonly in the patients over 50 years old, but diverticula with bleeding ulcers were usually found in the 15-25-year group (4/7cases). The over-25-year group accounted for the stromal tumors (10/12 cases). CONCLUSION: CE and DBE each have their own advantages and disadvantages. The appropriate choice depends on the patient’s age, tolerance, and clinical manifestations. Sometimes CE followed by DBE is necessary. PMID:26109818

  7. A benign gastric ulcer eroding into a splenic artery pseudoaneurysm presenting as a massive upper gastrointestinal bleed

    PubMed Central

    Syed, Shareef M.; Moradian, Simon; Ahmed, Mohammed; Ahmed, Umair; Shaheen, Samuel; Stalin, Vasanth

    2014-01-01

    Upper gastrointestinal (UGI) bleeding secondary to a ruptured splenic artery (SA) pseudoaneurysm into the stomach is a rare but a life-threatening condition. Owing to the low prevalence, it remains a diagnostic and therapeutic challenge. A frail 77-year-old Caucasian female presented with epigastric pain and hematemesis. Endoscopy was non-diagnostic for an etiology. She then underwent diagnostic angiography that revealed an SA pseudoaneurysm with active contrast extravasation into the stomach. Subsequent transcatheter arterial coil embolization was conducted of the SA. The patient was subsequently taken for a partial gastrectomy, distal pancreatectomy and splenectomy. She had an uncomplicated postoperative course. Diagnosis of an UGI bleeding secondary to a ruptured SA pseudoaneurysm into the stomach remains difficult. However, we report that in a hemodynamically stable patient, a multidisciplinary approach can be taken, with interval optimization of the patient prior to definitive surgery for a satisfactory outcome. PMID:25413998

  8. A benign gastric ulcer eroding into a splenic artery pseudoaneurysm presenting as a massive upper gastrointestinal bleed.

    PubMed

    Syed, Shareef M; Moradian, Simon; Ahmed, Mohammed; Ahmed, Umair; Shaheen, Samuel; Stalin, Vasanth

    2014-01-01

    Upper gastrointestinal (UGI) bleeding secondary to a ruptured splenic artery (SA) pseudoaneurysm into the stomach is a rare but a life-threatening condition. Owing to the low prevalence, it remains a diagnostic and therapeutic challenge. A frail 77-year-old Caucasian female presented with epigastric pain and hematemesis. Endoscopy was non-diagnostic for an etiology. She then underwent diagnostic angiography that revealed an SA pseudoaneurysm with active contrast extravasation into the stomach. Subsequent transcatheter arterial coil embolization was conducted of the SA. The patient was subsequently taken for a partial gastrectomy, distal pancreatectomy and splenectomy. She had an uncomplicated postoperative course. Diagnosis of an UGI bleeding secondary to a ruptured SA pseudoaneurysm into the stomach remains difficult. However, we report that in a hemodynamically stable patient, a multidisciplinary approach can be taken, with interval optimization of the patient prior to definitive surgery for a satisfactory outcome. PMID:25413998

  9. Subject-friendly entire gastrointestinal screening with a single capsule endoscope by magnetic navigation and the Internet.

    PubMed

    Ohta, Hidetoshi; Katsuki, Shinichi

    2014-01-01

    Ever since capsule endoscopy (CE) was introduced into clinical practice, we gastroenterologists have been dreaming of using this less invasive modality to explore the entire gastrointestinal (GI) tract. To realize this dream, we have developed a magnetic navigation system which includes real-time internet streaming of endoscopic video and some useful gadgets (position detection by means of magnetic impedance (MI) sensors and a modified capsule that is "weightless" in water). The design of the weightless capsule made it possible with 0.5T (Tesla) extracorporeal magnets to control the capsule beyond 20cm. A pair of MI sensors on the body surface could detect subtle magnetic flux generated by an intra-capsular magnet in the GI tract by utilizing the space diversity effect which eliminated the interference of terrestrial magnetism. Subjects underwent CE, during which they were free from confinement in the hospital, except for 1 hour when the capsule was manipulated in the stomach and colon. This study had a completion rate of 97.5%. The high completion rate indicates that our system (single capsule endoscopy-SCE) with further improvements could become a viable modality for screening of the entire GI tract. PMID:25571606

  10. Immunohistochemical features of the gastrointestinal tract tumors

    PubMed Central

    Wong, Hannah H.

    2012-01-01

    Gastrointestinal tract tumors include a wide variety of vastly different tumors and on a whole are one of the most common malignancies in western countries. These tumors often present at late stages as distant metastases which are then biopsied and may be difficult to differentiate without the aid of immunohistochemical stains. With the exception of pancreatic and biliary tumors where there are no distinct immunohistochemical patterns, most gastrointestinal tumors can be differentiated by their unique immunohistochemical profile. As the size of biopsies decrease, the role of immunohistochemical stains will become even more important in determining the origin and differentiation of gastrointestinal tract tumors. PMID:22943017

  11. Gastrointestinal anthrax: review of the literature.

    PubMed

    Beatty, Mark E; Ashford, David A; Griffin, Patricia M; Tauxe, Robert V; Sobel, Jeremy

    2003-11-10

    Recent events have drawn attention to cases of inhalational and cutaneous anthrax associated with contaminated mail. Gastrointestinal anthrax, the disease caused by ingestion of Bacillus anthracis organisms, has rarely been reported in the United States. This review provides background information on the gastrointestinal form of the disease. We describe the clinical course of gastrointestinal anthrax, outline current therapy, review the microbiology of B anthracis, examine the epidemiology of natural outbreaks, discuss considerations regarding deliberate contamination, and summarize existing literature on the inactivation of spores present in food and water. PMID:14609791

  12. REVIEW: Gastrointestinal Melatonin: Localization, Function, and Clinical Relevance

    Microsoft Academic Search

    George A. Bubenik

    2002-01-01

    The gastrointestinal tract of vertebrate species is a rich source of extrapineal melatonin. The concentration of melatonin in the gastrointestinal tissues surpasses blood levels by 10–100 times and there is at least 400× more melatonin in the gastrointestinal tract than in the pineal gland. The gastrointestinal tract contributes significantly to circulating concentrations of melatonin, especially during the daytime and melatonin

  13. H. pylori Infection and Genotyping in Patients Undergoing Upper Endoscopy at Inner City Hospitals

    Microsoft Academic Search

    E. W. Straus; H. Patel; J. Chang; R. M. Gupta; V. Sottile; J. Scirica; G. Tarabay; S. Iyer; S. Samuel; R. D. Raffaniello

    2002-01-01

    Kings County Hospital (KCH), and St. John's Episcopal Hospital (SJH) are inner-city hospitals in New York City serving predominantly minority populations. Staten Island University Hospital (SIUH) serves a predominantly middle-class Caucasian population. We examined H. pylori (HP) infection in patients undergoing upper endoscopy at these hospitals. Two gastric biopsies were obtained from each patient. One biopsy was examined by histology

  14. Fast extraction of minimal paths in 3D images and applications to virtual endoscopy

    Microsoft Academic Search

    Thomas Deschamps; Laurent D. Cohen

    2001-01-01

    The aim of this article is to build trajectories for virtual endoscopy inside 3D medical images, using the most automatic way. Usually the construction of this trajectory is left to the clinician who must define some points on the path manually using three orthogonal views. But for a complex structure such as the colon, those views give little information on

  15. Reliable Path for Virtual Endoscopy: Ensuring Complete Examination of Human Organs

    E-print Network

    of generating an optimal reliable path for virtual endoscopy is NP-complete. In practice, we develop and infection. It could also improve the diagnostic sensitivity and specificity and be used to explore body] or automatically [2], [7] specifying the camera parameters at each key frame. Obviously, such a technique prevents

  16. Abnormal Image Detection in Endoscopy Videos Using a Filter Bank and Local Binary Patterns.

    PubMed

    Nawarathna, Ruwan; Oh, JungHwan; Muthukudage, Jayantha; Tavanapong, Wallapak; Wong, Johnny; de Groen, Piet C; Tang, Shou Jiang

    2014-11-20

    Finding mucosal abnormalities (e.g., erythema, blood, ulcer, erosion, and polyp) is one of the most essential tasks during endoscopy video review. Since these abnormalities typically appear in a small number of frames (around 5% of the total frame number), automated detection of frames with an abnormality can save physician's time significantly. In this paper, we propose a new multi-texture analysis method that effectively discerns images showing mucosal abnormalities from the ones without any abnormality since most abnormalities in endoscopy images have textures that are clearly distinguishable from normal textures using an advanced image texture analysis method. The method uses a "texton histogram" of an image block as features. The histogram captures the distribution of different "textons" representing various textures in an endoscopy image. The textons are representative response vectors of an application of a combination of Leung and Malik (LM) filter bank (i.e., a set of image filters) and a set of Local Binary Patterns on the image. Our experimental results indicate that the proposed method achieves 92% recall and 91.8% specificity on wireless capsule endoscopy (WCE) images and 91% recall and 90.8% specificity on colonoscopy images. PMID:25132723

  17. Complications after outpatient upper GI endoscopy in children: 30-day follow-up

    Microsoft Academic Search

    M. Samer Ammar; Marian D. Pfefferkorn; Joseph M. Croffie; Sandeep K. Gupta; Mark R. Corkins; Joseph F. Fitzgerald

    2003-01-01

    OBJECTIVES:Upper GI endoscopy (UGE) is a common procedure performed for evaluation and treatment of various upper GI tract disorders in children. Limited comprehensive data are available on the complications of UGE in adults and particularly in children. The goals of this study were to identify complications and adverse events reported by patients and their parents after outpatient UGE under general

  18. Computer-Aided Detection of Bleeding Regions for Capsule Endoscopy Images

    Microsoft Academic Search

    Baopu Li; Max Q.-H. Meng

    2009-01-01

    Capsule endoscopy (CE) has been widely used to diagnose diseases in human digestive tract. However, a tough problem of this new technology is that too many images to be inspected by eyes cause a huge burden to physicians, so it is significant to investigate computerized diagnosis methods. In this paper, a new computer-aided system aimed for bleeding region detection in

  19. Implementation, Calibration and Accuracy Testing of an Image-Enhanced Endoscopy System

    Microsoft Academic Search

    Ramin Shahidi; Michael R. Bax; Calvin R. Maurer Jr.; Jeremy A. Johnson; Eric P. Wilkinson; Bai Wang; Jay B. West; Martin J. Citardi; Kim H. Manwaring; Rasool Khadem

    2002-01-01

    This paper presents a new method for image-guided surgery called image-enhanced endoscopy. Registered real and virtual endoscopic images (perspective volume renderings generated from the same view as the endoscope camera using a preoperative image) are displayed simultaneously; when combined with the ability to vary tissue transparency in the virtual images, this provides surgeons with the ability to see beyond visible

  20. [Electronic documentation of findings, performance statistics and image analysis in endoscopy].

    PubMed

    Swobodnik, W; Kuhn, K

    1992-03-01

    Endoscopic data processing in endoscopy departments can hardly be performed without electronic data management nowadays. Written report and endoscopic image storage have to be performed in parallel applying modern sophisticated electronic systems. Sufficient storage capacity has to be taken care for. In the near future image processing of electronically storage endoscopic images will become available. PMID:1590018

  1. Quality Indicators for Colonoscopy Procedures: A Prospective Multicentre Method for Endoscopy Units

    PubMed Central

    Coriat, Romain; Lecler, Augustin; Lamarque, Dominique; Deyra, Jacques; Roche, Hervé; Nizou, Catherine; Berretta, Olivier; Mesnard, Bruno; Bouygues, Martin; Soupison, Alain; Monnin, Jean-Luc; Podevin, Philippe; Cassaz, Carole; Sautereau, Denis; Prat, Frédéric; Chaussade, Stanislas

    2012-01-01

    Background and Aims Healthcare professionals are required to conduct quality control of endoscopy procedures, and yet there is no standardised method for assessing quality. The topic of the present study was to validate the applicability of the procedure in daily practice, giving physicians the ability to define areas for continuous quality improvement. Methods In ten endoscopy units in France, 200 patients per centre undergoing colonoscopy were enrolled in the study. An evaluation was carried out based on a prospectively developed checklist of 10 quality-control indicators including five dependent upon and five independent of the colonoscopy procedure. Results Of the 2000 procedures, 30% were done at general hospitals, 20% at university hospitals, and 50% in private practices. The colonoscopies were carried out for a valid indication for 95.9% (range 92.5–100). Colon preparation was insufficient in 3.7% (range 1–10.5). Colonoscopies were successful in 95.3% (range 81–99). Adenoma detection rate was 0.31 (range 0.17–0.45) in successful colonoscopies. Conclusion This tool for evaluating the quality of colonoscopy procedures in healthcare units is based on standard endoscopy and patient criteria. It is an easy and feasible procedure giving the ability to detect suboptimal practice and differences between endoscopy-units. It will enable individual units to assess the quality of their colonoscopy techniques. PMID:22509267

  2. Technical tip: percutaneous bone shaving and ulcer endoscopy to manage abnormal pressure point of the sole.

    PubMed

    Lui, T H

    2014-12-01

    Abnormal plantar pressure can follow post-traumatic foot deformity, Charcot neuroarthropathy and partial foot amputations. Surgery is indicated if the condition does not improve with orthotic treatment. We describe the techniques of percutaneous shaving of the plantar bone prominence and ulcer endoscopy to manage abnormal pressure points under the sole of the foot. PMID:25241265

  3. Implementation of HACCP in the risk management of medical waste generated from endoscopy

    Microsoft Academic Search

    Shinji Kojima; Masahiko Kato; Noriko Sakano; Masafumi Fujii; Keiki Ogino

    2008-01-01

    Medical waste poses health hazards, increases the environmental load and is costly to dispose of. To solve the above problems, we applied the hazard analysis and critical control point system (HACCP) to the management of wastes generated from endoscopy. First, the wastes in three hospitals were quantified. The number and weight of waste per case differed significantly among the three

  4. Reliable Path for Virtual Endoscopy: Ensuring Complete Examination of Human Organs

    Microsoft Academic Search

    Taosong He; Lichan Hong; Dongqing Chen; Zhengrong Liang

    2001-01-01

    Virtual endoscopy is a computerized, noninvasive procedure for detecting anomalies inside human organs. Several preliminary studies have demonstrated the benefits and effectiveness of this modality. Unfortunately, previous work cannot guarantee that an existing anomaly will be detected, especially for complex organs with multiple branches. In this paper, we introduce the concept of reliable navigation, which ensures the interior organ surface

  5. IEEE TRANSACTIONS ON MEDICAL IMAGING ---FINAL MANUSCRIPT 20040117 1 Interactive Virtual Endoscopy in Coronary Arteries

    E-print Network

    Wahle, Andreas

    in Coronary Arteries based on Multi­Modality Fusion Andreas Wahle, # Senior Member, IEEE, Mark E. Olszewski­independent virtual endoscopy in human coronary arteries is presented in this pa­ per. It incorporates previously results in a three­ or four­dimensional (3­D/4­D) model of a coronary artery, specifically of its lumen

  6. Value of nasal endoscopy and probing in the diagnosis and management of children with congenital epiphora

    Microsoft Academic Search

    C J MacEwen; J D H Young; C W Barras; B Ram; P S White

    2001-01-01

    BACKGROUNDCongenital nasolacrimal obstruction is usually the result of failure of canalisation of the distal end of the nasolacrimal duct. The most common outcome is spontaneous resolution, but some children do require surgical treatment by probing. Probing is a blind procedure with a recognised failure rate.METHODSIn 52 lacrimal systems of 40 children nasal endoscopy was combined with a “stepwise” systematic probing

  7. Drugs Approved for Gastrointestinal Stromal Tumors

    Cancer.gov

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for gastrointestinal stromal tumors (GIST). The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  8. Inverted diverticula of the gastrointestinal tract

    Microsoft Academic Search

    Patrick C. Freeny; John H. Walker

    1979-01-01

    Inverted diverticula of the gastrointestinal tract are rare. This paper briefly presents the roentgen findings of an inverted Meckel's diverticulum and is the first reported case of the roentgen appearance of an inverted colonic diverticulum.

  9. International Foundation for Functional Gastrointestinal Disorders

    MedlinePLUS

    ... Advocacy Activities, Legislative & Regulatory Research Leadership Code of Ethics Funding IFFGD Standards For Collaboration Industry Council GI ... aboutIncontinence.org | aboutKidsGI.org | GIresearch.org | ... Copyright 1998-2015 International Foundation for Functional Gastrointestinal Disorders, ...

  10. [Galanin: a new biologically active gastrointestinal neuropeptide].

