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Sample records for normal upper endoscopy

  1. The Utility of Endoscopic Biopsies in Patients with Normal Upper Endoscopy

    Directory of Open Access Journals (Sweden)

    Anouar Teriaky

    2016-01-01

    Full Text Available Background and Aims. Upper endoscopy is a valuable tool in the workup of gastrointestinal (GI complaints. The purpose of this study is to determine cost and yield of taking biopsies in a normal upper GI tract. Methods. This is a retrospective study where all upper GI biopsies were identified between May 2012 and April 2013, at a tertiary care center. Clinical, procedural, and pathology reports were reviewed to identify patient demographics, procedure information, and pathology diagnosis. Results. Biopsies of the upper GI tract were taken in 1297 patients with normal upper endoscopies. In patients with normal upper endoscopy, 22% of esophageal, 44% of gastric, and 12% of duodenal biopsies were abnormal. The most frequent abnormality was reflux esophagitis in 16% of esophageal biopsies, chronic gastritis in 23% of gastric biopsies, and increased intraepithelial lymphocytes in 6% of duodenal biopsies. The additional cost for taking biopsies in a normal upper GI tract for a diagnosis of eosinophilic esophagitis was $2963 Canadian (CAD, H. pylori associated gastritis was $1404 CAD, and celiac disease was $3024 CAD. Conclusions. The yield of biopsy in normal upper endoscopy varied with location, but the additional expense can be costly and should be tailored to appropriate clinical situations.

  2. Upper GI Endoscopy

    Science.gov (United States)

    ... Upper GI Series Urinary Tract Imaging Urodynamic Testing Virtual Colonoscopy Upper GI Endoscopy What is upper gastrointestinal ( ... endoscopy, a doctor obtains biopsies by passing an instrument through the endoscope to obtain a small piece ...

  3. Risk of gastrointestinal cancer in patients with unexplained chest/epigastric pain and normal upper endoscopy: a Danish 10-year follow-up study

    DEFF Research Database (Denmark)

    Munk, Estrid Muff; Drewes, Asbjørn Mohr; Gorst-Rasmussen, Anders

    2007-01-01

    patients with chest/epigastric pain, normal upper endoscopy, and no prior discharge diagnosis of ischemic heart disease (N = 386), compared with population controls (N = 3860). The overall 10-year risk of gastrointestinal cancer (stomach, colorectal, liver, and pancreas) was 2.9% for patients...

  4. Diagnostic indications for upper gastrointestinal endoscopy ...

    African Journals Online (AJOL)

    Background/Aim: Upper gastrointestinal (GI) endoscopy now assumes a prominent role in the diagnosis and therapy of upper GI diseases. Some indications for upper gastrointestinal endoscopy include dyspepsia, dysphagia, peptic ulcer disease (PUD) and upper gastrointestinal bleeding. This study aimed to review the ...

  5. Risk of peptic ulcer, oesophagitis, pancreatitis or gallstone in patients with unexplained chest/epigastric pain and normal upper endoscopy: a 10-year Danish cohort study

    DEFF Research Database (Denmark)

    Munk, E M; Drewes, A M; Gorst-Rasmussen, Anders

    2007-01-01

    BACKGROUND: No studies have examined the risk of upper gastrointestinal diseases among patients with unexplained chest/epigastric pain (UCEP) and a normal upper endoscopy. AIM: To examine the relative risk of peptic ulcer, oesophagitis, pancreatitis or gallstone in UCEP patients. METHODS...... for peptic ulcer, oesophagitis, pancreatitis or gallstone. RESULTS: Compared with controls, the adjusted relative risks among UCEP patients or = 1 year after upper endoscopy were for peptic ulcer 2.0 [95% confidence interval (CI) 0.2-18.4] and 1.7 (95% CI 0.9-3.4), for oesophagitis 8.2 (95% CI 1.......2-59.2) and 1.9 (95% CI 0.7-5.0), for pancreatitis 9.2 (95% CI 2.0-41.8) and 3.9 (95% CI 1.4-10.5), and for gallstone 14.1 (95% CI 5.4-37.2) and 3.3 (95% CI 1.9-5.8). CONCLUSIONS: UCEP is positively associated with all study outcomes especially in the first year after upper endoscopy, indicating that peptic...

  6. Appropriateness of Referrals for Upper Gastrointestinal Endoscopy ...

    African Journals Online (AJOL)

    Background: Uncomplicated dyspepsia has a low predictive value in diagnosing upper gastrointestinal organic disease making early endoscopy essential. Objective: To assess the reliability of clinical information in the diagnosis of organic disease in patients referred for upper gastrointestinal endoscopy. Methods: Patients ...

  7. Unsedated Flexible Upper Gastrointestinal Endoscopy: Need for ...

    African Journals Online (AJOL)

    Background: To determine the incidence of oxygen desaturation and whether routine oxygen monitoring is necessary during unsedated diagnostic flexible upper gastrointestinal endoscopy. Methods: A prospective study involving 54 consecutive in and out patients who had diagnostic upper gastrointestinal endoscopy at ...

  8. Upper gastrointestinal endoscopy in children: The Lagos University ...

    African Journals Online (AJOL)

    both diagnostic and therapeutic upper GI endoscopy services to both adult and paediatric populations from all over .... positive and had triple therapy with amoxicillin, clarithromycin and omeprazole. Four of the six subjects with .... Khan MR, Ahmed S, Ali SR, Maheshwari PK, Jamal MS. Spectrum of upper GI endoscopy in ...

  9. Upper gastrointestinal endoscopy findings in patients referred with ...

    African Journals Online (AJOL)

    Background: Dyspepsia is one of the major indications for upper gastrointestinal endoscopy. Other indications include dysphagia, odynophagia and gastrointestinal bleeding. Endoscopy is an expensive procedure that is out of reach of many patients in resource constrained region such as western Kenya. We reviewed ...

  10. Therapeutic upper gastrointestinal tract endoscopy in Paediatric Gastroenterology.

    Science.gov (United States)

    Rahman, Imdadur; Patel, Praful; Boger, Philip; Rasheed, Shahnawaz; Thomson, Mike; Afzal, Nadeem Ahmad

    2015-03-16

    Since the first report of use of endoscopy in children in the 1970s, there has seen an exponential growth in published experience and innovation in the field. In this review article we focus on modern age therapeutic endoscopy practice, explaining use of traditional as well as new and innovative techniques, for diagnosis and treatment of diseases in the paediatric upper gastrointestinal tract.

  11. upper gastrointestinal endoscopy findings in patients referred

    African Journals Online (AJOL)

    2014-08-01

    Aug 1, 2014 ... quartz fibers a concept used by Hopkins in 1954 to build a model of a flexible fibre imaging device (2) the precursor of fibre-optic endoscope. Since then endoscopes and endoscopy have undergone great technical developments to the current new dimension in imaging of endoscopic ultrasonography ...

  12. Upper gastrointestinal diseases in patients for endoscopy in South ...

    African Journals Online (AJOL)

    urease test (CLO kit, a container impregnated with rap- id urease test manufactured by Cambridge Life Science. Ltd 14 St.Thomas' Place, Cambridgeshire Business ..... Afr J Health Sci.2005;12(1-. 2 PubMed ):49-54. 12. Hussein YA, Doumi EA. Upper Gastrointestinal. Endoscopy in El Obeid, Western Sudan. Analysis of.

  13. Upper gastrointestinal fiberoptic endoscopy in pediatric patients.

    Science.gov (United States)

    Prolla, J C; Diehl, A S; Bemvenuti, G A; Loguercio, S V; Magalhães, D S; Silveira, T R

    1983-11-01

    Upper gastrointestinal fiberendoscopy in pediatric patients is done safely and under local anesthesia in most instances. This study of 47 children confirmed the value of fiberendoscopy in establishing the etiology of upper gastrointestinal hemorrhage and the presence of esophageal varices. It also contributed significantly to the management of patients with disphagia, pyrosis, epigastric pain, and ingestion of foreign bodies. No significant morbidity was caused.

  14. Upper gastrointestinal diseases in patients for endoscopy in South ...

    African Journals Online (AJOL)

    The most common endoscopy finding was gastritis (40.2%), followed by normal examination (15.2%), oesophageal cancer (13.6%), gastric ulcer (7.6%) and gastric cancer (7.1%). Patients older than 40 years (n=110) had significant findings including gastritis (50.9%), oesophageal cancer (22.7%) and gastric cancer ...

  15. Role of endoscopy in evaluating upper gastrointestinal tract lesions in rural population

    Directory of Open Access Journals (Sweden)

    Sharanabasavaraj Javali

    2015-01-01

    Full Text Available Background and Objectives: Before the advent of endoscopy direct access to the lesion for the confirmation of the diagnosis was difficult, this posed difficulty in contemplating adequate and appropriate surgery. Endoscopy as a diagnostic and therapeutic tool has grown in recent years. Upper gastrointestinal (GI endoscopy is one of the most fascinating branch which serves not only as a means of resolving or amplifying the diagnosis made clinically or by X-ray, but also a primary diagnostic procedure for conditions not otherwise diagnosable on unoperated case. Fiber optic upper GI endoscopy has already become firmly established as a reliable, quick and inexpensive tool. This study was done to detect the upper gastrointestinal lesions in rural population of Kolar District, the distribution pattern of various upper GI lesions in patients presenting with upper GI symptoms and to follow the endoscopic diagnosis for medical and surgical management. Materials and Methods: The study group includes patients reporting to outpatient department and also the inpatients in wards of General Surgery and other departments, who have upper GI symptoms, were advised endoscopy at R. L. JALAPPA Hospital and Research Centre, Kolar, from a period of December 2011 to August 2013. Results: Of the 600 cases, 370 were males, and 230 were females. Disease incidence was highest in 51-70 years age group, that is, 21.6%. Pain abdomen was the most common symptom. Epigastric tenderness was the most common sign among the patients clinically. Reflux esophagitis and diffuse gastritis formed most common cases (307 cases. The incidence of duodenitis - 7.83%, peptic ulcer -3.3%, esophageal varices - 1.5%, the incidence of carcinoma esophagus and carcinoma stomach was approximately same that is, 4.5% and 4.6% respectively. The incidence of esophageal candidiasis was 4.16%. The majority of the patients had a normal study that is, 14.5%. Conclusion: Upper GI lesions were more common in

  16. The Results of Upper Gastrointestinal Endoscopy Performed in Bayburt Province

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    Yavuz Ayar

    2013-09-01

    Full Text Available Aim: We analyzed the results of upper gastrointestinal endoscopy performed between November 2011 and January 2013 in the endoscopy unit at Bayburt State Hospital. Methods: Endoscopic analyses were done with a PENTAX EPK 100P equipment. The results were assessed retrospectively. Results: A total of 1008 patients (664 women, 344 men aged between 17 and 88 (mean: 50±18 years have undergone upper gastrointestinal endoscopy. 186 (18.4% patients were diagnosed with pangastritis, 81 - with esophagitis (8%, 68 - with antral gastritis (6.7%, 67 - with duodenal ulcer (6.6%, 57 - with gastric ulcer (5.6%, 35 - with alkaline reflux gastritis (3.6%, 21 - with duodenitis (2.1%, 5 - with gastric cancer (0.5%, 4 - with esophagial cancer (0.4%, 4 - with gastric polyp (0.4% and 3 patients were diagnosed with esophagial ulcer (0.3%. Conclusion: Lesions were most commonly observed in the stomach. Gastritis, esophagitis, duodenal and gastric ulcer were frequently observed in our city. (The Medical Bulletin of Haseki 2013; 51: 116-9

  17. Upper gastrointestinal endoscopy at the korle bu teaching hospital, accra, ghana.

    Science.gov (United States)

    Aduful, Hk; Naaeder, Sb; Darko, R; Baako, Bn; Clegg-Lamptey, Jna; Nkrumah, Kn; Adu-Aryee, Na; Kyere, M

    2007-03-01

    To study the indications for endoscopy, the endoscopic diagnosis and other lessons learnt. A retrospective and prospective audit of all upper gastrointestinal endoscopies performed in the Endoscopy Unit of the Korle-Bu Teaching Hospital from January 1995 to December 2002 was performed. A total of 6977 patients, 3777 males and 3200 females with age range 1 year 8 months to 93 years were endoscoped. The mean age of males was 43.5 +/- 0.5 and females 43.7 +/- 0.6 years. Epigastric pain (42.5%), dyspepsia (32.8%) and haematemesis and melaena (14.2%) were the commonest reasons for endoscopy. Chronic duodenal ulcer (19.6%), acute gastritis (12.7%), duodenitis (10.2%), oesophagitis (7.5%) were the commonest diagnoses. Normal endoscopy was reported in 41.1% patients, and was higher in the younger age group compared to the older (R = 0.973, P<0.001). Nine hundred and ninety (14.2%) patients were endoscoped for haematemesis and melaena of which chronic duodenal ulcer (32.1%), gastritis/gastric erosions (12.8%), oesophageal varices (9.8%), carcinoma of the stomach (6.4%), and duodenitis (4.2%), were the commonest causes. No lesion was found in 20.6% of these patients. Urease test was positive in 75% of all biopsy specimen and 85% in chronic duodenal ulcer, gastritis and duodenitis. The normal endoscopy rate is high and needs to be reduced in order to help prolong the lives of the endoscopes. Chronic duodenal ulcer is usually associated with H. pylori infection and is the commonest cause of upper gastrointestinal bleeding.

  18. Comfort, safety and quality of upper gastrointestinal endoscopy after 2 hours fasting: a randomized controlled trial.

    Science.gov (United States)

    Koeppe, Angélica Terezinha; Lubini, Marcio; Bonadeo, Nilton Maiolini; Moraes, Iran; Fornari, Fernando

    2013-11-09

    Upper gastrointestinal endoscopy has been performed after fasting 8 or more hours, which can be harmful to the patients. We assessed comfort, safety and quality of endoscopy under moderate sedation after 2 hours fasting for clear liquids. In this clinical trial, patients referred for elective endoscopy were randomly assigned to a fasting period of 8 hours (F8) or a shorter fasting (F2), in which 200 ml of clear liquids were ingested 2 hours before the procedure. Endoscopists blinded to patients fasting status carried out the endoscopies. Comfort was rated by the patients, whereas safety and quality were determined by the endoscopists. Ninety-eight patients were studied (aging 48.5 ± 16.5 years, 60% women): 50 patients (51%) in F2 and 48 in F8. Comfort was higher in F2 than F8 in regard to anxiety (8% vs. 25%; P = 0.029), general discomfort (18% vs. 42%; P = 0.010), hunger (44% vs. 67%; P = 0.024), and weakness (22% vs. 42%; P = 0.034). Regurgitation of gastric contents into the esophagus after endoscopic intubation did not differ between F2 and F8 (26% vs. 19%; P = 0.471). There was no case of pulmonary aspiration. Gastric mucosal visibility was normal in most patients either in F2 or F8 (96% vs. 98%; P = 0.999). Elective upper GI endoscopy after 2 hours fasting for clear liquids was more comfortable and equally safe compared to conventional fasting. This preparation might be cautiously applied for patients in regular clinical conditions referred for elective endoscopy. SAMMPRIS ClinicalTrial.gov number, NCT01492296.

  19. Helicobacter pylori infection in patients with dyspeptic symptoms having normal endoscopy

    International Nuclear Information System (INIS)

    Malik, M.F.; Hussain, T.; Khan, M.N.; Mirza, S.A.

    2010-01-01

    To find out the frequency of Helicobacter pylori infection in the local population presenting with dyspeptic symptoms but having normal upper gastrointestinal endoscopic findings. Hundred cases of dyspepsia having normal upper gastrointestinal endoscopy were taken as study population. Although the gold standard for presence or absence of Helicobacter pylori infection is culture but in this study the diagnostic method used was histopathology of gastric antrum. The male and female ratio was 2:1. Majority of the patients were either 40 years of age or less, mean age being 40.52 (sd+-13.22). The chief symptoms were pain epigastrium (46%) and upper abdominal discomfort (27%). Helicobacter pylori gastritis was found in 51% of cases. We conclude that Helicobacter pylori infection is quite common in dyspeptic patients apparently having normal endoscopic gastric mucosal findings. Eradication therapy should be instituted in positive cases to avoid its long-term complications. (author)

  20. Upper Gastro-Intestinal Endoscopy in Port Harcourt, Nigeria: An Audit

    African Journals Online (AJOL)

    Background: Accurate diagnosis of disease conditions using laboratory, imaging or endoscopic investigation is essential for appropriate treatment. There is paucity of data on upper GI endoscopy in Port-Harcourt. This audit of our early experience is intended to provide data on the pattern of endoscopy findings which is ...

  1. Capsule endoscopy in acute upper gastrointestinal hemorrhage: a prospective cohort study.

    Science.gov (United States)

    Gralnek, I M; Ching, J Y L; Maza, I; Wu, J C Y; Rainer, T H; Israelit, S; Klein, A; Chan, F K L; Ephrath, H; Eliakim, R; Peled, R; Sung, J J Y

    2013-01-01

    Capsule endoscopy may play a role in the evaluation of patients presenting with acute upper gastrointestinal hemorrhage in the emergency department. We evaluated adults with acute upper gastrointestinal hemorrhage presenting to the emergency departments of two academic centers. Patients ingested a wireless video capsule, which was followed immediately by a nasogastric tube aspiration and later by esophagogastroduodenoscopy (EGD). We compared capsule endoscopy with nasogastric tube aspiration for determination of the presence of blood, and with EGD for discrimination of the source of bleeding, identification of peptic/inflammatory lesions, safety, and patient satisfaction. The study enrolled 49 patients (32 men, 17 women; mean age 58.3 ± 19 years), but three patients did not complete the capsule endoscopy and five were intolerant of the nasogastric tube. Blood was detected in the upper gastrointestinal tract significantly more often by capsule endoscopy (15 /18 [83.3 %]) than by nasogastric tube aspiration (6 /18 [33.3 %]; P = 0.035). There was no significant difference in the identification of peptic/inflammatory lesions between capsule endoscopy (27 /40 [67.5 %]) and EGD (35 /40 [87.5 %]; P = 0.10, OR 0.39 95 %CI 0.11 - 1.15). Capsule endoscopy reached the duodenum in 45 /46 patients (98 %). One patient (2.2 %) had self-limited shortness of breath and one (2.2 %) had coughing on capsule ingestion. In an emergency department setting, capsule endoscopy appears feasible and safe in people presenting with acute upper gastrointestinal hemorrhage. Capsule endoscopy identifies gross blood in the upper gastrointestinal tract, including the duodenum, significantly more often than nasogastric tube aspiration and identifies inflammatory lesions, as well as EGD. Capsule endoscopy may facilitate patient triage and earlier endoscopy, but should not be considered a substitute for EGD. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Endoscopists’ Opinions of Indications for Upper Gastrointestinal Endoscopy

    Directory of Open Access Journals (Sweden)

    Lloyd R Sutherland

    1997-01-01

    Full Text Available OBJECTIVE: To determine whether endoscopists and general internists agreed with the characterization of appropriateness for endoscopy of various clinical scenarios, as previously reported by the RAND Corporation.

  3. Eosinophilic esophagitis prevalence in an adult population undergoing upper endoscopy in southeastern Mexico.

    Science.gov (United States)

    De la Cruz-Patiño, E; Ruíz Juárez, I; Meixueiro Daza, A; Grube Pagola, P; Roesch-Dietlen, F; Remes-Troche, J M

    2015-01-01

    Eosinophilic esophagitis (EoE) prevalence fluctuates according to the population studied and varies from 0.4% in an open population to 6.5% in subjects with esophageal symptoms. Even though this entity has been described in North American and European populations, it is still considered an 'unusual' condition in Latin America. The study aimed to determine EoE prevalence in patients undergoing elective endoscopy in a tertiary referral center in southeastern Mexico. Consecutive patients were evaluated that had been referred to the Medical and Biological Research Institute, Veracruz, Mexico, for upper endoscopy due to gastrointestinal symptoms. Demographic variables and symptoms were analyzed in all the cases. Eight mucosal biopsies of the esophagus (four proximal and four distal) were obtained and were reviewed by a blinded pathologist. Histological diagnosis was established when the mean eosinophil count at a large magnification was ≥15. A total of 235 subjects (137 women, 51.16 years) were evaluated, and EoE prevalence was 1.7% (4/235 95% confidence interval 0.2-3.6%). In all four cases, pH test were normal. Among patients with histological diagnosis of EoE, a greater number of patients with a past history of asthma (50% vs. 19.3%, P = 0.04) and a tendency for a greater frequency of dysphagia (50% vs. 25%, P = 0.10). There were no differences in the endoscopic findings (rings, grooves, plaques, or stricture) when compared with the patients presenting with erosive esophagitis. EoE prevalence among patients undergoing upper endoscopy from southeastern Mexico was 1.7%, which can be regarded as intermediate to low. © 2014 International Society for Diseases of the Esophagus.

  4. Upper gastrointestinal endoscopy for dyspepsia: Εxploratory study of factors influencing patient compliance in Greece

    Directory of Open Access Journals (Sweden)

    Kouroumalis Elias

    2011-02-01

    Full Text Available Abstract Background Upper gastrointestinal endoscopy is the most preferable diagnostic examination for patients over fifty when upper gastrointestinal symptoms appear. However, limited knowledge exists in concerns to the compliance of primary care patients' to the doctors' recommendations for endoscopy. Methods Patients who visited primary care practices in Greece and experienced upper gastrointestinal symptoms within a 10 days screening study, were referred for an upper endoscopy exam. The patients which refused to complete the endoscopy exam, were interviewed by the use of an open- ended translated and validated questionnaire, the Identification of Dyspepsia in General Population (IDGP questionnaire. A qualitative thematic analysis grounded on the theory of planned behavior was performed to reveal the reasons for patients' refusal, while socio-demographic predictors were also assessed. Results Nine hundred and ninety two patients were recorded, 159 of them (16% were found positive for dyspepsia and gastro-esophageal reflux disease according to the IDGP questionnaire. Out of the above, 131 (83.6% patients refused further investigation with endoscopy. Patients who refused upper endoscopy were predominantly female (87.8% (p = 0.036 and over the age of 50. The lack of severe symptoms, fear of pain, concerns of sedation, comorbidity and competing life demands were reported by patients as barriers to performing an endoscopic investigation. Conclusions Patients with dyspepsia in rural Greece tend to avoid upper gastrointestinal endoscopy, with two major axons considered to be the causes of patients' refusal: their beliefs towards endoscopy and their personal capability to cope with it. Future research examining reasons of low compliance should be carried out in combination with modern behavioral theories so as to investigate into the above.

  5. Appropriateness of upper-GI endoscopy: an Italian survey on behalf of the Italian Society of Digestive Endoscopy.

    Science.gov (United States)

    Hassan, Cesare; Bersani, Gianluca; Buri, Luigi; Zullo, Angelo; Anti, Marcello; Bianco, Maria Antonia; Di Giulio, Emilio; Ficano, Leonardo; Morini, Sergio; Di Matteo, Giovanni; Loriga, Piero; Pietropaolo, Vincenzo; Cipolletta, Livio; Costamagna, Guido

    2007-05-01

    Open-access endoscopy allows physicians to directly schedule endoscopic procedures for their patients without prior consultation. An evaluation of both appropriateness and diagnostic yield of endoscopic procedures is critical when assessing the costs and benefits of endoscopy in an open-access setting. The aim of this Italian multicenter study was to assess the appropriate use of upper endoscopy (EGD) in an open-access system and to establish the yield of diagnostic information relevant to patient care. Cross-sectional, prospective, multicenter study. A total of 6270 patients referred to 44 Italian centers for open-access EGD during 1 month were prospectively enrolled. The American Society for Gastrointestinal Endoscopy (ASGE) guidelines were used to assess the relation between the appropriate use of EGD and the presence of relevant endoscopic findings. The rate for "generally not indicated" EGDs was 22.9%: 29.4% for primary care physicians and 12.9% for specialists (P 20, 99% CI 3 to >100; P < .01). Open-access EGD is an useful procedure for clinical practice. Because most of the relevant findings were detected during examinations performed for appropriate indications, the use of ASGE guidelines emerges as crucial to the cost-effectiveness of an open-access system.

  6. [Sedation with intravenous midazolam during upper gastrointestinal endoscopy--changes in hemodynamics, oxygen saturation and memory].

    Science.gov (United States)

    Mizuno, Ju; Matsuki, Michiko; Gouda, Yoshinori; Nishiyama, Tomoki; Hanaoka, Kazuo

    2003-09-01

    Cardiorespiratory adverse effects are often observed in patients undergoing upper gastrointestinal endoscopy with sedation. In this study, we examined hemodynamics, oxygen saturation and memory during upper gastrointestinal endoscopy under sedation with intravenous midazolam. Eight healthy outpatients without any obvious complications received intravenous midazolam 5 mg for sedation for upper gastrointestinal endoscopy. Blood pressure, heart rate and percutaneous arterial oxygen saturation (SpO2) were measured before, during and after endoscopy. After the arousal by intravenous flumazenil, we inquired the patients about the level of memory during the endoscopy. Blood pressure decreased significantly two minutes after midazolam administration, but increased significantly after the insertion of an endoscope which was not different from the control value. Heart rate increased significantly one and three minutes after the insertion of the endoscope. SpO2 decreased significantly after midazolam administration and stayed at around 95%. No patients remembered the procedure. Sedation with intravenous midazolam during upper gastrointestinal endoscopy is useful to control the cardiovascular responses, and to obtain amnesia. However, a decrease in SpO2 should be watched carefully.

  7. The comparison of upper endoscopy and scintigraphy results in the diagnostics of duodenogastric reflux

    International Nuclear Information System (INIS)

    Leja, M.; Lejnieks, A.; Pokrotnieks, J.; Sosare, L.; Reinholds, E.; Brezinskis, G.; Aboltins, A.

    2002-01-01

    The results of upper endoscopy in respect to the symptoms potentially indicative for duodenogastric reflux (DGR) have been compared to the results obtained by a scintigraphic method, elaborated by the group of the authors. Altogether 89 patients (48 women, 41 men) have been studied. For the analysis of signs indicative for functional disturbances of the upper digestive symptoms (status of the lower esophageal sphincter, gastric tone, presence of bile in the gastric content, status of the pyloric sphincter, influx of the duodenal content observed during the upper endoscopy, presence of the bile in the duodenum) the maximum accepted interval between the two investigations was 24 hours, while 1 month interval was accepted for the evaluations of structural changes (esophagitis, presence of hiatal hernis, gastritis and duodenitis, deformation of the pyloric sphincter and duodenal bulb. No statistically significant correlations has been found between any of the above mentioned parameters at upper endoscopy and the presence or absence of DGR as determined by the scintigraphic method. If a influx of the duodenal content into the stomach during the upper endoscopy, this could be considered as a specific indicator (specificity - 91,3%0, while the sensitivity (16,7%) is very low. There has been a trend to decreased DGR in patients with an atrophic gastritis, still this correlation was not statistically significant. The conclusion is made that the intubation of the stomach during the upper endoscopy could be causative for artificial DGR therefore leading to incorrect data interpretation and hyper diagnostics. (authors)

  8. Comfort, safety and quality of upper gastrointestinal endoscopy after 2 hours fasting: a randomized controlled trial

    Science.gov (United States)

    2013-01-01

    Background Upper gastrointestinal endoscopy has been performed after fasting 8 or more hours, which can be harmful to the patients. We assessed comfort, safety and quality of endoscopy under moderate sedation after 2 hours fasting for clear liquids. Methods In this clinical trial, patients referred for elective endoscopy were randomly assigned to a fasting period of 8 hours (F8) or a shorter fasting (F2), in which 200 ml of clear liquids were ingested 2 hours before the procedure. Endoscopists blinded to patients fasting status carried out the endoscopies. Comfort was rated by the patients, whereas safety and quality were determined by the endoscopists. Results Ninety-eight patients were studied (aging 48.5 ± 16.5 years, 60% women): 50 patients (51%) in F2 and 48 in F8. Comfort was higher in F2 than F8 in regard to anxiety (8% vs. 25%; P = 0.029), general discomfort (18% vs. 42%; P = 0.010), hunger (44% vs. 67%; P = 0.024), and weakness (22% vs. 42%; P = 0.034). Regurgitation of gastric contents into the esophagus after endoscopic intubation did not differ between F2 and F8 (26% vs. 19%; P = 0.471). There was no case of pulmonary aspiration. Gastric mucosal visibility was normal in most patients either in F2 or F8 (96% vs. 98%; P = 0.999). Conclusions Elective upper GI endoscopy after 2 hours fasting for clear liquids was more comfortable and equally safe compared to conventional fasting. This preparation might be cautiously applied for patients in regular clinical conditions referred for elective endoscopy. Trial registration SAMMPRIS ClinicalTrial.gov number, NCT01492296 PMID:24209639

  9. upper gastrointestinal endoscopy findings in patients referred with ...

    African Journals Online (AJOL)

    2014-08-01

    Aug 1, 2014 ... quartz fibers a concept used by Hopkins in 1954 to build a model of a flexible fibre imaging device (2) the precursor of fibre-optic endoscope. Since then endoscopes and endoscopy have undergone great technical developments to the current new dimension in imaging of endoscopic ultrasonography ...

  10. Upper gastrointestinal endoscopy in children: The Lagos University Teaching Hospital experience

    Directory of Open Access Journals (Sweden)

    Oluwafunmilayo Funke Adeniyi

    2016-12-01

    Full Text Available Background. Paediatric endoscopy is now standard care in the developed world for the management of gastrointestinal (GI disorders. However, in developing countries endoscopy remains an underutilised tool. Objective. To determine the indications and the spectrum of endoscopic findings in children seen at the Lagos University Teaching Hospital, Nigeria. Methods. The indications for upper GI endoscopy and endoscopic findings in children ≤16 years old, referred for the procedure from June 2013 to June 2016, were documented. The endoscopic yield in these children was also determined. Results. In total 71 children were referred for upper GI endoscopy during the study period. There were 35 boys and 36 girls aged 3 months to 16 years. The indications for upper endoscopy were recurrent abdominal pain in 37 (52.1%, upper GI bleeding in 17 (23.9%, recurrent vomiting in 7 (9.9%, dyspepsia in 5 (7.0, heartburn in 2 (2.8%, dysphagia in 1 (1.4, portal hypertension in 1 (1.4 and ingestion of corrosives in 1 (1.4% of the subjects. Endoscopic findings were as follows: gastritis 19 (26.8%, hiatus hernia in 13 (18.3%, gastric erosions in 12 (16.9%, oesophageal varices 6 (8.4%, duodenitis in 4 (5.6%, gastric ulcer in 3 (4.2%, gastric polyp in 2 (2.8%. The overall endoscopic yield was 60.2%. Conclusion. There is a need to increase the awareness of the role of paediatric endoscopy in the diagnosis and treatment of GI disorders in developing countries. Recurrent abdominal pain still remains a relevant indication for the procedure. The need to develop training programmes for paediatric endoscopy and paediatric gastroenterology in general in developing countries cannot be overemphasised.

  11. New lidocaine lozenge as topical anesthesia compared to lidocaine viscous oral solution before upper gastrointestinal endoscopy

    DEFF Research Database (Denmark)

    Mogensen, Stine; Treldal, Charlotte; Feldager, Erik

    2012-01-01

    To evaluate the effect and acceptance of a new lidocaine lozenge compared with a lidocaine viscous oral solution as a pharyngeal anesthetic before upper gastrointestinal endoscopy (UGE), a diagnostic procedure commonly performed worldwide during which many patients experience severe discomfort mo...

  12. Cecal perforation with an ascending colon cancer caused by upper gastrointestinal endoscopy

    Directory of Open Access Journals (Sweden)

    Hiroyuki Miyatani

    2009-04-01

    Full Text Available Hiroyuki Miyatani1, Yukio Yoshida1, Hirokazu Kiyozaki21Department of Gastroenterology, Jichi Medical University, Saitama Medical Center, Saitama, Japan; 2Department of Surgery, Jichi Medical University, Saitama Medical Center, Saitama, JapanAbstract: Colonic perforation caused by upper gastrointestinal (GI endoscopy is extremely rare. A 69-year-old woman was referred to our hospital because of abdominal fullness. Colonoscopy could be performed only up to the hepatic flexure due to an elongated colon and residual stools. Because her symptoms improved, upper GI endoscopy was performed 11 days later. The patient developed severe abdominal pain two hours after the examination. Abdominal X-ray and computed tomography showed massive free air. Immediate laparotomy was performed for the intestinal perforation. After removal of stool, a perforation site was detected in the cecum with an invasive ascending colon cancer. Therefore, a right hemicolectomy, ileostomy, and transverse colostomy were performed. Although she developed postoperative septicemia, the patient was discharged 38 days after admission. Seven months postoperatively, the patient died of lung, liver, and brain metastases. Even in cases with a lesion that is not completely obstructed, it is important to note that air insufflations during upper GI endoscopy can perforate the intestinal wall in patients with advanced colon cancer.Keywords: colonic perforation, colon cancer, upper gastrointestinal endoscopy, fecal peritonitis

  13. Predictive Factors of Arterial Blood Oxygen Desaturation During Upper Gastrointestinal Endoscopy in Nonsedated Patients

    Directory of Open Access Journals (Sweden)

    O Alimardani

    2008-10-01

    Full Text Available Introduction: Hypoxemia can occur during upper gastrointestinal endoscopy with or without pharmacological sedation. Pulse oximetry saturation (SpO2 levels were assessed in patients attending for routine unsedated diagnostic upper gastrointestinal endoscopy to identify factors associated with oxygen desaturation. Methods: A total of 300 patients who underwent upper gastrointestinal endoscopy without sedation were monitored with continuous pulse oximetry. Factors related to the patient, the examination, and the monitoring data that could predict severe desaturation were evaluated. Results: Mild desaturation (SpO2 between 1-4% was found in 143(47.7% of the patients, while severe desaturation (SpO2≥5% and hypoxemia occurred in 65 (21.7% of patients, 40 (61.5% of those had previous illnesses (p<0.001. The variables found to predict severe desaturation were basal SpO2 <95%, chronic obstructive pulmonary disease, anemia, age more than 60 years and coronary artery disease. Conclusion: The decrease in SpO2 is related to increase in age, basal SaO2 < 95%, respiratory disease, coronary artery disease, and anemia, .We recommend continuous monitoring of SpO2 in these high-risk patients undergoing upper gastrointestinal endoscopy.

  14. Additional Value of Upper GI Tract Endoscopy in the Diagnostic Assessment of Childhood IBD

    NARCIS (Netherlands)

    Hummel, Thalia Z.; ten Kate, Fiebo J. W.; Reitsma, Johannes B.; Benninga, Marc A.; Kindermann, Angelika

    2012-01-01

    Objectives: For the choice of treatment in children with inflammatory bowel disease (IBD), it is important to make a distinction between Crohn disease (CD) and ulcerative colitis (UC). To look for pathognomonic features of CD, upper gastrointestinal tract (UGT) endoscopy has become part of the

  15. Patterns of upper gastrointestinal diseases based on endoscopy in ...

    African Journals Online (AJOL)

    Upper gastrointestinal complaints are common in Kenya. Though these have remained unchanged over the last 20 years, the pattern of upper gastrointestinal disease on endoscopic examination seems to be changing. There appears to be progressive increase in oesophagitis and cancer of the stomach. Peptic ulcer ...

  16. Gastric polyps: Retrospective analysis of 41,253 upper endoscopies.

    Science.gov (United States)

    Argüello Viúdez, Lidia; Córdova, Henry; Uchima, Hugo; Sánchez-Montes, Cristina; Ginès, Àngels; Araujo, Isis; González-Suárez, Begoña; Sendino, Oriol; Llach, Josep; Fernández-Esparrach, Gloria

    2017-10-01

    Gastric polyps are usually asymptomatic lesions incidentally discovered during endoscopy. To study the frequency of different types of gastric polyps in our population and their possible association with other factors. Retrospective study of gastroscopies performed in a tertiary hospital over a ten-year period. Demographics, medical history, indication for gastroscopy and morphological and histological characteristics of polyps were collected. Gastric polyps were found in 827 out of 41253 (2%) reviewed gastroscopies, corresponding to 709 patients. Mean age was 65.6 years, and 62% were female. 53.9% of patients had multiple polyps. The most common location was the fundus and 83.3% were smaller than 1cm. Histopathology was obtained in 607 patients: hyperplastic polyps were the most common (42.8%), followed by fundic gland polyps (37.7%). Factors independently associated with hyperplastic polyps were age and single polyp, size ≥6mm and location other than fundus. In contrast, fundic gland polyps were associated with reflux and multiple polyps, size <6mm and located in fundus. Adenomas were independently associated with single polyp. Fundic gland and hyperplastic polyps are the most common in our population and have characteristic features that can guide histological diagnosis. With single polyps it is advisable to take biopsies to rule out adenoma. Copyright © 2017 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

  17. Place of upper endoscopy before and after bariatric surgery: A multicenter experience with 3219 patients.

    Science.gov (United States)

    Abd Ellatif, Mohamed E; Alfalah, Haitham; Asker, Walid A; El Nakeeb, Ayman E; Magdy, Alaa; Thabet, Waleed; Ghaith, Mohamed A; Abdallah, Emad; Shahin, Rania; Shoma, Asharf; Dawoud, Ibraheim E; Abbas, Ashraf; Salama, Asaad F; Ali Gamal, Maged

    2016-05-25

    To study the preoperative and postoperative role of upper esophagogastroduodenoscopy (EGD) in morbidly obese patients. This is a multicenter retrospective study by reviewing the database of patients who underwent bariatric surgery (laparoscopic sleeve gastrectomy, laparoscopic Roux en Y gastric bypass, or laparoscopic minigastric bypass) in the period between 2001 June and 2015 August (Jahra Hospital-Kuwait, Hafr Elbatin Hospital and King Saud Medical City-KSA, and Mansoura University Hospital - Egypt). Patients with age 18-65 years, body mass index (BMI) > 40, or > 35 with comorbidities after failure of many dietetic regimen and acceptable levels of surgical risk were included in the study after having an informed signed consent. We retrospectively reviewed the medical charts of all morbidly obese patients. The patients' preoperative data included clinical history including upper digestive symptoms and preoperative full workup including EGD. Only patients whose charts revealed weather they were symptomatic or not were studied. We categorized patients accordingly into two groups; with (group A) or without (group B) upper digestive symptoms. The endoscopic findings were categorized into 4 groups based on predetermined criteria. The medical record of patients who developed stricture, leak or bleeding after bariatric surgery was reviewed. Logestic regression analysis was used to identify preoperative predictors that might be associated with abnormal endoscopic findings. Three thousand, two hundred and nineteen patients in the study period underwent bariatric surgery (75% LSG, 10% LRYDB, and 15% MGB). Mean BMI was 43 ± 13, mean age 37 ± 9 years, 79% were female. Twenty eight percent had presented with upper digestive symptoms (group A). EGD was considered normal in 2414 (75%) patients (9% group A vs 66% group B, P = 0.001). The abnormal endoscopic findings were found high in those patients with upper digestive symptoms. Abnormal findings (one or more) were found in

  18. Place of upper endoscopy before and after bariatric surgery: A multicenter experience with 3219 patients

    Science.gov (United States)

    Abd Ellatif, Mohamed E; Alfalah, Haitham; Asker, Walid A; El Nakeeb, Ayman E; Magdy, Alaa; Thabet, Waleed; Ghaith, Mohamed A; Abdallah, Emad; Shahin, Rania; Shoma, Asharf; Dawoud, Ibraheim E; Abbas, Ashraf; Salama, Asaad F; Ali Gamal, Maged

    2016-01-01

    AIM: To study the preoperative and postoperative role of upper esophagogastroduodenoscopy (EGD) in morbidly obese patients. METHODS: This is a multicenter retrospective study by reviewing the database of patients who underwent bariatric surgery (laparoscopic sleeve gastrectomy, laparoscopic Roux en Y gastric bypass, or laparoscopic minigastric bypass) in the period between 2001 June and 2015 August (Jahra Hospital-Kuwait, Hafr Elbatin Hospital and King Saud Medical City-KSA, and Mansoura University Hospital - Egypt). Patients with age 18-65 years, body mass index (BMI) > 40, or > 35 with comorbidities after failure of many dietetic regimen and acceptable levels of surgical risk were included in the study after having an informed signed consent. We retrospectively reviewed the medical charts of all morbidly obese patients. The patients’ preoperative data included clinical history including upper digestive symptoms and preoperative full workup including EGD. Only patients whose charts revealed weather they were symptomatic or not were studied. We categorized patients accordingly into two groups; with (group A) or without (group B) upper digestive symptoms. The endoscopic findings were categorized into 4 groups based on predetermined criteria. The medical record of patients who developed stricture, leak or bleeding after bariatric surgery was reviewed. Logestic regression analysis was used to identify preoperative predictors that might be associated with abnormal endoscopic findings. RESULTS: Three thousand, two hundred and nineteen patients in the study period underwent bariatric surgery (75% LSG, 10% LRYDB, and 15% MGB). Mean BMI was 43 ± 13, mean age 37 ± 9 years, 79% were female. Twenty eight percent had presented with upper digestive symptoms (group A). EGD was considered normal in 2414 (75%) patients (9% group A vs 66% group B, P = 0.001). The abnormal endoscopic findings were found high in those patients with upper digestive symptoms. Abnormal findings (one

  19. Upper Gastrointestinal Tract Cancers at Endoscopy in Kano, North ...

    African Journals Online (AJOL)

    Cancer registration in Nigeria is poorly done, this is even so in North-Western Nigeria. It is only of recent that attempts are being made to know the profile of cancers seen in clinical practice in our environment. This study was done to establish the pattern of upper gastrointestinal cancers at Kano, North-Western Nigeria.

  20. Satisfaction in open access versus traditional referral for upper endoscopy in children.

    Science.gov (United States)

    Isaac, Daniela Migliarese; Persad, Rabin; Huynh, Hien Q; Shirton, Leanne; Turner, Justine M

    2015-05-01

    In traditional access endoscopy (TAE), patients are booked for endoscopy following a gastroenterology clinic assessment. In contrast, open access endoscopy (OAE) patients are seen for the first time on the day of the procedure, providing same day procedural consent. Controversy exists over the use of OAE in adults, both with the consent process and with patient satisfaction. No literature exists describing satisfaction with OAE in pediatrics. We therefore aimed to assess pediatric patient and caregiver satisfaction in OAE compared with TAE. Consecutive pediatric patients, and their caregivers, undergoing elective upper endoscopy from May to December 2012 at the Stollery Children's Hospital (Edmonton, Alberta, Canada) were consented for a cross-sectional survey. Seven preprocedure and 5 postprocedure questions were completed regarding mood and satisfaction with the wait time and the information provided. Group demographics and endoscopy wait times were collected. Median wait time with OAE was less compared with TAE (57 days vs 196 days, P < 0.001). OAE patients reported worse mood preprocedure than TAE patients (35.3% vs 10.7%, P = 0.046). OAE caregivers and patients reported more mood disturbance if required to wait longer for endoscopy by attending clinic preprocedure (OAE caregivers 62.2%, OAE patients 64.7%). OAE is associated with worse preendoscopy patient mood; however, children and caregivers seem concerned about longer wait times associated with TAE. Given the significantly shorter wait times in OAE, identifying methods to minimize present limitations of OAE will be useful to improve clinical practices in pediatric gastroenterology.

  1. Three-dimensional motion tracking correlates with skill level in upper gastrointestinal endoscopy

    DEFF Research Database (Denmark)

    Arnold, Sif H.; Svendsen, Morten Bo Søndergaard; Konge, Lars

    2015-01-01

    Background and study aim: Feedback is an essential part of training in upper gastrointestinal endoscopy. Virtual reality simulators provide limited feedback, focusing only on visual recognition with no feedback on the procedural part of training. Motion tracking identifies patterns of movement...... untrained medical students) were tested using a virtual reality simulator. A motion sensor was used to collect data regarding the distance between the hands, and height and movement of the scope hand. Test characteristics between groups were explored using Kruskal-Wallis H and Man-Whitney U exact tests....... Results: All motion-tracking metrics showed discriminative ability primarily between experts and novices in specific sequences. Conclusion: Motion tracking can discriminate between operators with different experience levels in upper gastrointestinal endoscopy. Motion tracking can be used to provide...

  2. Frequency of peptic ulcer disease in patients of dyspepsia an analysis of upper gastrointestinal endoscopy

    International Nuclear Information System (INIS)

    Anwar, S.O.; Ambreen, S.; Ashraf, H.M.

    2010-01-01

    To evaluate the frequency of peptic ulcer disease in patients of dyspepsia on upper gastrointestinal endoscopy. A convenient non probability sampling was done and one hundred patients were selected from out patient department presenting within six months of dyspeptic symptoms. They were all subjected to upper gastrointestinal endoscopy Of all patients 61% (n=61) were males and 39% (n=39) were females with age ranging between 20 - 45 years. Study revealed functional dyspepsia (76%), duodenal ulcer (11%), gastric ulcer (4%) and esophagitis including gastoesophageal reflux disease (9%). This showed an overall frequency of peptic ulcer disease to be 15% in the studied population.Conclusion: Peptic ulcer disease is a common structural cause of dyspepsia and was responsible for 15% of dyspepsia. (author)

  3. STUDY OF UPPER GASTROINTESTINAL ENDOSCOPY FINDINGS AND PRESENCE OF HELICOBACTER PYLORI INFECTION AMONG ADULT PATIENTS OF UPPER ABDOMINAL PAIN AND DYSPEPSIA

    Directory of Open Access Journals (Sweden)

    Manju Singh

    2017-03-01

    Full Text Available BACKGROUND Dyspepsia is a common presenting complaint of various upper gastrointestinal disorders. The symptoms of causes of dyspepsia often overlap and this makes aetiological diagnosis difficult. Endoscopy is the ideal procedure for identifying organic diseases of the foregut and rapid urease test with endoscopy is a gold standard method for diagnosing the h.pylori infection. Helicobacter pylori infection is associated with various upper gastrointestinal pathologies. MATERIALS AND METHODS This hospital-based case-controlled study was carried out in a tertiary hospital, Dr. Bhim Rao Ambedkar Hospital, which is attached to Pt. J.N.M. Medical College, Raipur, and which provides open access service to endoscopy. Eighty two consecutive adult outpatients and admitted patients under Department of Surgery and Medicine with upper abdominal pain and dyspepsia were screened for eligibility and underwent upper gastrointestinal endoscopy using forward-viewing endoscopes from March 2015 to September 2016. Patients with dyspepsia who are over 18 years of age should undergoendoscopy (EGD for initial work up and divided in case having endoscopic findings and control having normal findings, then apply rapid urease test to all of these patients. RESULTS The most commonly identified endoscopic findings were gastritis (36%, Peptic Ulcer Disease (PUD (13.3%, oesophagitis (11%, duodenitis (7.3%. Gastric cancer was identified in 4.9% of patients and all of them were aged 18 years and above (p>0.05. H. pylori infection was detected in 51% (n=42 of patients. Gastritis andoesophagitis were statistically significantly associated with H. pylori (p0.05. Gastritis, GERD and PUD are the leading causes of dyspepsia. H. pylori infection is present in significant proportion of dyspeptic patients. CONCLUSION In present study, we are concluded that all upper abdominal pain is not due to acid peptic disease, but most of upper abdominal pain is due to acid peptic disease with H

  4. Glossopharyngeal Nerve Block versus Lidocaine Spray to Improve Tolerance in Upper Gastrointestinal Endoscopy

    Directory of Open Access Journals (Sweden)

    Moisés Ortega Ramírez

    2013-01-01

    Full Text Available Aim of the Study. To compare the effect of glossopharyngeal nerve block with topical anesthesia on the tolerance of patients to upper gastrointestinal endoscopy. Methods. We performed a clinical trial in one hundred patients undergoing upper gastrointestinal endoscopy. Subjects were randomly assigned to one of the following two groups: (1 treatment with bilateral glossopharyngeal nerve block (GFNB and intravenous midazolam or (2 treatment with topical anesthetic (TASS and intravenous midazolam. We evaluated sedation, tolerance to the procedure, hemodynamic stability, and adverse symptoms. Results. We studied 46 men and 54 women, from 17 to 78 years of age. The procedure was reported without discomfort in 48 patients (88% in the GFNB group and 32 (64% in the TAAS group; 6 patients (12% in GFNB group and 18 (36% in TAAS group reported the procedure as little discomfort (χ2=3.95, P=0.04. There was no difference in frequency of nausea (4% in both groups and retching, 4% versus 8% for GFNB and TASS group, respectively (P=0.55. Conclusions. The use of glossopharyngeal nerve block provides greater comfort and tolerance to the patient undergoing upper gastrointestinal endoscopy. It also reduces the need for sedation.

  5. Cardiovascular responses, arterial oxygen saturation and plasma catecholamine concentration during upper gastrointestinal endoscopy using conscious sedation with midazolam or propofol

    NARCIS (Netherlands)

    Oei-Lim, V. L.; Kalkman, C. J.; Bartelsman, J. F.; Res, J. C.; van Wezel, H. B.

    1998-01-01

    Hypoventilation as a consequence of deep intravenous sedation is the most frequently reported cause of cardiac arrest during upper gastrointestinal endoscopy (UGIE). Haemodynamic stress can contribute to myocardial ischaemia; therefore, this study was designed to observe prospectively the

  6. Stepwise sedation for elderly patients with mild/moderate COPD during upper gastrointestinal endoscopy

    Science.gov (United States)

    Xu, Can-Xia; Chen, Xiong; Jia, Yan; Xiao, Ding-Hua; Zou, Hui-Fang; Guo, Qin; Wang, Fen; Wang, Xiao-Yan; Shen, Shou-Rong; Tong, Ling-Ling; Cao, Ke; Liu, Xiao-Ming

    2013-01-01

    AIM: To investigate stepwise sedation for elderly patients with mild/moderate chronic obstructive pulmonary disease (COPD) during upper gastrointestinal (GI) endoscopy. METHODS: Eighty-six elderly patients with mild/moderate COPD and 82 elderly patients without COPD scheduled for upper GI endoscopy were randomly assigned to receive one of the following two sedation methods: stepwise sedation involving three-stage administration of propofol combined with midazolam [COPD with stepwise sedation (group Cs), and non-COPD with stepwise sedation (group Ns)] or continuous sedation involving continuous administration of propofol combined with midazolam [COPD with continuous sedation (group Cc), and non-COPD with continuous sedation (group Nc)]. Saturation of peripheral oxygen (SpO2), blood pressure, and pulse rate were monitored, and patient discomfort, adverse events, drugs dosage, and recovery time were recorded. RESULTS: All endoscopies were completed successfully. The occurrences of hypoxemia in groups Cs, Cc, Ns, and Nc were 4 (9.3%), 12 (27.9%), 3 (7.3%), and 5 (12.2%), respectively. The occurrence of hypoxemia in group Cs was significantly lower than that in group Cc (P < 0.05). The average decreases in value of SpO2, systolic blood pressure, and diastolic blood pressure in group Cs were significantly lower than those in group Cc. Additionally, propofol dosage and overall rate of adverse events in group Cs were lower than those in group Cc. Finally, the recovery time in group Cs was significantly shorter than that in group Cc, and that in group Ns was significantly shorter than that in group Nc (P < 0.001). CONCLUSION: The stepwise sedation method is effective and safer than the continuous sedation method for elderly patients with mild/moderate COPD during upper GI endoscopy. PMID:23922479

  7. Comfort, safety and quality of upper gastrointestinal endoscopy after 2 hours fasting: a randomized controlled trial

    OpenAIRE

    Koeppe, Angélica Terezinha; Lubini, Marcio; Bonadeo, Nilton Maiolini; Moraes, Iran; Fornari, Fernando

    2013-01-01

    Background Upper gastrointestinal endoscopy has been performed after fasting 8 or more hours, which can be harmful to the patients. We assessed comfort, safety and quality of endoscopy under moderate sedation after 2 hours fasting for clear liquids. Methods In this clinical trial, patients referred for elective endoscopy were randomly assigned to a fasting period of 8 hours (F8) or a shorter fasting (F2), in which 200 ml of clear liquids were ingested 2 hours before the procedure. Endoscopist...

  8. Upper Gastrointestinal Endoscopy prior to Bariatric Surgery-Mandatory or Expendable? An Analysis of 801 Cases.

    Science.gov (United States)

    Wolter, Stefan; Duprée, Anna; Miro, Jameel; Schroeder, Cornelia; Jansen, Marie-Isabelle; Schulze-Zur-Wiesch, Clarissa; Groth, Stefan; Izbicki, Jakob; Mann, Oliver; Busch, Philipp

    2017-08-01

    Upper gastrointestinal pathologies are common in bariatric patients. Preoperative esophagogastroduodenal endoscopy (EGD) should detect and treat pathologies that might alter the type of bariatric surgery. However, clinical consequences of these findings are often insignificant. The aim of this study was to assess the influence of preoperative endoscopy in our cohort and its clinical consequences. We conducted a retrospective analysis of endoscopic findings in patients under evaluation for bariatric surgery. Endoscopic findings were compared to preoperative risk factors as well as postoperative complications, and its clinical consequences were analyzed. Data was available for 801 patients. Abnormal endoscopic findings were found in 65.7% of all patients. The most common conditions were gastritis (32.1%) and gastroesophageal reflux (24.8%). Malignancies were observed in 0.5% of all patients. We observed early-stage adenocarcinoma of the esophagus in two patients through our routine preoperative evaluation. Helicobacter pylori infections were detected in preoperative biopsies in only 3.7% of all patients. Patients who reported reflux symptoms had a higher rate of pathological EGDs (74.2 vs. 64.9%, p .019). We did not find any other risk factors for a pathological endoscopy. The postoperative complication rate was 11.2%. Leakage rate was 1.1%. Mortality rate was 0.4%. We did not find any correlation between the incidence of postoperative complications and preoperative endoscopic findings. Relevant findings in routine preoperative endoscopy are rare but have significant influence on decision-making in bariatric patients and should be assessed as a necessary diagnostic tool.

  9. Appropriateness guidelines and predictive rules to select patients for upper endoscopy: a nationwide multicenter study.

    Science.gov (United States)

    Buri, Luigi; Hassan, Cesare; Bersani, Gianluca; Anti, Marcello; Bianco, Maria Antonietta; Cipolletta, Livio; Di Giulio, Emilio; Di Matteo, Giovanni; Familiari, Luigi; Ficano, Leonardo; Loriga, Pietro; Morini, Sergio; Pietropaolo, Vincenzo; Zambelli, Alessandro; Grossi, Enzo; Intraligi, Marco; Buscema, Massimo

    2010-06-01

    Selecting patients appropriately for upper endoscopy (EGD) is crucial for efficient use of endoscopy. The objective of this study was to compare different clinical strategies and statistical methods to select patients for EGD, namely appropriateness guidelines, age and/or alarm features, and multivariate and artificial neural network (ANN) models. A nationwide, multicenter, prospective study was undertaken in which consecutive patients referred for EGD during a 1-month period were enrolled. Before EGD, the endoscopist assessed referral appropriateness according to the American Society for Gastrointestinal Endoscopy (ASGE) guidelines, also collecting clinical and demographic variables. Outcomes of the study were detection of relevant findings and new diagnosis of malignancy at EGD. The accuracy of the following clinical strategies and predictive rules was compared: (i) ASGE appropriateness guidelines (indicated vs. not indicated), (ii) simplified rule (>or=45 years or alarm features vs. <45 years without alarm features), (iii) logistic regression model, and (iv) ANN models. A total of 8,252 patients were enrolled in 57 centers. Overall, 3,803 (46%) relevant findings and 132 (1.6%) new malignancies were detected. Sensitivity, specificity, and area under the receiver-operating characteristic curve (AUC) of the simplified rule were similar to that of the ASGE guidelines for both relevant findings (82%/26%/0.55 vs. 88%/27%/0.52) and cancer (97%/22%/0.58 vs. 98%/20%/0.58). Both logistic regression and ANN models seemed to be substantially more accurate in predicting new cases of malignancy, with an AUC of 0.82 and 0.87, respectively. A simple predictive rule based on age and alarm features is similarly effective to the more complex ASGE guidelines in selecting patients for EGD. Regression and ANN models may be useful in identifying a relatively small subgroup of patients at higher risk of cancer.

  10. Clinical, endoscopic and histopathological profiles of parasitic duodenitis cases diagnosed by upper digestive endoscopy

    Directory of Open Access Journals (Sweden)

    Reinaldo Benevides dos Santos

    2011-12-01

    Full Text Available CONTEXT: Intestinal parasites induce detectable histopathological changes, which have been studied in groups with known diagnosis of parasitic disease. There is no available study with a larger base without previous diagnosis. OBJECTIVE: To describe clinical and histopathological findings of parasitosis diagnosed by endoscopic biopsy in patients submitted to upper digestive endoscopy. METHODS: Recorded biopsies archive at "Complexo Hospitalar Professor Edgar Santos" , a general teaching Hospital in the state of Bahia, Northeast Brazil, from January 1995 to January 2009, were reviewed. One thousand ten duodenal biopsy reports were found. Reports positive for parasites had their specimens reviewed and photographed. All blocks of biopsy selected as case were retrieved and reviewed by an experienced pathologist. Clinical, laboratorial and endoscopic data were collected. RESULTS: Eleven biopsies showed parasites, including cases of Cryptosporidium sp. and Strongyloides stercoralis. Vomiting (91%, abdominal pain (78%, diarrhea (78% and weight loss (78% were usual symptoms. Seventy-five percent had duodenal mucosa changes on endoscopy, while 25% have no changes. Anemia and low serum albumin were important laboratorial data. HIV infection association was observed. Villus atrophy and reactive epithelium were usual in Strongyloides cases. CONCLUSIONS: No endoscopic or histopathologic finding was pathognomonic. One percent of duodenal endoscopic biopsies showed parasites.

  11. Upper GI endoscopy in elderly patients: predictive factors of relevant endoscopic findings.

    Science.gov (United States)

    Buri, Luigi; Zullo, Angelo; Hassan, Cesare; Bersani, Gianluca; Anti, Marcello; Bianco, Maria A; Cipolletta, Livio; Giulio, Emilio Di; Matteo, Giovanni Di; Familiari, Luigi; Ficano, Leonardo; Loriga, Piero; Morini, Sergio; Pietropaolo, Vincenzo; Zambelli, Alessandro; Grossi, Enzo; Tessari, Francesco; Intraligi, Marco; Buscema, Massimo

    2013-03-01

    Elderly patients are at increased risk for peptic ulcer and cancer. Predictive factors of relevant endoscopic findings at upper endoscopy in the elderly are unknown. This was a post hoc analysis of a nationwide, endoscopic study. A total of 3,147 elderly patients were selected. Demographic, clinical, and endoscopic data were systematically collected. Relevant findings and new diagnoses of peptic ulcer and malignancy were computed. Both univariate and multivariate analyses were performed. A total of 1,559 (49.5%), 213 (6.8%), 93 (3%) relevant findings, peptic ulcers, and malignancies were detected. Peptic ulcers and malignancies were more frequent in >85-year-old patients (OR 3.1, 95% CI = 2.0-4.7, p = 0.001). The presence of dysphagia (OR = 5.15), weight loss (OR = 4.77), persistent vomiting (OR = 3.68), anaemia (OR = 1.83), and male gender (OR = 1.9) were significantly associated with a malignancy, whilst overt bleeding (OR = 6.66), NSAIDs use (OR = 2.23), and epigastric pain (OR = 1.90) were associated with the presence of peptic ulcer. Peptic ulcer or malignancies were detected in 10% of elderly patients, supporting the use of endoscopy in this age group. Very elderly patients appear to be at higher risk of such lesions.

  12. PREVALENCE OF HELICOBACTER PYLORI IN PATIENTS WITH DYSPEPSIA UNDERGOING UPPER GASTRO INTESTINAL ENDOSCOPY IN TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Ajay Babu K

    2017-12-01

    Full Text Available BACKGROUND Acid peptic disease comprises of a wide spectrum of diseases, which cause considerable morbidity. Helicobacter pylori, a curved rod-shaped bacterium, has been consistently associated with patients suffering from acid peptic diseases, more in ulcer disease than in non-ulcer disease. Due to this high association, it is now believed that Helicobacter pylori plays an important role in the aetiopathogenesis of acid peptic disease. Several studies have revealed the association of Helicobacter pylori in 70-75 percent of patients with dyspepsia. Endoscopic studies have shown that, Helicobacter pylori is found in 80-100% of patients with duodenal ulcers and 60-75 per cent of patients with gastric ulcers. Amidst these profound variations proposed by many workers in the previous studies, we have attempted to study the prevalence of Helicobacter pylori in patients undergoing upper gastrointestinal endoscopy at our hospital and its association with acid-peptic disease. The objectives of this study were- 1. To study the prevalence of Helicobacter pylori in patients with dyspepsia undergoing upper gastrointestinal endoscopy. 2. To study the association of Helicobacter pylori with acid peptic Diseases. MATERIALS AND METHODS 344 cases of dyspepsia were studied clinically as per the proforma over a period of one and half years from July 2014 to October 2015. The inclusion and exclusion criteria were as follows; RESULTS Out of 344 patients, there were 224 male patients and 120 female patients, age ranging from 19 years to 60 years (Mean44.8. Out of 344 patients, 156 patients were diagnosed to have been infected with Helicobacter pylori (45.3%. CONCLUSION This was a prospective study conducted to determine the role of Helicobacter pylori in acid-peptic diseases. This study design was based on clinical study and endoscopic biopsy of gastric mucosa (and duodenal mucosa whenever necessary in 344 patients with a history of dyspepsia. Endoscopy confirmed the

  13. Bupivacaine Lozenge Compared with Lidocaine Spray as Topical Pharyngeal Anesthetic before Unsedated Upper Gastrointestinal Endoscopy

    DEFF Research Database (Denmark)

    Salale, Nesrin; Treldal, Charlotte; Mogensen, Stine

    2014-01-01

    Unsedated upper gastrointestinal endoscopy (UGE) can induce patient discomfort, mainly due to a strong gag reflex. The aim was to assess the effect of a bupivacaine lozenge as topical pharyngeal anesthetic compared with standard treatment with a lidocaine spray before UGE. Ninety-nine adult...... outpatients undergoing unsedated diagnostic UGE were randomized to receive either a bupivacaine lozenge (L-group, n = 51) or lidocaine spray (S-group, n = 42). Primary objective was assessment of patient discomfort including acceptance of the gag reflex during UGE. The L-group assessed the discomfort...... significantly lower on a visual analog scale compared with the S-group (P = 0.02). There was also a significant difference in the four-point scale assessment of the gag reflex (P = 0.03). It was evaluated as acceptable by 49% in the L-group compared with 31% in the S-group. A bupivacaine lozenge compared...

  14. The radiological and endoscopie appearances of Crohn's disease of the upper gastro-intenstinal tract

    International Nuclear Information System (INIS)

    Kurtz, B.; Steinhardt, H.J.; Malchow, H.; Tuebingen Univ.

    1982-01-01

    Involvement of the upper gastrointestinal tract (oesophagus, stomach, duodenum, jejunum) accounted for 13% of endoscopically proven Crohn's disease in patients at the University Clinic, Tuebingen between 1973 and 1980. The basis for the diagnosis was the presence of epitheloid granulomas. The diagnosis was suspected in 26% of patients in endoscopic appearances alone. In these two groups, the appearances were similar, consisting of atypical or linear ulcers, cobble-stone lesions, chronic erosions, aphthous ulcers, stenoses, coarsening of the mucosa and areas of engorgement and granularity. Most patients were also examined radiologically. The radiological findings correspond with the endoscopic observations. Using a double contrast technique, mucosal changes could be demonstrated which, up to now, were only seen by endoscopy. If these findings are observed either radiologically or endoscopically, it is essential to examine the distal portions of the gut. (orig.) [de

  15. Effects of Ramadan fasting on peptic ulcer disease as diagnosed by upper gastrointestinal endoscopy.

    Science.gov (United States)

    Gokakin, Ali Kagan; Kurt, Atilla; Akgol, Gunduz; Karakus, Boran Cihat; Atabey, Mustafa; Koyuncu, Ayhan; Topcu, Omer; Goren, Erdal

    2012-12-01

    The diagnostic methods such as upper gastrointestinal endoscopy (UGE) have played an important role in the evaluation of peptic ulcer (PU). Every year, millions of Muslims fast in Ramadan month. The aim of this study was to evaluate the effect of fasting on PU via UGE. A total of 321 patients in the period from 2009 to 2011, who underwent UGE as a diagnostic work-up mainly for epigastric pain, were analysed. Patients were divided into three groups: Patients who have been evaluated by UGE, in the month just before Ramadan (group I, n=69), in Ramadan month (group II, n=132) and in the month just after Ramadan (group III, n=120). Continuous data were expressed as the mean±SD, and were compared with one-way analysis of variance (ANOVA) test amongst groups. Categorical data were given as percentages and were compared with the chi-squared test. Epigastric pain was the most common indication for referral in each group. Interestingly, the indication 'bleeding' was found to be the least in group II, but was far from statistical significance. The highest prevalence of duodenal ulcers and duodenitis was found in group II; the differences to the other groups were statistically significant. Duodenal ulcers and duodenitis were found more during Ramadan month. We recommend that, the patients with epigastric pain may fast by taking their medications. Copyright © 2012 Arab Journal of Gastroenterology. Published by Elsevier Ltd. All rights reserved.

  16. How to predict a high rate of inappropriateness for upper endoscopy in an endoscopic centre?

    Science.gov (United States)

    Buri, L; Bersani, G; Hassan, C; Anti, M; Bianco, M A; Cipolletta, L; Di Giulio, E; Di Matteo, G; Familiari, L; Ficano, L; Loriga, P; Morini, S; Pietropaolo, V; Zambelli, A; Grossi, E; Intraligi, M; Tessari, F; Buscema, M

    2010-09-01

    Inappropriateness of upper endoscopy (EGD) indication causes decreased diagnostic yield. Our aim of was to identify predictors of appropriateness rate for EGD among endoscopic centres. A post-hoc analysis of two multicentre cross-sectional studies, including 6270 and 8252 patients consecutively referred to EGD in 44 (group A) and 55 (group B) endoscopic Italian centres in 2003 and 2007, respectively, was performed. A multiple forward stepwise regression was applied to group A, and independently validated in group B. A <70% threshold was adopted to define inadequate appropriateness rate clustered by centre. discrete variability of clustered appropriateness rates among the 44 group A centres was observed (median: 77%; range: 41-97%), and a <70% appropriateness rate was detected in 11 (25%). Independent predictors of centre appropriateness rate were: percentage of patients referred by general practitioners (GP), rate of urgent examinations, prevalence of relevant diseases, and academic status. For group B, sensitivity, specificity and area under receiver operating characteristic curve of the model in detecting centres with a <70% appropriateness rate were 54%, 93% and 0.72, respectively. A simple predictive rule, based on rate of patients referred by GPs, rate of urgent examinations, prevalence of relevant diseases and academic status, identified a small subset of centres characterised by a high rate of inappropriateness. These centres may be presumed to obtain the largest benefit from targeted educational programs. Copyright (c) 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  17. Impact of Ramadan on upper gastrointestinal endoscopy referrals in Brunei Darussalam.

    Science.gov (United States)

    Chong, V H

    2009-06-01

    Fasting during the month of Ramadan is one of the five holy pillars in the Islamic faith and is an obligation for all its followers. Prolonged fasting may precipitate or exacerbate gastrointestinal (GI) complaints. This study assessed the impact of Ramadan on referrals for upper GI endoscopy in a tertiary referral centre. 1,661 patients referred to the centre a month before, during and a month after the month of Ramadan over a four-year period (2004-07) were retrospectively studied. Significant endoscopic findings were taken as any bleeding lesions, severe or complicated oesophagitis, peptic ulcer disease, portal hypertension related pathologies and malignancies. Overall, there was significantly less workload generated during the fasting month (397 patients, 5.7 +/- 2.7 cases per list) compared to before (603 patients, 6.9 +/- 3.0 cases per list, p-value is equal to 0.036) and after (661 patients, 7.8 +/- 3.4 cases per list, p-value is less than 0.001) the fasting month. There was no significant difference between the period before and after the fasting month (p-value equal to 0.124). There were no significant differences in the mean age and gender of the patients. During the fasting month, there were differences in the ethnicity (fewer Malays and more Chinese, p-value is equal to 0.002) and referral sources (more wards and fewer clinics, p-value is less than 0.001). There were no differences in the referral indications, oesophageal and gastric findings, but there was a significant difference in the duodenal findings (p-value is equal to 0.001), especially ulcer disease, during the fasting month. This study showed that significantly less workload was generated during the fasting month of Ramadan compared to the non-fasting months. There were also some differences in the referral sources, ethnicity and the endoscopic findings.

