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Aleksandra Sokic-Milutinovic
Hereditary polyposis syndromes in which APC gene germline mutations can lead to colorectal carcinogenesis are familial adenomatous polyposis (FAP), attenuated FAP (AFAP) and MUTYH-associated polyposis. All 3 syndromes increase the potential for the development of colorectal cancer. AFAP is diagnosed if less than 100 adenomas are detected in the colon at presentation. AFAP is inherited in an autosomal dominant manner. We present a case of a 22-year-old female with AFAP who was treated with endoscopic polypectomy and surveilled by annual colonoscopy...
March 5, 2019: Digestive Diseases
Omnya Ahmed, Tamir Malley
Here we report a case of a patient with systemic lupus erythematosus presenting with pseudo-pseudo Meigs' syndrome (PPMS): a triad of pleural effusion, ascites and raised CA-125. There have only been nine other cases reported in the literature. To our knowledge, this is the first to have an oesophago-gastro-duodenoscopy and liver biopsy as part of the diagnostic work up. Its mechanism of action is not yet fully understood but PPMS is a treatable condition that is responsive to immunosuppression. It is therefore important to consider it in patients presenting like this, where alternative diagnoses, including malignancy, have been ruled out...
January 2019: Oxford Medical Case Reports
Avantika Singh, Michael Anderson, M Adnan Altaf
BACKGROUND: Caustic ingestion with concentrated detergent pods (CDPs) is a common problem encountered in pediatric population. There is insufficient literature about endoscopic findings in CDP ingestion and hence no current consensus or guidelines regarding the need for endoscopic evaluation. OBJECTIVES: To review cases of children with exposure to CDPs from 2010-2016 at a tertiary care children's hospital and to identifying the possibility of a correlation between clinical presentation and the endoscopic findings...
January 16, 2019: Journal of Pediatric Gastroenterology and Nutrition
Mina Morino, Masanari Sekine, Keita Matsumoto, Hitomi Kashima, Yudai Koito, Takaya Miura, Yuko Takahashi, Rumiko Tsuboi, Takehiro Ishii, Shuhei Yoshikawa, Haruka Ohtake, Junichi Fujiwara, Takeshi Uehara, Kazuhito Yuhashi, Takeharu Asano, Satohiro Matsumoto, Hiroyuki Miyatani, Akira Tanaka, Hirosato Mashima
A 73-year-old man with worsened diabetes underwent abdominal computed tomography and was diagnosed with localized enlargement of the pancreatic tail. Based on the suspicion of autoimmune pancreatitis, endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) was performed. A cytologic examination showed findings suggestive of adenocarcinoma. Due to discrepancies between the imaging and pathological findings, esophago-gastro-duodenoscopy was performed. An extensive early gastric cancer lesion was detected in the posterior wall of the gastric corpus...
January 10, 2019: Internal Medicine
Xin Shi, Hui Luo, Bo Ning, Xiangping Wang, Qin Tao, Shuhui Liang, Rongchun Zhang, Jie Chen, Bing Luo, Shaowei Yao, Yanglin Pan, Xuegang Guo, Daiming Fan
BACKGROUND:  Cap-assisted esophagogastroduodenoscopy (CA-EGD) using a transparent cap fitted to the tip of the scope has emerged as an alternative method for examination of the major duodenal papilla (MDP). However, it remains unclear whether CA-EGD is noninferior to standard duodenoscopy for MDP examination. The aim of this study was to compare the efficacies of the two methods for complete examination of the MDP. METHODS:  This prospective, noninferior, randomized controlled study was conducted at two endoscopy centers...
January 8, 2019: Endoscopy
M Rubayat Rahman, Abhilash Perisetti, Roxana Coman, Pardeep Bansal, Rajiv Chhabra, Hemant Goyal
The duodenoscope is among the most complex medical instruments that undergo disinfection between patients. Transmission of infection by contaminated scopes has remained a challenge since its inception. Notable risk factors for pathogen transmission include non-adherence to disinfection guidelines, encouragement of biofilm deposition due to complex design and surface defects and contaminated automated endoscope reprocessors. The most common infections following endoscopy are endogenous infections involving the patient's own gut flora...
December 19, 2018: Digestive Diseases and Sciences
Rachele Borgogni, Federica Gaiani, Francesco Di Mario, Fabiola Fornaroli, Gioacchino Leandro, Barbara Bizzarri, Alessia Ghiselli, Gian Luigi De' Angelis, Emilio Casolari
INTRODUCTION: Intraoperative endoscopy is a procedure that supports open and laparoscopic surgery, helping the surgeon to identify the presence of endoluminal gastrointestinal lesions which need to be treated, with a correct diagnosis and an adequate therapy. MATERIAL AND METHODS: A search on PubMed was performed using "intraoperative esophagoscopy", "intraoperative duodenoscopy", and "intraoperative enteroscopy" as Mesh terms. The applied exclusion criteria were: papers written before 2000, not concerning pediatric or gastrointestinal pathology, literature-review articles, language different from English...