    PubMed

    Bauer, F E

    1990-03-01

    The 29 amino acid containing neuropeptide galanin is localized in the intrinsic nervous system of the entire gastrointestinal tract and the pancreas. It was found in man and several animal species. Molecular biology studies revealed different molecular forms of galanin in several mammalian species including man. The galanin precursor was also found. Galanin shows several potent pharmacological actions: it inhibits gastrointestinal motility in man. It also has an inhibitory effect on intestinal smooth muscle contractility of several animal species. These actions are mediated directly by opening of potassium channels and indirectly by inhibition of acetylcholine release. In addition galanin inhibits pancreatic hormone secretion (i.e. hypoinsulinemia, hyperglycemia) and partly the release of hormones localized in the gastrointestinal tract. On exocrine glands in man (salivary glands) galanin has hydrokinetic actions. The physiological role of galanin might be regulation of gastrointestinal motility, control of secretory function of intestine and a regulatory role in endocrine and exocrine gland secretion. PMID:1693024

  11. Recent Advances in Gastrointestinal Stent Development.

    PubMed

    Park, Jin-Seok; Jeong, Seok; Lee, Don Haeng

    2015-05-01

    Endoscopic stenting is increasingly being used in the management of gastrointestinal luminal obstruction, and has become the current treatment of choice for the palliation of blockage caused by malignant or benign growths. A variety of stents have been developed to enhance the efficacy of the procedure, and improvements are ongoing. In this article, we review the history of, and recent advances in, gastrointestinal stenting. We describe the rationale behind the design as well as the resulting outcome for each stent type. PMID:26064820

  12. Recent Advances in Gastrointestinal Stent Development

    PubMed Central

    Park, Jin-Seok; Jeong, Seok

    2015-01-01

    Endoscopic stenting is increasingly being used in the management of gastrointestinal luminal obstruction, and has become the current treatment of choice for the palliation of blockage caused by malignant or benign growths. A variety of stents have been developed to enhance the efficacy of the procedure, and improvements are ongoing. In this article, we review the history of, and recent advances in, gastrointestinal stenting. We describe the rationale behind the design as well as the resulting outcome for each stent type. PMID:26064820

  13. Early detection of acute graft-versus-host disease by wireless capsule endoscopy and probe-based confocal laser endomicroscopy: results of a pilot study

    PubMed Central

    Laurent, Valerie; Malard, Florent; Le Rhun, Marc; Chevallier, Patrice; Guillaume, Thierry; Mosnier, Jean-François; Galmiche, Jean-Paul; Mohty, Mohamad

    2014-01-01

    Objective Acute gastrointestinal graft-versus-host disease (GI-GVHD) is usually diagnosed using endoscopic examinations and biopsies for conventional histology. The aim of this pilot study was to determine whether mini-invasive techniques such as probe-based confocal laser endomicroscopy (pCLE) combined with wireless capsule endoscopy (WCE) could detect early lesions of GI-GVHD prior to symptoms. Design Fifteen patients undergoing allogeneic haematopoietic stem cell transplantation (allo-HSCT) were prospectively examined with a small bowel WCE, duodenal and colorectal pCLE, and standard biopsies. Per study protocol, all these examinations were scheduled between day 21 and day 28 after allo-HSCT, independently of the presence or absence of digestive symptoms. Results During follow up, eight patients developed acute GI-GVHD. Sensitivity of WCE, pCLE, and histology were 50, 87.5, and 50%, respectively. Specificity of WCE, pCLE, and histology were 80, 71.5, and 80%, respectively. We showed a positive correlation between the Glücksberg scoring system and WCE (rho?=?0.543, p?=?0.036) and pCLE (rho?=?0.727, p?=?0.002) but not with standard histology (rho?=?0.481, p?=?0.069). Conclusions The results from this pilot study suggest that novel methods such as pCLE and WCE could be part of a mini-invasive algorithm for early detection of GI-GVHD. PMID:25360304

  14. Detection of Mucosal Recurrent Nasopharyngeal Carcinomas After Radiotherapy With Narrow-Band Imaging Endoscopy

    SciTech Connect

    Wang, Wen-Hung [Department of Otolaryngology, Chang Gung Memorial Hospital at Chiayi and Chang Gung University College of Medicine, Taiwan (China); Lin, Yen-Chun, E-mail: sarah_travel@hotmail.com [Department of Otolaryngology, Chang Gung Memorial Hospital at Chiayi and Chang Gung University College of Medicine, Taiwan (China); Chen, Wen-Cheng; Chen, Miao-Fen [Department of Radiation Oncology, Chang Gung Memorial Hospital at Chiayi and Chang Gung University College of Medicine, Taiwan (China); Chen, Chih-Cheng [Department of Hematology and Oncology, Chang Gung Memorial Hospital at Chiayi and Chang Gung University College of Medicine, Taiwan (China); Lee, Kam-Fai [Department of Pathology, Chang Gung Memorial Hospital at Chiayi and Chang Gung University College of Medicine, Taiwan (China)

    2012-07-15

    Purpose: This study evaluated the feasibility of screening mucosal recurrent nasopharyngeal carcinoma with narrow-band imaging (NBI) endoscopy. Methods and Materials: One hundred and six patients were enrolled. All patients underwent conventional white-light (WL) endoscopic examination of the nasopharynx followed by NBI endoscopy. Biopsies were performed if recurrence was suspected. Results: We identified 32 suspected lesions by endoscopy in WL and/or NBI mode. Scattered brown spots (BS) were identified in 22 patients, and 4 of the 22 who had negative MRI findings were histopathologically confirmed to be neoplasias that were successfully removed via endoscopy. A comparison of the visualization in NBI closer view corresponded to histopathological findings in 22 BS, and the prevalence rates of neoplasias in tail signs, round signs, and irregularities signs were 0% (0/6), 0% (0/7), and 44.4% (4/9), respectively (p = 0.048). The sensitivity, specificity, and diagnostic capability were 37.5%, 92.9% and 0.652 for WL, 87.5%, 74.5% and 0.810 for NBI, and 87.5%, 87.8%, and 0.876 for NBI closer view, respectively. NBI closer view was effective in increasing specificity compared with NBI alone (87.8% vs. 74.5%, p < 0.05), and in increasing sensitivity and diagnostic capability compared to WL alone (87.5% vs. 37.5%, p < 0.05; 0.876 vs. 0.652, p = 0.0001). Conclusions: Although NBI in endoscopy can improve sensitivity of mucosal recurrent nasopharyngeal neoplasias, false-positive (nonneoplasia BS) results may be obtained in areas with nonspecific inflammatory changes due to postradiation effects. NBI closer view not only can offer a timely, convenient, and highly reliable assessment of mucosal recurrent nasopharyngeal carcinoma, it can also make endoscopic removal possible.

  15. Gastrointestinal metabolism of contraceptive steroids.

    PubMed

    Back, D J; Madden, S; Orme, M L

    1990-12-01

    A number of oral contraceptive steroids undergo first-pass metabolism in the gastrointestinal mucosa. Ethinyl estradiol (mean systemic bioavailability 40% to 50%) is extensively metabolized, principally to a sulfate conjugate. In vivo studies that use portal vein catheterization and the administration of radiolabeled ethinyl estradiol have shown that the fraction of steroid metabolized in the gut wall is 0.44. In vitro studies with jejunal biopsy samples or larger pieces of jejunum or terminal ileum mounted in Ussing chambers have indicated that more than 30% of added ethinyl estradiol is sulfated. The progestogen desogestrel is a prodrug that is converted to the active metabolite 3-ketodesogestrel. Substantial first-pass metabolism of desogestrel occurs in the gut mucosa, with evidence from Ussing chamber studies for the formation of the active metabolite. Another progestogen, norgestimate, is also metabolized by the gut wall in vitro of which the principal metabolite is the deacetylated product, norgestrel oxime. It seems very likely that this will also occur in vivo. Drug interactions occurring in the gut wall have been reported with ascorbic acid (vitamin C) and paracetamol. PMID:2147818

  16. Self-Expandable Metal Stenting of Refractory Upper Gut Corrosive Strictures: A New Role for Endoscopy?

    PubMed Central

    Manta, Raffaele; Conigliaro, Rita; Bertani, Helga; Manno, Mauro; Soliman, Ahmed; Fedeli, Paolo; Bassotti, Gabrio

    2011-01-01

    Caustic strictures of the gastrointestinal tract are often difficult to treat, since relapses are frequent after medical or endoscopic treatment. Thus, novel approaches are needed. We report here our experience with self-expandable metallic stents (SEMS) as a new endoscopic approach in three patients with corrosive strictures of the upper gastrointestinal tract. PMID:22606415

  17. Upper gastrointestinal issues in athletes.

    PubMed

    Waterman, Jason J; Kapur, Rahul

    2012-01-01

    Gastrointestinal (GI) complaints are common among athletes with rates in the range of 30% to 70%. Both the intensity of sport and the type of sporting activity have been shown to be contributing factors in the development of GI symptoms. Three important factors have been postulated as contributing to the pathophysiology of GI complaints in athletes: mechanical forces, altered GI blood flow, and neuroendocrine changes. As a result of those factors, gastroesophageal reflux disease (GERD), nausea, vomiting, gastritis, peptic ulcers, GI bleeding, or exercise-related transient abdominal pain (ETAP) may develop. GERD may be treated with changes in eating habits, lifestyle modifications, and training modifications. Nausea and vomiting may respond to simple training modifications, including no solid food 3 hours prior to an athletic event. Mechanical trauma, decreased splanchnic blood flow during exercise, and non-steroidal anti-inflammatory drugs (NSAID) contribute to gastritis, GI bleeding, and ulcer formation in athletes. Acid suppression with proton-pump inhibitors may be useful in athletes with persistence of any of the above symptoms. ETAP is a common, poorly-understood, self-limited acute abdominal pain which is difficult to treat. ETAP incidence increases in athletes beginning a new exercise program or increasing the intensity of their current exercise program. ETAP may respond to changes in breathing patterns or may resolve simply with continued training. Evaluation of the athlete with upper GI symptoms requires a thorough history, a detailed training log, a focused physical examination aimed at ruling out potentially serious causes of symptoms, and follow-up laboratory testing based on concerning physical examination findings. PMID:22410703

  18. Surgical Treatment of Gastric Gastrointestinal Stromal Tumor

    PubMed Central

    Kong, Seong-Ho

    2013-01-01

    Gastrointestinal stromal tumor is the most common mesenchymal tumor in the gastrointestinal tract and is most frequently developed in the stomach in the form of submucosal tumor. The incidence of gastric gastrointestinal stromal tumor is estimated to be as high as 25% of the population when all small and asymptomatic tumors are included. Because gastric gastrointestinal stromal tumor is not completely distinguished from other submucosal tumors, a surgical excisional biopsy is recommended for tumors >2 cm. The surgical principles of gastrointestinal stromal tumor are composed of an R0 resection with a normal mucosa margin, no systemic lymph node dissection, and avoidance of perforation, which results in peritoneal seeding even in cases with otherwise low risk profiles. Laparoscopic surgery has been indicated for gastrointestinal stromal tumors <5 cm, and the indication for laparoscopic surgery is expanded to larger tumors if the above mentioned surgical principles can be maintained. A simple exogastric resection and various transgastric resection techniques are used for gastrointestinal stromal tumors in favorable locations (the fundus, body, greater curvature side). For a lesion at the gastroesophageal junction in the posterior wall of the stomach, enucleation techniques have been tried preserve the organ's function. Those methods have a theoretical risk of seeding a ruptured tumor, but this risk has not been evaluated by well-designed clinical trials. While some clinical trials are still on-going, neoadjuvant imatinib is suggested when marginally unresectable or multiorgan resection is anticipated to reduce the extent of surgery and the chance of incomplete resection, rupture or bleeding. PMID:23610714

  19. Recent Update of Gastrointestinal Endoscope Reprocessing

    PubMed Central

    Hong, Kyong Hee

    2013-01-01

    As infection-related issues have become one of the most important concerns in endoscopy centers, proper reprocessing of endoscopes has attracted great interest. Compliance with established guidelines for reprocessing is critical to prevent pathogen transmission. However, hospital compliance with guidelines has not been satisfactory. To increase compliance, efforts have focused on developing new and more innovative disinfectants and an automated endoscope reprocessor. Reprocessing must be performed by appropriately trained personnel and regular monitoring of reprocessing is essential for quality assurance to improve compliance. PMID:23767038

  20. Management Strategy for Patients With Gastroesophageal Reflux Disease: A Comparison Between Empirical Treatment With Esomeprazole and Endoscopy-Oriented Treatment

    Microsoft Academic Search

    Edoardo G. Giannini; Patrizia Zentilin; Pietro Dulbecco; Sergio Vigneri; Pamela Scarlata; Vincenzo Savarino

    2008-01-01

    OBJECTIVES:Whether patients with typical gastroesophageal reflux disease (GERD) symptoms and without alarm features should be treated empirically or undergo endoscopy first is a debated issue. In this study, our aim was to assess the efficacy, and to compare the direct costs and impact on health-related quality of life (HRQL), of two treatment strategies (empirical vs endoscopy-oriented treatment) in a large

  1. Role of Helicobacter pylori in causation of diabetic gastropathies and non-gastrointestinal complications in type 2 diabetes.

    PubMed

    Agrawal, R P; Sharma, R; Garg, D; Pokharna, R; Kochar, D K; Kothari, R P

    2010-03-01

    A cross-sectional case-control study was conducted in 80 diabetic patients, to evaluate the incidence of gastropathy by endoscopy in type 2 diabetes mellitus. An association between Helicobacter pylori infection and non-gastrointestinal complication of diabetes mellitus was also looked into. Gastric biopsies were subjected to rapid urease test for demonstration of Helicobacter pylori. The fasting blood glucose levels among Helicobacter pylori positive diabetes were 175 +/- 36.5 mg %, and in Helicobacter pylori negative diabetics were 138 +/- 39.4 mg %. The prevalence of endoscopically detectable gastro-intestinal complications were higher in Helicobacter pylori infected diabetics (odd's ratio 4:2; p < 0.05). The total prevalence of Helicobacter pylori positive in diabetics by rapid urease test was statistically significant (p < 0.05). Coronary heart disease was more prevalent in diabetics with Helicobacter pylori infection than those without Helicobacter pylori (57%). The prevalence of H. pylori positivity in other complications such as peripheral vascular diseases, cerebrovascular diseases was not significant. The association between nephropathy, retinopathy and neuropathy with Helicobacter pylori, was also observed and the strong association was seen in diabetic retinopathy (p < 0.001), diabetic neuropathy (p < 0.01) and nephropathy (p < 0.001). PMID:21043350

  2. Examination of visceral perception and gastric tone by gastric stimulation using air inflation during endoscopy.

    PubMed

    Suzuki, T; Hirano, M; Yamamoto, Y

    2005-01-01

    This study investigated the assessment of visceral perception and gastric tone using insufflation during endoscopy. The intragastric pressure was measured during insufflation in 16 patients with gastro-oesophageal reflux disease, 25 patients with functional dyspepsia and 24 normal controls, using a pressure transducer inserted through the forceps aperture until gastric symptoms appeared. The intragastric pressure at the visceral perception threshold, the time to threshold and the time-pressure curve gradient were measured. The visceral perception threshold was significantly reduced in the functional dyspepsia group compared with the normal controls. Balloons were also inserted into the duodenal bulbs of 10 normal controls to investigate the effect of efflux of air into the duodenum; the measured parameters were not influenced by inflation and deflation. These results suggest that it is possible to assess visceral perception and gastric tone by measuring changes in intragastric pressure, using gastric stimulation by insufflation during endoscopy. PMID:15790127

  3. Unexplained gastrointestinal symptoms: think mitochondrial disease.

    PubMed

    Chapman, Thomas P; Hadley, Gina; Fratter, Carl; Cullen, Sue N; Bax, Bridget E; Bain, Murray D; Sapsford, Robert A; Poulton, Joanna; Travis, Simon P

    2014-01-01

    Defects in mitochondrial function are increasingly recognised as central to the pathogenesis of many diseases, both inherited and acquired. Many of these mitochondrial defects arise from abnormalities in mitochondrial DNA and can result in multisystem disease, with gastrointestinal involvement common. Moreover, mitochondrial disease may present with a range of non-specific symptoms, and thus can be easily misdiagnosed, or even considered to be non-organic. We describe the clinical, histopathological and genetic findings of six patients from three families with gastrointestinal manifestations of mitochondrial disease. In two of the patients, anorexia nervosa was considered as an initial diagnosis. These cases illustrate the challenges of both diagnosing and managing mitochondrial disease and highlight two important but poorly understood aspects, the clinical and the genetic. The pathophysiology of gastrointestinal involvement in mitochondrial disease is discussed and emerging treatments are described. Finally, we provide a checklist of investigations for the gastroenterologist when mitochondrial disease is suspected. PMID:23768727

  4. Heme oxygenase-1 system and gastrointestinal tumors

    PubMed Central

    Zhu, Xiao; Fan, Wen-Guo; Li, Dong-Pei; Lin, Marie CM; Kung, Hsiangfu

    2010-01-01

    Heme oxygenase-1 (HO-1) system catabolizes heme into three products: carbon monoxide, biliverdin/bilirubin and free iron. It is involved in many physiological and pathophysiological processes. A great deal of data has demonstrated the roles of HO-1 in the formation, growth and metastasis of tumors. The interest in this system by investigators involved in gastrointestinal tumors is fairly recent, and few papers on HO-1 have touched upon this subject. This review focuses on the current understanding of the physiological significance of HO-1 induction and its possible roles in the gastrointestinal tumors studied to date. The implications for possible therapeutic manipulation of HO-1 in gastrointestinal tumors are also discussed. PMID:20518085

  5. The addition of high magnifying endoscopy improves rates of high confidence optical diagnosis of colorectal polyps

    PubMed Central

    Iwatate, Mineo; Sano, Yasushi; Hattori, Santa; Sano, Wataru; Hasuike, Noriaki; Ikumoto, Taro; Kotaka, Masahito; Murakami, Yoshitaka; Hewett, David G.; Soetikno, Roy; Kaltenbach, Tonya; Fujimori, Takahiro

    2015-01-01

    Background and study aims: The real-time optical diagnosis of colorectal polyps with high confidence predictions can achieve high levels of accuracy. Increasing the rates of high confidence optical diagnosis can improve the clinical application of real-time optical diagnosis in routine practice. The primary aim of this prospective study was to evaluate whether high magnifying endoscopy improves the rates of high confidence narrow-band imaging (NBI)?–?based optical diagnosis for differentiating between neoplastic and non-neoplastic colorectal lesions according to the NBI international colorectal endoscopic (NICE) classification. Patients and methods: Consecutive adult patients undergoing colonoscopy with a high magnifying (maximum, ×?80) colonoscope between April and August 2012 were recruited. The optical diagnosis for each polyp was evaluated during colonoscopy in two consecutive stages by the same endoscopist, who first used NBI with non-magnifying endoscopy (NBI-NME), then NBI with magnifying endoscopy (NBI-ME). A level of confidence was assigned to each prediction. Results: The analysis included 124 patients (mean age, 56.4 years; male-to-female ratio, 72:52) with 248 polyps smaller than 10?mm. Of the 248 polyps, 210 were 1 to 5?mm in size and 38 were 6 to 9?mm in size; 77 polyps were hyperplastic, 4 were sessile serrated adenomas/polyps, 160 were low grade adenomas, 5 were high grade adenomas, and 2 were deep submucosal invasive carcinomas. The rate of high confidence optical diagnosis when NBI-ME was used was significantly higher than the rate when NBI-NME was used for diminutive (1?–?5?mm) polyps (92.9?% vs 79.5?%, P?endoscopy significantly improved the rates of high confidence NBI-based optical diagnosis of diminutive and small colorectal polyps. Study registration: UMIN 000007608

  6. Usefulness of magnifying narrow-band imaging endoscopy for the diagnosis of gastric and colorectal lesions.

    PubMed

    Hirata, Ichiro; Nakagawa, Yoshihito; Ohkubo, Masaaki; Yahagi, Naohisa; Yao, Kenshi

    2012-01-01

    A series of studies about the potential usefulness of magnifying endoscopy with narrow-band imaging (NBI) for the diagnosis of gastric and colonic lesion is reviewed. Concerning the magnifying NBI appearances of gastric lesions, a light blue crest is a highly accurate sign of the presence of histological intestinal metaplasia. Also, the degree of irregularity of the mucosal and vascular pattern is correlated with the histological severity of Helicobacter pylori-associated chronic gastritis. According to the 'VS classification', an irregular microvascular pattern and/or an irregular microsurface pattern together with a clear demarcation line are characteristic for early gastric carcinoma, and a multicenter prospective randomized controlled trial demonstrated that magnifying endoscopy with NBI is superior to ordinary white light endoscopy for making a differential diagnosis of a small depressed lesion between carcinoma and non-carcinoma. Concerning the magnifying NBI appearances of colonic tumor, the vague or invisible microvascular pattern is mostly observed in hyperplastic polyp. The regular meshed microvascular pattern is mostly observed in adenoma. The irregular meshed microvascular pattern is mostly observed in intramucosal or shallow submucosal-invasive carcinoma. The decreased or loose microvasucular pattern is mostly observed in deep submucosal-invasive carcinoma. Thus, magnifying NBI endoscopy is useful for the differentiation of colorectal non-adenomatous lesions from adenoma, the differentiation of adenoma from carcinoma, and the assessment of invasion depth of early colorectal carcinoma. At present, several magnifying NBI classifications for the diagnosis of early colorectal neoplasia have been proposed in Japan. Recently, the NICE classification based on NBI findings with/without magnification for colorectal tumor was established by an international group. PMID:22269282