  18. Quality standards in upper gastrointestinal endoscopy: a position statement of the British Society of Gastroenterology (BSG) and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS).

    Science.gov (United States)

    Beg, Sabina; Ragunath, Krish; Wyman, Andrew; Banks, Matthew; Trudgill, Nigel; Pritchard, D Mark; Riley, Stuart; Anderson, John; Griffiths, Helen; Bhandari, Pradeep; Kaye, Phillip; Veitch, Andrew

    2017-11-01

    This document represents the first position statement produced by the British Society of Gastroenterology and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland, setting out the minimum expected standards in diagnostic upper gastrointestinal endoscopy. The need for this statement has arisen from the recognition that while technical competence can be rapidly acquired, in practice the performance of a high-quality examination is variable, with an unacceptably high rate of failure to diagnose cancer at endoscopy. The importance of detecting early neoplasia has taken on greater significance in this era of minimally invasive, organ-preserving endoscopic therapy. In this position statement we describe 38 recommendations to improve diagnostic endoscopy quality. Our goal is to emphasise practices that encourage mucosal inspection and lesion recognition, with the aim of optimising the early diagnosis of upper gastrointestinal disease and improving patient outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. [Usefulness of monitoring anaesthesia with the bispectral index in upper gastrointestinal endoscopies with spontaneous breathing].

    Science.gov (United States)

    Alados-Arboledas, F J; Millán-Bueno, M P; Expósito-Montes, J F; Santiago-Gutierrez, C; Arévalo-Garrido, A; Pérez-Parras, A; Millán-Miralles, L; Martínez-Padilla, M C; de la Cruz-Moreno, J

    2013-08-01

    The objective of this investigation is to determine whether bispectral index (BIS®) monitoring during intravenous anaesthesia with spontaneous breathing for upper gastrointestinal endoscopy (UGE) in a pediatric population is useful for: a) decreasing the amount of drug, b) decreasing the time for awakening, and c) improving patient safety. A quasi-experimental case-control prospective study was conducted in the setting of a second level hospital pediatric intensive care unit. Children aged 1-13 years. ASA I patient who needed a diagnostic UGE; eligible, 36, participants, 30. historical cohort of patients who needed UGE (years 2008-2010): 50 patients. UGE performed with anaesthetic protocol, vital signs monitoring, sedation level (Ramsay scale) and BIS monitoring. propofol total dose (mg/kg), induction time, time in performing the UGE, awakening time (min); initial BIS (iBIS), and BIS during the UGE; adverse effects. There were no significant differences in sex, age or weight between case (B) and control (C) population. No significant differences in total propofol doses: (B 4.9 ± 1.4 mg/kg; C 5.2 ± 1.6 mg/kg, P=.492), awakening time (B 12.2 ± 4.6 min; C 12.8 ± 4.4 min, P=.402), time for execution of UGE (B 9.5 ± 4.8 min; C 11.3 ± 6.5 min, P=.335) and induction time (B 11.1 ± 2.6 min; C 10.1 ± 4.2 min, P=.059), iBIS 55.4 ± 6.9. There were no significant differences in adverse effects: 2 patients suffered from mild desaturation in the control group. BIS monitoring for diagnostic UGE in spontaneous breathing in a pediatric population is feasible, but does not appear to decrease awakening time or the amount of propofol needed. Furthermore, there was no statistically significant decrease in the number of adverse effects. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Tayyibe Saler

    2014-01-01

    Full Text Available 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.

  1. Diagnostic Yield of Upper and Lower Gastrointestinal Endoscopies in Children in a Tertiary Centre.

    Science.gov (United States)

    Thomson, Mike; Sharma, Shishu

    2017-06-01

    Endoscopy is integral to the diagnosis and management of many gastrointestinal problems in children. Recently the number of endoscopic procedures performed has increased considerably worldwide raising questions about their appropriateness and cost-efficacy. The aim of the study was to determine the diagnostic yield (the likelihood that a procedure or test will provide information required to establish a diagnosis) of endoscopy in a paediatric population in a large tertiary referral centre and to determine the terminal ileum intubation (TII) rate of paediatric ileocolonosocopy (IC) in an active training environment and compare with previously calculated rates. Random selection of cases from a theatre electronic database from a 30-month period covering April 2012 to October 2014. The data were collected for initial presenting symptoms; age at diagnosis; indications for endoscopy; endoscopic findings; histopathological findings; and any change in management postendoscopic procedure. The diagnostic yield of the endoscopies and the TII rate of IC were calculated. Change in and contribution to management was assessed. Median age 9.58 (0.5-16.5) years and M:F ratio 1:1.42. The positive diagnostic yield was 18.9% for oesophago-gastro-duodenoscopy alone, 32.6% for IC alone, and 39.2% when both occurred. In 45% management was actively changed due to endoscopy/histopathology findings and a significant management contribution occurred in all patients. TII was achieved in 98% of cases, which compares favourably to a TII rate of 89% at the same centre during the period 2009 to 2011. Diagnostic yield was 32.6% for IC and 39.2% when oesophago-gastro-duodenoscopy also occurred. A TII rate of 98% should be achievable in children. A change in management occurred in 45% and as a significant negative finding may be as important as a positive diagnosis for exclusion of suspected disorders, with consequent reassurance and change in management. Contribution to management was therefore

  2. The role of upper gastrointestinal endoscopy in treating postoperative complications in bariatric surgery

    OpenAIRE

    Gill, Richdeep S; Whitlock, Kevin A; Mohamed, Rachid; Sarkhosh, Koroush; Birch, Daniel W; Karmali, Shahzeer

    2012-01-01

    There are an estimated 500 million obese individuals worldwide. Currently, bariatric surgery has been shown to result in clinically significant weight loss. With increasing demand for bariatric surgery, endoscopic techniques used intra and postoperatively continue to evolve. Endoscopic evaluation of anastomotic integrity following RYGB allows for early detection of anastomotic leaks. Furthermore, endoscopy is a valuable tool to diagnose and treat RYGB postoperative surgical complications such...

  3. Automated graphic assessment of respiratory activity is superior to pulse oximetry and visual assessment for the detection of early respiratory depression during therapeutic upper endoscopy.

    Science.gov (United States)

    Vargo, John J; Zuccaro, Gregory; Dumot, John A; Conwell, Darwin L; Morrow, J Brad; Shay, Steven S

    2002-06-01

    Recommendations from the American Society of Anesthesiologists suggest that monitoring for apnea using the detection of exhaled carbon dioxide (capnography) is a useful adjunct in the assessment of ventilatory status of patients undergoing sedation and analgesia. There are no data on the utility of capnography in GI endoscopy, nor is the frequency of abnormal ventilatory activity during endoscopy known. The aims of this study were to determine the following: (1) the frequency of abnormal ventilatory activity during therapeutic upper endoscopy, (2) the sensitivity of observation and pulse oximetry in the detection of apnea or disordered respiration, and (3) whether capnography provides an improvement over accepted monitoring techniques. Forty-nine patients undergoing therapeutic upper endoscopy were monitored with standard methods including pulse oximetry, automated blood pressure measurement, and visual assessment. In addition, graphic assessment of respiratory activity with sidestream capnography was performed in all patients. Endoscopy personnel were blinded to capnography data. Episodes of apnea or disordered respiration detected by capnography were documented and compared with the occurrence of hypoxemia, hypercapnea, hypotension, and the recognition of abnormal respiratory activity by endoscopy personnel. Comparison of simultaneous respiratory rate measurements obtained by capnography and by auscultation with a pretracheal stethoscope verified that capnography was an excellent indicator of respiratory rate when compared with the reference standard (auscultation) (r = 0.967, p < 0.001). Fifty-four episodes of apnea or disordered respiration occurred in 28 patients (mean duration 70.8 seconds). Only 50% of apnea or disordered respiration episodes were eventually detected by pulse oximetry. None were detected by visual assessment (p < 0.0010). Apnea/disordered respiration occurs commonly during therapeutic upper endoscopy and frequently precedes the development

  4. Selective endoscopy in management of ingested foreign bodies of the upper gastrointestinal tract: is it safe?

    LENUS (Irish Health Repository)

    O'Sullivan, S T

    2012-02-03

    During a four-year period, 308 patients presented following ingestion of foreign bodies. Ingestion was accidental in 272 cases (88.3%) and deliberate in the remainder. Symptoms at presentation included dysphagia, odynophagia, nausea and vomiting, chest pain and pharyngeal discomfort. Sixty-eight patients were asymptomatic. A policy of expectant management and selective endoscopy was employed. Following initial assessment 202 patients (65.6%) were discharged without treatment, 30 (9.7%) of whom were later reviewed as outpatients and did not require admission. Forty-nine patients (16%) were admitted for treatment; 27 had oesophagoscopy, five bronchoscopy and two had foreign body extraction with direct laryngoscopy. In nine patients who were endoscoped, no foreign body was identified. Twenty-seven others were referred to the otorhinolaryngology service in another hospital. There were no deaths in the group and morbidity was 1.2%. We conclude that a policy of selective endoscopy is safe and effective in the management of patients following ingestion of foreign bodies.

  5. Use of remifentanil to reduce propofol injection pain and the required propofol dose in upper digestive tract endoscopy diagnostic tests.

    Science.gov (United States)

    Uliana, Gustavo Nadal; Tambara, Elizabeth Milla; Baretta, Giorgio Alfredo Pedroso

    2015-01-01

    The introduction of propofol (2,6-diisopropylphenol) as a sedative agent has transformed the area of sedation for endoscopic procedures. However, a major drawback of sedation with the use of propofol is its high incidence of injection pain. The most widely used technique in reducing propofol injection pain is through the association of other drugs. The aim of this study was to evaluate the effect of remifentanil-propofol combination on the incidence of propofol injection pain and its influence on the total dose of propofol required for sedation in upper digestive tract endoscopy (UDE) diagnostic tests. One hundred and five patients undergoing upper digestive tract endoscopy were evaluated and randomly divided into 3 groups of 35 patients each. The Control Group received propofol alone; Study-group 1 received remifentanil at a fixed dose of 0.2mg/kg combined with propofol; Study-group 2 received remifentanil at a fixed dose of 0.3mg/kg combined with propofol. The incidence of propofol injection pain and the total dose of propofol required for the test were evaluated. The sample was very similar regarding age, weight, height, sex, and physical status. Statistical analysis was performed according to the nature of the evaluated data. Student's t-test was used to compare the mean of age, weight, height (cm), and dose (mg/kg) variables between groups. The χ(2) test was used to compare sex, physical status, and propofol injection pain between groups. The significance level was αpain and total dose of propofol (mg/kg) used. However, there were no statistical differences between the two study groups for these parameters. We conclude that the use of remifentanil at doses of 0.2mg/kg and 0.3mg/kg was effective for reducing both the propofol injection pain and the total dose of propofol used. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  6. Diagnostic yield of upper gastrointestinal endoscopy in the evaluation of iron deficiency anemia in older children and adolescents.

    Science.gov (United States)

    Gulen, Huseyin; Kasirga, Erhun; Yildirim, Sule Aslan; Kader, Sebnem; Sahin, Gulseren; Ayhan, Semin

    2011-11-01

    Iron deficiency anemia (IDA) is frequent in childhood. Inadequate nutrition and gastrointestinal malabsorption are the frequent causes of IDA in children. But reduced iron absorption and insidious blood loss from the gastrointestinal tract has been identified as the most frequent causes of IDA in older children and adolescents. Therefore the authors evaluated the frequency and etiologies of the upper gastrointestinal system pathologies causing IDA in older pediatric population. Patients with known hematological or chronic diseases, heavy menstrual flow, and obvious blood loss were excluded from the study. Forty-four children between the ages of 9.5 and 17.5 years and diagnosed with IDA were enrolled. They underwent upper gastrointestinal endoscopy and biopsy from esophagus, stomach, and duodenum. Mean age and hemoglobin (Hb) levels of study group (32 boys, and 12 girls) were 14.6 ± 2.0 years and 7.9 ± 1.8 g/dL, respectively. Only 1 patient had a positive serology testing with anti-tissue transglutaminase and small bowel biopsy correlating with celiac disease. Endoscopy revealed abnormal findings in 25 (56.8%) patients (21 endoscopic antral gastritis, 2 active duodenal ulcers, and 2 duodenal polyps). Helicobacter pylori (HP) infection was identified by using antral histopathological evaluation in 19 of 44 children (43.2%). In 2 of duodenal samples, one patient had celiac disease, and the other one was diagnosed as giardiasis. In conclusion, there are different etiologies resulting in IDA in older children and adolescents. When older children and adolescents are found to have iron deficiency, HP infection and other gastrointestinal pathologies should be ruled out before iron deficiency treatment.

  7. Predictors of mortality in patients with acute upper gastrointestinal hemorrhage who underwent endoscopy and confirmed to have variceal hemorrhage

    Directory of Open Access Journals (Sweden)

    Ahmed Gado

    2015-12-01

    Conclusion: Patients with acute VH and hemodynamic instability at admission, Child class C, blood in UGI tract at the index endoscopy, rebleeding within five days of endoscopy and in-hospital complications are at an increased risk of mortality after the acute VH episode. Rebleeding within five days of endoscopy and in-hospital complications are the most significant independent predictors of mortality.

  8. Esophageal polyps in pediatric patients undergoing routine diagnostic upper gastrointestinal endoscopy: a multicenter study.

    Science.gov (United States)

    Septer, S; Cuffari, C; Attard, T M

    2014-01-01

    Esophageal polyps are uncommon findings in pediatric patients, and reports have been limited to case reports. Esophageal polyps have been previously ascribed to esophagitis secondary to gastroesophageal reflux, medications, infections and recurrent vomiting. They have been associated with underlying conditions such as hiatal hernia, Barrett's esophagus, eosinophilic esophagitis and Crohn's disease. Presenting complaints of children with esophageal polyps have included vomiting, dysphagia, hematemesis and abdominal pain. The aim of this paper is to characterize the incidence, clinical presentation and progression, histologic subtypes and associated mucosal abnormalities in children with esophageal polyps. A retrospective multicenter study was performed at four institutions identifying diagnosis of esophageal polyps in pediatric patients (pediatric pathologists for all included cases. Esophageal polyps were identified in 13 patients (9 M) from 9438 esophagogastroduodenoscopies (0.14%). Mean age of subjects was 9.2 years. Vomiting was the most common indication for endoscopy. Polyp location was at the gastroesophageal junction in 7 of the 13 cases. Most polyps were inflammatory (n = 7). Esophagitis was noted in 69% of those with esophageal polyps. Repeat endoscopies in six patients at a mean interval of 8 months noted persistence of polyps in all six patients. This paper is the first to characterize esophageal polyps in pediatrics. These polyps are rare in children and often are associated with esophagitis. Presenting complaints seem to vary by age. Polyps did not consistently change with either time or acid suppression. The optimal management strategy has yet to be defined and likely depends on the underlying pathophysiologic process. © 2013 Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

  9. PREVALENCE OF HELICOBACTER PYLORI TEN YEARS AGO COMPARED TO THE CURRENT PREVALENCE IN PATIENTS UNDERGOING UPPER ENDOSCOPY.

    Science.gov (United States)

    Frugis, Sandra; Czeczko, Nicolau Gregori; Malafaia, Osvaldo; Parada, Artur Adolfo; Poletti, Paula Bechara; Secchi, Thiago Festa; Degiovani, Matheus; Rampanazzo-Neto, Alécio; D Agostino, Mariza D

    2016-01-01

    Helicobacter pylori has been extensively studied since 1982 it is estimated that 50% of the world population is affected. The literature lacks studies that show the change of its prevalence in the same population over time. To compare the prevalence of H. pylori in 10 years interval in a population that was submitted to upper endoscopy in the same endoscopy service. Observational, retrospective and cross-sectional study comparing the prevalence of H. pylori in two samples with 10 years apart (2004 and 2014) who underwent endoscopy with biopsy and urease. Patients were studied in three consecutive months of 2004, compared to three consecutive months of 2014. The total number of patients was 2536, and 1406 in 2004 and 1130 in 2014. There were positive for H. pylori in 17 % of the sample as a whole. There was a significant decrease in the prevalence from 19.3% in 2004 to 14.1% in 2014 (pmundial esteja afetada. A literatura carece de estudos que mostrem a mudança de sua prevalência em uma mesma população ao longo do tempo. Comparar a prevalência do H.pylori no intervalo de 10 anos em população que realizou endoscopia digestiva alta no mesmo serviço de endoscopia. Estudo observacional, retrospectivo e transversal, comparando a prevalência de H. pylori em duas amostras com intervalo de 10 anos (2004 e 2014) que realizaram endoscopia digestiva alta com biópsias e teste da urease para a pesquisa de H. pylori. Foram estudados pacientes em três meses consecutivos de 2004, comparados aos de três meses consecutivos de 2014. O número total de pacientes avaliados foi 2536, sendo 1406 em 2004 e 1130 em 2014. Constatou-se resultado positivo para H.pylori em 17% da amostra como um todo. Houve queda significativa da prevalência de H.pylori de 19,3% em 2004 para 14,1% em 2014 (p<0.005). Houve redução de 5,2% da prevalência de H. pylori comparando-se dois períodos de três meses consecutivos com intervalo de 10 anos em duas amostras populacionais equivalentes.

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

    Science.gov (United States)

    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.

  11. [Is there an appropriate bispectral index for upper gastrointestinal endoscopy in spontaneous breathing in the pediatric patient?].

    Science.gov (United States)

    Alados-Arboledas, F J; Millán-Bueno, M P; Expósito-Montes, J F; Arévalo-Garrido, A; Pérez-Parras, A; de la Cruz-Moreno, J

    2015-03-01

    The bispectral index (BIS) values that predict appropriate anesthetic level to perform an upper gastrointestinal endoscopy in spontaneous breathing are not well established in Pediatrics. The objective of this study is to determine whether it is possible to find an appropriate, less profound, BIS level in the pediatric patient that would enable an upper gastrointestinal endoscopy (UGE) to be performed in spontaneous breathing without causing gag reflex or motor response. A prospective study was designed and included 61 patients from 12-167 months old, and an ASAI-II who needed a diagnostic UGE. The study was conducted from October 2011 to March 2013. UGE performed with an anesthetic protocol using propofol. The vital signs measured were heart and respiratory rate, pulse oximetry, non-invasive blood pressure. The sedation level score (Ramsay scale) and BIS values were also measured. The first attempt was performed at BIS level 60-69, and this was not feasible, then the anesthetic was deepened and a second attempt made at BIS level 50-59. If this was still not possible a deeper anesthetic level was then achieved and a third attempt made at BIS level 45-49. Variables of interest were: effective BIS level (eBIS), BIS level at which UGE was performed without gag reflex or motor response; propofol total dose (mgkg(-1)), induction time (time from onset of sedation to effective start of UGE). A logistic regression analysis was performed to obtain an equation to estimate the possibility of UGE success. The distribution of the patient was: male 40%, female 60%, with 11 (18%) patients under 36 months. The statistical values are expressed as mean and standard deviation, with following results; age (months): 95.9±45.86; weight (kg): 30.5±14.68; effective BIS: 56.41±4.63; induction time (minutes): 11.07±2.69; total propofol dose (per kg): 4.86±1.21. An additional intra-procedure propofol bolus was given in 38 patients (62%), with 7/38 of them (18%) due to movement, and 31

  12. [Use of remifentanil to reduce propofol injection pain and the required propofol dose in upper digestive tract endoscopy diagnostic tests].

    Science.gov (United States)

    Uliana, Gustavo Nadal; Tambara, Elizabeth Milla; Baretta, Giorgio Alfredo Pedroso

    2015-01-01

    The introduction of propofol (2,6-diisopropylphenol) as a sedative agent has transformed the area of sedation for endoscopic procedures. However, a major drawback of sedation with the use of propofol is its high incidence of injection pain. The most widely used technique in reducing propofol injection pain is through the association of other drugs. The aim of this study was to evaluate the effect of remifentanil-propofol combination on the incidence of propofol injection pain and its influence on the total dose of propofol required for sedation in upper digestive tract endoscopy (UDE) diagnostic tests. One hundred and five patients undergoing upper digestive tract endoscopy were evaluated and randomly divided into 3 groups of 35 patients each. The Control Group received propofol alone; Study-group 1 received remifentanil at a fixed dose of 0.2mg/kg combined with propofol; Study-group 2 received remifentanil at a fixed dose of 0.3mg/kg combined with propofol. The incidence of propofol injection pain and the total dose of propofol required for the test were evaluated. The sample was very similar regarding age, weight, height, sex, and physical status. Statistical analysis was performed according to the nature of the evaluated data. Student's t-test was used to compare the mean of age, weight, height (cm), and dose (mg/kg) variables between groups. The ℵ(2) test was used to compare sex, physical status, and propofol injection pain between groups. The significance level was α < 0.05. There was significant statistical difference between the study groups and the control group regarding the parameters of propofol injection pain and total dose of propofol (mg/kg) used. However, there were no statistical differences between the two study groups for these parameters. We conclude that the use of remifentanil at doses of 0.2mg/kg and 0.3mg/kg was effective for reducing both the propofol injection pain and the total dose of propofol used. Copyright © 2015 Sociedade

  13. Image Documentation in Gastrointestinal Endoscopy: Review of Recommendations.

    Science.gov (United States)

    Marques, Susana; Bispo, Miguel; Pimentel-Nunes, Pedro; Chagas, Cristina; Dinis-Ribeiro, Mário

    2017-11-01

    In recent years, endoscopic image documentation has gained an important role in gastrointestinal (GI) endoscopic reporting and has become an integral aspect of quality control. Since 2001, several important guidelines and statements, some from major endoscopic societies, have been published to standardize endoscopic image documentation. Therefore, and according to the most recent recommendations of the European Society of Gastrointestinal Endoscopy, we propose a set of images to be routinely captured in upper and lower GI endoscopy. Systematic acquisition of 10 and 9 photographs of specific landmarks is recommended in upper-GI endoscopy and colonoscopy, respectively. In addition to photo documentation of the normal endoscopic features, imaging of pathologic findings is also advocated. Considering accurate and adequate image documentation as an essential part of endoscopic reporting, it should be systematically performed in upper and lower GI endoscopy.

  14. Classification of videocapsule endoscopy image patterns: comparative analysis between patients with celiac disease and normal individuals

    Directory of Open Access Journals (Sweden)

    Ciaccio Edward J

    2010-09-01

    Full Text Available Abstract Background Quantitative disease markers were developed to assess videocapsule images acquired from celiac disease patients with villous atrophy, and from control patients. Method Capsule endoscopy videoclip images (576 × 576 pixels were acquired at 2/second frame rate (11 celiacs, 10 controls at regions: 1. bulb, 2. duodenum, 3. jejunum, 4. ileum and 5. distal ileum. Each of 200 images per videoclip (= 100s were subdivided into 10 × 10 pixel subimages for which mean grayscale brightness level and its standard deviation (texture were calculated. Pooled subimage values were grouped into low, intermediate, and high texture bands, and mean brightness, texture, and number of subimages in each band (nine features in all were used for quantifying regions 1-5, and to determine the three best features for threshold and incremental learning classification. Classifiers were developed using 6 celiac and 5 control patients' data as exemplars, and tested on 5 celiacs and 5 controls. Results Pooled from all regions, the threshold classifier had 80% sensitivity and 96% specificity and the incremental classifier had 88% sensitivity and 80% specificity for predicting celiac versus control videoclips in the test set. Trends of increasing texture from regions 1 to 5 occurred in the low and high texture bands in celiacs, and the number of subimages in the low texture band diminished (r2 > 0.5. No trends occurred in controls. Conclusions Celiac videocapsule images have textural properties that vary linearly along the small intestine. Quantitative markers can assist in screening for celiac disease and localize extent and degree of pathology throughout the small intestine.

  15. A Randomized Trial of Topical Anesthesia Comparing Lidocaine Versus Lidocaine Plus Xylometazoline for Unsedated Transnasal Upper Gastrointestinal Endoscopy

    Directory of Open Access Journals (Sweden)

    Justin Cheung

    2010-01-01

    Full Text Available 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.

  16. Endoscopy in pregnancy.

    LENUS (Irish Health Repository)

    O'mahony, Seamus

    2012-02-03

    Endoscopy is rarely required during pregnancy. The potential risks of endoscopy during pregnancy include foetal hypoxia due to sedative drugs and exposure to radiation. There is no evidence that endoscopy precipitates premature labour, and studies in this area have concluded that endoscopy during pregnancy is generally safe. There should be a strong indication for the procedure, which should be deferred whenever possible to the second trimester. Procedures should be performed without any sedation, or with the lowest dose of sedative medication. Radiation exposure should be kept to a minimum. Support should be obtained from specialists in obstetrics and anaesthesia. Indications for endoscopy during pregnancy are as follows: (1) gastroscopy: upper gastrointestinal bleeding, dysphagia, uncontrolled nausea\\/vomiting; (2) sigmoidoscopy\\/colonoscopy: rectal bleeding, diarrhoea; and (3) ERCP: choledocholithiasis, biliary pancreatitis. Sedative drugs, such as midazolam appear to be safe if used carefully. Radiation exposure during ERCP can be kept well below the danger level for teratogenicity.

  17. Lean thinking transformation of the unsedated upper gastrointestinal endoscopy pathway improves efficiency and is associated with high levels of patient satisfaction.

    Science.gov (United States)

    Hydes, Theresa; Hansi, Navjyot; Trebble, Timothy M

    2012-01-01

    Upper gastrointestinal (UGI) endoscopy is a routine healthcare procedure with a defined patient pathway. The objective of this study was to redesign this pathway for unsedated patients using lean thinking transformation to focus on patient-derived value-adding steps, remove waste and create a more efficient process. This was to form the basis of a pathway template that was transferrable to other endoscopy units. A literature search of patient expectations for UGI endoscopy identified patient-derived value. A value stream map was created of the current pathway. The minimum and maximum time per step, bottlenecks and staff-staff interactions were recorded. This information was used for service transformation using lean thinking. A patient pathway template was created and implemented into a secondary unit. Questionnaire studies were performed to assess patient satisfaction. In the primary unit the patient pathway reduced from 19 to 11 steps with a reduction in the maximum lead time from 375 to 80 min following lean thinking transformation. The minimum value/lead time ratio increased from 24% to 49%. The patient pathway was redesigned as a 'cellular' system with minimised patient and staff travelling distances, waiting times, paperwork and handoffs. Nursing staff requirements reduced by 25%. Patient-prioritised aspects of care were emphasised with increased patient-endoscopist interaction time. The template was successfully introduced into a second unit with an overall positive patient satisfaction rating of 95%. Lean thinking transformation of the unsedated UGI endoscopy pathway results in reduced waiting times, reduced staffing requirements and improved patient flow and can form the basis of a pathway template which may be successfully transferred into alternative endoscopy environments with high levels of patient satisfaction.

  18. Outcome of index upper gastrointestinal endoscopy in patients presenting with dysphagia in a tertiary care hospital-A 10 years review

    Directory of Open Access Journals (Sweden)

    Fielding John W

    2007-11-01

    Full Text Available Abstract Background Patients with malignant tumours of the upper gastrointestinal tract tumours exhibit important alarm symptoms such as dysphagia that warrant clinical investigations. An endoscopic examination of the upper gastrointestinal tract will be required in most cases. This study evaluates the diagnostic potential of index endoscopy in a random population of patients with dysphagia. Methods This is a retrospective analysis of prospectively collected data over 10 years. Patients with previous endoscopic evaluation or upper gastrointestinal pathology were excluded from the study. Data was analysed to see the number and frequency of abnormal findings in upper gastrointestinal tract, and their significance in relation to the presenting symptoms. Results Total number of index endoscopies was 13, 881. 913 patients were included in the study including 465 males (age range: 17–92 years, median: 55 years and 448 females (age range: 18–100, median: 59 years, with male to female ratio of 1.04: 1. Oesophagus was abnormal in 678 cases (74% and biopsies were taken in 428 patients (47%. Superficial oesophagitis, Barrett's oesophagus, oesophageal cancer, and oesophageal ulcer were main histological findings. Age more than 50 years and weight loss were significant predictors of oesophageal cancer (p Conclusion OGD is an effective initial investigation to assess patients with dysphagia, especially males above the age of 50 years. Patients may be started on treatment or referred for further investigations, for example, a barium meal in the absence of any anatomical abnormality.

  19. [Acute hemodynamic effects of upper airway obstruction in normal dogs].

    Science.gov (United States)

    Lin, C C; Lai, D K; Liu, C C

    1990-09-01

    Eight normal dogs were anesthetized to assess the effects of an upper airway obstruction (UAO) on arterial blood gases (ABG) and hemodynamic (HD) parameters. Each dog was fitted with an arterial line, a Swan-Ganz catheter and an endotracheal tube. The HD parameters including heart rate, systolic blood pressure, central venous pressure (CVP), cardiac index (CI), pulmonary capillary wedge pressure (PCWP), systemic vascular resistance index (SVRI), pulmonary vascular resistance index (PVRI), left ventricle stroke work index (LVSWI) and right ventricle stroke work index (RVSWI), were monitored. The baseline ABG and HD parameters were taken prior to endotracheal tube clamping, and then checked at 0.3, 1.5, 3.0, 4.0 and 5.0 minutes. The clamp was subsequently removed to allow spontaneous breathing, and then another set of measurements were taken at 5, 15 and 30 minutes, respectively. The above procedures were then repeated a second time. The results showed that UAO can produce the following: (1) decreases in the CI, PaO2 and pH; (2) increases in the mean systemic and pulmonary arterial pressure, PCWP, SVRI, PVRI, LVSWI, RVSWI, and PaCO2; (3) significant and acute changes in PaO2 and pH, with the most significant changes occurring within 90 seconds after clamping and then reaching a plateau; and (4) repeated UAO increases in SVRI and PVRI. In conclusion, upper airway obstructions may possibly induce serious ABG and HD changes in humans, as it does in normal dogs.

  20. Propofol versus midazolam for upper gastrointestinal endoscopy in cirrhotic patients: a meta-analysis of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Hsiao-Chien Tsai

    Full Text Available Sedation during gastrointestinal endoscopy is often achieved using propofol or midazolam in general population. However, impaired protein synthesis, altered drug metabolism, and compromised hepatic blood flow in patients with liver cirrhosis might affect the pharmacokinetics of sedatives, placing cirrhotic patients undergoing endoscopy at a greater risk of adverse events. The objective of this study was to assess comparative efficacies and safety of propofol and midazolam in cirrhotic patients undergoing endoscopy.Randomized, controlled trials comparing propofol with midazolam in cirrhotic patients undergoing gastrointestinal endoscopy were selected. We performed the meta-analysis, using a random-effect model, the Review Manager, Version 5.2, statistical software package (Cochrane Collaboration, Oxford, UK according to the PRISMA guidelines.Five studies between 2003 and 2012, including 433 patients, were included. Propofol provided a shorter time to sedation (weight mean difference: -2.76 min, 95% confidence interval: -3.00 to -2.51 and a shorter recovery time (weight mean difference -6.17 min, 95% confidence interval: -6.81 to -5.54 than midazolam did. No intergroup difference in the incidence of hypotension, bradycardia, or hypoxemia was observed. Midazolam was associated with the deterioration of psychometric scores for a longer period than propofol.This meta-analysis suggests that Propofol sedation for endoscopy provides more rapid sedation and recovery than midazolam does. The risk of sedation-related side effects for propofol does not differ significantly from that of midazolam. The efficacy of propofol in cirrhotic patients undergoing endoscopy is superior to those of midazolam.

  1. Endoscopy-assisted removal through combined lower and middle meatotomies of an ectopic upper third molar in the sinus associated with a dentigerous cyst

    Directory of Open Access Journals (Sweden)

    E. Emanuelli

    2018-03-01

    Full Text Available The aim of this case report is to present an original conservative technique for the transnasal endoscopy-assisted extraction of an ectopic upper third molar associated with a dentigerous cyst occupying the whole maxillary sinus by means of combined lower and middle meatotomies. The proposed technique is a viable, minimally-invasive alternative to the Caldwell–Luc operation (with or without the repositioning of a bone lid, and also to endoscopic middle meatal antrostomy in cases where this would be unable to ensure adequate access because of the position and size of the ectopic tooth and associated cyst.

  2. Multicenter phase II randomized study evaluating dose-response of antiperistaltic effect of L-menthol sprayed onto the gastric mucosa for upper gastrointestinal endoscopy.

    Science.gov (United States)

    Hiki, Naoki; Kaminishi, Michio; Yasuda, Kenjiro; Uedo, Noriya; Kobari, Masumi; Sakai, Terufumi; Hiratsuka, Takashi; Ohno, Kyota; Honjo, Hajime; Nomura, Sachiyo; Yahagi, Naohisa; Tajiri, Hisao; Suzuki, Hiroaki

    2012-03-01

    Peppermint oil solution was found to be effective for reducing gastric spasm during upper gastrointestinal endoscopy. The aim of the present study was to assess whether the gastric peristalsis-suppressing effect is dose-dependently induced by L-menthol, the major constituent of peppermint oil, and to determine the recommended dose of an L-menthol preparation. In this phase II, multicenter, double-blind, dose-response study, 131 eligible patients were randomly assigned to receive 20 mL of 0.4% L-menthol (n = 32), 0.8% L-menthol (n = 35), 1.6% L-menthol (n = 30), or placebo (n = 34). The primary efficacy measure was the proportion of subjects with no peristalsis in two time periods, 75 to 105 s after treatment and immediately before the completion of endoscopy. The peristalsis-suppressing effect of L-menthol increased dose dependently (5.6%, 32.0%, 47.4% and 52.9% in the 0%, 0.4%, 0.8% and 1.6% groups, respectively: P peristalsis after administration was significantly higher in the 0.8% group (P = 0.015) and 1.6% group (P = 0.009). Adverse events in the L-menthol dose groups occurred with similar frequencies in the placebo group. L-menthol suppresses peristalsis in a dose-dependent manner, and the dose-response reaches a plateau at 0.8% L-menthol. Further Phase III studies are needed to establish the superiority of 0.8% L-menthol over placebo. © 2011 The Authors. Digestive Endoscopy © 2011 Japan Gastroenterological Endoscopy Society.

  3. Hemoglobin, ferritin, vitamin B12 and helicobacter pylori infection: a study in patients underwent upper GI endoscopy at civil hospital karachi

    International Nuclear Information System (INIS)

    Zuberi, B.F.; Asar, S.; Qadeer, R.; Baloch, I.; Saeed, M.

    2007-01-01

    To compare hemoglobin, ferritin, and vitamin B12 levels in patients undergoing upper GI endoscopy according to their Helicobacter pylori status. All patients undergoing upper GI Endoscopy were selected, while patients of active peptic ulcers, malignancy, varices, malabsorption and recent blood donation were excluded. Blood samples for CBC, serum ferritin and vitamin B12 were collected and H.pylori status was ascertained by urease test on gastric biopsy. Differences in mean values of age, ferritin, hemoglobin, MCV and vitamin B12 were done by students t-test. Significant confounding factors were identified on multivariate analysis and were further analyzed by univariate analysis. Two hundred and eighty-five subjects were studied, including 171 males and 114 females. H-pylori was positive in 214 (75.1%) patients. Significantly low levels of hemoglobin (p =0.0), ferritin (p = 0.0) and vitamin B12 (p = 0.0) were found in patients with H-pylori infection. Gender, menopause, contraception and history of peptic ulcer disease were identified as significant confounders. Significantly low levels of hemoglobin, ferritin and vitamin B12 were found in patients with H-pylori infection. (author)

  4. Effect of listening to Vedic chants and Indian classical instrumental music on patients undergoing upper gastrointestinal endoscopy: A randomized control trial.

    Science.gov (United States)

    Padam, Anita; Sharma, Neetu; Sastri, O S K S; Mahajan, Shivani; Sharma, Rajesh; Sharma, Deepak

    2017-01-01

    A high level of preoperative anxiety is common among patients undergoing medical and surgical procedures. Anxiety impacts of gastroenterological procedures on psychological and physiological responses are worth consideration. To analyze the effect of listening to Vedic chants and Indian classical instrumental music on anxiety levels and on blood pressure (BP), heart rate (HR), and oxygen saturation in patients undergoing upper gastrointestinal (GI) endoscopy. A prospective, randomized controlled trial was done on 199 patients undergoing upper GI endoscopy. On arrival, their anxiety levels were assessed using state and trait scores and various physiological parameters such as HR, BP, and SpO 2 . Patients were randomly divided into three groups: Group I of 67 patients who were made to listen prerecorded Vedic chants for 10 min, Group II consisting of 66 patients who listened to Indian classical instrumental music for 10 min, and Group III of 66 controls who remained seated for same period in the same environment. Thereafter, their anxiety state scores and physiological parameters were reassessed. A significant reduction in anxiety state scores was observed in the patients in Group I (from 40.4 ± 8.9 to 38.5 ± 10.7; P classical instrumental music has beneficial effects on alleviating anxiety levels induced by apprehension of invasive procedures and can be of therapeutic use.

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

    Science.gov (United States)

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

    2010-05-01

    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. To determine the effectiveness of lidocaine (L) versus L plus X (LX) for anesthesia in unsedated transnasal endoscopy. 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. 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). 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.

  6. Technical endoscopy

    International Nuclear Information System (INIS)

    Cavalar, K.O.

    1988-01-01

    A survey is provided on different versions of endoscopes, taking into account the new developments of video endoscopy. With a variety of practical examples it is shown that technical tests using endoscopy are a demanding task for nondestructive testing, whose requirements can only be met on a customized basis. (orig./HP) [de

  7. Factors associated with gastro-duodenal disease in patients undergoing upper GI endoscopy at the Korle-Bu Teaching Hospital, Accra, Ghana.

    Science.gov (United States)

    Archampong, Timothy N A; Asmah, Richard H; Wiredu, Edwin K; Gyasi, Richard K; Nkrumah, Kofi N

    2016-06-01

    There is a high prevalence of gastro-duodenal disease in sub-Saharan Africa. Peptic ulcer disease in dyspeptic patients, 24.5%, was comparable to prevalence of gastro-duodenal disease among symptomatic individuals in developed countries (12 - 25%). Limited data exists regarding its associated risk factors despite accumulating evidence indicating that gastroduodenal disease is common in Ghana. This study investigates risk factors associated with gastro-duodenal disease at the Korle-Bu Teaching Hospital, Accra, Ghana. This study utilized a cross-sectional design to consecutively recruit patients referred with upper gastro-intestinal symptoms for endoscopy. The study questionnaire was administered to study participants. Helicobacter pylori infection was confirmed by rapid-urease examination at endoscopy. Of 242 patients sampled; 64 had duodenal ulcer, 66 gastric ulcer, 27gastric cancer and 64 non-ulcer dyspepsia. Nineteen (19) had duodenal and gastric ulcer while 2 had gastric ulcer and cancer. A third (32.6%) of patients had history of NSAID-use. H. pyloriwas associated with gastric ulcer (p=0.033) and duodenal ulcer (p=0.001). There was an increased prevalence of duodenal ulcer in H. pylori-infected patients taking NSAIDs, P=0.003. H. pylori was a major risk factor for peptic ulcer disease. However, NSAID-related gastro-duodenal injury has been shown to be common in H. pylori infected patients. It highlights the need for awareness of the adverse gastro-intestinal effects in a H. pylori endemic area.

  8. An open-label, single-arm study assessing the efficacy and safety of L: -menthol sprayed onto the gastric mucosa during upper gastrointestinal endoscopy.

    Science.gov (United States)

    Hiki, Naoki; Kaminishi, Michio; Tanabe, Satoshi; Fujisaki, Junko; Yoshino, Junji; Iguchi, Mikitaka; Kobayashi, Hiroyuki; Ashida, Kiyoshi; Kawabe, Takao; Kawano, Tatsuyuki; Nomura, Sachiyo; Yahagi, Naohisa; Tajiri, Hisao; Suzuki, Hiroaki

    2011-07-01

    The results of a phase III, placebo-controlled study demonstrated that endoscopic direct spraying of L: -menthol onto the gastric mucosa effectively suppressed gastric peristalsis in the study patients. The aim of the study reported here was to determine whether the anti-peristaltic effect of an L: -menthol preparation facilitates endoscopic examinations in a clinical setting. This was a multicenter, open-label, single-arm trial in which the study cohort comprised patients in whom L: -menthol was likely to be used to facilitate endoscopic examination in clinical settings. The primary outcome was the proportion of subjects with no peristalsis (Grade 1) after treatment and at the end of endoscopy (defined as the complete suppression of gastric peristalsis). This variable was assessed according to the level of anti-Helicobacter pylori immunoglobulin G (IgG) antibody, pepsinogen test results, whether sedation was performed, and whether subjects were considered unsuitable for the use of conventional antispasmodics. Of the 119 enrolled subjects, data from 112 were included in the primary efficacy analysis. Gastric peristalsis was completely suppressed in 37.5% of the patients [42/112 patients; 95% confidence interval (CI) 28.5-47.1]. Subgroup analyses revealed that the rate of peristalsis suppression was significantly higher in patients with elevated levels of anti-H. pylori IgG antibody (26/44, 59.1%; 95% CI 43.2-73.7); P peristalsis during upper gastrointestinal endoscopy.

  9. Use of N-acetylcysteine plus simethicone to improve mucosal visibility during upper GI endoscopy: a double-blind, randomized controlled trial.

    Science.gov (United States)

    Monrroy, Hugo; Vargas, Jose Ignacio; Glasinovic, Esteban; Candia, Roberto; Azúa, Emilio; Gálvez, Camila; Rojas, Camila; Cabrera, Natalia; Vidaurre, Josefa; Álvarez, Natalia; González, Jessica; Espino, Alberto; González, Robinson; Parra-Blanco, Adolfo

    2018-04-01

    Upper GI endoscopy (UGE) is essential for the diagnosis of gastrointestinal diseases. Mucus and bubbles may decrease mucosal visibility. The use of mucolytics could improve visualization. Our aim was to determine whether premedication with simethicone or simethicone plus N-acetylcysteine is effective in improving visibility during UGE. This was a randomized, double-blinded, placebo-controlled trial with 2 control groups: no intervention and water 100 mL (W); and 3 intervention groups: simethicone 200 mg (S); S + N-acetylcysteine (NAC) 500 mg (S+NAC500); and S + NAC 1000 mg (S+NAC1000). The solution was ingested 20 minutes before UGE. Gastric visibility was evaluated in 4 segments with a previously described scale. A score of less than 7 points was defined as adequate visibility (AV). Water volume was used to improve visibility, and adverse reactions were evaluated as a secondary outcome. Multiple group comparison was performed using non-parametric one-way analysis of variance (ANOVA). Two hundred thirty patients were included in the study, 68% female, mean age 49 years. The most common indication for UGE was epigastric pain/dyspepsia (33%). AV was more frequent in the S+NAC500 and S+NAC1000 groups (65% and 67%) compared with no intervention (44%, P = .044) and water (41%, P = .022). The gastric total visibility scale (TVS) was significantly better in the S+NAC500 and S+NAC1000 groups compared with water (P = .03 and P = .008). Simethicone was not different from no intervention and water. S+NAC1000 required less water volume to improve visibility. No adverse reactions from the study drugs were observed. Premedication with S+NAC500 and S+NAC1000 improves visibility during UGE. The use of simethicone did not show improvements in gastric visibility. TVS was worse in patients using water alone. (Clinical trial registration number: NCT 01653171.). Copyright © 2018 American Society for Gastrointestinal Endoscopy. All rights reserved.

  10. An Automatic Bleeding Frame and Region Detection Scheme for Wireless Capsule Endoscopy Videos Based on Interplane Intensity Variation Profile in Normalized RGB Color Space

    Directory of Open Access Journals (Sweden)

    Amit Kumar Kundu

    2018-01-01

    Full Text Available Wireless capsule endoscopy (WCE is an effective video technology to diagnose gastrointestinal (GI disease, such as bleeding. In order to avoid conventional tedious and risky manual review process of long duration WCE videos, automatic bleeding detection schemes are getting importance. In this paper, to investigate bleeding, the analysis of WCE images is carried out in normalized RGB color space as human perception of bleeding is associated with different shades of red. In the proposed method, at first, from the WCE image frame, an efficient region of interest (ROI is extracted based on interplane intensity variation profile in normalized RGB space. Next, from the extracted ROI, the variation in the normalized green plane is presented with the help of histogram. Features are extracted from the proposed normalized green plane histograms. For classification purpose, the K-nearest neighbors classifier is employed. Moreover, bleeding zones in a bleeding image are extracted utilizing some morphological operations. For performance evaluation, 2300 WCE images obtained from 30 publicly available WCE videos are used in a tenfold cross-validation scheme and the proposed method outperforms the reported four existing methods having an accuracy of 97.86%, a sensitivity of 95.20%, and a specificity of 98.32%.

  11. Hindfoot endoscopy

    NARCIS (Netherlands)

    van Dijk, C. Niek

    2006-01-01

    Hindfoot pain can be caused by a variety of pathologies; most of these can be diagnosed and treated by means of endoscopy. The main indications are posterior tibial tenosynovectomy, diagnosis of a peroneus brevis length rupture, peroneal tendon athesiolysis, flexor hallucis longus release, os

  12. Capsule endoscopy

    DEFF Research Database (Denmark)

    Skovsen, Anders Peter; Burcharth, Jakob; Burgdorf, Stefan Kobbelgaard

    2013-01-01

    with ultrasound, MRI, and subsequently a capsule endoscopy. Six months later, the patient presented, and an abdominal CT-scan showed mechanical small bowel obstruction with suspicion of metallic foreign body and perforation. Laparotomy showed perforation, stenosis, and foreign body, approximately 5 cm from...

  13. Upper Gastrointestinal Endoscopy Detection of Synchronous Multiple Primary Cancers in Esophagus and Stomach: Single Center Experience from China

    Directory of Open Access Journals (Sweden)

    Rui Wang

    2012-01-01

    Full Text Available The present study was undertaken to clarify the prevalence and clinicopathological features of synchronous multiple primary cancers (SMPCs under upper gastrointestinal endoscopic examination. We enrolled 45,032 consecutive patients who underwent upper gastrointestinal endoscopic examination for digestive disease from January 2006 to December 2007 in our hospital and analyzed the clinicopathological features of SMPCs in esophagus and stomach. SMPCs are defined as two or over two different cancerous lesions developing in the same or other organs within 6 months. SMPCs were identified in 46 patients (0.1%. The gender ratio was 5.6 : 1 (male/female and the mean age was 59.4 years. Synchronous esophageal and gastric cancers were the most frequent, being seen in 32 patients (0.07%. The most common histological types of SMPCs were squamous cell carcinoma in esophagus and adenocarcinoma in stomach, respectively. There were 27 (59% SMPCs patients who had the history of simultaneous exposure to tobacco smoking and alcohol drinking. Additionally, 32 (78% esophageal squamous cell cancers were associated with tobacco use. And 23 adenocarcinomas of the stomach were associated with Helicobacter pylori infection.

  14. Comparative analysis of upper gastrointestinal endoscopy, double-contrast upper gastrointestinal barium X-ray radiography, and the titer of serum anti-Helicobacter pylori IgG focusing on the diagnosis of atrophic gastritis.

    Science.gov (United States)

    Yamamichi, Nobutake; Hirano, Chigaya; Takahashi, Yu; Minatsuki, Chihiro; Nakayama, Chiemi; Matsuda, Rie; Shimamoto, Takeshi; Takeuchi, Chihiro; Kodashima, Shinya; Ono, Satoshi; Tsuji, Yosuke; Fujishiro, Mitsuhiro; Wada, Ryoichi; Mitsushima, Toru; Koike, Kazuhiko

    2016-04-01

    Upper gastrointestinal endoscopy (UGI-ES) and double-contrast upper gastrointestinal barium X-ray radiography (UGI-XR) are two major image-based methods to diagnose atrophic gastritis, which is mostly induced by Helicobacter pylori infection. However, there have been few studies directly comparing them. Atrophic gastritis was evaluated using the data of 962 healthy subjects who underwent UGI-ES and UGI-XR within 1 year. Based on UGI-ES and UGI-XR, 602 subjects did not have atrophic gastritis and 254 subjects did have it. Considering UGI-ES-based atrophic gastritis as the standard, sensitivity and specificity of UGI-XR-based atrophic gastritis were 92.0 % (254/276) and 92.8 % (602/649), respectively. The seven-grade Kimura-Takemoto classification of UGI-ES-based atrophic gastritis showed a strong and significant association with the four-grade UGI-XR-based atrophic gastritis. Sensitivity and specificity of serum anti-Helicobacter pylori IgG to detect UGI-ES/UGI-XR-based atrophic gastritis were 89.4 % (227/254) and 99.8 % (601/602), indicating that atrophic gastritis can be overlooked according to serum anti-Helicobacter pylori IgG alone.

  15. Virtual endoscopy of the upper urinary tract based on contrast material-enhanced MR urography data sets; Virtuelle Endoskopie des oberen Harntraktes auf der Basis kontrastangehobener MR-Urographie Datensaetze

    Energy Technology Data Exchange (ETDEWEB)

    Nolte-Ernsting, C.C.A.; Krombach, G.; Staatz, G.; Kilbinger, M.; Adam, G.B.; Guenther, R.W. [RWTH Aachen (Germany). Klinik fuer Radiologische Diagnostik

    1999-06-01

    Purpose: To investigate the feasibility of reconstructing a virtual endoscopy from MR imaging data sets of the upper urinary tract. Method: The data obtained from 28 contrast-enhanced MR urographic examinations (5 normal; 23 pathologic) were post-processed to reconstruct a virtual ureterorenoscopy (VURS) using a threshold image segmentation. The visualization of the upper urinary tract was based on the acquisition of T{sub 1}-weighted 3D gradient-echo sequences after intravenous administration of gadolinium-DTPA and a prior injection of low-dose furosemide. Results: The employed MR urography technique created in all 28 cases a complete and strong contrast enhancement of the urinary tract. These 3D sequence data allowed the reconstruction of a VURS, even when the collecting system was not dilated. The best accuracy was provided by the MR urography sequences with the smallest voxel size. Moreover, the data acquisition based on a breath-hold technique has proved superior to that using a respiratory gating. Inside the renal pelvis, all calices could be assessed by turning the virtual endoscope in the appropriate direction. The visualization of the ureteral orifices in the bladder was also possible. All filling defects that were diagnosed by MR urography could be evaluated from the endoluminal view using the VURS. The exact characterization of the lesions based only on the assessment of the surface structure was difficult. Conclusion: A virtual endoscopy of the upper urinary tract can be successfully reconstructed using the data sets of high-resolution 3D MR urography sequences. (orig.) [Deutsch] Ziel: Untersuchungen zur Anwendung der virtuellen Endoskopie auf MR-tomographische Datensaetze des oberen Harntraktes. Methoden: Die Daten von 28 kontrastangehobenen MR-Urographien (5 normal; 23 pathologisch) wurden zur Erstellung einer virtuellen Ureterorenoskopie (VURS) mittels Schwellenwert-Bildsegmentierung nachverarbeitet. Als Grundlage fuer die Darstellung des Harntraktes

  16. Polysomnography evaluation and swallowing endoscopy of patients with Pierre Robin sequence.

    Science.gov (United States)

    Pinheiro Neto, Carlos Diógenes; Alonso, Nivaldo; Sennes, Luiz Ubirajara; Goldenberg, Dov Charles; Santoro, Patrícia de Paula

    2009-01-01

    The Pierre Robin sequence is characterized by micrognathia, glossoptosis and upper airway obstruction. Symptom severity varies, and this makes the treatment of these patients a true challenge. to identify the presence of sleep hypopnea-apnea in patients with Pierre-Robin sequence. retrospective study in which we assessed 14 children with Pierre-Robin sequence, eight girls. The children were submitted to swallowing video-endoscopy study and polysomnography. eight patients were included in this study. Six had normal polysomnography and only one patient had mild central hypopnea-apnea. Swallowing video-endoscopy was normal in five patients and moderate dysphagia was detected in three patients, who were then submitted to gastrostomy. Mandible distraction was carried out in four patients who were also submitted to tracheostomy during the same procedure. dysphagia was more prevalent than sleep apnea. Swallowing video-endoscopy proved to be a dynamic test and one able to detect feeding disorders in patients with Pierre Robin sequence.

  17. Gastrointestinal endoscopy at Amana Municipal Referral Hospital in ...

    African Journals Online (AJOL)

    Gastrointestinal endoscopy at Amana Municipal Referral Hospital in Tanzania: reasons for referral and findings. ... endoscopy findings observed falls within normal range. These findings are important for further development of the endoscopy unit, for streamlining services, training of the required skills, and for planning.

  18. Anesthesia related Complications in Pediatric GI Endoscopy

    Directory of Open Access Journals (Sweden)

    A Sabzevari

    2014-04-01

    Full Text Available Introduction: Elective upper and lower GI endoscopy is usually performed in children on an outpatient basis with the child under sedation or general anesthesia (GA. The objective of this study was to describe Anesthesia related complications in   children undergoing elective GI endoscopy.   Materials and Methods: The study design was descriptive on 1388 patients undergoing elective GI endoscopy in Sheikh Hospital from 2009 to 2013. All patient received propofol or standard inhalational anesthesia. We examined patients’ demographic data  ,  location of GI endoscopy ,  perioperative vital singe ,  recovery time , respiratory and cardiac complications , post operative nausea and vomiting , agitation , diagnosis and outcome   Results: Pediatric patients aged 2 to 17 years. 29 % of elective GI endoscopy was upper GI endoscopy and 70.3 % was lower GI endoscopy and 0.7 was both of them. 47.7 % of Pediatric patients were female and 52.3 % was male. We haven’t significant or fatal anesthesia related respiratory and cardiac complications (no apnea, no cardiac arrest. 8 patients (0.5% have transient bradicardia in post operative care Unit. 83 patients (5.9% have post operative nausea and vomiting controlled by medication.  6 patients (0.4% have post operative agitation controlled by medication.   Conclusions: General anesthesia and deep sedation in children undergoing elective GI endoscopy haven’t significant or fatal anesthesia related complications. We suggest Anesthesia for infants, young children, children with neurologic impairment, and some anxious older children undergoing elective GI endoscopy. Keyword: Anesthesia, Complication, Endoscopy, Pediatric.

  19. The Upper Bound for GMRES on Normal Tridiagonal Toeplitz Linear System

    Directory of Open Access Journals (Sweden)

    R. Doostaki∗

    2015-09-01

    Full Text Available The Generalized Minimal Residual method (GMRES is often used to solve a large and sparse system Ax = b. This paper establishes error bound for residuals of GMRES on solving an N × N normal tridiagonal Toeplitz linear system. This problem has been studied previously by Li [R.-C. Li, Convergence of CG and GMRES on a tridiagonal Toeplitz linear system, BIT 47 (3 (2007 577-599.], for two special right-hand sides b = e1, eN . Also, Li and Zhang [R.-C. Li, W. Zhang, The rate of convergence of GMRES on a tridiagonal Toeplitz linear system, Numer. Math. 112 (2009 267-293.] for non-symmetric matrix A, presented upper bound for GMRES residuals. But in this paper we establish the upper bound on normal tridiagonal Toeplitz linear systems for special right-hand sides b = b(lel, for 1  l  N

  20. A 12 years audit of upper gastrointestinal endoscopic procedures

    International Nuclear Information System (INIS)

    Khurram, M.; Khaar, H.B.; Hasan, Z.; Umar, M.; Javed, S.; Asghar, T.; Minhas, Z.; Akbar, A.; Atta, N.; Nassar, F.; Sultana, Q.; Pervaiz, A.; Masoom, A.

    2003-01-01

    Objective: Evaluation of upper gastrointestinal (GI) endoscopy in terms of indications, diagnostic efficacy, and diseases diagnosed. Results: Of the 8481 patients, 4935 (58.2%) were female and 3546 (41.8%) male. Mean patient age was 40.5 years. Dyspepsia (42.6%), upper GI bleed (32.8%), and evaluation of chronic liver disease (10.2%) were common indications of the procedure. An endoscopic diagnosis was possible in 82.6% patients. Varices, gastritis, duodenitis, and combined lesions were common endoscopic diagnosis. Gastritis and duodenitis were most frequent causes of upper GI bleed. We noted more gastric ulcers compared to duodenal ulcers. Females had significantly more normal endoscopies, p-value = 0.02. Conclusion: Upper GI endoscopy is an effective procedure. Dyspepsia evaluation is commonest indication for upper GI endoscopy in our patients. Etiology of upper GI bleed, and incidence of duodenal ulcer compared to gastric ulcer in our patients are different than described in literature. Females have significantly more normal endoscopies. (author)

  1. Unusual idiopathic normal pressure hydrocephalus patient with marked asymmetric and upper body parkinsonism

    Directory of Open Access Journals (Sweden)

    Kyunghun Kang

    2016-01-01

    Full Text Available Asymmetry of parkinsonian symptoms is strong evidence toward the diagnosis of Parkinson's disease (PD. Lower body parkinsonism is characteristic in idiopathic normal pressure hydrocephalus (INPH. We report an unusual INPH patient with marked asymmetric and upper body parkinsonism. An 83-year-old man presented with gait impairment and asymmetric clumsiness of movement. According to the Unified Parkinson's Disease Rating Scale (UPDRS, the motor subscore was 12 in the left limb and 8 in the right. The score was 14 for both the upper and lower body. After the cerebrospinal fluid tap test (CSFTT, he showed marked improvement in the upper body score. A loss of asymmetry of parkinsonian signs, with greater improvement in the left limb, was presented. Fluorinated N-3-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl-nortropane (F-18 FP-CIT positron emission tomography (PET imaging was normal. In the differential diagnosis of elderly patients presenting with parkinsonism compatible with PD, we might need to consider a diagnosis of INPH.

  2. An evaluation of the Integrated Pulmonary Index (IPI) for the detection of respiratory events in propofol sedated patients undergoing upper gastrointestinal endoscopy

    NARCIS (Netherlands)

    Vaessen, Paul H H B; Knape, JTA

    2016-01-01

    Background: Monitoring of patients respiratory and ventilatory status during moderate-to-deep sedation in upper gastrointestinal (GI) endoscopic procedures may enable early recognition of altered respiratory patterns with potential danger for vital functions. The current standards of care for

  3. Wireless Capsule Endoscopy Detects Meckel’s Diverticulum in a Child with Unexplained Intestinal Blood Loss

    Directory of Open Access Journals (Sweden)

    I. Xinias

    2012-10-01

    Full Text Available Meckel’s diverticulum (MD is the most common congenital anomaly of the gastrointestinal (GI tract, affecting about 2% of the population. Most cases of Meckel’s diverticula are asymptomatic. The diagnosis of symptomatic MD is often difficult to make. We report the case of an 8-year-old boy who presented with GI bleeding due to MD. The diagnostic difficulties after an initial negative endoscopic evaluation and the diagnostic value of the various endoscopic procedures are discussed. The patient had suffered from bright red stools for 20 h before hospital admission. GI scintigraphy with 99mTc-Na-pertechnetate was negative for heterotopic gastric tissue in the small bowel area. Colonoscopy performed in order to exclude Crohn’s disease was also negative. He was placed on ranitidine at a dose of 6 mg/kg body weight twice daily. The patient remained asymptomatic over a period of 6 months before he was readmitted due to macroscopic rectal bleeding. Upper endoscopy and colonoscopy used to investigate the source of bleeding showed normal macroscopic findings. Radiolabeling of blood constituents with 99mTc on delayed imaging showed radionucleotide concentration in the ascending and transverse colon suggestive of a lesion in the ileocecal area. Further investigation with the use of wireless capsule endoscopy revealed a MD. Wireless capsule endoscopy may thus be indicated for patients with GI blood loss when other diagnostic methods, such as upper and lower endoscopy and colonoscopy, have failed to identify the source of bleeding.

  4. Wireless Capsule Endoscopy Detects Meckel's Diverticulum in a Child with Unexplained Intestinal Blood Loss.

    Science.gov (United States)

    Xinias, I; Mavroudi, A; Fotoulaki, M; Tsikopoulos, G; Kalampakas, A; Imvrios, G

    2012-09-01

    Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal (GI) tract, affecting about 2% of the population. Most cases of Meckel's diverticula are asymptomatic. The diagnosis of symptomatic MD is often difficult to make. We report the case of an 8-year-old boy who presented with GI bleeding due to MD. The diagnostic difficulties after an initial negative endoscopic evaluation and the diagnostic value of the various endoscopic procedures are discussed. The patient had suffered from bright red stools for 20 h before hospital admission. GI scintigraphy with (99m)Tc-Na-pertechnetate was negative for heterotopic gastric tissue in the small bowel area. Colonoscopy performed in order to exclude Crohn's disease was also negative. He was placed on ranitidine at a dose of 6 mg/kg body weight twice daily. The patient remained asymptomatic over a period of 6 months before he was readmitted due to macroscopic rectal bleeding. Upper endoscopy and colonoscopy used to investigate the source of bleeding showed normal macroscopic findings. Radiolabeling of blood constituents with (99m)Tc on delayed imaging showed radionucleotide concentration in the ascending and transverse colon suggestive of a lesion in the ileocecal area. Further investigation with the use of wireless capsule endoscopy revealed a MD. Wireless capsule endoscopy may thus be indicated for patients with GI blood loss when other diagnostic methods, such as upper and lower endoscopy and colonoscopy, have failed to identify the source of bleeding.

  5. Spatial arrangement and size distribution of normal faults, Buckskin detachment upper plate, Western Arizona

    Science.gov (United States)

    Laubach, S. E.; Hundley, T. H.; Hooker, J. N.; Marrett, R. A.

    2018-03-01

    Fault arrays typically include a wide range of fault sizes and those faults may be randomly located, clustered together, or regularly or periodically located in a rock volume. Here, we investigate size distribution and spatial arrangement of normal faults using rigorous size-scaling methods and normalized correlation count (NCC). Outcrop data from Miocene sedimentary rocks in the immediate upper plate of the regional Buckskin detachment-low angle normal-fault, have differing patterns of spatial arrangement as a function of displacement (offset). Using lower size-thresholds of 1, 0.1, 0.01, and 0.001 m, displacements range over 5 orders of magnitude and have power-law frequency distributions spanning ∼ four orders of magnitude from less than 0.001 m to more than 100 m, with exponents of -0.6 and -0.9. The largest faults with >1 m displacement have a shallower size-distribution slope and regular spacing of about 20 m. In contrast, smaller faults have steep size-distribution slopes and irregular spacing, with NCC plateau patterns indicating imposed clustering. Cluster widths are 15 m for the 0.1-m threshold, 14 m for 0.01-m, and 1 m for 0.001-m displacement threshold faults. Results demonstrate normalized correlation count effectively characterizes the spatial arrangement patterns of these faults. Our example from a high-strain fault pattern above a detachment is compatible with size and spatial organization that was influenced primarily by boundary conditions such as fault shape, mechanical unit thickness and internal stratigraphy on a range of scales rather than purely by interaction among faults during their propagation.

  6. Endoscopy services in KwaZulu-Natal Province, South Africa, are ...

    African Journals Online (AJOL)

    There were 0.06 registered gastroenterologists (GEs) per 100 000 population. Each endoscopist performed an average of 263 endoscopies per annum. There were 1.18 endoscopy rooms available per unit, and two units had on-site fluoroscopy available. The average waiting period for an upper endoscopy was 27 (range 7 ...

  7. A Case of Esophagopericardial Fistula as a Complication of Upper ...

    African Journals Online (AJOL)

    [10] The barium swallows done in this patient were normal and did not reveal the EPF (gross filling of the pericardial sac with contrast material) and is consistent with the reported barium swallow sensitivity of 69‑80[11] for the detection of esophagopericardial fistula. Upper gastro‑intestinal endoscopy (UGIE) may show the ...

  8. The future of wireless capsule endoscopy.

    Science.gov (United States)

    Swain, Paul

    2008-07-14

    We outline probable and possible developments with wireless capsule endoscopy. It seems likely that capsule endoscopy will become increasingly effective in diagnostic gastrointestinal endoscopy. This will be attractive to patients especially for cancer or varices detection because capsule endoscopy is painless and is likely to have a higher take up rate compared to conventional colonoscopy and gastroscopy. Double imager capsules with increased frame rates have been used to image the esophagus for Barrett's and esophageal varices. The image quality is not bad but needs to be improved if it is to become a realistic substitute for flexible upper and lower gastrointestinal endoscopy. An increase in the frame rate, angle of view, depth of field, image numbers, duration of the procedure and improvements in illumination seem likely. Colonic, esophageal and gastric capsules will improve in quality, eroding the supremacy of flexible endoscopy, and become embedded into screening programs. Therapeutic capsules will emerge with brushing, cytology, fluid aspiration, biopsy and drug delivery capabilities. Electrocautery may also become possible. Diagnostic capsules will integrate physiological measurements with imaging and optical biopsy, and immunologic cancer recognition. Remote control movement will improve with the use of magnets and/or electrostimulation and perhaps electromechanical methods. External wireless commands will influence capsule diagnosis and therapy and will increasingly entail the use of real-time imaging. However, it should be noted that speculations about the future of technology in any detail are almost always wrong.

  9. Endoscopy in Amphibians.

    Science.gov (United States)

    Chai, Norin

    2015-09-01

    Despite advances in exotic animal endoscopy, descriptions involving amphibians are scarce. Amphibian endoscopy shares some similarities with reptiles, especially in lizards. Selected procedures are discussed, including stomatoscopy, gastroscopy, coelioscopy, and biopsy of coelomic organs and lesions. This short overview provides the practitioner with pragmatic advice on how to conduct safe and effective endoscopic examinations in amphibians. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. NORMAL NASOPHARYNGEAL MICROFLORA AS A RESERVOIR OF MULTIRESISTANT STRAINS OF UPPER RESPIRATORY TRACT INFECTIONS

    Directory of Open Access Journals (Sweden)

    Minukhin V.V.

    2015-05-01

    Full Text Available Nasopharinheal carriage of bacteria may play a central role in the development and spread of respiratory infections. In addition, so-called "healthy" carriage is often transformed under the influence of various factors into an active infection.It is necessary to take into account not only the range of possible pathogens, but also trends in the development of antibiotic resistance of leading etiologic agents while choosing tactics of antimicrobial therapy. The investigation was designed to study the role of normal microflora of the nasopharynx as a reservoir of resistant strains of respiratory infections. Materials and Methods. Fifty three healthy individuals and 168 patients with acute upper respiratory tract infections who had been treated in CEHC "Kharkiv Municipal Clinical Hospital № 30" were examined. Microbiological study included isolation and identification of pathogens in accordance with the Order of the Ministry of Health Care № 535 from 22.04.1985., determination of the sensitivity of microorganisms to antibiotics by diffusion method according to the Order of the Ministry of Health Care of Ukraine № 167 from 05.04.2007. Results and discussion. Bacteriological study of nasal swabs of healthy people showed that the composition of the microflora of the nasopharynx contained potentially pathogenic microorganisms. Among the isolated microorganisms essential place was occupied by S. epidermidis and S. aureus, both in monoculture and association. Epidermal staphylococcus was isolated in 36 % and Staphylococcus aureus in 27% of cases. Pneumococcus and hemolytic streptococcus of group A were isolated in 23 and 14% of cases, respectively. One hundred and eighty strains of opportunistic microorganisms were isolated in the study of nasopharyngeal microflora of patients with acute upper respiratory tract infection. The leading role belonged to S. pyogenes (40.5% and S.epidermidis (33,3%. S. aureus (12,8% and S.pneumoniae (10,6% were next

  11. Anomlus pulmonary venous return aaccompanied by normal superior pulmonary veins in the left upper lobe: A case report

    International Nuclear Information System (INIS)

    Kim, Dong Eon; Kang, Min Jin; Lee, Ji Hae; Bae, Kyung Eun; Kim, Jae Hyung; Kang, Tae Kyung; Kim, Soung Hee; Kim, Ji Young; Jeong, Myeong Ja; Kim, Soo Hyun

    2017-01-01

    Partial anomalous pulmonary venous return is a rare congenital pulmonary venous anomaly, in which some of the pulmonary veins drain into the systemic circulation rather than the left atrium. Many variants of partial anomalous pulmonary venous return have been reported. We present a rare type of partial anomalous pulmonary venous return in which the anomalous left upper lobe pulmonary vein drained into the left innominate vein via the vertical vein, accompanying the left upper lobe pulmonary vein in the normal location

  12. Anomlus pulmonary venous return aaccompanied by normal superior pulmonary veins in the left upper lobe: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Eon; Kang, Min Jin; Lee, Ji Hae; Bae, Kyung Eun; Kim, Jae Hyung; Kang, Tae Kyung; Kim, Soung Hee; Kim, Ji Young; Jeong, Myeong Ja; Kim, Soo Hyun [Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2017-08-15

    Partial anomalous pulmonary venous return is a rare congenital pulmonary venous anomaly, in which some of the pulmonary veins drain into the systemic circulation rather than the left atrium. Many variants of partial anomalous pulmonary venous return have been reported. We present a rare type of partial anomalous pulmonary venous return in which the anomalous left upper lobe pulmonary vein drained into the left innominate vein via the vertical vein, accompanying the left upper lobe pulmonary vein in the normal location.