December 17, 2018: Acta Bio-medica: Atenei Parmensis
Ayad Ahmad Mohammed, Sardar Hasan Arif, Abdulwahid M Salih, Fahmi Hussein Kakamad
Intestinal obstruction resulted from balloon migration is an extremely rare but serious late complication of the intragastric balloon (IGB). The aim of this study is to report a case of small bowel obstruction occurring in a middle age corpulent female following embedding of IGB. A 47-year-old obese female presented with abdominal pain, nausea, and vomiting for two days. She had a history of an endoscopically placed IGB nine months before presentation. Physical examination showed an obese woman with mild distress, and the right upper abdomen was tender...
November 2018: Annals of Medicine and Surgery
Kazuhiro Ota, Satoshi Kikutani, Yuka Kawasaki, Noriaki Sugawara, Satoshi Harada, Yuichi Kojima, Sadaharu Nouda, Toshihisa Takeuchi, Hiroshi Akutagawa, Kazuhide Higuchi
Herein, we report for the first time a case of a surficial superficial non-ampullary duodenal cancer causing obscure intestinal bleeding that was identified by small-bowel capsule endoscopy and treated by endoscopic mucosal resection. A 73-year-old man underwent upper gastrointestinal endoscopy to identify the cause of anemia. Although conventional duodenoscopy revealed a flat, elevated 5-mm lesion with a central recess and "milk-white mucosa" at the inferior duodenal angulus, capsule endoscopy revealed a white nodular 5-mm lesion with central recess at the duodenum slightly to the anal side from the major duodenal papilla...
September 26, 2018: Clinical Journal of Gastroenterology
Xiaobo Cai, Haiyun Zhang, Shenzheng Luo, Li Baiwen, Jing Ma, Lungen Lu, Xinjian Wan
BACKGROUND AND AIM: Endoscopic biliary drainage is difficult in patients with biliary obstruction combined with gastric outlet stricture (GOS). Endoscopic ultrasound is useful for such patients, but needs advanced technique and sophisticated equipment. This study aimed to evaluate the efficacy and safety of conventional endoscopic retrograde cholangiopancreatography (ERCP) in patients with GOS and biliary obstruction without the assistance of endoscopic ultrasound. PATIENTS AND METHODS: Seventy-four patients with GOS proximal to the ampulla and biliary obstruction, including 27 with benign GOS and 47 with malignant GOS, were retrospectively enrolled...
November 2018: European Journal of Gastroenterology & Hepatology
Duygu Kara, Nevzat Aykut Bayrak, Burcu Volkan, Cihat Uçar, Mehmet Nuri Cevizci, Sedat Yılmaz
OBJECTIVES: Esophagogastroduodenoscopy (EGD) can cause fear and anxiety in children. Cortisol, which is the most important glucocorticoid hormone in humans, can increase under physiological stress. The purpose of this study was to measure the salivary cortisol level (SCL) and anxiety level in patients undergoing EGD and evaluate their effects on the procedure. METHODS: Children undergoing EGD under sedoanalgesia with propofol for various reasons were included. Their basal SCLs were compared with those of healthy age- and sex-matched controls...
August 30, 2018: Journal of Pediatric Gastroenterology and Nutrition
Chad Bisambar, Andrew Collier, Fraser Duthie, Carron Meney
A 40-year-old Caucasian female presented with hyperglycaemia, polyuria, polydipsia and weight loss of 6 kg over a 1-month period. There was no personal or family history of malignancy or diabetes mellitus. On examination, she was jaundiced with pale mucous membranes and capillary glucose was 23.1 mmol/L. Initial investigations showed iron deficiency anaemia and obstructive pattern of liver function tests. HbA1c was diagnostic of diabetes mellitus at 79 mmol/mol. Malignancy was suspected and CT chest, abdomen and pelvis showed significant dilatation of intra- and extra-hepatic biliary tree including pancreatic duct, with periampullary 30 mm mass lesion projecting into lumen of duodenum...
2018: Endocrinology, Diabetes & Metabolism Case Reports
J Hayes, C Matava, C Pehora, H El-Beheiry, S Jarvis, Y Finkelstein
BACKGROUND: Propofol is used to induce deep sedation or general anaesthesia for procedures in children. Adjuvants, such as ketamine, are routinely added to reduce the dose of propofol required and propofol-related adverse events. We conducted a randomised controlled trial to determine the effective bolus dose of propofol in combination with ketamine that induces adequate depth of anaesthesia in 50% of children (ED50 ) undergoing gastro-duodenoscopy. METHODS: Children were randomised to one of four doses of ketamine: 0 (control), 0...