  7. Fluconazole compared with endoscopy for human immunodeficiency virus- infected patients with esophageal symptoms

    Microsoft Academic Search

    CM Wilcox; LN Alexander; WS Clark; SE Thompson

    1996-01-01

    BACKGROUND & AIMS: The best initial treatment of human immunodeficiency virus (HIV)-infected patients with esophageal symptoms is unknown. The outcome, including safety and cost-effectiveness, of fluconazole compared with endoscopy as a treatment strategy for HIV-infected patients with new-onset esophageal symptoms was evaluated. METHODS: During a 53-month period, 134 HIV-infected patients with esophageal symptoms were randomized prospectively to groups receiving either

  8. A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease

    Microsoft Academic Search

    Guido Costamagna; Saumil K. Shah; Maria Elena Riccioni; Francesca Foschia; Massimiliano Mutignani; Vincenzo Perri; Amorino Vecchioli; Maria Gabriella Brizi; Aurelio Picciocchi; Pasquale Marano

    2002-01-01

    Background & Aims: This study was undertaken to prospectively compare the clinical outcomes of small bowel radiographs with the wireless capsule endoscopy. Methods: Twenty-two patients were selected consecutively because of suspected small bowel disease. Two patients were excluded owing to ileal stenosis. Thus, the results of barium follow-through and the Given M2A wireless video capsule (Given Imaging Ltd., Yoqneam, Israel)

  9. Propofol versus midazolam and meperidine for conscious sedation in GI endoscopy

    Microsoft Academic Search

    Gita Koshy; Satheesh Nair; Edward P. Norkus; Hilary I. Hertan; C. S. Pitchumoni

    2000-01-01

    OBJECTIVE:Propofol (2,6-diisopropyl phenol) is a relatively new intravenous sedative hypnotic with an ideal pharmacokinetic profile for conscious sedation. In this study, we compared the safety and efficacy of propofol versus the conventional regimen of midazolam and meperidine for conscious sedation in GI endoscopy.METHODS:In this prospective study, 274 patients that included many elderly patients with multiple comorbid conditions underwent GI endoscopic

  10. KIT gene mutations in gastrointestinal stromal tumor.

    PubMed

    Kang, Weiming; Zhu, Changzhen; Yu, JianChun; Ye, Xin; Ma, ZhiQiang

    2015-01-01

    Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract. It arises in the stomach, small intestine, colon, rectum and esophagus. KIT gene mutation is a feature of GIST, in addition to PDGFRA gene mutation. KIT gene mutations have been observed to be involved in the development of GIST, its recurrence after surgery and chemotherapy resistance in GIST. Exons 13, 17, 9, and mainly exon 11 are concerned in these biological behaviors of GIST. In this review, we will discuss on the involvement of KIT gene mutations in the tumorigenesis, recurrence and chemotherapeutic resistance of GIST. PMID:25961532

  11. A rare cause of gastrointestinal bleeding, "GANT".

    PubMed

    ?pekçi, Fuat; Engin, Ömer; Çapkis, Yahya; Etit, Demet

    2014-12-01

    Acute gastrointestinal hemorrhage is frequently seen in emergency surgical conditions. Benign pathologies are generally responsible in etiologic factors. Our case is a GANT. GANT is a mesenchymal tumor originated from Cajal cells or precursors of them. Cajal cells are pacemaker cells in the intestinal wall. Because GANT is a very rare tumor, we would like to report our case to the medical literature. We think very rare cases and treatments of its as like our case create view point states in etiology of acute gastrointestinal hemorrhage. PMID:25910310

  12. Large melanoma metastases to the gastrointestinal tract.

    PubMed Central

    Silverman, J M; Hamlin, J A

    1989-01-01

    It is well known that malignant melanoma can metastasize widely. Although these metastases in the gastrointestinal tract usually appear as small 'bull's-eye' or 'target' lesions, there are a few reports of relatively large melanoma metastases. We report five cases of large melanoma lesions metastatic to the alimentary canal. We also emphasise the consideration of a thorough gastrointestinal tract evaluation in patients with malignant melanoma especially if they are symptomatic. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 PMID:2612991

  13. Multiphoton gradient index endoscopy for evaluation of diseased human prostatic tissue ex vivo

    NASA Astrophysics Data System (ADS)

    Huland, David M.; Jain, Manu; Ouzounov, Dimitre G.; Robinson, Brian D.; Harya, Diana S.; Shevchuk, Maria M.; Singhal, Paras; Xu, Chris; Tewari, Ashutosh K.

    2014-11-01

    Multiphoton microscopy can instantly visualize cellular details in unstained tissues. Multiphoton probes with clinical potential have been developed. This study evaluates the suitability of multiphoton gradient index (GRIN) endoscopy as a diagnostic tool for prostatic tissue. A portable and compact multiphoton endoscope based on a 1-mm diameter, 8-cm length GRIN lens system probe was used. Fresh ex vivo samples were obtained from 14 radical prostatectomy patients and benign and malignant areas were imaged and correlated with subsequent H&E sections. Multiphoton GRIN endoscopy images of unfixed and unprocessed prostate tissue at a subcellular resolution are presented. We note several differences and identifying features of benign versus low-grade versus high-grade tumors and are able to identify periprostatic tissues such as adipocytes, periprostatic nerves, and blood vessels. Multiphoton GRIN endoscopy can be used to identify both benign and malignant lesions in ex vivo human prostate tissue and may be a valuable diagnostic tool for real-time visualization of suspicious areas of the prostate.

  14. Perspective volume rendering of cross-sectional images for simulated endoscopy and intraparenchymal viewing

    NASA Astrophysics Data System (ADS)

    Napel, Sandy; Rubin, Geoffrey D.; Beaulieu, Christopher F.; Jeffrey, R. Brooke, Jr.; Argiro, Vincent

    1996-04-01

    The capability of today's clinical scanners to create large quantities of high resolution and near isotropically sampled volume data, coupled with a rapidly improving performance/price ratio of computers, has created the challenge and feasibility of creating new ways to explore cross- sectional medical imagery. Perspective volume rendering (PVR) allows an observer to 'fly- through' image data and view its contents from within for diagnostic and treatment planning purposes. We simulated flights through 14 data sets and, where possible, these were compared to conventional endoscopy. We demonstrated colonic masses and polyps as small as 5 mm, tracheal obstructions and precise positioning of endoluminal stent-grafts. Simulated endoscopy was capable of generating views not possible with conventional endoscopy due to its restrictions on camera location and orientation. Interactive adjustment of tissue opacities permitted views beyond the interior of lumina to reveal other structures such as masses, thrombus, and calcifications. We conclude that PVR is an exciting new technique with the potential to supplement and/or replace some conventional diagnostic imaging procedures. It has further utility for treatment planning and communication with colleagues, and the potential to reduce the number of normal people who would otherwise undergo more invasive procedures without benefit.

  15. Tolerability of magnifying narrow band imaging endoscopy for esophageal cancer screening

    PubMed Central

    Yamasaki, Yasushi; Takenaka, Ryuta; Hori, Keisuke; Takemoto, Koji; Kawano, Seiji; Kawahara, Yoshiro; Okada, Hiroyuki; Fujiki, Shigeatsu; Yamamoto, Kazuhide

    2015-01-01

    AIM: To compare the tolerability of magnifying narrow band imaging endoscopy for esophageal cancer screening with that of lugol chromoendoscopy. METHODS: We prospectively enrolled and analyzed 51 patients who were at high risk for esophageal cancer. All patients were divided into two groups: a magnifying narrow band imaging group, and a lugol chromoendoscopy group, for comparison of adverse symptoms. Esophageal cancer screening was performed on withdrawal of the endoscope. The primary endpoint was a score on a visual analogue scale for heartburn after the examination. The secondary endpoints were scale scores for retrosternal pain and dyspnea after the examinations, change in vital signs, total procedure time, and esophageal observation time. RESULTS: The scores for heartburn and retrosternal pain in the magnifying narrow band imaging group were significantly better than those in the lugol chromoendoscopy group (P = 0.004, 0.024, respectively, ANOVA for repeated measures). The increase in heart rate after the procedure was significantly greater in the lugol chromoendoscopy group. There was no significant difference between the two groups with respect to other vital sign. The total procedure time and esophageal observation time in the magnifying narrow band imaging group were significantly shorter than those in the lugol chromoendoscopy group (450 ± 116 vs 565 ± 174, P = 0.004, 44 ± 26 vs 151 ± 72, P < 0.001, respectively). CONCLUSION: Magnifying narrow band imaging endoscopy reduced the adverse symptoms compared with lugol chromoendoscopy. Narrow band imaging endoscopy is useful and suitable for esophageal cancer screening periodically. PMID:25759551

  16. Calculus detection calibration among dental hygiene faculty members utilizing dental endoscopy: a pilot study.

    PubMed

    Partido, Brian B; Jones, Archie A; English, Dana L; Nguyen, Carol A; Jacks, Mary E

    2015-02-01

    Dental and dental hygiene faculty members often do not provide consistent instruction in the clinical environment, especially in tasks requiring clinical judgment. From previous efforts to calibrate faculty members in calculus detection using typodonts, researchers have suggested using human subjects and emerging technology to improve consistency in clinical instruction. The purpose of this pilot study was to determine if a dental endoscopy-assisted training program would improve intra- and interrater reliability of dental hygiene faculty members in calculus detection. Training included an ODU 11/12 explorer, typodonts, and dental endoscopy. A convenience sample of six participants was recruited from the dental hygiene faculty at a California community college, and a two-group randomized experimental design was utilized. Intra- and interrater reliability was measured before and after calibration training. Pretest and posttest Kappa averages of all participants were compared using repeated measures (split-plot) ANOVA to determine the effectiveness of the calibration training on intra- and interrater reliability. The results showed that both kinds of reliability significantly improved for all participants and the training group improved significantly in interrater reliability from pretest to posttest. Calibration training was beneficial to these dental hygiene faculty members, especially those beginning with less than full agreement. This study suggests that calculus detection calibration training utilizing dental endoscopy can effectively improve interrater reliability of dental and dental hygiene clinical educators. Future studies should include human subjects, involve more participants at multiple locations, and determine whether improved rater reliability can be sustained over time. PMID:25640616

  17. Nasal and sinus endoscopy for medical management of resistant rhinosinusitis, including postsurgical patients.

    PubMed

    Tichenor, Wellington S; Adinoff, Allen; Smart, Brian; Hamilos, Daniel L

    2008-04-01

    Nasal endoscopy has been practiced by allergists since the early 1980s; however, allergists in general have not embraced endoscopic evaluation of patients with sinus disease, either before or after surgery. Allergists are in a unique position to render medical (as opposed to surgical) care of patients with sinusitis. There has been a growing realization that endoscopy is a valuable procedure for the evaluation and medical treatment of patients with difficult sinusitis. This has resulted in the need for a resource to allow allergists to understand the nature of endoscopic findings in patients with sinusitis, either preoperatively or postoperatively. This article introduces the findings at endoscopy that are common in patients with sinusitis, including those that may be seen after surgery. The findings include perforation of the septum, retained secretions, small surgical ostium caused by postoperative ostial stenosis, previous Caldwell Luc procedure, recirculation of mucus, hyperplastic nasal disease, synechiae, recurrent disease in previously unaffected sinuses, empty nose syndrome, frontal sinus disease, dental disease, and other, more complicated entities. PMID:17981318

  18. Crohn's disease and ulcerative colitis. Evaluation with double-contrast barium examination and endoscopy.

    PubMed

    Freeny, P C

    1986-09-01

    Double-contrast barium examination of the colon can demonstrate the changes associated with inflammatory bowel disease more completely and specifically than the single-contrast barium study. However, endoscopy is slightly more sensitive than double-contrast examination for detection of disease. In general, between 18% and 20% of patients with Crohn's disease or ulcerative colitis may be expected to have normal radiographic findings but endoscopically detectable disease. However, most false-negative double-contrast colon studies are associated with mild or minimal findings at proctosigmoidoscopy. Although double-contrast radiography may be less sensitive than endoscopy in detection of inflammatory bowel disease, it has similar accuracy for classification and differentiation. Most studies indicate an accuracy of 95% to 98% in differentiating Crohn's disease and ulcerative colitis, due to the fact that morphologic changes detected by the double-contrast mucosal study rarely overlap in the two diseases. Double-contrast barium examination and endoscopy are complementary studies, and the use of both may provide valuable information for evaluation of patients with suspected inflammatory bowel disease. PMID:3748918

  19. Oral adverse effects of gastrointestinal drugs and considerations for dental management in patients with gastrointestinal disorders

    PubMed Central

    Karthik, Ramya; Karthik, K. S.; David, Chaya; Ameerunnisa; Keerthi, G.

    2012-01-01

    Gastrointestinal disease is associated with alterations in the mouth or influence the course of the dental diseases, and the dental health care workers are expected to recognize, diagnose, and treat oral conditions associated with gastrointestinal diseases and also provide safe and appropriate dental care for afflicted individuals. Drugs used in the management of these diseases result in oral adverse effects and also are known to interact with those prescribed during dental care. Hence, this article has reviewed the drug considerations and guidelines for drug use during dental management of patients with gastrointestinal diseases. PMID:23066260

  20. Multiphoton tomographic imaging: a potential optical biopsy tool for detecting gastrointestinal inflammation and neoplasia

    PubMed Central

    Makino, Tomoki; Jain, Manu; Montrose, David C.; Aggarwal, Amit; Sterling, Joshua; Bosworth, Brian P.; Milsom, Jeffrey W.; Robinson, Brian D.; Shevchuk, Maria M.; Kawaguchi, Kathy; Zhang, Ning; Brown, Christopher M.; Rivera, David R.; Williams, Wendy O.; Xu, Chris; Dannenberg, Andrew J.; Mukherjee, Sushmita

    2012-01-01

    Endoscopy is widely used to detect and remove premalignant lesions with the goal of preventing gastrointestinal (GI) cancers. Because current endoscopes do not provide cellular resolution, all suspicious lesions are biopsied and subjected to histological evaluation. Technologies that facilitate directed biopsies should decrease both procedure-related morbidity and cost. Here we explore the use of multiphoton microscopy (MPM), an optical biopsy tool that relies on intrinsic tissue emissions, to evaluate pathology in both experimental and human GI specimens, using hematoxylin and eosin (H&E)-stained sections from these tissues for comparison. After evaluating the entire normal mouse GI tract, MPM was used to investigate disease progression in mouse models of colitis and colorectal carcinogenesis. MPM provided sufficient histological detail to identify all relevant substructures in ex vivo normal GI tissue, visualize both acute and resolving stages of colitis, and show the progression of colorectal carcinogenesis. Next, ex vivo specimens from human subjects with celiac sprue, inflammatory bowel disease, and colorectal neoplasia were imaged by MPM. Finally, colonic mucosa in live anesthetized rats was imaged in vivo using a flexible endoscope prototype. In both animal models and human specimens, MPM images demonstrated a striking similarity to the results of H&E staining, as demonstrated by the 100% concordance achieved by the study pathologists’ diagnoses. In summary, MPM is a promising technique that accurately visualizes histology in fresh, unstained tissues. Our findings support the continued development of MPM as a technology to enhance the early detection of GI pathologies including premalignant lesions. PMID:22961775

  1. Patient characteristics with high or low blood urea nitrogen in upper gastrointestinal bleeding

    PubMed Central

    Tomizawa, Minoru; Shinozaki, Fuminobu; Hasegawa, Rumiko; Shirai, Yoshinori; Motoyoshi, Yasufumi; Sugiyama, Takao; Yamamoto, Shigenori; Ishige, Naoki

    2015-01-01

    AIM: To examine characteristics of patients with blood urea nitrogen (BUN) levels higher and lower than the normal limit. METHODS: Patient records between April 2011 and March 2014 were analyzed retrospectively. During this time, 3296 patients underwent upper endoscopy. In total, 50 male (69.2 ± 13.2 years) and 26 female (72.3 ± 10.2 years) patients were assessed. Patients were divided into two groups based on BUN levels: higher than the normal limit (21.0 mg/dL) (H) and lower than the normal limit (L). One-way analysis of variance was performed to reveal differences in the variables between the H and L groups. Fisher’s exact test was used to compare the percentage of patients with gastric ulcer or gastric cancer in the H and L groups. RESULTS: White blood cell count was higher in the H group than in the L group (P = 0.0047). Hemoglobin level was lower in the H group than in the L group (P = 0.0307). Glycated hemoglobin was higher in the H group than in the L group (P = 0.0264). The percentage of patients with gastric ulcer was higher in the H group (P = 0.0002). The H group contained no patients with gastric cancer. CONCLUSION: Patients with BUN ? 21 mg/dL might have more severe upper gastrointestinal bleeding.

  2. Does Preendoscopy Rockall Score Safely Identify Low Risk Patients following Upper Gastrointestinal Haemorrhage?

    PubMed Central

    Johnston, Matthew R.; Murray, Iain A.; Schultz, Michael; McLeod, Peter; O'Donnell, Nathan; Norton, Heather; Baines, Chelsea; Fawcett, Emily; Fesaitu, Terry; Leung, Hin; Park, Jeong-Yoon; Salleh, Adibah; Zhang, Wei; García, José A.