  13. Lower gastrointestinal endoscopies results

    Directory of Open Access Journals (Sweden)

    Ahmet Bozdağ

    2014-12-01

    Full Text Available Objectives: Endoscopic examinations have great potential in early diagnosis of colorectal adenomas and carcinomas with reducing to colorectal cancer incidence and mortality. We aimed to evaluate for diagnostic purposeful lower gastrointestinal endoscopic procedures in the second step state hospital retrospectively Methods: Between June 2010 and June 2013, we evaluated 278 patients with rectal bleeding, constipation and abdominal pain detected by lower gastrointestinal endoscopic procedures retrospectively. Results: The mean age of the patients was 54.8 ± 16.8 (15-90 year, respectively. 172 (61.9% of the patients were male and 106 (38.1% of the patients were female. 116 (41.7% of the patients was performed rectosigmoidoscopy and 162 (58.3% of the patients was performed colonoscopy. 51(18.3% of our patients were normal. 10 (3.6% of patients had colorectal cancer, 11(3.9% of patients had inflammatory bowel disease, 8 (2.9% of patients had parasitosis, 31(11.1% of patients had colorectal polyps, 12 (4.3% , in patients had diverticular disease, 2 (0.7% patients had rectal ulcer, 25 (9% patients had anal fissure and 159 (57.2% of the patients had hemorrhoidal disease. Conclusion: Lower gastrointestinal endoscopy is a method been the gold standard with a low complication rate and that can be easily applied in the evaluation to pathology of colorectal and anal canal. J Clin Exp Invest 2014; 5 (4: 580-582

  14. SEMG analysis of astronaut upper arm during isotonic muscle actions with normal standing posture

    Science.gov (United States)

    Qianxiang, Zhou; Chao, Ma; Xiaohui, Zheng

    sEMG analysis of astronaut upper arm during isotonic muscle actions with normal standing posture*1 Introduction Now the research on the isotonic muscle actions by using Surface Electromyography (sEMG) is becoming a pop topic in fields of astronaut life support training and rehabilitations. And researchers paid more attention on the sEMG signal processes for reducing the influence of noise which is produced during monitoring process and the fatigue estimation of isotonic muscle actions with different force levels by using the parameters which are obtained from sEMG signals such as Condition Velocity(CV), Median Frequency(MDF), Mean Frequency(MNF) and so on. As the lucubrated research is done, more and more research on muscle fatigue issue of isotonic muscle actions are carried out with sEMG analysis and subjective estimate system of Borg scales at the same time. In this paper, the relationship between the variable for fatigue based on sEMG and the Borg scale during the course of isotonic muscle actions of the upper arm with different contraction levels are going to be investigated. Methods 13 young male subjects(23.4±2.45years, 64.7±5.43Kg, 171.7±5.41cm) with normal standing postures were introduced to do isotonic actions of the upper arm with different force levels(10% MVC, 30%MVC and 50%MVC). And the MVC which means maximal voluntary contraction was obtained firstly in the experiment. Also the sEMG would be recorded during the experiments; the Borg scales would be recorded for each contraction level. By using one-third band octave method, the fatigue variable (p) based on sEMG were set up and it was expressed as p = i g(fi ) · F (fi ). And g(fi ) is defined as the frequent factor which was 0.42+0.5 cos(π fi /f0 )+0.08 cos(2π fi /f0 ), 0 f0 . According to the equations, the p could be computed and the relationship between variable p and the Borg scale would be investigated. Results In the research, three kinds of fitted curves between variable p and Borg

  15. Quality metrics in endoscopy.

    Science.gov (United States)

    Gurudu, Suryakanth R; Ramirez, Francisco C

    2013-04-01

    Endoscopy has evolved in the past 4 decades to become an important tool in the diagnosis and management of many digestive diseases. Greater focus on endoscopic quality has highlighted the need to ensure competency among endoscopists. A joint task force of the American College of Gastroenterology and the American Society for Gastrointestinal Endoscopy has proposed several quality metrics to establish competence and help define areas of continuous quality improvement. These metrics represent quality in endoscopy pertinent to pre-, intra-, and postprocedural periods. Quality in endoscopy is a dynamic and multidimensional process that requires continuous monitoring of several indicators and benchmarking with local and national standards. Institutions and practices should have a process in place for credentialing endoscopists and for the assessment of competence regarding individual endoscopic procedures.

  16. Wireless capsule endoscopy

    Science.gov (United States)

    Iddan, Gavriel; Meron, Gavriel; Glukhovsky, Arkady; Swain, Paul

    2000-05-01

    We have developed a new type of endoscopy, which for the first time allows painless endoscopic imaging of the whole of the small bowel. This procedure involves a wireless capsule endoscope and we describe here its successful testing in humans.

  17. THE USE OF THE FORCEPS BIOPSY AS AN AUXILIARY TECHNIQUE FOR THE VISUALIZATION OF THE MAJOR DUODENAL PAPILLA USING THE FOWARD-VIEWING UPPER ENDOSCOPY

    Directory of Open Access Journals (Sweden)

    Nathalia Saber de ANDRADE

    Full Text Available ABSTRACT BACKGROUND: - Conventional esophagogastroduodenoscopy is the best method for evaluation of the upper gastrointestinal tract, but it has limitations for the identification of the major duodenal papilla, even after the use of the straightening maneuver. Side-viewing duodenoscope is recommended for optimal examination of major duodenal papilla in patients at high risk for lesions in this region. OBJECTIVE: To evaluate the use of the biopsy forceps during conventional esophagogastroduodenoscopy as an additional tool to the straightening maneuver, in the evaluation of the major duodenal papilla. METHODS: A total of 671 patients were studied between 2013 and 2015, with active major duodenal papilla search in three endoscope steps: not straightened, straightened and use of the biopsy forceps after straightening. In all of them it was recorded whether: major duodenal papilla was fully visualized (position A, partially visualized (position B or not visualized (position C. If major duodenal papilla was not fully visualized, patients continued to the next step. RESULTS: A total of 341 were female (50.8% with mean age of 49 years. Of the 671 patients, 324 (48.3% major duodenal papilla was identified in position A, 112 (16.7% in position B and 235 (35% in position C. In the 347 patients who underwent the straightening maneuver, position A was found in 186 (53.6%, position B in 51 (14.7% and position C in 110 (31.7%. Of the 161 remaining patients and after biopsy forceps use, position A was seen in 94 (58.4%, position B in 14 (8.7% and position C in 53 (32.9%. The overall rate of complete visualization of major duodenal papilla was 90%. CONCLUSION: The use of the biopsy forceps significantly increased the total major duodenal papilla visualization rate by 14%, reaching 604/671 (90% of the patients (P<0.01 and it can be easily incorporated into the routine endoscopic examination of the upper gastrointestinal tract.

  18. Gastric polyps: a retrospective analysis of 26,000 digestive endoscopies

    OpenAIRE

    Morais, Drausio Jefferson; Yamanaka, Ademar; Zeitune, José Murilo Robilotta; Andreollo, Nelson Adami

    2007-01-01

    BACKGROUND: Gastric polyps are small gastric lesions, asymptomatic in most cases and are generally discovered inadvertently during upper digestive endoscopy. AIM: To retrospectively review the characteristics and frequency of gastric polyps, derived from the gastric mucosal epithelium in a large series of endoscopies. METHODS: One hundred and fifty three patients in a series of 26,000 consecutive upper digestive endoscopies done over a 5-year period, being that each patient had only one exami...

  19. Impact of different IMRT techniques to improve conformity and normal tissue sparing in upper esophageal cancer

    Directory of Open Access Journals (Sweden)

    Amin E Amin

    2015-03-01

    Full Text Available Purpose: Intensity modulated radiotherapy (IMRT for cervical esophageal cancer is challenging. Although IMRT techniques using inverse planning algorithms are facilitating the treatment planning process, the irradiation dose to the normal tissues can be a critical issue. This study was performed to investigate the effect of beam numbers and their directions and local optimization on: (1 dose conformity and homogeneity to the planning target volume (PTV and (2 dose to the organ at risks (OARs.Methods: Four upper esophageal cancer cases were randomly selected for this treatment planning study. Eight IMRT plans were generated for each case with the same dose-volume constraints but with different beam numbers and arrangements. Local optimization using regular structures drawn automatically around the PTV with margins from 0.5-1.5 cm was performed. IMRT plans were evaluated with respect to isodose distributions, dose-volume histograms (DVHs parameters, homogeneity index (HI, and conformity index (CI. The statistical comparison between the types of plans was done using the One Way ANOVA test.Results: The results showed that IMRT using three or five beams was not sufficient to obtain good dose optimization. The seven field plans showed the best coverage for the PTV with tolerable doses for the OARs, and the beam orientation was very critical. Increasing beams (Bs number from 7 to 13 did not show significant differences in the PTV coverage, while the mean lung dose was increased. The PTV coverage were 95.1, 95.1, 98.1, 97.3, 97.3, 97.3, 97.0, and 97.0% for 3Bs, 5Bs, 7Bs, 9Bs, 13Bs, 7Bs(30, 7Bs(60 (beam angles were changed from 0o to 30o and 60o, and 7Bs(R (seven IMRT plans with ring, respectively. The mean heart dose did not exceed 0.36 Gy with p < 0.05. For lung doses, the best plan was the one with 9Bs which reduced lung volume doses V20Gy (% and V30Gy (%, and reduced mean lung dose from 5.4 to 4.5 Gy with p < 0.05 for 7Bs(R plans. IMRT improved the

  20. Upper-airway flow limitation and transcutaneous carbon dioxide during sleep in normal pregnancy.

    Science.gov (United States)

    Rimpilä, Ville; Jernman, Riina; Lassila, Katariina; Uotila, Jukka; Huhtala, Heini; Mäenpää, Johanna; Polo, Olli

    2017-08-01

    Sleep during pregnancy involves a physiological challenge to provide sufficient gas exchange to the fetus. Enhanced ventilatory responses to hypercapnia and hypoxia may protect from deficient gas exchange, but sleep-disordered breathing (SDB) may predispose to adverse events. The aim of this study was to analyze sleep and breathing in healthy pregnant women compared to non-pregnant controls, with a focus on CO 2 changes and upper-airway flow limitation. Healthy women in the third trimester and healthy non-pregnant women with normal body mass index (BMI) were recruited for polysomnography. Conventional analysis of sleep and breathing was performed. Transcutaneous carbon dioxide (TcCO 2 ) was determined for each sleep stage. Flow-limitation was analyzed using the flattening index and TcCO 2 values were recorded for every inspiration. Eighteen pregnant women and 12 controls were studied. Pregnancy was associated with shorter sleep duration and more superficial sleep. Apnea-hypopnea index, arterial oxyhemoglobin desaturation, flow-limitation, snoring or periodic leg movements were similar in the two groups. Mean SaO 2 and minimum SaO 2 were lower and average heart rate was higher in the pregnant group. TcCO 2 levels did not differ between groups but variance of TcCO 2 was smaller in pregnant women during non-rapid eye movement (NREM). TcCO 2 profiles showed transient TcCO 2 peaks, which seem specific to pregnancy. Healthy pregnancy does not predispose to SDB. Enhanced ventilatory control manifests as narrowing threshold of TcCO 2 between wakefulness and sleep. Pregnant women have a tendency for rapid CO 2 increases during sleep which might have harmful consequences if not properly compensated. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Robotics in endoscopy.

    Science.gov (United States)

    Klibansky, David; Rothstein, Richard I

    2012-09-01

    The increasing complexity of intralumenal and emerging translumenal endoscopic procedures has created an opportunity to apply robotics in endoscopy. Computer-assisted or direct-drive robotic technology allows the triangulation of flexible tools through telemanipulation. The creation of new flexible operative platforms, along with other emerging technology such as nanobots and steerable capsules, can be transformational for endoscopic procedures. In this review, we cover some background information on the use of robotics in surgery and endoscopy, and review the emerging literature on platforms, capsules, and mini-robotic units. The development of techniques in advanced intralumenal endoscopy (endoscopic mucosal resection and endoscopic submucosal dissection) and translumenal endoscopic procedures (NOTES) has generated a number of novel platforms, flexible tools, and devices that can apply robotic principles to endoscopy. The development of a fully flexible endoscopic surgical toolkit will enable increasingly advanced procedures to be performed through natural orifices. The application of platforms and new flexible tools to the areas of advanced endoscopy and NOTES heralds the opportunity to employ useful robotic technology. Following the examples of the utility of robotics from the field of laparoscopic surgery, we can anticipate the emerging role of robotic technology in endoscopy.

  2. Normal and sonographic anatomy of selected peripheral nerves. Part II: Peripheral nerves of the upper limb

    Directory of Open Access Journals (Sweden)

    Berta Kowalska

    2012-06-01

    Full Text Available The ultrasonographic examination is frequently used for imaging peripheral nerves. It serves to supplement the physical examination, electromyography, and magnetic resonance imaging. As in the case of other USG imaging studies, the examination of peripheral nerves is non-invasive, well-tolerated by patients, and relatively inexpensive. Part I of this article series described in detail the characteristic USG picture of peripheral nerves and the proper examination technique, following the example of the median nerve. This nerve is among the most often examined peripheral nerves of the upper limb. This part presents describes the normal anatomy and ultrasound picture of the remaining large nerve branches in the upper extremity and neck – the spinal accessory nerve, the brachial plexus, the suprascapular, axillary, musculocutaneous, radial and ulnar nerves. Their normal anatomy and ultrasonographic appearance have been described, including the division into individual branches. For each of them, specific reference points have been presented, to facilitate the location of the set trunk and its further monitoring. Sites for the application of the ultrasonographic probe at each reference point have been indicated. In the case of the ulnar nerve, the dynamic component of the examination was emphasized. The text is illustrated with images of probe positioning, diagrams of the normal course of the nerves as well as a series of ultrasonographic pictures of normal nerves of the upper limb. This article aims to serve as a guide in the ultrasound examination of the peripheral nerves of the upper extremity. It should be remembered that a thorough knowledge of the area’s topographic anatomy is required for this type of examination.

  3. Normalization.

    Science.gov (United States)

    Cuevas, Eduardo J.

    1997-01-01

    Discusses cornerstone of Montessori theory, normalization, which asserts that if a child is placed in an optimum prepared environment where inner impulses match external opportunities, the undeviated self emerges, a being totally in harmony with its surroundings. Makes distinctions regarding normalization, normalized, and normality, indicating how…

  4. Gastric cancer missed at endoscopy

    African Journals Online (AJOL)

    Ahmed Gado

    2012-09-21

    Sep 21, 2012 ... fore endoscopy taking into account risk factors for cancer and the clinical presentation. Careful examination of the stomach during endoscopy should be performed in order not to miss any lesion. All gastric ulcers must be biopsied and a repeat endoscopy be performed following a course of acid suppres-.

  5. Analysis on actual state of selective upper gastrointestinal study in medical examination

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Seong Ho; Son, Soon Yong; Joo, Mi Hwa; Kim, Chang Bok; Kim, Keon Chung [Asan Medical Center, Asan (Korea, Republic of)

    1999-04-01

    The purpose of this study is to present controversial point and reform measurements by analysing factors having important effect on selection of upper gastrointestinal study in total health promotion. We examined 200 persons for this study, who visited for upper gastrointestinal study from January to February in 1999. We classified this group into Endoscopy, Upper gastrointestinal series, and sleeping endoscopy. We also investigated standard of satisfaction and factors having effect on selection of each study. As is results, in the motive of selection, Item of 'making accurate observation' and 'without pain' was 39.3% and 34.7%, respectively. In this study, sleeping endoscopy was 45.7%, but on the other side upper gastrointestinal series was low 22.6%(P<0.05). In the standard of preference of study, the man was 55.7% in the endoscopy, and the woman was 61.8% in the upper gastrointestinal series(P<0.05). The standard of preference of upper gastrointestinal series show that it was satisfied on the whole irrespective of sex, dwelling place, age, occupation, and level of education. In the selection of study, one's own will was showed the highest frequency, and family inducement was showed second(P<0.05). Persons over 60% were examined before the same study. Selection of upper gastrointestinal series was 47.9% of person with normal findings, and endoscopy and sleeping endoscopy was over 70% with gastritis, gastric and duodenal(P<0.01). For one's accurate selection of examination, it is important that objective and credible information should be given to a recipient for examination.

  6. Analysis on actual state of selective upper gastrointestinal study in medical examination

    International Nuclear Information System (INIS)

    Kang, Seong Ho; Son, Soon Yong; Joo, Mi Hwa; Kim, Chang Bok; Kim, Keon Chung

    1999-01-01

    The purpose of this study is to present controversial point and reform measurements by analysing factors having important effect on selection of upper gastrointestinal study in total health promotion. We examined 200 persons for this study, who visited for upper gastrointestinal study from January to February in 1999. We classified this group into Endoscopy, Upper gastrointestinal series, and sleeping endoscopy. We also investigated standard of satisfaction and factors having effect on selection of each study. As is results, in the motive of selection, Item of 'making accurate observation' and 'without pain' was 39.3% and 34.7%, respectively. In this study, sleeping endoscopy was 45.7%, but on the other side upper gastrointestinal series was low 22.6%(P<0.05). In the standard of preference of study, the man was 55.7% in the endoscopy, and the woman was 61.8% in the upper gastrointestinal series(P<0.05). The standard of preference of upper gastrointestinal series show that it was satisfied on the whole irrespective of sex, dwelling place, age, occupation, and level of education. In the selection of study, one's own will was showed the highest frequency, and family inducement was showed second(P<0.05). Persons over 60% were examined before the same study. Selection of upper gastrointestinal series was 47.9% of person with normal findings, and endoscopy and sleeping endoscopy was over 70% with gastritis, gastric and duodenal(P<0.01). For one's accurate selection of examination, it is important that objective and credible information should be given to a recipient for examination

  7. Cardiorespiratory changes during upper gastrointestinal endoscopy ...

    African Journals Online (AJOL)

    Mild to moderate hypoxia was found in 19 (47.5%) patients. Severe hypoxia was found in 5 (12.5%) patients.The variables that reached statistical significance for desaturation were age greater than 50 years and duration longer than 27 minutes. Changes in pulse rate were significant post-sedation, during probe insertion, ...

  8. Upper Gastro-intestinal'Fibre-Optic Endoscopy

    African Journals Online (AJOL)

    1974-04-27

    Apr 27, 1974 ... When severe gastritis and stoma- titis (which are of dubious clinical significance and hardly amenable to radiological detection) were excluded, an ab- ..... perience and great care. This study was supported by the South African Medical. Research Council. REFERENCES. 1. Hirshowitz, B. 1., Curtiss, L. E., ...

  9. Association between the facial type and morphology of the upper central incisor in normal occlusion subjects.

    Science.gov (United States)

    Paranhos, Luiz Renato; Zaroni, Miller; Carli, João Paulo de; Okamoto, Roberta; Zogheib, Lucas Villaça; Torres, Fernando César

    2014-01-01

    The purpose of this study was to verify the association between the facial type and the morphology of the upper central incisor, to potentially provide a guide for artificial tooth selection in esthetic and prosthetic rehabilitation. The sample consisted of 51 lateral teleradiographs (lateral cephalometric radiographs) and cast models of subjects with a naturally optimal occlusion and at least four of the six keys of Andrews, for optimal occlusion. The facial type was defined by two cephalometric measurements (SN.Gn and SN.GoGn) and classified into dolichofacial, meso- facial and brachyfacial after digitizing the radiographs. The incisor morphology was classified into quadrangular, oval and triangular after 3D digitizing the models and evaluation of the images by 12 dentists. The evaluation between the examiners was performed by Kappa test. In order to test the differences between the variables, it was used a chi-square test (5%). No significant difference (p morphology of the upper central incisor, considering the methodology and population included in the present study. Using the facial type as a way to select the morphology of the upper central incisor proved to be inadequate in this study.

  10. Normal state above the upper critical feld in Fe1+y Te1-x (Se,S)x

    Science.gov (United States)

    Wang, Aifeng; Kampert, Erik; Saadaoui, H.; Luetkens, H.; Hu, Rongwei; Morenzoni, E.; Wosnitza, J.; Petrovic, Cedomir

    We have investigated characteristics of the normal state above the upper critical field (Hc2) in Fe1.14Te0.7Se0.3, Fe1.02Te0.61Se0.39, Fe1.05Te0.89Se0.11, and Fe1.06Te0.86S0.14. Superconductivity is suppressed in high magnetic fields above 60 Tesla, allowing for the insight into normal state below the superconducting transition temperature (Tc). We show that Fe1.14Te0.7Se0.3 and Fe1.02Te0.61Se0.39 resistivity above the Hc2 is metallic as T -->0, just like the normal state resistivity above Tc. On the other hand, Fe1.05Te0.89Se0.11 and Fe1.06Te0.86S0.14 normal state resistivity is nonmetallic as T -->0, reflecting the normal state resistivity above Tc. These results suggest that conductivity of normal states above Hc2 is connected with the details of crystal structure inhomogeneity.

  11. Present status of endoscopy, therapeutic endoscopy and the endoscopy training system in Indonesia.

    Science.gov (United States)

    Makmun, Dadang

    2014-04-01

    Recently, Indonesia was ranked as the fourth most populous country in the world. Based on 2012 data, 85000 general practitioners and 25000 specialists are in service around the country. Gastrointestinal (GI) disease remains the most common finding in daily practise, in both outpatient and inpatient settings, and ranks fifth in causing mortality in Indonesia. Management of patients with GI disease involves all health-care levels with the main portion in primary health care. Some are managed by specialists in secondary health care or are referred to tertiary health care. GI endoscopy is one of the main diagnostic and therapeutic modalities in the management of GI disease. Development of GI endoscopy in Indonesia started before World War II and, today, many GI endoscopy procedures are conducted in Indonesia, both diagnostic and therapeutic. Based on August 2013 data, there are 515 GI endoscopists in Indonesia. Most GI endoscopists are competent in carrying out basic endoscopy procedures, whereas only a few carry out advanced endoscopy procedures, including therapeutic endoscopy. Recently, the GI endoscopy training system in Indonesia consists of basic GI endoscopy training of 3-6 months held at 10 GI endoscopy training centers. GI endoscopy training is also eligible as part of a fellowship program of consultant gastroenterologists held at six accredited fellowship centers in Indonesia. Indonesian Society for Digestive Endoscopy in collaboration with GI endoscopy training centers in Indonesia and overseas has been working to increase quality and number of GI endoscopists, covering both basic and advanced GI endoscopy procedures. © 2014 The Author. Digestive Endoscopy © 2014 Japan Gastroenterological Endoscopy Society.

  12. Endoscopy in endodontics.

    Science.gov (United States)

    Moshonov, Joshua; Nahlieli, Oded

    2011-01-01

    A successful outcome of endodontic treatment depends to a large extent on accurate intraoperative findings. Conventionally, micromirrors and microprobes have been used for this purpose. The dental operating microscope (DOM) has been implemented to enhance visibility during dental procedures. However, the microscope, a sizable tool, remains between operating field and the dental practitioner, making his ability to manipulate more complicated. Also, the interference of the hands and the handpiece with the visualization of the surgical field and inaccurate observation of the endodontic instruments during the procedure. Endoscopy reportedly provides the dentist with excellent vision and ease of use. It also provides a better intraoperative visualization in comparison with micromirrors. Further development of endoscopy made it possible to combine magnification, light, irrigation/suction and surgical microinstruments in one device. This combination could lead to an advanced root canal treatment technique.

  13. Head and neck computed tomography virtual endoscopy: evaluation of a new imaging technique.

    Science.gov (United States)

    Gallivan, R P; Nguyen, T H; Armstrong, W B

    1999-10-01

    To evaluate a new radiographic imaging technique: computed tomography virtual endoscopy (CTVE) for head and neck tumors. Twenty-one patients presenting with head and neck masses who underwent axial computed tomography (CT) scan with contrast were evaluated by CTVE. Comparisons were made with video-recorded images and operative records to evaluate the potential utility of this new imaging technique. Twenty-one patients with aerodigestive head and neck tumors were evaluated by CTVE. One patient had a nasal cylindrical cell papilloma; the remainder, squamous cell carcinomas distributed throughout the upper aerodigestive tract. Patients underwent complete head and neck examination, flexible laryngoscopy, axial CT with contrast, CTVE, and in most cases, operative endoscopy. Available clinical and radiographic evaluations were compared and correlated to CTVE findings. CTVE accurately demonstrated abnormalities caused by intraluminal tumor, but where there was apposition of normal tissue against tumor, inaccurate depictions of surface contour occurred. Contour resolution was limited, and mucosal irregularity could not be defined. There was very good overall correlation between virtual images, flexible laryngoscopic findings, rigid endoscopy, and operative evaluation in cases where oncological resections were performed. CTVE appears to be most accurate in evaluation of subglottic and nasopharyngeal anatomy in our series of patients. CTVE is a new radiographic technique that provides surface-contour details. The technique is undergoing rapid technical evolution, and although the image quality is limited in situations where there is apposition of tissue folds, there are a number of potential applications for this new imaging technique.

  14. Upper gastrointestinal examinations: a radiographic study of clinically normal Beagle puppies

    International Nuclear Information System (INIS)

    Miyabayashi, T.; Morgan, J.P.

    1991-01-01

    A total of 24 upper gastrointestinal examinations were performed on four weanling beagle puppies over six weeks, using liquid barium (10 ml/kg body weight of 60 per cent w/v barium sulphate suspension] and barium food (8 g/kg of crushed kibble dog food and 7 ml/kg body weight of 60 per cent w/v barium sulphate suspension) as contrast media. The radiographic appearance was similar to that noted in adult dogs except for the consistent location of the pylorus on or near the midline. Duodenal pseudoulcers were seen more often with liquid barium and the caecal shadows were identified more often with the longer examination time with barium food. The stomach of the puppies appeared to have discriminatory emptying function; that is, semi-solid food was emptied from the stomach at a slower rate (210 to 450 minutes) than liquid (60 to 90 minutes). Solid meals emptied faster in puppies than in adult dogs. Dosages of 13 to 15 mg/kg body weight for the liquid barium examination and 14 g of ground kibble and 16 ml of barium sulphate suspension per m2 of body surface area for the barium food examination are suggested as more appropriate for contrast studies in puppies

  15. MR imaging of upper abdomen following cholecystectomy: normal and abnormal findings

    Energy Technology Data Exchange (ETDEWEB)

    Haakansson, K. [Kalmar Hospital, (Sweden). Dept. of Radiology; Leander, P.; Ekberg, O. [Malmoe Univ. Hospital (Sweden). Dept. of Radiology; Haakansson, H.O. [Kalmar Hospital, (Sweden). Dept. of Surgery

    2001-03-01

    To describe the normal MR appearance after cholecystectomy and the findings in patients with postoperative complications using fast pulse sequences in abdominal MR imaging. Material and methods: In a prospective study of 119 patients, 64 were examined with MR after cholecystectomy. In total, 56 patients with uncomplicated cholecystectomy were examined with MR 1-5 days (mean 1.6 days) after cholecystectomy. Nine patients had an abdominal postoperative complication and 8 of these were examined with MR after the complication commenced 1-12 days after the cholecystectomy. Results: Oedema in the gallbladder fossa was the only finding in 39 patients (61%), all with uneventful recovery. Small fluid collections in an area consistent with the gallbladder fossa were seen in 9/64 (14%) patients, of which 3 had surgical complications: 1 bleeding and 2 bile duct leakage. Twenty-two (34%) patients had small locally situated fluid collections adjacent to the liver, 14 were uneventful and 8 showed postoperative surgical complications. Seven patients had fluid in the rest of the abdomen of which 5 had surgical complications; 4 due to bile duct leakage and 1 acute pancreatitis. One patient had a postoperative bleeding not seen on MR images. Conclusion: MR is very sensitive in detecting fluid collections. Early MR findings following cholecystectomy are normally only subtle changes, mainly in the gallbladder fossa. Fluid collections diagnosed elsewhere than in the gallbladder fossa usually indicate a surgical complication and a surgical complication is unlikely if MR fails to show a fluid collection.

  16. Diagnostic Yield of Microscopic Colitis in Open Access Endoscopy Center.

    Science.gov (United States)

    Ellingson, Derek; Miick, Ronald; Chang, Faye; Hillard, Robert; Choudhary, Abhishek; Ashraf, Imran; Bechtold, Matthew; Diaz-Arias, Alberto

    2011-08-01

    The diagnostic yield in open access endoscopy has been evaluated which generally support the effectiveness and efficiency of open access endoscopy. With a few exceptions, diagnostic yield studies have not been performed in open access endoscopy for more specific conditions. Therefore, we conducted a study to determine the efficiency of open access endoscopy in the detection of microscopic colitis as compared to traditional referral via a gastroenterologist. A retrospective search of the pathology database at the University of Missouri for specimens from a local open access endoscopy center was conducted via SNOMED code using the terms: "microscopic", "lymphocytic", "collagenous", "spirochetosis", "focal active colitis", "melanosis coli" and "histopathologic" in the diagnosis line for the time period between January 1, 2004 and May 25, 2006. Specimens and colonoscopy reports were reviewed by a single pathologist. Of 266 consecutive patients with chronic diarrhea and normal colonoscopies, the number of patients with microscopic disease are as follows: Lymphocytic colitis (n = 12, 4.5%), collagenous colitis (n = 17, 6.4%), focal active colitis (n = 15, 5.6%), and spirochetosis (n = 2, 0.4%). The diagnostic yield of microscopic colitis in this study of an open access endoscopy center does not differ significantly from that seen in major medical centers. In terms of diagnostic yield, open access endoscopy appears to be as effective in diagnosing microscopic colitis.

  17. A retrospective analysis comparing small bowel follow-through with wireless capsule endoscopy in the evaluation of obscure gastrointestinal bleeding.

    Science.gov (United States)

    Nutter, Melanie; Dunston, Diana; Ieyoub, Jonathan; Hart, Albert; Harper, Jeannie; Burke, Mary S

    2010-01-01

    A comparative retrospective study was conducted to evaluate diagnostic findings between small bowel follow-through (SBFT) and wireless capsule endoscopy in the presence of obscure gastrointestinal bleeding. A convenience sample of 31 patients with previous negative upper and lower endoscopy was included in the study. Wireless capsule endoscopy established a significant source of obscure gastrointestinal bleeding 53% of the time. The diagnostic capacity of radiographic SBFT was measured at 17% as compared with that of the wireless capsule endoscopy. The clinical findings along with the digital images obtained from the wireless capsule endoscopy was found to be the optimum diagnostic tool in the evaluation of obscure gastrointestinal bleeding in the small bowel.

  18. Normal state above the upper critical field in Fe1 +yTe1 -x(Se,S ) x

    Science.gov (United States)

    Wang, Aifeng; Kampert, Erik; Saadaoui, H.; Luetkens, H.; Hu, Rongwei; Morenzoni, E.; Wosnitza, J.; Petrovic, C.

    2017-05-01

    We have investigated the magnetotransport above the upper critical field (Hc 2) in Fe1.14Te0.7Se0.3 , Fe1.02Te0.61Se0.39 , Fe1.05Te0.89Se0.11 , and Fe1.06Te0.86S0.14 . The μ SR measurements confirm electronic phase separation in Fe1.06Te0.86S0.14 , similar to Fe1 +yTe1 -xSex . Superconductivity is suppressed in high magnetic fields above 60 T, allowing us to gain insight into the normal-state properties below the zero-field superconducting transition temperature (Tc). We show that the resistivity of Fe1.14Te0.7Se0.3 and Fe1.02Te0.61Se0.39 above Hc 2 is metallic as T →0 , just like the normal-state resistivity above Tc. On the other hand, the normal-state resistivity in Fe1.05Te0.89Se0.11 and Fe1.06Te0.86S0.14 is nonmetallic down to lowest temperatures, reflecting the superconductor-insulator transition due to electronic phase separation.

  19. Gastrointestinal endoscopy in Nigeria-a prospective two year audit

    African Journals Online (AJOL)

    abp

    Upper GI endoscopy findings included 14 (11.5%) cases of peptic ulcer disease, 5 complicated by gastric outlet obstruction, and 21 ... the implications on the diagnosis of gastrointestinal pathology and their treatment. Thus it has .... ulcerative colitis was seen and 2 patients had diverticular disease. (Table 3). Competency in ...

  20. Helicobacter pylori as an occupational hazard in the endoscopy room

    African Journals Online (AJOL)

    Background: It remains controversial whether or not healthcare workers on upper gastrointestinal endoscopy teams are at risk of Helicobacter pylori infection. An association between occupational exposure and an increased risk of infection has been shown in a number of studies, while such a risk was not confirmed in ...

  1. Role of sleep endoscopy in obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Suzan Salama

    2013-07-01

    Conclusion: Sleep endoscopy is a useful tool for the assessment of level, degree and shape of the upper airway obstruction during sleep in OSAS and this could be helpful in preoperative evaluation. Presence of obstruction at hypopharyngeal level or tongue base obstruction is an indicator of OSAS severity.

  2. Endoscopy and surgery for obesity

    International Nuclear Information System (INIS)

    Mejia, Andres Felipe; Unigarro, Ivan; Bolanos, Eduardo; Chaux, Carlos Felipe

    2006-01-01

    Actually bariatric surgery appears to be a secure, feasible and durable option for patients with morbid obesity. Most of the complications that arise from bariatric surgery can be solved with the use of endoscopy avoiding the morbidity and mortality of a surgical intervention. This group of patients has become a challenge for the endoscopist and favours the development of interventional endoscopy

  3. [Learning gastroenterologic endoscopy].

    Science.gov (United States)

    Koelsch, K A

    1976-11-01

    1. Knowledge of the gastroenterological endoscopy and biopsy is necessary at all levels of medical education. 2. Knowledge of students: possible methods, diagnostic effectiveness, stress of the patients. Knowledge of the candidates for specialisation: indications, contraindications, possibilities of the method also in reference to the individual case. Persons interested in the subspecialisation gastro-enterology: theory, possibilities and limits, technical performance. Experienced endoscopists: regular refreshment and supplementation of knowledge and skill in highly specialised endoscopic centres. 3. Tested teaching methods are lecture, report, study of atlants and text-books, demonstrations of diapositives in connection with schematic figures, seminars with diapositives, film demonstrations, work at the patient under supervision of the tutor and use of a demonstration device as well as endoscopic demonstration by means of colour television. The centre is, however, the individual examination of the patient. 4. Knowledge of the subspecialist: History of endoscopy, knowledge of instruments, optics and endoscopic perspective, physical fundaments about light and photography, human macro- and microscopic anatomy, care of instruments and desinfection. Indications, contraindications, possibilities and limits of the method, emergency and intensive medicine, writing of the findings.

  4. Chromoendoscopy in magnetically guided capsule endoscopy

    Science.gov (United States)

    2013-01-01

    Background Diagnosis of intestinal metaplasia and dysplasia via conventional endoscopy is characterized by low interobserver agreement and poor correlation with histopathologic findings. Chromoendoscopy significantly enhances the visibility of mucosa irregularities, like metaplasia and dysplasia mucosa. Magnetically guided capsule endoscopy (MGCE) offers an alternative technology for upper GI examination. We expect the difficulties of diagnosis of neoplasm in conventional endoscopy to transfer to MGCE. Thus, we aim to chart a path for the application of chromoendoscopy on MGCE via an ex-vivo animal study. Methods We propose a modified preparation protocol which adds a staining step to the existing MGCE preparation protocol. An optimal staining concentration is quantitatively determined for different stain types and pathologies. To that end 190 pig stomach tissue samples with and without lesion imitations were stained with different dye concentrations. Quantitative visual criteria are introduced to measure the quality of the staining with respect to mucosa and lesion visibility. Thusly determined optimal concentrations are tested in an ex-vivo pig stomach experiment under magnetic guidance of an endoscopic capsule with the modified protocol. Results We found that the proposed protocol modification does not impact the visibility in the stomach or steerability of the endoscopy capsule. An average optimal staining concentration for the proposed protocol was found at 0.4% for Methylene blue and Indigo carmine. The lesion visibility is improved using the previously obtained optimal dye concentration. Conclusions We conclude that chromoendoscopy may be applied in MGCE and improves mucosa and lesion visibility. Systematic evaluation provides important information on appropriate staining concentration. However, further animal and human in-vivo studies are necessary. PMID:23758801

  5. Clinical predictors of outcome in acute upper gastrointestinal bleeding

    African Journals Online (AJOL)

    Objective. Endoscopy has traditionally been used to risk stratify patients with upper gastrointestinal bleeding (UGIB). This is problematic in resource-poor environments. The study aimed to identify patients who would not require urgent endoscopy by identifying clinical variables before endoscopy that predict uneventful ...

  6. Development of a flexible cryo-instrument for gastrointestinal endoscopy

    International Nuclear Information System (INIS)

    Lifton, L.J.

    1986-01-01

    Recent advances in therapeutic gastrointestinal endoscopy and cryosurgical techniques have caused an interest in creating a cryo-instrument for endoscopic use. The development of a prototype instrument for use in both upper gastrointestinal endoscopy and colonoscopy is described. This instrument is based on the expansion of high pressure carbon dioxide in a series of flexible tubes designed to fit through a 2.6 mm endoscopic accessory channel. This self-enclosed system has been used clinically for cryo-extraction of cauterized colonic polyps. Its potential use for treatment of gastrointestinal malignancies is discussed

  7. [Emergency endoscopy in children: experience of a digestive endoscopy department].

    Science.gov (United States)

    Pacchione, D; Mortilla, M G; Ricci, E; Bertoni, G; Conigliaro, R; Orsi, P; Bedogni, G; Lamborghini, A; Banchini, G

    1992-01-01

    Many changes and advances have been achieved in the last years, so that emergency endoscopy has now a definite role also in the diagnosis and treatment of diseases in childhood. In order to determinate main indications to endoscopic examination, and which are the most useful diagnostic and therapeutic measures that should be performed, we examined the records of 202 patients (aged 1 day-14 years) undergone emergency endoscopy from June 1979 to January 1990. Patients were referred to endoscopy because of foreign bodies or caustic ingestion, hematemesis, and in one patient a suspected intussusception. We didn't record any complication. Our study shows that emergency endoscopy has a definite role also in pediatric age and gives a diagnostic and therapeutic gain in the management of many diseases.

  8. Gastric polyps: a retrospective analysis of 26,000 digestive endoscopies Pólipos gástricos: análise retrospectiva de 26 000 endoscopias digestivas

    OpenAIRE

    Drausio Jefferson Morais; Ademar Yamanaka; José Murilo Robilotta Zeitune; Nelson Adami Andreollo

    2007-01-01

    BACKGROUND: Gastric polyps are small gastric lesions, asymptomatic in most cases and are generally discovered inadvertently during upper digestive endoscopy. AIM: To retrospectively review the characteristics and frequency of gastric polyps, derived from the gastric mucosal epithelium in a large series of endoscopies. METHODS: One hundred and fifty three patients in a series of 26,000 consecutive upper digestive endoscopies done over a 5-year period, being that each patient had only one exami...

  9. Real-time holographic endoscopy

    Science.gov (United States)

    Smigielski, Paul; Albe, Felix; Dischli, Bernard

    1992-08-01

    Some new experiments concerning holographic endoscopy are presented. The quantitative measurements of deformations of objects are obtained by the double-exposure and double- reference beam method, using either a cw-laser or a pulsed laser. Qualitative experiments using an argon laser with time-average holographic endoscopy are also presented. A video film on real-time endoscopic holographic interferometry was recorded with the help of a frequency-doubled YAG-laser working at 25 Hz for the first time.

  10. [Endonasal skull base endoscopy].

    Science.gov (United States)

    Simal-Julián, Juan Antonio; Miranda-Lloret, Pablo; Pancucci, Giovanni; Evangelista-Zamora, Rocío; Pérez-Borredá, Pedro; Sanromán-Álvarez, Pablo; Perez-de-Sanromán, Laila; Botella-Asunción, Carlos

    2013-01-01

    The endoscopic endonasal techniques used in skull base surgery have evolved greatly in recent years. Our study objective was to perform a qualitative systematic review of the likewise systematic reviews in published English language literature, to examine the evidence and conclusions reached in these studies comparing transcranial and endoscopic approaches in skull base surgery. We searched the references on the MEDLINE and EMBASE electronic databases selecting the systematic reviews, meta-analyses and evidence based medicine reviews on skull based pathologies published from January 2000 until January 2013. We focused on endoscopic impact and on microsurgical and endoscopic technique comparisons. Full endoscopic endonasal approaches achieved gross total removal rates of craniopharyngiomas and chordomas higher than those for transcranial approaches. In anterior skull base meningiomas, complete resections were more frequently achieved after transcranial approaches, with a trend in favour of endoscopy with respect to visual prognosis. Endoscopic endonasal approaches minimised the postoperative complications after the treatment of cerebrospinal fluid (CSF) leaks, encephaloceles, meningoceles, craniopharyngiomas and chordomas, with the exception of postoperative CSF leaks. Randomized multicenter studies are necessary to resolve the controversy over endoscopic and microsurgical approaches in skull base surgery. Copyright © 2013 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  11. Advances in Capsule Endoscopy

    Science.gov (United States)

    Scott, Ryan

    2015-01-01

    Wireless video capsule endoscopy (VCE) is a minimally invasive technology that has revolutionized the approach to small intestinal disease investigation and management. Designed primarily to provide diagnostic imaging of the small intestine, VCE is used predominantly for obscure gastrointestinal bleeding and suspected Crohn’s disease; however, numerous other indications have been established, including the assessment of celiac disease, investigation of small bowel tumors, and surveillance of hereditary polyposis syndromes. Since the introduction of small bowel VCE in 2000, more than 1600 articles have been published describing the evolution of this technology. The main adverse outcome is capsule retention, which can potentially be avoided by careful patient selection or by using a patency capsule. Despite the numerous advances in the past 15 years, limitations such as incomplete VCE studies, missed lesions, and time-consuming reporting remain. The inability to control capsule movement for the application of targeted therapy or the acquisition of tissue for histologic analysis remains among the greatest challenges in the further development of capsule technology. This article outlines the recent technological and clinical advances in VCE and the future directions of research in this field. PMID:27482183

  12. Current status of advanced gastrointestinal endoscopy training fellowships in the United States

    Directory of Open Access Journals (Sweden)

    Stephen J Heller

    2011-01-01

    Full Text Available Stephen J Heller, Jeffrey L TokarDepartment of Medicine, Fox Chase Cancer Center, Philadelphia, PA, USAAbstract: Rapid growth in the field of advanced gastrointestinal endoscopy has led to an increase in specialized therapeutic endoscopy fellowships. The cornerstones of these programs are training in endoscopic retrograde cholangiopancreatography (ERCP and endoscopic ultrasound. These procedures are more complex and challenging to master than routine colonoscopy and upper endoscopy, and in the case of ERCP, higher risk. The concentration of the educational experience in the hands of relatively fewer trainees with specialized interest in advanced endoscopy has resulted in providing a focused cohort of graduating fellows with higher case volumes in training, which likely enhances diagnostic and therapeutic success and safer performance of these procedures. Endoscopic simulators, although not currently in widespread use, have the potential to improve advanced procedural training without jeopardizing patient safety.Keywords: gastrointestinal endoscopy, training, procedures, safety 

  13. Development of stress ulcers assessed by gastric electrical potential difference, pH of gastric juice, and endoscopy in patients in the intensive care unit

    DEFF Research Database (Denmark)

    Rubinstein, E; Gjørup, I; Schulze, S

    1992-01-01

    OBJECTIVE: To assess measurement of gastric electrical potential difference, pH of gastric mucosa, and endoscopic findings in patients in intensive care units who are at risk of developing stress ulcers. DESIGN: Open comparison with age- and sex-matched control subjects. SETTING: Herlev Hospital......, Denmark. SUBJECTS: Sixteen consecutive patients with no history of gastrointestinal haemorrhage, coagulopathy, or ulcer disease who had been admitted to the intensive care unit, and 16 age- and sex-matched outpatients with normal endoscopic findings. INTERVENTIONS: Upper gastrointestinal endoscopy, during...... which any lesions that were found were scored according to severity, the gastric potential difference, and the pH of gastric juice were measured. OUTCOME MEASURES: Correlation between the incidence of stress ulceration found at endoscopy, gastric potential difference, and gastric pH. RESULTS: Gastric...

  14. High-definition endoscopy with iScan and Lugol's solution for the detection of inflammation in patients with nonerosive reflux disease: histologic evaluation in comparison with a control group.

    Science.gov (United States)

    Rey, J W; Deris, N; Marquardt, J U; Thomaidis, T; Moehler, M; Kittner, J M; Nguyen-Tat, M; Dümcke, S; Tresch, A; Biesterfeld, S; Goetz, M; Mudter, J; Neurath, M F; Galle, P R; Kiesslich, R; Hoffman, A

    2016-01-01

    Nonerosive reflux disease (NERD) is commonly diagnosed in patients with symptoms of reflux. The aim of the present study was to determine whether high-definition endoscopy (HD) plus equipped with the iScan function or chromoendoscopy with Lugol's solution might permit the differentiation of NERD patients from those without reflux symptoms, proven by targeted biopsies of endoscopic lesions. A total of 100 patients without regular intake of proton pump inhibitors and with a normal conventional upper endoscopy were prospectively divided into NERD patients and controls. A second upper endoscopy was performed using HD+ with additional iScan function and then Lugol's solution was applied. Biopsy specimens were taken from the gastroesophageal junction in all patients. A total of 65 patients with reflux symptoms and 27 controls were included. HD(+) endoscopy with iScan revealed subtle mucosal breaks in 52 patients; the subsequent biopsies confirmed esophagitis in all cases. After Lugol's solution, 58 patients showed mucosal breaks. Sensitivity for the iScan procedure was 82.5%, whereas that for Lugol's solution was 92.06%. Excellent positive predictive values of 100% and 98.3%, respectively, were noted. The present study suggests that the majority of patients with NERD and typical symptoms of reflux disease can be identified by iScan or Lugol's chromoendoscopy as minimal erosive reflux disease (ERD) patients. © 2014 International Society for Diseases of the Esophagus.

  15. Wireless capsule endoscopy and double-balloon enteroscopy for the diagnosis of obscure gastrointestinal bleeding.

    Science.gov (United States)

    Gerson, Lauren B; Van Dam, Jacques

    2004-09-01

    Standard endoscopic examination (upper gastrointestinal endoscopy and colonoscopy) fails to detect the cause of gastrointestinal hemorrhage in approximately 5% of patients. Before the availability of wireless capsule endoscopy and double-balloon enteroscopy, imaging modalities for the small intestine distal to the ligament of Treitz included barium contrast examination and/or enteroclysis, push, passive, or intraoperative enteroscopy, technetium 99m labeled sulfur colloid scanning, angiography, and computed tomography, although the diagnostic yield of all of these imaging modalities was low. In 2001, wireless capsule endoscopy became available for the evaluation of patients with probable small intestinal hemorrhage. Advantages of wireless capsule endoscopy include that the procedure is noninvasive, requires no sedation, and does not expose the patient to ionizing radiation. In patients with obscure gastrointestinal hemorrhage, studies have demonstrated an additional 25 to 50% diagnostic yield using wireless capsule endoscopy when compared to other diagnostic modalities. The major limitations of capsule endoscopy were its inability to obtain a biopsy, precisely localize a lesion, or perform therapeutic endoscopy. In 2001, the double-balloon enteroscope was introduced. This new endoscopic technique provides the gastroenterologist with an opportunity for further evaluation and treatment of abnormalities detected on wireless capsule endoscopy or other small intestinal imaging studies.

  16. Technical Evolution of Medical Endoscopy

    Directory of Open Access Journals (Sweden)

    S. Gross

    2009-01-01

    Full Text Available This paper gives a summary of the technical evolution of medical endoscopy. The first documented redirection of sunlight into the human body dates back to the 16th century. Rigid tubes with candle light were given a trial later on. Low light intensity forced the development of alternative light sources. Some of these experiments included burning chemical components. Electric lighting finally solved the problems of heat production and smoke. Flexible endoscopy increased the range of medical examinations as it allowed access to tight and angular body cavities. The first cameras for endoscopic applications made taking photos from inside the human body possible. Later on, digital video endoscopy made endoscopes easier to use and allowed multiple spectators to observe the endoscopic intervention. Swallowable capsules called pill-cams made endoscopic examinations of the small intestine possible. Modern technologies like narrow band imaging and fluorescence endoscopy increased the diagnostic significance of endoscopic images. Today, image processing is applied to decrease noise and enhance image quality. These enhancements have made medical endoscopy an invaluable tool in many diagnostic processes. In closing, an example is given of an interdisciplinary examination, which is taken from the archaeological field. 

  17. [Diagnostic yield of video capsule endoscopy in premenopausal women with iron-deficiency anemia].

    Science.gov (United States)

    Garrido Durán, Carmen; Iyo Miyashiro, Eduardo; Páez Cumpa, Claudia; Khorrami Minaei, Sam; Erimeiku Barahona, Alicia; Llompart Rigo, Alfredo

    2015-01-01

    Clinical practice guidelines recommend video capsule endoscopy (VCE) studies in patients with iron-deficiency anemia (IDA) after conventional upper and lower endoscopies but there is a need for studies demonstrating the diagnostic yield, clinical impact, and cost in some patient subgroups. 1.To determine the diagnostic yield of VCE in premenopausal women with IDA compared with that in men and postmenopausal women. 2. To identify the presence of VCE predictors in premenopausal women. 3. To estimate the cost-clinical impact relationship associated with VCE in this indication. We retrospectively analyzed 408 patients who underwent VCE. Patients with IDA were enrolled (premenopausal, postmenopausal women, and men), with previous normal work-up by conventional endoscopies. A total of 249 patients were enrolled: 131 women (52.6%), of which 51 were premenopausal and 80 were post-menopausal, and 118 men. The mean age was 60.7±16 years. The diagnostic yield of VCE for the diagnosis of IDA was 44.6% (95% CI 39.9 - 50.8). Diagnostic yield was 50.8% vs 38.9% in men vs women (p=0.05) and was 55% vs 13.7% in postmenopausal vs premenopausal women (p<0.001). No predictors of small bowel lesions were found in premenopausal women. The most common findings in the postmenopausal group were angioectasias (70.5%) and erosions (57.1%) in the premenopausal group. The cost in premenopausal women was 44.727€ and 86.3% of the procedures had no clinical impact. The diagnostic yield of VCE is low in the etiological study of IDA in premenopausal women and there is no cost-effectiveness in relation to clinical impact. No predictors of small bowel lesions were found in this group. Copyright © 2015 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  18. Oral chlorhexidine and microbial contamination during endoscopy

    DEFF Research Database (Denmark)

    Donatsky, Anders Meller; Holzknecht, Barbara Juliane; Arpi, Magnus

    2013-01-01

    BACKGROUND: One of the biggest concerns associated with transgastric surgery is contamination and risk of intra-abdominal infection with microbes introduced from the access route. The purpose of this study was to evaluate the effect of oral decontamination with chlorhexidine on microbial contamin......BACKGROUND: One of the biggest concerns associated with transgastric surgery is contamination and risk of intra-abdominal infection with microbes introduced from the access route. The purpose of this study was to evaluate the effect of oral decontamination with chlorhexidine on microbial...... contamination of the endoscope. METHODS: In a prospective, randomized, single-blinded, clinical trial the effect of chlorhexidine mouth rinse was evaluated. As a surrogate for the risk of intra-abdominal contamination during transgastric surgery, microbial contamination of the endoscope during upper endoscopy...... microbial contamination of the endoscope, but micro-organisms with abscess forming capabilities were still present. PPI treatment significantly increased CFU and should be discontinued before transgastric surgery....

  19. Innovation and Best Practices in Endoscopy

    NARCIS (Netherlands)

    C.W. Teshima (Christopher)

    2013-01-01

    textabstractAdvances in gastrointestinal (GI) endoscopy have played an important role in improving the diagnostic and therapeutic options for physicians treating patients with GI diseases. Indeed, the advent of endoscopy transformed the field of Gastroenterology and contributed significantly to

  20. [Future prospects in digestive endoscopy: wireless capsule endoscopy].

    Science.gov (United States)

    Sacher-Huvelin, S; Bourreille, A; Le Rhun, M; Galmiche, J-P

    2009-01-01

    Since the beginning of the millennium, the development of wireless capsule endoscopy has represented a major technological advance. The capsule is ingested by the patient and images are transmitted via several sensors positioned on the skin of the patient and downloaded in a computer system. The first applications were focused on the exploration of the small bowel which was previously considered as an obscure area for conventional endoscopy. Wireless capsule endoscopy of the small bowel is now an established technique with many acknowledged indications for the diagnosis of obscure bleeding, anemia of presumed digestive origin, Crohn's disease and small bowel tumors. Recently, thanks to technological progresses, novel capsules have been developed for specific segments of the gut namely the oesophagus and the colon. Recent data suggest that these new capsules could have potential applications for the diagnosis of oesophageal varices, Barrett's oesophagus and for the screening and/or surveillance of polyps of the colon. However, further studies are required before such strategies could be approved for clinical use or even replace conventional endoscopic modalities. In the long-term, progresses in signal processing as well as in the miniaturisation of sensors or markers may lead to a new generation of endoscopic robots. This technological breakthrough may ultimately result in new concepts and change current practice of digestive endoscopy.

  1. Digestive Endoscopy in Morocco: What Future Perspectives?

    Directory of Open Access Journals (Sweden)

    Professor Adil Ibrahimi

    2016-12-01

    Full Text Available Interventional endoscopy has evolved in parallel with diagnostic endoscopy and throughout the years, the performance of interventional endoscopy has proved to be efficient in improving morbidity and mortality in many diseases: biliopancreatic catheterism, dilatations of most stenosis in different parts of the digestive tube, haemostatic treatment, prosthetic fitting and installation, as well as benign and malignant tumors removal (polypectomy, mucosectomy....

  2. Prevalence of Helicobacter pylori in Northern Jordan: Endoscopy based study

    International Nuclear Information System (INIS)

    Bani-Hani, Kamal E.; Hammouri, Shadi M.

    2001-01-01

    Helicobacter pylori infection is considered the most common infection worldwide and is associated with many other disorders. The aim of this study is to determine the prevalence of this infection among patients undergoing endoscopy in Northern Jordan. Between November 1998 and September 2000, all patients referred from the Gastro-esophageal Clinic to the Endoscopy Unit at Princess Basma Teaching Hospital, Irbid, Northern Jordan were enrolled in this prospective study. For each patient clinical and epidemiological data was collected and endoscopy was performed. At least 3 antral biopsies were obtained from each patient, and these were examined histologically for the presence of gastritis and stained for Helicobacter pylori using modified Giemsa stain. A total of 197 consecutive patients (113 females) with a mean age of 40.2 years (range 15-91 years) were studied. Abdominal pain was the highest presenting symptom. Gastritis 91% and esophagitis 42% were the most frequent endoscopic findings. Gastritis was documented histologically in 183 (93%) of patients. Helicobacter pylori was found in 161 patients (82%), with all of these having histological gastritis. The 11 patients with gastric ulcer, compared to the 51 out of the 59 (86%) patients with duodenal ulcer, showed Helicobacter pylori in their biopsies. The prevalence of Helicobacter pylori infection in patients subjected to an upper gastrointestinal endoscopy in Jordan is high. This study confirms that Helicobacter pylori is significantly associated with gastritis and peptic ulcer. Further studies are needed to determine the types of Helicobacter pylori strains present in Jordan. (author)

  3. Prevalência e fatores associados ao uso de antiinflamatórios não-esteróides por pacientes submetidos a endoscopia digestiva alta, Belo Horizonte, Minas Gerais, 2000 Prevalence of and factors associated with nonsteroidal anti-inflammatory drug use by patients submitted to upper endoscopy, Belo Horizonte, Minas Gerais, 2000

    Directory of Open Access Journals (Sweden)

    Andréia Queiroz Ribeiro

    2005-09-01

    Full Text Available OBJETIVO: Determinar a prevalência e os fatores associados ao uso de AINE por pacientes submetidos a endoscopia digestiva alta no Hospital das Clínicas da UFMG. MÉTODOS: Estudo transversal de uma amostra de 533 pacientes com idade igual ou superior a 17 anos, com endoscopia previamente marcada na Seção de Endoscopia do Hospital das Clínicas da Universidade Federal de Minas Gerais. Os dados foram coletados por meio de entrevistas. Foram considerados quatro grupos de variáveis exploratórias: sociodemográficas, relacionadas aos hábitos de vida, relacionadas à história de morbidades e relacionadas ao uso de medicamentos. Os dados foram submetidos às análises estatísticas bivariada e multivariada. RESULTADOS E CONCLUSÕES: Entre os entrevistados, 34,1% relataram algum uso de AINE no período de 1 mês anterior à realização da endoscopia. Os AINE mais utilizados foram o ácido acetilsalicílico e o diclofenaco. Os fatores associados ao uso de AINE foram: sexo feminino (OR = 2,07; IC 95% = 1,28-3,34, renda igual ou superior a 3 salários mínimos (OR = 3,20; IC 95% = 1,74-5,90, uso de álcool (OR = 2,43; IC 95% = 1,39-4,24, presença de sintomas gastrintestinais (OR = 1,82; IC 95% = 1,18-2,80, uso regular de 4 ou mais medicamentos (OR = 4,33; IC 95% = 2,49-7,54 e história prévia de úlcera e/ou hemorragia digestiva (OR = 0,40; IC 95% = 0,22-0,75. Estes resultados mostram semelhanças aos observados em países desenvolvidos. Além disso, alertam para a necessidade de maior atenção por profissionais de saúde para com os subgrupos de uso evidenciados.INTRODUCTION: The objective was to determine the prevalence and the factors associated with nonsteroidal anti-inflammatory drugs (NSAID used by patients submitted to upper endoscopy at Hospital das Clínicas/UFMG, Belo Horizonte, MG. METHODS: Cross-sectional study of a 533 patients, aged 17 or older, whose endoscopies had been previously scheduled at the Endoscopy Section of Hospital

  4. Wireless capsule endoscopy in adolescents with familial adenomatous polyposis.

    Science.gov (United States)

    Cavallo, Debora; Ballardini, Giovanni; Ferrari, Andrea; Delconte, Gabriele; Signoroni, Stefano; Sala, Paola; Chiaravalli, Stefano; Massimino, Maura; Bertario, Lucio; Vitellaro, Marco

    2016-01-01

    Guidelines for surveillance in patients with familial adenomatous polyposis (FAP) recommend mutation carriers to undergo periodic colorectal examination starting in the early teens. Performing colonoscopy in children may lead to complications. Wireless capsule endoscopy (WCE) has been introduced recently to evaluate both the upper and lower gastrointestinal tract, and seems suitable as a first screening examination for adolescents. The aim of this study was to evaluate the pros and cons of WCE. This was a retrospective review of a single institution database of adolescent patients with FAP identified through the Hereditary Colorectal Tumor Registry between 2007 and 2013. The main outcomes were identification of upper and lower gastrointestinal tract polyps, tolerance of the examination, and number and size of polyps. Of 46 adolescent patients with FAP, 14 (30.4%) patients carrying adenomatous polyposis coli gene (APC) mutation, 6 male and 8 female, age (median, range) 12 (10-17) years, body mass index 19 (13-24), underwent WCE as first screening examination. The examination was completed in 13 patients (93.3%). Wireless capsule endoscopy identified the duodenal papilla in 4 patients and colonic and rectal polyps in all 13 patients. In 7 patients, fewer than 25 polyps were identified. No complications were recorded related to the use of the video capsule. Wireless capsule endoscopy is feasible and well-tolerated as a first screening examination in adolescent patients. It cannot be used as alternative to the colonoscopy, but could improve compliance with colonoscopy, and increase early adherence to a surveillance program.

  5. [Endoscopy of the middle ear].

    Science.gov (United States)

    Ayache, Stéphane

    2010-12-20

    The otoscopy is a major point in a daily practice. The otoscope is usually used. In an ENT practice, the microscope is the main instrument but presents limits. The use of rigid endoscopes allows to refine considerably this otoscopy. In ear surgery, the endoscopy of the middle ear for ear chronic diseases has evolved, from an additional tool to the microscope towards an exclusive surgical procedure with its own indications, advantages and limits.

  6. Contraindications for video capsule endoscopy

    OpenAIRE

    Bandorski, Dirk; Kurniawan, Niehls; Baltes, Peter; Hoeltgen, Reinhard; Hecker, Matthias; Stunder, Dominik; Keuchel, Martin

    2016-01-01

    Video capsule endoscopy (VCE) has been applied in the last 15 years in an increasing field of applications. Although many contraindications have been put into perspective, some precautions still have to be considered. Known stenosis of the gastrointestinal tract is a clear contraindication for VCE unless surgery is already scheduled or at least has been considered as an optional treatment modality. In patients with a higher incidence of stenosis, as in an established diagnosis of Crohn?s dise...

  7. An assessment of racial differences in the upper limits of normal ALT levels in children and the effect of obesity on elevated values.

    Science.gov (United States)

    Kliethermes, S; Ma, M; Purtell, C; Balasubramanian, N; Gonzalez, B; Layden, T J; Cotler, S J

    2017-10-01

    Childhood obesity is a risk factor for non-alcoholic fatty liver disease and poses important public health issues for children. Racial differences in alanine aminotransferase (ALT) levels among children have not been described. This study aimed to identify racial differences in upper limit normal (ULN) ALT levels and evaluate the effect of obesity on elevated levels in children without other metabolic risk factors. National Health and Nutrition Examination Surveys and clinical data from the Loyola University Health System were used to determine ULN ALT by race and gender. Quantile regression was used to evaluate the impact of obesity on elevated ALT and to identify potential risk factors for ALT above the ULN. Upper limit normal (ULN) ALT was approximately 28.0 and 21.0-24.0 U/L for boys and girls, respectively. No significant difference in ULN ALT across race was observed. Obesity was significantly associated with elevated ALT; obese children with elevated ALT had values 10 U/L higher than normal-weight children. Racial differences in ALT levels among adults are not evident in children. Obesity, in the absence of metabolic risk factors and other causes of liver disease, is associated with elevated ALT, providing evidence against the concept of healthy obesity in children. © 2016 World Obesity Federation.

  8. Dynamic upper respiratory abnormalities in Thoroughbred racehorses in South Africa

    Directory of Open Access Journals (Sweden)

    Javier E. Mirazo

    2014-11-01

    Full Text Available Upper airway endoscopy at rest has been the diagnostic method of choice for equine upper respiratory tract (URT conditions. Development of high-speed treadmill endoscopy improved the sensitivity of URT endoscopy by allowing observation of the horse’s nasopharynx and larynx during exercise. However, treadmill exercise may not always accurately represent the horse’s normal exercise as track surface, rider, tack and environmental variables are altered. Recently, the development of dynamic overground endoscopy (DOE has addressed some of these shortcomings. A retrospective study was undertaken to describe the URT abnormalities detected during DOE in racehorses presenting with poor performance and/or abnormal respiratory noise. Patient records of Thoroughbred racehorses undergoing DOE from November 2011 to August 2012 were reviewed. Data collected included signalment, primary complaint, distance exercised, maximum speed and dynamic airway abnormalities detected. Fifty-two horses underwent DOE for investigation of poor performance and/or abnormal respiratory noise. The main abnormalities detected included axial deviation of the aryepiglottic folds (40%, vocal cord collapse (35%, abnormal arytenoid function (33% and dorsal displacement of the soft palate (25%. A total of 40 horses were diagnosed with one or more abnormalities of the URT (77%. Fifteen horses (29% had a single abnormality and 25 horses (48% had multiple abnormalities. This study showed that DOE is a useful technique for investigating dynamic disorders of the URT in racehorses in South Africa. The total number and type of dynamic pathological conditions were comparable with those identified in similar populations in other geographical locations.

  9. Role of wireless capsule endoscopy in reclassifying inflammatory bowel disease in children.

    Science.gov (United States)

    Ouahed, Jodie; Shagrani, Mohammad; Sant'Anna, Ana

    2013-01-01

    To evaluate the role of wireless capsule endoscopy in identifying small bowel lesions in pediatric patients with newly diagnosed colonic inflammatory bowel disease (IBD) type unclassified (IBDU), and to assess whether capsule endoscopy findings result in altered patient management. Ten pediatric patients recently diagnosed with IBDU through standard investigations were recruited from the pediatric gastroenterology clinic at McMaster Children's Hospital to undergo capsule endoscopy using the Pillcam SB(TM) (Given Imaging) capsule. Findings consistent with a diagnosis of Crohn's disease required the identification of at least three ulcerations. Three out of ten patients had newly identified findings on capsule endoscopy that met criteria for Crohn's disease. Three more patients had findings suspicious for Crohn's disease, but failed to meet the diagnostic criteria. Three additional patients had findings most consistent with ulcerative colitis, and one had possible gastritis with a normal intestine. Findings from capsule endoscopy allowed for changes in the medical management of three patients. In all ten cases, capsule endoscopy allowed for a better characterization of the type and extent of disease. No adverse outcomes occurred in the present cohort. This prospective study reveals that wireless capsule endoscopy is feasible, valuable, and non-invasive, offering the ability to potentially better characterize newly diagnosed pediatric IBDU cases by identifying lesions in the small bowel and reclassifying these as Crohn's disease. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  10. Anatomical Network Comparison of Human Upper and Lower, Newborn and Adult, and Normal and Abnormal Limbs, with Notes on Development, Pathology and Limb Serial Homology vs. Homoplasy.

    Science.gov (United States)

    Diogo, Rui; Esteve-Altava, Borja; Smith, Christopher; Boughner, Julia C; Rasskin-Gutman, Diego

    2015-01-01

    How do the various anatomical parts (modules) of the animal body evolve into very different integrated forms (integration) yet still function properly without decreasing the individual's survival? This long-standing question remains unanswered for multiple reasons, including lack of consensus about conceptual definitions and approaches, as well as a reasonable bias toward the study of hard tissues over soft tissues. A major difficulty concerns the non-trivial technical hurdles of addressing this problem, specifically the lack of quantitative tools to quantify and compare variation across multiple disparate anatomical parts and tissue types. In this paper we apply for the first time a powerful new quantitative tool, Anatomical Network Analysis (AnNA), to examine and compare in detail the musculoskeletal modularity and integration of normal and abnormal human upper and lower limbs. In contrast to other morphological methods, the strength of AnNA is that it allows efficient and direct empirical comparisons among body parts with even vastly different architectures (e.g. upper and lower limbs) and diverse or complex tissue composition (e.g. bones, cartilages and muscles), by quantifying the spatial organization of these parts-their topological patterns relative to each other-using tools borrowed from network theory. Our results reveal similarities between the skeletal networks of the normal newborn/adult upper limb vs. lower limb, with exception to the shoulder vs. pelvis. However, when muscles are included, the overall musculoskeletal network organization of the upper limb is strikingly different from that of the lower limb, particularly that of the more proximal structures of each limb. Importantly, the obtained data provide further evidence to be added to the vast amount of paleontological, gross anatomical, developmental, molecular and embryological data recently obtained that contradicts the long-standing dogma that the upper and lower limbs are serial homologues

  11. Deep Learning in Gastrointestinal Endoscopy.

    Science.gov (United States)

    Patel, Vivek; Armstrong, David; Ganguli, Malika; Roopra, Sandeep; Kantipudi, Neha; Albashir, Siwar; Kamath, Markad V

    2016-01-01

    Gastrointestinal (GI) endoscopy is used to inspect the lumen or interior of the GI tract for several purposes, including, (1) making a clinical diagnosis, in real time, based on the visual appearances; (2) taking targeted tissue samples for subsequent histopathological examination; and (3) in some cases, performing therapeutic interventions targeted at specific lesions. GI endoscopy is therefore predicated on the assumption that the operator-the endoscopist-is able to identify and characterize abnormalities or lesions accurately and reproducibly. However, as in other areas of clinical medicine, such as histopathology and radiology, many studies have documented marked interobserver and intraobserver variability in lesion recognition. Thus, there is a clear need and opportunity for techniques or methodologies that will enhance the quality of lesion recognition and diagnosis and improve the outcomes of GI endoscopy. Deep learning models provide a basis to make better clinical decisions in medical image analysis. Biomedical image segmentation, classification, and registration can be improved with deep learning. Recent evidence suggests that the application of deep learning methods to medical image analysis can contribute significantly to computer-aided diagnosis. Deep learning models are usually considered to be more flexible and provide reliable solutions for image analysis problems compared to conventional computer vision models. The use of fast computers offers the possibility of real-time support that is important for endoscopic diagnosis, which has to be made in real time. Advanced graphics processing units and cloud computing have also favored the use of machine learning, and more particularly, deep learning for patient care. This paper reviews the rapidly evolving literature on the feasibility of applying deep learning algorithms to endoscopic imaging.