August 2018: British Journal of Anaesthesia
Muhammad Shafique Sajid, Saad Rehman, Fergus Chedgy, Krishna K Singh
Background: The objective of this article is to study the role of Simethicone ± N-acetylcysteine in improving the mucosal visualization during oesophago-gastro-duodenoscopy (OGD). Methods: The data retrieved from the published randomized controlled trials (RCTs) reporting the role of Simethicone ± N-acetylcysteine during OGD was analysed using the principles of meta-analysis. The summated outcome of continuous variables was expressed as standardized mean difference (SMD) and dichotomous data was presented in odds ratio (OR)...
2018: Translational Gastroenterology and Hepatology
Cosmin Caraşca, George Simion, Adela Corina Nechifor-Boilă, Alina Mioara Boeriu, Ecaterina Daniela Dobru
Primary duodenal cancer is a rare entity accounting for only 0.3% of all gastrointestinal cancers. Histopathologically, most duodenal cancers are mucin-producing adenocarcinomas, 34% being poorly differentiated. Signet-ring cell (SRC) carcinoma is extremely uncommon in the duodenum. Herein, we report a rare case of SRC carcinoma associated with poorly differentiated adenocarcinoma of the non-ampullary duodenum in a 74-year-old woman. The patient was admitted to the hospital for persistent epigastric pain, significant weight loss and hypochromic microcytic anemia...
2018: Romanian Journal of Morphology and Embryology
QunGuang Jiang, TaiYuan Li, DongNing Liu, Cheng Tang
RATIONALE: Synchronous double malignancies, including carcinoma of the ampulla of Vater and rectal carcinoma, are generally uncommon occurrences in the gastrointestinal tract. PATIENT CONCERNS: The present study report a case of a 37-year-old man who was incidentally found to suffer from carcinoma of the ampulla of Vater and rectal carcinoma. DIAGNOSES: The duodenoscopy was performed and revealed an ulcerated and bulky ampulla of Vater, the biopsy from which revealed a moderate-differentiated adenocarcinoma, A local hospital colonoscopy confirmed a tumor located in rectal 7 cm from the anal margin and biopsy-confirmed poorly differentiated adenocarcinoma...
May 2018: Medicine (Baltimore)
C Bourigault, F Le Gallou, N Bodet, N Musquer, M-E Juvin, S Corvec, N Ferronnière, S Wiesel, J Gournay, G Birgand, M Le Rhun, D Lepelletier
Carbapenemase-producing Klebsiella pneumoniae (OXA-48 CPE) were identified in five patients who underwent an endoscopy with the same duodenoscope in October 2015. The endoscope was the only epidemiological link between these cases. A transient contamination of the duodenoscope following a failure in the disinfection process may have been the cause of transmission.
August 2018: Journal of Hospital Infection
Mizelle D'Silva, Aparna Govil Bhasker, Nimisha S Kantharia, Muffazal Lakdawala
ᅟ: Obesity is a global epidemic and will soon become the number one priority in healthcare management. Bariatric surgery causes a significant improvement in obesity and its related complications. Pre-operative esophago-gastro-duodenoscopy (EGD) is done by several bariatric surgical teams across the world but is still not mandatory. AIM: To study the percentage of symptomatic and asymptomatic pathological EGD findings in obese patients undergoing bariatric surgery and to analyze whether these findings influence the eventual choice of bariatric surgery...
September 2018: Obesity Surgery
Yuji Eso, Norimitsu Uza, Kotaro Shirakawa, Kenji Sawada, Kentaro Katsuragi, Minoru Matsuura, Hiroshi Seno
We herein report a patient with a history of rheumatoid arthritis treated with methotrexate, which caused methotrexate-associated lymphoproliferative disorder and obstructive jaundice due to an enlarged lymph node. The obstructive jaundice was treated with endoscopic biliary stenting. A histopathological examination revealed features of Hodgkin's lymphoma, and chemotherapy with brentuximab vedotin was administered. Cholangiography and duodenoscopy after four rounds of chemotherapy revealed a choledochoduodenal fistula that developed in response to chemotherapy...
August 1, 2018: Internal Medicine
Manuel Calvopiña, Jessica Flores, Isabel Guaman, Gabriela Lara, Jeyson Abarca
For 11 years, a 38-year-old male residing in a subtropical region of Ecuador, was repeatedly diagnosed with chronic anemia, and treated with blood transfusions in a hospital of province of Cotopaxi, Ecuador. He was transferred to Quito for severe anemia, having hemoglobin of 4 g/dL. Duodenoscopy was performed and adult nematodes, identified later as Ancylostoma duodenale, were observed. The patient was successfully treated with albendazole for five consecutive days and given blood transfusions. In the control visit at eight months, without anemia and no hookworm ova in the stool examined were found...
October 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
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