    2015-01-01

    Objective. To determine if preendoscopy Rockall score (PERS) enables safe outpatient management of New Zealanders with upper gastrointestinal haemorrhage (UGIH). Methods. Retrospective analysis of adults with UGIH over 59 consecutive months. PERS, diagnosis, demographics, need for endoscopic therapy, transfusion or surgery and 30-day mortality and 14-day rebleeding rate, and sensitivity and specificity of PERS for enabling safe discharge preendoscopy were calculated. Results. 424 admissions with UGIH. Median age was 74.3 years (range 19–93 years), with 55.1% being males. 30-day mortality was 4.6% and 14-day rebleeding rate was 6.0%. Intervention was required in 181 (46.6%): blood transfusion (147?:?37.9%), endoscopic intervention (75?:?19.3%), and surgery (8?:?2.1%). 42 (10.8%) had PERS = 0 with intervention required in 15 (35.7%). Females more frequently required intervention, OR 1.73 (CI: 1.12–2.69). PERS did not predict intervention but did predict 30-day mortality: each point increase equated to an increase in mortality of OR 1.46 (CI: 1.11–1.92). Taking NSAIDs/aspirin reduced 30-day mortality, OR 0.22 (CI: 0.08–0.60). Conclusion. PERS identifies 10.8% of those with UGIH as low risk but 35.7% required intervention or died. It has a limited role in assessing these patients and should not be used to identify those suitable for outpatient endoscopy. PMID:26089867

  3. Consensus on Control of Risky Nonvariceal Upper Gastrointestinal Bleeding in Taiwan with National Health Insurance

    PubMed Central

    Sheu, Bor-Shyang; Wu, Chun-Ying; Wu, Ming-Shiang; Chiu, Cheng-Tang; Hsu, Ping-I; Cheng, Hsiu-Chi; Wang, Hsiu-Po; Lin, Jaw-Town

    2014-01-01

    Background and Aims. To compose upper gastrointestinal bleeding (UGIB) consensus from a nationwide scale to improve the control of UGIB, especially for the high-risk comorbidity group. Methods. The steering committee defined the consensus scope to cover preendoscopy, endoscopy, postendoscopy, and overview from Taiwan National Health Insurance Research Database (NHIRD) assessments for UGIB. The expert group comprised thirty-two Taiwan experts of UGIB to conduct the consensus conference by a modified Delphi process through two separate iterations to modify the draft statements and to vote anonymously to reach consensus with an agreement ?80% for each statement and to set the recommendation grade. Results. The consensus included 17 statements to highlight that patients with comorbidities, including liver cirrhosis, end-stage renal disease, probable chronic obstructive pulmonary disease, and diabetes, are at high risk of peptic ulcer bleeding and rebleeding. Special considerations are recommended for such risky patients, including raising hematocrit to 30% in uremia or acute myocardial infarction, aggressive acid secretory control in high Rockall scores, monitoring delayed rebleeding in uremia or cirrhosis, considering cycloxygenase-2 inhibitors plus PPI for pain control, and early resumption of antiplatelets plus PPI in coronary artery disease or stroke. Conclusions. The consensus comprises recommendations to improve care of UGIB, especially for high-risk comorbidities. PMID:25197649

  4. Does Preendoscopy Rockall Score Safely Identify Low Risk Patients following Upper Gastrointestinal Haemorrhage?

    PubMed

    Johnston, Matthew R; Murray, Iain A; Schultz, Michael; McLeod, Peter; O'Donnell, Nathan; Norton, Heather; Baines, Chelsea; Fawcett, Emily; Fesaitu, Terry; Leung, Hin; Park, Jeong-Yoon; Salleh, Adibah; Zhang, Wei; García, José A

    2015-01-01

    Objective. To determine if preendoscopy Rockall score (PERS) enables safe outpatient management of New Zealanders with upper gastrointestinal haemorrhage (UGIH). Methods. Retrospective analysis of adults with UGIH over 59 consecutive months. PERS, diagnosis, demographics, need for endoscopic therapy, transfusion or surgery and 30-day mortality and 14-day rebleeding rate, and sensitivity and specificity of PERS for enabling safe discharge preendoscopy were calculated. Results. 424 admissions with UGIH. Median age was 74.3 years (range 19-93 years), with 55.1% being males. 30-day mortality was 4.6% and 14-day rebleeding rate was 6.0%. Intervention was required in 181 (46.6%): blood transfusion (147?:?37.9%), endoscopic intervention (75?:?19.3%), and surgery (8?:?2.1%). 42 (10.8%) had PERS = 0 with intervention required in 15 (35.7%). Females more frequently required intervention, OR 1.73 (CI: 1.12-2.69). PERS did not predict intervention but did predict 30-day mortality: each point increase equated to an increase in mortality of OR 1.46 (CI: 1.11-1.92). Taking NSAIDs/aspirin reduced 30-day mortality, OR 0.22 (CI: 0.08-0.60). Conclusion. PERS identifies 10.8% of those with UGIH as low risk but 35.7% required intervention or died. It has a limited role in assessing these patients and should not be used to identify those suitable for outpatient endoscopy. PMID:26089867

  5. Opportunistic disorders of the gastrointestinal tract in the age of highly active antiretroviral therapy.

    PubMed

    Huppmann, Alison R; Orenstein, Jan Marc

    2010-12-01

    Since the 1996 advent of highly active antiretroviral therapy (HAART) for the treatment of HIV/AIDS, the incidence of most opportunistic disorders in the developed world has dramatically declined but definitely has not disappeared. The number of new yearly HIV infections (about 55,000) and the total number of US infections (more than 1.1 million) remain very significant. Post-HAART gastrointestinal (GI) symptoms and biopsy results are still common, especially in large inner-city hospitals. The same opportunistic GI disorders were diagnosed in 442 endoscopies performed since 1996 as before, but at about one half the rate. The esophagus had the highest rate of positive biopsy results (46%), especially due to Candida. Helicobacter pylori infection has become the most common gastric infection. The small bowel still showed cytomegalovirus (CMV), cryptosporidia, and Mycobacterium avium complex (MAC) infections. In decreasing order, the most common large bowel infections were CMV, cryptosporidiosis, MAC, and spirochetosis. Cases of adenovirus, bacterial colitis, Kaposi sarcoma, and lymphoma were still diagnosed. Rectal biopsy specimens were the least productive. Microsporidiosis is now being diagnosed with special stains. Thus, where HIV/AIDS is common, it is important to be able to diagnose these GI processes. In addition to presenting post-HAART incidences, diagnostic features and aids are described for selected entities. PMID:21078437

  6. Multiphoton tomographic imaging: a potential optical biopsy tool for detecting gastrointestinal inflammation and neoplasia.

    PubMed

    Makino, Tomoki; Jain, Manu; Montrose, David C; Aggarwal, Amit; Sterling, Joshua; Bosworth, Brian P; Milsom, Jeffrey W; Robinson, Brian D; Shevchuk, Maria M; Kawaguchi, Kathy; Zhang, Ning; Brown, Christopher M; Rivera, David R; Williams, Wendy O; Xu, Chris; Dannenberg, Andrew J; Mukherjee, Sushmita

    2012-11-01

    Endoscopy is widely used to detect and remove premalignant lesions with the goal of preventing gastrointestinal (GI) cancers. Because current endoscopes do not provide cellular resolution, all suspicious lesions are biopsied and subjected to histologic evaluation. Technologies that facilitate directed biopsies should decrease both procedure-related morbidity and cost. Here we explore the use of multiphoton microscopy (MPM), an optical biopsy tool that relies on intrinsic tissue emissions, to evaluate pathology in both experimental and human GI specimens, using hematoxylin and eosin (H&E)-stained sections from these tissues for comparison. After evaluating the entire normal mouse GI tract, MPM was used to investigate disease progression in mouse models of colitis and colorectal carcinogenesis. MPM provided sufficient histologic detail to identify all relevant substructures in ex vivo normal GI tissue, visualize both acute and resolving stages of colitis, and show the progression of colorectal carcinogenesis. Next, ex vivo specimens from human subjects with celiac sprue, inflammatory bowel disease, and colorectal neoplasia were imaged by MPM. Finally, colonic mucosa in live anesthetized rats was imaged in vivo using a flexible endoscope prototype. In both animal models and human specimens, MPM images showed a striking similarity to the results of H&E staining, as shown by the 100% concordance achieved by the study pathologists' diagnoses. In summary, MPM is a promising technique that accurately visualizes histology in fresh, unstained tissues. Our findings support the continued development of MPM as a technology to enhance the early detection of GI pathologies including premalignant lesions. PMID:22961775

  7. Epistaxis in end stage liver disease masquerading as severe upper gastrointestinal hemorrhage

    PubMed Central

    Camus, Marine; Jensen, Dennis M; Matthews, Jason D; Ohning, Gordon V; Kovacs, Thomas O; Jutabha, Rome; Ghassemi, Kevin A; Machicado, Gustavo A; Dulai, Gareth S

    2014-01-01

    AIM: To describe the prevalence, diagnosis, treatment, and outcomes of end stage liver disease (ESLD) patients with severe epistaxis thought to be severe upper gastrointestinal hemorrhage (UGIH). METHODS: This observational single center study included all consecutive patients with ESLD and epistaxis identified from consecutive subjects hospitalized with suspected UGIH and prospectively enrolled in our databases of severe UGIH between 1998 and 2011. RESULTS: A total of 1249 patients were registered for severe UGIH in the data basis, 461 (36.9%) were cirrhotics. Epistaxis rather than UGIH was the bleeding source in 20 patients. All patients had severe coagulopathy. Epistaxis was initially controlled in all cases. Fifteen (75%) subjects required posterior nasal packing and 2 (10%) embolization in addition to correction of coagulopathy. Five (25%) patients died in the hospital, 12 (60%) received orthotopic liver transplantation (OLT), and 3 (15%) were discharged without OLT. The mortality rate was 63% in patients without OLT. CONCLUSION: Severe epistaxis in patients with ESLD is (1) a diagnosis of exclusion that requires upper endoscopy to exclude severe UGIH; and (2) associated with a high mortality rate in patients not receiving OLT. PMID:25320538

  8. Laboratory test variables useful for distinguishing upper from lower gastrointestinal bleeding

    PubMed Central

    Tomizawa, Minoru; Shinozaki, Fuminobu; Hasegawa, Rumiko; Shirai, Yoshinori; Motoyoshi, Yasufumi; Sugiyama, Takao; Yamamoto, Shigenori; Ishige, Naoki

    2015-01-01

    AIM: To distinguish upper from lower gastrointestinal (GI) bleeding. METHODS: Patient records between April 2011 and March 2014 were analyzed retrospectively (3296 upper endoscopy, and 1520 colonoscopy). Seventy-six patients had upper GI bleeding (Upper group) and 65 had lower GI bleeding (Lower group). Variables were compared between the groups using one-way analysis of variance. Logistic regression was performed to identify variables significantly associated with the diagnosis of upper vs lower GI bleeding. Receiver-operator characteristic (ROC) analysis was performed to determine the threshold value that could distinguish upper from lower GI bleeding. RESULTS: Hemoglobin (P = 0.023), total protein (P = 0.0002), and lactate dehydrogenase (P = 0.009) were significantly lower in the Upper group than in the Lower group. Blood urea nitrogen (BUN) was higher in the Upper group than in the Lower group (P = 0.0065). Logistic regression analysis revealed that BUN was most strongly associated with the diagnosis of upper vs lower GI bleeding. ROC analysis revealed a threshold BUN value of 21.0 mg/dL, with a specificity of 93.0%. CONCLUSION: The threshold BUN value for distinguishing upper from lower GI bleeding was 21.0 mg/dL. PMID:26034359

  9. A rare cause of recurrent gastrointestinal bleeding: mesenteric hemangioma

    PubMed Central

    Kazimi, Mircelal; Ulas, Murat; Ibis, Cem; Unver, Mutlu; Ozsan, Nazan; Yilmaz, Funda; Ersoz, Galip; Zeytunlu, Murat; Kilic, Murat; Coker, Ahmet

    2009-01-01

    Lower gastrointestinal hemorrhage accounts for approximately 20% of gastrointestinal hemorrhage. The most common causes of lower gastrointestinal hemorrhage in adults are diverticular disease, inflammatory bowel disease, benign anorectal diseases, intestinal neoplasias, coagulopathies and arterio-venous malformations. Hemangiomas of gastrointestinal tract are rare. Mesenteric hemangiomas are also extremely rare. We present a 25-year-old female who was admitted to the emergency room with recurrent lower gastrointestinal bleeding. An intraluminal bleeding mass inside the small intestinal segment was detected during explorative laparotomy as the cause of the recurrent lower gastrointestinal bleeding. After partial resection of small bowel segment, the histopathologic examination revealed a cavernous hemagioma of mesenteric origin. Although rare, gastrointestinal hemangioma should be thought in differential diagnosis as a cause of recurrent lower gastrointestinal bleeding. PMID:19178725

  10. A rare cause of recurrent gastrointestinal bleeding: mesenteric hemangioma.

    PubMed

    Kazimi, Mircelal; Ulas, Murat; Ibis, Cem; Unver, Mutlu; Ozsan, Nazan; Yilmaz, Funda; Ersoz, Galip; Zeytunlu, Murat; Kilic, Murat; Coker, Ahmet

    2009-01-01

    Lower gastrointestinal hemorrhage accounts for approximately 20% of gastrointestinal hemorrhage. The most common causes of lower gastrointestinal hemorrhage in adults are diverticular disease, inflammatory bowel disease, benign anorectal diseases, intestinal neoplasias, coagulopathies and arterio-venous malformations. Hemangiomas of gastrointestinal tract are rare. Mesenteric hemangiomas are also extremely rare.We present a 25-year-old female who was admitted to the emergency room with recurrent lower gastrointestinal bleeding. An intraluminal bleeding mass inside the small intestinal segment was detected during explorative laparotomy as the cause of the recurrent lower gastrointestinal bleeding. After partial resection of small bowel segment, the histopathologic examination revealed a cavernous hemagioma of mesenteric origin.Although rare, gastrointestinal hemangioma should be thought in differential diagnosis as a cause of recurrent lower gastrointestinal bleeding. PMID:19178725

  11. Gastrointestinal eosinophils in health, disease and functional disorders.

    PubMed

    Powell, Nicholas; Walker, Marjorie M; Talley, Nicholas J

    2010-03-01

    Eosinophils are potent innate immune cells that home to the gastrointestinal tract where they participate in host immunity to luminal pathogens, and help to maintain intestinal epithelial homeostasis. However, these cells are now recognized to have key functions in the pathogenesis of numerous other disorders of the gastrointestinal tract, including primary eosinophilic gastrointestinal disease, common functional conditions, such as dyspepsia, and also in gastrointestinal disorders in patients with allergic disease. We are just beginning to understand the potential pathological role of eosinophils in gastrointestinal disease, and it is increasingly likely that gastroenterologists and histopathologists will need to account for the presence of gastrointestinal eosinophils and relate their presence to gastrointestinal symptoms. This Review discusses the role of gastrointestinal eosinophils in health and disease, including their associations with functional and allergic disorders. PMID:20125092

  12. What's New in Gastrointestinal Carcinoid Tumors Research and Treatment?

    MedlinePLUS

    ... Topic Additional resources for gastrointestinal carcinoid tumors What’s new in gastrointestinal carcinoid tumor research and treatment? There ... for the causes of , ways to prevent , and new approaches to diagnose and treat GI carcinoid tumors. ...

  13. What Are the Key Statistics about Gastrointestinal Carcinoid Tumors?

    MedlinePLUS

    ... for gastrointestinal carcinoid tumors? What are the key statistics about gastrointestinal carcinoid tumors? Although the exact number ... Symptoms of Cancer Treatments & Side Effects Cancer Facts & Statistics News About Cancer Expert Voices Blog Programs & Services ...

  14. Effect of pronase as mucolytic agent on imaging quality of magnifying endoscopy

    PubMed Central

    Kim, Gwang Ha; Cho, Yu Kyung; Cha, Jae Myung; Lee, Sun-Young; Chung, Il-Kwun

    2015-01-01

    AIM: To investigate the efficacy of premedication with pronase, a proteolytic enzyme, in improving image quality during magnifying endoscopy. METHODS: The study was of a blinded, randomized, prospective design. Patients were assigned to groups administered oral premedication of either pronase and simethicone (Group A) or simethicone alone (Group B). First, the gastric mucosal visibility grade (1-4) was determined during conventional endoscopy, and then a magnifying endoscopic examination was conducted. The quality of images obtained by magnifying endoscopy at the stomach and the esophagus was scored from 1 to 3, with a lower score indicating better visibility. The endoscopist used water flushes as needed to obtain satisfactory magnifying endoscopic views. The main study outcomes were the visibility scores during magnifying endoscopy and the number of water flushes. RESULTS: A total of 144 patients were enrolled, and data from 143 patients (M:F = 90:53, mean age 57.5 years) were analyzed. The visibility score was significantly higher in the stomach following premedication with pronase (73% with a score of 1 in Group A vs 49% in Group B, P < 0.05), but there was no difference in the esophagus visibility scores (67% with a score of 1 in Group A vs 58% in Group B). Fewer water flushes [mean 0.7 ± 0.9 times (range: 0-3 times) in Group A vs 1.9 ± 1.5 times (range: 0-6 times) in Group B, P < 0.05] in the pronase premedication group did not affect the endoscopic procedure times [mean 766 s (range: 647-866 s) for Group A vs 760 s (range: 678-854 s) for Group B, P = 0.88]. The total gastric mucosal visibility score was also lower in Group A (4.9 ± 1.5 vs 8.3 ± 1.8 in Group B, P < 0.01). CONCLUSION: The addition of pronase to simethicone premedication resulted in clearer images during magnifying endoscopy and reduced the need for water flushes. PMID:25741158

  15. Gastrointestinal functioning during sleep: a new horizon in sleep medicine

    Microsoft Academic Search

    William C Orr

    2001-01-01

    A body of clinical and research literature is accumulating suggesting that there are significant alterations in gastrointestinal functioning during sleep, as well as sleep complaints and disorders in patients suffering from gastrointestinal disease. This review addresses the clinical applications of some basic alterations in gastrointestinal functioning during sleep, with a particular focus on gastroesophageal reflux disease and functional bowel disorders.

  16. Increased prevalence of gastrointestinal symptoms in patients with allergic disease

    Microsoft Academic Search

    Nick Powell; Benedict Huntley; Thomas Beech; William Knight; Hannah Knight; Christopher J Corrigan

    2007-01-01

    Background: Children with allergic diseases such as asthma and atopic dermatitis experience increased gastrointestinal symptoms. Further, physiological and histological abnormalities of the gastrointestinal tract in patients with allergic diseases have been reported. It is not certain whether adult patients experience increased gastrointestinal symptoms.Methods: A retrospective, case–control study of 7235 adult (?20 years old) primary care patients was conducted. A general

  17. Gastrointestinal disturbances in eating disorders: Clinical and neurobiological aspects

    Microsoft Academic Search

    Stephan Zipfel; Isa Sammet; Nora Rapps; Wolfgang Herzog; Stephan Herpertz; Ute Martens

    2006-01-01

    Symptoms of the upper and lower gastrointestinal (gastrointestinal) tract have been described in anorexia nervosa and bulimia nervosa. Studies focusing on general outcome and medical comorbidity describe a worse outcome in the binge eating\\/purging subtype of anorexia nervosa compared to the restricting subtype. Both anorexia nervosa subtypes experience substantial delays in gastric emptying as well as constipation. These gastrointestinal disturbances

  18. Rational pharmacotherapy of gastrointestinal motility disorders

    Microsoft Academic Search

    P. Demol; H.-J. Ruoff; T. R. Weihrauch

    1989-01-01

    Nervous control of gastrointestinal motility is extremely complex, is regulated by the enteric system, the “brain of the gut”, and modulated by extrinsic nerves. This system with its multiplicity of transmitters and receptors does not always allow a clear interpretation of experimental data, especially with compounds lacking specificity. In this review the complex situation is described particularly in relation to

  19. Mechanisms of Obesity-induced Gastrointestinal Neoplasia

    PubMed Central

    Eusebi, Leonardo H.; Ricciardiello, Luigi; Patidar, Kavish; Sanyal, Arun J.