  12. A STUDY ON UPPER GASTRO INTESTINAL ENDOSCOPIC FINDINGS IN PATIENTS ADMITTED WITH UPPER GASTRO INTESTINAL BLEEDING

    Directory of Open Access Journals (Sweden)

    Sudhakar Merugu

    2017-01-01

    Full Text Available BACKGROUND Endoscopy is key diagnostic tool for management of upper gastro intestinal bleeding. In addition it provides a unique therapeutic opportunity which has over years reduced the need for emergency surgery, but the impact on survival is less dramatic with the mortality from severe upper gastro intestinal bleeding remaining fairly constant. MATERIALS AND METHODS Hundred Patients who were giving definite history of vomiting of frank blood or coffee ground coloured vomit and or passed dark coloured stools were admitted during study period and were subjected to endoscopy to identify the aetiology. RESULTS In this study of 100 patients mean age of the patients was 48 years. Majority of them are males (82% and Male to Female ratio was 4.5:1. The most common cause of UGIB was portal hypertension related variceal bleed seen in 28% of patients. Peptic ulcer related bleed was seen in 25% of patients. Mallory Weiss tear was seen in 15% of patients, Oesophagitis (12% of patients, gastric erosions 7% of patients, duodenitis 6% of patients, GAVE accounted for 3% of patients, 2% of patients showing normal endoscopic findings, post EVL variceal bleed (1% and carcinoma stomach accounted for 1% of cases. CONCLUSION In present study variceal bleed was the most common cause of UGIB, followed by peptic ulcer bleed and variceal bleed was most common cause for major UGI bleed.

  13. Validation of a realistic simulator for veterinary gastrointestinal endoscopy training.

    Science.gov (United States)

    Usón-Gargallo, Jesús; Usón-Casaús, Jesús M; Pérez-Merino, Eva M; Soria-Gálvez, Federico; Morcillo, Esther; Enciso, Silvia; Sánchez-Margallo, Francisco M

    2014-01-01

    This article reports on the face, content, and construct validity of a new realistic composite simulator (Simuldog) used to provide training in canine gastrointestinal flexible endoscopy. The basic endoscopic procedures performed on the simulator were esophagogastroduodenoscopy (EGD), gastric biopsy (GB), and gastric foreign body removal (FBR). Construct validity was assessed by comparing the performance of novices (final-year veterinary students and recent graduates without endoscopic experience, n=30) versus experienced subjects (doctors in veterinary medicine who had performed more than 50 clinical upper gastrointestinal endoscopic procedures as a surgeon, n=15). Tasks were scored based on completion time, and specific rating scales were developed to assess performance. Internal consistency and inter-rater agreement were assessed. Face and content validity were determined using a 5-point Likert-type scale questionnaire. The novices needed considerably more time than the experts to perform EGD, GB, and FBR, and their performance scores were significantly lower (pinternal validity of the rating scales were good. Face validity was excellent, and both groups agreed that the endoscopy scenarios were very realistic. The experts highly valued the usefulness of Simuldog for veterinary training and as a tool for assessing endoscopic skills. Simuldog is the first validated model specifically developed to be used as a training tool for endoscopy techniques in small animals.

  14. Clinical features of snoring patients during sedative endoscopy.

    Science.gov (United States)

    Chung, Jung Wha; Kim, Nayoung; Wee, Jee Hye; Lee, Jaebong; Lee, Jongchan; Kwon, Soohoon; Hwang, Young-Jae; Yoon, Hyuk; Shin, Cheol Min; Park, Young Soo; Lee, Dong Ho; Kim, Jin-Wook

    2017-11-15

    Snoring is the sound of turbulence and vibration of the upper respiratory tissues and has been identified as a risk factor of obstructive sleep apnea (OSA) and cardiovascular disease. The aim of this study was to identify associated clinical factors in snoring patients undergoing sedative endoscopy. A total of 49 patients who snored during standard sedative endoscopy and 127 controls were prospectively enrolled from June 2015 to June 2016. The Korean version of the Berlin Questionnaire was used to identify risk factors of OSA. Clinical information, including comorbidities, was collected from electronic medical records. The snoring group showed a higher risk of OSA (42.9% vs. 26.8%, p = 0.039), and a higher prevalence of coronary artery disease (10.2% vs. 0.8%, p = 0.007) and advanced gastric cancer (12.2% vs. 2.4%, p = 0.015) compared with the control group. Multivariate analysis showed that coronary artery disease (odds ratio [OR], 13.93; 95% confidence interval [CI], 1.24 to 155.90; p = 0.033) and advanced gastric cancer (OR, 5.21; 95% CI, 1.01 to 26.98; p = 0.049) were significantly associated with snoring. However, a history of gastrectomy showed only a marginally significant association with snoring (OR, 2.16; 95% CI, 0.91 to 5.11; p = 0.079). Patients who snore during sedative endoscopy may need to be evaluated for possible coronary artery disease.

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

    Science.gov (United States)

    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.

  16. Does the reporting of gastro-intestinal endoscopy meet the minimal ...

    African Journals Online (AJOL)

    Background: The Minimal Standard Terminology (MST) was developed to standardise endoscopic reporting. This study is aimed at assessing current reporting at a tertiary hospital and whether it meets this Minimal Standard Terminology. Methods: This was a retrospective observational study of upper endoscopy reports ...

  17. Reporting systems in gastrointestinal endoscopy: Requirements and standards facilitating quality improvement: European Society of Gastrointestinal Endoscopy position statement

    NARCIS (Netherlands)

    Bretthauer, Michael; Aabakken, Lars; Dekker, Evelien; Kaminski, Michal F.; Rösch, Thomas; Hultcrantz, Rolf; Suchanek, Stepan; Jover, Rodrigo; Kuipers, Ernst J.; Bisschops, Raf; Spada, Cristiano; Valori, Roland; Domagk, Dirk; Rees, Colin; Rutter, Matthew D.

    2016-01-01

    To develop standards for high quality of gastrointestinal endoscopy, the European Society of Gastrointestinal Endoscopy (ESGE) has established the ESGE Quality Improvement Committee. A prerequisite for quality assurance and improvement for all gastrointestinal endoscopy procedures is

  18. Quantitative measurements in capsule endoscopy.

    Science.gov (United States)

    Keuchel, M; Kurniawan, N; Baltes, P; Bandorski, D; Koulaouzidis, A

    2015-10-01

    This review summarizes several approaches for quantitative measurement in capsule endoscopy. Video capsule endoscopy (VCE) typically provides wireless imaging of small bowel. Currently, a variety of quantitative measurements are implemented in commercially available hardware/software. The majority is proprietary and hence undisclosed algorithms. Measurement of amount of luminal contamination allows calculating scores from whole VCE studies. Other scores express the severity of small bowel lesions in Crohn׳s disease or the degree of villous atrophy in celiac disease. Image processing with numerous algorithms of textural and color feature extraction is further in the research focuses for automated image analysis. These tools aim to select single images with relevant lesions as blood, ulcers, polyps and tumors or to omit images showing only luminal contamination. Analysis of motility pattern, size measurement and determination of capsule localization are additional topics. Non-visual wireless capsules transmitting data acquired with specific sensors from the gastrointestinal (GI) tract are available for clinical routine. This includes pH measurement in the esophagus for the diagnosis of acid gastro-esophageal reflux. A wireless motility capsule provides GI motility analysis on the basis of pH, pressure, and temperature measurement. Electromagnetically tracking of another motility capsule allows visualization of motility. However, measurement of substances by GI capsules is of great interest but still at an early stage of development. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Senior Surgical Resident Confidence in Performing Flexible Endoscopy: What Can We Do Differently?

    Science.gov (United States)

    Fonseca, Annabelle L; Reddy, Vikram; Yoo, Peter S; Gusberg, Richard J; Longo, Walter E

    2016-01-01

    The American Board of Surgery endoscopy requirements for general surgery training are evolving. In 2006, the Residency Review Committee in Surgery increased the total number of endoscopy cases required before completion of general surgery residency training. This requirement is set to change further, given the new Flexible Endoscopic Curriculum that would be a requirement for applicants graduating surgical training during or after the 2017 to 2018 academic year. Given these changes, our goal was to evaluate the confidence of senior surgical residents performing flexible endoscopy. A survey was developed and sent to general surgery residents nationally, querying them regarding demographics and program-specific characteristics; additionally they were asked to rate their confidence level in performing flexible upper endoscopy and colonoscopy on a Likert scale of 1 to 5. We then compared those residents who indicated confidence (Likert scale 4-5) to those who did not (Likert scale 1-3). For the purpose of this study, only senior (postgraduate year 4 and 5) general surgery residents were assessed. We received 1176 responses from senior surgical residents: 56% of these were postgraduate year 5 residents, 65% male, 68% from University Programs, and 56% from programs associated with a Veteran's Affairs Hospital; 33% were from programs in the Northeast, 29% in the South, 24% in the Midwest, and 14% in the West; 75% were going on to additional fellowship training after the completion of residency; 42% indicated that they would go into academic practice and 32% into private practice; 66.7% reported confidence performing upper endoscopy and 52.7% reported confidence performing colonoscopy. Male gender, overall operative volume, and graduating from a medium-sized program or program in the South were associated with increased confidence performing flexible endoscopy. A large percentage of senior residents do not report confidence in performing flexible endoscopy. Although

  20. Therapeutic Capsule Endoscopy: Opportunities and Challenges

    Directory of Open Access Journals (Sweden)

    Mahdi Rasouli

    2011-01-01

    Full Text Available The increasing demand for non-invasive (or less-invasive monitoring and treatment of medical conditions has attracted both physicians and engineers to work together and investigate new methodologies. Wireless capsule endoscopy is a successful example of such techniques which has become an accepted routine for diagnostic inspection of the gastrointestinal tract. This method offers a non-invasive alternative to traditional endoscopy and provides the opportunity for exploring distal areas of the small intestine which are otherwise not accessible. Despite these advantages, wireless capsule endoscopy is still limited in functionality compared to traditional endoscopy. Wireless capsule endoscopes with advanced functionalities, such as biopsy or drug delivery, are highly desirable. In this article, the current status of wireless capsule endoscopy is reviewed together with some of its possible therapeutic applications as well as the existing challenges.

  1. The predictive capacity of the Glasgow-Blatchford score for the risk stratification of upper gastrointestinal bleeding in an emergency department

    Directory of Open Access Journals (Sweden)

    José Manuel Recio-Ramírez

    2015-05-01

    Full Text Available Objectives: To assess the ability of the Glasgow Blatchford Score (GBS system to identify the need for urgent upper gastrointestinal endoscopy (UGIE in patients with upper gastrointestinal bleeding (UGIB. Methods: An observational, retrospective study was carried out in all patients attended at the ER for suspected UGIB in one year. Patients were split into two categories -high-risk (>2 and low-risk (≤2- by means of the GBS system. Results: A total of 60 patients were included. Of these, 46 were classified as "high-risk" (> 2 and 14 as "low-risk" (≤ 2 subjects. The characteristics of patients in the low-risk group included: Mean age: 46.6 ± 13.7 (18-88 years. Males/females: 7/7. Urgent endoscopy revealed: normal (50%; n = 7; esophagitis (21.4%; n = 3; gastritis (14.2%; n = 2; Mallory-Weiss syndrome (7.1%; n = 1; non-bleeding varices (7.1%; n = 1. The characteristics of patients in the high-risk group included: Mean age: 68.7 ± 19.8 (31-91 years. Males/females: 30/16. Digestive endoscopy revealed: Gastric/duodenal ulcer (56.52%; n = 26; normal (17.39%; n = 8; esophagitis (8.69%; n = 4; gastritis (8.69%; n = 4; angioectasia (4.34%; n = 2; bleeding varices (4.34%; n = 2. Low-risk patients exhibited no lesions requiring urgent management during endoscopy, and the sensitivity of the GBS scale for high-risk UGIB detection was found to be 100% (95% CI: 86.27%, 99.71%, with a specificity of 48.28% (95% CI: 29.89, 67.1%. Conclusions: The GBS scale seems to accurately identify patients with low-risk UGIB, who may be managed on an outpatient basis and undergo delayed upper GI endoscopy at the outpatient clinic.

  2. Diagnostic and Therapeutic Yield of Endoscopy in Patients with Elevated INR and Gastrointestinal Bleeding.

    Science.gov (United States)

    Peloquin, Joanna M; Seraj, Siamak M; King, Lindsay Y; Campbell, Emily J; Ananthakrishnan, Ashwin N; Richter, James M

    2016-06-01

    Gastrointestinal bleeding is a well-known risk of systemic anticoagulation. However, bleeding in the setting of supratherapeutic anticoagulation may have a milder natural history than unprovoked bleeding. It is a common clinical gestalt that endoscopy is common, but bleeding source identification or intervention is uncommon, yet few data exist to inform this clinical impression. Consequently, we sought to examine our institutional experience with gastrointestinal bleeding in the setting of supratherapeutic international normalized ratio (INR) with the aim of identifying predictors of endoscopically identifiable lesions, interventions, and outcomes. A retrospective review was conducted at a tertiary referral academic medical center to identify patients presenting with gastrointestinal bleeding in the setting of warfarin and a supratherapeutic INR (>3.5) who underwent an endoscopic procedure. Relevant clinical covariates, endoscopic findings, need for intervention, and outcomes were collected by review of the medical record. Logistic regression adjusting for potential confounders identified predictors of endoscopically significant lesions as well as intervention and outcomes. A total of 134 patients with INR 3.5 or greater (mean 5.5, range 3.5-17.1) presented with symptoms of gastrointestinal bleeding, most commonly as melena or symptomatic anemia. Antiplatelet agents were used by 54% of patients, and 60% of patients were on concomitant acid suppression on admission. Procedures included esophagogastroduodenoscopy (upper endoscopy; EGD) (n = 128), colonoscopy (n = 73), and video capsule endoscopy (n = 32). Active bleeding at first EGD or colonoscopy was found in only 19 patients (18%), with endoscopic intervention in only 26 patients (25%). At a critical threshold of INR 7.5 at presentation, the likelihood of finding an endoscopically significant lesion fell to therapy (odds ratio [OR] 2.59; 95% confidence interval [CI], 1.13-5.94), timing of EGD within 12 hours of

  3. Stray energy transfer during endoscopy.

    Science.gov (United States)

    Jones, Edward L; Madani, Amin; Overbey, Douglas M; Kiourti, Asimina; Bojja-Venkatakrishnan, Satheesh; Mikami, Dean J; Hazey, Jeffrey W; Arcomano, Todd R; Robinson, Thomas N

    2017-10-01

    Endoscopy is the standard tool for the evaluation and treatment of gastrointestinal disorders. While the risk of complication is low, the use of energy devices can increase complications by 100-fold. The mechanism of increased injury and presence of stray energy is unknown. The purpose of the study was to determine if stray energy transfer occurs during endoscopy and if so, to define strategies to minimize the risk of energy complications. A gastroscope was introduced into the stomach of an anesthetized pig. A monopolar generator delivered energy for 5 s to a snare without contacting tissue or the endoscope itself. The endoscope tip orientation, energy device type, power level, energy mode, and generator type were varied to mimic in vivo use. The primary outcome (stray current) was quantified as the change in tissue temperature (°C) from baseline at the tissue closest to the tip of the endoscope. Data were reported as mean ± standard deviation. Using the 60 W coag mode while changing the orientation of the endoscope tip, tissue temperature increased by 12.1 ± 3.5 °C nearest the camera lens (p energy transfer (p = 0.04 and p = 0.002, respectively) as did utilizing the low-voltage cut mode (6.6 ± 0.5 °C, p energy transfer compared to a standard generator (1.5 ± 3.5 °C vs. 9.5 ± 0.8 °C, p energy is transferred within the endoscope during the activation of common energy devices. This could result in post-polypectomy syndrome, bleeding, or perforation outside of the endoscopist's view. Decreasing the power, utilizing low-voltage modes and/or an impedance-monitoring generator can decrease the risk of complication.

  4. Leadership and team building in gastrointestinal endoscopy.

    Science.gov (United States)

    Valori, Roland M; Johnston, Deborah J

    2016-06-01

    A modern endoscopy service delivers high volume procedures that can be daunting, embarrassing and uncomfortable for patients [1]. Endoscopy is hugely beneficial to patients but only if it is performed to high standards [2]. Some consequences of poor quality endoscopy include worse outcomes for cancer and gastrointestinal bleeding, unnecessary repeat procedures, needless damage to patients and even avoidable death [3]. New endoscopy technology and more rigorous decontamination procedures have made endoscopy more effective and safer, but they have placed additional demands on the service. Ever-scarcer resources require more efficient, higher turnover of patients, which can be at odds with a good patient experience, and with quality and safety. It is clear from the demands put upon it, that to deliver a modern endoscopy service requires effective leadership and team working [4]. This chapter explores what constitutes effective leadership and what makes great clinical teams. It makes the point that endoscopy services are not usually isolated, independent units, and as such are dependent for success on the organisations they sit within. It will explain how endoscopy services are affected by the wider policy and governance context. Finally, within the context of the collection of papers in this edition of Best Practice & Research: Clinical Gastroenterology, it explores the potentially conflicting relationship between training of endoscopists and service delivery. The effectiveness of leadership and teams is rarely the subject of classic experimental designs such as randomized controlled trials. Nevertheless there is a substantial literature on this subject within and particularly outside healthcare [5]. The authors draw on this wider, more diffuse literature and on their experience of delivering a Team Leadership Programme (TLP) to the leaders of 70 endoscopy teams during the period 2008-2012. (Team Leadership Programme Link-http

  5. Clinical applications of endoscopy in otology

    Science.gov (United States)

    Poe, Dennis S.

    1993-07-01

    The role of endoscopes in otologic surgery is growing as optical systems become increasingly sophisticated with smaller diameters and improved resolution. This author has performed 52 transtympanic middle ear endoscopic procedures in the office since 1990. Endoscopy, as a diagnostic procedure, was found to be a valuable technique yielding high quality examinations that eliminated the need for surgical exploration in all but one patient. Examinations were well tolerated, and no complications have occurred. It is anticipated that endoscopy will become an important technique for diagnostic middle ear exploration. Surgical intervention by endoscopy may prove useful in the future as dedicated otologic instruments become available, and laser systems are integrated.

  6. Challenges and Future of Wireless Capsule Endoscopy.

    Science.gov (United States)

    Saurin, Jean-Christophe; Beneche, Nicolas; Chambon, Christine; Pioche, Mathieu

    2016-01-01

    In 2015, capsule endoscopy was introduced as the main investigation method for small bowel mucosal diseases, and its role in colonic diseases has been gradually revealed. Future challenges for capsule endoscopy, besides improvements of image quality and visualization of each part of the small bowel and colonic mucosa, include the development of gastric capsules, the capacity to perform histological examination of the mucosa, and maybe in the future, some capsule endoscopy-driven therapeutics. The aim of this review was to evaluate the clinical demands and feasibility of achieving the aforementioned objectives.

  7. ViewPoint: Upper Gastrointestinal Endoscopy in Malawi: An ...

    African Journals Online (AJOL)

    Thus the endoscope both provides macroscopic diagnostic information and can sample tissue for histopathological or microbiological analysis. In addition therapeutic techniques can be performed: ulcers can be injected through the biopsy channel, polyps removed, and varices injected or ligated with small rubber bands.

  8. Patterns of upper gastrointestinal diseases based on endoscopy in ...

    African Journals Online (AJOL)

    Majority of the patients had abnormal findings with gastritis being the most common (25.8%). It is concluded that gastritis is an important cause of morbidity in Kenya. Oesophagitis, mainly due to gastroesopahageal reflux disease, seems to be on the increase. Gastric cancer is not as rare as previously thought and peptic ...

  9. Upper gastrointestinal endoscopy in children: The Lagos University ...

    African Journals Online (AJOL)

    18.3%), gastric erosions in 12 (16.9%), oesophageal varices 6 (8.4%), duodenitis in 4 (5.6%), gastric ulcer in 3 (4.2%), gastric polyp in 2 (2.8%). The overall endoscopic yield was 60.2%. Conclusion. There is a need to increase the awareness of ...

  10. Upper Gastrointestinal Endoscopy in Sudanese Infants and Children ...

    African Journals Online (AJOL)

    65 out of 100 children who presented with failure to thrive, short stature, and persistent diarrhoea were found to have macroscopic duodenal lesions. 65 duodenal biopsies showed total villous atrophy. H. pylori infection andgastritis were found in 165out of 180 biopsies [91.7%]. Ultrasound abdomen was performed in the ...

  11. A Simple Laparoscopic Procedure to Restore a Normal Vaginal Length After Colpohysterectomy With Large Upper Colpectomy for Cervical and/or Vaginal Neoplasia.

    Science.gov (United States)

    Leblanc, Eric; Bresson, Lucie; Merlot, Benjamin; Puga, Marco; Kridelka, Frederic; Tsunoda, Audrey; Narducci, Fabrice

    2016-01-01

    Colpohysterectomy is sometimes associated with a large upper colpectomy resulting in a shortened vagina, potentially impacting sexual function. We report on a preliminary experience of a laparoscopic colpoplasty to restore a normal vaginal length. Patients with shortened vaginas after a laparoscopic colpohysterectomy were considered for a laparoscopic modified Davydov's procedure to create a new vaginal vault using the peritoneum of the rectum and bladder. From 2010 to 2014, 8 patients were offered this procedure, after informed preoperative consent. Indications were 2 extensive recurrent vaginal intraepithelial neoplasias grade 3 and 6 radical hysterectomies for cervical cancer. Mean vaginal length before surgery was 3.8 cm (standard deviation, 1.6). Median operative time was 50 minutes (range, 45-90). Blood loss was minimal (50-100 mL). No perioperative complications occurred. Median vaginal length at discharge was 11.3 cm (range, 9-13). Sexual intercourse could be resumed around 10 weeks after surgery. At a median follow-up of 33.8 months (range, 2.4-51.3), 6 patients remained sexually active but 2 had stopped. Although this experience is small, this laparoscopic modified Davydov's procedure seems to be an effective procedure, adaptable to each patient's anatomy. If the initial postoperative regular self-dilatation is carefully observed, vaginal patency is durably restored and enables normal sexual function. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

  12. Development of Bariatric and Metabolic Endoscopy

    Directory of Open Access Journals (Sweden)

    Shi-Han Li

    2018-01-01

    Conclusions: Bariatric and metabolic endoscopy would help obese people lose weight or prepare for bariatric surgery and hopefully alleviate some of the complications of bariatric procedures. Adequate studies and data are still needed for the new endoscopic devices.

  13. Indicators of Safety Compromise in Gastrointestinal Endoscopy

    Directory of Open Access Journals (Sweden)

    Mark R Borgaonkar

    2012-01-01

    Full Text Available The growth in the use of endoscopy to diagnose and treat many gastointestinal disorders, and its central role in cancer screening programs, has led to a significant increase in the number of procedures performed. This growth, however, has also led to many variations in, among others, the provision of services, the choice of sedative medications and the training of providers. The recognition of the significance of quality in endoscopy has prompted several countries, including Canada, to initiate efforts to adopt nationwide quality improvement programs. The Canadian Association of Gastroenterology formed a committee to review endoscopy and quality with the aim of stimulating improvement. This article focuses specifically on patient safety indicators that were developed at a consensus conference aimed at generating a broad range of recommendations for selected endoscopic procedures, which if adopted, could lead to significant changes in how endoscopy services are provided.

  14. Ketamine Sedation in Gastrointestinal Endoscopy in Children

    Directory of Open Access Journals (Sweden)

    Ayman E. Eskander

    2016-07-01

    CONCLUSION: Ketamine sedation found to be safe for paediatric gastrointestinal endoscopy in Egyptian children without co-morbidities. Transient Hypoxia (13% may occur but easily reversed by nasal oxygen therapy.

  15. Microrobotics for future gastrointestinal endoscopy.

    Science.gov (United States)

    Menciassi, Arianna; Quirini, Marco; Dario, Paolo

    2007-01-01

    The impulse given by robotic technologies and imaging techniques to the development of a new way to conceive and perform surgery is clearly visible. Nowadays, minimally invasive surgical (MIS) procedures are often performed with the assistance of robots, such as the Da Vinci master-slave system, the AESOP robot with voice control, etc. In addition, mechatronic technologies are becoming the elective technologies for designing advanced hand-held surgical tools. The introduction of robotic technologies in endoscopy has been slower than in MIS, since the development of miniaturized robotic components for entering the small orifices of the human body is difficult. On the other hand, the large contribution that robotic technologies could bring to endoluminal techniques has been evident since the first development of instrumented catheters. In the 1990s, there was an increasing activity in the application of robotic technologies to improve endoscopic procedures in the gastrointestinal tract. The objective of robotic colonoscopy and gastroscopy was to obtain more effective diagnoses in terms of reduced pain for the patients, and to make uniform the diagnostic procedures, which too often depended on the manual abilities of the endoscopist. Currently, the availability of more reliable robotic technologies for miniaturization of size and integration of functions has allowed to conceive and develop robotic pills for the early screening of the digestive tract, with dramatic potential advantages for patients, endoscopists, and healthcare system.

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

    Directory of Open Access Journals (Sweden)

    Arif Ali Kolethekkat

    2013-11-01

    Full Text Available 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 (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

  17. Virtual MR endoscopy of the ventricles prior to neurosurgical interventional endoscopy - evaluation of different presentation techniques

    International Nuclear Information System (INIS)

    Lemke, A.J.; Schurig-Urbaniak, A.M.; Niehues, S.M.; Felix, R.; Liebig, T.

    2004-01-01

    Purpose: In the past, virtual endoscopies have been performed for planning of endoscopic interventions or for diagnostic purposes in various organ systems with increasing frequency. This study evaluates the ability of virtual ventricular endoscopy to depict anatomical structures and the use for planning of real endoscopy. Materials and Methods: In a prospective study, 4 volunteers and 8 patients were examined with MRI. In 3 of the patients endoscopy was performed by our neurosurgeons thereafter. The calculation of the virtual endoscopy was based on 1 mm sagittal T2-weighted images. Comparison of surface rendering and volume rendering was made by means of video sequencing of individual views, and these were compared with the intraoperative endoscopic videos concerning the depictability of anatomical landmarks. Results: The reconstructions using volume rendering were more significant and easier to calculate than those based on surface rendering. Virtual endoscopy in the transparent mode allowed visualization of hazardous structures outside the ventricular system such as the basilar artery tip. Transparent 3D images of the ventricles gave a good overview on the depicted structures and enabled a better orientation during the virtual camera flight than surface rendered views. Conclusion: MR-based virtual endoscopy of the ventricular system can be obtained on the basis of surface- and volume-rendered views of sagittal T2-weighted thin sections. Preoperative utilization of this method simplifies the planning of endoscopy by visualization of anatomical structures. (orig.)

  18. Predictive value of upper lip bite test and ratio of height to thyromental distance compared to other multivariate airway assessment tests for difficult laryngoscopy in apparently normal patients

    Directory of Open Access Journals (Sweden)

    Pratibha Jain Shah

    2013-01-01

    Full Text Available Background: Various anatomical measurements and non-invasive clinical tests, singly or in various combinations can be performed to predict difficult intubation. Recently introduced "Upper lip bite test" (ULBT and "Ratio of height to Thyromental distance" (RHTMD are claimed to have high predictability. We conducted a study to compare the Predictive Value of ULBT and RHTMD with Mouth opening (Inter-Incisor gap (IIG, Modified Mallampatti Test (MMT, Head and neck movement (HNM and Thyromental Distance (TMD for Difficult Laryngoscopy. Materials and Methods: In this prospective, single blinded observational study, 480 adult patients of either sex, ASA grade I and II were assessed and graded for ULBT, RHTMD, TMD, MMT, IIG, and HNM according to standard methods and correlated with the Cormack and Lehane grade. Results: ULBT and RHTMD had highest sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio, i.e., 74.63%, 91.53%, 58.82%, 95.7%, 31.765 and 71.64%, 92.01%, 59.26%, 95.24%, 8.96 respectively, compared to TMD, MMT, IIG and HNM. Conclusions: ULBT is the best predictive test for difficult laryngoscopy in apparently normal patients but RHTMD can also be used as an acceptable alternative.

  19. Predictive value of upper lip bite test and ratio of height to thyromental distance compared to other multivariate airway assessment tests for difficult laryngoscopy in apparently normal patients

    Science.gov (United States)

    Shah, Pratibha Jain; Dubey, Kamta Prasad; Yadav, Jai Prakash

    2013-01-01

    Background: Various anatomical measurements and non-invasive clinical tests, singly or in various combinations can be performed to predict difficult intubation. Recently introduced “Upper lip bite test” (ULBT) and “Ratio of height to Thyromental distance” (RHTMD) are claimed to have high predictability. We conducted a study to compare the Predictive Value of ULBT and RHTMD with Mouth opening (Inter-Incisor gap) (IIG), Modified Mallampatti Test (MMT), Head and neck movement (HNM) and Thyromental Distance (TMD) for Difficult Laryngoscopy. Materials and Methods: In this prospective, single blinded observational study, 480 adult patients of either sex, ASA grade I and II were assessed and graded for ULBT, RHTMD, TMD, MMT, IIG, and HNM according to standard methods and correlated with the Cormack and Lehane grade. Results: ULBT and RHTMD had highest sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio, i.e., 74.63%, 91.53%, 58.82%, 95.7%, 31.765 and 71.64%, 92.01%, 59.26%, 95.24%, 8.96 respectively, compared to TMD, MMT, IIG and HNM. Conclusions: ULBT is the best predictive test for difficult laryngoscopy in apparently normal patients but RHTMD can also be used as an acceptable alternative. PMID:23878440

  20. Wireless capsule endoscopy for obscure small-bowel disorders: final results of the first pediatric controlled trial.

    Science.gov (United States)

    Guilhon de Araujo Sant'Anna, Ana Maria; Dubois, Josée; Miron, Marie-Claude; Seidman, Ernest G

    2005-03-01

    Obscure small-bowel disorders are jejunal and ileal lesions undiagnosed by traditional imaging techniques (endoscopic, radiologic). We evaluated the diagnostic usefulness and safety of capsule endoscopy for obscure small-bowel disorders in children and adolescents. Comparative, prospective, self-controlled trials in patients (age, 10-18 y) suspected to have either small-bowel Crohn's disease, polyps, or obscure gastrointestinal (GI) bleeding. Capsule results were compared with the diagnostic imaging studies normally used in this age group. Among 20 patients suspected of Crohn's disease, multiple lesions consistent with this diagnosis were observed by capsule endoscopy in 50%. Small-bowel Crohn's disease was ruled out in 8 patients. Eosinophilic enteropathy was found in 2 others. For polyp detection (n = 6), capsule endoscopy yielded 100% concordance with the control studies when analyzed per patient. However, capsule endoscopy revealed a greater number (50%) of polyps. Among patients with obscure bleeding (n = 4), the capsule examination confirmed a diagnosis of vascular malformations in 3. Capsule endoscopy more accurately identified the precise source of bleeding compared with angiography. All 30 capsule studies were well tolerated, although 1 capsule was retained owing to an inflammatory stenosis. The capsule eventually was expelled after corticosteroid therapy. Capsule endoscopy correctly diagnosed or excluded a bleeding source, small-bowel polyps, or Crohn's disease of the small bowel in 29 of 30 patients. Capsule endoscopy permits an accurate, noninvasive approach for diagnosing obscure small bowel lesions in children over the age of 10.

  1. Simple serum markers for significant liver inflammation in chronic hepatitis B patients with an alanine aminotransferase level lower than 2 times upper limit of normal

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    LI Qiang

    2016-06-01

    Full Text Available ObjectiveTo investigate the simple serum markers for significant liver inflammation in chronic hepatitis B (CHB patients with an alanine aminotransferase (ALT level of <2 times upper limit of normal (ULN. MethodsThe clinical data of 278 CHB patients with ALT <2×ULN (ULN=40 U/L were analyzed retrospectively. Significant liver inflammation was defined as a liver inflammatory activity grade (G ≥2. The t-test was used for comparison of normally distributed continuous data between groups, and the Kruskal-Wallis rank sum test was used for non-normally distributed continuous data; the chi-square test was used for comparison of categorical data between groups. Multivariate logistic regression analysis was used to identify independent predictors for significant liver inflammation in CHB patients with ALT <2×ULN. The receiver operating characteristic (ROC curve was used to evaluate the diagnostic value of serum markers in significant liver inflammation. ResultsOf the 278 CHB patients enrolled, 175 (62.9% had no significant liver inflammation (G0-1 group and 103 (37.1% had significant liver inflammation (G2-4 group. There were significant differences in ALT, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase (GGT, albumin, globulin, prothrombin time (PT, platelet, absolute neutrophil count, hyaluronic acid (HA, glycocholic acid, precollagen Ⅲ, and collagen type Ⅳ(ⅣC between the two groups (all P<0.05. The multivariate regression analysis showed that GGT, PT, ⅣC, and HA were independent predictors for significant liver inflammation in CHB patients with ALT<2×ULN (OR=1.015, 1.600, 1.151, and 1.014, P=0.008, 0.021, 0.003, and 0.018. The areas under the ROC curve for GGT, PT, IVC, and HA to diagnose significant liver inflammation were 0.804, 0.722, 0.707, and 0.632, respectively. The cut-off value of 48.5 U/L for GGT to predict significant liver inflammation had a specificity of 90.3% and a negative

  2. Virtual reality simulators for gastrointestinal endoscopy training

    Science.gov (United States)

    Triantafyllou, Konstantinos; Lazaridis, Lazaros Dimitrios; Dimitriadis, George D

    2014-01-01

    The use of simulators as educational tools for medical procedures is spreading rapidly and many efforts have been made for their implementation in gastrointestinal endoscopy training. Endoscopy simulation training has been suggested for ascertaining patient safety while positively influencing the trainees’ learning curve. Virtual simulators are the most promising tool among all available types of simulators. These integrated modalities offer a human-like endoscopy experience by combining virtual images of the gastrointestinal tract and haptic realism with using a customized endoscope. From their first steps in the 1980s until today, research involving virtual endoscopic simulators can be divided in two categories: investigation of the impact of virtual simulator training in acquiring endoscopy skills and measuring competence. Emphasis should also be given to the financial impact of their implementation in endoscopy, including the cost of these state-of-the-art simulators and the potential economic benefits from their usage. Advances in technology will contribute to the upgrade of existing models and the development of new ones; while further research should be carried out to discover new fields of application. PMID:24527175

  3. Virtual reality simulators for gastrointestinal endoscopy training.

    Science.gov (United States)

    Triantafyllou, Konstantinos; Lazaridis, Lazaros Dimitrios; Dimitriadis, George D

    2014-01-16

    The use of simulators as educational tools for medical procedures is spreading rapidly and many efforts have been made for their implementation in gastrointestinal endoscopy training. Endoscopy simulation training has been suggested for ascertaining patient safety while positively influencing the trainees' learning curve. Virtual simulators are the most promising tool among all available types of simulators. These integrated modalities offer a human-like endoscopy experience by combining virtual images of the gastrointestinal tract and haptic realism with using a customized endoscope. From their first steps in the 1980s until today, research involving virtual endoscopic simulators can be divided in two categories: investigation of the impact of virtual simulator training in acquiring endoscopy skills and measuring competence. Emphasis should also be given to the financial impact of their implementation in endoscopy, including the cost of these state-of-the-art simulators and the potential economic benefits from their usage. Advances in technology will contribute to the upgrade of existing models and the development of new ones; while further research should be carried out to discover new fields of application.

  4. Nanotechnology in gastrointestinal endoscopy: A primer

    Directory of Open Access Journals (Sweden)

    Ashish Kumar Jha

    2012-01-01

    Full Text Available Nanotechnology is the understanding, control of matter and development of engineered devices in nanometer range (1-100 nm. Nanoparticles have different physicochemical properties (small size, large surface area to volume ratio, and high reactivity in comparison to bulk materials of the same composition. The nanotechnology has proved its usefulness in early diagnosis, proteonomics, imaging diagnostics and multifunctional therapeutics. Recent studies have shown its role in early diagnosis and targeted therapy of various gastrointestinal disorders such as hepatitis B virus and hepatitis C virus related liver disease, inflammatory bowel disease, gastric ulcer, and malignancy. Application of this technology appears promising in diagnostic and therapeutic endoscopy such as the endoscopic hemostasis of peptic ulcer bleeding, prevention of clogging of plastic stent and advance capsule endoscopy. This article will highlight the basic concepts of nanotechnology and its potential application in gastrointestinal endoscopy.

  5. Correlation of cardiac Troponin I levels (10 folds upper limit of normal) and extent of coronary artery disease in Non-ST elevation myocardial infarction

    International Nuclear Information System (INIS)

    Qadir, F.; Khan, M.; Hanif, B.; Lakhani, S.L.; Farooq, S.

    2010-01-01

    Objective: To determine the correlation of cardiac troponin I (cTnI) 10 folds upper limit of normal (ULN) and extent of coronary artery disease (CAD) in Non-ST-elevation myocardial infarction (NSTEMI). Methods: A cross-sectional study was conducted on 230 consecutive NSTEMI patients admitted in Tabba Heart Institute, Karachi between April to December 2008. cTnI was measured using MEIA method. All patients underwent coronary angiography in the index hospitalization. Stenosis > 70% in any of the three major epicardial vessels was considered significant CAD. Extent of CAD was defined as significant single, two or three vessel CAD. Chi-square test was applied to test the association between cTnI levels and CAD extent. Results: Out of 230 patients, in 111 patients with cTnI levels 10 folds ULN, 23(19.3%) had single vessel, 37(31.1 %) had two vessel and 55(46.2%) had three vessel significant CAD. The results suggest that there was an insignificant association between the cTnI levels and single vessel, two vessel and the overall CAD extent (p= 0.35, p= 0.21 and p= 0.13 respectively), however there was a statistically significant association between the cTnI levels and three vessel CAD (p < 0.04). Conclusion: Higher cTnI levels are associated with an increased proportion of severe three vessel CAD involvement. Prompt identification and referral of this patient subset to early revascularization strategies would improve clinical outcomes. (author)

  6. Effect of amlodipine, efonidipine, and trichlormethiazide on home blood pressure and upper-normal microalbuminuria assessed by casual spot urine test in essential hypertensive patients.

    Science.gov (United States)

    Hosaka, Miki; Inoue, Ryusuke; Satoh, Michihiro; Watabe, Daisuke; Hanazawa, Tomohiro; Ohkubo, Takayoshi; Asayama, Kei; Obara, Taku; Imai, Yutaka

    2017-11-27

    The aim of this study was to assess the effects of irbesartan alone and combined with amlodipine, efonidipine, or trichlormethiazide on blood pressure (BP) and urinary albumin (UA) excretion in hypertensive patients with microalbuminuria (30≤UA/creatinine (Cr) ratio [UACR] <300 mg/g Cr) and upper-normal microalbuminuria (10≤UACR<30 mg/g Cr). This randomized controlled trial enrolled 175 newly diagnosed and untreated hypertensive patients (home systolic blood pressure [SBP]≥135 mmHg; 10≤UACR<300 mg/g Cr of casual spot urine at the first visit to clinic). All patients were treated with irbesartan (week 0). Patients who failed to achieve home SBP ≤125 mmHg on 8-week irbesartan monotherapy (nonresponders, n = 115) were randomized into three additional drug treatment groups: trichlormethiazide (n = 42), efonidipine (n = 39), or amlodipine (n = 34). Irbesartan monotherapy decreased home SBP and first morning urine samples (morning UACR) for 8 weeks (p < 0.0001). At 8 weeks after randomization, all three additional drugs decreased home SBP (p < 0.0002) and trichlormethiazide significantly decreased morning UACR (p = 0.03). Amlodipine decreased morning UACR in patients with microalbuminuria based on casual spot urine samples (p = 0.048). However, multivariate analysis showed that only higher home SBP and UACR at week 8, but not any additional treatments, were significantly associated with UACR reduction between week 8 and week 16. In conclusion, crucial points of the effects of combination therapy on UACR were basal UACR and SBP levels. The effect of trichlormethiazide or amlodipine treatment in combination with irbesartan treatment on microalbuminuria needs to be reexamined based on a larger sample size after considering basal UACR and SBP levels.

  7. Change in ALT levels after administration of HMG-CoA reductase inhibitors to subjects with pretreatment levels three times the upper normal limit in clinical practice.

    Science.gov (United States)

    Kim, Hyunah; Lee, Hyeseon; Kim, Tong Min; Yang, So Jung; Baik, Seo Yeon; Lee, Seung-Hwan; Cho, Jae-Hyoung; Lee, Hyunyong; Yim, Hyeon Woo; Choi, In Young; Yoon, Kun-Ho; Kim, Hun-Sung

    2018-02-21

    Prescription of statins to patients with chronic liver disease whose alanine transaminase (ALT) is over three times the upper normal limit (UNL) is not recommended. In this study, we attempted to evaluate patients with baseline ALT levels > 3 ×  UNL who were prescribed statins without ethical problems, using electronic medical records. We enrolled subjects with ALT levels > 3 ×  UNL. The patients were divided into three groups consisting of those who had been taking agents affecting liver function (HEPA) and continued to do so after the statin prescription (HepCon), those who had not previously taken HEPA and began doing so after statin prescription (HepNew), and those who had never taken HEPA (HepNo). All ALT levels were determined within 3 months of statins administration, and changes were monitored. From January 2009 to December 2012, 61 patients with baseline ALT levels > 3 ×  UNL were prescribed statins for the first time. During the 3-month ALT monitoring, levels of the HepCon, HepNew, and HepNo groups decreased by 45 ± 8%, 64 ± 10%, and 42 ± 8%, respectively; however, intergroup differences were not significant (P = .386). All the subjects who were administered statins showed improvement or maintained their ALT levels, except for two subjects, which showed deterioration. However, the ALT levels of the two subjects subsequently remained stable. It is not clear whether it is safe to prescribe statins to patients with ALT > 3 times the UNL. Our study showed that prescription of statins in combination with HEPA did not cause deleterious effects, suggesting that ALT levels > 3 times the UNL do not have harmful effects. © 2018 John Wiley & Sons Ltd.

  8. Peripheral facial nerve palsy after therapeutic endoscopy.

    Science.gov (United States)

    Kim, Eun Jeong; Lee, Jun; Lee, Ji Woon; Lee, Jun Hyung; Park, Chol Jin; Kim, Young Dae; Lee, Hyun Jin

    2015-03-01

    Peripheral facial nerve palsy (FNP) is a mononeuropathy that affects the peripheral part of the facial nerve. Primary causes of peripheral FNP remain largely unknown, but detectable causes include systemic infections (viral and others), trauma, ischemia, tumor, and extrinsic compression. Peripheral FNP in relation to extrinsic compression has rarely been described in case reports. Here, we report a case of a 71-year-old man who was diagnosed with peripheral FNP following endoscopic submucosal dissection. This case is the first report of the development of peripheral FNP in a patient undergoing therapeutic endoscopy. We emphasize the fact that physicians should be attentive to the development of peripheral FNP following therapeutic endoscopy.

  9. Colon capsule endoscopy: toward the future.

    Science.gov (United States)

    Muguruma, Naoki; Tanaka, Kumiko; Teramae, Satoshi; Takayama, Tetsuji

    2017-02-01

    Colon capsule endoscopy is a wireless and minimally invasive technique for visualization of the whole colon. With recent improvements of technical features in second-generation systems, a more important role for colon capsule endoscopy is rapidly emerging. Although several limitations and drawbacks are yet to be resolved, its usefulness as a tool for colorectal cancer screening and monitoring disease activity in inflammatory bowel diseases has become more apparent with increased use. Further investigations, including multicenter trials, are required to evaluate the substantial role of the colon capsule in managing colorectal diseases.

  10. Impact of clinical symptoms and referral volume on endoscopy for detecting peptic ulcer and gastric neoplasms.

    Science.gov (United States)

    Voutilainen, M; Mäntynen, T; Kunnamo, I; Juhola, M; Mecklin, J P; Färkkilä, M

    2003-01-01

    We investigated the volume of dyspeptic patients referred by general practitioners (GPs) to upper gastrointestinal endoscopy and the impact on endoscopic findings. We also examined the correlation between clinical symptoms and endoscopic findings. We collected data on patients sent for upper gastrointestinal endoscopy by GPs of 30 healthcare centres in 1996 in our hospital referral area of 260,000 inhabitants. In addition, national and local cancer registries were used to enumerate the gastric cancer cases detected in 1996. The study population consisted of 3378 patients, mean age 58 years (interquartile range 25 years, male:female 1:1.3). Among the 30 healthcare centres, referral volumes for upper gastrointestinal endoscopy varied from 0.6 to 9.2 per 1000 inhabitants per year (median 3.3/1000/year). In healthcare units with 'high' (> or = 3.3/1000/year, 15 healthcare units, 1297 patients) and 'low' (detection rates were as follows: duodenal ulcer (DU) 3.5% (n = 46) versus 4.0% (n = 83, P = 0.5), gastric ulcer (GU) 4.9% (n = 64) versus 5.3% (n = 110, P = 0.6), gastropathy 43.8% (n = 568) versus 35.6% (n = 736, P peptic ulcers or gastric cancer. Alarm symptoms associate strongly with significant gastric lesions such as GU and cancer. Increased referral volume results in an increased number of gastropathy and gastric polyp(s), but not of peptic ulcer or cancer.

  11. Watermelon stomach seen by wireless‐capsule endoscopy

    OpenAIRE

    MASCARENHAS‐SARAIVA, M.; LOPES, L.; MASCARENHAS‐SARAIVA, A.

    2003-01-01

    Endoscopy. 2003 Jan;35(1):100. Watermelon stomach seen by wireless-capsule endoscopy. Mascarenhas-Saraiva M, Lopes L, Mascarenhas-Saraiva A. SourceDigestive Endoscopy and Motility Unit, Trindade Hospital, Rua Trinidade 115, 4000-541 Porto, Portugal. PMID:12510242[PubMed - indexed for MEDLINE

  12. Potential impact of enhanced practice efficiency on endoscopy waiting times.

    LENUS (Irish Health Repository)

    Harewood, G C

    2009-06-01

    With the growing demand on endoscopy services, optimising practice efficiency has assumed increasing importance. Prior research has identified practice changes, which increase the efficiency in endoscopy. In this study, the potential impact of these practice changes on the current and projected future endoscopy waiting times at our institution was assessed.

  13. Upper gastrointestinal endoscopic findings and prevalence of ...

    African Journals Online (AJOL)

    Upper gastrointestinal endoscopic findings and prevalence of Helicobacter pylori infection among adult patients with dyspepsia in northern Tanzania. ... Endoscopy (EGD) for initial work up. Study on antimicrobial susceptibility pattern of H. pylori is recommended to guide choices for evidence based treatment option.

  14. Standardization and Coding of Gastrointestinal Endoscopy Reports

    NARCIS (Netherlands)

    M.J.M. Groenen (Marcel)

    2011-01-01

    textabstractGastrointestinal endoscopy has developed rapidly in the last five decades. It started in the sixties, when the first commercial model of the then recently invented fully flexible fiberoptic gastroscope was developed. In the late sixties fiberoptic endoscopes changed to forward viewing,

  15. Three-dimensional endoscopy in sinus surgery.

    Science.gov (United States)

    Singh, Ameet; Saraiya, Rupali

    2013-02-01

    Surgical endoscopy revolutionized the management of disease in nearly every surgical field, including rhinology. Endoscopy offered several advantages for the surgical management of rhinologic disease. However, it had a distinct disadvantage compared to direct vision, namely loss of binocular vision. Two-dimensional (2D) endoscopy limited depth perception, widely regarded as an important parameter for accurate and efficient movements during surgery. Three-dimensional (3D) endoscopic visualization has been actively pursued for decades by endoscopic surgeons in multiple surgical specialties. However, its clinical role has been limited due to technical limitations as well as successful adaptation by endoscopic surgeons to monocular cues offered by 2D technology. Until recently, stereoscopic technology included variations of dual channel video, dual chip-on-the-tip, and shutter mechanism, as well as various 3D displays. Over the past decade a novel 3D endoscopic technology was introduced. This technology used a lenticular array of lenses in front of a single video chip at the distal end of an endoscope to generate a stereoscopic view of the surgical field. Also known as the 'insect eye' technology since it mimics the compound eye of arthropods, this endoscope has reinvigorated the field of 3D endoscopic surgery. Recent developments in 3D endoscopy hold much promise for all surgical subspecialties, particularly endoscopic sinus and skull-base surgery.

  16. Zoonotic Ancylostoma ceylanicum Infection Detected by Endoscopy

    Science.gov (United States)

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

    2014-01-01

    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

  17. Hindfoot endoscopy for posterior ankle pain

    NARCIS (Netherlands)

    van Dijk, C. Niek

    2006-01-01

    Hindfoot pain can be caused by a variety of pathologies, most of which can be diagnosed and treated with endoscopy. The main indications are posterior tibial tenosynovectomy, diagnosis of a longitudinal peroneus brevis rupture, peroneal tendon adhesiolysis, flexor hallucis longus release, os

  18. Capsule Endoscopy: New Technology, Old Complication ...

    African Journals Online (AJOL)

    Wireless capsule endoscopy is a new tool in the armamentarium of the gastroenterologist to evaluate the small bowel non-invasively. It allows improved diagnostic yield with low complication rates relative to traditional modalities. But this new technology has its own set of complications, some which can lead to significant ...

  19. Hardware image assessment for wireless endoscopy capsules.

    Science.gov (United States)

    Khorsandi, M A; Karimi, N; Samavi, S; Hajabdollahi, M; Soroushmehr, S M R; Ward, K; Najarian, K

    2016-08-01

    Wireless capsule endoscopy is a new technology in the realm of telemedicine that has many advantages over the traditional endoscopy systems. Transmitted images should help diagnosis of diseases of the gastrointestinal tract. Two important technical challenges for the manufacturers of these capsules are power consumption and size of the circuitry. Also, the system must be fast enough for real-time processing of image or video data. To solve this problem, many hardware designs have been proposed for implementation of the image processing unit. In this paper we propose an architecture that could be used for the assessment of endoscopy images. The assessment allows avoidance of transmission of medically useless images. Hence, volume of data is reduced for more efficient transmission of images by the endoscopy capsule. This is done by color space conversion and moment calculation of images captured by the capsule. The inputs of the proposed architecture are RGB image frames and the outputs are images with converted colors and calculated image moments. Experimental results indicate that the proposed architecture has low complexity and is appropriate for a real-time application.

  20. Double-balloon endoscopy: Who needs it?

    DEFF Research Database (Denmark)

    Hendel, J.W.; Vilmann, P.; Jensen, T.

    2008-01-01

    Objective. Double-balloon endoscopy (DBE) made the small bowel accessible to inspection and therapy in its entirety. However, DBE is a time-consuming procedure that requires a highly skilled endoscopist, several nurses and - more often than not - anesthesiological support. This makes the selection...

  1. Can we reduce capsule endoscopy reading times?

    NARCIS (Netherlands)

    Westerhof, Jessie; Koornstra, Jan J.; Weersma, Rinse K.

    Background: Analyzing small-bowel capsule endoscopy (CE) images is time Consuming. Objective: To determine the effect of reducing the number Of images on reacting time and interpretation of CE procedures. Design: Two techniques aimed at reducing the number of images to he viewed were Studied. The

  2. Requirements and standards facilitating quality improvement for reporting systems in gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

    NARCIS (Netherlands)

    Bretthauer, Michael; Aabakken, Lars; Dekker, Evelien; Kaminski, Michal F.; Rösch, Thomas; Hultcrantz, Rolf; Suchanek, Stepan; Jover, Rodrigo; Kuipers, Ernst J.; Bisschops, Raf; Spada, Cristiano; Valori, Roland; Domagk, Dirk; Rees, Colin; Rutter, Matthew D.

    2016-01-01

    To develop standards for high quality in gastrointestinal (GI) endoscopy, the European Society of Gastrointestinal Endoscopy (ESGE) has established the ESGE Quality Improvement Committee. A prerequisite for quality assurance and improvement for all GI endoscopy procedures is state-of-the-art

  3. Moment magnitude, local magnitude and corner frequency of small earthquakes nucleating along a low angle normal fault in the Upper Tiber valley (Italy)

    Science.gov (United States)

    Munafo, I.; Malagnini, L.; Chiaraluce, L.; Valoroso, L.

    2015-12-01

    The relation between moment magnitude (MW) and local magnitude (ML) is still a debated issue (Bath, 1966, 1981; Ristau et al., 2003, 2005). Theoretical considerations and empirical observations show that, in the magnitude range between 3 and 5, MW and ML scale 1∶1. Whilst for smaller magnitudes this 1∶1 scaling breaks down (Bethmann et al. 2011). For accomplishing this task we analyzed the source parameters of about 1500 (30.000 waveforms) well-located small earthquakes occurred in the Upper Tiber Valley (Northern Apennines) in the range of -1.5≤ML≤3.8. In between these earthquakes there are 300 events repeatedly rupturing the same fault patch generally twice within a short time interval (less than 24 hours; Chiaraluce et al., 2007). We use high-resolution short period and broadband recordings acquired between 2010 and 2014 by 50 permanent seismic stations deployed to monitor the activity of a regional low angle normal fault (named Alto Tiberina fault, ATF) in the framework of The Alto Tiberina Near Fault Observatory project (TABOO; Chiaraluce et al., 2014). For this study the direct determination of MW for small earthquakes is essential but unfortunately the computation of MW for small earthquakes (MW < 3) is not a routine procedure in seismology. We apply the contributions of source, site, and crustal attenuation computed for this area in order to obtain precise spectral corrections to be used in the calculation of small earthquakes spectral plateaus. The aim of this analysis is to achieve moment magnitudes of small events through a procedure that uses our previously calibrated crustal attenuation parameters (geometrical spreading g(r), quality factor Q(f), and the residual parameter k) to correct for path effects. We determine the MW-ML relationships in two selected fault zones (on-fault and fault-hanging-wall) of the ATF by an orthogonal regression analysis providing a semi-automatic and robust procedure for moment magnitude determination within a

  4. Efficacy and safety of flumazenil injection for the reversal of midazolam sedation after elective outpatient endoscopy.

    Science.gov (United States)

    Lee, Sang Pyo; Sung, In-Kyung; Kim, Jeong Hwan; Lee, Sun-Young; Park, Hyung Seok; Shim, Chan Sup

    2018-02-01

    Midazolam sedation during elective endoscopy is widely performed and flumazenil is frequently administered after endoscopy to reverse sedation in clinical practice. This study aimed to investigate the safety and efficacy of flumazenil injections after elective endoscopy under midazolam sedation. Participants who underwent an upper endoscopy under midazolam sedation were randomly divided into two groups. In group I, flumazenil was administered i.v. 10 min after the patient's transfer to the recovery room, and no antidote was injected in group II. The time of stay in the recovery room and adverse events were reviewed through the nursing records. We asked the patients about their pain and degree of satisfaction according to a visual analogue scale (VAS), their memory of the procedure, mental status and the presence of uncomfortable symptoms on the day of the procedure and the day afterwards. The length of stay in recovery was significantly shorter in group I than in group II. No significant differences were found in the number of patients with pain (VAS ≥1), adverse events and discomfort between the two groups. Additionally, there were no differences in the patients' memory of the procedure, satisfaction with sedation, willingness to repeat the endoscopy and mental status. The time in the recovery room after flumazenil administration was significantly shortened, and the use of the drug did not increase the risk of adverse events or discomfort. The use of flumazenil for reversing midazolam sedation seems to be safe and effective. © 2018 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  5. Endoscopic evaluation of upper abdominal symptoms in adult patients, Saudi Aramco-Ai Hasa Health Center, Saudi Arabia.

    Science.gov (United States)

    Nkrumah, K N

    2002-01-01

    Upper oesophago-gastro-duodenoscopies (UGI endoscopies) were performed on adult patients who attended Saudi Aramco Health Centre at Al Hasa, Saudi Arabia, between June 1986 and December 1993, with complaint of upper abdominal pain. During this period, three hundred and fifteen (315) patients were examined. Sixty one percent were females and the rest males. Peptic ulcer disease including gastritis was the most common diagnosis made. Helicobacter pylori-like organisms were documented historically in biopsy samples in 113 of 178 (63%) patients. Nearly all were associated with gastritis; no organisms were reported in normal histology specimens. This confirms the association of this organism with gastritis. Gastric cancer suspected radiologically were not confirmed endoscopically or histologically. It is important to endoscope and biopsy for histology suspected gastric cancer and ulcer; a negative result may save the patient from unnecessary surgery, ideally all normal looking gastric mucosa should be biopsied so that histological gastritis is not missed.

  6. Video endoscopy: removal of retained sewing needles from the duodenum.

    Science.gov (United States)

    Gajbhiye, Ashok S; Gajbhiye, Raj N; Tirupude, Bhupesh H; Bajaj, Prasang P; Gupta, Tarush H

    2013-06-01

    We report an interesting case of a 21-year-old unmarried girl who swallowed six sewing needles. Her complaints were pain in the epigastrium, associated with nausea and vomiting. On examination, there was mild tenderness in the epigastrium. X-ray of the abdomen and endoscopy confirmed the presence of six needles in the duodenum, with tips lodged in the duodenal wall. Psychiatric opinion was sought which was normal. Under video endoscope (Pentax 2.8, EG 27708) guidance with Captura biopsy forceps without spikes (Cook DBF-2.4-160-S), six sewing needles were removed successfully from the duodenum through the endoscope channel without any complications. However, a video endoscopic removal of the retained six needles from duodenum is probably being reported for the first time.

  7. Saliency-Based Bleeding Localization for Wireless Capsule Endoscopy Diagnosis

    Directory of Open Access Journals (Sweden)

    Hongda Chen

    2017-01-01

    Full Text Available Stomach bleeding is a kind of gastrointestinal disease which can be diagnosed noninvasively by wireless capsule endoscopy (WCE. However, it requires much time for physicians to scan large amount of WCE images. Alternatively, computer-assisted bleeding localization systems are developed where color, edge, and intensity features are defined to distinguish lesions from normal tissues. This paper proposes a saliency-based localization system where three saliency maps are computed: phase congruency-based edge saliency map derived from Log-Gabor filter bands, intensity histogram-guided intensity saliency map, and red proportion-based saliency map. Fusing the three maps together, the proposed system can detect bleeding regions by thresholding the fused saliency map. Results demonstrate the accuracy of 98.97% for our system to mark bleeding regions.

  8. Multicenter study on the safety of bariatric endoscopy

    Directory of Open Access Journals (Sweden)

    Eduardo Espinet-Coll

    Full Text Available Introduction: Bariatric endoscopy includes a series of specific techniques focused on the management of obese patients. As a quality criterion, safety as expressed by a minimal incidence of serious complications is required in addition to efficacy. Methods: A descriptive, retrospective, multicenter review of the experience recorded at seven hospitals included in the Grupo Español de Endoscopia Bariátrica (GETTEMO in order to document the incidence, cause, and resolution (including legal consequences of serious complications reported for each bariatric technique, and according to endoscopist expertise. Results: In all, 6,771 bariatric endoscopic procedures were collected, wherein 57 serious complications (0.84% were identified. Balloons: Orbera®-Medsil®, 5/5,589; Spatz2® (older model: 44/225; Heliosphere®: 1/70; Obalon®: 0/107. Sutures: POSE®, 5/679; sleeve gastroplasty with Apollo® system: 0/55. Prostheses: Endobarrier®: 2/46. All complications were resolved with medical/endoscopic management except for five cases (0.07% that required surgery. A single lawsuit occurred (esophageal perforation with Spatz2® balloon, which had a favorable outcome. There was no mortality, and apparently no differences were found according to endoscopist expertise level. Conclusions: In our multicenter experience, bariatric endoscopy may be considered as a safe procedure (0.84% of serious complications in all. However, some devices may induce a higher proportion of complications, such as 19.55% for Spatz2® balloons (already replaced or 4.34% for Endobarrier® (at the upper limit of accepted safety, although our experience with the latter is limited. All complications were resolved with conservative medical management, and only exceptionally required surgery (0.07%. No technique-related mortality was seen, and only one lawsuit occurred. Further evolutionary studies are required on the novel endoscopic techniques presently emerging to authenticate our

  9. Multicenter study on the safety of bariatric endoscopy.

    Science.gov (United States)

    Espinet Coll, Eduardo; Nebreda Durán, Javier; López-Nava Breviere, Gontrand; Ducóns García, Julio; Rodríguez-Téllez, Manuel; Crespo García, Javier; Marra-López Valenciano, Carlos

    2017-05-01

    Bariatric endoscopy includes a series of specific techniques focused on the management of obese patients. As a quality criterion, safety as expressed by a minimal incidence of serious complications is required in addition to efficacy. A descriptive, retrospective, multicenter review of the experience recorded at seven hospitals included in the Grupo Español de Endoscopia Bariátrica (GETTEMO) in order to document the incidence, cause, and resolution (including legal consequences) of serious complications reported for each bariatric technique, and according to endoscopist expertise. In all, 6,771 bariatric endoscopic procedures were collected, wherein 57 serious complications (0.84%) were identified. Balloons: Orbera®-Medsil®, 5/5,589; Spatz2® (older model): 44/225; Heliosphere®: 1/70; Obalon®: 0/107. Sutures: POSE®, 5/679; sleeve gastroplasty with Apollo® system: 0/55. Prostheses: Endobarrier®: 2/46. All complications were resolved with medical/endoscopic management except for five cases (0.07%) that required surgery. A single lawsuit occurred (esophageal perforation with Spatz2® balloon), which had a favorable outcome. There was no mortality, and apparently no differences were found according to endoscopist expertise level. In our multicenter experience, bariatric endoscopy may be considered as a safe procedure (0.84% of serious complications in all). However, some devices may induce a higher proportion of complications, such as 19.55% for Spatz2® balloons (already replaced) or 4.34% for Endobarrier® sleeves (at the upper limit of accepted safety), although our experience with the latter is limited. All complications were resolved with conservative medical management, and only exceptionally required surgery (0.07%). No technique-related mortality was seen, and only one lawsuit occurred. Further evolutionary studies are required on the novel endoscopic techniques presently emerging to authenticate our results.

  10. A human case of Echinostoma hortense (Trematoda: Echinostomatidae) infection diagnosed by gastroduodenal endoscopy in Korea

    Science.gov (United States)

    Cho, Chang-Min; Tak, Won-Young; Kweon, Young-Oh; Kim, Sung-Kook; Choi, Yong-Hwan; Kong, Hyun-Hee

    2003-01-01

    A human Echinostoma hortense infection was diagnosed by gastroduodenoscopy. An 81-year-old Korean male, living in Yeongcheon-shi, Gyeongsangbuk-do and with epigastric discomfort of several days duration, was subjected to upper gastrointestinal endoscopy. He was in the habit of eating fresh water fish. Two live worms were found in the duodenal bulb area and were removed using an endoscopic forcep. Based on their morphological characteristics, the worms were identified as E. hortense. The patient was treated with praziquantel 10 mg/kg as a single dose. The source of the infection in this case remains unclear, but the fresh water fish consumed, including the loach, may have been the source. This is the second case of E. hortense infection diagnosed by endoscopy in Korea. PMID:12815324

  11. The history of time for capsule endoscopy.

    Science.gov (United States)

    Adler, Samuel N

    2017-05-01

    Capsule endoscopy was conceived by inventive minds of good people. In the beginning there was a will to do something for medicine. The idea fomented after a discourse between the talented engineer with his physician friend. It took years to develop the concept. Then excellent engineers created de novo the necessary components to turn the capsule into a viable reality. The story is a tribute to human ingenuity.

  12. Automatic blood detection in capsule endoscopy video

    Czech Academy of Sciences Publication Activity Database

    Novozámský, Adam; Flusser, Jan; Tachecí, I.; Sulík, L.; Bureš, J.; Krejcar, O.

    2016-01-01

    Roč. 21, č. 12 (2016), s. 1-8, č. článku 126007. ISSN 1083-3668 R&D Projects: GA ČR GA15-16928S Institutional support: RVO:67985556 Keywords : Automatic blood detection * capsule endoscopy video Subject RIV: JD - Computer Applications, Robotics Impact factor: 2.530, year: 2016 http://library.utia.cas.cz/separaty/2016/ZOI/flusser-0466936.pdf

  13. Monitoring of Intracranial Pressure During Intracranial Endoscopy

    Directory of Open Access Journals (Sweden)

    Rajeev Kumar

    2013-08-01

    Full Text Available Background: Intracranial endoscopy is a minimum invasive procedure, which reduces trauma to the brain, is cost-effective, and carries a shortened hospital stay with an improved postoperative outcome. Objective: To monitor intracranial pressure changes during intracranial endoscopy among children and adults under general anesthesia/sedation, and to compare the intracranial pressure changes between children and adults receiving general anesthesia and among adults receiving general anesthesia and sedation. Methods: The present cross-sectional study was conducted in one of the tertiary care hospitals of Lucknow. This was carried out in the department of neurosurgery from January 2008 to December 2008. Patients who were not fit for general anesthesia received local anesthesia under sedation. Patients participating in the study were divided into three groups. Intracranial pressure was recorded at specific intervals. Parametric data were subjected to statistical analysis using a student\\s t test. Result: A total of 70 patients were undergoing intracranial endoscopy under general anesthesia during the study period. In both groups A and B, intracranial pressure increases the maximum during inflation of the balloon. In group C, all the variations in ICP were found to be statistically significant. In the comparison of intracranial pressure changes between groups A and B, no significant difference was found. All correlations in the comparison of groups B and C were found to be statistically significant (p< 0.001. Conclusion: There is a need for continuous intraoperative monitoring of ICP intracranial endoscopy, because ICP increases in various stages of the procedure, which can be detrimental to the perfusion of the brain. [Arch Clin Exp Surg 2013; 2(4.000: 240-245

  14. Sedation-related complications in gastrointestinal endoscopy

    OpenAIRE

    Amornyotin, Somchai

    2013-01-01

    Sedation practices for gastrointestinal endoscopic (GIE) procedures vary widely in different countries depending on health system regulations and local circumstances. 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-related complications in gastrointestinal endoscopy, once occurred, can lead to significant morbidity and occasional mortality in patients. The risk fa...

  15. Endoscopy and autopsy follow-up of biodegradable oesophageal anastomoses in dogs.

    Science.gov (United States)

    Kovács, T; Németh, T; Orosz, Z; Köves, I

    2001-01-01

    The biofragmentable Anastomosis Ring (BAR) is a mechanical device composed of absorbable material and creates an inverting, atraumatic compressive anastomosis with no foreign material at the anastomotic site after healing. The aim of the present experimental study was to assess the safety of oesophagoscopy in early days after oesophageal anastomoses performed with the BAR and to follow-up the healing of BAR anastomoses by in vivo endoscopy and autopsy examination. Thirty mongrel dogs divided into subgroups according to the time-points of endoscopy and autopsy (4th, 7th, 14th, 28th day) were used. There was no significant difference in the healing of anastomoses performed under or above the tracheal bifurcation. Pleural adhesions helped to cover and seal small subclinical leaks. The mortality was 13.3% (4 dogs) and the overall leakage rate 14.3%. We looked for bleeding, haematoma, erosion, ulceration and granulation tissue in the anastomosis. Due to the high mechanical strength of these anastomoses, oesophagoscopy was a safe, easy and feasible method for follow-up BAR intrathoracic anastomoses, with no significant difference between the number of lesions found with endoscopy as compared to the autopsy data. The overall sensitivity of oesophagoscopy to discover mucosal lesions was 73.1%. Endoscopy had no complications, therefore it is a useful method of follow-up and may help predict the normal or compromised healing of oesophageal anastomoses.

  16. Ultrasound capsule endoscopy: sounding out the future.

    Science.gov (United States)

    Cox, Benjamin F; Stewart, Fraser; Lay, Holly; Cummins, Gerard; Newton, Ian P; Desmulliez, Marc P Y; Steele, Robert J C; Näthke, Inke; Cochran, Sandy

    2017-05-01

    Video capsule endoscopy (VCE) has been of immense benefit in the diagnosis and management of gastrointestinal (GI) disorders since its introduction in 2001. However, it suffers from a number of well recognized deficiencies. Amongst these is the limited capability of white light imaging, which is restricted to analysis of the mucosal surface. Current capsule endoscopes are dependent on visual manifestation of disease and limited in regards to transmural imaging and detection of deeper pathology. Ultrasound capsule endoscopy (USCE) has the potential to overcome surface only imaging and provide transmural scans of the GI tract. The integration of high frequency microultrasound (µUS) into capsule endoscopy would allow high resolution transmural images and provide a means of both qualitative and quantitative assessment of the bowel wall. Quantitative ultrasound (QUS) can provide data in an objective and measurable manner, potentially reducing lengthy interpretation times by incorporation into an automated diagnostic process. The research described here is focused on the development of USCE and other complementary diagnostic and therapeutic modalities. Presently investigations have entered a preclinical phase with laboratory investigations running concurrently.

  17. Surveillance of FAP: a prospective blinded comparison of capsule endoscopy and other GI imaging to detect small bowel polyps

    Directory of Open Access Journals (Sweden)

    Tescher Paul

    2010-04-01

    Full Text Available Abstract Background Familial adenomatous polyposis (FAP is a hereditary disorder characterized by polyposis along the gastrointestinal tract. Information on adenoma status below the duodenum has previously been restricted due to its inaccessibility in vivo. Capsule Endoscopy (CE may provide a useful adjunct in screening for polyposis in the small bowel in FAP patients. This study aims to evaluate the effectiveness of CE in the assessment of patients with FAP, compared to other imaging modalities for the detection of small bowel polyps. Method 20 consecutive patients with previously diagnosed FAP and duodenal polyps, presenting for routine surveillance of polyps at The Royal Melbourne Hospital were recruited. Each fasted patient initially underwent a magnetic resonance image (MRI of the abdomen, and a barium small bowel follow-through study. Capsule Endoscopy was performed four weeks later on the fasted patient. An upper gastrointestinal side-viewing endoscopy was done one (1 to two (2 weeks after this. Endoscopists and investigators were blinded to results of other investigations and patient history. Results Within the stomach, upper gastrointestinal endoscopy found more polyps than other forms of imaging. SBFT and MRI generally performed poorly, identifying fewer polyps than both upper gastrointestinal and capsule endoscopy. CE was the only form of imaging that identified polyps in all segments of the small bowel as well as the only form of imaging able to provide multiple findings outside the stomach/duodenum. Conclusion CE provides important information on possible polyp development distal to the duodenum, which may lead to surgical intervention. The place of CE as an adjunct in surveillance of FAP for a specific subset needs consideration and confirmation in replication studies. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12608000616370

  18. Endoscopy in Canada: Proceedings of the National Roundtable

    Directory of Open Access Journals (Sweden)

    Noah Switzer

    2015-01-01

    Full Text Available 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.

  19. Impact of the endoscopist's experience on the negative predictive value of capsule endoscopy.

    Science.gov (United States)

    Velayos Jiménez, Benito; Alcaide Suárez, Noelia; González Redondo, Guillermo; Fernández Salazar, Luis; Aller de la Fuente, Rocío; Del Olmo Martínez, Lourdes; Ruiz Rebollo, Lourdes; González Hernández, José Manuel

    2017-01-01

    The impact of the accumulated experience of the capsule endoscopy (CE) reader on the accuracy of this test is discussed. To determine whether the negative predictive value of CE findings changes along the learning curve. We reviewed the first 900 CE read by 3 gastroenterologists experienced in endoscopy over 8 years. These 900 CE were divided into 3 groups (300 CE each): group 1 consisted of the sum of the first 100 CE read by each of the 3 endoscopists; group 2, the sum of the second 100 and groups 3, the sum of the third 100. Patients with normal CE were monitored for at least 28 months to estimate the negative predictive value. A total of 54 (18%) CE in group 1, 58 (19.3%) in group 2 and 47 (15.6%) in group 3 were normal, although only 34 patients in group 1, 38 in group 2 and 36 in group 3 with normal CE completed follow up and were eventually studied. The negative predictive value was 88.2% in group 1, 89.5% in group 2 and 97% in group 3 (P>.05). The negative predictive value tended to increase, but remained high and did not change significantly after the first 100 when readers are experienced in conventional endoscopy and have preliminary specific training. Copyright © 2016 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

  20. Three dimensional volume rendering virtual endoscopy of the ossicles using a multi-row detector CT: applications and limitations

    International Nuclear Information System (INIS)

    Kim, Su Yeon; Choi, Sun Seob; Kang, Myung Jin; Shin, Tae Beom; Lee, Ki Nam; Kang, Myung Koo

    2005-01-01

    This study was conducted to know the applications and limitations of three dimensional volume rendering virtual endoscopy of the ossicles using a multi-row detector CT. This study examined 25 patients who underwent temporal bone CT using a 16-row detector CT as a result of hearing problems or trauma. The axial CT scan of the temporal bone was performed with a 0.6 mm collimation, and a reconstruction was carried out with a U70u sharp of kernel value, a 1 mm thickness and 0.5-1.0 mm increments. After observing the ossicles in the axial and coronal images, virtual endoscopy was performed using a three dimensional volume rendering technique with a threshold value of-500 HU. The intra-operative otoendoscopy was performed in 12 ears, and was compared with the virtual endoscopy findings. Virtual endoscopy of the 29 ears without hearing problems demonstrated hypoplastic or an incomplete depiction of the stapes superstructures in 25 ears and a normal depiction in 4 ears. Virtual endoscopy of 21 ears with hearing problems demonstrated no ossicles in 1 ears, no malleus in 3 ears, a malleoincudal subluxation in 6 ears, a dysplastic incus in 5 ears, an incudostapedial subluxation in 9 ears, dysplastic stapes in 2 ears, a hypoplastic or incomplete depiction of the stapes in 16 ears and no stapes in 1 ears. In contrast to the intra-operative otoendoscopy, 8 out of 12 ears showed a hypoplastic or deformed stapes in the virtual endoscopy. Volume rendering virtual endoscopy using a multi-row detector CT is an excellent method for evaluation the ossicles in three dimension, even thought the partial volume effect for the stapes superstructures needs to be considered

  1. Three dimensional volume rendering virtual endoscopy of the ossicles using a multi-row detector CT: applications and limitations

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Su Yeon; Choi, Sun Seob; Kang, Myung Jin; Shin, Tae Beom; Lee, Ki Nam; Kang, Myung Koo [College of Medicine, Donga University, Pusan (Korea, Republic of)

    2005-08-15

    This study was conducted to know the applications and limitations of three dimensional volume rendering virtual endoscopy of the ossicles using a multi-row detector CT. This study examined 25 patients who underwent temporal bone CT using a 16-row detector CT as a result of hearing problems or trauma. The axial CT scan of the temporal bone was performed with a 0.6 mm collimation, and a reconstruction was carried out with a U70u sharp of kernel value, a 1 mm thickness and 0.5-1.0 mm increments. After observing the ossicles in the axial and coronal images, virtual endoscopy was performed using a three dimensional volume rendering technique with a threshold value of-500 HU. The intra-operative otoendoscopy was performed in 12 ears, and was compared with the virtual endoscopy findings. Virtual endoscopy of the 29 ears without hearing problems demonstrated hypoplastic or an incomplete depiction of the stapes superstructures in 25 ears and a normal depiction in 4 ears. Virtual endoscopy of 21 ears with hearing problems demonstrated no ossicles in 1 ears, no malleus in 3 ears, a malleoincudal subluxation in 6 ears, a dysplastic incus in 5 ears, an incudostapedial subluxation in 9 ears, dysplastic stapes in 2 ears, a hypoplastic or incomplete depiction of the stapes in 16 ears and no stapes in 1 ears. In contrast to the intra-operative otoendoscopy, 8 out of 12 ears showed a hypoplastic or deformed stapes in the virtual endoscopy. Volume rendering virtual endoscopy using a multi-row detector CT is an excellent method for evaluation the ossicles in three dimension, even thought the partial volume effect for the stapes superstructures needs to be considered.

  2. WEO position statement on hygiene in digestive endoscopy: Focus on endoscopy units in Asia and the Middle East.

    Science.gov (United States)

    Murdani, Abdullah; Kumar, Ajay; Chiu, Han-Mo; Goh, Khean-Lee; Jang, Byung Ik; Khor, Christopher J L; Lau, James; Mostafa, Ibrahim; Ramchandani, Mohan; Ratanalert, Siriporn; Tajiri, Hisao; Yuen, Minghwa; Zhang, Shu Tian; Duforest-Rey, Dianelle; Rey, Jean-Francois

    2017-01-01

    The aim of this position statement is to reinforce the key points of hygiene in digestive endoscopy. The present article details the minimum hygiene requirements for reprocessing of endoscopes and endoscopic devices, regardless of the reprocessing method (automated washer-disinfector or manual cleaning) and the endoscopy setting (endoscopy suite, operating room, elective or emergency procedures). These minimum requirements are mandatory for patient safety. Both advanced diagnostic and therapeutic endoscopies should be carried out in an environment that is safe for patients and staff. Particular attention is given to contaminants. Procedural errors in decontamination, defective equipment, and failure to follow disinfection guidelines are major factors contributing to transmission of infection during endoscopy. Other important risk factors include inadequate cleaning, use of older endoscopes with surface and working channel irregularities, and contamination of water bottles or irrigating solutions. Infections by multidrug-resistant organisms have become an increasing problem in health-care systems worldwide. Since 2010, outbreaks of multidrug-resistant bacteria associated with endoscopic retrograde cholangiopancreatography have been reported from the USA, France, Germany, and The Netherlands. In many endoscopy units in Asia and the Middle East, reprocessing procedures have lagged behind those of Western countries for cultural reasons or lack of financial resources. This inconsistency in standards is now being addressed, and the World Endoscopy Organization has prepared this position statement to highlight key points for quality assurance in any endoscopy unit in any country. © 2016 Japan Gastroenterological Endoscopy Society.

  3. MICROTOUGH - calculation of characteristic upper shelf fracture toughness values from microstructural parameters for high strength structural steels with normalized or quenched and tempered microstructure

    International Nuclear Information System (INIS)

    Muenstermann, S.; Dahl, W.; Langenberg, P.; Deimel, P.; Sattler, E.

    2004-01-01

    In modern applications, high strength steels are often utilised to increase the load bearing capacity of components. For safe design it is also necessary that these steels have an adequate fracture toughness. The mechanical properties of high strength structural steels are a result of the production process. In consequence, they are strongly related to the microstructure. Therefore, the aim of the research work in the Microtough project is to develop and apply a new method of quantitative correlation between microstructural parameters and characteristic fracture toughness values. This correlation will on the one hand help for the design of new structural steels with high toughness. On the other hand, it shall allow to characterise the fracture toughness of steel without performing expensive fracture mechanics tests. The research work is carried out in the full temperature range from lower to upper shelf. As both RWTH Aachen University and MPA Uni Stuttgart concentrate on ductile fracture behaviour in their research work, the focus of the presentation lies in the upper shelf. (orig.)

  4. Portal hypertensive enteropathy diagnosed by capsule endoscopy and demonstration of the ileal changes after transjugular intrahepatic portosystemic shunt placement: a case report

    Directory of Open Access Journals (Sweden)

    Carella Alessandra

    2011-03-01

    Full Text Available Abstract Introduction Recent data suggest that mucosal abnormalities can occur even in the duodenum, jejunum, and distal ileum of cirrhosis patients. We present a case of portal hypertensive enteropathy in a cirrhosis patient shown by capsule endoscopy and the effect of transjugular intrahepatic portosystemic shunt on the ileal pictures. Case presentation An 83-year-old Caucasian woman was admitted to our hospital for anemia and a positive fecal occult blood test. An upper gastrointestinal endoscopy revealed small varices without bleeding signs and hypertensive gastropathy. Colonoscopy was negative. To rule out any other cause of bleeding, capsule endoscopy was performed; capsule endoscopy revealed severe hyperemia of the jejunum-ileal mucosa with active bleeding. Because of the persistence of anemia and the frequent blood transfusions, not responding to β-blocker drugs or octreotide infusion, a transjugular intrahepatic portosystemic shunt was performed. Anemia improved quickly after the transjugular intrahepatic portosystemic shunt, and no further blood transfusion was necessary in the follow-up. The patient developed portal encephalopathy two months later and was readmitted to our department. We repeated the capsule endoscopy that showed a significant improvement of the gastric and ileal mucosa without any signs of bleeding. Conclusion Hypertensive enteropathy is a rare condition, but it seems more common with the introduction of capsule endoscopy in clinical practice. This case shows that the jejunum can be a source of bleeding in cirrhosis patients, and this is the first demonstration of its resolution after transjugular intrahepatic portosystemic shunt placement.

  5. Automatic blood detection in capsule endoscopy video

    Science.gov (United States)

    Novozámský, Adam; Flusser, Jan; Tachecí, Ilja; Sulík, Lukáš; Bureš, Jan; Krejcar, Ondřej

    2016-12-01

    We propose two automatic methods for detecting bleeding in wireless capsule endoscopy videos of the small intestine. The first one uses solely the color information, whereas the second one incorporates the assumptions about the blood spot shape and size. The original idea is namely the definition of a new color space that provides good separability of blood pixels and intestinal wall. Both methods can be applied either individually or their results can be fused together for the final decision. We evaluate their individual performance and various fusion rules on real data, manually annotated by an endoscopist.

  6. Reducing redundancy in wireless capsule endoscopy videos.

    Science.gov (United States)

    Lee, Hyun-Gyu; Choi, Min-Kook; Shin, Byeong-Seok; Lee, Sang-Chul

    2013-07-01

    We eliminate similar frames from a wireless capsule endoscopy video of the human intestines to maximize spatial coverage and minimize the redundancy in images. We combine an intensity correction method with a method based an optical flow and features to detect and reduce near-duplicate images acquired during the repetitive backward and forward egomotions due to peristalsis. In experiments, this technique reduced duplicate image of 52.3% from images of the small intestine. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  7. Propofol and remifentanil for deep sedation in children undergoing gastrointestinal endoscopy.

    Science.gov (United States)

    Abu-Shahwan, Ibrahim; Mack, David

    2007-05-01

    The aim of this study was to evaluate the safety and efficacy of a combination of propofol and remifentanil deep sedation in spontaneously breathing children less than 7 years of age undergoing upper and/or lower gastrointestinal endoscopy. The effect of propofol and remifentanil sedation was prospectively studied in 42 unpremedicated children undergoing gastrointestinal endoscopy. Anesthesia was induced with a combination of sevoflurane, nitrous oxide and oxygen. Anesthesia was maintained with an infusion of propofol (50-80 microg x kg(-1) x min(-1)) and remifentanil (0.1 microg x kg(-1) x min(-1)). Demographic data, heart rate, blood pressure, respiratory rate, and oxygen saturation were recorded every 5 min for each child. In addition, recovery and discharge times were recorded. All 42 procedures were completed with no complications. The combination of propofol and remifentanil resulted in a decrease in heart rate, blood pressure, and respiratory rate. There was no respiratory depression or oxygen desaturation in any child. A bolus of propofol (1 mg x kg(-1)) was necessary in one child for excessive movement. No patient experienced any side effects in the recovery period. The combination of propofol and remifentanil for sedation in children undergoing gastrointestinal endoscopy can be considered safe, effective and acceptable.

  8. How should we establish the clinical case numbers required to achieve proficiency in flexible endoscopy?

    Science.gov (United States)

    Vassiliou, Melina C; Kaneva, Pepa A; Poulose, Benjamin K; Dunkin, Brian J; Marks, Jeffrey M; Sadik, Riadh; Sroka, Gideon; Anvari, Mehran; Thaler, Klaus; Adrales, Gina L; Hazey, Jeffrey W; Lightdale, Jenifer R; Velanovich, Vic; Swanstrom, Lee L; Mellinger, John D; Fried, Gerald M

    2010-01-01

    Recommended procedure numbers for upper endoscopy (UE) and colonoscopy (C) are 35 and 50 for surgical residents, and 130 and 140 for gastroenterology fellows, respectively. The purpose of this study was to challenge the methods used to determine proficiency in flexible endoscopy. Global assessment of gastrointestinal endoscopic skills (GAGES) was used to evaluate 139 procedures. Scores for UE were compared using self-reported case numbers and grouped according to requirements for each discipline. C scores were compared using the requirements to define novice and experienced endoscopists. Procedure volumes were plotted against GAGES scores. Three groups were compared for UE based on case volumes: fewer than 35 cases (group 1), 35 to 130 cases (group 2), and more than 130 cases (group 3). There was no difference between group 2 (17.8 +/- 1.8) and group 3 (19.1 +/- 1.1), but both scored higher than group 1 (14.4 +/- 3.7; P cut-off level, respectively. The curve of procedures versus GAGES plateaued at 50 (UE) and 75 (C). The surgical and gastroenterology case recommendations may not represent the experience needed to achieve proficiency. GAGES scores could help define proficiency in basic endoscopy.

  9. Significantly reduced hypoxemic events in morbidly obese patients undergoing gastrointestinal endoscopy: Predictors and practice effect

    Directory of Open Access Journals (Sweden)

    Basavana Gouda Goudra

    2014-01-01

    Full Text Available Background: Providing anesthesia for gastrointestinal (GI endoscopy procedures in morbidly obese patients is a challenge for a variety of reasons. The negative impact of obesity on the respiratory system combined with a need to share the upper airway and necessity to preserve the spontaneous ventilation, together add to difficulties. Materials and Methods: This retrospective cohort study included patients with a body mass index (BMI >40 kg/m 2 that underwent out-patient GI endoscopy between September 2010 and February 2011. Patient data was analyzed for procedure, airway management technique as well as hypoxemic and cardiovascular events. Results: A total of 119 patients met the inclusion criteria. Our innovative airway management technique resulted in a lower rate of intraoperative hypoxemic events compared with any published data available. Frequency of desaturation episodes showed statistically significant relation to previous history of obstructive sleep apnea (OSA. These desaturation episodes were found to be statistically independent of increasing BMI of patients. Conclusion: Pre-operative history of OSA irrespective of associated BMI values can be potentially used as a predictor of intra-procedural desaturation. With suitable modification of anesthesia technique, it is possible to reduce the incidence of adverse respiratory events in morbidly obese patients undergoing GI endoscopy procedures, thereby avoiding the need for endotracheal intubation.

  10. Significantly reduced hypoxemic events in morbidly obese patients undergoing gastrointestinal endoscopy: Predictors and practice effect.

    Science.gov (United States)

    Goudra, Basavana Gouda; Singh, Preet Mohinder; Penugonda, Lakshmi C; Speck, Rebecca M; Sinha, Ashish C

    2014-01-01

    Providing anesthesia for gastrointestinal (GI) endoscopy procedures in morbidly obese patients is a challenge for a variety of reasons. The negative impact of obesity on the respiratory system combined with a need to share the upper airway and necessity to preserve the spontaneous ventilation, together add to difficulties. This retrospective cohort study included patients with a body mass index (BMI) >40 kg/m(2) that underwent out-patient GI endoscopy between September 2010 and February 2011. Patient data was analyzed for procedure, airway management technique as well as hypoxemic and cardiovascular events. A total of 119 patients met the inclusion criteria. Our innovative airway management technique resulted in a lower rate of intraoperative hypoxemic events compared with any published data available. Frequency of desaturation episodes showed statistically significant relation to previous history of obstructive sleep apnea (OSA). These desaturation episodes were found to be statistically independent of increasing BMI of patients. Pre-operative history of OSA irrespective of associated BMI values can be potentially used as a predictor of intra-procedural desaturation. With suitable modification of anesthesia technique, it is possible to reduce the incidence of adverse respiratory events in morbidly obese patients undergoing GI endoscopy procedures, thereby avoiding the need for endotracheal intubation.

  11. Gastrointestinal endoscopy in Nigeria - a prospective two year audit ...

    African Journals Online (AJOL)

    Lower gastrointestinal endoscopy findings included 7 cases of polyps, 3 cases of colorectal cancer and 2 cases of diverticulosis. Commonest lesion on lower GI endoscopy was haemorrhoids (41.7%). Adjusted caecal intubation was 81.4% for colonoscopies performed. Overall adenoma detection rate for male and female ...

  12. The validity of nasal endoscopy in patients with chronic rhinosinusitis

    DEFF Research Database (Denmark)

    Larsen, K. L.; Lange, B.; Darling, P.

    2018-01-01

    Objectives: Nasal endoscopy is a cornerstone in diagnosing sinonasal disease, but different raters might generate different results using the technique. Our study aims to evaluate the agreement between multiple raters to assess the validity of nasal endoscopy. Design/Participants: Three independe...

  13. Effectiveness of a novel endoscopy training concept.

    Science.gov (United States)

    Götzberger, M; Rösch, T; Geisenhof, S; Gülberg, V; Schmitt, W; Niemann, G; Kopp, V M; Faiss, S; Heldwein, W; Fischer, M R

    2011-09-01

    Training standards in gastrointestinal endoscopy are poorly defined even though different simulators are increasingly used for skills training. In 2001 a new training concept called "GATE--gastroenterological education-training endoscopy" was established, which provides a combination of background theory, video demonstrations, and simulator training. We aimed to evaluate the acceptance and training effect of this training model. In total, 98 physicians participating in four training courses were included. Data were collected on baseline characteristics, acceptance (5-point Likert scale), and pre- and post-course knowledge through a structured questionnaire (A-type and Pick-N multiple choice questions). A total of 13 trainees were randomly selected for additional simulator assessment of training effects on manual skills (5-point Likert scale). A total of 78 trainees (80%) provided complete data sets. The evaluation showed a positive acceptance of the training program (value 1 and 2, Likert scale); for example, 88% of participants suggested the inclusion of the GATE course as an obligatory part of endoscopic education. There was a significant improvement in theoretical knowledge in the post-test set compared with the pre-test set (mean 3.27 ±1.30 vs. 1.69 ±1.01 points; PLikert scale ( P=0.085). The integrated GATE training improved theoretical knowledge and manual skill. The GATE courses have been accredited by the German Society of Gastroenterology, underlining the demand for implementing preclinical training courses in endoscopic training. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Panic Attack during Elective Gastrointestinal Endoscopy

    Directory of Open Access Journals (Sweden)

    Charalampos Mitsonis

    2011-01-01

    Full Text Available Background. Esophagogastroduodenoscopy (EGD and colonoscopy (CS can evoke anxiety, embarrassment, and discomfort. These concerns can culminate in panic attacks, which may traumatize patients and significantly decrease their compliance to the procedure. The objective of this study was to evaluate the relationship between preendoscopic anxiety and the possibility of a panic attack during an elective gastrointestinal endoscopy (EGE. Methods. The study population comprised of 79 Greek outpatients. The examination was carried out without the use of conscious sedation. Patients' anxiety levels were assessed before the procedure using the Greek version of the Spielberger State-Trait Anxiety Inventory (STAI-Y. Results. Seventy-nine patients were enrolled: 45 EGD and 34 CS. Females had higher state and trait anxiety levels than males (48.14 ± 7.94 versus 44.17 ± 7.43, <0.05; and 43.68 ± 6.95 versus 39.86 ± 7.46, <0.05. Patients who experienced panic attack had significantly higher levels of both trait and state anxiety, compared to those who were panic-free. There was no significant relationship between panic attacks and sex or type of procedure. Conclusions. Patients who experience panic attacks during endoscopic procedures appear to have significantly higher anxiety levels before the procedure. Administering the STAI questionnaire prior to the endoscopy seems to be a useful screening method for vulnerable patients.

  15. Endoscopy training in Canadian general surgery residency programs.

    Science.gov (United States)

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

    2015-06-01

    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.

  16. Obscure gastrointestinal bleeding and small bowel pathology: comparison between wireless capsule endoscopy and multidetector-row CT enteroclysis.

    Science.gov (United States)

    Filippone, Antonella; Cianci, Roberta; Milano, Angelo; Valeriano, Sergio; Di Mizio, Veronica; Storto, Maria Luigia

    2008-01-01

    Obscure gastrointestinal bleeding is defined as bleeding of unknown origin, that persists or recurs after negative conventional barium contrast studies and upper and lower tract endoscopy. The causes of such a bleeding frequently arise in the small bowel, and they are represented by mucosal vascular abnormalities, neoplasms and other conditions such as Crohn's disease, Meckel's diverticulum, and vasculitis. Conventional barium contrast studies and push enteroscopy allow only a limited small bowel examination; moreover, intraoperative endoscopy may be inconclusive, since the small bowel is difficult to evaluate given its length and tortuous course. In the same way, angiographic diagnosis is stricktly related to the activity rate of hemorrhage. Wireless capsule endoscopy and multidetector-row CT enteroclysis are two recently developed minimally invasive techniques that may provide a complete small bowel examination, the first offering a direct visualization of the mucosal aspect, the second allowing evaluation of mural and extramural pathologies. This review is an update of the technique and clinical application of capsule endoscopy and multidetector-row CT enteroclysis in patients suffering from obscure small bowel bleeding.

  17. Characterizing variability in in vivo Raman spectra of different anatomical locations in the upper gastrointestinal tract toward cancer detection

    Science.gov (United States)

    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

  18. Multilevel wireless capsule endoscopy video segmentation

    Science.gov (United States)

    Hwang, Sae; Celebi, M. Emre

    2010-03-01

    Wireless Capsule Endoscopy (WCE) is a relatively new technology (FDA approved in 2002) allowing doctors to view most of the small intestine. WCE transmits more than 50,000 video frames per examination and the visual inspection of the resulting video is a highly time-consuming task even for the experienced gastroenterologist. Typically, a medical clinician spends one or two hours to analyze a WCE video. To reduce the assessment time, it is critical to develop a technique to automatically discriminate digestive organs and shots each of which consists of the same or similar shots. In this paper a multi-level WCE video segmentation methodology is presented to reduce the examination time.

  19. Fecal calprotectin as a biomarker of inflammatory lesions of the small bowel seen by videocapsule endoscopy

    Directory of Open Access Journals (Sweden)

    Juan Egea-Valenzuela

    2015-04-01

    Full Text Available Introduction: The levels of calprotectin in the stools are proportional to neutrophil activity in the enteric lumen, so fecal calprotectin is a useful intestinal inflammatory biomarker. It is an extended tool as predictor of colonic pathology but there is scare evidence about its utility in the small bowel. Objective: To test the yield of fecal calprotectin to detect lesions in the small bowel. Material and methods: We have retrospectively included 71 patients sent for small bowel capsule endoscopy in study for suspected inflammatory bowel disease. All of them had a determination of fecal calprotectin and had been sent to colonoscopy with no findings. Patients have been divided in groups: A, fecal calprotectin 100 µg/g, and we have analyzed which of them presented inflammatory lesions in capsule endoscopy studies. Results: The rate of patients with signi ficative lesions was 1 out of 10 (10% in group A, 6 out of 24 (25% in group B, and 21 out of 34 (62% in group C. If we consider levels over 50 µg/g pathologic, fecal calprotectin presents sensitivity: 96%, specificity: 23%, NPV: 90% and PPV: 56%. If we consider levels over 100 µg/g pathologic these values are sensitivity: 75%, specificity: 67%, NPV: 79% and PPV: 62%. Conclusions: Fecal calprotectin has high sensitivity but not so good specificity for predicting small bowel lesions after a normal colonoscopy. In daily practice it will be more useful to establish in 100 µg/g the limit to indicate capsule endoscopy studies.

  20. Endoscopic Evaluation of Upper and Lower Gastro‑Intestinal Bleeding

    African Journals Online (AJOL)

    Injection sclerotherapy was successfully performed in the hemorrhoids and a case of gastric varices. The mortality recorded was 0%. Conclusion: Endoscopy is vital in the diagnosis and treatment of GIB. Gastritis and Haemorrhoid are the most common causes of upper and lower GI bleeding respectively, in our environment.

  1. Upper gastrointestinal endoscopic findings in adolescents at Lacor ...

    African Journals Online (AJOL)

    Endoscopic diagnose included duodenal ulcer (14.8%) and gastritis (12.6%); duodenal scarring (5.2%), bile reflux (5.2%) duodenitis (4.4%) and miscellaneous 6.4%. Conclusion: In Upper gastrointestinal endoscopy is a diagnostic procedure in children with gastrointestinal disorder. Gastritis and duodenal disease are ...

  2. A Case of Esophagopericardial Fistula as a Complication of Upper ...

    African Journals Online (AJOL)

    A case of suppurative pericarditis from an esophagopericardial fistula (EPF) following the upper gastrointestinal endoscopy (UGIE). A 38‑year‑old schizophrenic male patient with gastro-esophageal reflux disease (GORD) and previously dilated esophageal stricture was presented with acute retrosternal chest pain.

  3. The Value of Endoscopy in a Wildlife Raptor Service.

    Science.gov (United States)

    Desmarchelier, Marion R; Ferrell, Shannon T

    2015-09-01

    Although endoscopy is part of the basic standard of care in most avian practices, many wildlife rehabilitation centers do not have access to the equipment or do not use it on a regular basis. Endoscopic equipment is easily available at a lower cost on the used market or can be acquired through donations from local human hospitals. Several medical conditions encountered in wild raptors have an improved prognosis if they are diagnosed or treated early with the aid of endoscopy. In many cases, endoscopy provides a noninvasive alternative to exploratory surgery, saving cost and time and decreasing postoperative pain. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Avaliação polissonográfica e de videoendoscopia da deglutição de pacientes portadores da sequência de Pierre-Robin Polysomnography evaluation and swallowing endoscopy of patients with Pierre Robin sequence

    Directory of Open Access Journals (Sweden)

    Carlos Diógenes Pinheiro Neto

    2009-12-01

    Full Text Available Asequência de Pierre Robin é caracterizada por micrognatia, glossoptose e obstrução das vias aéreas superiores. A gravidade dos sintomas é muito variável, o que torna o tratamento destes pacientes um desafio. OBJETIVOS: Identificar a presença de apneia-hipopneia obstrutiva do sono e avaliar a presença de alterações da deglutição em pacientes portadores da sequência de Pierre-Robin. MATERIAL E MÉTODOS: Estudo retrospectivo em que foram avaliadas 14 crianças com sequência de Pierre-Robin, sendo oito do sexo feminino. As crianças foram submetidas à videoendoscopia da deglutição e polissonografia. RESULTADO: Oito pacientes foram incluídos no estudo. Seis apresentaram polissonografia normal e apenas 1 paciente apresentou apneia-hipopneia leve de origem central. A videoendoscopia da deglutição mostrou-se normal em cinco pacientes e disfagia moderada foi detectada em três pacientes sendo submetidos à gastrostomia. A distração da mandíbula foi realizada em quatro pacientes que também foram submetidos à traqueostomia no mesmo tempo cirúrgico. CONCLUSÕES: Disfagia foi mais prevalente do que a apneia do sono. A videoendoscopia da deglutição mostrou ser um exame dinâmico e eficaz na detecção de distúrbios alimentares em pacientes com a sequência de Pierre Robin.The Pierre Robin sequence is characterized by micrognathia, glossoptosis and upper airway obstruction. Symptom severity varies, and this makes the treatment of these patients a true challenge. AIM: to identify the presence of sleep hypopneaapnea in patients with Pierre-Robin sequence. MATERIALS AND METHODS: retrospective study in which we assessed 14 children with Pierre-Robin sequence, eight girls. The children were submitted to swallowing video-endoscopy study and polysomnography. RESULTS: eight patients were included in this study. Six had normal polysomnography and only one patient had mild central hypopnea-apnea. Swallowing video-endoscopy was normal in

  5. Microscopic polyangiitis complicated with ileal involvement detected by double-balloon endoscopy: a case report.

    Science.gov (United States)

    Fukushima, Masashi; Inoue, Satoko; Ono, Yuichiro; Tamaki, Yoshitaka; Yoshimura, Hajime; Imai, Yukihiro; Inokuma, Tetsuro

    2013-03-02

    Microscopic polyangiitis is characterized by pauci-immune, necrotizing small-vessel vasculitis and an anti-neutrophil cytoplasmic antibody-associated vasculitis. Although gastrointestinal involvement in microscopic polyangiitis is not rare, endoscopic observation of it is extremely rare. To the best of our knowledge, this is the first case report of small intestinal involvement in microscopic polyangiitis detected and followed up by double-balloon endoscopy. A 70-year-old Japanese woman was transferred to our hospital for close examination of suspected small intestinal lymphoma. Retrograde double-balloon endoscopy revealed various forms of ulcers with redness and edema in the ileum. Histological findings suggested ischemic changes. Because mononeuritis multiplex and a fever spike appeared later, vasculitis was suspected. The perinuclear anti-neutrophil cytoplasmic antibody titer was elevated. Nerve biopsy results suggested vasculitis. From these findings, microscopic polyangiitis was diagnosed. It was suggested that microscopic polyangiitis caused the intestinal involvement. Intravenous pulse cyclophosphamide and oral predonisolone were started. After treatment, perinuclear anti-neutrophil cytoplasmic antibodies decreased to the normal range. Retrograde double-balloon endoscopy after treatment showed ulcer scars and no ulcer. The cause of gastrointestinal involvement in microscopic polyangiitis is ischemia due to vasculitis. It is difficult to diagnose small-vessel vasculitis by endoscopic biopsy. Although histological evidence of microscopic polyangiitis is important, the treatment should not be delayed by repeating the biopsy, because such delay can result in adverse sequela.This case report shows that microscopic polyangiitis should be considered as a differential diagnosis when small intestinal changes like those in the present case are observed by endoscopy.

  6. Pancreatic Aetiology for Massive Upper Gastrointestinal Haemorrhage in Pregnancy

    OpenAIRE

    Zaborowski, Alexandra; Walsh, Siun M.; Ravi, Narayanasamy; Reynolds, John V.

    2016-01-01

    We present herein what we believe is the first reported case of massive upper gastrointestinal bleeding in pregnancy due to a pancreatic neuroendocrine tumour causing left sided portal hypertension. A 37-year-old 27-week pregnant female presented with massive haematemesis and melaena requiring transfusion of 10 units of red cell concentrate. Gastric varices were evident at endoscopy. An MRI revealed a large mass infiltrating the pancreatic tail and spleen with massive upper abdominal varix fo...

  7. Identifying Emergency Department Patients at Low Risk for a Variceal Source of Upper Gastrointestinal Hemorrhage.

    Science.gov (United States)

    Klein, Lauren R; Money, Joel; Maharaj, Kaveesh; Robinson, Aaron; Lai, Tarissa; Driver, Brian E

    2017-11-01

    Assessing the likelihood of a variceal versus nonvariceal source of upper gastrointestinal bleeding (UGIB) guides therapy, but can be difficult to determine on clinical grounds. The objective of this study was to determine if there are easily ascertainable clinical and laboratory findings that can identify a patient as low risk for a variceal source of hemorrhage. This was a retrospective cohort study of adult ED patients with UGIB between January 2008 and December 2014 who had upper endoscopy performed during hospitalization. Clinical and laboratory data were abstracted from the medical record. The source of the UGIB was defined as variceal or nonvariceal based on endoscopic reports. Binary recursive partitioning was utilized to create a clinical decision rule. The rule was internally validated and test characteristics were calculated with 1,000 bootstrap replications. A total of 719 patients were identified; mean age was 55 years and 61% were male. There were 71 (10%) patients with a variceal UGIB identified on endoscopy. Binary recursive partitioning yielded a two-step decision rule (platelet count > 200 × 10 9 /L and an international normalized ratio [INR] low risk for a variceal source of hemorrhage. For the bootstrapped samples, the rule performed with 97% sensitivity (95% confidence interval [CI] = 91%-100%) and 49% specificity (95% CI = 44%-53%). Although this derivation study must be externally validated before widespread use, patients presenting to the ED with an acute UGIB with platelet count of >200 × 10 9 /L and an INR of low risk for a variceal source of their upper gastrointestinal hemorrhage. © 2017 by the Society for Academic Emergency Medicine.

  8. Gastric cancer missed at endoscopy | Gado | Alexandria Journal of ...

    African Journals Online (AJOL)

    with biopsies) is the gold standard for its diagnosis but missed oesophageal and gastric cancers are not infrequent in patients who have undergone previous endoscopy. Errors by the endoscopist account for the majority of these missed lesions.

  9. [Wireless capsule endoscopy: basic principles and clinical utility].

    Science.gov (United States)

    González-Suárez, Begoña; Galter, Sara; Balanzó, Joaquín

    2007-06-01

    Wireless capsule endoscopy (PillCam) represents a major advance in the study of small bowel disease since this procedure allows images of hitherto unreachable areas to be obtained. Approved for use by the Food and Drug Administration in August 2000, capsule endoscopy is currently a first line procedure in the study of small bowel disease. This technique consists of a non-reusable swallowable capsule (length 26 x 11 mm) that acquires video images while moving through the gastrointestinal tract propelled by natural peristalsis. The main indications of capsule endoscopy are evaluation of obscure gastrointestinal bleeding, chronic anemia, and inflammatory bowel disease. Contraindications are swallowing disorders and known or suspected small bowel strictures of any etiology. Consequently, small bowel follow through is useful prior to capsule endoscopy when these lesions are suspected.

  10. Colon capsule endoscopy: Advantages, limitations and expectations. Which novelties?

    Science.gov (United States)

    Riccioni, Maria Elena; Urgesi, Riccardo; Cianci, Rossella; Bizzotto, Alessandra; Spada, Cristiano; Costamagna, Guido

    2012-01-01

    Since the first reports almost ten years ago, wireless capsule endoscopy has gained new fields of application. Colon capsule endoscopy represents a new diagnostic technology for colonic exploration. Clinical trials have shown that colon capsule endoscopy is feasible, accurate and safe in patients suffering from colonic diseases and might be a valid alternative to conventional colonoscopy in selected cases such as patients refusing conventional colonoscopy or with contraindications to colonoscopy or when colonoscopy is incomplete. Despite the enthusiasm surrounding this new technique, few clinical and randomized controlled trials are to be found in the current literature, leading to heterogeneous or controversial results. Upcoming studies are needed to prove the substantial utility of colon capsule endoscopy for colon cancer screening, especially in a low prevalence of disease population, and for other indications such as inflammatory bowel disease. Possible perspectives are critically analysed and reported in this paper. PMID:22523610

  11. Computerisation of endoscopy reports using standard reports and text blocks

    NARCIS (Netherlands)

    M.J.M. Groenen (Marcel); E.J. Kuipers (Ernst); G.P. van Berge Henegouwen (Gerard); P. Fockens (Paul); R.J.T. Ouwendijk (Rob)

    2006-01-01

    textabstractBACKGROUND: The widespread use of gastrointestinal endoscopy for diagnosis and treatment requires effective, standardised report systems. This need is further increased by the limited storage of images, and by the need for structured databases for surveillance and

  12. Avaliação da lidocaína tópica como pré-medicação para a endoscopia digestiva alta em crianças Evaluation of topical lidocaine spray as premedication to upper gastrointestinal endoscopy in children

    Directory of Open Access Journals (Sweden)

    Rodrigo Strehl Machado

    2009-12-01

    Full Text Available OBJETIVO: Avaliar a eficácia da lidocaína spray tópica como droga adjuvante na sedação e analgesia de crianças e adolescentes para endoscopia digestiva. MÉTODOS: Foram incluídos 80 pacientes (49 femininos e 31 masculinos, idade média 12±3 anos, 40 no grupo placebo e 40 no grupo lidocaína. Os pacientes foram alocados aleatoriamente e um paciente de cada grupo foi excluído. Lidocaína a 10% ou placebo (ácido tânico 0,5% aerossol (dois jatos foram aplicados na orofaringe antes da infusão de propofol. Os pacientes foram monitorizados durante o procedimento e após, sendo respondido questionário para avaliar odinofagia e a pré-medicação. O desfecho primário foi a dose de propofol empregada, enquanto os desfechos secundários foram incidência de complicações, tempo de sala e duração do procedimento. RESULTADOS: Não houve diferenças entre os grupos quanto à idade, sexo e indicação da endoscopia. A dose de propofol empregada não foi diferente nos dois grupos (grupo placebo 3,1±1,1 e grupo lidocaína 2,9±1,3mg/kg; p=0,69, mesmo quando considerada a dose bruta (p=0,33. No entanto, o tempo de sala médio foi maior no grupo placebo do que no lidocaína (23±7 versus 20±5 minutos; IC95% da diferença: 0,47-5,89 minutos, p=0,02. Não houve diferenças entre os grupos quanto à duração do procedimento, incidência de complicações e aceitação pelo paciente. CONCLUSÕES: O emprego de medicação tópica anestésica em endoscopia reduz o tempo de sala sem aumentar a incidência de efeitos adversos (NCT00521703.OBJECTIVE: This study aims to evaluate the efficacy of topical lidocaine as an adjuvant drug to sedatives in children and adolescents undergoing digestive endoscopies. METHODS: 80 patients (49 females and 31 males, 12±3 years old were randomly allocated into placebo (n=40 or lidocaine group (n=40. One patient was excluded from each group after allocation. Two puffs of either 10% lidocaine or placebo (tannic acid 0

  13. Successful wireless capsule endoscopy for a 2.5-year-old child: obscure gastrointestinal bleeding from mixed, juvenile, capillary hemangioma-angiomatosis of the jejunum.

    Science.gov (United States)

    Kavin, Hymie; Berman, James; Martin, Thomas L; Feldman, Ansley; Forsey-Koukol, Kimberly

    2006-02-01

    The lesion responsible for obscure gastrointestinal bleeding in the pediatric population may not be determined with standard primary endoscopic methods. Wireless capsule endoscopy, now a first-line modality for evaluation of the small bowel in the adult population, is a tool that may be useful among children. We report a case of a 2.5-year-old girl who presented with melenic stools. Upper and lower endoscopy, Meckel scans, and mesenteric angiography yielded negative results. Wireless capsule endoscopy identified numerous abnormal, dilated, blood vessels in the proximal jejunum, with associated fresh blood. The patient underwent surgical exploration, with resection of the affected portion of the jejunum. Pathologically, the dilated blood vessels were consistent with mixed, juvenile, capillary hemangioma-angiomatosis of developmental or congenital origin. The patient fared well postoperatively, with no additional bleeding in 9 months of follow-up monitoring. This case report highlights the use of capsule endoscopy in the diagnosis and successful treatment of gastrointestinal bleeding in a young infant. This is the youngest reported patient treated with the use of wireless capsule endoscopy in the pediatric population.

  14. Computerisation of endoscopy reports using standard reports and text blocks

    OpenAIRE

    Groenen, Marcel; Kuipers, Ernst; Berge Henegouwen, Gerard; Fockens, Paul; Ouwendijk, Rob

    2006-01-01

    textabstractBACKGROUND: The widespread use of gastrointestinal endoscopy for diagnosis and treatment requires effective, standardised report systems. This need is further increased by the limited storage of images, and by the need for structured databases for surveillance and epidemiology. We therefore aimed for a report system which would be quick, easy to learn, and suitable for use in busy daily practice. METHODS: Endobase III is an endoscopy information system offering three different way...

  15. Drug-induced sleep endoscopy in the identification of obstruction sites in patients with obstructive sleep apnea: a systematic review.

    Science.gov (United States)

    Viana, Alonço da Cunha; Thuler, Luiz Claudio Santos; Araújo-Melo, Maria Helena de

    2015-01-01

    Obstructive sleep apnea syndrome has multifactorial causes. Although indications for surgery are evaluated by well-known diagnostic tests in the awake state, these do not always correlate with satisfactory surgical results. To undertake a systematic review on endoscopy during sleep, as one element of the diagnosis routine, aiming to identify upper airway obstruction sites in adult patients with OSAS. By means of electronic databases, a systematic review was performed of studies using drug-induced sleep endoscopy to identify obstruction sites in patients with OSAS. Ten articles were selected that demonstrated the importance of identifying multilevel obstruction, especially in relation to retrolingual and laryngeal collapse in OSAS. DISE is an additional method to reveal obstruction sites that have not been detected in awake patients. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  16. Nurse-administered propofol sedation for endoscopy

    DEFF Research Database (Denmark)

    Jensen, J T; Vilmann, P; Horsted, T

    2011-01-01

    BACKGROUND AND STUDY AIMS: The aim of the present study was to perform a risk analysis during the implementation phase of nurse-administered propofol sedation (NAPS) and to validate our structured training program. PATIENTS AND METHODS: A structured training program was developed both for endosco......BACKGROUND AND STUDY AIMS: The aim of the present study was to perform a risk analysis during the implementation phase of nurse-administered propofol sedation (NAPS) and to validate our structured training program. PATIENTS AND METHODS: A structured training program was developed both...... for endoscopists and for endoscopy nurses who were administering propofol sedation. The nurses' program comprised a 6-week course including theoretical and practical training in airway management, and the endoscopists' program consisted of 2.5 h of theory and a short course in practical airway management....... In the implementation phase, data from 1822 endoscopic procedures in 1764 patients were prospectively collected. All adverse events related to sedation were recorded (defined as oxygen saturation change in blood pressure > 20 mmHg). RESULTS: 78 cases...

  17. A UWB wireless capsule endoscopy device.

    Science.gov (United States)

    Thotahewa, Kasun M S; Redoute, Jean-Michel; Yuce, Mehmet Rasit

    2014-01-01

    Wireless capsule endoscopy (WCE) presents many advantages over traditional wired endoscopic methods. The performance of WCE devices can be improved using high-frequency communication systems such as Impulse Radio-Ultra-Wideband (IR-UWB) to enable a high data rate transmission with low-power consumption. This paper presents the hardware implementation and experimental evaluation of a WCE device that uses IR-UWB signals in the frequency range of 3.5 GHz to 4.5 GHz to transmit image data from inside the body to a receiver placed outside the body. Key components of the IR-UWB transmitter, such as the narrow pulse generator and up-conversion based RF section are described in detail. This design employs a narrowband receiver in the WCE device to receive a control signal externally in order to control and improve the data transmission from the device in the body. The design and performance of a wideband implantable antenna that operates in the aforementioned frequency range is also described. The operation of the WCE device is demonstrated through a proof-of-concept experiment using meat.

  18. Electropermanent magnetic anchoring for surgery and endoscopy.

    Science.gov (United States)

    Tugwell, Josef; Brennan, Philip; O'Shea, Conor; O'Donoghue, Kilian; Power, Timothy; O'Shea, Michael; Griffiths, James; Cahill, Ronan; Cantillon-Murphy, Padraig

    2015-03-01

    The use of magnets for anchoring of instrumentation in minimally invasive surgery and endoscopy has become of increased interest in recent years. Permanent magnets have significant advantages over electromagnets for these applications; larger anchoring and retraction force for comparable size and volume without the need for any external power supply. However, permanent magnets represent a potential hazard in the operating field where inadvertent attraction to surgical instrumentation is often undesirable. The current work proposes an interesting hybrid approach which marries the high forces of permanent magnets with the control of electromagnetic technology including the ability to turn the magnet OFF when necessary. This is achieved through the use of an electropermanent magnet, which is designed for surgical retraction across the abdominal and gastric walls. Our electropermanent magnet, which is hand-held and does not require continuous power, is designed with a center lumen which may be used for trocar or needle insertion. The device in this application has been demonstrated successfully in the porcine model where coupling between an intraluminal ring magnet and our electropermanent magnet facilitated guided insertion of an 18 Fr Tuohy needle for guidewire placement. Subsequent investigations have demonstrated the ability to control the coupling distance of the system alleviating shortcomings with current methods of magnetic coupling due to variation in transabdominal wall thicknesses. With further refinement, the magnet may find application in the anchoring of endoscopic and surgical instrumentation for minimally invasive interventions in the gastrointestinal tract.

  19. Diagnosis by endoscopy and advanced imaging.

    Science.gov (United States)

    Swager, A; Curvers, W L; Bergman, J J

    2015-02-01

    Evaluation of patients with Barrett's oesophagus (BO) using dye-based chromoendoscopy, optical chromoendoscopy, autofluorescence imaging, or confocal laser endomicroscopy does not significantly increase the number of patients with a diagnosis of early neoplasia compared with high-definition white light endoscopy (HD-WLE) with random biopsy analysis. These newer imaging techniques are not more effective in standard surveillance of patients with BO because the prevalence of early neoplasia is low and HD-WLE with random biopsy analysis detects most cases of neoplasia. The evaluation and treatment of patients with BO and early-stage neoplasia should be centralized in tertiary referral centers, where procedures are performed under optimal conditions, by expert endoscopists. Lesions that require resection are almost always detected by HD-WLE, although advanced imaging techniques can detect additional flat lesions. However, these are of limited clinical significance because they are effectively eradicated by ablation therapy. No endoscopic imaging technique can reliably assess submucosal or lymphangio-invasion. Endoscopic resection of early-stage neoplasia in patients with BO is important for staging and management. Optical chromoendoscopy can also be used to evaluate lesions before endoscopic resection and in follow-up after successful ablation therapy. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Capsule Endoscopy for Portal Hypertensive Enteropathy

    Directory of Open Access Journals (Sweden)

    Seong Ran Jeon

    2016-01-01

    Full Text Available Portal hypertensive enteropathy (PHE is a mucosal abnormality of the small bowel that is observed in patients with portal hypertension (PH and can lead to gastrointestinal bleeding and anemia. The pathogenesis is still not completely understood. The introduction of new endoscopic methods, including capsule endoscopy (CE or balloon-assisted enteroscopy, has increased the detection of these abnormalities. CE can also serve as a road map for deciding subsequent interventions and evaluating the treatment effect. The prevalence of PHE is reportedly 40–70% in patients with PH. Endoscopic findings can be roughly divided into vascular and nonvascular lesions such as inflammatory-like lesions. Traditionally, PHE-associated factors include large esophageal varices, portal hypertensive gastropathy or colopathy, Child-Turcotte-Pugh class B or C, a history of variceal treatment, and acute gastrointestinal bleeding. More recently, on using scoring systems, a high computed tomography or transient elastography score was reportedly PHE-related factors. However, the prevalence of PHE and its related associated factors remain controversial. The management of PHE has not yet been standardized. It should be individualized according to each patient’s situation, the availability of therapy, and each institutional expertise.

  1. Video capsule endoscopy of the small bowel.

    Science.gov (United States)

    Eliakim, Rami

    2013-03-01

    Small bowel capsule endoscopy (SBCE) was introduced 13 years ago by Given Imaging (Yokneam, Israel). It has become one of the most important investigational tools of the small bowel. The capsule is swallowed with water after a 12 h fast, propelled via peristalsis through the gastrointestinal tract and excreted naturally. A nonvideo patency capsule was developed to confirm functional patency of the gastrointestinal tract. Four additional companies have introduced competitive small bowel video capsules, some of which are Food and Drug Admistration (FDA) approved. Due to the easiness of the procedure, SBCE has become a first-line tool to detect small bowel abnormalities. The main indications for SBCE include obscure gastrointestinal bleeding, suspected Crohn's disease, small bowel tumors and practically any abnormal small bowel imaging. New indications are emerging like small bowel motility and monitoring of drug therapy and mucosal healing. The present review will describe the available capsules in the market, the procedure itself, present indications and future expectations. It will focus on the PillCam SB of Given Imaging as it is the one on which most of the literature is written. Over the past 10 years, SBCE has become a routine, first-line investigational tool of many small bowel pathologies.

  2. Wireless capsule endoscopy: perspectives beyond gastrointestinal bleeding.

    Science.gov (United States)

    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.

  3. Sedation-related complications in gastrointestinal endoscopy.

    Science.gov (United States)

    Amornyotin, Somchai

    2013-11-16

    Sedation practices for gastrointestinal endoscopic (GIE) procedures vary widely in different countries depending on health system regulations and local circumstances. 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-related complications in gastrointestinal endoscopy, once occurred, can lead to significant morbidity and occasional mortality in patients. The risk factors of these complications include the type, dose and mode of administration of sedative agents, as well as the patient's age and underlying medical diseases. Complications attributed to moderate and deep sedation levels are more often associated with cardiovascular and respiratory systems. However, sedation-related complications during GIE procedures are commonly transient and of a mild degree. The risk for these complications while providing any level of sedation is greatest when caring for patients already medically compromised. Significant unwanted complications can generally be prevented by careful pre-procedure assessment and preparation, appropriate monitoring and support, as well as post-procedure management. Additionally, physicians must be prepared to manage these complications. This article will review sedation-related complications during moderate and deep sedation for GIE procedures and also address their appropriate management.

  4. Sedation and monitoring for gastrointestinal endoscopy.

    Science.gov (United States)

    Amornyotin, Somchai

    2013-02-16

    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.

  5. Vibration measurements by pulsed digital holographic endoscopy

    Science.gov (United States)

    Schedin, Staffan; Pedrini, Giancarlo; Perez-Lopez, Carlos; Mendoza Santoyo, Fernando

    2005-02-01

    Digital holographic interferometry in combination with a flexible fiber endoscope allows high precision measurements of deformations on hidden objects surfaces, inside cavities and objects with small access apertures. A digital holographic endoscopy system is described with a frequency-doubled, twin oscillator Q-switched pulsed Nd:YAG laser as light source. A sequence of digital hologram pairs are recorded with a maximum repetition rate of 260 ms. Each digital hologram is captured at separate video frames of a CCD-camera. The time separation between the laser pulses from each cavity can be set in the range from 50 to 500 μs. The digital holograms are transferred to a PC via a frame grabber and evaluated quantitatively by the Fourier transform method. The resulting phase fringe pattern has the information needed to evaluate quantitatively the amount of the deformation. Experimental results of vibration measurements of hidden mechanical and biological object surfaces are presented. The quality of the results obtained by mechanical object surfaces is usually higher than for biological surfaces. This can be explained easily by the fact that a biological surface is much more complex than a mechanical surface in the sense that some parts of the surface may reflect the light well whereas other parts may absorb the light. Also, biological surfaces are translucent, which means that part of the light may enter inside the sample where it may be absorbed or reflected.

  6. Endoprobe: A system for radionuclide-guided endoscopy

    International Nuclear Information System (INIS)

    Raylman, Raymond R.; Srinivasan, Amarnath

    2004-01-01

    Methods to guide the surgical treatment of cancer utilizing handheld beta-sensitive probes in conjunction with tumor-avid radiopharmaceuticals [such as 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

  7. Advanced endoscopic imaging: European Society of Gastrointestinal Endoscopy (ESGE) Technology Review.

    Science.gov (United States)

    East, James E; Vleugels, Jasper L; Roelandt, Philip; Bhandari, Pradeep; Bisschops, Raf; Dekker, Evelien; Hassan, Cesare; Horgan, Gareth; Kiesslich, Ralf; Longcroft-Wheaton, Gaius; Wilson, Ana; Dumonceau, Jean-Marc

    2016-11-01

    Background and aim: This technical review is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the utilization of advanced endoscopic imaging in gastrointestinal (GI) endoscopy. Methods: This technical review is based on a systematic literature search to evaluate the evidence supporting the use of advanced endoscopic imaging throughout the GI tract. Technologies considered include narrowed-spectrum endoscopy (narrow band imaging [NBI]; flexible spectral imaging color enhancement [FICE]; i-Scan digital contrast [I-SCAN]), autofluorescence imaging (AFI), and confocal laser endomicroscopy (CLE). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was adopted to define the strength of recommendation and the quality of evidence. Main recommendations: 1. We suggest advanced endoscopic imaging technologies improve mucosal visualization and enhance fine structural and microvascular detail. Expert endoscopic diagnosis may be improved by advanced imaging, but as yet in community-based practice no technology has been shown consistently to be diagnostically superior to current practice with high definition white light. (Low quality evidence.) 2. We recommend the use of validated classification systems to support the use of optical diagnosis with advanced endoscopic imaging in the upper and lower GI tracts (strong recommendation, moderate quality evidence). 3. We suggest that training improves performance in the use of advanced endoscopic imaging techniques and that it is a prerequisite for use in clinical practice. A learning curve exists and training alone does not guarantee sustained high performances in clinical practice. (Weak recommendation, low quality evidence.) Conclusion: Advanced endoscopic imaging can improve mucosal visualization and endoscopic diagnosis; however it requires training and the use of validated classification systems. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Corrosive injuries of the upper gastrointestinal tract

    Directory of Open Access Journals (Sweden)

    Babu Lal Meena

    2017-01-01

    Full Text Available Corrosive injury of the upper gastrointestinal tract is a worldwide clinical problem, mostly occurring in children. Alkaline agents produce deeper injuries whereas acidic agents produce superficial injuries usually. Hoarseness, stridor, and respiratory distress indicate airway injury. Dysphagia, odynophagia, and drooling of saliva suggest esophageal injury whereas abdominal pain, nausea, and vomiting are indicative of stomach injury. X-rays should be done to rule out perforation. Endoscopy is usually recommended in the first 12–48 h although it is safe up to 96 h after caustic ingestion. Endoscopy should be performed with caution and gentle insufflation. Initial management includes getting intravenous access and replacement of fluids. Hyperemia and superficial ulcerations have excellent recovery while deeper injuries require total parenteral nutrition or feeding jejunostomy. Patients suspected of perforation should be subjected to laparotomy. Common complications after corrosive injury are esophageal stricture, gastric outlet obstruction, and development of esophageal and gastric carcinoma.

  9. Wireless capsule endoscopy: a comparison with push enteroscopy in patients with gastroscopy and colonoscopy negative gastrointestinal bleeding

    Science.gov (United States)

    Mylonaki, M; Fritscher-Ravens, A; Swain, P

    2003-01-01

    Background: The development of wireless capsule endoscopy allows painless imaging of the small intestine. Its clinical use is not yet defined. The aim of this study was to compare the clinical efficacy and technical performance of capsule endoscopy and push enteroscopy in a series of 50 patients with colonoscopy and gastroscopy negative gastrointestinal bleeding. Methods: A wireless capsule endoscope was used containing a CMOS colour video imager, transmitter, and batteries. Approximately 50 000 transmitted images are received by eight abdominal aerials and stored on a portable solid state recorder, which is carried on a belt. Push enteroscopy was performed using a 240 cm Olympus video enteroscope. Results: Studies in 14 healthy volunteers gave information on normal anatomical appearances and preparation. In 50 patients with gastrointestinal bleeding and negative colonoscopy and gastroscopy, push enteroscopy was compared with capsule endoscopy. A bleeding source was discovered in the small intestine in 34 of 50 patients (68%). These included angiodysplasia (16), focal fresh bleeding (eight), apthous ulceration suggestive of Crohn’s disease (three), tumour (two), Meckel’s diverticulum (two), ileal ulcer (one), jejunitis (one), and ulcer due to intussusception (one). One additional intestinal diagnosis was made by enteroscopy. The yield of push enteroscopy in evaluating obscure bleeding was 32% (16/50). The capsule identified significantly more small intestinal bleeding sources than push enteroscopy (pcapsule endoscopy to push enteroscopy (pcapsule endoscopy was superior to push enteroscopy in the diagnosis of recurrent bleeding in patients who had a negative gastroscopy and colonoscopy. It was safe and well tolerated. PMID:12865269

  10. Hygiene: The Looming Achilles Heel in Endoscopy.

    Science.gov (United States)

    Jung, Michael; Beilenhoff, Ulrike

    2016-02-01

    Since the late 1970s there have been sporadic reports of nosocomial infections linked to endoscopic procedures. Infections by multidrug-resistant organisms (MDRO) have an increasing impact on healthcare systems worldwide. Since 2010 outbreaks involving MDRO have been reported as a result of endoscopic retrograde cholangiopancreatography (ERCP) from the USA, France, Germany and the Netherlands. This article evaluates the recent outbreaks and developments and demonstrates a structural approach to how to prevent future infections. Current national and international guidelines were used as a basis for discussions. In some cases insufficient cleaning or drying supported the outbreak. In the majority of cases, outbreaks occurred despite the apparently appropriate reprocessing protocols being in use. Microlesions were identified on a number of endoscopes, which supported the growth of bacteria and represented a vehicle for the transmission of infectious material. National official bodies responded with warnings. Manufacturers informed their customers accordingly. Separate, purpose-designed reprocessing rooms and a sufficient number of competent staff provide the structural quality for a safe reprocessing. The process quality includes a thorough cleaning of all endoscope channels and crucial instrument components, followed by an automated and validated reprocessing procedure. Strict adherence to manufacturers' recommendations is essential. The outcome quality should be evaluated by regular audits, validation of reprocessing procedures and microbiological surveillance. If outbreaks occur, a close co-operation with official bodies and manufacturers is essential. Health care professionals and manufacturers should be aware of their responsibility to ensure patient safety. A structural approach is key in prevention of endoscopy-associated infections.

  11. Effect of physical stress on drug-induced sleep endoscopy for obstructive sleep apnea.

    Science.gov (United States)

    Park, Sang Min; Kim, Dong-Kyu

    2017-08-01

    Drug-induced sleep endoscopy (DISE) is a reliable upper airway evaluation tool, widely used to improve surgical results in patients with obstructive sleep apnea (OSA). Several factors, including sleeping position and depth of sedation, affect DISE findings. This study aimed to evaluate the impact of physical stress on DISE findings. Eighty-five patients with OSA underwent two DISE examinations at the same level of sedation. The "first DISE" (control group) was performed after polysomnography, while the "second DISE" (test group) performed immediately after a treadmill stress test. The two groups were compared for changes in degree and configuration of airway obstruction at the levels of the velum, oropharynx, tongue base, and epiglottis. There were several differences in DISE findings between the control and test groups. DISE findings obtained after the stress test revealed significant narrowing of multiple airway structures; upper airway narrowing was observed at the velum (19/48; 39.6%), oropharynx (31/63; 49.2%), and tongue base (9/61; 14.8%). Changes in configuration of upper airway obstruction were observed only at the level of the velum (33/85; 38.8%). Stress exercise test induces changes in the degree and configuration of upper airways narrowing, which causes surgeons to over or underestimate the obstructive pattern, depending on the clinical circumstance. When counseling patients on the likely value of sleep surgery based on DISE findings, stressful physical activity should be included as a contributing factor in treatment planning.

  12. Paediatric endoscopy in Nigeria humble beginning | Ikobah ...

    African Journals Online (AJOL)

    ... ground to impart the needed knowledge and skills. Training involved didactic lectures, hands-on sessions using manikins and three live sessions involving the upper gastrointestinal tract. Results: There were 40 attendees on day 1: 22 (55%) paediatric residents, 12 (30%) consultant paediatricians and six (15%) nurses.

  13. High definition endoscopy with or without I-Scan increases the detection of celiac disease during routine endoscopy.

    Science.gov (United States)

    Penny, Hugo A; Mooney, Peter D; Burden, Mitchell; Patel, Nisha; Johnston, Alexander J; Wong, Simon H; Teare, Julian; Sanders, David S

    2016-06-01

    Celiac disease remains underdiagnosed at endoscopy. We aimed to assess the utility of I-Scan (virtual chromo-endoscopy) to improve sensitivity of endoscopy to detect markers of villous atrophy in this condition. Patients from 2 UK hospitals were studied in 3 groups. Group 1: standard high definition, white light endoscopy (WLE); Group 2: WLE plus I-Scan; Group 3: non-high definition control group. The presence of endoscopic markers was recorded. At least 4 duodenal biopsies were taken from all patients. Serology was performed concurrently and observations were compared with histology. 758 patients (62% female, mean age 52) were recruited (Group 1: 230; Group 2: 228; Group 3: 300). 135 (17.8%) new diagnoses of coeliac disease were made (21 Group 1; 24 Group 2; 89 Group 3). The sensitivity for detection of endoscopic markers of villous atrophy was significantly higher in both Group 1 (85.7%, p=0.0004) and Group 2 (75%, p=0.005) compared to non-high definition controls (41.6%). There was no significant difference between high definition only and I-Scan groups (p=0.47). In non-high definition endoscopy a missed diagnosis was associated with lesser degrees of villous atrophy (p=0.019) and low tTG titre (p=0.007). High definition endoscopy with or without I-Scan increases the detection of celiac disease during routine endoscopy. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  14. Capsule endoscopy in young patients with iron deficiency anaemia and negative bidirectional gastrointestinal endoscopy

    Science.gov (United States)

    Rondonotti, Emanuele; Giannakou, Andry; Avni, Tomer; Rosa, Bruno; Toth, Ervin; Lucendo, Alfredo J; Sidhu, Reena; Beaumont, Hanneke; Ellul, Pierre; Negreanu, Lucian; Jiménez-Garcia, Victoria Alejandra; McNamara, Deidre; Kopylov, Uri; Elli, Luca; Triantafyllou, Konstantinos; Shibli, Fahmi; Riccioni, Maria Elena; Bruno, Mauro; Dray, Xavier; Plevris, John N; Koulaouzidis, A; Argüelles-Arias, Federico; Becq, Aymeric; Branchi, Federica; Tejero-Bustos, María Ángeles; Cotter, Jose; Eliakim, Rami; Ferretti, Francesca; Gralnek, Ian M; Herrerias-Gutierrez, Juan Manuel; Hussey, Mary; Jacobs, Maarten; Johansson, Gabriele Wurm; McAlindon, Mark; Montiero, Sara; Nemeth, Artur; Pennazio, Marco; Rattehalli, Deepa; Stemate, Ana; Tortora, Annalisa; Tziatzios, Georgios

    2017-01-01

    Background Recent data imply young patients (age ≤50 years) undergoing small-bowel (SB) capsule endoscopy (CE) for iron deficiency anaemia (IDA) show higher diagnostic yield (DY) for sinister pathology. We aimed to investigate DY of CE in a large cohort of young IDA patients, and evaluate factors predicting significant SB pathology. Materials and methods This was a retrospective, multicentre study (2010–2015) in consecutive, young patients (≤50 years) from 18 centres/12 countries, with negative bidirectional gastrointestinal (GI) endoscopy undergoing SBCE for IDA. Exclusion criteria: previous/ongoing obscure-overt GI bleeding; age 50 years; comorbidities associated with IDA. Data retrieved: SBCE indications; prior investigations; medications; SBCE findings; final diagnosis. Clinical and laboratory data were analysed by multivariate logistic regression. Results Data on 389 young IDA patients were retrieved. In total, 169 (43.4%) were excluded due to incomplete clinical data; data from 220 (122F/98M; mean age 40.5 ± 8.6 years) patients were analysed. Some 71 patients had at least one clinically significant SBCE finding (DY: 32.3%). They were divided into two groups: neoplastic pathology (10/220; 4.5%), and non-neoplastic but clinically significant pathology (61/220; 27.7%). The most common significant but non-neoplastic pathologies were angioectasias (22/61) and Crohn’s disease (15/61). On multivariate analysis, weight loss and lower mean corpuscular volume(MCV) were associated with significant SB pathology (OR: 3.87; 95%CI: 1.3–11.3; p = 0.01; and OR: 0.96; 95%CI: 0.92–0.99; p = 0.03; respectively). Our model also demonstrates association between use of antiplatelets and significant SB pathology, although due to the small number of patients, definitive conclusions cannot be drawn. Conclusion In IDA patients ≤50 years with negative bidirectional GI endoscopy, overall DY of SBCE for clinically significant findings was 32.3%. Some 5% of our

  15. Obscure gastrointestinal bleeding: preliminary comparison of 64-section CT enteroclysis with video capsule endoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Khalife, Samer; Vahedi, Kouroche; Dray, Xavier; Marteau, Philippe [Hopital Lariboisiere-AP-HP, Universite Diderot-Paris 7, Department of Digestive Diseases, Paris Cedex 10 (France); Soyer, Philippe; Hamzi, Lounis; Place, Vinciane; Boudiaf, Mourad [Hopital Lariboisiere-AP-HP, Universite Diderot-Paris 7, Department of Abdominal Imaging, Paris Cedex 10 (France); Alatawi, Abdullah [Hopital Lariboisiere-AP-HP, Universite Diderot-Paris 7, Department of Digestive Diseases, Paris Cedex 10 (France); Hopital Lariboisiere-AP-HP, Universite Diderot-Paris 7, Department of Abdominal Imaging, Paris Cedex 10 (France)

    2011-01-15

    To retrospectively compare the diagnostic capabilities of 64-section CT enteroclysis with those of video capsule endoscopy (VCE) to elucidate the cause of obscure gastrointestinal bleeding. Thirty-two patients who had 64-section CT enteroclysis and VCE because of obscure gastrointestinal bleeding were included. Imaging findings were compared with those obtained at double balloon endoscopy, surgery and histopathological analysis, which were used as a standard of reference. Concordant findings were found in 22 patients (22/32; 69%), including normal findings (n = 13), tumours (n = 7), lymphangiectasia (n = 1) and inflammation (n = 1), and discrepancies in 10 patients (10/32; 31%), including ulcers (n = 3), angioectasias (n = 2), tumours (n = 2) and normal findings (n = 3). No statistical difference in the proportions of abnormal findings between 64-section CT enteroclysis (11/32; 34%) and VCE (17/32, 53%) (P = 0.207) was found. However, 64-section CT enteroclysis helped identify tumours not detected at VCE (n = 2) and definitely excluded suspected tumours (n = 3) because of bulges at VCE. Conversely, VCE showed ulcers (n = 3) and angioectasias (n = 2) which were not visible at 64-section CT enteroclysis. Our results suggest that 64-section CT enteroclysis and VCE have similar overall diagnostic yields in patients with obscure gastrointestinal bleeding. However, the two techniques are complementary in this specific population. (orig.)