    2014-01-01

    Obesity is among the fastest growing diseases worldwide; treatment is inadequate and associated disorders, including gastrointestinal cancers, have high morbidity and mortality. An increased understanding of the mechanisms of obesity-induced carcinogenesis is required to develop methods to prevent or treat these cancers. We review the mechanisms of obesity-associated colorectal, esophageal, gastric, and pancreatic cancers and potential treatment strategies. PMID:24315827

  20. Pediatric and Adolescent Gastrointestinal Motility & Pain Program

    E-print Network

    Pediatric and Adolescent Gastrointestinal Motility & Pain Program Department of Pediatrics by Recognizing AEROPHAGIA Before the Big Work-up By: Paul Hyman, M.D., Professor of Pediatrics, Chief, Division of Pediatric Gastroenterology, Louisiana State University Health Science Center, New Orleans, LA "My 3-year old

  1. Sleep, immunity and inflammation in gastrointestinal disorders.

    PubMed

    Ali, Tauseef; Choe, James; Awab, Ahmed; Wagener, Theodore L; Orr, William C

    2013-12-28

    Sleep disorders have become a global issue, and discovering their causes and consequences are the focus of many research endeavors. An estimated 70 million Americans suffer from some form of sleep disorder. Certain sleep disorders have been shown to cause neurocognitive impairment such as decreased cognitive ability, slower response times and performance detriments. Recent research suggests that individuals with sleep abnormalities are also at greater risk of serious adverse health, economic consequences, and most importantly increased all-cause mortality. Several research studies support the associations among sleep, immune function and inflammation. Here, we review the current research linking sleep, immune function, and gastrointestinal diseases and discuss the interdependent relationship between sleep and these gastrointestinal disorders. Different physiologic processes including immune system and inflammatory cytokines help regulate the sleep. The inflammatory cytokines such as tumor necrosis factor, interleukin-1 (IL-1), and IL-6 have been shown to be a significant contributor of sleep disturbances. On the other hand, sleep disturbances such as sleep deprivation have been shown to up regulate these inflammatory cytokines. Alterations in these cytokine levels have been demonstrated in certain gastrointestinal diseases such as inflammatory bowel disease, gastro-esophageal reflux, liver disorders and colorectal cancer. In turn, abnormal sleep brought on by these diseases is shown to contribute to the severity of these same gastrointestinal diseases. Knowledge of these relationships will allow gastroenterologists a great opportunity to enhance the care of their patients. PMID:24409051

  2. Aspirin, gastrointestinal bleeding, and peptic ulcer

    Microsoft Academic Search

    M. Levrat; R. Lambert

    1960-01-01

    Summary  1. We have observed 52 cases of digestive attacks provoked by aspirin; 13 were cases of nonhemorrhagic peptic ulcer with 1 perforated ulcer; 39 were cases of gastrointestinal hemorrhage.2. Among the hemorrhages, radiological proof of the peptic ulcer was obtained in 15 cases, and X-ray evidence was noted in 21 cases (isolated hemorrhages). In the 3 cases of the latter

  3. Nutrition support to patients undergoing gastrointestinal surgery

    Microsoft Academic Search

    Nicola Ward

    2003-01-01

    Nutritional depletion has been demonstrated to be a major determinant of the development of post-operative complications. Gastrointestinal surgery patients are at risk of nutritional depletion from inadequate nutritional intake, surgical stress and the subsequent increase in metabolic rate. Fears of postoperative ileus and the integrity of the newly constructed anastomosis have led to treatment typically entailing starvation with administration of

  4. Sensory testing of the human gastrointestinal tract

    Microsoft Academic Search

    Christina Brock; Lars Arendt-Nielsen; Oliver Wilder-Smith; Asbjørn Mohr Drewes

    2009-01-01

    The objective of this appraisal is to shed light on the various approaches to screen sensory information in the human gut. Understanding and characterization of sensory symptoms in gastrointestinal disorders is poor. Experimental methods allowing the investigator to control stimulus intensity and modality, as well as using validated methods for assessing sensory response have contributed to the understanding of pain

  5. Lower gastrointestinal malignancy in Crohn's disease

    Microsoft Academic Search

    W R Connell; J P Sheffield; M A Kamm; J K Ritchie; P R Hawley; J E Lennard-Jones

    1994-01-01

    An increased incidence of carcinoma of the small bowel and colon has been described in patients with Crohn's disease. Tumours arising in the rectum and anus are reported less often. Between 1940 and 1992, of some 2500 patients with Crohn's disease seen at this hospital, 15 are known to have developed carcinoma of the lower gastrointestinal tract. Malignancy occurred in

  6. Gastrointestinal Involvement in Chronic Granulomatous Disease

    Microsoft Academic Search

    Beatriz E. Marciano; Sergio D. Rosenzweig; David E. Kleiner; Victoria L. Anderson; Dirk N. Darnell; Sandra Anaya-O; Dianne M. Hilligoss; Harry L. Malech; John I. Gallin; Steven M. Holland

    Objective. Chronic granulomatous dis- ease (CGD) is a rare disorder of phagocyte oxidative metabolism. In addition to infectious complications, granulomatous lesions often involve hollow viscera, es- pecially the gastrointestinal (GI) tract. The objective of this study was to evaluate the clinical presentation, prev- alence, and consequences of GI involvement in patients with CGD. Methods. The medical records of 140 patients

  7. Nutritional Influences in Selected Gastrointestinal Diseases

    Microsoft Academic Search

    Peter Laszlo Lakatos; Lajos S. Kiss; Pal Miheller

    2011-01-01

    Nutritional factors, as sources of luminal antigens, have been thought to be important factors in the immunopathogenesis of numerous gastrointestinal diseases. In some diseases, the role of the nutritional component is causal in the susceptible host. Such diseases include celiac disease, a common heritable chronic inflammatory condition of the small intestine induced by dietary wheat, rye and barley, in susceptible

  8. Citología intraoperatoria de tumores del estroma gastrointestinal

    Microsoft Academic Search

    Mercedes Santamaría Martínez; Ana Bertol Uso; Irene Amat Villegas; Raquel Beloqui Pérez

    2003-01-01

    SUMMARY Introduction: Gastrointestinal stromal tumors (GIST) are frequent mesenchymal tumors origi- nating from Cajal interstitial cells (CIC). They are localized in the digestive tract wall but do not usually involve the mucosa and therefore can be difficult to detect by endoscopic biopsy. A preo- perative diagnosis can sometimes be made on the basis of fine needle aspiration (FNA) biopsy. In

  9. Association of Local Capacity for Endoscopy with Individual Use of Colorectal Cancer Screening and Stage at Diagnosis

    PubMed Central

    Haas, Jennifer S.; Brawarsky, Phyllis; Iyer, Aarthi; Fitzmaurice, Garrett M.; Neville, Bridget A.; Earle, Craig; Kaplan, Celia Patricia

    2010-01-01

    Background Limited capacity for endoscopy in areas where African-Americans and Hispanics live may be a reason for persistent disparities in colorectal cancer (CRC) screening and stage at diagnosis. Methods We linked data from the National Health Interview Survey (NHIS) on the use of CRC screening and data from SEER-Medicare on CRC stage with measures of county capacity for colonoscopy and sigmoidoscopy (“endoscopy”) derived from Medicare claims. Results Hispanics lived in counties with less capacity for endoscopy than African-Americans or whites (for NHIS, an average of 1,224, 1,569, and 1,628 procedures per 100,000 individuals age 50 and above respectively). Individual use of CRC screening increased modestly as county capacity increased. For example, as the number of endoscopies per 100,000 residents increased by 750, the odds of being screened increased by 4%. Disparities in screening were mitigated or diminished by adjustment for area endoscopy capacity, racial/ ethnic composition, and socioeconomic status. Similarly, among individuals with CRC, those who lived in counties with less endoscopy capacity were marginally less likely to be diagnosed at an early stage. Adjustment for area characteristics diminished disparities in stage for Hispanics compared to whites but not African-Americans. Conclusions Increasing the use of CRC screening may require interventions to improve capacity for endoscopy in some areas. The characteristics of the area where an individual resides may in part mediate disparities in CRC screening use for both African-Americans and Hispanics, and disparities in cancer stage for Hispanics. PMID:20564398

  10. Unmeasured improvement work: the lack of routinely collected, service-related data in NHS endoscopy units in England involved in "modernisation"

    PubMed Central

    Thorne, Kymberley; Hutchings, Hayley A; Elwyn, Glyn

    2008-01-01

    Background The availability of routinely collected service-related endoscopy data from NHS endoscopy units has never been quantified. Methods This retrospective observational study asked 19 endoscopy units to submit copies of all in-house, service-related endoscopy data that had been routinely collected by the unit – Referral numbers, Activity, Number of patients waiting and Number of lost slots. Nine of the endoscopy units had previously participated in the Modernising Endoscopy Services (MES) project during 2003 to redesign their endoscopy services. These MES sites had access to additional funding and data collection software. The other ten (Control sites) had modernised independently. All data was requested in two phases and corresponded to eight specific time points between January 2003 and April 2006. Results Only eight of 19 endoscopy units submitted routinely collected, service-related data. Another site's data was collected specifically for the study. A further two units claimed to routinely collect service-related data but did not submit any to the study. The remaining eight did not collect any service-related endoscopy data routinely and liaised with their Trust for data. Of the eight sites submitting service-related data, only three were MES project sites. Of these three, the data variables collected were limited and none collected the complete set of endoscopy data variables requested. Of the other five sites, two collected all four endoscopy data types. Data for the three MES project sites went back as far as January 2003, whilst the five Control sites were only able to submit data from December 2003 onwards. Conclusion There was a lack of service-related endoscopy data routinely collected by the study sites, especially those who had participated in the MES project. Without this data, NHS endoscopy services cannot have a true understanding of their services, cannot identify problems and cannot measure the impact of any changes. With the increasing pressures placed on NHS endoscopy services, the need to effectively inform redesign plans is paramount. We recommend the compulsory collection of service-related endoscopy data by all NHS endoscopy units using a standardised format with rigorous guidelines. PMID:18218079

  11. Dissecting Lewis score under the light of fecal calprotectin; an analysis of correlation of score components with calprotectin levels in capsule endoscopy

    PubMed Central

    Koulaouzidis, Anastasios; Nemeth, Artur; Johansson, Gabriele Wurm; Toth, Ervin

    2015-01-01

    Background Lewis Score (LS) is an inflammatory score in small-bowel capsule endoscopy (SBCE). Fecal calprotectin (FC) is considered the non-invasive, ‘gold standard’ marker of gastrointestinal (GI) inflammation. Recently, we reported that LS shows only a moderate correlation with FC. In this study, we aim to evaluate which LS parameters have greater correlation with FC. Methods A retrospective, two-center study; 74 patients who underwent SBCE within 7 (median 1.5) days from a FC measurement. LS was calculated; univariate and multivariate analyses were performed, investigating LS correlation with FC, and which LS parameters had stronger correlation coefficient (rs) with FC. Results 74 patients had an FC measurement within 7 days of their SBCE examination (median 22 time-interval: 1.5 days; IQR: 5). Coefficient rs between LS and FC was moderate (0.454). In univariate analysis, the variables that gave the strongest association with FC were: the higher tertile subscore for ulcer, the summative ulcer subscore, the higher tertile ulcer score (only with descriptors of ulcer size and number), the summative ulcer score (only with descriptors of ulcer size and number), and subscores including various combinations of the stenosis descriptors. In multivariate analysis, the only positive predictor for FC was the higher tertile ulcer subscore (only with descriptors of ulcer size and number). Conclusion LS shows only moderate correlation to FC. This is due to a) an inherent limitation of LS, and b) the notion of correlating the 2 parameters, and consideration should be given to development of a new, simplified (or composite) inflammation score/index for SBCE. PMID:25830236

  12. Endoscopic appearance of AIDS-related gastrointestinal lymphoma with c-MYC rearrangements: case report and literature review.

    PubMed

    Tanaka, Shohei; Nagata, Naoyoshi; Mine, Sohtaro; Igari, Toru; Kobayashi, Taiichiro; Sugihara, Jun; Honda, Haruhito; Teruya, Katsuji; Kikuchi, Yoshimi; Oka, Shinichi; Uemura, Naomi

    2013-08-01

    Acquired immune deficiency syndrome (AIDS)-related lymphoma (ARL) remains the main cause of AIDS-related deaths in the highly active anti-retroviral therapy (HAART) era. Recently, rearrangement of MYC is associated with poor prognosis in patients with diffuse large B-cell lymphoma. Here, we report a rare case of gastrointestinal (GI)-ARL with MYC rearrangements and coinfected with Epstein-Barr virus (EBV) infection presenting with various endoscopic findings. A 38-year-old homosexual man who presented with anemia and was diagnosed with an human immunodeficiency virus infection for the first time. GI endoscopy revealed multiple dish-like lesions, ulcerations, bloody spots, nodular masses with active bleeding in the stomach, erythematous flat lesions in the duodenum, and multiple nodular masses in the colon and rectum. Magnified endoscopy with narrow band imaging showed a honeycomb-like pattern without irregular microvessels in the dish-like lesions of the stomach. Biopsy specimens from the stomach, duodenum, colon, and rectum revealed diffuse large B-cell lymphoma concomitant with EBV infection that was detected by high tissue EBV-polymerase chain reaction levels and Epstein-Barr virus small RNAs in situ hybridization. Fluorescence in situ hybridization analysis revealed a fusion between the immunoglobulin heavy chain (IgH) and c-MYC genes, but not between the IgH and BCL2 loci. After 1-mo of treatment with HAART and R-CHOP, endoscopic appearance improved remarkably, and the histological features of the biopsy specimens revealed no evidence of lymphoma. However, he died from multiple organ failure on the 139(th) day after diagnosis. The cause of his poor outcome may be related to MYC rearrangement. The GI tract involvement in ARL is rarely reported, and its endoscopic findings are various and may be different from those in non-AIDS GI lymphoma; thus, we also conducted a literature review of GI-ARL cases. PMID:23922484

  13. Characterizing variability in in vivo Raman spectra of different anatomical locations in the upper gastrointestinal tract toward cancer detection

    NASA Astrophysics Data System (ADS)

    Bergholt, Mads Sylvest; Zheng, Wei; Lin, Kan; Ho, Khek Yu; Teh, Ming; Yeoh, Khay Guan; So, Jimmy Bok Yan; Huang, Zhiwei

    2011-03-01

    Raman spectroscopy is an optical vibrational technology capable of probing biomolecular changes of tissue associated with cancer transformation. This study aimed to characterize in vivo Raman spectroscopic properties of tissues belonging to different anatomical regions in the upper gastrointestinal (GI) tract and explore the implications for early detection of neoplastic lesions during clinical gastroscopy. A novel fiber-optic Raman endoscopy technique was utilized for real-time in vivo tissue Raman measurements of normal esophageal (distal, middle, and proximal), gastric (antrum, body, and cardia) as well as cancerous esophagous and gastric tissues from 107 patients who underwent endoscopic examinations. The non-negativity-constrained least squares minimization coupled with a reference database of Raman active biochemicals (i.e., actin, histones, collagen, DNA, and triolein) was employed for semiquantitative biomolecular modeling of tissue constituents in the upper GI. A total of 1189 in vivo Raman spectra were acquired from different locations in the upper GI. The Raman spectra among the distal, middle, and proximal sites of the esophagus showed no significant interanatomical variability. The interanatomical variability of Raman spectra among normal gastric tissue (antrum, body, and cardia) was subtle compared to cancerous tissue transformation, whereas biomolecular modeling revealed significant differences between the two organs, particularly in the gastroesophageal junction associated with proteins, DNA, and lipids. Cancerous tissues can be identified across interanatomical regions with accuracies of 89.3% [sensitivity of 92.6% (162/175) specificity of 88.6% (665/751)], and of 94.7% [sensitivity of 90.9% (30/33) specificity of 93.9% (216/230)] in the gastric and esophagus, respectively, using partial least squares-discriminant analysis together with the leave-one tissue site-out, cross validation. This work demonstrates that Raman endoscopy technique has promising clinical potential for real-time, in vivo diagnosis and detection of malignancies in the upper GI at the molecular level.

  14. Michael Liedlgruber, Andreas Uhl, Computer-aided Decision Support Sys-tems for Endoscopy in the Gastrointestinal Tract: A Review, IEEE Reviews in

    E-print Network

    Uhl, Andreas

    -malignant or to increase the risk of cancer in the GI tract are adenomas, Barrett's esophagus, Crohn's disease, celiac of the GI tract, physicians are able to detect severe diseases already in early development stages and therefore the mortality rate for many diseases, especially different types of cancers, has been lowered

  15. Drug-induced sleep endoscopy: conventional versus target controlled infusion techniques--a randomized controlled study.

    PubMed

    De Vito, Andrea; Agnoletti, Vanni; Berrettini, Stefano; Piraccini, Emanuele; Criscuolo, Armando; Corso, Ruggero; Campanini, Aldo; Gambale, Giorgio; Vicini, Claudio

    2011-03-01

    Understanding the sites of pharyngeal collapse is mandatory for surgical treatment decision-making in obstructive sleep-apnea-hypopnea syndrome patients. Drug-induced sleep endoscopy (DISE) allows for the direct observation of the upper airway during sedative-induced sleep. In order to re-create snoring and apnea patterns related to a spontaneous sleep situation, the authors used a target-controlled infusion (TCI) sleep endoscopy (DISE-TCI), comparing this technique to conventional DISE, in which sedation was reached by a manual bolus injection. The authors conducted a prospective, randomized, unicenter study. The apneic event observation and its correlation with pharyngeal collapse patterns is the primary endpoint; secondary endpoints are defined as stability and safety of sedation plans of DISE-TCI technique. From January 2009 to June 2009, 40 OSAHS patients were included in the study and randomized allocated in two groups: the bolus injection conventional DISE group and the DISE-TCI group. We recorded the complete apnea event at the oropharynx and hypopharynx levels in 4 patients of the conventional DISE group (20%) and in 17 patients of the DISE-TCI group (85%) (P < 0.0001). Two patients needed oxygen in the conventional DISE group because of severe desaturation that resulted from the first bolus of propofol (1 mg/kg) (P = 0.4872 ns). We recorded the instability of the sedation plan in 13 patients from the conventional DISE group (65%) and 1 patient from the DISE-TCI group (5%) (P = 0.0001). Our results suggest that the DISE-TCI technique should be the first choice in performing sleep endoscopy because of its increased accuracy, stability and safety. PMID:20811901

  16. Nasal and oral snoring endoscopy: novel and promising diagnostic tools in OSAS patients.

    PubMed

    Lovato, Andrea; Kotecha, Bhik; Vianello, Andrea; Giacomelli, Luciano; Staffieri, Alberto; Marchese-Ragona, Rosario

    2015-07-01

    The aim of the present study was to investigate if any of the three awake procedures [fiberoptic nasopharyngoscopy with modified Müller Maneuver (FNMM), nasal snoring endoscopy (NSE), or oral snoring endoscopy (OSE)] could efficiently predict the grade or pattern of upper airway (UA) collapse found with drug-induced sleep endoscopy (DISE), which is considered by many authors as the current gold standard in optimizing obstructive sleep apnea syndrome (OSAS) patient selection for UA surgery. Twenty consecutive patients (simple snorers and OSAS patients) were studied with FNMM, NSE, OSE, and DISE. The inter-test agreement was evaluated with Cohen's kappa coefficient (?). In the current series, we found that NSE and OSE were better than FNMM in predicting the pattern of collapse found with DISE. A significant pattern agreement between NSE and DISE was present in all sub-sites, and the agreement was measured with a scale proposed by Landis and Koch as: moderate in velo- and oropharynx (? = 0.52, p = 0.001, and ? = 0.47, p = 0.003, respectively), and substantial in hypopharynx (? = 0.63, p < 0.00001). Comparing OSE with DISE, the pattern agreement was almost perfect at oropharyngeal level (? = 0.82, p < 0.00001), and moderate at hypopharyngeal level (? = 0.55, p = 0.0002); while a trend towards significance was found at velopharyngeal level (? = 0.20, p = 0.07). FNMM showed a fair pattern agreement with DISE only at oropharyngeal level (? = 0.31, p = 0.009); while in the other sub-sites, no significant agreement was found. NSE and OSE are new promising diagnostic tools in OSAS patients. Further investigations are needed to see if they could predict the effectiveness of UA surgery. PMID:25573835