  16. Obscure gastrointestinal bleeding: preliminary comparison of 64-section CT enteroclysis with video capsule endoscopy

    International Nuclear Information System (INIS)

    Khalife, Samer; Vahedi, Kouroche; Dray, Xavier; Marteau, Philippe; Soyer, Philippe; Hamzi, Lounis; Place, Vinciane; Boudiaf, Mourad; Alatawi, Abdullah

    2011-01-01

    To retrospectively compare the diagnostic capabilities of 64-section CT enteroclysis with those of video capsule endoscopy (VCE) to elucidate the cause of obscure gastrointestinal bleeding. Thirty-two patients who had 64-section CT enteroclysis and VCE because of obscure gastrointestinal bleeding were included. Imaging findings were compared with those obtained at double balloon endoscopy, surgery and histopathological analysis, which were used as a standard of reference. Concordant findings were found in 22 patients (22/32; 69%), including normal findings (n = 13), tumours (n = 7), lymphangiectasia (n = 1) and inflammation (n = 1), and discrepancies in 10 patients (10/32; 31%), including ulcers (n = 3), angioectasias (n = 2), tumours (n = 2) and normal findings (n = 3). No statistical difference in the proportions of abnormal findings between 64-section CT enteroclysis (11/32; 34%) and VCE (17/32, 53%) (P = 0.207) was found. However, 64-section CT enteroclysis helped identify tumours not detected at VCE (n = 2) and definitely excluded suspected tumours (n = 3) because of bulges at VCE. Conversely, VCE showed ulcers (n = 3) and angioectasias (n = 2) which were not visible at 64-section CT enteroclysis. Our results suggest that 64-section CT enteroclysis and VCE have similar overall diagnostic yields in patients with obscure gastrointestinal bleeding. However, the two techniques are complementary in this specific population. (orig.)

  17. European Society of Gastrointestinal Endoscopy - Establishing the key unanswered research questions within gastrointestinal endoscopy

    DEFF Research Database (Denmark)

    Rees, Colin J; Ngu, Wee Sing; Regula, Jaroslaw

    2016-01-01

    the field of endoscopy and prioritizing those that are important enables researchers and funders to appropriately allocate resources. Methods: Over 2 years, the ESGE Research Committee gathered information on research priorities and refined them through a modified Delphi approach. Consultations were held...... with the ESGE Governing Board and Quality Improvement Committee to identify important unanswered questions. Research workshops were held at the 21st United European Gastroenterology Week. Research questions were refined by the ESGE Research Committee and Governing Board, compiled into an online survey...... %) and were specialist endoscopists (51 %). Responses were analyzed with weighted rankings, resulting in prioritization of 26 key unanswered questions. The top ranked generic questions were: 1) How do we define the correct surveillance interval following endoscopic diagnosis? 2) How do we correctly utilize...

  18. Polyp Detection and Segmentation from Video Capsule Endoscopy: A Review

    Directory of Open Access Journals (Sweden)

    V. B. Surya Prasath

    2016-12-01

    Full Text Available Video capsule endoscopy (VCE is used widely nowadays for visualizing the gastrointestinal (GI tract. Capsule endoscopy exams are prescribed usually as an additional monitoring mechanism and can help in identifying polyps, bleeding, etc. To analyze the large scale video data produced by VCE exams, automatic image processing, computer vision, and learning algorithms are required. Recently, automatic polyp detection algorithms have been proposed with various degrees of success. Though polyp detection in colonoscopy and other traditional endoscopy procedure based images is becoming a mature field, due to its unique imaging characteristics, detecting polyps automatically in VCE is a hard problem. We review different polyp detection approaches for VCE imagery and provide systematic analysis with challenges faced by standard image processing and computer vision methods.

  19. Flexible and capsule endoscopy for screening, diagnosis and treatment.

    Science.gov (United States)

    Sliker, Levin J; Ciuti, Gastone

    2014-11-01

    Endoscopy dates back to the 1860s, but many of the most significant advancements have been made within the past decade. With the integration of robotics, the ability to precisely steer and advance traditional flexible endoscopes has been realized, reducing patient pain and improving clinician ergonomics. Additionally, wireless capsule endoscopy, a revolutionary alternative to traditional scopes, enables inspection of the digestive system with minimal discomfort for the patient or the need for sedation, mitigating some of the risks of flexible endoscopy. This review presents a research update on robotic endoscopic systems, including both flexible scope and capsule technologies, detailing actuation methods and therapeutic capabilities. A future perspective on endoscopic potential for screening, diagnostic and therapeutic gastrointestinal procedures is also presented.

  20. Wireless capsule endoscopy years after Michelassi stricturoplasty for Crohn's disease.

    Science.gov (United States)

    Sciaudone, G; Pellino, G; Guadagni, I; Pezzullo, A; Selvaggi, F

    2010-01-01

    The use of wireless capsule endoscopy in Crohn's disease has been a matter of debate. We report the case of a 27-year-old woman operated for Crohn's disease with a Michelassi stricturoplasty presenting with anaemia. We tested the patient with a patency capsule before undertaking a wireless capsule endoscopy. Although the absorbable capsule was successfully expelled, the wireless capsule was retained next to the distal edge of the Michelassi stricturoplasty, where it revealed an otherwise undetected stenotic recurrence. We successfully treated the recurrence with a Heineke-Mikulicz stricturoplasty on the stenotic outlet of the previous Michelassi, extracting the capsule. We found our treatment effective. We believe that capsule endoscopy can be performed in patients operated on for Crohn's disease, although further studies are needed to clarify its role in patients with long-stricturoplasties and to establish which examination could be the most effective in selecting patients.

  1. Non-anesthesiologist administration of propofol for gastrointestinal endoscopy

    DEFF Research Database (Denmark)

    Dumonceau, Jean-Marc; Riphaus, Andrea; Schreiber, Florian

    2015-01-01

    This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA). It addresses the administration of propofol by non-anesthesiologists for gastrointestinal (GI) endoscopy....... Main Recommendations 1 We recommend that the type of endoscopic procedure and the patient's American Society of Anesthesiologists (ASA) physical status, age, body mass index, Mallampati's classification, and risk factors for obstructive sleep apnea (OSA) be assessed before each procedure with non...... deep sedation, and long procedures (weak recommendation, high quality evidence). 4 We suggest propofol monotherapy except in particular situations (weak recommendation, high quality evidence). 5 We recommend administering propofol through intermittent bolus infusion or perfusor systems, including...

  2. Computer aided wireless capsule endoscopy video segmentation.

    Science.gov (United States)

    Li, Baopu; Xu, Guoqing; Zhou, Ran; Wang, Tianfu

    2015-02-01

    Wireless capsule endoscopy (WCE) opens a new door for the digestive tract examination and diagnosis. However, the examination of its video data is tedious. This study aims to assist a physician to interpret a WCE video by segmenting it into different anatomic parts in the digestive tract. A two level WCE video segmentation scheme is proposed to locate the boundary between the stomach, small intestine, and large intestine. In the rough level, the authors utilize color feature to draw a dissimilarity curve for a WCE video and obtain an approximate boundary. Meanwhile, training data for the fine level segmentation can be collected automatically between the two approximate boundaries of organs to overcome the difficulty of training data collection in traditional approaches. In the fine level, color histogram in the HSI color space is used to segment the stomach and small intestine. Then, color uniform local binary pattern (CULBP) algorithm is applied for discrimination of the small intestine and large intestine, which includes two patterns, namely, color norm and color angle pattern. The CULBP feature is robust to variation of illumination and discriminative for classification. In order to increase the performance of support vector machine, the authors integrate it with the Adaboost approach. Finally, the authors refine the classification results to segment a WCE video into different parts, that is, the stomach, small intestine, and large intestine. The average precision and recall are 91.2% and 90.6% for the stomach/small intestine classification, 89.2% and 88.7% for the small/large intestine discrimination. Paired t-test also demonstrates a significant better performance of the proposed scheme compared to some traditional methods. The average segmentation error is 8 frames for the stomach/small intestine discrimination, and 14 frames for the small/large intestine segmentation. The results have demonstrated that the new video segmentation method can accurately locate

  3. Comprehensive approach to endoscopies in children and adolescents

    Directory of Open Access Journals (Sweden)

    Klavdija Medja

    2013-10-01

    Full Text Available For children, endoscopies are very unpleasant and difficult to cope with. Endoscopies require a very good teamwork.The objective of the endoscopic team is to perform endoscopic procedures skillfully, safely, quickly, and as painlessly for children as possible.To perform a good endoscopic procedure, good preparation of the child and parents is essential. They should all be actively involved in all phases of the procedure, including during the endoscopy. We have to provide children holistic care. We have to abide physiological, developmental, social and cultural aspects of the child.Sedation of children during endoscopy minimizes bad experience for them, and allows better performance of the procedure or intervention. We perform gastroscopy under sedation in children younger than ten years of age, with rare exceptions. Colonoscopies are always performed under sedation.Capsule endoscopy is a newer diagnostic method in gastroenterology that enables examination of the whole small bowel. In children, it is an important and safe diagnostic method that is being successfully used in young children as well.A child scheduled for capsule endoscopy receives nursing care from admission onwards. The primary care nurse and graduate nurse work together in all phases of the diagnostic procedure: in the preparation of the child for the procedure, and in the introduction of capsule (with or without an endoscope. The nurse is responsible for the child’s safety during the procedure, for his correct timing of feeding, his well-being, regular defecation, and for monitoring the child for any side effects following the procedure. The child’s parents, when necessary, are included in all these activities.The aim of nursing care is good preparation of the child for the procedure, inclusion of his parents and teamwork to provide a safe, child-friendly and well-performed procedure.

  4. The Endoscopy Global Rating Scale – Canada: Development And Implementation of a Quality Improvement Tool

    Directory of Open Access Journals (Sweden)

    Donald MacIntosh

    2013-01-01

    Full Text Available 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.

  5. The application value of capsule endoscopy in diagnosing small intestinal carcinoma

    Directory of Open Access Journals (Sweden)

    Xiaohuan Li

    2018-01-01

    Conclusion: Capsule endoscopy demonstrated a high diagnostic value for various small bowel diseases, including both tumor and inflammatory lesions. Given its simplicity, safety, and reliability, capsule endoscopy was an important examination tool for the diagnosis of small bowel diseases.

  6. Preventing Ulcer Rebleeding: The Role of Second-Look Endoscopy

    Directory of Open Access Journals (Sweden)

    SC Sydney Chung

    1999-01-01

    Full Text Available Whether a second-look endoscopy after initial endoscopic hemostasis is of value is controversial. Routine surveillance endoscopy on the next day and treatment of any remaining stigmata may provide marginal benefit, but existing studies are not large enough to demonstrate significant differences. Endoscopic retreatment when patients develop rebleeding may allow emergency surgery to be avoided if successful but may endanger life if further bleeding occurs. Early data indicate that surgery can be avoided in about 75% of patients by retreatment without an increase in mortality.

  7. Comparison of endoscopy and barium swallow with marshmallow in dysphagia.

    Science.gov (United States)

    Somers, S; Stevenson, G W; Thompson, G

    1986-06-01

    Forty-four patients with dysphagia were examined both by endoscopy and by barium swallow with a marshmallow bolus. In these patients 36 stenoses were found: 34 by radiology and 30 by endoscopy. The radiologic criteria for stenosis included arrest of the marshmallow in a manner to support a column of barium and reproduction of the patient's symptoms at the time this occurred. Radiologic false negative findings were partly due to an inability by patients to swallow an adequate marshmallow bolus; endoscopic failures were associated with small endoscopes and mild stenoses.

  8. Gastrointestinal endoscopy- An emerging soft power in health care

    Directory of Open Access Journals (Sweden)

    G V Rao

    2012-01-01

    Full Text Available "Soft power" is a relatively new concept that describes an entity′s ability to influence and alter the behavior of other entities through attraction and co-option, in contrast to hard power which uses incentives and coercion. Assessment of the role of GI GI (Gastrointestinal Endoscopy in present day′s health care shows it to have the required attractive and influential properties of a soft power. In this article we examine the diagnostic and therapeutic roles that GI endoscopy, as a soft power, has taken over, and the further evolution of this field into a smart power.

  9. Endoscopy as a diagnostic and therapeutic alternative technique of taeniasis

    Directory of Open Access Journals (Sweden)

    Héctor Julian Canaval-Zuleta

    Full Text Available Despite a low incidence in developed countries, gastrointestinal taeniasis should be suspected in patients with abdominal pain, diarrhea, anemia, and/or malabsorption of unknown origin, even more so if they come from endemic regions or areas with poor hygienic and alimentary habits. Diagnosis is traditionally reached by identifying the parasite in stools, but more recently both serological and immunological approaches are also available. Based on a patient diagnosed by gastroscopy, a literature review was undertaken of patients diagnosed by endoscopy. We discuss endoscopy as diagnostic modality, and the effectiveness and safety that endoscopic treatment may provide in view of the potential risk for neurocysticercosis.

  10. Prediction of Helicobacter pylori status by conventional endoscopy, narrow-band imaging magnifying endoscopy in stomach after endoscopic resection of gastric cancer.

    Science.gov (United States)

    Yagi, Kazuyoshi; Saka, Akiko; Nozawa, Yujiro; Nakamura, Atsuo

    2014-04-01

    To reduce the incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer, Helicobacter pylori eradication therapy has been endorsed. It is not unusual for such patients to be H. pylori negative after eradication or for other reasons. If it were possible to predict H. pylori status using endoscopy alone, it would be very useful in clinical practice. To clarify the accuracy of endoscopic judgment of H. pylori status, we evaluated it in the stomach after endoscopic submucosal dissection (ESD) of gastric cancer. Fifty-six patients treated by ESD were enrolled. The diagnostic criteria for H. pylori status by conventional endoscopy and narrow-band imaging (NBI)-magnifying endoscopy were decided, and H. pylori status was judged by two endoscopists. Based on the H. pylori stool antigen test as a diagnostic gold standard, conventional endoscopy and NBI-magnifying endoscopy were compared for their sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Interobserver agreement was assessed in terms of κ value. Interobserver agreement was moderate (0.56) for conventional endoscopy and substantial (0.77) for NBI-magnifying endoscopy. The sensitivity, specificity, PPV, and NPV were 0.79, 0.52, 0.70, and 0.63 for conventional endoscopy and 0.91, 0.83, 0.88, and 0.86 for NBI-magnifying endoscopy, respectively. Prediction of H. pylori status using NBI-magnifying endoscopy is practical, and interobserver agreement is substantial. © 2013 John Wiley & Sons Ltd.

  11. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anesthesiologist administration of propofol for GI endoscopy

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.

    2010-01-01

    of this evidence- and consensus-based set of guideline is to provide non-anesthesiologists with a comprehensive framework for propofol sedation during digestive endoscopy. This guideline results from a collaborative effort from representatives of the European Society of Gastrointestinal Endoscopy (ESGE......), the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline....

  12. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anaesthesiologist administration of propofol for GI endoscopy

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.

    2010-01-01

    of this evidence- and consensus-based set of guideline is to provide non-anaesthesiologists with a comprehensive framework for propofol sedation during digestive endoscopy. This guideline results from a collaborative effort from representatives of the European Society of Gastrointestinal Endoscopy (ESGE......), the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline.The guideline is published simultaneously in the Journals Endoscopy and European Journal of Anaesthesiology....

  13. CT virtual endoscopy: a study of the capability to display the structures and abnormalities in nasal cavity

    International Nuclear Information System (INIS)

    Han Ping; Brambs, H.J.; Sokiranski, R.

    1999-01-01

    Objective: To evaluate display ability of virtual endoscopy and its clinical application in comparison with fiberoptic nasal endoscopy. Methods: 11 patients (22 nasal cavities) were examined by virtual endoscopy after axial spiral CT scanning was performed. Virtual endoscopy was performed by Explorer software package in a computer workstation. 9 patients (18 nasal cavities) underwent fiberoptic endoscopy. Results: Virtual endoscopy could clearly demonstrate the anatomical structures in nasal cavity, septal deviation, nasal meatus narrowing and obstruction, turbinate hyperplasia, and pathological masses larger than 3 mm in diameter. However, 'false adhesions' may appear in virtual endoscopy. The main limitation of virtual endoscopy was inability to evaluate mucosa and lack of histological diagnosis. Conclusions: Virtual endoscopy is a new, non-invasive method for demonstrating anatomical structures and diseases in nasal cavity. Its display ability is comparable with fiberoptic nasal endoscopy and is a supplement to fiberoptic nasal endoscopy

  14. Virtual MRI endoscopy of the intracranial cerebrospinal fluid spaces

    International Nuclear Information System (INIS)

    Shigematsu, Y.; Korogi, Y.; Hirai, T.; Okuda, T.; Ikushima, I.; Sugahara, T.; Liang, L.; Ge, Y.; Takahashi, M.

    1998-01-01

    We used constructive interference in steady state (CISS) 3D Fourier transform (3DFT) MRI data sets to obtain three-dimensional (3D) virtual MRI endoscopic views of the intracranial cerebrospinal fluid (CSF) spaces, processing them with a commercially available perspective endoscopic algorithm. We investigated the potential of the intracranial virtual MRI endoscopy applied to visualisation of the pathology in 13 patients with surgically confirmed trigeminal neuralgia (3), hemifacial spasm (3), acoustic neuroma (3), suprasellar germinoma (1), Langerhans cell histiocytosis (1), lateral ventricle nodules (1) and pituitary dwarfism (1). All images were acquired using a 1.5-T imager employing a circular polarised head coil. The CISS-3DFT data sets were transferred to a workstation for processing with the perspective endoscopic algorithm. Postprocessing for virtual MRI endoscopy was possible for all data sets. The lesions in 12 patients, and their complex anatomical relationships with the surrounding structures, were well seen on the 3D images. A small acoustic neuroma in the internal auditory meatus was not seen using virtual endoscopy. Although virtual MRI endoscopy has limitations, it provides 3D images which cannot be acquired using any other procedure. (orig.)

  15. Lower gastrointestinal endoscopy in Enugu, Nigeria: an experience ...

    African Journals Online (AJOL)

    14.6%), diverticulosis 15 (10%) and colorectal cancer 9(6%).Ulcerative colitis was seen in 1 patient (0.7%).However, 38(25.2%) of the patients hadnormal findings. Conclusion: The commonest indication for lower gastrointestinal endoscopy in ...

  16. Endoscopy in GERD: Boondoggle, Diagnostic Test, or Risk Management Tool?

    Science.gov (United States)

    Vakil, Nimish

    2008-02-01

    The role of endoscopy in reflux disease is debated. Diagnostic certainty is attractive to patients and physicians, to affirm health and to ensure the absence of serious disease, but it is expensive and the majority of patients will have no endoscopic abnormalities. Empirical treatment with acid suppression in patients with symptoms of gastroesophageal reflux disease (GERD) is now widely practiced in primary care in many countries but in others, endoscopy is mandatory to receive approval from the payors for proton pump inhibitor therapy. In patients with dysphagia, endoscopy has a role in ruling out an obstructing lesion. A "once-in-a-lifetime" endoscopy has been proposed as a way to improve our ability to diagnose Barrett's esophagus, but cost-models suggest that this strategy is not cost-effective if current surveillance guidelines are followed after the diagnosis of Barrett's esophagus is made. The role of routine endoscopic examination in GERD is therefore questionable and needs better definition in carefully designed trials.

  17. Application of endoscopy to treat mandibular keratocystic odontogenic tumors

    Directory of Open Access Journals (Sweden)

    Z. Gao

    Full Text Available The aim of this study was to evaluate the feasibility of endoscopy to remove keratocystic odontogenic tumors (KCOTs with virtual 3D mandibular images. Fifteen patients (mean age, 40.27±14.58 years who underwent endoscopic mandibular KCOT enucleation between May 2009 and October 2009 were included. Virtual 3D mandibular reconstructions derived from computed tomography (CT imaging were generated for all patients. Recurrence and pathological fracture were evaluated as the primary outcome variables at 1 and 12 months after operation. Secondary infection and inferior alveolar nerve injury were evaluated as the secondary outcome variables at 1 and 6 months after operation. None of the 15 patients exhibited signs of recurrence or pathological fracture after operation. During long-term follow-up, no symptoms of inferior alveolar nerve injury or secondary infection were observed and no signs of recurrence were found in any of the patients. Endoscopy helps surgeons to remove mandibular KCOTs with small incisions. Moreover, endoscopy can provide clear and magnified views and help to avoid damage to the inferior alveolar neurovascular bundle. Therefore, under the support of preoperative virtual 3D mandibular images, the application of endoscopy to remove the tumors should be considered to be a treatment option for KCOTs.

  18. Application of endoscopy to treat mandibular keratocystic odontogenic tumors

    Science.gov (United States)

    Gao, Z.; Ni, Q.W.; Gao, W.; Liu, Y.P.; Zhang, Q.

    2017-01-01

    The aim of this study was to evaluate the feasibility of endoscopy to remove keratocystic odontogenic tumors (KCOTs) with virtual 3D mandibular images. Fifteen patients (mean age, 40.27±14.58 years) who underwent endoscopic mandibular KCOT enucleation between May 2009 and October 2009 were included. Virtual 3D mandibular reconstructions derived from computed tomography (CT) imaging were generated for all patients. Recurrence and pathological fracture were evaluated as the primary outcome variables at 1 and 12 months after operation. Secondary infection and inferior alveolar nerve injury were evaluated as the secondary outcome variables at 1 and 6 months after operation. None of the 15 patients exhibited signs of recurrence or pathological fracture after operation. During long-term follow-up, no symptoms of inferior alveolar nerve injury or secondary infection were observed and no signs of recurrence were found in any of the patients. Endoscopy helps surgeons to remove mandibular KCOTs with small incisions. Moreover, endoscopy can provide clear and magnified views and help to avoid damage to the inferior alveolar neurovascular bundle. Therefore, under the support of preoperative virtual 3D mandibular images, the application of endoscopy to remove the tumors should be considered to be a treatment option for KCOTs. PMID:28700034

  19. Is there an application for wireless capsule endoscopy in horses?

    Science.gov (United States)

    Montgomery, Julia B; Bracamonte, Jose L; Alam, Mohammad Wajih; Khan, Alimul H; Mohammed, Shahed K; Wahid, Khan A

    2017-12-01

    This pilot study assessed wireless capsule endoscopy in horses. Image transmission was achieved with good image quality. Time to exit the stomach was variable and identified as one limitation, together with gaps in image transmission, capsule tumbling, and inability to accurately locate the capsule. Findings demonstrate usefulness and current limitations.

  20. Computerisation of endoscopy reports using standard reports and text blocks

    NARCIS (Netherlands)

    Groenen, M. J. M.; Kuipers, E. J.; van Berge Henegouwen, G. P.; Fockens, P.; Ouwendijk, R. J. Th

    2006-01-01

    BACKGROUND: The widespread use of gastrointestinal endoscopy for diagnosis and treatment requires effective, standardised report systems. This need is further increased by the limited storage of images, and by the need for structured databases for surveillance and epidemiology. We therefore aimed

  1. Person-centered endoscopy safety checklist: Development, implementation, and evaluation.

    Science.gov (United States)

    Dubois, Hanna; Schmidt, Peter T; Creutzfeldt, Johan; Bergenmar, Mia

    2017-12-28

    To describe the development and implementation of a person-centered endoscopy safety checklist and to evaluate the effects of a "checklist intervention". The checklist, based on previously published safety checklists, was developed and locally adapted, taking patient safety aspects into consideration and using a person-centered approach. This novel checklist was introduced to the staff of an endoscopy unit at a Stockholm University Hospital during half-day seminars and team training sessions. Structured observations of the endoscopy team's performance were conducted before and after the introduction of the checklist. In addition, questionnaires focusing on patient participation, collaboration climate, and patient safety issues were collected from patients and staff. A person-centered safety checklist was developed and introduced by a multi-professional group in the endoscopy unit. A statistically significant increase in accurate patient identity verification by the physicians was noted (from 0% at baseline to 87% after 10 mo, P importance of patient participation were rated more highly after the introduction of the checklist, but this did not result in statistical significance ( P = 0.07/ P = 0.08). The patients rated almost all items as very high both before and after the introduction of the checklist; hence, no statistical difference was noted. The intervention led to increased patient identity verification by physicians - a patient safety improvement. Clear evidence of enhanced person-centeredness or team work was not found.

  2. [Structuralization of digestive endoscopy report based on NLP].

    Science.gov (United States)

    Kong, Xiao-feng; Li, Ying; Li, Hao-min; Lu, Xu-dong

    2008-09-01

    This paper presents a method based on NLP to realize structuralization of digestive endoscopy reports. The method is taking advantage of existing NLP's processing technologies and introducing minimal standard terminology (MST) to transform a narrative gastroscopy report into the structuralization report based on MST, whose accuracy rate is 92.3%.

  3. Singular Value Decomposition Based Features for Automatic Tumor Detection in Wireless Capsule Endoscopy Images

    Directory of Open Access Journals (Sweden)

    Vahid Faghih Dinevari

    2016-01-01

    Full Text Available Wireless capsule endoscopy (WCE is a new noninvasive instrument which allows direct observation of the gastrointestinal tract to diagnose its relative diseases. Because of the large number of images obtained from the capsule endoscopy per patient, doctors need too much time to investigate all of them. So, it would be worthwhile to design a system for detecting diseases automatically. In this paper, a new method is presented for automatic detection of tumors in the WCE images. This method will utilize the advantages of the discrete wavelet transform (DWT and singular value decomposition (SVD algorithms to extract features from different color channels of the WCE images. Therefore, the extracted features are invariant to rotation and can describe multiresolution characteristics of the WCE images. In order to classify the WCE images, the support vector machine (SVM method is applied to a data set which includes 400 normal and 400 tumor WCE images. The experimental results show proper performance of the proposed algorithm for detection and isolation of the tumor images which, in the best way, shows 94%, 93%, and 93.5% of sensitivity, specificity, and accuracy in the RGB color space, respectively.

  4. Singular Value Decomposition Based Features for Automatic Tumor Detection in Wireless Capsule Endoscopy Images.

    Science.gov (United States)

    Faghih Dinevari, Vahid; Karimian Khosroshahi, Ghader; Zolfy Lighvan, Mina

    2016-01-01

    Wireless capsule endoscopy (WCE) is a new noninvasive instrument which allows direct observation of the gastrointestinal tract to diagnose its relative diseases. Because of the large number of images obtained from the capsule endoscopy per patient, doctors need too much time to investigate all of them. So, it would be worthwhile to design a system for detecting diseases automatically. In this paper, a new method is presented for automatic detection of tumors in the WCE images. This method will utilize the advantages of the discrete wavelet transform (DWT) and singular value decomposition (SVD) algorithms to extract features from different color channels of the WCE images. Therefore, the extracted features are invariant to rotation and can describe multiresolution characteristics of the WCE images. In order to classify the WCE images, the support vector machine (SVM) method is applied to a data set which includes 400 normal and 400 tumor WCE images. The experimental results show proper performance of the proposed algorithm for detection and isolation of the tumor images which, in the best way, shows 94%, 93%, and 93.5% of sensitivity, specificity, and accuracy in the RGB color space, respectively.

  5. Endoluminal pharmacologic stimulation of the upper urinary tract.

    Science.gov (United States)

    Jakobsen, Jørn Skibsted

    2013-05-01

    The experiments performed in this PhD thesis were conducted at the Institute of Experimental Surgery, Skejby Hospital, Aarhus, Denmark and at the Laboratory of Animal Science, Odense University Hospital, Denmark. The thesis is based on 3 peer review articles published in international journals and a review. Diagnostic or therapeutic endoscopic upper urinary tract procedures are usually characterised as minimal invasive procedures and associated with a low complication rate. Most often fever or pain are seen and sometimes septicaemia. However, mucosa lesion or even ureteric ruptures are known complications. Research has suggested that high renal pelvic pressures generated during these procedures, might contribute to per-/postoperative complications seen, and even possible renal parenchymal damage. Nevertheless, local administration (endoluminal) of a relaxant drug has not previously been tried in order to lower renal pelvic pressure. The purposes of this thesis were to examine the effect of local administration (endoluminal) of the nonspecific β-adrenergic agonist ISOproterenol (ISO) on: 1) The normal pressure flow relation in porcine ureter, 2) The effect of endoluminal ISO perfusion during flexible ureterorenoscopy, 3) The pressure flow relation during semirigid ureterorenoscopy and 4) The cardiovascular system. Among other receptor-types β-adrenergic receptor are located in the upper urinary tract and the activation thereof mediates smooth muscle relaxation. We have shown - in an animal experimental model - that ISO added to the irrigation fluid had significant impact on the renal pelvic pressures generated during upper urinary tract endoscopy. ISO significantly and dose dependently reduced the normal pressure flow relations by approximately 80% without concomitant cardiovascular side effects or measurable plasma levels of ISO. During flexible ureterorenoscopy 0.1 µg/ml ISO added to the irrigation fluid significantly reduced renal pelvic pressure during

  6. Video summarization based tele-endoscopy: a service to efficiently manage visual data generated during wireless capsule endoscopy procedure.

    Science.gov (United States)

    Mehmood, Irfan; Sajjad, Muhammad; Baik, Sung Wook

    2014-09-01

    Wireless capsule endoscopy (WCE) has great advantages over traditional endoscopy because it is portable and easy to use. More importantly, WCE combined with mobile computing ensures rapid transmission of diagnostic data to hospitals and enables off-site senior gastroenterologists to offer timely decision making support. However, during this WCE process, video data are produced in huge amounts, but only a limited amount of data is actually useful for diagnosis. The sharing and analysis of this video data becomes a challenging task due the constraints such as limited memory, energy, and communication capability. In order to facilitate efficient WCE data collection and browsing tasks, we present a video summarization-based tele-endoscopy service that estimates the semantically relevant video frames from the perspective of gastroenterologists. For this purpose, image moments, curvature, and multi-scale contrast are computed and are fused to obtain the saliency map of each frame. This saliency map is used to select keyframes. The proposed tele-endoscopy service selects keyframes based on their relevance to the disease diagnosis. This ensures the sending of diagnostically relevant frames to the gastroenterologist instead of sending all the data, thus saving transmission costs and bandwidth. The proposed framework also saves storage costs as well as the precious time of doctors in browsing patient's information. The qualitative and quantitative results are encouraging and show that the proposed service provides video keyframes to the gastroenterologists without discarding important information.

  7. A Rare Cause of Upper Airway Obstruction in a Child

    OpenAIRE

    Ahmed, H.; Ndiaye, C.; Barry, M. W.; Thiongane, Aliou; Mbaye, A.; Zemene, Y.; Ndiaye, I. C.

    2017-01-01

    Ventricular band cyst is a rare condition in children but can result in severe upper airway obstruction with laryngeal dyspnea or death. The diagnosis should be considered in any stridor in children with previous history of intubation or respiratory infections. We report a case of a 4-year-old girl, received in an array of severe respiratory distress, emergency endoscopy was done, and a large ventricular tape band cyst obstructing the air way was found. Complete excision was made, and postope...

  8. Wireless capsule endoscopy of the small intestine: a review with future directions.

    Science.gov (United States)

    Neumann, Helmut; Fry, Lucía C; Nägel, Andreas; Neurath, Markus F

    2014-09-01

    Here, we review the clinical applications of small bowel capsule endoscopy. Moreover, we provide an outlook on the exceptional future developments of small bowel capsule endoscopy. We discuss clinical algorithms for diagnosis of small bowel diseases. Multiple studies have shown the potential of capsule endoscopy for identification of the bleeding source located in the small bowel and the increased diagnostic yield over radiographic studies. Capsule endoscopy could detect villous atrophy and severe complications in patients with nonresponsive celiac disease. In addition, small bowel capsule endoscopy was proven as a valid tool to diagnose polyps and tumors and Crohn's disease. Major current clinical indications of capsule endoscopy in the small bowel include evaluation of obscure gastrointestinal bleeding, diagnosis and surveillance of small bowel polyps and tumors, celiac disease and Crohn's disease. Recent developments have also passed the way for small bowel capsule endoscopy to become a therapeutic instrument.

  9. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anesthesiologist administration of propofol for GI endoscopy

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.

    2010-01-01

    of this evidence- and consensus-based set of guideline is to provide non-anesthesiologists with a comprehensive framework for propofol sedation during digestive endoscopy. This guideline results from a collaborative effort from representatives of the European Society of Gastrointestinal Endoscopy (ESGE...

  10. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anaesthesiologist administration of propofol for GI endoscopy

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.

    2010-01-01

    of this evidence- and consensus-based set of guideline is to provide non-anaesthesiologists with a comprehensive framework for propofol sedation during digestive endoscopy. This guideline results from a collaborative effort from representatives of the European Society of Gastrointestinal Endoscopy (ESGE...

  11. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anaesthesiologist administration of propofol for GI endoscopy

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.

    2010-01-01

    ), the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline.The guideline is published simultaneously in the Journals Endoscopy and European Journal of Anaesthesiology....

  12. Coffee grounds emesis: not just an upper GI bleed.

    Science.gov (United States)

    Bou-Abdallah, Jad Z; Murthy, Uma K; Mehta, Nilish; Prasad, Heramba N; Kaul, Vivek

    2012-07-01

    Acute upper gastrointestinal (UGI) bleeding manifests as hematemesis, melena, or hematochezia. Initial management is identical, irrespective of nasogastric (NG) aspirate results. Current practice includes early upper endoscopy. Significantly fewer high-risk bleeding lesions are found on endoscopy in patients with coffee grounds vs. bloody NG aspirates. We present a case series to illustrate that patients with coffee grounds emesis (CGE) often have other unsuspected illnesses that may be overlooked due to preoccupation with the GI bleed. A retrospective chart review of a series of 6 patients presenting with CGE and admitted for upper GI bleeding was performed. All 6 patients were hemodynamically stable at admission. NG lavage showed coffee grounds that cleared easily. None of the patients required blood transfusions during their hospital stay. Endoscopy in 3 of 6 patients failed to find any significant UGI lesions or stigmata of recent bleed. Although patients were admitted for UGI bleeding, the more significant associated diagnoses included acute myocardial infarction, urosepsis, small bowel obstruction, bilateral pulmonary emboli, and acute renal failure. Hemodynamically stable patients presenting with coffee grounds NG aspirate and no fall in hemoglobin/hematocrit should be evaluated for other non-GI bleeding-related conditions even as the GI bleed is being managed. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. A comparative study of hysterosalpingography and endoscopy/laparotomy in infertile patients

    International Nuclear Information System (INIS)

    Nielsen, D.T.; Rasmussen, F.; Justesen, P.

    1987-01-01

    A comparison of hysterosalpingography (HSG), using Lipiodol ultrafluid as contrast medium, with endoscopy/laparotomy in the evaluation of the tubal function in 124 infertile women is presented. There was agreement between the results of both methods in 73.4% of the patients. The false-negative rate was 2.4% and the false-positive rate was 8.9%. Complications in the form of intravasation were seen in three patients but none of them had any symptoms. The conception rate was 35% in the subgroup of patients with normal HSG. The authors recommended the continuous use of HSG in the overall evaluation of infertile patients. It is recommended to use oil-soluble contrast media because of its high diagnostic accuracy, low frequency of complications and its therapeutic advantages. (orig.)

  14. Predictors of gastrointestinal lesions on endoscopy in iron deficiency anemia without gastrointestinal symptoms

    Directory of Open Access Journals (Sweden)

    Wasaya Rozina

    2008-11-01

    Full Text Available Abstract Background Iron deficiency anaemia (IDA due to occult gastrointestinal (GI blood loss usually remains unnoticed until patient become symptomatic. There is sparse data in IDA patients without gastrointestinal symptoms. This study was designed to find out the frequency and predictors of endoscopic lesions in IDA without gastrointestinal symptoms. Cross-sectional study performed on a convenience sample of consecutive subjects. Methods Ninety five consecutive patients with laboratory based diagnosis of IDA having no gastrointestinal symptoms were interviewed and their clinical and biochemical variables were recorded. All the study patients underwent esophago-gastroduodenoscopy (EGD and colonoscopy. Endoscopic findings were documented as presence/absence of bleeding related lesion and presence/absence of cause of IDA. Multiple logistic regressions were performed to identify variables significantly related to outcome variables. Results Possible cause of anaemia was found in 71% and bleeding related lesions were found in 53% of patients. Upper gastrointestinal tract lesions were found in 41% of patients with bleeding related lesions. On multivariable logistic regression; advancing age, low mean corpuscular volume (MCV ≤ 60 fl, and positive fecal occult blood test were predictive factors for bleeding related GI lesions and cause of IDA Conclusion Clinical and Biochemical markers can predict gastrointestinal lesions on endoscopy in IDA patients without gastrointestinal symptoms. High proportion of upper gastrointestinal involvement warrants EGD as initial endoscopic procedure however, this needs validation by further studies.

  15. Drug-induced sedation endoscopy (DISE) classification systems: a systematic review and meta-analysis.

    Science.gov (United States)

    Dijemeni, Esuabom; D'Amone, Gabriele; Gbati, Israel

    2017-12-01

    Drug-induced sedation endoscopy (DISE) classification systems have been used to assess anatomical findings on upper airway obstruction, and decide and plan surgical treatments and act as a predictor for surgical treatment outcome for obstructive sleep apnoea management. The first objective is to identify if there is a universally accepted DISE grading and classification system for analysing DISE findings. The second objective is to identify if there is one DISE grading and classification treatment planning framework for deciding appropriate surgical treatment for obstructive sleep apnoea (OSA). The third objective is to identify if there is one DISE grading and classification treatment outcome framework for determining the likelihood of success for a given OSA surgical intervention. A systematic review was performed to identify new and significantly modified DISE classification systems: concept, advantages and disadvantages. Fourteen studies proposing a new DISE classification system and three studies proposing a significantly modified DISE classification were identified. None of the studies were based on randomised control trials. DISE is an objective method for visualising upper airway obstruction. The classification and assessment of clinical findings based on DISE is highly subjective due to the increasing number of DISE classification systems. Hence, this creates a growing divergence in surgical treatment planning and treatment outcome. Further research on a universally accepted objective DISE assessment is critically needed.

  16. Computer vision and augmented reality in gastrointestinal endoscopy

    Science.gov (United States)

    Mahmud, Nadim; Cohen, Jonah; Tsourides, Kleovoulos; Berzin, Tyler M.

    2015-01-01

    Augmented reality (AR) is an environment-enhancing technology, widely applied in the computer sciences, which has only recently begun to permeate the medical field. Gastrointestinal endoscopy—which relies on the integration of high-definition video data with pathologic correlates—requires endoscopists to assimilate and process a tremendous amount of data in real time. We believe that AR is well positioned to provide computer-guided assistance with a wide variety of endoscopic applications, beginning with polyp detection. In this article, we review the principles of AR, describe its potential integration into an endoscopy set-up, and envisage a series of novel uses. With close collaboration between physicians and computer scientists, AR promises to contribute significant improvements to the field of endoscopy. PMID:26133175

  17. Swallowable Wireless Capsule Endoscopy: Progress and Technical Challenges

    Directory of Open Access Journals (Sweden)

    Guobing Pan

    2012-01-01

    Full Text Available 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.

  18. Low power design of wireless endoscopy compression/communication architecture

    Directory of Open Access Journals (Sweden)

    Zitouni Abdelkrim

    2018-05-01

    Full Text Available A wireless endoscopy capsule represents an efficient device interesting on the examination of digestive diseases. Many performance criteria’s (silicon area, dissipated power, image quality, computational time, etc. need to be deeply studied.In this paper, our interest is the optimization of the indicated criteria. The proposed methodology is based on exploring the advantages of the DCT/DWT transforms by combining them into single architecture. For arithmetic operations, the MCLA technique is used. This architecture integrates also a CABAC entropy coder that supports all binarization schemes. AMBA/I2C architecture is developed for assuring optimized communication.The comparisons of the proposed architecture with the most popular methods explained in related works show efficient results in terms dissipated power, hardware cost, and computation speed. Keywords: Wireless endoscopy capsule, DCT/DWT image compression, CABAC entropy coder, AMBA/I2C multi-bus architecture

  19. Swallowable Wireless Capsule Endoscopy: Progress and Technical Challenges

    Science.gov (United States)

    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

  20. Italian National Survey of Digestive Endoscopy Disinfection Procedures.

    Science.gov (United States)

    Orsi, G B; Filocamo, A; Di Stefano, L; Tittobello, A

    1997-10-01

    Inadequate disinfection of endoscopes and associated instrumentation can result in transmission of bacterial infections to patients. The aim of this study was to investigate the disinfection procedures carried out in the Italian centers of digestive endoscopy. An anonymous postal questionnaire on the methods of cleaning and disinfecting endoscopy equipment in Italy was sent to 781 digestive endoscopy centers; 386 units (49.4 %) replied. Automatic washers were available in 47.6% of units. Nearly all the respondets (99.2%) cleaned the instruments before disinfection, using detergent, germicidal or enzymatic cleaner, but only 69.7% carried out brushing. Most centers (89.2 %) used a glutaraldehyde-based disinfectant (51 % used 2 % glutaraldehyde; 26.9% used 0.4% glutaraldehyde with 1.41% phenol and 0.26% sodium phenate; 5.9% used either; 5.4% did not specify glutaraldehyde formulation). The contact time of the disinfectant was or = 30 minutes (16.6%). The use-life of the disinfectant was > or = 14 days in 27.3 % of the centers with automatic washers and 30.8% in all centers. Only 25.4% of the centers carried out some form of sterilization for biopsy forceps. The majority (83.4 %) modified their disinfection procedures in the case of infectious disease patients. Quality control tests on the efficacy of the endoscopy disinfection procedures were carried out in 44.6 % of units. Only 43 % of the centers were based in hospitals with an infection control (surveillance) program. The data collected in the study showed that, in general, there is compliance with the Società Italiana di Endoscopia Digestiva (SIED) and Società Italiana di Gastroenterologia (SIGE) guidelines, although with some important exceptions.

  1. Gastrointestinal mucosal abnormalities using videocapsule endoscopy in systemic sclerosis.

    Science.gov (United States)

    Marie, I; Antonietti, M; Houivet, E; Hachulla, E; Maunoury, V; Bienvenu, B; Viennot, S; Smail, A; Duhaut, P; Dupas, J-L; Dominique, S; Hatron, P-Y; Levesque, H; Benichou, J; Ducrotté, P

    2014-07-01

    To date, there are no large studies on videocapsule endoscopy in systemic sclerosis (SSc). Consequently, the prevalence and features of gastrointestinal mucosal abnormalities in SSc have not been determined. To determine both prevalence and characteristics of gastrointestinal mucosal abnormalities in unselected patients with SSc, using videocapsule endoscopy. To predict which SSc patients are at risk of developing potentially bleeding gastrointestinal vascular mucosal abnormalities. Videocapsule endoscopy was performed on 50 patients with SSc. Prevalence of gastrointestinal mucosal abnormalities was 52%. Potentially bleeding vascular mucosal lesions were predominant, including: watermelon stomach (34.6%), gastric and/or small intestinal telangiectasia (26.9%) and gastric and/or small intestinal angiodysplasia (38.5%). SSc patients with gastrointestinal vascular mucosal lesions more often exhibited: limited cutaneous SSc (P = 0.06), digital ulcers (P = 0.05), higher score of nailfold videocapillaroscopy (P = 0.0009), anaemia (P = 0.02), lower levels of ferritin (P correlation between gastrointestinal vascular mucosal lesions and presence of severe extra-digestive vasculopathy (digital ulcers and higher nailfold videocapillaroscopy scores). This latter supports the theory that SSc-related diffuse vasculopathy is responsible for both cutaneous and digestive vascular lesions. Therefore, we suggest that nailfold videocapillaroscopy may be a helpful test for managing SSc patients. In fact, nailfold videocapillaroscopy score should be calculated routinely, as it may result in identification of SSc patients at higher risk of developing potentially bleeding gastrointestinal vascular mucosal lesions. © 2014 John Wiley & Sons Ltd.

  2. Fast volume rendering algorithm in a virtual endoscopy system

    Science.gov (United States)

    Kim, Sang H.; Kim, Jin K.; Ra, Jong Beom

    2002-05-01

    Recently, 3D virtual endoscopy has been used as an alternative noninvasive procedure for visualization of a hollow organ. In this paper, we propose a fast volume rendering scheme based on perspective ray casting for virtual endoscopy. As a pre-processing step, the algorithm divides a volume into hierarchical blocks and classifies them into opaque or transparent blocks. Then, the rendering procedure is as follows. In the first step, we perform ray casting only for sub-sampled pixels on the image plane, and determine their pixel values and depth information. In the second step, by reducing the sub-sampling factor by half, we repeat ray casting for newly added pixels, and their pixel values and depth information are determined. Here, the previously obtained depth information is utilized to reduce the processing time. This step is performed recursively until the full-size rendering image is acquired. Experiments conducted on a PC shows that the proposed algorithm can reduce the rendering time by 70-80% for the bronchus and colon endoscopy, compared with the brute-force ray casting scheme. Thereby, interactive rendering becomes more realizable in a PC environment without any specific hardware.

  3. Advanced Therapeutic Gastrointestinal Endoscopy in Children - Today and Tomorrow.

    Science.gov (United States)

    Nabi, Zaheer; Reddy, Duvvur Nageshwar

    2017-12-12

    Gastrointestinal (GI) endoscopy plays an indispensable role in the diagnosis and management of various pediatric GI disorders. While the pace of development of pediatric GI endoscopy has increased over the years, it remains sluggish compared to the advancements in GI endoscopic interventions available in adults. The predominant reasons that explain this observation include lack of formal training courses in advanced pediatric GI interventions, economic constraints in establishing a pediatric endoscopy unit, and unavailability of pediatric-specific devices and accessories. However, the situation is changing and more pediatric GI specialists are now performing complex GI procedures such as endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography for various pancreatico-biliary diseases and more recently, per-oral endoscopic myotomy for achalasia cardia. Endoscopic procedures are associated with reduced morbidity and mortality compared to open surgery for GI disorders. Notable examples include chronic pancreatitis, pancreatic fluid collections, various biliary diseases, and achalasia cardia for which previously open surgery was the treatment modality of choice. A solid body of evidence supports the safety and efficacy of endoscopic management in adults. However, additions continue to be made to literature describing the pediatric population. An important consideration in children includes size of children, which in turn determines the selection of endoscopes and type of sedation that can be used for the procedure.

  4. Hyperspectral Imaging Using Flexible Endoscopy for Laryngeal Cancer Detection

    Directory of Open Access Journals (Sweden)

    Bianca Regeling

    2016-08-01

    Full Text Available Hyperspectral imaging (HSI is increasingly gaining acceptance in the medical field. Up until now, HSI has been used in conjunction with rigid endoscopy to detect cancer in vivo. The logical next step is to pair HSI with flexible endoscopy, since it improves access to hard-to-reach areas. While the flexible endoscope’s fiber optic cables provide the advantage of flexibility, they also introduce an interfering honeycomb-like pattern onto images. Due to the substantial impact this pattern has on locating cancerous tissue, it must be removed before the HS data can be further processed. Thereby, the loss of information is to minimize avoiding the suppression of small-area variations of pixel values. We have developed a system that uses flexible endoscopy to record HS cubes of the larynx and designed a special filtering technique to remove the honeycomb-like pattern with minimal loss of information. We have confirmed its feasibility by comparing it to conventional filtering techniques using an objective metric and by applying unsupervised and supervised classifications to raw and pre-processed HS cubes. Compared to conventional techniques, our method successfully removes the honeycomb-like pattern and considerably improves classification performance, while preserving image details.

  5. Endoscopy-assisted cerebral falx incision via unilateral

    Directory of Open Access Journals (Sweden)

    DONG Ji-rong

    2012-04-01

    Full Text Available 【Abstract】Objective: To investigate the clinical features and treatment strategy of dissymmetric bilateral frontal contusion, and to summarize our experience in treat-ing these patients by minimally invasive surgery. Methods: Over the past 3 years, we have treated a total of 31 patients with dissymmetric bilateral frontal contusion using endoscopy-assisted unilateral cerebral falx incision. Other 30 patients treated by routine bilateral approaches within the same period were taken as control. Results: Seventeen cases (54.8% in the unilateral operation group survived and were in good condition, 8 (25.8% had moderate disability, 4 (12.9% had severe disability, 1 (3.2% was in vegetative state, and 1 (3.2% died. Compared with the control group, the Glasgow Out-come Scale score was not significantly different in the uni-lateral operation group, but the operation time, blood trans-fusion volume, the length of hospital stay, the incidences of mental disorder and olfactory nerve injury were greatly reduced in the unilateral operation group. Conclusions: Endoscopy-assisted unilateral cerebral falx incision can shorten the operation time, reduce surgical trauma and complications in treatment of patients with dis-symmetric bilateral frontal contusion. It can obviously di-minish the chance of delayed intracerebral hematoma and subsequently minimize the incidences of subfalcial and centrencephalic herniation. Key words: Brain injuries; Intracranial hemorrage, traumatic; Endoscopy; Surgically procedures, minimally invasive

  6. Percutaneous lithotripsy for removing difficult bile duct stones using endoscopy

    International Nuclear Information System (INIS)

    Kim, See Hyung; Sohn, Chul Ho; Kim, Young Hwan

    2008-01-01

    To describe efficacy of percutaneous lithotripsy for removing difficult bile duct stones using endoscopy. A total of 88 patients with difficulties for the removal of bile duct stones using endoscopy (an impacted stone, stone size > 15 mm, intrahepatic duct (IHD) stone, stone size to bile duct diameter ratio > 1.0), were enrolled in this study. A 12 Fr sheath was inserted through the percutaneous transhepatic biliary drainage (PTBD) tract, and then nitrol stone baskets and a 0.035' snare wire were used to capture, fragment and remove the stones. The technical and clinical success rates were analyzed, together with an analysis of any complications. The overall technical success rate of stone removal was achieved in 79 of 88 patients (89.8%). In five of nine patients with failed stone removal, small residual IHD stones were noted on a cholangiogram. Even if stone removal failed in these cases, cholangitic symptoms were improved and the drainage catheter was successfully removed. Therefore, clinical success was achieved in 84 of 88 patients (95.5%). There were no significant procedure-related complications, except for sepsis in one case. Billiary stone removal using the stone basket and guide-wire snare technique through the PTBD tract is a safe and effective procedure that can be used as a primary method in patients with difficulties for the removal of bile duct stones using endoscopy

  7. First progress report on the Japan Endoscopy Database project.

    Science.gov (United States)

    Kodashima, Shinya; Tanaka, Kiyohito; Matsuda, Koji; Fujishiro, Mitsuhiro; Saito, Yutaka; Ohtsuka, Kazuo; Oda, Ichiro; Katada, Chikatoshi; Kato, Masayuki; Kida, Mitsuhiro; Kobayashi, Kiyonori; Hoteya, Shu; Horimatsu, Takahiro; Matsuda, Takahisa; Muto, Manabu; Yamamoto, Hironori; Ryozawa, Shomei; Iwakiri, Ryuichi; Kutsumi, Hiromu; Miyata, Hiroaki; Kato, Mototsugu; Haruma, Ken; Fujimoto, Kazuma; Uemura, Naomi; Kaminishi, Michio; Tajiri, Hisao

    2018-01-01

    The Japan Endoscopy Database (JED) Project was started to develop the world's largest endoscopic database, capture the actual performance of endoscopic practice, and standardize the terminology and fundamental items needed for a clinical and research registry. This paper presents a progress report on the first phase of this project undertaken at eight endoscopic centers in Japan. The list of data items to be collected was drafted by the MSED-J (Minimal Standard Endoscopic Database) subcommittee. These items were aggregated offline by integrating data from two endoscopic filing systems between July 2015 and December 2015. The study population included all patients who underwent esophagogastroduodenoscopy or colonoscopy at all eight centers, patients who underwent enteroscopy at five of the eight centers, and patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) at four of the eight centers. Data collected in this phase included 61 070 endoscopic procedures, of which 40 475 were esophagogastroduodenoscopies, 215 were enteroscopies, 19 204 were colonoscopies, and 1176 were ERCPs. Frequencies of complications were 0.68% for esophagogastroduodenoscopy, 0% for enteroscopy, 0.43% for colonoscopy, and 13.34% for ERCP. In addition, we obtained various data including Helicobacter pylori infection status, past history of endoscopy in patients who underwent enteroscopy or colonoscopy, and degree of difficulty of ERCP, although the frequencies of reporting were sometimes low, with some items <20%. Results of the first phase suggest that the JED project can provide vast quantities of useful data about endoscopic procedures. © 2017 Japan Gastroenterological Endoscopy Society.

  8. [Gastric schwannoma: rare differenzial diagnosis of acute upper gastrointestinal (GI) bleeding].

    Science.gov (United States)

    Lyros, Orestis; Schickel, Stephan; Schierle, Katrin; Hoffmeister, Albrecht; Gockel, Ines

    2017-08-01

    Schwannomas are benign tumors derived from Schwann cells and their typical site of origin is the subcutaneous tissue of the extremities. Gastrointestinal localization of Schwannomas is extremely rare and the stomach is the prevalent site. Gastric schwannomas primarily occur in the gastric submucosa and are usually asymptomatic.We present a rare case of a solitary gastric schwannoma in a 51-year old male, which initially manifested with hematemesis by acute upper gastrointestinal (GI) bleeding. The upper GI-Endoscopy revealed a gastric submucosal tumor, 7 cm in size, located in the proximal corpus and fundus. In the endoscopical Ultrasound (EUS-Examination), the lesion appeared to arise from the fourth proper muscle layer (Muscularis propria). The fourth layer origin and the isoechogenicity, as compared to the normal muscle layer, are endoscopic ultrasonographic characteristics of gastric schwannomas and help in distinguishing them from gastrointestinal tumors (GIST). Because of the unclear histological identity, the patient underwent a "rendezvous" endoscopic-laparoscopic surgical resection of the tumor in toto. The histomorphological features of the lesion and the strong expression of S100 in combination with absence of DOG1 expression indicated the diagnosis of gastric schwannoma. There was no evidence of malignancy. The postoperative course was uncomplicated.This is a very rare manifestation of gastric schwannoma, representing a rare differenzial diagnosis in a case of acute upper GI-Bleeding. Only 14 % of gastric schwanommas are presented with gastrointestinal bleeding, including mainly melena rather than hematemesis. This case is considered to be worthy of presentation owing to the rare and unusual cause of upper GI bleeding implied in it. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Random duodenal biopsy to exclude coeliac disease as a cause of anaemia is not cost-efective and should be replaced with universally performed pre-endoscopy serology in patients on a suspected cancer pathway.

    Science.gov (United States)

    Herrod, P J J; Lund, J N

    2018-02-01

    Random duodenal biopsy to exclude coeliac disease during upper gastrointestinal endoscopy for the investigation of iron deficiency anaemia remains a common procedure, but is expensive and time-consuming. Serological investigation for coeliac disease is also recommended, having excellent accuracy with the added benefit of lower cost. This study sought to examine the utility of duodenal biopsy and coeliac serology in the diagnosis of coeliac disease. A prospectively maintained database was interrogated to identify all patients having upper gastrointestinal endoscopy for the investigation of anaemia between January 01, 2016, and December 31, 2016. Of the 1131 patients having an endoscopy, coeliac serology was measured in only 412 (36%) and was positive in 9 cases (2%), leading to 6 histological diagnoses of coeliac disease and 3 false positives. Two-hundred and seventy-four patients with negative serology had biopsies taken which were all negative. Only 2/451 (0.4%) patients who had biopsies performed in the absence of a serology test were histologically positive for coeliac disease. The cost per diagnosis of a case of coeliac disease in those with either negative or absent coeliac serology was £18,839 (US$25,244, €21,196). Random duodenal biopsy is not a cost-effective method of diagnosing coeliac disease and should be replaced with pre-endoscopy coeliac serology.

  10. Avoid Endoscopy in Children With Suspected Inflammatory Bowel Disease Who Have Normal Calprotectin Levels

    NARCIS (Netherlands)

    Heida, Anke; Holtman, Gea A.; Lisman-van Leeuwen, Yvonne; Berger, Marjolein Y.; van Rheenen, Patrick F.

    In children with suspected inflammatory bowel disease, adding calprotectin stool testing to the screening strategy has been recommended to distinguish organic from nonorganic disease. In this cohort study with historical controls, we could not confirm that screening with stool calprotectin improves

  11. Back-to-back colon capsule endoscopy and optical colonoscopy in colorectal cancer screening individuals

    DEFF Research Database (Denmark)

    Kobaek-Larsen, Morten; Kroijer, Rasmus; Dyrvig, Anne-Kirstine

    2018-01-01

    mm polyps in colon capsule endoscopy (97%; 95% CI: 94-100) was superior to colonoscopy (89%; 95% CI: 84-94). A complete capsule endoscopy examination (N=134) could detect patients with intermediate or greater risk (according to the European guidelines) with an accuracy, sensitivity, specificity......AIM: To determine the polyp detection rate and per-patient sensitivity for polyps >9 mm of colon capsule endoscopy (CCE) compared with colonoscopy as well as the diagnostic accuracy of CCE. METHOD: Individuals who had positive immunochemical faecal occult blood test during screening had...... investigator blinded colon capsule endoscopy and colonoscopy. Participants underwent repeat endoscopy if significant lesions detected by colon capsule endoscopy were considered to have been missed by colonoscopy. RESULTS: There were 253 participants. The polyp detection rate was significantly higher in colon...

  12. Overview of technical solutions and assessment of clinical usefulness of capsule endoscopy.

    Science.gov (United States)

    Koprowski, Robert

    2015-12-01

    The paper presents an overview of endoscopic capsules with particular emphasis on technical aspects. It indicates common problems in capsule endoscopy such as: (1) limited wireless communication (2) the use of capsule endoscopy in the case of partial patency of the gastrointestinal tract, (3) limited imaging area, (4) external capsule control limitations. It also presents the prospects of capsule endoscopy, the most recent technical solutions for biopsy and the mobility of the capsule in the gastrointestinal tract. The paper shows the possibilities of increasing clinical usefulness of capsule endoscopy resulting from technological limitations. Attention has also been paid to the current role of capsule endoscopy in screening tests and the limitations of its effectiveness. The paper includes the author's recommendations concerning the direction of further research and the possibility of enhancing the scope of capsule endoscopy.

  13. Hyaluronic acid solution injection for upper and lower gastrointestinal bleeding after failed conventional endoscopic therapy.

    Science.gov (United States)

    Lee, Jin Wook; Kim, Hyung Hun

    2014-03-01

    Hyaluronic acid solution injection can be an additional endoscopic modality for controlling bleeding in difficult cases when other techniques have failed. We evaluated 12 cases in which we used hyaluronic acid solution injection for stopping bleeding. Immediately following hyaluronic acid solution injection, bleeding was controlled in 11 out of 12 cases. There was no clinical evidence of renewed bleeding in 11 cases during follow up.Hyaluronic acid solution injection can be a simple and efficient additional method for controlling upper and lower gastrointestinal bleeding after failed endoscopic therapy. © 2013 The Authors. Digestive Endoscopy © 2013 Japan Gastroenterological Endoscopy Society.

  14. Apport de l'endoscopie digestive dans l'hypertension portale de l ...

    African Journals Online (AJOL)

    ... le rôle de l'endoscopie dans le traitement et la surveillance. Méthodes: Notre étude est une analyse rétrospective de 135 endoscopies digestives hautes effectuées chez 68 enfants atteints d'hypertension portale sur une période de 8 ans. Résultats: L'endoscopie a permis de mettre en évidence les varices oesogastriques ...

  15. A literature review of quality in lower gastrointestinal endoscopy from the patient perspective

    OpenAIRE

    Sewitch, Maida J; Gong, Shasha; Dubé, Catherine; Barkun, Alan; Hilsden, Robert; Armstrong, David

    2011-01-01

    BACKGROUND: Given the limited state of health care resources, increased demand for colorectal cancer (CRC) screening raises concerns about the quality of endoscopy services. Little is known about quality in colonoscopy and endoscopy from the patient perspective.OBJECTIVE: To systematically review the literature on quality that is relevant to patients who require colonoscopy or endoscopy services.METHODS: A systematic PubMed search was performed on articles that were published between January ...

  16. Add-on cases in the endoscopy unit: Factors that affect volume.

    Science.gov (United States)

    Segal, B; Lam, E; Amar, J; Bressler, B; Halparin, L; Ramji, A; Telford, J; Whittaker, S; Enns, R

    2009-07-01

    Although most procedures in the endoscopy clinic are elective, emergency add-on cases in hospital-based endoscopy clinics are common, frequently consuming a great deal of time and resources relative to elective endoscopy procedures. To determine which specific factors correlate with the high volume of add-on emergency cases in a tertiary care, hospital-based endoscopy unit. A retrospective chart review of all gastrointestinal add-on, and electively booked cases of esophagastroduodenoscopy (EGD), colonoscopy(C) and flexible sigmoidoscopy(FS)procedures from September 2006 to May 2007, was conducted. The day of the week, month, type of procedure and physician were recorded. Emergency add-on procedures performed during the weekends were not assessed. These cases were then compared with elective cases during a similar time frame to determine differences in the aspects of add-on cases versus those that were elective. Seven hundred twenty-one add-on cases were reviewed (mean patient age 57.4 years; 46% women) and compared with 736 elective cases (mean age 56 years; 49% women; P not significant). Of the add-on cases, 377 (52%) were EGD, 216 C (30%) and 105 (15%) were FS, with 23 combined procedures (3.2%) versus 202 (27%) EGD, 442 (60%) C and 74 (10%) FS in the elective group. Add-on cases were more likely to be EGDs than elective cases (OR 2.7; 95% CI 1.8 to 4.3; Padd-on cases on Mondays (OR 1.7; 95% CI 1.0 to 2.28; P>0.03). Conversely, there were significantly fewer procedures added on Fridays (OR 0.31; 95% CI 0.16 to 0.57; P=0.0001). There were statistically fewer add-on cases in September compared with the other months that were evaluated (OR 0.31; 95% CI 0.11 to 0.78; P=0.0006). With the present system of performing only emergency cases on the weekend, Monday tends to have more add-on cases. Consistent with the fact that upper gastrointestinal bleeding is the most common emergency condition, EGD is more common in add-on cases than with elective cases. Although

  17. 'Horses for courses' in the upper gastrointestinal tract: a rational approach to diagnosis

    International Nuclear Information System (INIS)

    Mendelson, R.M.

    1989-01-01

    In Australia, the number of barium studies performed in teaching hospitals has fallen markedly while in the community at large a 113% increase occurred in the number of upper gastrointestinal endoscopic procedures performed between 1980 and 1986. Protagonists of primary endoscopy cite studies that report on the superiority of oesophagogastroduodenoscopy in patients with dyspepsia and related symptoms but several studies have shown that upper gastrointestinal barium studies miss very few important lesions. Fibreoptic endoscopy and radiology each have strengths and weaknesses which determine their respective places in the investigation of the different symptom complexes that are referable to the upper gastrointestinal tract. Double-contrast barium-meal examination is the suggested imaging modality for simple dyspepsia, for the oesophagitis-reflux-hiatus hernia complex and for dysphagia; while oesophagogastroduodenoscopy is the method of choice for the investigation of complicated dyspepsia, haematemesis and melaena. In patients who have previously undergone gastric surgery, endoscopy and radiology are complementary procedures - the former more accurate in the diagnosis of recurrent disease like ulceration, and the later useful for the delineation of anatomical changes. The time for the across-the-board replacement of barium studies by primary endoscopy has not yet arrived. 57 refs

  18. Barium enema and endoscopy for the detection of colorectal neoplasia: Sensitivity, specificity, complications and its determinants

    International Nuclear Information System (INIS)

    Zwart, Ingrid M. de; Griffioen, Gerrit; Shaw, M. Pertaap Chandie; Lamers, Cornelis B.H.W.; Roos, Albert de

    2001-01-01

    AIM: To analyse sensitivity, specificity and complication rate of endoscopy, and barium enema for the detection of colorectal neoplasia. MATERIALS AND METHODS: A MEDLINE search was performed (1980-2000) directed at the endoscopic and radiologic literature on barium enema. Articles were selected based on the type of study, availability of sensitivity and specificity values in sizeable patient groups, and reports on complications. Sixty articles were included in the analysis. RESULTS: Endoscopy proved to have superior sensitivity for polyps in patients at high-risk for colorectal neoplasia. The role of endoscopy and radiology in average-risk screening populations is not known. Sensitivity and specificity rates ranged widely, probably due to bias. For the detection of small polyps endoscopy has superior performance, whereas sensitivity is similar for endoscopy and barium enema for the detection of larger (>1 cm) polyps and tumours. Overall, endoscopy is associated with a higher complication rate. CONCLUSION: Endoscopy is the preferred detection method in high-risk patients. The role of endoscopy and radiology in a screening setting requires evaluation. This review provides the test characteristics of endoscopy and radiology which are relevant for a cost-effectiveness analysis. Double-contrast barium enema may play an important role for screening purposes, owing to its good sensitivity for detecting larger (>1 cm) polyps and its lack of major complications. Zwart, I.M. de et al. (2001)

  19. The effect of music on pain and vital signs of children before and after endoscopy.

    Science.gov (United States)

    Sabzevari, Alireza; Kianifar, Hamidreza; Jafari, Seyed Ali; Saeidi, Masumeh; Ahanchian, Hamid; Kiani, Mohammad Ali; Jarahi, Lida

    2017-07-01

    Gentle music has relaxing and pain reducing effects. In this study, the effect of music on patients' vital signs and pain was investigated before and after endoscopy. This clinical trial study was conducted on 100 children from seven to fourteen years of age in Gha'em Hospital, Mashhad in 2015. Children were divided into two equal groups (case group=50 and control group=50). The control group received endoscopy according to the standards, without any other procedure. For the case group, a classic musical piece by Clayderman was played during endoscopy (from the time of entering the endoscopy room to the end of the process). After conducting endoscopy, FALCC scale and Baker-Wong pain scale were filled for both groups. In addition, children's vital signs including: heart rate (pulse), diastolic and systolic blood pressure were measured before and after endoscopy for both groups. Data analysis was conducted using SPSS16 with the help of Mann-Whitney and Chi-square tests. No significant difference was found in age, gender distribution of case or control groups (p>0.05). Heart rate and diastolic blood pressure was significantly lower in the music (case) group compared to the control group before endoscopy (p=0.012). In addition, pain score in patients of the music group was lower than the control group (pmusic for children during endoscopy can reduce pain and anxiety in patients before and after endoscopy.