  17. Estimating the size of polyps during actual endoscopy procedures using a spatio-temporal characterization.

    PubMed

    Martínez, Fabio; Ruano, Josué; Gómez, Martín; Romero, Eduardo

    2015-07-01

    Colorectal cancer usually appears in polyps developed from the mucosa. Carcinoma is frequently found in those polyps larger than 10mm and therefore only this kind of polyps is sent for pathology examination. In consequence, accurate estimation of a polyp size determines the surveillance interval after polypectomy. The follow up consists in a periodic colonoscopy whose frequency depends on the estimation of the size polyp. Typically, this polyp measure is achieved by examining the lesion with a calibrated endoscopy tool. However, measurement is very challenging because it must be performed during a procedure subjected to a complex mix of noise sources, namely anatomical variability, drastic illumination changes and abrupt camera movements. This work introduces a semi-automatic method that estimates a polyp size by propagating an initial manual delineation in a single frame to the whole video sequence using a spatio-temporal characterization of the lesion, during a routine endoscopic examination. The proposed approach achieved a Dice Score of 0.7 in real endoscopy video-sequences, when comparing with an expert. In addition, the method obtained a root mean square error (RMSE) of 0.87mm in videos artificially captured in a cylindric structure with spheres of known size that simulated the polyps. Finally, in real endoscopy sequences, the diameter estimation was compared with measures obtained by a group of four experts with similar experience, obtaining a RMSE of 4.7mm for a set of polyps measuring from 5 to 20mm. An ANOVA test performed for the five groups of measurements (four experts and the method) showed no significant differences (p<0.01). PMID:25670148

  18. Upper-gastrointestinal bleeding secondary to peptic ulcer disease: Incidence and outcomes

    PubMed Central

    Quan, Samuel; Frolkis, Alexandra; Milne, Kaylee; Molodecky, Natalie; Yang, Hong; Dixon, Elijah; Ball, Chad G; Myers, Robert P; Ghosh, Subrata; Hilsden, Robert; van Zanten, Sander Veldhuyzen; Kaplan, Gilaad G

    2014-01-01

    AIM: To evaluate the incidence, surgery, mortality, and readmission of upper gastrointestinal bleeding (UGIB) secondary to peptic ulcer disease (PUD). METHODS: Administrative databases identified all hospitalizations for UGIB secondary to PUD in Alberta, Canada from 2004 to 2010 (n = 7079) using the International Classification of Diseases Codes (ICD-10). A subset of the data was validated using endoscopy reports. Positive predictive value and sensitivity with 95% confidence intervals (CI) were calculated. Incidence of UGIB secondary to PUD was calculated. Logistic regression was used to evaluate surgery, in-hospital mortality, and 30-d readmission to hospital with recurrent UGIB secondary to PUD. Co-variants accounted for in our logistic regression model included: age, sex, area of residence (i.e., urban vs rural), number of Charlson comorbidities, presence of perforated PUD, undergoing upper endoscopy, year of admission, and interventional radiological attempt at controlling bleeding. A subgroup analysis (n = 6356) compared outcomes of patients with gastric ulcers to those with duodenal ulcers. Adjusted estimates are presented as odds ratios (OR) with 95%CI. RESULTS: The positive predictive value and sensitivity of ICD-10 coding for UGIB secondary to PUD were 85.2% (95%CI: 80.2%-90.2%) and 77.1% (95%CI: 69.1%-85.2%), respectively. The annual incidence between 2004 and 2010 ranged from 35.4 to 41.2 per 100000. Overall risk of surgery, in-hospital mortality, and 30-d readmission to hospital for UGIB secondary to PUD were 4.3%, 8.5%, and 4.7%, respectively. Interventional radiology to control bleeding was performed in 0.6% of patients and 76% of these patients avoided surgical intervention. Thirty-day readmission significantly increased from 3.1% in 2004 to 5.2% in 2010 (OR = 1.07; 95%CI: 1.01-1.14). Rural residents (OR rural vs urban: 2.35; 95%CI: 1.83-3.01) and older individuals (OR ? 65 vs < 65: 1.57; 95%CI: 1.21-2.04) were at higher odds of being readmitted to hospital. Patients with duodenal ulcers had higher odds of dying (OR = 1.27; 95%CI: 1.05-1.53), requiring surgery (OR = 1.73; 95%CI: 1.34-2.23), and being readmitted to hospital (OR = 1.54; 95%CI: 1.19-1.99) when compared to gastric ulcers. CONCLUSION: UGIB secondary to PUD, particularly duodenal ulcers, was associated with significant morbidity and mortality. Early readmissions increased over time and occurred more commonly in rural areas. PMID:25516672

  19. The Safety of Same-Day Endoscopy and Percutaneous Liver Biopsy

    Microsoft Academic Search

    Jonathan G. Stine; Gordon Liss; James H. Lewis

    2011-01-01

    Background and Aims  The aim of this study was to review our experience with same-day endoscopy (SDE) plus percutaneous liver biopsy (PLB) and\\u000a to evaluate its safety compared to PLB alone.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We retrospectively examined records of all patients who underwent PLB between January 2003 and September 2009 and identified\\u000a those who underwent SDE and matched these patients to those undergoing PLB

  20. Closing perforations and postperforation management in endoscopy: duodenal, biliary, and colorectal.

    PubMed

    Boumitri, Christine; Kumta, Nikhil A; Patel, Milan; Kahaleh, Michel

    2015-01-01

    Early recognition of adverse events arising from endoscopy is essential. In some cases the injury can be viewed clearly during the procedure, and immediate action should be taken to repair the defect endoscopically if feasible. If perforation is unclear, imaging can be used to confirm the diagnosis. Surgical intervention is not always necessary; however, a surgical consultation for backup is essential. Selective cases can be managed conservatively or endoscopically with successful outcomes. Early recognition and intervention, input from specialist colleagues, and communication with the patient and family are keys to successfully managing the event. PMID:25442957

  1. A novel broadband Raman endoscopy for in vivo diagnosis of intestinal metaplasia in the stomach

    NASA Astrophysics Data System (ADS)

    Lin, Kan; Bergholt, Mads S.; Wang, Jianfeng; Zheng, Wei; Xu, Hongzhi; Ren, Jian-lin; Ho, Khek Yu; Teh, Ming; Yeoh, Khay Guan; Huang, Zhiwei

    2015-03-01

    We report a novel simultaneous fingerprint (FP) and high-wavenumber (HW) fiber-optic Raman spectroscopy developed for in vivo diagnosis of intestinal metaplasia (IM) in the stomach under wide-field endoscopic imaging. The FP/HW Raman endoscopy technique was performed to differentiate IM from normal tissues with sensitivity of 89% and specificity of 83%. This study shows the great potential of the FP/HW Raman endoscopic technique for early diagnosis of non-neoplastic gastric disease in vivo during routine endoscopic examination.

  2. Path-loss estimation of wireless channels in capsule endoscopy from X-ray CT images.

    PubMed

    Takizawa, Kenichi; Hagiwara, Hiroaki; Hamaguchi, Kiyoshi

    2011-01-01

    The paper describes an estimation method of path-loss for capsule endoscopy using wireless communications to send images from digestive tract. This method is based on the use of a set of X-ray computer tomography (CT) images of the patient. In order to evaluate this method, we conducted a measurement of received signal strength (RSS) by introducing a signal generator (SG) in esophagus and duodenum of a participant. As a result of comparisons, the method provides estimates on path-loss for the participant with estimation errors of less than 6 dB in 75% measurement positions. PMID:22254786

  3. The role of nanotechnology in gastrointestinal cancer.

    PubMed

    Vyas, Dinesh; Castro, Pamela; Saadeh, Yamaan; Vyas, Arpita

    2014-11-01

    The rising interest in the utilization of nanoparticles for diagnosis and treatment in all cancers including gastrointestinal cancer has increased research interest, and funding in the area of medical nanotechnology. Interesting outcomes of research studies on different applications are published every day, and it include approaches such as molecular targeting, photodynamic therapy, and magnetic localization. The discoveries being made by research teams and the hypothesized applications are thus far very promising. There are limitations that must be researched and overcome, but the increasing evidence for the use of nanoparticles in cancer treatment cannot be ignored. In this review, several recent techniques are discussed on the development of more effective and targeted cellular/molecular techniques in the diagnosis and treatment of gastrointestinal cancer. PMID:26000381

  4. Gastrointestinal stenting: Current status and imaging features.

    PubMed

    Malgras, B; Lo Dico, R; Pautrat, K; Dohan, A; Boudiaf, M; Pocard, M; Soyer, P

    2015-06-01

    The use of stents in the gastrointestinal tract has been subjected to major changes. Initially, the use of stents was restricted to malignant strictures in patients with metastatic disease. But thanks to reduction of the morbidity and mortality rates, they are now used with curative intention and in patients with benign diseases after careful selection. However, for patients presenting with colon obstruction due to an advanced colon carcinoma, the mortality and morbidity are still high. The purpose of this review is to provide an overview of indications, techniques and further developments of the stents in the gastrointestinal tract and to highlight the predominant role of multidetector row computed tomography (MDCT) in the detection of potential complications. PMID:25953525

  5. Gastrointestinal Stromal Tumor – An Evolving Concept

    PubMed Central

    Tornillo, Luigi

    2014-01-01

    Gastrointestinal stromal tumors (GISTs) are the most frequent mesenchymal tumors of the gastrointestinal tract. The discovery that these tumors, formerly thought of smooth muscle origin, are indeed better characterized by specific activating mutation in genes coding for the receptor tyrosine kinases (RTKs) CKIT and PDGFRA and that these mutations are strongly predictive for the response to targeted therapy with RTK inhibitors has made GISTs the typical example of the integration of basic molecular knowledge in the daily clinical activity. The information on the mutational status of these tumors is essential to predict (and subsequently to plan) the therapy. As resistant cases are frequently wild type, other possible oncogenic events, defining other “entities,” have been discovered (e.g., succinil dehydrogenase mutation/dysregulation, insuline growth factor expression, and mutations in the RAS-RAF-MAPK pathway). The classification of disease must nowadays rely on the integration of the clinico-morphological characteristics with the molecular data. PMID:25593916

  6. Thromboembolism during neoadjuvant therapy for gastrointestinal cancer.

    PubMed

    Smart, Philip J; Burbury, Kate L; Lynch, A Craig; Mackay, John R; Heriot, Alexander G

    2014-12-01

    Thromboembolism a common, costly, and morbid complication that is also associated with decreased survival in cancer patients. The risk of thromboembolism in cancer patients is underappreciated. In addition to symptomatic deep venous thrombosis and pulmonary embolism, asymptomatic and arterial thromboembolic events are important consideration in ambulatory cancer patients receiving neoadjuvant chemoradiotherapy (nCRT). No specific randomized trial examining thromboprophylaxis (TP) during nCRT for gastrointestinal cancer has been performed, and none is accruing. Most guidelines currently recommend against TP in ambulatory cancer patients due to a lack of data rather than proof of harm or lack of efficacy. It is clear that robust data are urgently required, and that treatment with nCRT in patients with gastrointestinal malignancy is not an indication for routine pharmacological TP at the present time. PMID:23466578

  7. Presentation and management of gastrointestinal stromal tumours.

    PubMed

    Mongan, A M; Malik, V; Rowley, S; Claxton, Z; Muldoon, C; O'Toole, D; Ravi, N; Reynolds, J V

    2013-06-01

    Gastrointestinal stromal tumour (GIST) is the most common mesenchymal tumour of the gastrointestinal tract. The aim of this study was to present the experience of a single centre. A prospective GIST database from 1997 to 2011 in a tertiary referral centre wa reviewed. 78 patients (36 male/42 female) with a median age of 66 (range 10-93) were diagnosed with GIST during this period. Surgery was the primary treatment for 70 patients (90%); 19 (24%) resections were laparoscopic. Nineteen patients (24%) received Imatinib therapy. At a median follow up of 3 years, 10 patients (15%) had recurrence. Five-year survival was 89%. Surgery remains the mainstay of treatment. Minimally invasive approaches may be carried out with high cure rates. This study highlights the changing presentation and treatment approach, as well as the excellent outcomes achievable for GIST tumours. PMID:23909154

  8. Immunity to gastrointestinal nematodes: mechanisms and myths

    PubMed Central

    Grencis, Richard K; Humphreys, Neil E; Bancroft, Allison J

    2014-01-01

    Immune responses to gastrointestinal nematodes have been studied extensively for over 80 years and intensively investigated over the last 30–40 years. The use of laboratory models has led to the discovery of new mechanisms of protective immunity and made major contributions to our fundamental understanding of both innate and adaptive responses. In addition to host protection, it is clear that immunoregulatory processes are common in infected individuals and resistance often operates alongside modulation of immunity. This review aims to discuss the recent discoveries in both host protection and immunoregulation against gastrointestinal nematodes, placing the data in context of the specific life cycles imposed by the different parasites studied and the future challenges of considering the mucosal/immune axis to encompass host, parasite, and microbiome in its widest sense. PMID:24942690

  9. Gastrointestinal motility revisited: The wireless motility capsule

    PubMed Central

    Farmer, Adam D; Scott, S Mark

    2013-01-01

    Introduction The wireless motility capsule (WMC) is a novel ambulatory technology that concurrently measures intraluminal pH, temperature, and pressure as it traverses the gastrointestinal tract. Objectives We aim to provide a concise summary of the WMC, detailing the procedure for its administration and the parameters it records. We also review the evidence that has validated the WMC against other methods currently regarded as ‘gold standard’. Conclusions The WMC offers a number of advantages over and above current techniques, especially with respect to patient tolerability, safety, and standardization. The WMC represents a considerable enhancement of the researchers’ and clinicians’ investigatory armamentarium. If this technology becomes widely adopted, coupled with international consensus upon the interpretation of physiological data derived therein, it may herald a new and exciting era in gastrointestinal physiology. PMID:24917991

  10. Gastrointestinal stem cell up-to-date

    PubMed Central

    Pirvulet, V

    2015-01-01

    Cellular and tissue regeneration in the gastrointestinal tract depends on stem cells with properties of self-renewal, clonogenicity, and multipotency. Progress in stem cell research and the identification of potential gastric, intestinal, colonic stem cells new markers and the signaling pathways provide hope for the use of stem cells in regenerative medicine and treatments for disease. This review provides an overview of the different types of stem cells, focusing on tissue-restricted adult stem cells. PMID:25866586

  11. Mechanisms of obesity-induced gastrointestinal neoplasia.

    PubMed

    Alemán, José O; Eusebi, Leonardo H; Ricciardiello, Luigi; Patidar, Kavish; Sanyal, Arun J; Holt, Peter R

    2014-02-01

    Obesity is among the fastest growing diseases worldwide; treatment is inadequate, and associated disorders, including gastrointestinal cancers, have high morbidity and mortality. An increased understanding of the mechanisms of obesity-induced carcinogenesis is required to develop methods to prevent or treat these cancers. In this report, we review the mechanisms of obesity-associated colorectal, esophageal, gastric, and pancreatic cancers and potential treatment strategies. PMID:24315827

  12. Treatment of gastrointestinal problems in cystic fibrosis

    Microsoft Academic Search

    Maria R. Mascarenhas

    2003-01-01

    Opinion statement  The gastrointestinal (GI) manifestations of cystic fibrosis (CF) are varied and include pancreatic insufficiency, meconium\\u000a ileus, distal intestinal obstruction syndrome (DIOS), liver disease, and other less common manifestations. Treatment of pancreatic\\u000a insufficiency consists of providing appropriate pancreatic enzyme replacement therapy and may include raising duodenal pH\\u000a to allow for optimal action of these enzymes. Despite a number of pancreatic

  13. Primary extranodal lymphomas of gastrointestinal localizations

    Microsoft Academic Search

    B. Mihaljevi?; R. Nedeljkov-Jan?i?; V. Vuji?i?; D. Anti?; S. Jankovi?; N. ?olovi?

    2006-01-01

    This study is aimed at comparison of patients with extranodal lymphomas based on pathohistological findings differences (MALT\\u000a vs non-MALT) as well as regarding gastric and non-gastric localization, and determining the significance of clinical-laboratory\\u000a parameters with respect to therapeutic response and length of survival. A total of 56 patients with extranodal non-Hodgkin's\\u000a lymphomas of the gastrointestinal tract were evaluated over a

  14. ULTRASONOGRAPHIC FEATURES OF CANINE GASTROINTESTINAL STROMAL TUMORS COMPARED TO OTHER GASTROINTESTINAL SPINDLE CELL TUMORS.

    PubMed

    Hobbs, Joshua; Sutherland-Smith, James; Penninck, Dominique; Jennings, Samuel; Barber, Lisa; Barton, Bruce

    2015-07-01

    Canine gastrointestinal stromal tumors (GISTs) are a recent subtype of gastrointestinal spindle cell tumor recognized with the increasing use of immunohistochemistry. To our knowledge, no imaging features have been described in immunistochemically confirmed canine GISTs. The objective of this retrospective, cross-sectional study was to describe ultrasonographic features of canine GISTs compared with other spindle cell tumors. Thirty-seven dogs with an ultrasonographically visible gastrointestinal mass and a histopathologic diagnosis of spindle cell neoplasia were examined. Immunohistochemistry staining was performed for retrieved tissue samples to further differentiate the tumor type and each sample was interpreted by a single veterinary pathologist. Ultrasonographic features recorded examined included mass echogenicity, homogeneity, presence of cavitation, layer of origin, bowel wall symmetry, and loss of wall layering, location, size, vascularity, and evidence of perforation or ulceration. Tumor types included 19 GISTs, eight leiomyosarcomas, six leiomyomas, and four nonspecified sarcomas. Gastrointestinal stromal tumors were significantly more likely to be associated (P < 0.03) with abdominal effusion than other tumor types. There was overlap between the anatomical locations of all tumors types with the exception of the cecum where all eight tumors identified were GISTs. Besides location, there were no unique ultrasound features of GISTs that would allow distinction from other gastrointestinal spindle cell tumors. Similar to previous studies, GISTs appeared to be the most common spindle cell tumor associated with the cecum in our sample of dogs. The high frequency of abdominal effusion with GIST's was of unknown etiology could possibly have been due to septic peritonitis. PMID:25846814

  15. Imatinib treatment for gastrointestinal stromal tumour (GIST)

    PubMed Central

    Lopes, Lisandro F; Bacchi, Carlos E

    2010-01-01

    Abstract Gastrointestinal stromal tumour (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. GISTs are believed to originate from intersticial cells of Cajal (the pacemaker cells of the gastrointestinal tract) or related stem cells, and are characterized by KIT or platelet-derived growth factor receptor alpha (PDGFRA) activating mutations. The use of imatinib has revolutionized the management of GIST and altered its natural history, substantially improving survival time and delaying disease progression in many patients. The success of imatinib in controlling advanced GIST led to interest in the neoadjuvant and adjuvant use of the drug. The neoadjuvant (preoperative) use of imatinib is recommended to facilitate resection and avoid mutilating surgery by decreasing tumour size, and adjuvant therapy is indicated for patients at high risk of recurrence. The molecular characterization (genotyping) of GISTs has become an essential part of the routine management of the disease as KIT and PDGFRA mutation status predicts the likelihood of achieving response to imatinib. However, the vast majority of patients who initially responded to imatinib will develop tumour progression (secondary resistance). Secondary resistance is often related to secondary KIT or PDGFRA mutations that interfere with drug binding. Multiple novel tyrosine kinase inhibitors may be potentially useful for the treatment of imatinib-resistant GISTs as they interfere with KIT and PDGFRA receptors or with the downstream-signalling proteins. PMID:19968734

  16. Themes in fibrosis and gastrointestinal inflammation

    PubMed Central

    Lund, P. Kay

    2011-01-01

    Wound healing is an appropriate response to inflammation and tissue injury in the gastrointestinal tract. If wound healing responses are excessive, perpetuated, or prolonged, they lead to fibrosis, distortion of tissue architecture, and loss of function. This introductory editorial and the minireviews or reviews in this themes series highlight the diversity in severity and location of fibrosis in response to gastrointestinal inflammation. The multiplicity of cellular and molecular mediators and new players, including stem cells or extracellular matrix-producing cells derived from nonmesenchymal cell types, is reviewed. Comparisons of inflammation-induced fibrosis across organ systems and the need for integrated and systems-based molecular approaches, new imaging modalities, well-characterized animal models, cell culture models, and improved diagnostic or predictive markers are reviewed. To date, intestinal fibrosis has received much less attention than inflammation in terms of defining mechanisms and underlying causes. This themes series aims to illustrate the importance of research in this area in gastrointestinal health and disease. PMID:21415411

  17. Gastrointestinal problems in the handicapped child.

    PubMed

    Chong, S K

    2001-10-01

    Gastrointestinal issues are a major chronic problem in 80 to 90% of children with cerebral palsy and in children with neurodevelopmental disabilities who are at special risk of developing malnutrition because of uncoordinated swallowing, gastroesophageal reflux, and constipation. In addition to poor linear growth, there is a decrease in muscle strength and coordination, impaired cerebral function leading to decreased motivation and energy. Significant neurodevelopmental progress can be achieved with improved nutritional status. A multidisciplinary approach, with input from neurologists, gastroenterologists, nurses, occupational therapists, and dieticians, can make a major contribution to the medical wellbeing and quality of life of these children. Different neurological diseases ( eg, spinal dysraphism, syringomyelia, tethered cord syndromes) can give rise to gastrointestinal dysfunction and symptoms that may need different gastrointestinal or surgical management. The introduction of new drugs, including proton pump inhibitors and innovative endoscopic and surgical techniques in the management of gastroesophageal reflux disease and constipation also may have an impact on the treatment of neurologically handicapped children in the future. PMID:11801890

  18. Gastrointestinal anthrax: clinical experience in 5 cases

    PubMed Central

    Maddah, Ghodratollah; Abdollahi, Abbas; Katebi, Mehrdad

    2013-01-01

    Background: Bacillus anthracis may usually cause three forms of anthrax: inhalation, gastrointestinal and cutaneous. The gastrointestinal (GI) anthrax develops after eating contaminated meat. Thus, in this paper were report 5 cases of intestinal anthrax. Case Presentation: We report a case series of intestinal anthrax, with history of consumption of raw or poorly cooked liver of sheep. One patient was female and 4 were males with the age range between 17 and 26 years. All patients were admitted with abdominal pain, nausea, and vomiting. Examination revealed abdominal distention on the right lower quadrant or diffuse tenderness. Laboratory examination in all patients showed leukocytosis with polymorphonuclear of >80%. Because of the unclear and questionable diagnosis, exploratory laparotomy was performed on several patients, invariably showing an abundant yellowish and thick ascitic fluid, soft hypertrophied mesenteric lymph nodes (3-5 cm) mostly in the ileocecal region, and substantial edema involving one segment of small bowel, cecum or ascending colon. Anthrax was diagnosed on the epidemiologic basis (ingestion history of half cooked liver of sheep) or microbiologic (microscopy with bacterial culture) and pathologic testing (post surgery in four patients or autopsy in one patient). With appropriate treatment, 4 survived and one patient died. Conclusion: Gastrointestinal anthrax is characterized by rapid onset, fever, ascitis and septicemia. The symptoms can mimic those seen in an acute surgical abdomen. Rapid diagnosis and prompt initiation of antibiotic therapy and then exploratory laparotomy (right hemicolectomy) are keys to survival. PMID:24009958

  19. Evaluation of radiography, ultrasonography and endoscopy for detection of shell lesions in live abalone Haliotis iris (Mollusca: Gastropoda).

    PubMed

    Nollens, Hendrik H; Schofield, John C; Keogh, Jonathan A; Probert, P Keith

    2002-07-01

    Radiography, ultrasonography and endoscopy were examined for their efficacy as non-destructive techniques for the detection of shell lesions in the marine gastropod Haliotis iris Gmelin. X-rays provided 69% correct diagnoses, with detection being restricted to those lesions which were mineralised. Ultrasound also showed potential to reliably detect lesions (83% correct diagnoses), but only where the lesions demonstrated a clear 3-dimensional relief. Lesion dimensions were underestimated using ultrasound. Endoscopy, applied to anaesthetised individuals, provided the most accurate method (92% correct diagnoses) for lesion detection and, although invasive, had no discernible effect on survival of the abalone 8 mo after screening. PMID:12180705

  20. Low-dose aspirin is a prominent cause of bleeding ulcers in patients who underwent emergency endoscopy

    Microsoft Academic Search

    Masayuki Nakayama; Ryuichi Iwakiri; Megumi Hara; Hibiki Ootani; Ryo Shimoda; Seiji Tsunada; Hiroyuki Sakata; Kazuma Fujimoto

    2009-01-01

    Objective  This study aimed to clarify the current situation of bleeding peptic ulcers and examined the temporal changes in the pathogenic\\u000a mechanisms requiring emergency endoscopy.\\u000a \\u000a \\u000a \\u000a Patients and methods  Study subjects were 285 bleeding peptic ulcer patients who received emergency endoscopy in Saga Medical School Hospital between\\u000a 2000 and 2007. The ratios of H. pylori infection, NSAID use and low-dose aspirin use were

  1. Primary leiomyosarcomas of the gastrointestinal tract in the post-gastrointestinal stromal tumor era.

    PubMed

    Aggarwal, Gitika; Sharma, Suash; Zheng, Mei; Reid, Michelle D; Crosby, John H; Chamberlain, Sherman M; Nayak-Kapoor, Asha; Lee, Jeffrey R

    2012-12-01

    Most mesenchymal neoplasms of the gastrointestinal tract are currently classified as gastrointestinal stromal tumors (GIST). Gastrointestinal stromal tumors are diagnosed by immunopositivity for CD117, CD34, and DOG1.1, with or without molecular analyses. According to the World Health Organization classification, the diagnosis of primary leiomyosarcomas of the gastrointestinal tract is so rare that there are no significant data on demographic, clinical, or gross features of this tumor. A comprehensive literature search was performed to identify gastrointestinal leiomyosarcomas. Searches were limited to the past 12 years because definitive tools to differentiate leiomyosarcomas from GIST were introduced in the late 1990s. Cases were included only if convincing data were presented. Six cases of esophageal leiomyosarcoma and 5 cases of gastric leiomyosarcoma were confirmed. Furthermore, 26 cases of leiomyosarcoma of the small bowel, 11 cases of the colon, and 8 cases arising in the rectum were identified. Finally, 28 cases of infantile and adolescent leiomyosarcoma were reviewed. Although survival analysis is precluded by small case numbers and limited survival data availability, the trend identifies that increased size and mitotic activity portends to a worse prognosis in small bowel leiomyosarcomas. Colonic leiomyosarcomas appear to be aggressive tumors, regardless of tumor size and mitotic activity. Rectal leiomyosarcomas present as smaller tumors with favorable prognosis. Leiomyosarcomas in post-GIST era are rare tumors of the gastrointestinal tract with distinctive clinicopathologic characteristics. Owing to different treatment options, it is necessary to accurately differentiate these from GIST, using a combination of histologic appearance, presence of smooth muscle antigens, and absence of specific GIST immunomarkers. PMID:22917807

  2. In vivo early diagnosis of gastric dysplasia using narrow-band image-guided Raman endoscopy

    NASA Astrophysics Data System (ADS)

    Huang, Zhiwei; Bergholt, Mads Sylvest; Zheng, Wei; Lin, Kan; Ho, Khek Yu; Teh, Ming; Yeoh, Khay Guan

    2010-05-01

    We first report on the implementation of a novel narrow-band image-guided Raman endoscopy technique for in vivo diagnosis of gastric dysplasia. High-quality in vivo Raman spectra can be acquired from normal and dysplastic gastric mucosal tissue within 0.5 sec under narrow-band image (NBI) guidance at gastroscopy. Significant differences are observed in in vivo Raman spectra between normal (n=54) and dysplastic (n=18) gastric tissue from 30 gastric patients, particularly in the spectral ranges of 825 to 950, 1000 to 1100, 1250 to 1500, and 1600 to 1800 cm-1, which primarily contain signals related to proteins, nucleic acids, and lipids. The multivariate analysis [i.e., principal components analysis (PCA) and linear discriminant analysis (LDA)], together with the leave-one tissue site-out, cross validation on in vivo gastric Raman spectra yields a diagnostic sensitivity of 94.4% (17/18) and specificity of 96.3% (52/54) for distinction of gastric dysplastic tissue. This study suggests that narrowband image-guided Raman endoscopy associated with PCA-LDA diagnostic algorithms has potential for the noninvasive, in vivo early diagnosis and detection of gastric precancer during clinical gastroscopic examination.

  3. A 3D endoscopy reconstruction as a saliency map for analysis of polyp shapes

    NASA Astrophysics Data System (ADS)

    Ruano, Josue; Martínez, Fabio; Gómez, Martín.; Romero, Eduardo

    2015-01-01

    A first diagnosis of colorectal cancer is performed by examination of polyp shape and appearance during an endoscopy routine procedure. However, the video-endoscopy is highly noisy because exacerbated physiological conditions like increased motility or secretion may limit the visual analysis of lesions. In this work a 3D reconstruction of the digestive tract is proposed, facilitating the polyp shape evaluation by highlighting its surface geometry and allowing an analysis from different perspectives. The method starts by a spatio-temporal map, constructed to group the different regions of the tract by their similar dynamic patterns during the sequence. Then, such map was convolved with a second derivative of a Gaussian kernel that emulates the camera distortion and allows to highlight the polyp surface. The position initialization in each frame of the kernel was computed from expert manual delineation and propagated along the sequence based on. Results show reliable reconstructions, with a salient 3D polyp structure that can then be better observed.

  4. Image enhancement of surface micro-structure on mucosa for polarimetric endoscopy

    NASA Astrophysics Data System (ADS)

    Kanamori, Katsuhiro

    2015-03-01

    This paper describes a novel image processing method for endoscopy that enhances the appearance of microstructures on mucosa. The new technique employs two pairs of parallel- and crossed-nicols polarimetric images, from which an averaged subtracted polarization image (AVSPI) is calculated. Experiments were first executed using a manual experimental setup with ring-type lighting, two rotating polarizers and a color camera. A new objective evaluation method that uses texture analysis (GLCM) was developed and applied to evaluation of the enhanced microstructure images. Experiments using excised porcine stomach tissue showed better results than with conventional color intensity image processing. Next, an online rigid-type polarimetric endoscope system using a polarized ring-shaped LED and a special three-CCD color polarimetric camera was developed. The two types of equipment described above are quite different as to extinction ratio values, but show similarly enhanced image quality. Our results show that polarimetric endoscopy is not only effective but also practical for hardware implementation.

  5. Colon capsule endoscopy: What we know and what we would like to know

    PubMed Central

    Spada, Cristiano; Barbaro, Federico; Andrisani, Gianluca; Minelli Grazioli, Leonardo; Hassan, Cesare; Costamagna, Isabella; Campanale, Mariachiara; Costamagna, Guido

    2014-01-01

    Colonoscopy is usually perceived as an invasive and potentially painful procedure, being also affected by a small, but definite, risk of major complications (cardiopulmonary complications, perforation, hemorrhage) and even mortality. To improve both acceptability and safety, PillCam Colon Capsule Endoscopy (CCE) (Given Imaging Ltd, Yoqneam, Israel) has been developed. CCE represents a non-invasive technique that is able to explore the colon without sedation and air insufflation. The Second Generation of Colon Capsule Endoscopy (PillCam Colon 2) (CCE-2) was proven to be an accurate tool to detect colonic neoplastic lesions when used in average risk individuals. To date, the evidence supports the use of CCE-2 in case of colonoscopy failure, in patients unwilling to perform colonoscopy and when colonoscopy is contraindicated. Other potential applications, such as colorectal cancer screening or diagnostic surveillance of inflammatory bowel disease need to be clarified. In this paper, the current “state of the art”, potential application of CCE and future needs are evaluated. PMID:25493007

  6. Integrated micro-endoscopy system for simultaneous fluorescence and optical-resolution photoacoustic imaging

    NASA Astrophysics Data System (ADS)

    Shao, Peng; Shi, Wei; Hajireza, Parsin; Zemp, Roger J.

    2012-07-01

    We present a new integrated micro-endoscopy system combining label-free, fiber-based, real-time C-scan optical-resolution photoacoustic microscopy (F-OR-PAM) and a high-resolution fluorescence micro-endoscopy system for visualizing fluorescently labeled cellular components and optically absorbing microvasculature simultaneously. With a diode-pumped 532-nm fiber laser, the F-OR-PAM sub-system is able to reach a resolution of ~7 ?m. The fluorescence subsystem, which does not require any mechanical scanning, consists of a 447.5-nm-centered diode laser as the light source, an objective lens, and a CCD camera. Proflavine is used as the fluorescent contrast agent by topical application. The scanning laser and the diode laser light source share the same light path within an optical fiber bundle containing 30,000 individual single-mode fibers. The absorption of proflavine at 532 nm is low, which mitigates absorption bleaching of the contrast agent by the photoacoustic excitation source. We demonstrate imaging in live murine models. The system is able to provide cellular morphology with cellular resolution co-registered with the structural information given by F-OR-PAM. Therefore, the system has the potential to serve as a virtual biopsy technique, helping visualize angiogenesis and the effects of anti-cancer drugs on both cells and the microcirculation, as well as aid in the study of other diseases.

  7. Integrated micro-endoscopy system for simultaneous fluorescence and optical-resolution photoacoustic imaging.

    PubMed

    Shao, Peng; Shi, Wei; Hajireza, Parsin; Zemp, Roger J

    2012-07-01

    We present a new integrated micro-endoscopy system combining label-free, fiber-based, real-time C-scan optical-resolution photoacoustic microscopy (F-OR-PAM) and a high-resolution fluorescence micro-endoscopy system for visualizing fluorescently labeled cellular components and optically absorbing microvasculature simultaneously. With a diode-pumped 532-nm fiber laser, the F-OR-PAM sub-system is able to reach a resolution of ?7???m. The fluorescence subsystem, which does not require any mechanical scanning, consists of a 447.5-nm-centered diode laser as the light source, an objective lens, and a CCD camera. Proflavine is used as the fluorescent contrast agent by topical application. The scanning laser and the diode laser light source share the same light path within an optical fiber bundle containing 30,000 individual single-mode fibers. The absorption of proflavine at 532 nm is low, which mitigates absorption bleaching of the contrast agent by the photoacoustic excitation source. We demonstrate imaging in live murine models. The system is able to provide cellular morphology with cellular resolution co-registered with the structural information given by F-OR-PAM. Therefore, the system has the potential to serve as a virtual biopsy technique, helping visualize angiogenesis and the effects of anti-cancer drugs on both cells and the microcirculation, as well as aid in the study of other diseases. PMID:22894507

  8. The role of drug-induced sleep endoscopy in surgical planning for obstructive sleep apnea syndrome.

    PubMed

    Aktas, Ozturk; Erdur, Omer; Cirik, Ahmet Adnan; Kayhan, Fatma Tulin

    2015-08-01

    This study investigated the role of drug-induced sleep endoscopy (DISE) in the surgical treatment planning of patients with obstructive sleep apnea syndrome (OSAS). This study was conducted using patients diagnosed with OSAS between January 2007 and March 2009, who were scheduled for surgical treatment. DISE was performed using propofol in patients considered to have upper respiratory tract obstruction as indicated by Muller's maneuver. After completing the sleep endoscopy, the patient was intubated and surgery was performed (tonsillectomy and uvulopalatopharyngoplasty). A successful operation was defined as a decrease in the respiratory disturbance index to below 5 or a decrease of ?50 % following the operation. The study included 20 patients (4 female and 16 male) aged 19-57 years. No statistically significant correlation between modified Mallampati class and operation success or between the polysomnographic stage of disease and operation success was identified. A significantly high operation success rate was found in the group with obstruction of the upper airway according to DISE (p < 0.05), whereas a significantly low operation success rate was found in the group with obstruction of the lower airway according to DISE (p < 0.01). DISE may be used to identify the localization of obstruction for diagnostic purposes, and it can be helpful in selecting the treatment method. PMID:24972543

  9. Advances in the diagnosis and treatment of gastrointestinal neuroendocrine tumors

    Microsoft Academic Search

    Jeffrey E. Lee; Douglas B. Evans

    \\u000a Gastrointestinal neuroendocrine tumors are rare neoplasms that share a common histology and biochemical features yet differ\\u000a widely in their natural histories. Recent advances in our understanding of the biology of these tumors have been helpful in\\u000a designing diagnostic localization strategies, selecting patients for appropriate treatment, and developing novel therapeutic\\u000a approaches. Gastrointestinal neuroendocrine tumors constitute approximately 2% of all malignant gastrointestinal

  10. The gastrointestinal microbiome: a malleable, third genome of mammals

    PubMed Central

    Carroll, Ian M.; Threadgill, David W.

    2015-01-01

    The nonpathogenic, mutualistic bacteria of the mammalian gastrointestinal tract provide a number of benefits to the host. Recent reports have shown how the aggregate genomes of gastrointestinal bacteria provide novel benefits by functioning as the third major genome in mammals along with the nuclear and mitochondrial genomes. Consequently, efforts are underway to elucidate the complexity of the organisms comprising the unique ecosystem of the gastrointestinal tract, as well as those associated with other epidermal surfaces. The current knowledge of the gastrointestinal microbiome, its relationship to human health and disease with a particular focus on mammalian physiology, and efforts to alter its composition as a novel therapeutic approach are reviewed. PMID:19629594

  11. Gastrointestinal imaging-practical magnetic resonance imaging approach

    PubMed Central

    Liu, Baodong; Ramalho, Miguel; AlObaidy, Mamdoh; Busireddy, Kiran K; Altun, Ersan; Kalubowila, Janaka; Semelka, Richard C

    2014-01-01

    Over the past two decades, advances in cross-sectional imaging such as computed tomography and magnetic resonance imaging (MRI) have dramatically changed the concept of gastrointestinal imaging. MR is playing an increasing role in the evaluation of gastrointestinal disorders. MRI combines the advantages of excellent soft-tissue contrast, noninvasiveness, functional information and lack of ionizing radiation. Furthermore, recent developments of MRI have led to improved spatial and temporal resolution as well as decreased motion artifacts. In this article we describe the technical aspects of gastrointestinal MRI and present a practical approach for a well-known spectrum of gastrointestinal disease processes. PMID:25170393

  12. Oxaliplatin Plus Irinotecan in Treating Patients With Metastatic Gastrointestinal Cancer

    ClinicalTrials.gov

    2013-06-24

    Anal Cancer; Colorectal Cancer; Esophageal Cancer; Extrahepatic Bile Duct Cancer; Gallbladder Cancer; Gastric Cancer; Gastrointestinal Carcinoid Tumor; Liver Cancer; Pancreatic Cancer; Small Intestine Cancer

  13. 21 CFR 876.5980 - Gastrointestinal tube and accessories.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5980 Gastrointestinal tube and accessories. (a)...