  20. CT virtual endoscopy of the auditory ossicular chain and its preliminary clinical application

    International Nuclear Information System (INIS)

    Wang Dong; Zhang Wanshi; Xiong Minghui; Xu Jiaxing; Yu Min; Xu Changyu

    2000-01-01

    Objective: To evaluate the ability of CT virtual endoscopy (CTVE) in visualization of auditory ossicular chain and its clinical application. Methods: CTVE of auditory ossicular chain was performed on GE HiSpeed CT/i with 1.0 mm slice thickness at pitch 1.0, bone algorithm, 9.6 cm FOV, and 0.1 mm reconstruction interval in 10 normal subjects and 21 patients with middle ear diseases, 14 of them were proved by operation. The threshold values for normal and abnormal auditory ossicular chain were -600--200 HU and 50-300 HU respectively. Results: CTVE could clearly demonstrate the shape, size, and relation of the normal auditory ossicular chain. A visualization rate of malleus, incus, and incudomalleal articulation was 100%, and was 32% for the stapedial foot plate. However, in only 21% could the anterior and posterior crura of stapes be distinguished. Cholesteatoma was found in 12 cases with chronic otitis media, in which CTVE demonstrated varying degrees of destruction of the auditory ossicle. In 1 case with congenital anomaly, ossicle dysplasia was seen. Conclusion: CTVE being a new, non-invasive method for demonstrating the three-dimensional image of auditory ossicular chain is useful in evaluating diseases of the ear, especially the auditory ossicles

  1. Screening examinations for double cancer in patients with oral cancer. Usefulness of gastrointestinal endoscopy and positron emission tomography

    International Nuclear Information System (INIS)

    Takahashi, Hidenori; Umeda, Masahiro; Oguni, Akiko; Kataoka, Tomoko; Minamikawa, Tsutomu; Shibuya, Yasuyuki; Komori, Takahide; Shigeta, Takashi; Ri, Shinsho

    2010-01-01

    Many patients with oral cancer have double cancers, especially in the upper gastrointestinal tract. We studied synchronous double cancers in 138 patients with oral cancer who underwent gastrointestinal endscopy and 161 who underwent positron emission tomography (PET) preoperatively. Fifteen patients (10.9%) had cancer or precancerous lesions in the upper gastrointestinal tract on gastrointestinal endoscopy: 10 in the esophagus and 5 in the stomach. The histopathological diagnosis was severe epithelial dysplasia in 6 patients, carcinoma in situ in 4, and carcinoma in 5. These 15 lesions were asymptomatic and detected by gastrointestinal endscopy for the first time. Patients with severe epithelial dysplasia were observed, and those with carcinoma or carcinoma in situ underwent radical therapy. All of these gastrointestinal lesions were treated successfully, without any recurrence or metastasis. Double cancers were detected by PET in 3 patients (1.9%): lung and esophageal cancer, gastric cancer, and ovarian cancer in one patient each. These 3 cases also were detected by PET for the first time and were free of clinical symptoms. Radical therapy was performed in 2 patients. The other patient had advanced disease and received only palliative therapy. Although PET could not detect most cancers or precancerous lesions in the upper gastrointestinal tract that could be detected by gastrointestinal endscopy, it was useful for detecting malignant lesions in sites other than the upper gastrointestinal tract. Our results suggest that preoperative gastrointestinal endscopy and PET examinations can detect double cancer in the early stage and contribute to better outcomes in patients with oral cancer. (author)

  2. Laparoscopic diverticulectomy with the aid of intraoperative gastrointestinal endoscopy to treat epiphrenic diverticulum

    Directory of Open Access Journals (Sweden)

    Lei Yu

    2016-01-01

    Full Text Available Objective: Most researchers believe that the presence of large epiphrenic diverticulum (ED with severe symptoms should lead to the consideration of surgical options. The choice of minimally invasive techniques and whether Heller myotomy with antireflux fundoplication should be employed after diverticulectomy became points of debate. The aim of this study was to describe how to perform laparoscopic transhiatal diverticulectomy (LTD and oesophagomyotomy with the aid of intraoperative gastrointestinal (GI endoscopy and how to investigate whether the oesophagomyotomy should be performed routinely after LTD. Patients and Methods: From 2008 to 2013, 11 patients with ED underwent LTD with the aid of intraoperative GI endoscopy at our department. Before surgery, 4 patients successfully underwent oesophageal manometry: Oesophageal dysfunction and an increase of the lower oesophageal sphincter pressure (LESP were found in 2 patients. Results: There were 2 cases of conversion to an open transthoracic procedure. Six patients underwent LTD, Heller myotomy and Dor fundoplication; and 3 patients underwent only LTD. The dysphagia and regurgitation 11 patients experienced before surgery improved significantly. Motor function studies showed that there was no oesophageal peristalsis in 5 patients during follow-up, while 6 patients showed seemingly normal oesophageal motility. The LESP of 6 patients undergoing LTD, myotomy and Dor fundoplication was 16.7 ± 10.2 mmHg, while the LESPs of 3 patients undergoing only LTD were 26 mmHg, 18 mmHg and 21 mmHg, respectively. In 4 cases experiencing LTD, myotomy and Dor fundoplication, the gastro-oesophageal reflux occurred during the sleep stage. Conclusions: LTD constitutes a safe and valid approach for ED patients with severe symptoms. As not all patients with large ED have oesophageal disorders, according to manometric and endoscopic results, surgeons can categorise and decide whether or not myotomy and antireflux surgery

  3. Magnified endoscopy combined with narrow band imaging of minimal superficial esophageal neoplasia-indicators to differentiate intraepithelial neoplasias.

    Science.gov (United States)

    Mochizuki, Yosuke; Saito, Yasuharu; Kobori, Ayako; Ban, Hiromitsu; Shioya, Makoto; Nishimura, Takashi; Inatomi, Osamu; Bamba, Shigeki; Tsujikawa, Tomoyuki; Ishida, Mitsuaki; Andoh, Akira; Fujiyama, Yoshihide

    2012-12-01

    Clinical application of narrow band imaging facilitates diagnosis of esophageal neoplasia. However, no previous investigation has been conducted on magnifying endoscopy combined with narrow band imaging in detection of minimal superficial esophageal neoplasia, which is defined as neoplasia neoplasia. Between January 2005 and November 2011, 53 minimal superficial esophageal neoplasias in 40 patients were diagnosed by screening upper gastrointestinal endoscopy with narrow band imaging at our hospital. We investigated findings including brownish dots, brownish epithelium, and demarcation line of minimal superficial esophageal neoplasia diagnosed histopathologically as low-grade intraepithelial neoplasia, high-grade intraepithelial neoplasia, and squamous cell carcinoma. Significantly more brownish dots (P neoplasia compared with low-grade neoplasia. When minimal superficial esophageal neoplasia was diagnosed as high-grade intraepithelial neoplasia or squamous cell carcinoma, sensitivity, specificity, positive predictive value, and negative predictive value were 88.9, 42.9, 44.4, and 88.2%, respectively, for brownish dots; 94.4, 51.4, 50.0, and 94.7%, respectively, for brownish epithelium; and 66.7, 62.9, 48.0, and 78.6%, respectively, for demarcation line. The combined technique was useful in the differential diagnosis of minimal superficial esophageal neoplasia.

  4. New techniques for evaluating the gastrointestinal tract: capsular endoscopy

    Directory of Open Access Journals (Sweden)

    A E Karateyev

    2009-01-01

    Full Text Available The paper describes a procedure for capsular endoscopy (CE, a new high-technology method of evaluating the small bowel, and reports on its use in rheumatological care. Small bowel involvement is noted to be frequently encountered in rheumatic diseases, such as Behcet's disease, diffuse scleroderma, and seronegative spondylitis. According to the data of clinical trials, CE is effective in timely detecting this visceral abnormality. At the same time, CE is actually the only accurate method of diagnosing drug-induced enteropathy, a potentially menacing disease that frequently occurs with the use of nonsteroidal anti-inflammatory drugs.

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

    DEFF Research Database (Denmark)

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

    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....... Use of WCE as a diagnostic tool was invaluable in establishing the diagnosis of AE....

  6. Colon capsule endoscopy: Current status and future directions

    Science.gov (United States)

    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

  7. Small-bowel neoplasms in patients undergoing video capsule endoscopy

    DEFF Research Database (Denmark)

    Rondonotti, E; Pennazio, M; Toth, E

    2008-01-01

    BACKGROUND AND STUDY AIM: Small-bowel tumors account for 1% - 3% of all gastrointestinal neoplasms. Recent studies with video capsule endoscopy (VCE) suggest that the frequency of these tumors may be substantially higher than previously reported. The aim of the study was to evaluate the frequency...... of the neoplasm seen in 29 centers of 10 European Countries. RESULTS: Of 5129 patients undergoing VCE, 124 (2.4%) had small-bowel tumors (112 primary, 12 metastatic). Among these patients, indications for VCE were: obscure gastrointestinal bleeding (108 patients), abdominal pain (9), search for primary neoplasm...

  8. Simulation-based patient flow analysis in an endoscopy unit

    DEFF Research Database (Denmark)

    Koo, Pyung-Hoi; Nielsen, Karl Brian; Jang, Jaejin

    2010-01-01

    One of the major elements in improving efficiency of healthcare services is patient flow. Patients require a variety of healthcare resources as they receive healthcare services. Poor management of patient flow results in long waiting time of patients, under/over utilization of medical resources......, low quality of care and high healthcare cost. This article addresses patient flow problems at a Gastrointestinal endoscopy unit. We attempt to analyze the main factors that contribute to the inefficient patient flow and process bottlenecks and to propose efficient patient scheduling and staff...... allocation alternatives to increase the system efficiency. Simulation models are used to examine various healthcare operational strategies....

  9. Oral endoscopy in prosthodontic management of the soft palate defect.

    Science.gov (United States)

    Beery, Q C; Aramany, M A; Katzenberg, B

    1985-08-01

    Telescopic oral endoscopy is an effective aid in the construction and modification of a speech aid prosthesis. The method is noninvasive and easy to perform, permits the prosthodontist to achieve the goal of functional effectiveness in prosthesis construction while keeping the weight and size of the pharyngeal extension at a minimum, decreases the number and length of patient visits required for modification, and when coupled to a fiberoptic teaching arm or a video camera and recording system, it becomes an excellent aid in teaching, patient education and orientation, and record keeping.

  10. Relationship between chronic diarrhea with normal colonoscopy findings and terminal ileum lesions.

    Science.gov (United States)

    Li, Hongling; Wang, Changcheng; Liu, Shuqing; Xu, Dongsheng; Zhang, Ju; Chen, Hongmei

    2014-01-01

    The causes and mechanisms of chronic diarrhea are complex. This study aimed to explore the relationship between chronic diarrhea with normal colonoscopy findings and terminal ileum lesions. All cases were collected from January 2009 to June 2010. The 40 patients in the patient group had chronic diarrhea with normal colonoscopy findings. Those who had hyperthyroidism, diabetes, chronic pancreatitis, cirrhosis, atrophic gastritis, short bowel syndrome and connective tissue diseases had been excluded. The control group contained 40 healthy individuals without diarrhea. Endoscopy of the terminal ileum was applied in both groups, with the endoscope inserted into terminal ileum for more than 20 cm. The patients diagnosed of chronic diarrhea with terminal ileum lesions were treated with metronidazole and probiotics for 10-14 days. Before treatment there were significant differences in endoscopy findings of the terminal ileum between the two groups (P diarrhea, and terminal ileum lesions disappeared in 30 cases as determined by endoscopy. In the control group, endoscopy showed scattered hyperplasia of lymphoid follicles in 5 cases, and the follicles were small with the maximal diameter being 3 mm. There was no hyperemia, edema, erosion or ulcers. Chronic diarrhea patients with normal colonoscopy findings may have lesions in the terminal ileum that can be detected by endoscopy; including hyperemia, erosion, ulcers and lymphoid follicle hyperplasia. Therapeutic effect is good with metronidazole and probiotics.

  11. Low hemoglobin levels are associated with upper gastrointestinal bleeding.

    Science.gov (United States)

    Tomizawa, Minoru; Shinozaki, Fuminobu; Hasegawa, Rumiko; Shirai, Yoshinori; Motoyoshi, Yasufumi; Sugiyama, Takao; Yamamoto, Shigenori; Ishige, Naoki

    2016-09-01

    Upper gastrointestinal (GI) bleeding can be fatal. Blood test variables were reviewed in search of threshold values to detect the presence of occult upper GI bleeding. The records of 1,023 patients who underwent endoscopy at the National Hospital Organization Shimoshizu Hospital from October 2014, to September 2015, were retrospectively reviewed. Of those, 95 had upper GI bleeding. One-way analysis of variance was applied to blood test variables comparing patients with and without upper GI bleeding. Logistic regression analysis was applied to detect the association of blood test parameters with upper GI bleeding, and receiver-operator characteristics were applied to establish threshold values. White blood cell count (WBC), platelet (Plt) count, and blood urea nitrogen (BUN) levels were higher, and hemoglobin (Hb) and albumin (Alb) levels were lower in patients with upper GI bleeding. Logistic regression analysis showed that low Hb was significantly associated with upper GI bleeding and a Hb value of 10.8 g/dl was established as the threshold for the diagnosis. In patients with upper GI bleeding, WBC, Plt count, and BUN levels were higher and Hb and Alb levels were reduced. Hb at 10.8 g/dl was established as a threshold value to detect upper GI bleeding.

  12. The value of Integrated Pulmonary Index (IPI) monitoring during endoscopies in children.

    Science.gov (United States)

    Garah, Jamal; Adiv, Orly Eshach; Rosen, Irit; Shaoul, Ron

    2015-12-01

    The Integrated Pulmonary Index (IPI) is an algorithm included in commercially available monitors that constitutes a representation of 4 parameters: EtCO2, RR, SpO2 and PR. The IPI index has been validated for adults and children older than 1 year of age. In this study we aimed to study the value of IPI monitoring during pediatric endoscopic procedures. Our data consisted of 124 measurements of 109 patients undergoing different procedures (upper endoscopy 84 patients, colonoscopy 6 patients, both 9 patients). The data was divided into 3 groups based on the drug type used: propofol only, 5 patients (group 1); propofol & midazolam, 89 patients (group 2); propofol, midazolam and Fentanyl, 15 patients (group 3). Patients in group 2 and 3 had significantly higher IPI levels than group 1. Significantly lower IPI values were found between ages 4-6 compared to 7-12 years old. High midazolam dose was associated with lower IPI levels during the procedure. No significant differences were found for propofol doses. Patients who had an anesthetist present had lower IPI levels during the procedure compared to those who did not. No differences were noted between the different procedures. IPI alerted all apnea episodes (58 events, IPI = 1) and hypoxia (26 events, IPI ≤ 3) episodes, whereas pulse oximetry captured only the hypoxia episodes (IPI sensitivity = 1, specificity 0.98, positive predictive value 0.95). Younger patient age, use of propofol alone, higher midazolam doses and presence of anesthetist are all associated with lower IPI levels.

  13. Wireless capsule endoscopy and proximal small bowel lesions in Crohn’s disease

    Science.gov (United States)

    Petruzziello, Carmelina; Onali, Sara; Calabrese, Emma; Zorzi, Francesca; Ascolani, Marta; Condino, Giovanna; Lolli, Elisabetta; Naccarato, Paola; Pallone, Francesco; Biancone, Livia

    2010-01-01

    AIM: To investigate the prevalence of proximal small bowel (SB) lesions detected by wireless capsule endoscopy (WCE) in Crohn’s disease (CD). METHODS: WCE was performed in 64 patients: 32 with CD of the distal ileum, and 32 controls with iron-deficiency anemia (IDA) or diarrhea. WCE was performed using the Given SB-WCE, followed by small intestine contrast ultrasonography (SICUS). Findings compatible with CD by using WCE included erosions, aphthoid or deep ulcers, and strictures/stenosis. RESULTS: WCE detected proximal SB lesions in 16/32 (50%) patients (14 aphthoid ulcers, 2 deep ulcers, one stricture), which appeared not to be related to clinical parameters [epigastric pain, age, smoking, non-steroidal anti-inflammatory drugs (NSAIDs), IDA]. Among patients with proximal SB lesions, 6 (37%) were smokers, 3 (19%) NSAID users, 3 (19%) had epigastric pain and 4 (25%) had IDA. SICUS detected proximal SB lesions in 3/32 patients (19%) also showing lesions with WCE. No correlations were observed between proximal SB lesions assessed by WCE or by SICUS (χ2 = 1.5, P = 0.2). CONCLUSION: The use of WCE allows the detection of previously unknown upper SB lesions in a high proportion of patients with a previous diagnosis of CD involving the distal ileum. PMID:20614486

  14. Semantic and topological classification of images in magnetically guided capsule endoscopy

    Science.gov (United States)

    Mewes, P. W.; Rennert, P.; Juloski, A. L.; Lalande, A.; Angelopoulou, E.; Kuth, R.; Hornegger, J.

    2012-03-01

    Magnetically-guided capsule endoscopy (MGCE) is a nascent technology with the goal to allow the steering of a capsule endoscope inside a water filled stomach through an external magnetic field. We developed a classification cascade for MGCE images with groups images in semantic and topological categories. Results can be used in a post-procedure review or as a starting point for algorithms classifying pathologies. The first semantic classification step discards over-/under-exposed images as well as images with a large amount of debris. The second topological classification step groups images with respect to their position in the upper gastrointestinal tract (mouth, esophagus, stomach, duodenum). In the third stage two parallel classifications steps distinguish topologically different regions inside the stomach (cardia, fundus, pylorus, antrum, peristaltic view). For image classification, global image features and local texture features were applied and their performance was evaluated. We show that the third classification step can be improved by a bubble and debris segmentation because it limits feature extraction to discriminative areas only. We also investigated the impact of segmenting intestinal folds on the identification of different semantic camera positions. The results of classifications with a support-vector-machine show the significance of color histogram features for the classification of corrupted images (97%). Features extracted from intestinal fold segmentation lead only to a minor improvement (3%) in discriminating different camera positions.

  15. The predictive value of drug-induced sleep endoscopy for CPAP titration in OSA patients.

    Science.gov (United States)

    Lan, Ming-Chin; Hsu, Yen-Bin; Lan, Ming-Ying; Huang, Yun-Chen; Kao, Ming-Chang; Huang, Tung-Tsun; Chiu, Tsan-Jen; Yang, Mei-Chen

    2017-12-15

    The aim of this study was to identify possible upper airway obstructions causing a higher continuous positive airway pressure (CPAP) titration level, utilizing drug-induced sleep endoscopy (DISE). A total of 76 patients with obstructive sleep apnea (OSA) underwent CPAP titration and DISE. DISE findings were recorded using the VOTE classification system. Polysomnographic (PSG) data, anthropometric variables, and patterns of airway collapse during DISE were analyzed with CPAP titration levels. A significant association was found between the CPAP titration level and BMI, oxygen desaturation index (ODI), apnea-hypopnea index (AHI), and neck circumference (NC) (P titration level (P titration level and any other collapse at the tongue base or epiglottis. By analyzing PSG data, anthropometric variables, and DISE results with CPAP titration levels, we can better understand possible mechanisms resulting in a higher CPAP titration level. We believe that the role of DISE can be expanded as a tool to identify the possible anatomical structures that may be corrected by oral appliance therapy or surgical intervention to improve CPAP compliance.

  16. Autofluorescence endoscopy with "real-time" digital image processing in differential diagnostics of selected benign and malignant lesions in the oesophagus.

    Science.gov (United States)

    Sieroń-Stołtny, Karolina; Kwiatek, Sebastian; Latos, Wojciech; Kawczyk-Krupka, Aleksandra; Cieślar, Grzegorz; Stanek, Agata; Ziaja, Damian; Bugaj, Andrzej M; Sieroń, Aleksander

    2012-03-01

    Oesophageal papilloma and Barrett's oesophagus are benign lesions known as risk factors of carcinoma in the oesophagus. Therefore, it is important to diagnose these early changes before neoplastic transformation. Autofluorescence endoscopy is a fast and non-invasive method of imaging of tissues based on the natural fluorescence of endogenous fluorophores. The aim of this study was to prove the diagnostic utility of autofluorescence endoscopy with digital image processing in histological diagnosis of endoscopic findings in the upper digestive tract, primarily in the imaging of oesophageal papilloma. During the retrospective analysis of about 200 endoscopic procedures in the upper digestive tract, 67 cases of benign, precancerous or cancerous changes were found. White light endoscopy (WLE) image, single-channel (red or green) autofluorescence images, as well as green and red fluorescence intensities in two modal fluorescence image and red-to-green (R/G) ratio (Numerical Colour Value, NCV) were correlated with histopathologic results. The NCV analysis in autofluorescence imaging (AFI) showed increased R/G ratio in cancerous changes in 96% vs. 85% in WLE. Simultaneous analysis with digital image processing allowed us to diagnose suspicious tissue as cancerous in all of cases. Barrett's metaplasia was confirmed in 90% vs. 79% (AFI vs. WLE), and 98% in imaging with digital image processing. In benign lesions, WLE allowed us to exclude tissue as malignant in 85%. Using autofluorescence endoscopy R/G ratio was increased in only 10% of benign changes causing the picture to be interpreted as suspicious, but when both methods were used together, 97.5% were cases excluded as malignancies. Mean R/G ratios were estimated to be 2.5 in cancers, 1.25 in Barrett's metaplasia and 0.75 in benign changes and were statistically significant (p=0.04). Autofluorescence imaging is a sensitive method to diagnose precancerous and cancerous early stages of the diseases located in oesophagus

  17. Relationship between timing of endoscopy and mortality in patients with peptic ulcer bleeding

    DEFF Research Database (Denmark)

    Laursen, Stig B; Leontiadis, Grigorios I; Stanley, Adrian J

    2017-01-01

    BACKGROUND AND AIMS: The optimal timing of endoscopy in patients with peptic ulcer bleeding (PUB) remains unclear. The aim of this study was to examine the association between timing of endoscopy and mortality in PUB. METHODS: A nationwide cohort study based on a database of consecutive patients...

  18. Wireless Capsule Endoscopy for Obscure Gastrointestinal Bleeding: Single Center, One Year Experience

    Directory of Open Access Journals (Sweden)

    Shou-jiang Tang

    2004-01-01

    Full Text Available BACKGROUND: Wireless capsule endoscopy (CE is increasingly being used in the investigation of obscure gastrointestinal (GI bleeding, but some studies have found that many of the bleeding lesions recognized by this technique are within the reach of conventional endoscopy.

  19. A Patient Flow Analysis: Identification of Process Inefficiencies and Workflow Metrics at an Ambulatory Endoscopy Unit

    Directory of Open Access Journals (Sweden)

    Rowena Almeida

    2016-01-01

    Full Text Available Background. The increasing demand for endoscopic procedures coincides with the paradigm shift in health care delivery that emphasizes efficient use of existing resources. However, there is limited literature on the range of endoscopy unit efficiencies. Methods. A time and motion analysis of patient flow through the Hotel-Dieu Hospital (Kingston, Ontario endoscopy unit was followed by qualitative interviews. Procedures were directly observed in three segments: individual endoscopy room use, preprocedure/recovery room, and overall endoscopy unit utilization. Results. Data were collected for 137 procedures in the endoscopy room, 139 procedures in the preprocedure room, and 143 procedures for overall room utilization. The mean duration spent in the endoscopy room was 31.47 min for an esophagogastroduodenoscopy, 52.93 min for a colonoscopy, 30.47 min for a flexible sigmoidoscopy, and 66.88 min for a double procedure. The procedure itself accounted for 8.11 min, 34.24 min, 9.02 min, and 39.13 min for the above procedures, respectively. The focused interviews identified the scheduling template as a major area of operational inefficiency. Conclusions. Despite reasonable procedure times for all except colonoscopies, the endoscopy room durations exceed the allocated times, reflecting the impact of non-procedure-related factors and the need for a revised scheduling template. Endoscopy units have unique operational characteristics and identification of process inefficiencies can lead to targeted quality improvement initiatives.

  20. A Patient Flow Analysis: Identification of Process Inefficiencies and Workflow Metrics at an Ambulatory Endoscopy Unit.

    Science.gov (United States)

    Almeida, Rowena; Paterson, William G; Craig, Nancy; Hookey, Lawrence

    2016-01-01

    Background. The increasing demand for endoscopic procedures coincides with the paradigm shift in health care delivery that emphasizes efficient use of existing resources. However, there is limited literature on the range of endoscopy unit efficiencies. Methods. A time and motion analysis of patient flow through the Hotel-Dieu Hospital (Kingston, Ontario) endoscopy unit was followed by qualitative interviews. Procedures were directly observed in three segments: individual endoscopy room use, preprocedure/recovery room, and overall endoscopy unit utilization. Results. Data were collected for 137 procedures in the endoscopy room, 139 procedures in the preprocedure room, and 143 procedures for overall room utilization. The mean duration spent in the endoscopy room was 31.47 min for an esophagogastroduodenoscopy, 52.93 min for a colonoscopy, 30.47 min for a flexible sigmoidoscopy, and 66.88 min for a double procedure. The procedure itself accounted for 8.11 min, 34.24 min, 9.02 min, and 39.13 min for the above procedures, respectively. The focused interviews identified the scheduling template as a major area of operational inefficiency. Conclusions. Despite reasonable procedure times for all except colonoscopies, the endoscopy room durations exceed the allocated times, reflecting the impact of non-procedure-related factors and the need for a revised scheduling template. Endoscopy units have unique operational characteristics and identification of process inefficiencies can lead to targeted quality improvement initiatives.

  1. Summary of Guidelines for Infection Prevention and Control for Flexible Gastrointestinal Endoscopy

    Directory of Open Access Journals (Sweden)

    Lawrence Hookey

    2013-01-01

    Full Text Available BACKGROUND: High-quality processes to ensure infection prevention and control in the delivery of safe endoscopy services are essential. In 2010, the Public Health Agency of Canada and the Canadian Association of Gastroenterology (CAG developed a Canadian guideline for the reprocessing of flexible gastrointestinal endoscopy equipment.

  2. The European Society of Gastrointestinal Endoscopy Quality Improvement Initiative: developing performance measures

    NARCIS (Netherlands)

    Rutter, Matthew D.; Senore, Carlo; Bisschops, Raf; Domagk, Dirk; Valori, Roland; Kaminski, Michal F.; Spada, Cristiano; Bretthauer, Michael; Bennett, Cathy; Bellisario, Cristina; Minozzi, Silvia; Hassan, Cesare; Rees, Colin; Dinis-Ribeiro, Mário; Hucl, Tomas; Ponchon, Thierry; Aabakken, Lars; Fockens, Paul

    2016-01-01

    The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology (UEG) have a vision to create a thriving community of endoscopy services across Europe, collaborating with each other to provide high quality, safe, accurate, patient-centered and accessible endoscopic

  3. Advanced endoscopic imaging: European Society of Gastrointestinal Endoscopy (ESGE) Technology Review

    NARCIS (Netherlands)

    East, James E.; Vleugels, Jasper L.; Roelandt, Philip; Bhandari, Pradeep; Bisschops, Raf; Dekker, Evelien; Hassan, Cesare; Horgan, Gareth; Kiesslich, Ralf; Longcroft-Wheaton, Gaius; Wilson, Ana; Dumonceau, Jean-Marc

    2016-01-01

    Background and aim: This technical review is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the utilization of advanced endoscopic imaging in gastrointestinal (GI) endoscopy. Methods: This technical review is based on a systematic literature search

  4. Diagnosis of Ascaris lumbricoides infection using capsule endoscopy.

    Science.gov (United States)

    Yamashita, Eduardo Tomohissa; Takahashi, Wagner; Kuwashima, Daniel Yuiti; Langoni, Tiago Ribeiro; Costa-Genzini, Adriana

    2013-04-16

    Ascaris lumbricoides (A. lumbricoides) is the most common intestinal roundworm parasite, infecting approximately one quarter of the world's population. Infection can lead to various complications because it can spread along the gastrointestinal tract. Although A. lumbricoides infection is a serious healthcare issue in developing countries, it now also has a worldwide distribution as a result of increased immigration and travel. Intestinal obstruction is the most common complication of A. lumbricoides infection, potentially leading to even more serious consequences such as small bowel perforation and peritonitis. Diagnosis is based primarily on stool samples and the patient's history. Early diagnosis, aided in part by knowledge of the local prevalence, can result in early treatment, thereby preventing surgical complications associated with intestinal obstruction. Further, delay in diagnosis may have fatal consequences. Capsule endoscopy can serve as a crucial, non-invasive diagnostic tool for A. lumbricoides infection, especially when other diagnostic methods have failed to detect the parasite. We report a case of A. lumbricoides infection that resulted in intestinal obstruction at the level of the ileum. Both stool sample examination and open surgery failed to indicate the presence of A. lumbricoides, and the cause of the obstruction was only revealed by capsule endoscopy. The patient was treated with anthelmintics.

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

    Science.gov (United States)

    Bechara, Robert; Inoue, Haruhiro

    2015-01-01

    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

  6. Generic feature learning for wireless capsule endoscopy analysis.

    Science.gov (United States)

    Seguí, Santi; Drozdzal, Michal; Pascual, Guillem; Radeva, Petia; Malagelada, Carolina; Azpiroz, Fernando; Vitrià, Jordi

    2016-12-01

    The interpretation and analysis of wireless capsule endoscopy (WCE) recordings is a complex task which requires sophisticated computer aided decision (CAD) systems to help physicians with video screening and, finally, with the diagnosis. Most CAD systems used in capsule endoscopy share a common system design, but use very different image and video representations. As a result, each time a new clinical application of WCE appears, a new CAD system has to be designed from the scratch. This makes the design of new CAD systems very time consuming. Therefore, in this paper we introduce a system for small intestine motility characterization, based on Deep Convolutional Neural Networks, which circumvents the laborious step of designing specific features for individual motility events. Experimental results show the superiority of the learned features over alternative classifiers constructed using state-of-the-art handcrafted features. In particular, it reaches a mean classification accuracy of 96% for six intestinal motility events, outperforming the other classifiers by a large margin (a 14% relative performance increase). Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    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. PMID:26060592

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

    Directory of Open Access Journals (Sweden)

    Jorge Pablo Batista

    2015-01-01

    Full Text Available 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.

  9. Technology Insight: current status of video capsule endoscopy.

    Science.gov (United States)

    Cave, David R

    2006-03-01

    Video capsule endoscopy (VCE) is the most recent major practical and conceptual development in the field of endoscopy. The video capsule endoscope-a small, pill-sized, passive imaging device-has been demonstrated to be the pre-eminent imaging device for disorders of the small intestine. The initial use for VCE was to detect the origin of obscure gastrointestinal bleeding. Several other indications have now been justified, or are in the process of evaluation. More than 200,000 of these disposable devices have been used worldwide, with an extraordinarily good safety record: indeed, the device has been approved for use in children as young as 10 years of age. In addition, a double-ended capsule has now been approved for the evaluation of mucosal disease in the esophagus. The now-widespread deployment of the device into gastrointestinal practice in the US and many other countries suggests that VCE has achieved mainstream utility. The development of similar competitor devices, and devices whose movement can be controlled, is in progress.

  10. A Simple Evaluation Tool (ET-CET) Indicates Increase of Diagnostic Skills From Small Bowel Capsule Endoscopy Training Courses

    Science.gov (United States)

    Albert, J.G.; Humbla, O.; McAlindon, M.E.; Davison, C.; Seitz, U.; Fraser, C.; Hagenmüller, F.; Noetzel, E.; Spada, C.; Riccioni, M.E.; Barnert, J.; Filmann, N.; Keuchel, M.

    2015-01-01

    Abstract Small bowel capsule endoscopy (SBCE) has become a first line diagnostic tool. Several training courses with a similar format have been established in Europe; however, data on learning curve and training in SBCE remain sparse. Between 2008 and 2011, different basic SBCE training courses were organized internationally in UK (n = 2), Italy (n = 2), Germany (n = 2), Finland (n = 1), and nationally in Germany (n = 10), applying similar 8-hour curricula with 50% lectures and 50% hands-on training. The Given PillCam System was used in 12 courses, the Olympus EndoCapsule system in 5, respectively. A simple evaluation tool for capsule endoscopy training (ET-CET) was developed using 10 short SBCE videos including relevant lesions and normal or irrelevant findings. For each video, delegates were required to record a diagnosis (achievable total score from 0 to 10) and the clinical relevance (achievable total score 0 to 10). ET-CET was performed at baseline before the course and repeated, with videos in altered order, after the course. Two hundred ninety-four delegates (79.3% physicians, 16.3% nurses, 4.4% others) were included for baseline analysis, 268 completed the final evaluation. Forty percent had no previous experience in SBCE, 33% had performed 10 or less procedures. Median scores for correct diagnosis improved from 4.0 (IQR 3) to 7.0 (IQR 3) during the courses (P endoscopy may be useful before attending an SBCE course. PMID:26512623

  11. Diagnostic capabilities of high-definition white light endoscopy for the diagnosis of gastric intestinal metaplasia and correlation with histologic and clinical data.

    Science.gov (United States)

    Panteris, Vasileios; Nikolopoulou, Stamatina; Lountou, Anastasia; Triantafillidis, John K

    2014-06-01

    The aim of this study was the evaluation of the diagnostic accuracy of a specific high-definition white light endoscopy (HD-WLE) system for the optical recognition of intestinal metaplasia (IM) and the assessment of its correlation with histologic and clinical data. A total of 234 patients undergoing upper gastrointestinal endoscopy in an outpatient endoscopy suite for various indications were prospectively enrolled in this cross-sectional study. Gastric IM was diagnosed on the basis of three mucosal patterns identified using HD-WLE in a per-patient analysis. Histological evaluation was used as the gold standard, and special staining was conducted for subtyping of IM. Main outcome measurements were sensitivity, specificity, and likelihood ratio of HD-WLE and secondary associations with histologic and clinical data. IM was found in 63/234 (27%) patients and low-grade dysplasia in 6/63 patients (9.5%). Sensitivity, specificity, accuracy, and likelihood ratio of all mucosal patterns were 74.6, 94, 88% and 13, respectively. All clinically significant type III IM and dysplasia lesions were endoscopically detected. All nonvisible lesions were of types I and II with mild grade and no dysplasia. Ten patients were considered false positives and the lesions were associated with severe inflammation and antralization. The specific HD-WLE system showed satisfactory accuracy and high specificity during real-time, routine endoscopy practice. Specific mucosal patterns were correlated with level and grade of lesions. The sensitivity of the system is even higher when only clinically significant IM lesions are considered.

  12. Empiric treatment based on Helicobacter pylori serology cannot substitute for early endoscopy in the management of dyspeptic rural black Africans.

    Science.gov (United States)

    O'Keefe, S J; Salvador, B; Nainkin, J; Majiki, S; Stevens, H; Atherstone, A

    2000-11-01

    Evidence that chronic gastric Helicobacter pylori (HP) infection is an aetiological factor in dyspepsia, peptic ulcer disease, gastric carcinoma and lymphoma has led to the suggestion that all serologically positive dyspeptic patients should be treated empirically with antibiotics to eradicate the infection, without endoscopic diagnosis. The following study was performed to determine whether such a policy would prove to be of benefit in rural Africa, where endoscopic facilities are lacking and infection rates high. Four district clinics were visited and 97 consecutive patients with persistent upper gastro-intestinal symptoms studied. After history-taking and physical examination, a blood sample was taken for HP serology (IgG anti-HP EIA) and endoscopy was performed. In comparison with similar studies in westernised countries HP was considerably more common (80%), and similar to that reported for the background population (83-86%), but peptic ulceration (17%) and gastric cancer (1%) were not. HP status and antibody levels failed to predict the presence of serious disease; patients with 'alarm' signs (78%), cancer (78%) and peptic ulcers (81%) had similar seropositivity rates to patients with non-ulcer dyspepsia (81%). Interestingly, many patients with distal oesophagitis were seronegative (40%). Haemoglobin concentrations and nutritional status were similar in HP-positive and negative patients. On the basis of published decision analysis strategies, empiric treatment of HP-positive patients with uncomplicated dyspepsia could be expected to produce symptomatic relief in 50% of cases, but would have delayed the diagnosis of 3 cases of cancer if patients over the age of 45 were included. The lack of association between HP serology and upper gastro-intestinal disease indicates that serological investigation cannot substitute for endoscopy in the management of black Africans with dyspepsia, and that empiric anti-HP therapy cannot be justified.

  13. Canadian Association of Gastroenterology consensus guidelines on safety and quality indicators in endoscopy.

    Science.gov (United States)

    Armstrong, David; Barkun, Alan; Bridges, Ron; Carter, Rose; de Gara, Chris; Dube, Catherine; Enns, Robert; Hollingworth, Roger; Macintosh, Donald; Borgaonkar, Mark; Forget, Sylviane; Leontiadis, Grigorios; Meddings, Jonathan; Cotton, Peter; Kuipers, Ernst J

    2012-01-01

    Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality, highlight the need for clearly defined, evidence-based processes to support quality improvement in endoscopy. To identify processes and indicators of quality and safety relevant to high-quality endoscopy service delivery. A multidisciplinary group of 35 voting participants developed recommendation statements and performance indicators. Systematic literature searches generated 50 initial statements that were revised iteratively following a modified Delphi approach using a web-based evaluation and voting tool. Statement development and evidence evaluation followed the AGREE (Appraisal of Guidelines, REsearch and Evaluation) and GRADE (Grading of Recommendations, Assessment, Development and Evaluation) guidelines. At the consensus conference, participants voted anonymously on all statements using a 6-point scale. Subsequent web-based voting evaluated recommendations for specific, individual quality indicators, safety indicators and mandatory endoscopy reporting fields. Consensus was defined a priori as agreement by 80% of participants. Consensus was reached on 23 recommendation statements addressing the following: ethics (statement 1: agreement 100%), facility standards and policies (statements 2 to 9: 90% to 100%), quality assurance (statements 10 to 13: 94% to 100%), training, education, competency and privileges (statements 14 to 19: 97% to 100%), endoscopy reporting standards (statements 20 and 21: 97% to 100%) and patient perceptions (statements 22 and 23: 100%). Additionally, 18 quality indicators (agreement 83% to 100%), 20 safety indicators (agreement 77% to 100%) and 23 recommended endoscopy-reporting elements (agreement 91% to 100%) were identified. The consensus process identified a clear need for high-quality clinical and outcomes research to support quality improvement in the delivery of endoscopy services. The

  14. A Retrospective Evaluation of the Utility of Capsule Endoscopy and Double-Balloon Endoscopy in Crohn’s Disease

    Directory of Open Access Journals (Sweden)

    Masanao Nakamura

    2016-01-01

    Full Text Available Background. Although the usefulness of capsule endoscopy (CE and double-balloon endoscopy (DBE for the evaluation of Crohn’s disease (CD is established, their capabilities in the differential diagnosis of small bowel stenosis have not been sufficiently addressed. The present study therefore aimed to retrospectively determine the types of patients for whom CE and DBE would confer the most benefit. Patients and Methods. We retrospectively reviewed data from 185 patients with established CD. A change of treatment based on CE or DBE results or successful DBE balloon dilation was defined as clinically useful indication. We then analyzed the factors significantly related to useful and poor indications. Results. CE results were assessed as useful indications in 28 (45% of 62 patients. Multivariate analysis demonstrated that positive CRP and low IOIBD score are factors significantly related to a useful indication. DBE results were recognized as useful indications in 118 (77% of 153 patients. Multivariate analysis indicated small bowel stenosis and abdominal pain as factors significantly associated with useful indications. All patients with a poor indication on CE had small bowel stenosis. Conclusions. CE was most useful for patients in clinical remission with positive CRP and without stenosis, whereas DBE was useful for patients with symptoms of stenosis.

  15. A STUDY ON ENDOSCOPIC EVALUATION OF UPPER GASTROINTESTINAL BLEEDING

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    Pranaya Kumar

    2016-03-01

    Full Text Available CONTEXT Upper gastrointestinal bleeding (UGIB is one of the commonest gastrointestinal emergencies encountered by clinicians. Peptic ulcers are the most common cause of UGIB. Endoscopy has become the preferred method for diagnosis in patients with acute UGIB. This study is done in a diagnostic upper gastrointestinal endoscopy (UGIE setup of a tertiary care hospital to ascertain the causes of UGIB prevalent in this part of our country which might differ from other studies. AIM To ascertain prevalent causes of UGIB in patients of this part of India admitted to a Govt. Tertiary Hospital with a provisional diagnosis of UGIB. METHOD One hundred consecutive patients with UGIB were subjected to UGIE to find out the aetiology. The clinical profile and endoscopic findings were analysed and compared with the data on UGIB from other studies. RESULTS The mean age of patients was 47.03 years with male: female ratio of 2.33:1. 58% of patients were first time bleeders. Majority of patients presented with melaena. Visualisation of active bleeding achieved to 85.7% when endoscopy was done within first 24 hrs. The commonest cause of UGIB was duodenal ulcer (DU which accounted for 41% cases. Gastric ulcer was responsible in 13% of cases. Portal hypertension was responsible for bleed in only 13%. Neoplasms accounted for 25% of cases. Other less common causes were erosive gastritis (3%, gastric polyp (3%, Mallory-Weiss tear (1%, and Dieulafoy’s lesion (1%. Among bleeding peptic ulcers, 27.8% of cases were classified as Forrest IIa and 20.4% in Forrest IIb & IIc each. Acid peptic disease was past history elicited in majority (33% followed by NSAID (26% and alcohol (26%. CONCLUSION The present study has diagnosed various causes of upper gastrointestinal bleeding in this part of country. The incidence of gastric carcinoma as a cause of upper gastrointestinal bleeding is significantly high compared to those in other studies. UGI endoscopy should be done in every case

  16. Helicobacter pylori infection status had no influence on upper gastrointestinal symptoms: a cross-sectional analysis of 3,005 Japanese subjects without upper gastrointestinal lesions undergoing medical health checkups

    OpenAIRE

    Yoshioka, Tomomi; Takeshita, Eri; Sakata, Yasuhisa; Hara, Megumi; Akutagawa, Kayo; Sakata, Natsuko; Endo, Hiroyoshi; Ohyama, Takashi; Matsunaga, Keiji; Tanaka, Yuichiro; Shirai, Shinpei; Ito, Yoichiro; Tsuruoka, Nanae; Iwakiri, Ryuichi; Kusano, Motoyasu

    2017-01-01

    Background This study aimed to evaluate the influence of Helicobacter pylori infection and its eradication on the upper gastrointestinal symptoms of relatively healthy Japanese subjects. Methods A total of 3,005 subjects (male/female: 1,549/1,456) undergoing medical health checkups were enrolled in the present study, at five hospitals in Saga, Japan, from January to December 2013. They had no significant findings following upper gastrointestinal endoscopy. All subjects completed a questionnai...

  17. Multicenter experience with upper gastrointestinal polyps in pediatric patients with familial adenomatous polyposis.

    Science.gov (United States)

    Attard, Thomas M; Cuffari, Carmen; Tajouri, Tanya; Stoner, Julie A; Eisenberg, Marcia T; Yardley, John H; Abraham, Susan C; Perry, Deborah; Vanderhoof, Jon; Lynch, Henry

    2004-04-01

    Familial adenomatous polyposis (FAP) is a hereditary cancer syndrome that includes gastro-duodenal involvement, polyposis, and a propensity to adenocarcinoma necessitating endoscopic surveillance. There are few data describing pediatric upper gastrointestinal FAP resulting in conflicting screening recommendations. To characterize pediatric gastroduodenal FAP and to investigate the association between symptoms at endoscopy and APC mutation analysis with endoscopic-histologic findings warranting surveillance. A retrospective chart review was performed, including all children with FAP who underwent upper endoscopy (EGD) at two institutions; (UNMC: 1992-2002, JHH: 1983-2002), all biopsies were reviewed and the APC mutations present in the cohort of patients were correlated to the pattern of severity of endoscopic findings and the frequency of APC mutations identified through commercially available testing for FAP (Labcorp: 1998-2002). Twenty-four patients from 21 families underwent 49 EGDs. Eighty-three percent were asymptomatic at the time of endoscopy. The most common finding was fundic gland polyposis (FGP) (51%), of which 42% and 15% harbored dysplasia and changes indefinite for dysplasia, respectively. Periampullary duodenal adenomata were present in 41% of patients with one patient necessitating ampullectomy. Symptoms at endoscopy were not predictive of premalignant changes. In 15 patients where the APC mutation was known patients with dysplastic FGP, gastric, or duodenal adenoma were more likely to harbor a mutation between codons 1225-1694 than the reference population (p= 0.006). All pediatric patients with FAP warrant upper gastrointestinal screening and surveillance endoscopy from the time of initial colonoscopy irrespective of referable symptoms. Patients with APC mutation between codon 1225-1694 may be more susceptible to aggressive gastroduodenal involvement in FAP.

  18. Bleeding and starving: fasting and delayed refeeding after upper gastrointestinal bleeding.

    Science.gov (United States)

    Fonseca, Jorge; Meira, Tânia; Nunes, Ana; Santos, Carla Adriana

    2014-01-01

    Early refeeding after nonvariceal upper gastrointestinal bleeding is safe and reduces hospital stay/costs. The aim of this study was obtaining objective data on refeeding after nonvariceal upper gastrointestinal bleeding. From 1 year span records of nonvariceal upper gastrointestinal bleeding patients that underwent urgent endoscopy: clinical features; rockall score; endoscopic data, including severity of lesions and therapy; feeding related records of seven days: liquid diet prescription, first liquid intake, soft/solid diet prescription, first soft/solid intake. From 133 patients (84 men) Rockall classification was possible in 126: 76 score ≥5, 50 score gastrointestinal bleeding patients must be refed earlier, according to guidelines.

  19. Management of upper dyspepsia in general practice

    DEFF Research Database (Denmark)

    Kjeldsen, Hans Christian; Kier, Svend; Husum, Gitte

     Aim: To compare the effect of two strategies for management of dyspepsia. Evaluation based on GP's assessment after two weeks and patients assessment after three months.   Design: Prospective randomised controlled trial in general practice   Methods: 357 patients with dyspepsia where the general...... practitioner (GP) finds indication for treatment with antisecretory therapy and/or diagnostic Helicobacter Pylori test were included in general practice between June 2000 and June 2002.  Patients the GP want to refer to endoscopy were not included. Dyspepsia definition: persistent or recurrent pain...... or discomfort centred in the upper abdomen with or without nausea, vomiting, heartburn, acid regurgitation, early satiety or bloating. Patients were initially treated according to one of two management strategies. The patient was the unit of randomisation. Strategy 1:   Proton pump inhibitor (40 mg omeprazol...

  20. Esophageal dysplasias are detected by endoscopy with Lugol in patients at risk for squamous cell carcinoma in southern Brazil.

    Science.gov (United States)

    Freitag, C P; Barros, S G; Kruel, C D; Putten, A C; Dietz, J; Gruber, A C; Diehl, A S; Meurer, L; Breyer, H P; Wolff, F; Vidal, R; Arruda, C A; Luz, L P; Fagundes, R B; Prolla, J C

    1999-01-01

    Diagnosis of squamous cell carcinoma of the esophagus is usually late. Staining of the mucosa with Lugol's solution during endoscopy has been suggested to identify early cancer/dysplasia and may improve prognosis. Lugol was tested during endoscopy in 96 asymptomatic subjects at risk for this tumor, who were found to have atypias after exfoliative cytology in southern Brazil. Biopsies were obtained in Lugol's 'stained' and 'unstained' areas in the esophageal mucosa and the histologic results were compared. 'Unstained' areas were present in 64 (66.7%) instances: 44 'unstained' areas over mucosa with normal appearance revealed seven dysplasias (four high and three low grade), whereas 20 'unstained' areas with visible lesions contained only one dysplasia (low grade). 'Stained' areas in 96 (100%) subjects showed two additional dysplasias (one high and one low grade). In this study, Lugol 'unstained' areas were of great value for detection of dysplasias (sensitivity = 80%; specificity = 63%; p = 0.01, Fisher's exact test; CI = 95%; odds ratio = 6.7).

  1. Fishbones in the Upper Aerodigestive Tract: A Review of 24 Cases of Adult Patients

    Directory of Open Access Journals (Sweden)

    Stanislas Ballivet- de -Regloix

    2017-07-01

    From our experience, we recommend a systematic nasofibroscopy. If it is normal, the patient is assessed at 48h. The complementary investigation by CT scan and/or oesophagoscopy must be reserved in cases of suspicion of oesophageal localization or complication. Otherwise, rigid or flexible endoscopy may be performed when laryngoscopy is unsuccessful or for the treatment of foreign bodies lodged below this area.

  2. About human taeniasis and Taenia saginata diagnosis by endoscopy.

    Science.gov (United States)

    Galán Puchades, María Teresa

    2016-10-01

    La carta al editor se refiere al artículo de Canaval-Zuleta et al. aceptado para publicación, titulado "Endoscopy as an alternative diagnostic and therapeutic technique for Taenia saginata". El trabajo presenta una serie de incorrecciones que deben ser aclaradas, o al menos parte de ellas en solo 300 palabras. La información sobre las vias de infeccion en taeniasis, así como la patogenia y técnicas de diagnóstico, no se ajustan a la realidad. Asimismo, ya está publicado que el diagnóstico por endoscopia es una técnica muy sensible pero nada específica, pues no permite distinguir entre las 3 especies humanas del género Taenia.

  3. Results From a Patient Experience Study in Pediatric Gastrointestinal Endoscopy

    Directory of Open Access Journals (Sweden)

    Divya Ann Jacob MBBS

    2015-11-01

    Full Text Available Objective: Gastrointestinal endoscopy in children has become a standard diagnostic and therapeutic modality. The aim of our study was to characterize the most memorable elements of the patient experience from the parent’s and patient’s perspective and determine ways to improve the overall quality of their experience. Methods: Using a structured questionnaire, we conducted 47 phone interviews with families who had recently undergone gastrointestinal endoscopic procedures. Results: Our study showed clear communication and mutual agreement on care decisions contributed to positive experiences. Inadequate communication of information regarding alternatives to the procedure and risk of complications during the informed consent discussion contributed to negative patient experiences. Standardization of postprocedure follow-up and timely communication of pathology findings also had potential for improvement. Conclusion: Our study revealed 2 areas for quality improvement interventions: The need to ensure that alternatives and complications are thoroughly discussed and the need for standardization of postprocedure follow-up.

  4. Role of virtual reality simulation in endoscopy training

    Science.gov (United States)

    Harpham-Lockyer, Louis; Laskaratos, Faidon-Marios; Berlingieri, Pasquale; Epstein, Owen

    2015-01-01

    Recent advancements in virtual reality graphics and models have allowed virtual reality simulators to be incorporated into a variety of endoscopic training programmes. Use of virtual reality simulators in training programmes is thought to improve skill acquisition amongst trainees which is reflected in improved patient comfort and safety. Several studies have already been carried out to ascertain the impact that usage of virtual reality simulators may have upon trainee learning curves and how this may translate to patient comfort. This article reviews the available literature in this area of medical education which is particularly relevant to all parties involved in endoscopy training and curriculum development. Assessment of the available evidence for an optimal exposure time with virtual reality simulators and the long-term benefits of their use are also discussed. PMID:26675895

  5. Electromechanical performance of piezoelectric scanning mirrors for medical endoscopy

    Science.gov (United States)

    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 μm long cantilever. The largest angular displacement of 30° mechanical scan range was obtained with a 500 μm 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

  6. Role of virtual reality simulation in endoscopy training.

    Science.gov (United States)

    Harpham-Lockyer, Louis; Laskaratos, Faidon-Marios; Berlingieri, Pasquale; Epstein, Owen

    2015-12-10

    Recent advancements in virtual reality graphics and models have allowed virtual reality simulators to be incorporated into a variety of endoscopic training programmes. Use of virtual reality simulators in training programmes is thought to improve skill acquisition amongst trainees which is reflected in improved patient comfort and safety. Several studies have already been carried out to ascertain the impact that usage of virtual reality simulators may have upon trainee learning curves and how this may translate to patient comfort. This article reviews the available literature in this area of medical education which is particularly relevant to all parties involved in endoscopy training and curriculum development. Assessment of the available evidence for an optimal exposure time with virtual reality simulators and the long-term benefits of their use are also discussed.

  7. Portable wireless power transmission system for video capsule endoscopy.

    Science.gov (United States)

    Zhiwei, Jia; Guozheng, Yan; Bingquan, Zhu

    2014-10-01

    Wireless power transmission is considered a practical way of overcoming the power shortage of wireless capsule endoscopy (VCE). However, most patients cannot tolerate the long hours of lying in a fixed transmitting coil during diagnosis. To develop a portable wireless power transmission system for VCE, a compact transmitting coil and a portable inverter circuit driven by rechargeable batteries are proposed. The couple coils, optimized considering the stability and safety conditions, are 28 turns of transmitting coil and six strands of receiving coil. The driven circuit is designed according to the portable principle. Experiments show that the integrated system could continuously supply power to a dual-head VCE for more than 8 h at a frame rate of 30 frames per second with resolution of 320 × 240. The portable VCE exhibits potential for clinical applications, but requires further improvement and tests.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    2015-07-06

    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. 2015 BMJ Publishing Group Ltd.

  10. Analysis of Wireless Capsule Endoscopy Images using Local Binary Patterns

    Directory of Open Access Journals (Sweden)

    Adriana Florentina CONSTANTINESCU

    2015-06-01

    Full Text Available Wireless capsule endoscopy, the gold standard in the screening and diagnosis of small bowel diseases, is one of the most recent investigations for gastrointestinal pathology. This examination has the advantages of being non-invasive, painless, with a large clinical yield, especially for small bowel diseases, but also some disadvantages. The long time necessary for reading and interpreting all frames acquired is one of these disadvantages. This inconvenient could be improved through different methods by using software applications. In this study we have used a software application for texture analysis based on local binary pattern (LBP operator. This operator detects and removes non-informative frames in a first step, then identifies potential lesions. Our study group consisted of 33 patients from the Gastroenterology and Hepatology Centre Craiova and from the 1st Internal Medicine and Gastroenterology Clinic from the Emergency County Hospital of Craiova. The patients included in the study have corresponded to our inclusion criteria established. The exclusion criteria were represented by the contraindications of the capsule endoscopy. In the first phase of the study, we have removed the non-informative frames from the original videos obtained, and we have acquired an average reduction of 6.96% from the total number of images. In the second phase, using the same LBP operator, we have correctly identified 93.16% of telangiectasia lesions. Our study demonstrated that software applications based on LBP operator can lead to a shorter analysis time, by reducing the overall frames number, and can also provide support in diagnosis.

  11. Impact of educational intervention on the inter-rater agreement of nasal endoscopy interpretation

    Science.gov (United States)

    Colley, Patrick; Mace, Jess C.; Schaberg, Madeleine R.; Smith, Timothy L.; Tabaee, Abtin

    2015-01-01

    OBJECTIVE Nasal endoscopy is integral to the evaluation of sinonasal disorders. However, prior studies have shown significant variability in the inter-rater agreement of nasal endoscopy interpretation amongst practicing rhinologists. The objective of the current study is to evaluate the inter-rater agreement of nasal endoscopy amongst otolaryngology residents from a single training program at baseline and following an educational intervention. METHODS 11 otolaryngology residents completed nasal endoscopy grading forms for 8 digitally recorded nasal endoscopic examinations. An instructional lecture reviewing nasal endoscopy interpretation was subsequently provided. The residents then completed grading forms for 8 different nasal endoscopic examinations. Inter-rate agreement amongst residents for the pre- and post-lecture videos was calculated using the unweighted Fleiss’ kappa statistic (Kf) and intra-class correlation agreement (ICC). RESULTS Inter-rater agreement improved from a baseline level of fair (Kf range 0.268–0.383) to a post-educational level of moderate (Kf range 0.401–0.547) for nasal endoscopy findings of middle meatus mucosa, middle turbinate mucosa, middle meatus discharge, sphenoethmoid recess mucosa, sphenoethmoid recess discharge and atypical lesions (ICC, pendoscopy interpretation amongst otolaryngology residents. The inter-rater agreement for the majority of the characteristics that were evaluated improved after educational intervention. Further study is needed to improve nasal endoscopy interpretation. PMID:25781864

  12. A STUDY OF CORRELATION BETWEEN NASAL ENDOSCOPY AND CT SCAN IN CASES OF CHRONIC RHINOSINUSITIS

    Directory of Open Access Journals (Sweden)

    Arun Kumar

    2015-07-01

    Full Text Available BACKGROUND: The accurate diagnosis of Chronic Rhinosinusitis (CRS is still a challenge therefore, the American Academy of Otorhinolaryngology - Head and Neck Surgery (AAO - HNS 1 has met in a multidisciplinary encounter and formulated a consensus based on only clinical symptoms. The computed tomography (CT scan and the nasal endoscopy (NE were introduced to make an accurate diagnosis of CRS and verify the disease severity. AIM: The aim of this study is to make a correlation between nasal endoscopy and CT scan in cases of clinically diagnosed Chronic Rhinosinusitis patients. METHOD: A study was carried out on 90 patients at Jhalawar Medical College, Jhalawar (Raj. during Sept. 20 12 to Dec. 2014. Diagnostic Nasal Endoscopy and CT Scan PNS done in patients, suffering from Chronic Rhinosinusitis. As a classification instruments, Metson / Gliklich's classification was used to evaluate the tomographic diagnosis and the Stankiewicz / Chow' s classification to evaluate the endoscopic diagnosis of Chronic Rhinosinusitis. RESULTS: Our study showed high specificity of endoscopy in comparison to CT scan though CT scan results are more sensitive. CONCLUSION: Endoscopy can confirm a Chronic Rhinosi nusitis diagnosis, but cannot rule it out, and that CT should be performed in cases of suspected CRS even if mucopurulence is not noted on endoscopy. The CT scan and the nasal endoscopy making easier the treatment planning and the disease resolution.

  13. Expanding the net: The re-evaluation of the multidimensional nomogram calculating the upper limit of normal PTH (maxPTH) in the setting of secondary hyperparathyroidism and the development of the MultIdimensional Predictive hyperparaTHyroid model (Mi-PTH).

    Science.gov (United States)

    Rajhbeharrysingh, Uma; El Youssef, Joseph; Leon, Enrique; Lasarev, Michael R; Klein, Robert; Vanek, Chaim; Mattar, Samer; Berber, Eren; Siperstein, Allan; Shindo, Maisie; Milas, Mira

    2016-01-01

    The multidimensional nomogram calculating the upper limit of normal PTH (maxPTH) model identifies a personalized upper limit of normal parathyroid hormone (PTH) and successfully predicts classical primary hyperparathyroidism (PHP). We aimed to assess whether maxPTH can distinguish normocalcemic PHP (NCPHP) from secondary hyperparathyroidism (SHP), including subjects who underwent bariatric surgery (BrS). A total of 172 subjects with 359 complete datasets of serum calcium (Ca), 25-OH vitamin D, and intact PTH from Oregon were analyzed: 123 subjects (212 datasets) with PHP and 47 (143) with SHP, including 28 (100) with previous BrS. An improved prediction model, MultIdimensional evaluation for Primary hyperparaTHyroidism (Mi-PTH), was created with the same variables as maxPTH by the use of a combined cohort (995 subjects) including participants from previous studies. In the Oregon cohort, maxPTH's sensitivity was 100% for classical PHP and 89% for NCPHP, but only 50% for normohormonal PHP (NHPHP) and 40% specific for SHP. In comparison, although sensitivity for NCPHP was similar (89%), Mi-PTH vastly improved SHP specificity (85%). In the combined cohort, Mi-PTH had better sensitivity of 98.5% (vs 95%) and specificity 97% (vs 85%). MaxPTH was sensitive in detecting PHP; however, there was low specificity for SHP, especially in patients who underwent BrS. The creation of Mi-PTH provided improved performance measures but requires further prospective evaluation. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. A Rare Cause of Upper Airway Obstruction in a Child

    Directory of Open Access Journals (Sweden)

    H. Ahmed

    2017-01-01

    Full Text Available Ventricular band cyst is a rare condition in children but can result in severe upper airway obstruction with laryngeal dyspnea or death. The diagnosis should be considered in any stridor in children with previous history of intubation or respiratory infections. We report a case of a 4-year-old girl, received in an array of severe respiratory distress, emergency endoscopy was done, and a large ventricular tape band cyst obstructing the air way was found. Complete excision was made, and postoperative prophylaxis tracheotomy was done. The postoperative course was uneventful with improvement of clinical and endoscopic signs.

  15. A cerebrovascular stroke following endoscopy for an elderly patient ...

    African Journals Online (AJOL)

    Ahmed Gado

    2015-02-02

    Feb 2, 2015 ... Abstract Elderly people constitute an increasing proportion of those presenting with acute upper gastrointestinal bleeding. Not only in upper gastrointestinal bleeding is advanced age a risk of death, but also exceeding 60 years of age results in an increased risk of cerebrovascular and cardio- vascular ...

  16. A cerebrovascular stroke following endoscopy for an elderly patient ...

    African Journals Online (AJOL)

    Elderly people constitute an increasing proportion of those presenting with acute upper gastrointestinal bleeding. Not only in upper gastrointestinal bleeding is advanced age a risk of death, but also exceeding 60 years of age results in an increased risk of cerebrovascular and cardiovascular events. Factors likely to ...

  17. Endoscopy-assisted transoral resection of the styloid process in Eagle's syndrome. Case report

    Directory of Open Access Journals (Sweden)

    Matsumoto Fumihiko

    2012-07-01

    Full Text Available Abstract Eagle's syndrome is often associated with elongated styloid process or ossified stylohyoid or stylomandibular ligament. Patients with this syndrome present with recurrent cervicofacial pain. Surgical removal of the elongated styloid process is a standard treatment and can be accomplished through either a transoral or extraoral approach. Both approaches have advantages and disadvantages, and the best surgical approach remains controversial. In our case, the elongated styloid process was removed by transoral approach assisted by endoscopy. Endoscopy provides clear surgical view thus lessen the chance of neurovascular injury and other intraoperative complications. Endoscopy-assisted transoral resection is an optional alternative surgical procedure for Eagle's syndrome.

  18. Canadian Association of Gastroenterology Consensus Guidelines on Safety and Quality Indicators in Endoscopy

    Directory of Open Access Journals (Sweden)

    David Armstrong

    2012-01-01

    Full Text Available Several organizations worldwide have developed procedure-based guidelines and/or position statements regarding various aspects of quality and safety indicators, and credentialing for endoscopy. Although important, they do not specifically address patient needs or provide a framework for their adoption in the context of endoscopy services. The consensus guidelines reported in this article, however, aimed to identify processes and indicators relevant to the provision of high-quality endoscopy services that will support ongoing quality improvement across many jurisdictions, specifically in the areas of ethics, facility standards and policies, quality assurance, training and education, reporting standards and patient perceptions.

  19. The effect of marriage on utilization of colorectal endoscopy exam in the United States.

    Science.gov (United States)

    Stimpson, Jim P; Wilson, Fernando A; Watanabe-Galloway, Shinobu; Peek, M Kristen

    2012-10-01

    This study examines the association between marriage and colorectal endoscopy exam, and whether this association varies by gender and financial benefits of marriage including improved access to health insurance and pooled family income. Representative survey data of the non-institutionalized United States population were used from the 2000, 2005, and 2008 National Health Interview Survey. Analyses targeted persons 50-85 years of age without a personal history of cancer and with complete information on all study variables (n=21,760). Multivariate logistic regression was used to model marital status differences in the probability of undergoing a colorectal endoscopy exam with interaction effects used to model variation over time by gender, health insurance, and poverty level. Married persons were more likely than unmarried persons to report ever having undergone a colorectal endoscopy exam (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.12-1.29), and the difference between married and unmarried persons in the probability of undergoing a colorectal endoscopy exam remained stable over time. Married persons were more likely than unmarried persons to report having undergone a colorectal endoscopy exam within the past 10 years (OR, 1.49; 95% CI, 1.15-1.95). For each survey year, married men were significantly more likely than women and unmarried men to report having undergone a colorectal endoscopy exam. For example, in 2008, 56% of married men reported having undergone a colorectal endoscopy exam, compared to 49% of unmarried men, 52% of married women, and 50% of unmarried women. Among persons with health insurance, married persons were significantly more likely than unmarried persons to have undergone a colorectal endoscopy exam. Among persons who were poor, there was no difference by marital status in the likelihood of having undergone a colorectal endoscopy exam. However, among persons who were not poor, married persons were more likely than unmarried persons

  20. Blood-based biomarkers at large bowel endoscopy and prediction of future malignancies

    DEFF Research Database (Denmark)

    Kring, Thomas S.; Piper, Thomas B.; Jørgensen, Lars Nannestad

    2015-01-01

    development of malignant diseases. In a major study of 4,990 subjects undergoing large bowel endoscopy, 691 were without pathology and comorbidity. Plasma levels of TIMP-1, CEA, CA19-9, and YKL-40 were determined in samples collected just before endoscopy and compared with subsequent development...... associated with subsequent development of a malignant disease (P = 0.002). The cumulative risk of developing malignant disease within the first 5 years after endoscopy was group 0, 3.3%; group 1, 5.8%; group 2, 7.8%. It is concluded that increased levels of plasma TIMP-1, CEA, CA19-9, and serum YKL-40...

  1. Virtual reality surgical simulation for lower urinary tract endoscopy and procedures.

    Science.gov (United States)

    Manyak, Michael J; Santangelo, Kristin; Hahn, James; Kaufman, Roger; Carleton, Thurston; Hua, Xing Cheng; Walsh, Raymond J

    2002-04-01

    To provide a realistic experience of lower urinary tract endoscopic procedures, we have developed and continue to expand a computer-based surgical simulator that incorporates a surgical tool interface with anatomic detail and haptic feedback. Surface-based geometric data for the lower urinary tract were generated from the National Library of Medicine Visible Human dataset. The three-dimensional texture map of the surface geometry was developed from recorded endoscopic video procedures. Geometry and associated texture maps were rendered in real time using the Silicon Graphics Extreme Impacts program. The surgical interface device incorporated all normal ranges of motion and resistance that occur within an actual operative environment. The hands-on endoscopic device attached to the interface device was provided by Circon-ACMI, Inc. Urologic residents evaluated the program for correlation with actual endoscopic procedures. Texture-mapped digitized images provided a close anatomic similarity to actual videoendoscopic images. Virtual endoscopy of the lower urinary tract was reproducible and closely simulated actual visual and tactile endoscopic experience. Virtual reality surgical simulation is feasible for a variety of lower urinary tract procedures. This system coordinates visual perception with appropriate haptic feedback in both longitudinal and rotational axes. These types of procedures may be incorporated into future educational experiences for urologists to introduce new techniques and to provide documentation of surgical experience.

  2. Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding

    DEFF Research Database (Denmark)

    Stanley, Adrian J; Laine, Loren; Dalton, Harry R

    2017-01-01

    OBJECTIVE: To compare the predictive accuracy and clinical utility of five risk scoring systems in the assessment of patients with upper gastrointestinal bleeding. DESIGN: International multicentre prospective study. SETTING: Six large hospitals in Europe, North America, Asia, and Oceania....... PARTICIPANTS: 3012 consecutive patients presenting over 12 months with upper gastrointestinal bleeding. MAIN OUTCOME MEASURES: Comparison of pre-endoscopy scores (admission Rockall, AIMS65, and Glasgow Blatchford) and post-endoscopy scores (full Rockall and PNED) for their ability to predict predefined...... clinical endpoints: a composite endpoint (transfusion, endoscopic treatment, interventional radiology, surgery, or 30 day mortality), endoscopic treatment, 30 day mortality, rebleeding, and length of hospital stay. Optimum score thresholds to identify low risk and high risk patients were determined...