  14. 21 CFR 876.1725 - Gastrointestinal motility monitoring system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Diagnostic Devices § 876.1725 Gastrointestinal motility monitoring system. (a)...

  15. 21 CFR 876.1725 - Gastrointestinal motility monitoring system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Diagnostic Devices § 876.1725 Gastrointestinal motility monitoring system. (a)...

  16. 21 CFR 876.5980 - Gastrointestinal tube and accessories.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5980 Gastrointestinal tube and accessories. (a)...

  17. 21 CFR 876.1725 - Gastrointestinal motility monitoring system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Diagnostic Devices § 876.1725 Gastrointestinal motility monitoring system. (a)...

  18. 21 CFR 876.1725 - Gastrointestinal motility monitoring system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Diagnostic Devices § 876.1725 Gastrointestinal motility monitoring system. (a)...

  19. 21 CFR 876.5980 - Gastrointestinal tube and accessories.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5980 Gastrointestinal tube and accessories. (a)...

  20. 21 CFR 876.5980 - Gastrointestinal tube and accessories.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5980 Gastrointestinal tube and accessories. (a)...

  1. 21 CFR 876.5980 - Gastrointestinal tube and accessories.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5980 Gastrointestinal tube and accessories. (a)...

  2. 21 CFR 876.1725 - Gastrointestinal motility monitoring system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Diagnostic Devices § 876.1725 Gastrointestinal motility monitoring system. (a)...

  3. Small Bowel Pleomorphic Liposarcoma: A Rare Cause of Gastrointestinal Bleeding

    PubMed Central

    Schlag, Christoph; Becker, Valentin; Neu, Bruno; Hüser, Norbert; Gertler, Ralf; Schmid, Roland M.; von Delius, Stefan

    2014-01-01

    In this case report we present a 60-year-old male patient with overt midgastrointestinal bleeding of a primary ileal pleomorphic liposarcoma diagnosed by video capsule endoscopy (VCE). Clinical work-up for final diagnosis and the pathological background of this uncommon tumorous entity of the small bowel will be discussed in this paper. PMID:25161780

  4. Motion Estimation of the Endoscopy Capsule using Region-based Kernel SVM Classifier

    E-print Network

    Pahlavan, Kaveh

    ) allows physicians to examine the entire digestive system without any surgical operation. Although for clinical procedure for 12 years. It provides a noninvasive imaging technology of examining the digestive system. Such capsules travel inside the human's gastrointestinal (GI) tract in almost the same way

  5. Gastrointestinal hormone research - with a Scandinavian annotation.

    PubMed

    Rehfeld, Jens F

    2015-06-01

    Gastrointestinal hormones are peptides released from neuroendocrine cells in the digestive tract. More than 30 hormone genes are currently known to be expressed in the gut, which makes it the largest hormone-producing organ in the body. Modern biology makes it feasible to conceive the hormones under five headings: The structural homology groups a majority of the hormones into nine families, each of which is assumed to originate from one ancestral gene. The individual hormone gene often has multiple phenotypes due to alternative splicing, tandem organization or differentiated posttranslational maturation of the prohormone. By a combination of these mechanisms, more than 100 different hormonally active peptides are released from the gut. Gut hormone genes are also widely expressed outside the gut, some only in extraintestinal endocrine cells and cerebral or peripheral neurons but others also in other cell types. The extraintestinal cells may release different bioactive fragments of the same prohormone due to cell-specific processing pathways. Moreover, endocrine cells, neurons, cancer cells and, for instance, spermatozoa secrete gut peptides in different ways, so the same peptide may act as a blood-borne hormone, a neurotransmitter, a local growth factor or a fertility factor. The targets of gastrointestinal hormones are specific G-protein-coupled receptors that are expressed in the cell membranes also outside the digestive tract. Thus, gut hormones not only regulate digestive functions, but also constitute regulatory systems operating in the whole organism. This overview of gut hormone biology is supplemented with an annotation on some Scandinavian contributions to gastrointestinal hormone research. PMID:25786560

  6. Probiotics as drugs against human gastrointestinal infections.

    PubMed

    Sanz, Yolanda; Nadal, Inmaculada; Sánchez, Ester

    2007-06-01

    The commensal gut microbiota confer health benefits to their host by helping dietary digestion, regulating gut immunity, maintaining the microbial balance, and preventing pathogen colonization. A number of probiotic strains have been introduced in the market in dietary and pharmaceutical forms. Lactic acid bacteria (e.g. Lactobacillus) and Bifidobacterium constitute the main group of probiotics commercialized for human consumption. The treatment of gastrointestinal infections continues to be complicated due to the expansion of antibiotic resistances. Of the benefits of probiotics, those related to their preventive and therapeutic uses against gastrointestinal infections have an outstanding position, as reflected in a large number of patents. The mechanisms of action of probiotics against gastrointestinal pathogens addressed in diverse patent applications include: (i) modification of the environmental conditions, (ii) competition for nutrients and adhesion sites, (iii) production of antimicrobial metabolites and (iv) modulation of the immune and non-immune defense mechanisms of the host. The bioactive components of probiotics include cell-wall fractions, surface proteins, nucleic acids, organic and short-chain fatty acids, antimicrobial proteins and other less-well identified soluble factors. The effectiveness of probiotics is supported by solid clinical studies mainly on treatment of acute diarrhea in children and prevention of antibiotic associated disorders. Currently, probiotics and their bioactive compounds constitute attractive alternative drugs that can help to reduce the use of antibiotics as well as to improve conventional pharmacological therapies. The advances on the knowledge of the intricate host-microbe dialogues within the intestine and extraintestinal sites will result in the future development of a new generation probiotic-based products targeting broader range of pathologies and their etiologic agents. PMID:18221171

  7. OX40 interactions in gastrointestinal nematode infection

    PubMed Central

    Ierna, Michelle X; Scales, Hannah E; Schwarz, Herbert; Bunce, Campbell; McIlgorm, Anne; Garside, Paul; Lawrence, Catherine E

    2006-01-01

    The immune expulsion of gastrointestinal nematode parasites is usually associated with T helper type 2 (Th2) responses, but the effector mechanisms directly responsible for parasite loss have not been elucidated. The intestinal inflammatory response accompanying infection with gastrointestinal helminths is thought to be a contributory factor leading to the expulsion of the parasite. However, we have shown that the intestinal inflammation, which is controlled by interleukin (IL)-4, is not required for parasite expulsion. OX40–OX40 ligand (L) signals have been shown to be important for the development of Th2 immune responses but are also involved in a number of inflammatory diseases including those of the intestine. Here, we have investigated the effect of OX40 and OX40L fusion protein treatment on the induction of protective Th2 responses and enteropathy following infection with the gastrointestinal nematode Trichinella spiralis. Treatment with an OX40–immunoglobulin (Ig) blocking fusion protein resulted in enhanced expulsion of the parasite and an increase in the accompanying mastocytosis, despite unaltered levels of Th2 cytokines. Furthermore, there was a delay in the villus atrophy and crypt hyperplasia usually associated with this infection. In contrast, levels of Th2 cytokines were greatly up-regulated in mice treated with an OX40L–Ig activating fusion protein, yet the expulsion of the parasite and the enteropathy were unaffected. Therefore, OX40 ligation potentiates the Th2 response without enhancing host protective immune responses, whereas blocking the OX40–OX40L interaction enhances host protection without promoting Th2 cytokine responses during Trichinella spiralis infection. PMID:16423046

  8. Laparoscopic gastric resection for gastrointestinal stromal tumors

    Microsoft Academic Search

    Jennifer A. Sexton; Richard A. Pierce; Valerie J. Halpin; J. Christopher Eagon; William G. Hawkins; David C. Linehan; L. Michael Brunt; Margaret M. Frisella; Brent D. Matthews

    2008-01-01

    Background  This study aimed to review clinical outcomes for patients selected to undergo laparoscopic resection for gastrointestinal\\u000a stromal tumor (GIST) of the stomach.\\u000a \\u000a \\u000a \\u000a Methods  All 112 laparoscopic gastric resections performed from February 1995 to March 2007 were reviewed. Pre- and postoperative variables\\u000a were analyzed, and data are given as mean ± standard deviation.\\u000a \\u000a \\u000a \\u000a Results  Laparoscopic gastric resection was attempted for 63 GIST in 61 patients

  9. Influence of gastrointestinal trichostrongylidosis on ram fertility.

    PubMed

    Gaglio, G; Poglayen, G; Capelli, G; Gruner, L; Maras, L; Giannetto, S; Scala, A

    2010-01-01

    A study on the influence of gastrointestinal trichostrongyles on ram fertility was performed. Two groups of semen donor rams (Sarda breed) were utilized; one was experimentally infected with Haemonchus contortus, Trichostrongylus colubriformis and Teladorsagia circumcincta and the other was used as a control group. In all animals, coprological, haematological and reproductive parameters were studied. The results suggest that the parasites had a limited effect with some changes in phosphorus, cholesterol and chlorine levels. In our experience the parasitic burden produced no significant change on ram fertility. PMID:21370756

  10. [Gastrointestinal disorders in patients with renal impairment].

    PubMed

    Mo?seienko, V O; Al'ianova, T S

    2014-11-01

    In the study the most common gastroenterological disorders among patients with CRF are reviewed. It was shown two main types of such disorders: as a manifestation of the underlying disease (CKD) or as an associated disease. It was determined that anorexia, nausea, vomiting, constipation, gastrointestinal bleeding, and acute abdominal pain are the most common gastroenterological symptoms. The necessity of further studying of the pathogenetic mechanisms of gastroenterological disorders in the case of presence of CRF and the importance of an integrated approach to the screening and management of patients with CRF was shown. PMID:25528827

  11. Gastrointestinal motility in space motion sickness

    NASA Technical Reports Server (NTRS)

    Thornton, William E.; Linder, Barry J.; Moore, Thomas P.; Pool, Sam L.

    1987-01-01

    Gastrointestinal symptoms in space motion sickness (SMS) are significantly different from those in ordinary motion sickness (MS). Recording and tabulation of sounds was the only technique that could be used as a measure of motility during spaceflight operations. There were 17 subjects, six unaffected by SMS, who made ambulatory recordings preflight and inflight. With one exception, all those affected had sharply reduced sounds, while those unaffected had increases or moderate reductions. The mechanism of vomiting in SMS appears to be secondary to this ileus, in contrast to vomiting in ordinary MS, where the emesis center is thought to be directly triggered by the vestibular system.

  12. Real-time depth-resolved fiber optic Raman endoscopy for in vivo diagnosis of gastric precancer

    NASA Astrophysics Data System (ADS)

    Bergholt, Mads S.; Zheng, Wei; Ho, Khek Yu; Yeoh, Khay Guan; Teh, Ming; So, Jimmy B. Y.; Huang, Zhiwei

    2014-03-01

    Raman spectroscopy represents a unique optical vibrational technique based on the fundamental premise of inelastic light scattering. Raman spectroscopy enables histopathological assessment at the biomolecular level. We have developed a fiber-optic depth-resolved near-infrared (NIR) Raman endoscopy technique integrated with on-line diagnostic algorithms for in vivo real-time epithelial diagnostics under multimodal wide-field imaging (i.e., white light reflectance (WLR), narrow-band imaging (NBI), autofluorescence imaging (AFI)) modalities. A selection of 450 patients who previously underwent Raman endoscopy (n=1900 spectra) was used to render diagnostic models for identifying gastric precancer (i.e., dysplasia) based on probabilistic partial least squares (PLS) - discriminant analysis (DA). The on-line Raman endoscopy technique was tested prospectively on (n=5) patients for real-time in vivo gastric epithelium tissue diagnosis. The fiber-optic confocal Raman endoscopic technique developed could prospectively identify gastric dysplasia in real-time with a sensitivity: 81.3% (61/75) and specificity 88.3% (188/213) on spectrum basis. On lesion basis, all dysplastic lesions were identified. This study successfully demonstrates for the first time the prospective real-time in vivo diagnosis of gastric precancer using depth-resolved Raman endoscopy.

  13. Preparation of nose for nasal endoscopy: cotton pledget packing versus topical spray. A prospective randomized blinded study.

    PubMed

    Mishra, Prasun; Kaushik, Maitri; Dehadaray, Arun; Qadri, Haris; Raichurkar, Annapurna; Seth, Tanvi

    2013-01-01

    During nasal endoscopy it is essential to have proper visualization of structures with minimal discomfort to patient and surgeon. For this it is essential that the nose is well prepared before the procedure. The main objective of the study is to compare and evaluate the efficacy of cotton pledget packing versus topical sprays in preparation of nose for nasal endoscopy. The method includes prospective randomized blinded study on 100 patients. Patients were randomly divided in two groups. In first group the nose was packed with 4% lignocaine with xylometazoline nasal drops and in the other group it was prepared with 10% lignocaine topical spray and xylometazoline nose drops. Following the procedure, patient and the surgeon were asked a pre-formed questionnaire to know their experience during endoscopy. It was observed the packing group required more preparatory time as compared to the spray group. The group which was packed had less discomfort, less pain while endoscopy. The visualization of structures was significantly better in the packed group. Eight patients in the packed group did have some mucosal bleed during the process of packing which was not seen in the spray group. Both methods of preparation have merits and demerits but in terms of discomfort, pain during procedure and visualization of structure, packing of nasal cavity with 4% lignocaine and xylometazoline drops is better than spraying of nose with 10% lignocaine and xylometazoline drops. PMID:22427029

  14. Real-time depth-resolved Raman endoscopy for in vivo diagnosis of dysplasia in Barrett's esophagus

    NASA Astrophysics Data System (ADS)

    Bergholt, Mads Sylvest; Zheng, Wei; Ho, Khek Yu; Yeoh, Khay Guan; Teh, Ming; So, Jimmy Bok Yan; Huang, Zhiwei

    2013-03-01

    Raman spectroscopy is a vibrational analytic technique sensitive to the changes in biomolecular composition and conformations occurring in tissue. With our most recent development of depth-resolved near-infrared (NIR) Raman endoscopy integrated with on-line diagnostic algorithms, in vivo real-time epithelial diagnostics has been realized under multimodal wide-field imaging (i.e., white- light reflectance (WLR), narrow-band imaging (NBI), autofluorescence imaging (AFI)) modalities. A selection of 43 patients who previously underwent Raman endoscopy (n=146 spectra) was used to render a robust model based on partial least squares - discriminant analysis (PLS-DA) for diagnosis of dysplasia in Barrett's esophagus. The Raman endoscopy technique was validated prospectively on 2 new esophageal patients for in vivo tissue diagnosis. The Raman endoscopic technique could identify esophageal high-grade dysplasia in vivo with an accuracy of 85.9% (sensitivity: 91.3% (21/23): specificity 83.3% (40/48)) on spectrum basis. This study realizes for the first time depth-resolved Raman endoscopy for real-time in vivo diagnosis of dysplasia in Barrett's epithelium at the biomolecular level.

  15. Wireless Capsule Endoscopy Video Segmentation Using an Unsupervised Learning Approach Based on Probabilistic Latent Semantic Analysis With Scale Invariant Features

    Microsoft Academic Search

    Yao Shen; Bill P. Buckles

    2012-01-01

    Since wireless capsule endoscopy (WCE) is a novel technology for recording the videos of the digestive tract of a patient, the problem of segmenting the WCE video of the digestive tract into subvideos corresponding to the entrance, stomach, small intestine, and large intestine regions is not well addressed in the literature. A selected few papers addressing this problem follow supervised

  16. 3rd caesarium Computer Aided Medicine Bonn, Germany, November 12-13, 2001 Integration of Navigation, Optical and Virtual Endoscopy

    E-print Network

    Bartz, Dirk

    of Navigation, Optical and Virtual Endoscopy in Neurosurgery and Oral and Maxillofacial Surgery Dirk Bartz1 Hospital T¨ubingen 4Department of Oral and Maxillofacial Surgery, University Hospital T¨ubingen Email-operative navigation are already used in the departments of neurosurgery [5, 6] and oral and maxillofacial surgery [8

  17. IEEE TRANSACTIONS ON MEDICAL IMAGING --FINAL MANUSCRIPT 2004-0117 1 Interactive Virtual Endoscopy in Coronary Arteries

    E-print Network

    Wahle, Andreas

    in Coronary Arteries based on Multi-Modality Fusion Andreas Wahle, Senior Member, IEEE, Mark E. Olszewski-independent virtual endoscopy in human coronary arteries is presented in this pa- per. It incorporates previously results in a three- or four-dimensional (3-D/4-D) model of a coronary artery, specifically of its lumen

  18. Capsule endoscopy in the evaluation of patients with suspected small intestinal bleeding: Results of a pilot study

    Microsoft Academic Search

    Blair S. Lewis; Paul Swain

    2002-01-01

    Background: A video capsule has been developed to acquire photographic images of the small intestine during normal peristaltic motion. Methods: Patients between 21 and 80 years of age referred for enteroscopy because of obscure GI bleeding were offered entry into a trial in which they would undergo both capsule endoscopy and subsequent push enteroscopy. Results of capsule examinations were compared

  19. ENDOSCOPY SUITE DIRECT ENDOSCOPY REQUEST

    E-print Network

    Viola, Ronald

    of colon cancer ­ who _______ ______ Iron deficiency anemia with ______ Family history of colon polyps/or vomiting ______ Melena with negative EGD ______ Other: _________________ ______ Iron deficiency anemia

  20. Using an ‘action set’ for the management of acute upper gastrointestinal bleeding

    PubMed Central

    Murray, Charles; Hamilton, Mark; Epstein, Owen; Negus, Rupert; Peachey, Tim; Kaul, Arvind; O’Beirne, James

    2013-01-01

    Background: We studied the management of patients with acute upper gastrointestinal (GI) bleeding (AUGIB) at the Royal Free Hospital. The aim was to compare our performance with the national standard and determine ways of improving the delivery of care in accordance with the recently published ‘Scope for improvement’ report. Methods: We randomly selected patients who presented with haematemesis, melaena, or both, and had an oesophageogastroduodenoscopy (OGD) between April and October 2009. We developed local guidelines and presented our findings in various forums. We collaborated with the British Medical Journal’s Evidence Centre and Cerner Millennium electronic patient record system to create an electronic ‘Action Set’ for the management of patients presenting with AUGIB. We re-audited using the same standard and target. Results: With the action set, documentation of pre-OGD Rockall scores increased significantly (p ? 0.0001). The differences in the calculation and documentation of post-OGD full Rockall scores were also significant between the two audit loops (p = 0.007). Patients who inappropriately received proton-pump inhibitors (PPIs) before endoscopy were reduced from 73.8% to 33% (p = 0.02). Patients receiving PPIs after OGD were also reduced from 66% to 50% (p = 0.01). Discharges of patients whose full Rockall score was less than or equal to two increased from 40% to 100% (p = 0.43). Conclusion: The use of the Action Set improved calculation and documentation of risk scores and facilitated earlier hospital discharge for low-risk patients. Significant improvements were also seen in inappropriate use of PPIs. Actions sets can improve guideline adherence and can potentially promote cost-cutting and improve health economics. PMID:24179478