  3. Computer-aided gastrointestinal hemorrhage detection in wireless capsule endoscopy videos.

    Science.gov (United States)

    Hassan, Ahnaf Rashik; Haque, Mohammad Ariful

    2015-12-01

    Wireless Capsule Endoscopy (WCE) can image the portions of the human gastrointestinal tract that were previously unreachable for conventional endoscopy examinations. A major drawback of this technology is that a large volume of data are to be analyzed in order to detect a disease which can be time-consuming and burdensome for the clinicians. Consequently, there is a dire need of computer-aided disease detection schemes to assist the clinicians. In this paper, we propose a real-time, computationally efficient and effective computerized bleeding detection technique applicable for WCE technology. The development of our proposed technique is based on the observation that characteristic patterns appear in the frequency spectrum of the WCE frames due to the presence of bleeding region. Discovering these discriminating patterns, we develop a texture-feature-descriptor-based-algorithm that operates on the Normalized Gray Level Co-occurrence Matrix (NGLCM) of the magnitude spectrum of the images. A new local texture descriptor called difference average that operates on NGLCM is also proposed. We also perform statistical validation of the proposed scheme. The proposed algorithm was evaluated using a publicly available WCE database. The training set consisted of 600 bleeding and 600 non-bleeding frames. This set was used to train the SVM classifier. On the other hand, 860 bleeding and 860 non-bleeding images were selected from the rest of the extracted images to form the test set. The accuracy, sensitivity and specificity obtained from our method are 99.19%, 99.41% and 98.95% respectively which are significantly higher than state-of-the-art methods. In addition, the low computational cost of our method makes it suitable for real-time implementation. This work proposes a bleeding detection algorithm that employs textural features from the magnitude spectrum of the WCE images. Experimental outcomes backed by statistical validations prove that the proposed algorithm is superior

  4. An audit of lidocaine spray and its use in endoscopy with particular attention to its ethanol content

    Directory of Open Access Journals (Sweden)

    Affifa Farrukh

    2014-01-01

    Full Text Available Objective: The aim was to investigate the attitude of patients about to undergo upper gastrointestinal endoscopy toward the use of an oral lidocaine spray which contained alcohol. Materials and Method: It is customary to offer patients about to undergo a gastroscopy intravenous sedation, an oral local anesthetic spray or a combination of both. However, the presence of alcohol within the oral spray is seldom discussed with patients. There are some religious groups, such as fundamentalist Christians and Muslims, who will only consider the use of alcohol in exceptional circumstances. There are also others who are reluctant to use it for a range of reasons. One hundred patients undergoing a diagnostic gastroscopy because of dyspeptic symptoms at the University Hospitals of Leicester were provided with an information sheet about sedation. Of the 100 patients asked to take part in the audit 25 were South Asian. Eleven of these patients were Muslim and 11 Hindu. Results: Fifteen patients declined to use the spray (13 Europeans and 2 South Asians. The reasons varied with only two doing so for religious reasons. One of the patients was a Muslim and the other a Christian. However, almost 90% of people believed all patients should be told of the alcohol content of the oral spray so as to allow them to make an informed choice. Conclusion: All patients who are to undergo an endoscopy should be told of the alcohol content of any oral anesthetic spray, so that they can make an informed choice as to whether they wish to receive it.

  5. Clinical Efficacy of Proton Pump Inhibitor versus Prompt Endoscopy for Management of People with Dyspepsia

    DEFF Research Database (Denmark)

    Kjeldsen, Hans Christian; Lauritzen, Torsten; Christensen, Bo

      Title:   Clinical Efficacy of Proton Pump Inhibitor versus Prompt Endoscopy for Management of People with Dyspepsia: A Randomized Clinical Trial in General Practice.     Purpose: To compare the clinical efficacy of two strategies for management of dyspepsia in general practice in a RCT design.......   Setting: June 2000 to August 2002, 41 GPs, Aarhus County, Denmark   Methods: 368 people with dyspepsia (epigastric pain/discomfort, no alarm symptoms) were randomly assigned to treatment with omeprazol 40 mg/day for two weeks (PPI group, n:185) or endoscopy (endoscopy group, n:183). Due to migration......, dyspeptic contacts to GP or patients' satisfaction. Conclusions: Prompt endoscopy was superior to proton pump inhibitor concerning symptom improvement in management of dyspepsia in general practice when pain/discomfort was the primary symptom. There were no differences between the two strategies in respect...

  6. Valeur de l'endoscopie de routine dans le diagnostic de la gastrite ...

    African Journals Online (AJOL)

    Valeur de l'endoscopie de routine dans le diagnostic de la gastrite chronique antrale à Yaoundé. D Noah Noah, F Ankouane Andoulo, SAF Eloumou Bagnaka, PJA Atangana, C Tzeuton, EC Ndjitoyap Ndam ...

  7. Competence and quality assessment: the future of training in GI endoscopy

    NARCIS (Netherlands)

    V.E. Ekkelenkamp (Vivian)

    2014-01-01

    markdownabstract__Abstract__ __Introduction__: Training procedural skills in gastrointestinal endoscopy once focused on threshold numbers. However, as threshold numbers poorly reflect individual competence, the focus gradually shifts towards a more individual approach. Tools to assess and

  8. Capsule Endoscopy: A Single Centre Experience with the First 226 Capsules

    Directory of Open Access Journals (Sweden)

    R Enns

    2004-01-01

    Full Text Available BACKGROUND: Capsule endoscopy (CE refers to a novel diagnostic method of imaging the gastrointestinal tract using a wireless capsule that transmits images to a data recorder while the device traverses the small intestine.

  9. Reproducibility of Wireless Capsule Endoscopy in the Investigation of Chronic Obscure Gastrointestinal Bleeding

    Directory of Open Access Journals (Sweden)

    Dimitrios Christodoulou

    2007-01-01

    Full Text Available BACKGROUND: Capsule endoscopy (CE is a valuable tool in the diagnostic evaluation of obscure gastrointestinal bleeding, but limited information is available on the reproducibility of CE findings.

  10. Usefulness of post-mortem ophthalmological endoscopy during forensic autopsy: a case report.

    Science.gov (United States)

    Tsujinaka, Masatake; Akaza, Kayoko; Nagai, Atsushi; Nakamura, Isao; Bunai, Yasuo

    2005-01-01

    Post-mortem intraocular findings in two autopsy cases with traumatic intracranial haemorrhage were obtained using an ophthalmological endoscope. The endoscopy results clearly revealed the presence of intraocular haemorrhages and papilledema caused by intracranial haemorrhage. Post-mortem ophthalmological endoscopy offers several benefits. First, post-mortem intraocular findings can be directly observed in corpses with post-mortem clouding of the cornea. Secondly, the endoscopy only requires a 0.9 mm incision in the sclera and does not require the removal of the eye from the corpse, a procedure that should be avoided for ethical and cosmetic reasons. Thus, post-mortem opthalmological endoscopy is a useful method for obtaining intraocular findings in autopsies.

  11. A prospective randomized study comparing transnasal and peroral 5-mm ultrathin endoscopy

    Directory of Open Access Journals (Sweden)

    Lian-Feng Lin

    2014-06-01

    Conclusion: PO intubation seems an excellent alternative method when using a 5-mm ultrathin endoscopy because it achieves comparable patient tolerance, acceptance, and satisfaction as TN intubation, takes less time and causes lower intubation failure and epistaxis.

  12. Upper respiratory tract nociceptor stimulation and stress response following acute and repeated Cyfluthrin inhalation in normal and pregnant rats: Physiological rat-specific adaptions can easily be misunderstood as adversities.

    Science.gov (United States)

    Pauluhn, Juergen

    2018-01-05

    This paper reviews the results from past regulatory and mechanistic inhalation studies in rats with the type II pyrethroid Cyfluthrin. Apart from many chemical irritants, Cyfluthrin was shown to be a neuroexcitatory agent without any inherent tissue-destructive or irritant property. Thus, any Cyfluthrin-induced neuroexcitatory afferent sensory stimulus from peripheral nociceptors in the upper respiratory tract is likely to be perceived as a transient stimulus triggering annoyance and/or avoidance by both rats and humans. However, while thermolabile rats respond to such stresses reflexively, homeothermic humans appear to respond psychologically. With this focus in mind, past inhalation studies in rats and human volunteers were reevaluated and assessed to identify common denominators to such neuroexcitatory stimuli upon inhalation exposure. This analysis supports the conclusion that the adaptive physiological response occurring in rats secondary to such chemosensory stimuli requires inhalation exposures above the chemosensory threshold. Rats, a species known to undergo adaptively a hibernation-like physiological state upon environmental stresses, experienced reflexively-induced bradypnea, bradycardia, hypothermia, and changes in acid-base status during inhalation exposure. After cessation of the sensory stimulus, rapid recovery occurred. Physiological data of male and female rats from a 4-week repeated inhalation study (exposure 6-h/day, 5-times/week) were used to select concentration for a 10-day developmental inhalation toxicity study in pregnant rats. Maternal hypothermia and hypoventilation were identified as likely cause of fetal and placental growth retardations because of a maternal adaptation-driven reduced feto-placental transfer of oxygen. In summary, maternal reflex-hypothermia, reduced cardiac output and placental perfusion, and disruption of the gestation-related hyperventilation are believed to be the maternally mediated causes for developmental

  13. What we have learned and what to expect from capsule endoscopy.

    Science.gov (United States)

    Adler, Samuel N; Bjarnason, Ingvar

    2012-10-16

    Capsule endoscopy was conceived by Gabriel Iddan and Paul Swain independently two decades ago. These applications include but are not limited to Crohn's disease of the small bowel, occult gastrointestinal bleeding, non steroidal anti inflammatory drug induced small bowel disease, carcinoid tumors of the small bowel, gastro intestinal stromal tumors of the small bowel and other disease affecting the small bowel. Capsule endoscopy has been compared to traditional small bowel series, computerized tomography studies and push enteroscopy. The diagnostic yield of capsule endoscopy has consistently been superior in the diagnosis of small bowel disease compared to the competing methods (small bowel series, computerized tomography, push enteroscopy) of diagnosis. For this reason capsule endoscopy has enjoyed a meteoric success. Image quality has been improved with increased number of pixels, automatic light exposure adaptation and wider angle of view. Further applications of capsule endoscopy of other areas of the digestive tract are being explored. The increased transmission rate of images per second has made capsule endoscopy of the esophagus a realistic possibility. Technological advances that include a double imager capsule with a nearly panoramic view of the colon and a variable frame rate adjusted to the movement of the capsule in the colon have made capsule endoscopy of the colon feasible. The diagnostic rate for the identification of patients with polyps equal to or larger than 6 mm is high. Future advances in technology and biotechnology will lead to further progress. Capsule endoscopy is following the successful modern trend in medicine that replaces invasive tests with less invasive methodology.

  14. Role of wireless capsule endoscopy in reclassifying inflammatory bowel disease in children

    OpenAIRE

    Jodie Ouahed; Mohammad Shagrani; Ana Sant’Anna

    2013-01-01

    Objective: To evaluate the role of wireless capsule endoscopy in identifying small bowel lesions in pediatric patients with newly diagnosed colonic inflammatory bowel disease (IBD) type unclassified (IBDU), and to assess whether capsule endoscopy findings result in altered patient management. Methods: Ten pediatric patients recently diagnosed with IBDU through standard investigations were recruited from the pediatric gastroenterology clinic at McMaster Children's Hospital to undergo capsul...

  15. Preoperative wireless capsule endoscopy does not predict outcome after ileal pouch-anal anastomosis.

    Science.gov (United States)

    Murrell, Zuri; Vasiliauskas, Eric; Melmed, Gil; Lo, Simon; Targan, Stephan; Fleshner, Phillip

    2010-03-01

    The extent of preoperative small-bowel mucosal inflammation may be an important predictor of pouchitis after ileal pouch-anal anastomosis. This study examined the value of preoperative wireless capsule endoscopy in predicting outcome of ileal pouch-anal anastomosis in patients with ulcerative colitis or indeterminate colitis. Patients undergoing complete wireless capsule endoscopy before ileal pouch-anal anastomosis were identified. Findings on wireless capsule endoscopy were classified as positive (erosions, ulcers or erythema) or negative. Outcome was assessed prospectively and included no pouchitis, acute pouchitis, chronic pouchitis, or de novo Crohn disease. Patients with acute pouchitis, chronic pouchitis, or de novo Crohn disease were considered to have pouch inflammation. The 68 study patients (48 ulcerative colitis; 20 indeterminate colitis) had a median age of 38 years and included 34 males. Median follow-up time after ileostomy closure was 12 months (range, 3-63 months). Wireless capsule endoscopy was positive in 15 patients (22%) and negative in 53 patients (78%). Pouch inflammation was observed in 23 patients (34%), and included 8 patients with acute pouchitis, 3 patients with chronic pouchitis, and 12 patients with de novo Crohn disease. The incidence of acute pouchitis, chronic pouchitis, de novo Crohn disease, and pouch inflammation in the wireless capsule endoscopy-positive patient group was 7%, 7%, 20%, and 33% compared with 13%, 4%, 17%, and 34% in the wireless capsule endoscopy-negative patient group (all P = NS). There was no statistical association between the results of preoperative wireless capsule endoscopy and outcome after ileal pouch-anal anastomosis in patients with ulcerative colitis or indeterminate colitis. There seems to be little value of wireless capsule endoscopy in the preoperative evaluation of these patients.

  16. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anesthesiologist administration of propofol for GI endoscopy

    NARCIS (Netherlands)

    Dumonceau, J. M.; Riphaus, A.; Aparicio, J. R.; Beilenhoff, U.; Knape, J. T. A.; Ortmann, M.; Paspatis, G.; Ponsioen, C. Y.; Racz, I.; Schreiber, F.; Vilmann, P.; Wehrmann, T.; Wientjes, C.; Walder, B.; Aabakken, L.; Axon, A.; Costamagna, G.; Giostra, E.; Hornslet, P.; Ladas, S.; Marek, T.; Dinis-Ribeiro, M.

    2010-01-01

    Propofol sedation by non-anesthesiologists is an upcoming sedation regimen in several countries throughout Europe. Numerous studies have shown the efficacy and safety of this sedation regimen in gastrointestinal endoscopy. Nevertheless, this issue remains highly controversial. The aim of this

  17. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anaesthesiologist administration of propofol for GI endoscopy

    NARCIS (Netherlands)

    Dumonceau, J. M.; Riphaus, A.; Aparicio, J. R.; Beilenhoff, U.; Kanpe, J. T. A.; Ortmann, M.; Paspatis, G.; Ponsioen, C. Y.; Racz, I.; Schreiber, F.; Vilmann, P.; Wehrmann, T.; Wientjes, C.; Walder, B.

    2010-01-01

    Propofol sedation by non-anaesthesiologists is an upcoming sedation regimen in several countries throughout Europe. Numerous studies have shown the efficacy and safety of this sedation regimen in gastrointestinal endoscopy. Nevertheless, this issue remains highly controversial. The aim of this

  18. The evolution of endoscopy: wireless capsule cameras for the diagnosis of occult gastrointestinal bleeding and inflammatory bowel disease.

    Science.gov (United States)

    Davis, Brian R; Harris, Hobart; Vitale, Gary C

    2005-06-01

    Occult gastrointestinal bleeding and lesions associated with inflammatory bowel disease represent a diagnostic dilemma because they often lie in areas of the small bowel that are difficult to access with flexible fiberoptic endoscopy. Capsule endoscopy has been developed to access these areas in a way that avoids the pain and anesthesia risks of push endoscopy. The diagnostic yield of capsule endoscopy has proven to be superior to both flexible small-bowel endoscopy and radiologic studies in several prospective trials. Capsule endoscopy transmits a large number of images that do not correlate well with the standard endoscopic view, creating a diagnostic challenge for the endoscopist. Complications of this procedure include capsule retention in diverticulae or at stricture sites. The technology of this procedure continues to evolve through improving image resolution and diagnostic accuracy. Capsule endoscopy also represents an overall economic saving despite a high unit price compared with the expense of repeat diagnostic testing. Because the diagnostic yield of capsule endoscopy is nearly twofold greater than conventional endoscopy, it has become the procedure of choice for the dilemma of assessing small-bowel pathology for many clinicians. Further studies are needed to determine whether the capsule endoscope can replace conventional endoscopy in the first-line diagnosis of pathology in other parts of the alimentary tract.

  19. Non-technical skills and gastrointestinal endoscopy: a review of the literature.

    Science.gov (United States)

    Hitchins, Charlotte R; Metzner, Magdalena; Edworthy, Judy; Ward, Catherine

    2018-04-01

    Non-technical skills (NTS) have gained increasing recognition in recent years for their role in safe, effective team performance in healthcare. Gastrointestinal endoscopy is a procedure-based specialty with rapidly advancing technology, significant operational pressures and rapidly changing 'teams of experts'. However, to date there has been little focus on the effect of NTS in this field. This review aims to examine the existing literature on NTS in gastrointestinal endoscopy and identify areas for further research. A systematic search of MEDLINE, Embase, Cochrane Library, PsychINFO, CINAHL Plus and PubMed databases was performed using search terms Non-Technical Skills, Team Performance or Team Skills, and Endoscopy, Colonoscopy, OGD, Gastroscopy, Endoscopic Retrograde Cholangio-Pancreatography or Endoscopic Ultrasound. Eighteen relevant publications were found. NTS are deemed an essential component of practice, but so far there is little evidence of their integration into training or competency assessment. Those studies examining the effects of NTS and team training in endoscopy are small and have variable outcome measures with limited evidence of improvement in skills or clinical outcomes. NTS assessment in endoscopy is in its early phases with a few tools in development. The current literature on NTS in gastrointestinal endoscopy is limited. NTS, however, are deemed an essential component of practice, with potential positive effects on team performance and clinical outcomes. A validated reliable tool would enable evaluation of training and investigation into the effects of NTS on outcomes. There is a clear need for further research in this field.

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

    Science.gov (United States)

    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.

  1. Job Stress and Job Satisfaction among Health-Care Workers of Endoscopy Units in Korea

    Science.gov (United States)

    Nam, Seung-Joo; Chun, Hoon Jai; Moon, Jeong Seop; Park, Sung Chul; Hwang, Young-Jae; Yoo, In Kyung; Lee, Jae Min; Kim, Seung Han; Choi, Hyuk Soon; Kim, Eun Sun; Keum, Bora; Jeen, Yoon Tae; Lee, Hong Sik; Kim, Chang Duck

    2016-01-01

    Background/Aims: The management of job-related stress among health-care workers is critical for the improvement of healthcare services; however, there is no existing research on endoscopy unit workers as a team. Korea has a unique health-care system for endoscopy unit workers. In this study, we aimed to estimate job stress and job satisfaction among health-care providers in endoscopy units in Korea. Methods: We performed a cross-sectional survey of health-care providers in the endoscopy units of three university-affiliated hospitals in Korea. We analyzed the job stress levels by using the Korean occupational stress scale, contributing factors, and job satisfaction. Results: Fifty-nine workers completed the self-administered questionnaires. The job stress scores for the endoscopy unit workers (46.39±7.81) were relatively lower compared to those of the national sample of Korean workers (51.23±8.83). Job stress differed across job positions, with nurses showing significantly higher levels of stress (48.92±7.97) compared to doctors (42.59±6.37). Job stress and job satisfaction were negatively correlated with each other (R2=0.340, pjob stress and job satisfaction significantly differ according to job positions. Job demand, insufficient job control, and job insecurity are the most important stressors in the endoscopy unit. PMID:26898513

  2. Pursuing Normality

    DEFF Research Database (Denmark)

    Madsen, Louise Sofia; Handberg, Charlotte

    2018-01-01

    BACKGROUND: The present study explored the reflections on cancer survivorship care of lymphoma survivors in active treatment. Lymphoma survivors have survivorship care needs, yet their participation in cancer survivorship care programs is still reported as low. OBJECTIVE: The aim of this study...... implying an influence on whether to participate in cancer survivorship care programs. Because of "pursuing normality," 8 of 9 participants opted out of cancer survivorship care programming due to prospects of "being cured" and perceptions of cancer survivorship care as "a continuation of the disease...

  3. Upper Limb Exoskeleton

    NARCIS (Netherlands)

    Rusak, Z.; Luijten, J.; Kooijman, A.

    2015-01-01

    The present invention relates a wearable exoskeleton for a user having a torso with an upper limb to support motion of the said upper limb. The wearable exoskeleton comprises a first fixed frame mountable to the torso, an upper arm brace and a first group of actuators for moving the upper arm brace

  4. Diagnosis by Endoscopy and Advanced Imaging of Barrett's Neoplasia.

    Science.gov (United States)

    Swager, Anne-Fré; Curvers, Wouter L; Bergman, Jacques J

    Evaluation of patients with Barrett's esophagus (BE) using dye-based chromoendoscopy, optical chromoendoscopy, autofluorescence imaging, or confocal laser endomicroscopy does not significantly increase the number of patients with a diagnosis of early neoplasia compared with high-definition white light endoscopy (HD-WLE) with random biopsy analysis. These newer imaging techniques are not more effective in standard surveillance of patients with BE because the prevalence of early neoplasia is low and HD-WLE with random biopsy analysis detects most cases of neoplasia. The evaluation and treatment of patients with BE and early stage neoplasia should be centralized in tertiary referral centers, where procedures are performed under optimal conditions, by expert endoscopists. Lesions that require resection are almost always detected by HD-WLE, although advanced imaging techniques can detect additional flat lesions. However, these are of limited clinical significance because they are effectively eradicated by ablation therapy. No endoscopic imaging technique can reliably assess submucosal or lymphangio invasion. Endoscopic resection of early stage neoplasia in patients with BE is important for staging and management. Optical chromoendoscopy can also be used to evaluate lesions before endoscopic resection and in follow-up after successful ablation therapy.

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

    Science.gov (United States)

    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.

  6. A general framework for wireless capsule endoscopy study synopsis.

    Science.gov (United States)

    Zhao, Qian; Mullin, Gerard E; Meng, Max Q-H; Dassopoulos, Themistocles; Kumar, Rajesh

    2015-04-01

    We present a general framework for analysis of wireless capsule endoscopy (CE) studies. The current available workstations provide a time-consuming and labor-intense work-flow for clinicians which requires the inspection of the full-length video. The development of a computer-aided diagnosis (CAD) CE workstation will have a great potential to reduce the diagnostic time and improve the accuracy of assessment. We propose a general framework based on hidden Markov models (HMMs) for study synopsis that forms the computational engine of our CAD workstation. Color, edge and texture features are first extracted and analyzed by a Support Vector Machine classifier, and then encoded as the observations for the HMM, uniquely combining the temporal information during the assessment. Experiments were performed on 13 full-length CE studies, instead of selected images previously reported. The results (e.g. 0.933 accuracy with 0.933 recall for detection of polyps) show that our framework achieved promising performance for multiple classification. We also report the patient-level CAD assessment of complete CE studies for multiple abnormalities, and the patient-level validation demonstrates the effectiveness and robustness of our methods. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Automatic Hookworm Detection in Wireless Capsule Endoscopy Images.

    Science.gov (United States)

    Wu, Xiao; Chen, Honghan; Gan, Tao; Chen, Junzhou; Ngo, Chong-Wah; Peng, Qiang

    2016-07-01

    Wireless capsule endoscopy (WCE) has become a widely used diagnostic technique to examine inflammatory bowel diseases and disorders. As one of the most common human helminths, hookworm is a kind of small tubular structure with grayish white or pinkish semi-transparent body, which is with a number of 600 million people infection around the world. Automatic hookworm detection is a challenging task due to poor quality of images, presence of extraneous matters, complex structure of gastrointestinal, and diverse appearances in terms of color and texture. This is the first few works to comprehensively explore the automatic hookworm detection for WCE images. To capture the properties of hookworms, the multi scale dual matched filter is first applied to detect the location of tubular structure. Piecewise parallel region detection method is then proposed to identify the potential regions having hookworm bodies. To discriminate the unique visual features for different components of gastrointestinal, the histogram of average intensity is proposed to represent their properties. In order to deal with the problem of imbalance data, Rusboost is deployed to classify WCE images. Experiments on a diverse and large scale dataset with 440 K WCE images demonstrate that the proposed approach achieves a promising performance and outperforms the state-of-the-art methods. Moreover, the high sensitivity in detecting hookworms indicates the potential of our approach for future clinical application.

  8. Detection of small colon bleeding in wireless capsule endoscopy videos.

    Science.gov (United States)

    Usman, Muhammad Arslan; Satrya, G B; Usman, Muhammad Rehan; Shin, Soo Young

    2016-12-01

    In the recent years, wireless capsule endoscopy (WCE) technology has played a very important role in diagnosing diseases within the gastro intestinal (GI) tract of human beings. The WCE device captures images of the GI tract of patient with a certain frame rate. Physicians examine these images in order to find abnormalities in the GI tract. This examination process is very time consuming and hectic for the physician as a WCE device captures around 60,000 images on the average. At present, there are no standards defined for the WCE image classification. Computer aided methods help reducing the burden on the physicians by automatically detecting the abnormalities in the GI tract such as small colon bleeding. In this paper, a pixel based approach to detect bleeding regions in the WCE videos by using a support vector classifier is proposed. Threshold analysis in HSV color space is performed to compute the features for training an optimal support vector machine. The HSV features of the WCE images are fed to the trained support vector classifier for classification. Also, our method includes image enhancement and edge removal in WCE images, which is done prior to classification, for robust results. The method offers high sensitivity, specificity and accuracy in terms of correctly classifying images that contain bleeding regions as compared to another contemporary method. A detailed experimental analysis is also provided for the purpose of method evaluation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Engineering Micromechanical Systems for the Next Generation Wireless Capsule Endoscopy.

    Science.gov (United States)

    Woods, Stephen; Constandinou, Timothy

    2015-01-01

    Wireless capsule endoscopy (WCE) enables the detection and diagnosis of inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. However treatment of these pathologies can only be achieved through conventional means. This paper describes the next generation WCE with increased functionality to enable targeted drug delivery in the small intestinal tract. A prototype microrobot fabricated in Nylon 6 is presented which is capable of resisting peristaltic pressure through the deployment of an integrated holding mechanism and delivering targeted therapy. The holding action is achieved by extending an "anchor" spanning a 60.4 mm circumference, for an 11.0 mm diameter WCE. This function is achieved by a mechanism that occupies only 347.0 mm(3) volume, including mechanics and actuator. A micropositioning mechanism is described which utilises a single micromotor to radially position and then deploy a needle 1.5 mm outside the microrobot's body to deliver a 1 mL dose of medication to a targeted site. An analysis of the mechanics required to drive the holding mechanism is presented and an overview of microactuators and the state of the art in WCE is discussed. It is envisaged that this novel functionality will empower the next generation of WCE to help diagnose and treat pathologies of the GI tract.

  10. Clinicoepidemiologic characterization and endoscopy in patients with colorectal cancer

    International Nuclear Information System (INIS)

    Hano Garcia, Olga Marina; Wood Rodriguez, Lisette; Villa Jimenez, Oscar Manuel

    2010-01-01

    Colorectal carcinoma is recognized as the second death cause from cancer in most of developed countries; the increasing exposure to risk factor such as smoking, changes in diet, in lifestyles, as well as environmental and infectious factors is conductive to its morbidity and mortality increase. A prospective and descriptive study was conducted in 65 patients older than 18 years seen from April, 2007 to April, 2008 in the Endoscopy Service of the National Institute of Gastroenterology, diagnosed with colorectal carcinoma by colonoscopy and histology. In collection form were registered: sex, age, personal backgrounds of colon cancer, polyps, intestinal inflammatory disease and cholecystectomy; family backgrounds of colon cancer or another location; toxic habits: smoking and alcoholism; diet as regards: vegetal fiber ingestion and animal fat; anatomic location of cancer and histology. We conclude that there was predominance of female sex, the more frequent diagnosis age was between 60 and 70 years. The personal background of colon polyp and the family background of colon cancer were the more frequent. There was also predominance of smokers and heavy drinkers with or without effect. There was a great ingestion of animal fat and few ingestion of vegetal fiber. The more frequent anatomical location was the rectosygmoid, where the histological colon adenocarcinoma had the greater frequency

  11. Reduction of capsule endoscopy reading times by unsupervised image mining.

    Science.gov (United States)

    Iakovidis, D K; Tsevas, S; Polydorou, A

    2010-09-01

    The screening of the small intestine has become painless and easy with wireless capsule endoscopy (WCE) that is a revolutionary, relatively non-invasive imaging technique performed by a wireless swallowable endoscopic capsule transmitting thousands of video frames per examination. The average time required for the visual inspection of a full 8-h WCE video ranges from 45 to 120min, depending on the experience of the examiner. In this paper, we propose a novel approach to WCE reading time reduction by unsupervised mining of video frames. The proposed methodology is based on a data reduction algorithm which is applied according to a novel scheme for the extraction of representative video frames from a full length WCE video. It can be used either as a video summarization or as a video bookmarking tool, providing the comparative advantage of being general, unbounded by the finiteness of a training set. The number of frames extracted is controlled by a parameter that can be tuned automatically. Comprehensive experiments on real WCE videos indicate that a significant reduction in the reading times is feasible. In the case of the WCE videos used this reduction reached 85% without any loss of abnormalities.

  12. Engineering Micromechanical Systems for the Next Generation Wireless Capsule Endoscopy

    Directory of Open Access Journals (Sweden)

    Stephen Woods

    2015-01-01

    Full Text Available Wireless capsule endoscopy (WCE enables the detection and diagnosis of inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis. However treatment of these pathologies can only be achieved through conventional means. This paper describes the next generation WCE with increased functionality to enable targeted drug delivery in the small intestinal tract. A prototype microrobot fabricated in Nylon 6 is presented which is capable of resisting peristaltic pressure through the deployment of an integrated holding mechanism and delivering targeted therapy. The holding action is achieved by extending an “anchor” spanning a 60.4 mm circumference, for an 11.0 mm diameter WCE. This function is achieved by a mechanism that occupies only 347.0 mm3 volume, including mechanics and actuator. A micropositioning mechanism is described which utilises a single micromotor to radially position and then deploy a needle 1.5 mm outside the microrobot’s body to deliver a 1 mL dose of medication to a targeted site. An analysis of the mechanics required to drive the holding mechanism is presented and an overview of microactuators and the state of the art in WCE is discussed. It is envisaged that this novel functionality will empower the next generation of WCE to help diagnose and treat pathologies of the GI tract.

  13. Imaging efficacy of a targeted imaging agent for fluorescence endoscopy

    Science.gov (United States)

    Healey, A. J.; Bendiksen, R.; Attramadal, T.; Bjerke, R.; Waagene, S.; Hvoslef, A. M.; Johannesen, E.

    2008-02-01

    Colorectal cancer is a major cause of cancer death. A significant unmet clinical need exists in the area of screening for earlier and more accurate diagnosis and treatment. We have identified a fluorescence imaging agent targeted to an early stage molecular marker for colorectal cancer. The agent is administered intravenously and imaged in a far red imaging channel as an adjunct to white light endoscopy. There is experimental evidence of preclinical proof of mechanism for the agent. In order to assess potential clinical efficacy, imaging was performed with a prototype fluorescence endoscope system designed to produce clinically relevant images. A clinical laparoscope system was modified for fluorescence imaging. The system was optimised for sensitivity. Images were recorded at settings matching those expected with a clinical endoscope implementation (at video frame rate operation). The animal model was comprised of a HCT-15 xenograft tumour expressing the target at concentration levels expected in early stage colorectal cancer. Tumours were grown subcutaneously. The imaging agent was administered intravenously at a dose of 50nmol/kg body weight. The animals were killed 2 hours post administration and prepared for imaging. A 3-4mm diameter, 1.6mm thick slice of viable tumour was placed over the opened colon and imaged with the laparoscope system. A receiver operator characteristic analysis was applied to imaging results. An area under the curve of 0.98 and a sensitivity of 87% [73, 96] and specificity of 100% [93, 100] were obtained.

  14. Hookworm Detection in Wireless Capsule Endoscopy Images With Deep Learning.

    Science.gov (United States)

    He, Jun-Yan; Wu, Xiao; Jiang, Yu-Gang; Peng, Qiang; Jain, Ramesh

    2018-05-01

    As one of the most common human helminths, hookworm is a leading cause of maternal and child morbidity, which seriously threatens human health. Recently, wireless capsule endoscopy (WCE) has been applied to automatic hookworm detection. Unfortunately, it remains a challenging task. In recent years, deep convolutional neural network (CNN) has demonstrated impressive performance in various image and video analysis tasks. In this paper, a novel deep hookworm detection framework is proposed for WCE images, which simultaneously models visual appearances and tubular patterns of hookworms. This is the first deep learning framework specifically designed for hookworm detection in WCE images. Two CNN networks, namely edge extraction network and hookworm classification network, are seamlessly integrated in the proposed framework, which avoid the edge feature caching and speed up the classification. Two edge pooling layers are introduced to integrate the tubular regions induced from edge extraction network and the feature maps from hookworm classification network, leading to enhanced feature maps emphasizing the tubular regions. Experiments have been conducted on one of the largest WCE datasets with WCE images, which demonstrate the effectiveness of the proposed hookworm detection framework. It significantly outperforms the state-of-the-art approaches. The high sensitivity and accuracy of the proposed method in detecting hookworms shows its potential for clinical application.

  15. Saliency based ulcer detection for wireless capsule endoscopy diagnosis.

    Science.gov (United States)

    Yuan, Yixuan; Wang, Jiaole; Li, Baopu; Meng, Max Q-H

    2015-10-01

    Ulcer is one of the most common symptoms of many serious diseases in the human digestive tract. Especially for the ulcers in the small bowel where other procedures cannot adequately visualize, wireless capsule endoscopy (WCE) is increasingly being used in the diagnosis and clinical management. Because WCE generates large amount of images from the whole process of inspection, computer-aided detection of ulcer is considered an indispensable relief to clinicians. In this paper, a two-staged fully automated computer-aided detection system is proposed to detect ulcer from WCE images. In the first stage, we propose an effective saliency detection method based on multi-level superpixel representation to outline the ulcer candidates. To find the perceptually and semantically meaningful salient regions, we first segment the image into multi-level superpixel segmentations. Each level corresponds to different initial region sizes of the superpixels. Then we evaluate the corresponding saliency according to the color and texture features in superpixel region of each level. In the end, we fuse the saliency maps from all levels together to obtain the final saliency map. In the second stage, we apply the obtained saliency map to better encode the image features for the ulcer image recognition tasks. Because the ulcer mainly corresponds to the saliency region, we propose a saliency max-pooling method integrated with the Locality-constrained Linear Coding (LLC) method to characterize the images. Experiment results achieve promising 92.65% accuracy and 94.12% sensitivity, validating the effectiveness of the proposed method. Moreover, the comparison results show that our detection system outperforms the state-of-the-art methods on the ulcer classification task.

  16. Deep learning for polyp recognition in wireless capsule endoscopy images.

    Science.gov (United States)

    Yuan, Yixuan; Meng, Max Q-H

    2017-04-01

    Wireless capsule endoscopy (WCE) enables physicians to examine the digestive tract without any surgical operations, at the cost of a large volume of images to be analyzed. In the computer-aided diagnosis of WCE images, the main challenge arises from the difficulty of robust characterization of images. This study aims to provide discriminative description of WCE images and assist physicians to recognize polyp images automatically. We propose a novel deep feature learning method, named stacked sparse autoencoder with image manifold constraint (SSAEIM), to recognize polyps in the WCE images. Our SSAEIM differs from the traditional sparse autoencoder (SAE) by introducing an image manifold constraint, which is constructed by a nearest neighbor graph and represents intrinsic structures of images. The image manifold constraint enforces that images within the same category share similar learned features and images in different categories should be kept far away. Thus, the learned features preserve large intervariances and small intravariances among images. The average overall recognition accuracy (ORA) of our method for WCE images is 98.00%. The accuracies for polyps, bubbles, turbid images, and clear images are 98.00%, 99.50%, 99.00%, and 95.50%, respectively. Moreover, the comparison results show that our SSAEIM outperforms existing polyp recognition methods with relative higher ORA. The comprehensive results have demonstrated that the proposed SSAEIM can provide descriptive characterization for WCE images and recognize polyps in a WCE video accurately. This method could be further utilized in the clinical trials to help physicians from the tedious image reading work. © 2017 American Association of Physicists in Medicine.

  17. The feasibility of endoscopy-CT image registration in the head and neck without prospective endoscope tracking.

    Directory of Open Access Journals (Sweden)

    W Scott Ingram

    Full Text Available Endoscopic examinations are frequently-used procedures for patients with head and neck cancer undergoing radiotherapy, but radiation treatment plans are created on computed tomography (CT scans. Image registration between endoscopic video and CT could be used to improve treatment planning and analysis of radiation-related normal tissue toxicity. The purpose of this study was to explore the feasibility of endoscopy-CT image registration without prospective physical tracking of the endoscope during the examination.A novel registration technique called Location Search was developed. This technique uses physical constraints on the endoscope's view direction to search for the virtual endoscope coordinates that maximize the similarity between the endoscopic video frame and the virtual endoscopic image. Its performance was tested on phantom and patient images and compared to an established registration technique, Frame-To-Frame Tracking.In phantoms, Location Search had average registration errors of 0.55 ± 0.60 cm for point measurements and 0.29 ± 0.15 cm for object surface measurements. Frame-To-Frame Tracking achieved similar results on some frames, but it failed on others due to the virtual endoscope becoming lost. This weakness was more pronounced in patients, where Frame-To-Frame tracking could not make it through the nasal cavity. On successful patient video frames, Location Search was able to find endoscope positions with an average distance of 0.98 ± 0.53 cm away from the ground truth positions. However, it failed on many frames due to false similarity matches caused by anatomical structural differences between the endoscopic video and the virtual endoscopic images.Endoscopy-CT image registration without prospective physical tracking of the endoscope is possible, but more development is required to achieve an accuracy suitable for clinical translation.

  18. Minimizing occupational hazards in endoscopy: personal protective equipment, radiation safety, and ergonomics.

    Science.gov (United States)

    Pedrosa, Marcos C; Farraye, Francis A; Shergill, Amandeep K; Banerjee, Subhas; Desilets, David; Diehl, David L; Kaul, Vivek; Kwon, Richard S; Mamula, Petar; Rodriguez, Sarah A; Varadarajulu, Shyam; Song, Louis-Michel Wong Kee; Tierney, William M

    2010-08-01

    The ASGE Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, by using a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but in many cases, data from randomized, controlled trials are lacking. In such cases, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. Technology Status Evaluation Reports are drafted by 1 or 2 members of the ASGE Technology Committee, reviewed and edited by the committee as a whole, and approved by the Governing Board of the ASGE. When financial guidance is indicated, the most recent coding data and list prices at the time of publication are provided. For this review, the MEDLINE database was searched through August 2009 for articles related to personal protection equipment by using the key words "personal protection equipment" (exp Protective Clothing/ or exp Protective Devices/ or exp Masks/ or exp Occupational Exposure/'') "infection control" paired with "Endoscopy." For the radiation section, the following key words were used: "radiation and endoscopy," "radiation and ERCP," and "radiation safety." For the ergonomics section, the following key words were used: "ergonomics of endoscopy," "endoscopist injury," "medical ergonomics," "endoscopy and musculoskeletal strain," "musculoskeletal injury and endoscopists," "occupational diseases and endoscopy

  19. Bleeding detection in wireless capsule endoscopy using adaptive colour histogram model and support vector classification

    Science.gov (United States)

    Mackiewicz, Michal W.; Fisher, Mark; Jamieson, Crawford

    2008-03-01

    Wireless Capsule Endoscopy (WCE) is a colour imaging technology that enables detailed examination of the interior of the gastrointestinal tract. A typical WCE examination takes ~ 8 hours and captures ~ 40,000 useful images. After the examination, the images are viewed as a video sequence, which generally takes a clinician over an hour to analyse. The manufacturers of the WCE provide certain automatic image analysis functions e.g. Given Imaging offers in their Rapid Reader software: The Suspected Blood Indicator (SBI), which is designed to report the location in the video of areas of active bleeding. However, this tool has been reported to have insufficient specificity and sensitivity. Therefore it does not free the specialist from reviewing the entire footage and was suggested only to be used as a fast screening tool. In this paper we propose a method of bleeding detection that uses in its first stage Hue-Saturation-Intensity colour histograms to track a moving background and bleeding colour distributions over time. Such an approach addresses the problem caused by drastic changes in blood colour distribution that occur when it is altered by gastrointestinal fluids and allow detection of other red lesions, which although are usually "less red" than fresh bleeding, they can still be detected when the difference between their colour distributions and the background is large enough. In the second stage of our method, we analyse all candidate blood frames, by extracting colour (HSI) and texture (LBP) features from the suspicious image regions (obtained in the first stage) and their neighbourhoods and classifying them using Support Vector Classifier into Bleeding, Lesion and Normal classes. We show that our algorithm compares favourably with the SBI on the test set of 84 full length videos.

  20. Computer-aided detection of early cancer in the esophagus using HD endoscopy images

    Science.gov (United States)

    van der Sommen, Fons; Zinger, Svitlana; Schoon, Erik J.; de With, Peter H. N.

    2013-02-01

    Esophageal cancer is the fastest rising type of cancer in the Western world. The recent development of High-Definition (HD) endoscopy has enabled the specialist physician to identify cancer at an early stage. Nevertheless, it still requires considerable effort and training to be able to recognize these irregularities associated with early cancer. As a first step towards a Computer-Aided Detection (CAD) system that supports the physician in finding these early stages of cancer, we propose an algorithm that is able to identify irregularities in the esophagus automatically, based on HD endoscopic images. The concept employs tile-based processing, so our system is not only able to identify that an endoscopic image contains early cancer, but it can also locate it. The identification is based on the following steps: (1) preprocessing, (2) feature extraction with dimensionality reduction, (3) classification. We evaluate the detection performance in RGB, HSI and YCbCr color space using the Color Histogram (CH) and Gabor features and we compare with other well-known features to describe texture. For classification, we employ a Support Vector Machine (SVM) and evaluate its performance using different parameters and kernel functions. In experiments, our system achieves a classification accuracy of 95.9% on 50×50 pixel tiles of tumorous and normal tissue and reaches an Area Under the Curve (AUC) of 0.990. In 22 clinical examples our algorithm was able to identify all (pre-)cancerous regions and annotate those regions reasonably well. The experimental and clinical validation are considered promising for a CAD system that supports the physician in finding early stage cancer.

  1. Contact endoscopy of the nose in patients with Rendu-Osler-Weber syndrome.

    Science.gov (United States)

    Folz, B J; Werner, J A

    2007-03-01

    Teleangiectases are the source of hemorrhage in many HHT patients. Most frequent site of bleeding is the nose and more than 90% of all individuals with HHT suffer from recurrent epistaxis. Despite all efforts, treatment of epistaxis in HHT continues to be a problem for many otorhinolaryngologists, who can alleviate recurrent nosebleeds by Septodermoplasty or laser therapy, but rarely can stop nasal hemorrhages permanently. Recurrence is almost inevitable, but the mechanisms of recurrence are not fully understood. Prior to routine Nd:YAG laser therapy of nasal telangiectases the nasal mucosa of 17 patients with HHT according to the clinical diagnostic criteria of the HHT Foundation International was examined with a 0 degrees contact rhinoscope in areas with clinically visible telangiectases as well as in clinically normal mucosa. The digitally recorded images were compared to findings of a group of five healthy volunteers and the findings of five patients with polypoid sinusitis. Visualization of subepithelial vessels was feasible in all individuals of the study group as well as the control groups. Dilated vascular loops and tortuous vessels could be found in the study groups as well as in the control group, but the overall density of telangiectatic vessels was on an average higher in the HHT group. The process of vessel dilatation and tortuous configuration seemed to progress with age. Contact endoscopy allows the investigation of the angioarchitecture of capillaries of the nasal mucosa in vivo. This observation may be of significance for studies of nasal diseases, which are accompanied by epistaxis. With this regard it seems to be of special interest for studies of HHT.

  2. Bleeding Frame and Region Detection in the Wireless Capsule Endoscopy Video.

    Science.gov (United States)

    Yuan, Yixuan; Li, Baopu; Meng, Max Q-H

    2016-03-01

    Wireless capsule endoscopy (WCE) enables noninvasive and painless direct visual inspection of a patient's whole digestive tract, but at the price of long time reviewing large amount of images by clinicians. Thus, an automatic computer-aided technique to reduce the burden of physicians is highly demanded. In this paper, we propose a novel color feature extraction method to discriminate the bleeding frames from the normal ones, with further localization of the bleeding regions. Our proposal is based on a twofold system. First, we make full use of the color information of WCE images and utilize K-means clustering method on the pixel represented images to obtain the cluster centers, with which we characterize WCE images as words-based color histograms. Then, we judge the status of a WCE frame by applying the support vector machine (SVM) and K-nearest neighbor methods. Comprehensive experimental results reveal that the best classification performance is obtained with YCbCr color space, cluster number 80 and the SVM. The achieved classification performance reaches 95.75% in accuracy, 0.9771 for AUC, validating that the proposed scheme provides an exciting performance for bleeding classification. Second, we propose a two-stage saliency map extraction method to highlight bleeding regions, where the first-stage saliency map is created by means of different color channels mixer and the second-stage saliency map is obtained from the visual contrast. Followed by an appropriate fusion strategy and threshold, we localize the bleeding areas. Quantitative as well as qualitative results show that our methods could differentiate the bleeding areas from neighborhoods correctly.

  3. Automated Adaptive Brightness in Wireless Capsule Endoscopy Using Image Segmentation and Sigmoid Function.

    Science.gov (United States)

    Shrestha, Ravi; Mohammed, Shahed K; Hasan, Md Mehedi; Zhang, Xuechao; Wahid, Khan A

    2016-08-01

    Wireless capsule endoscopy (WCE) plays an important role in the diagnosis of gastrointestinal (GI) diseases by capturing images of human small intestine. Accurate diagnosis of endoscopic images depends heavily on the quality of captured images. Along with image and frame rate, brightness of the image is an important parameter that influences the image quality which leads to the design of an efficient illumination system. Such design involves the choice and placement of proper light source and its ability to illuminate GI surface with proper brightness. Light emitting diodes (LEDs) are normally used as sources where modulated pulses are used to control LED's brightness. In practice, instances like under- and over-illumination are very common in WCE, where the former provides dark images and the later provides bright images with high power consumption. In this paper, we propose a low-power and efficient illumination system that is based on an automated brightness algorithm. The scheme is adaptive in nature, i.e., the brightness level is controlled automatically in real-time while the images are being captured. The captured images are segmented into four equal regions and the brightness level of each region is calculated. Then an adaptive sigmoid function is used to find the optimized brightness level and accordingly a new value of duty cycle of the modulated pulse is generated to capture future images. The algorithm is fully implemented in a capsule prototype and tested with endoscopic images. Commercial capsules like Pillcam and Mirocam were also used in the experiment. The results show that the proposed algorithm works well in controlling the brightness level accordingly to the environmental condition, and as a result, good quality images are captured with an average of 40% brightness level that saves power consumption of the capsule.

  4. Evaluation of CT virtual intravascular endoscopy in fenestrated stent grafts: a preliminary study

    International Nuclear Information System (INIS)

    Sun, Z.; Allen, Y.; Fitzsimmons, B.; Hartely, D.; Lawrence-Brown, M.

    2007-01-01

    We aim in this study to investigate the potential value of CT virtual intravascular endoscopy in patients diagnosed with abdominal aortic aneurysms undergoing fenestrated stent grafts. Both pre-and post-fenestration (within 3 months of implantation) multislice CT data were collected in eight patients and used for generation of virtual endoscopy images in our preliminary study. Variable fenestrations were deployed in 25 aortic branches with scallop fenestration implanted in six aortic ostia, large fenestration in four aortic ostia and small fenestration in 15 renal ostia, respectively. Measurements of the aortic ostia diameters both pre- and post-fenestration were successfully performed with virtual intravascular endoscopy visualization, and endovascular stents as well as their relationship to the aortic ostia were clearly demonstrated. Our results showed that there was no significant change of diameter of the aortic ostia following fenestrated stem grafts. Endovascular stents were clearly visualized on virtual endoscopy images, and no apparent deformity or malrotation was observed in this small group. Our preliminary study provides new insights into anatomic configuration/dimension of aortic ostia and endovascular stents, and virtual intravascular endoscopy could be a valuable technique to follow-up patients treated with fenestrated stent grafts. (orig.)

  5. The effect of virtual endoscopy simulator training on novices: a systematic review.

    Science.gov (United States)

    Qiao, Weiguang; Bai, Yang; Lv, Ruxi; Zhang, Wendi; Chen, Yuqing; Lei, Shan; Zhi, Fachao

    2014-01-01

    Advances in virtual endoscopy simulators have paralleled an interest in medical simulation for gastrointestinal endoscopy training. The primary objective was to determine whether the virtual endoscopy simulator training could improve the performance of novices. A systematic review. Randomized controlled trials (RCTs) that compared virtual endoscopy simulator training with bedside teaching or any other intervention for novices were collected. Novice endoscopists. The PRISMA statement was followed during the course of the research. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and ScienceDirect were searched (up to July 2013). Data extraction and assessment were independently performed. Independent procedure completion, total procedure time and required assistance. Fifteen studies (n = 354) were eligible for inclusion: 9 studies designed for colonoscopy training, 6 for gastroscopy training. For gastroscopy training, procedure completed independently was reported in 87.7% of participants in simulator training group compared to 70.0% of participants in control group (1 study; 22 participants; RR 1.25; 95% CI 1.13-1.39; Ptraining, procedure completed independently was reported in 89.3% of participants in simulator training group compared to 88.9% of participants in control group (7 study; 163 participants; RR 1.10; 95% CI 0.88-1.37; P = 0.41; I(2) = 85%). The included studies are quite in-homogeneous with respect to training schedule and procedure. Virtual endoscopy simulator training might be effective for gastroscopy, but so far no data is available to support this for colonoscopy.

  6. Acute extensive ischemic enteritis in a young man diagnosed with wireless capsule endoscopy: a case report.

    Science.gov (United States)

    Jeong, Woo Seong; Song, Hyun Joo; Na, Soo Young; Boo, Sun Jin; Kim, Heung Up; Kim, Jinseok; Choi, Guk Myung

    2013-03-25

    Ischemic enteritis is caused by either the interruption or significant reduction of arterial inflow to the small intestine. Risk factors are old age, diabetes mellitus and cardiovascular disease. It is very rare in young patients. We experienced a 21-year-old man with recurrent acute ischemic enteritis who was diagnosed with capsule endoscopy. He had previously taken medications for pulmonary hypertension and obstruction of both carotid arteries, and about 20 months earlier, he had been admitted due to hematochezia. Two sessions of angiography did not reveal the cause of hematochezia. At that time, capsule endoscopy showed mucosal edema and erythema in the terminal ileum, suggesting healed ischemic enteritis. The patient was admitted again due to hematochezia. Abdominal computed tomography showed focal celiac trunk stenosis and diffuse wall thickening of the small intestine, suggesting ischemic enteritis. Capsule endoscopy showed multiple active ulcers and severe hemorrhage with exudate, extending from the proximal jejunum to the terminal ileum. Using capsule endoscopy, the patient was diagnosed with acute extensive ischemic enteritis. Because endoscopic images of ischemic enteritis have rarely been reported, we report a case of a 21-year-old man who was diagnosed acute extensive ischemic enteritis with capsule endoscopy.

  7. Spiral CT biliary virtual endoscopy: preliminary clinical applications in the detection of biliary calculus

    International Nuclear Information System (INIS)

    Xiong Minghui; Wang Dong; Song Yunlong; Zhang Wanshi; Xu Jiaxing

    2000-01-01

    Objective: To evaluate imaging features and clinical value of CT biliary virtual endoscopy in the detection of biliary calculus. Methods: Eighteen patients with biliary calculi underwent volume scanning using spiral CT (Hispeed Advantage CT/i GE ). All data were transferred to computer workstation, and CT biliary virtual endoscopy images with pseudocolor encoding were generated from the volumetric data using the Navigator Smooth soft-ware. All cases were proved by ultrasound, axial CT or operation. Results: Among 18 cases, gallstones were found 8 in cases, common bile duct stones in 2 cases, gallstones and bile duct stones in 6 cases. The stones were 0.3-3.2 cm in size. CT biliary virtual endoscopy correctly demonstrated the surface details of stones which were viewed from extra- or intraluminal orientation in a 3D fashion. The findings were consistent with those of US, CT or operation. Conclusion: The CT virtual biliary endoscopy is a further development of virtual endoscopy for observing biliary calculus from intra- and extra-luminal views and providing three dimensional information of stone

  8. Extended endoscopic endonasal surgery using three-dimensional endoscopy in the intra-operative MRI suite for supra-diaphragmatic ectopic pituitary adenoma.

    Science.gov (United States)

    Fuminari, Komatsu; Hideki, Atsumi; Manabu, Osakabe; Mitsunori, Matsumae

    2015-01-01

    We describe a supra-diaphragmatic ectopic pituitary adenoma that was safely removed using the extended endoscopic endonasal approach, and discuss the value of three-dimensional (3D) endoscopy and intra-operative magnetic resonance imaging (MRI) to this type of procedure. A 61-year-old-man with bitemporal hemianopsia was referred to our hospital, where MRI revealed an enhanced suprasellar tumor compressing the optic chiasma. The tumor extended on the planum sphenoidale and partially encased the right internal carotid artery. An endocrinological assessment indicated normal pituitary function. The extended endoscopic endonasal approach was taken using a 3D endoscope in the intraoperative MRI suite. The tumor was located above the diaphragma sellae and separated from the normal pituitary gland. The pathological findings indicated non-functioning pituitary adenoma and thus the tumor was diagnosed as a supra-diaphragmatic ectopic pituitary adenoma. Intra-operative MRI provided useful information to minimize dural opening and the supra-diaphragmatic ectopic pituitary adenoma was removed from the complex neurovascular structure via the extended endoscopic endonasal approach under 3D endoscopic guidance in the intra-operative suite. Safe and effective removal of a supra-diaphragmatic ectopic pituitary adenoma was accomplished via the extended endoscopic endonasal approach with visual information provided by 3D endoscopy and intra-operative MRI.

  9. Upper Extremity Length Equalization

    OpenAIRE

    DeCoster, Thomas A.; Ritterbusch, John; Crawford, Mark

    1992-01-01

    Significant upper extremity length inequality is uncommon but can cause major functional problems. The ability to position and use the hand may be impaired by shortness of any of the long bones of the upper extremity. In many respects upper and lower extremity length problems are similar. They most commonly occur after injury to a growing bone and the treatment modalities utilized in the lower extremity may be applied to the upper extremity. These treatment options include epiphysiodesis, sho...

  10. Lower pH values of weakly acidic refluxes as determinants of heartburn perception in gastroesophageal reflux disease patients with normal esophageal acid exposure.

    Science.gov (United States)

    de Bortoli, N; Martinucci, I; Savarino, E; Franchi, R; Bertani, L; Russo, S; Ceccarelli, L; Costa, F; Bellini, M; Blandizzi, C; Savarino, V; Marchi, S

    2016-01-01

    Multichannel impedance pH monitoring has shown that weakly acidic refluxes are able to generate heartburn. However, data on the role of different pH values, ranging between 4 and 7, in the generation of them are lacking. The aim of this study was to evaluate whether different pH values of weakly acidic refluxes play a differential role in provoking reflux symptoms in endoscopy-negative patients with physiological esophageal acid exposure time and positive symptom index and symptom association probability for weakly acidic refluxes. One hundred and forty-three consecutive patients with gastroesophageal reflux disease, nonresponders to proton pump inhibitors (PPIs), were allowed a washout from PPIs before undergoing: upper endoscopy, esophageal manometry, and multichannel impedance pH monitoring. In patients with both symptom index and symptom association probability positive for weakly acidic reflux, each weakly acidic reflux was evaluated considering exact pH value, extension, physical characteristics, and correlation with heartburn. Forty-five patients with normal acid exposure time and positive symptom association probability for weakly acidic reflux were identified. The number of refluxes not heartburn related was higher than those heartburn related. In all distal and proximal liquid refluxes, as well as in distal mixed refluxes, the mean pH value of reflux events associated with heartburn was significantly lower than that not associated. This condition was not confirmed for proximal mixed refluxes. Overall, a low pH of weakly acidic reflux represents a determinant factor in provoking heartburn. This observation contributes to better understand the pathophysiology of symptoms generated by weakly acidic refluxes, paving the way toward the search for different therapeutic approaches to this peculiar condition of esophageal hypersensitivity. © 2014 International Society for Diseases of the Esophagus.

  11. Impact of Protocol-Based Guidelines on the Management and Outcome of Acute Upper Gastrointestinal Hemorrhage in a District General Hospital

    Directory of Open Access Journals (Sweden)

    RM Anwar

    2003-01-01

    Full Text Available A prospective audit of acute upper gastrointestinal (GI hemorrhage was conducted between January and September 2000 at Frimley Park Hospital to determine the impact of introducing an upper GI bleeding protocol based on Rockall’s initial risk scoring system. Fifty-seven patients and 52 patients were in the pre- and postprotocol phases of the study respectively. Fifty per cent (28 of the patients in the first phase and 40% (21 of the patients in the second phase belonged to the high risk group. In the preprotocol phase, endoscopy was performed in 86% (49 of cases with 60% of patients having an esophogastroduodenoscopy within 24 h. Thirty-three per cent of the high risk group failed to have an endoscopic examination within 24 h. Only two of 57 patients required surgery and the mortality was 14%. In the postprotocol phase, endoscopy was performed in 79% (42 of patients and 68% (36 patients had endoscopy within 24 h. Only four of 21 patients belonging to the high risk group had their endoscopy after 24 h of the admission. Patients were better monitored and mortality was reduced to 7.5%. Reduction of mortality from upper GI hemorrhage followed the introduction of an agreed protocol based on risk scoring.

  12. Upper Gastrointestinal (GI) Series

    Science.gov (United States)

    ... standard barium upper GI series, which uses only barium a double-contrast upper GI series, which uses both air and ... evenly coat your upper GI tract with the barium. If you are having a double-contrast study, you will swallow gas-forming crystals that ...

  13. Comparative study of the endoscope-based bevelled and volume fiber-optic Raman probes for optical diagnosis of gastric dysplasia in vivo at endoscopy.

    Science.gov (United States)

    Wang, Jianfeng; Lin, Kan; Zheng, Wei; Ho, Khek Yu; Teh, Ming; Yeoh, Khay Guan; Huang, Zhiwei

    2015-11-01

    This study aims to compare the diagnostic performance of the two different endoscope-based fiber-optic Raman probe designs (i.e., bevelled and volume Raman probes) for real-time, in vivo detection of gastric dysplasia at endoscopy. To conduct the clinical comparison, a total of 1,050 in vivo tissue Raman spectra (normal: n = 864; dysplasia: n = 186) were acquired from 66 gastric patients (normal: n = 48; dysplasia: n = 18) by using bevelled Raman probe, while a total of 1,913 in vivo tissue Raman spectra (normal: n = 1,786; dysplasia: n = 127) were acquired from 98 gastric patients (normal: n = 87; dysplasia: n = 11) by using volume Raman probe. The bevelled Raman probe provides approximately twofold improvements in tissue Raman-to-autofluorescence intensity ratios as compared to the use of volume Raman probe. Partial least squares discriminant analysis together with leave-one patient-out cross-validation on in vivo tissue Raman spectra acquired yields a diagnostic accuracy of 93.0 % (sensitivity of 92.5 %; specificity of 93.1 %) for differentiating gastric dysplasia from normal gastric tissue by using the bevelled fiber-optic Raman probe, which is superior to the diagnostic performance (accuracy of 88.4 %; sensitivity of 85.8 %; specificity of 88.6 %) by using the volume Raman probe. This work demonstrates that the Raman spectroscopic technique coupled with bevelled fiber-optic Raman probe has great potential to enhance in vivo diagnosis of gastric precancer and early cancer at endoscopy. Graphical Abstract Comparison of in vivo gastric tissue Raman spectra acquired by using bevelled and volume fiber-optic Raman probes.

  14. [Vascular lesions of the upper gastrointestinal tract in the national hospital Daniel A. Carrion (2007-2008)].

    Science.gov (United States)

    Guzman, Edson; Espinoza, Miguel; Monge, Eduardo

    2008-01-01

    To display the experience of vascular lesions in the upper digestive tract in 2007-2008 at Daniel Alcides Carrión Hospital. Transverse study. All endoscopies performed in the indicated period were reviewed. Vascular lesions found were record. The OMED classification for vascular lesions was used in this research. 1.979 examinations were reviewed. 26 vascular injuries were found (prevalence = 13.13/1000 endoscopies). The most frequent location was in stomach (65.4%). The most common type of injury was vascular angiectasia(57.7%). Vascular lesions in the upper digestive tract were rare; these lesions were more common in the stomach. Vascular angiectasias were the most frequently reported.

  15. Radioimmuno-guided endoscopy (RIGE) in the detection of primary and recurrent rectal tumor.

    Science.gov (United States)

    Prati, U; Roveda, L; Butera, R; Nazari, S; Trespi, E; Aprile, C; Zonta, A

    1992-09-01

    The usefulness of radioimmunoguided endoscopy in the detection of primary and recurrent rectal cancer was investigated. Of the 15 patients included in our study, 4 with suspected primary rectal cancer were examined preoperatively, while the remaining 11 were studied after radical resection of rectal carcinoma with the aim of detecting local recurrence. Radioimmunoguided endoscopy was performed employing a hand-held gamma-detecting probe (mod. 2 Oris, France), after the administration of a 111In labeled monoclonal antibody to CEA. Radioimmuno-guided endoscopy results detected the presence of primary or recurrent periluminal cancer in seven cases. In four it modified the preoperative stage based on the findings of conventional investigation and it influenced the surgical decision in five cases. No toxicity was noted and none of the patients developed HAMAs.

  16. The role of capnography in endoscopy patients undergoing nurse-administered propofol sedation

    DEFF Research Database (Denmark)

    Slagelse, Charlotte; Vilmann, Peter; Hornslet, Pernille

    2013-01-01

    . The existing literature on capnography for endoscopy patients sedated with nurse-administered propofol sedation (NAPS) is limited. Can the addition of capnography to standard monitoring during endoscopy with NAPS reduce the number, duration, and level of hypoxia. Materials and methods. This study...... was a randomized controlled trial with an intervention group (capnography) and a control group (without capnography). Eligible subjects were consecutive patients for endoscopy at Gentofte Hospital compliant with the criteria of NAPS. Results. Five hundred and forty patients, 263 with capnography and 277 without......-value 0.05). Capnography is able to detect insufficient respiration that may lead to hypoxia prior to changes in pulse oximetry. However, due to a limited clinical benefit and additional costs associated with capnography, we do not find capnography necessary during the use of NAPS....

  17. Indications for and diagnostic yield of capsule endoscopy in the elderly.

    Science.gov (United States)

    Pérez-Cuadrado-Robles, E; Zamora-Nava, L E; Jiménez-García, V A; Pérez-Cuadrado-Martínez, E

    2018-02-15

    The growing elderly population and wide use of capsule endoscopy have led to a higher number of procedures in those patients. The aim of the present study was to assess the usefulness of capsule endoscopy in older patients. All consecutive patients undergoing capsule endoscopy at our center within the time frame of 2004-2016 were classified as older (≥75 years of age) and younger. Findings and diagnostic yield were comparatively assessed. Of 2311 patients (mean age: 59.5 ± 19.23 years, 44.48% male), 648 were in the older group and 1663 in the younger group. Gastric transit time was shorter in the older patients (p=0.001), whereas small bowel transit time was shorter in the younger patients (p<0.001). Overall diagnostic yield in the elderly was higher (50.66% vs. 41.19%, p<0.001). Obscure gastrointestinal bleeding was the most frequent indication for capsule endoscopy in the elderly (90.4% vs. 53.77%, p<0.001), achieving a higher diagnostic yield than in the younger population (51.47% vs. 42.76%, p=0.002), whereas Crohn's disease, suspected or known neoplasms/polyps, malabsorption syndrome, and abdominal pain were the indications in the younger patient group. Such indications were rare in the older group. Vascular lesions and active bleeding were more frequently diagnosed in the older patients, whereas ulcers/erosions and mucosal atrophy were more common in the younger patients (p<0.001). Capsule endoscopy achieved a higher overall diagnostic yield in the elderly patients. Obscure gastrointestinal bleeding indication for capsule endoscopy was much more frequent in the advanced-age group and had a higher diagnostic yield. Copyright © 2018 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  18. Suspected blood indicator in capsule endoscopy: a valuable tool for gastrointestinal bleeding diagnosis

    Directory of Open Access Journals (Sweden)

    Pedro BOAL CARVALHO

    Full Text Available ABSTRACT BACKGROUND Small bowel bleeding is a leading indication for small bowel capsule endoscopy. The Suspected Blood Indicator (SBI is a software feature directed to automatically detect bleeding lesions during small bowel capsule endoscopy. OBJECTIVE We aimed to assess SBI diagnostic accuracy for small bowel haemorrhage or potentially bleeding lesions during small bowel capsule endoscopy for small bowel bleeding. Methods - Single-centre retrospective study including 281 consecutive small bowel capsule endoscopy performed for small bowel bleeding during 6 years. The investigators marked lesions with high bleeding potential (P2, such as angioectasias, ulcers and tumours, as well as active bleeding during regular small bowel capsule endoscopy viewing with PillCam SB2(r. All small bowel capsule endoscopy were independently reviewed by another central reader using SBI. RESULTS Among the 281 patients, 29 (10.3% presented with active haemorrhage while 81 (28.9% presented with a P2 lesion. The most frequently observed P2 lesions were angioectasias (52, ulcers (15, polyps (7 and ulcerated neoplasias (7. SBI showed a 96.6% (28/29 sensitivity for active small bowel bleeding, with a 97.7% negative predictive value. Regarding P2 lesions, the SBI displayed an overall sensitivity of 39.5%, being highest for ulcerated neoplasias (100%, but significantly lower for angioectasias (38.5% or ulcers (20.0%. CONCLUSION Although SBI sensitivity for the automatic detection of potentially bleeding lesions was low, it effectively detected active small bowel bleeding with very high sensitivity and negative predictive value.

  19. Utility of capsule endoscopy for evaluating anthelmintic efficacy in fully conscious dogs.

    Science.gov (United States)

    Lee, Alice C Y; Epe, Christian; Simpson, Kenneth W; Bowman, Dwight D

    2011-11-01

    The current accepted standard for evaluating the efficacy of gastrointestinal anthelmintic drugs is necropsy of infected animals followed by a comparison of worm counts between treated and non-treated groups. In this study capsule endoscopy, a minimally invasive method of imaging the small intestine of humans, is evaluated as a possible alternative to necropsy for the purposes of worm quantification in dogs. Eighteen Beagle dogs were included in this study. These dogs were part of a separate trial intended to determine the efficacy of various candidate parasiticides against Ancylostoma caninum via the necropsy standard. Dogs were inoculated with A. caninum L3s 4 weeks prior to treatment with one of the candidate compounds; a control group (n=8) received no treatment. Capsule endoscopy was performed 6-14 days post-treatment, followed by necropsy the following day. Seventeen dogs had complete examinations, i.e. the capsule traversed the small intestine and reached the colon within the battery life of the capsule. A strong correlation (r(s)=0.87, Pcapsule endoscopy and necropsy. There was no clear relationship between the ability of the capsule endoscope to detect hookworms and either visibility of the intestinal lumen or small intestinal transit time. Generation of a virtual spatial record of hookworm location from the capsule endoscopy data revealed a temporal trend, with the majority of worms present in the proximal small intestine in the morning versus the central to distal small intestine in the afternoon. Worm distribution as determined by capsule endoscopy closely resembled post-mortem findings. In conclusion, capsule endoscopy shows promise as an alternative to necropsy for the enumeration of A. caninum in the canine small intestine, although further work is required to improve completion rates and optimise intestinal examination. Copyright © 2011 Australian Society for Parasitology Inc. Published by Elsevier Ltd. All rights reserved.

  20. Prospective blinded comparison of wireless capsule endoscopy and multiphase CT enterography in obscure gastrointestinal bleeding.

    Science.gov (United States)

    Huprich, James E; Fletcher, Joel G; Fidler, Jeff L; Alexander, Jeffrey A; Guimarães, Luís S; Siddiki, Hassan A; McCollough, Cynthia H

    2011-09-01

    To compare the performance of multiphase computed tomographic (CT) enterography with that of capsule endoscopy in a group of patients with obscure gastrointestinal bleeding (OGIB). This prospective HIPAA-compliant study was approved by the institutional review board and the institutional conflict of interest committee. All patients provided written informed consent. Two radiologists, blinded to clinical data and results of capsule endoscopy, interpreted images from CT enterography independently, with discordant interpretations resolved by consensus. Results were compared with those from a reference standard (surgery or endoscopy) and clinical follow-up. Sensitivity and 95% confidence intervals were calculated for each modality. Fifty-eight adult patients, referred for the evaluation of OGIB (occult, 25 patients [43%]; overt, 33 patients [57%]), underwent both tests. A small bowel bleeding source was identified in 16 of the 58 patients (28%). The sensitivity of CT enterography was significantly greater than that of capsule endoscopy (88% [14 of 16 patients] vs 38% [six of 16 patients], respectively; P = .008), largely because it depicted more small bowel masses (100% [nine of nine patients] vs 33% [three of nine patients], respectively; P = .03). No additional small bowel tumors were discovered during the follow-up period (range, 5.6-45.9 months; mean, 16.6 months). In this referral population, the sensitivity of CT enterography for detecting small bowel bleeding sources and small bowel masses was significantly greater than that of capsule endoscopy. On the basis of these findings, the addition of multiphase CT enterography to the routine diagnostic work-up of patients with OGIB should be considered, particularly in patients with negative findings at capsule endoscopy.

  1. High definition versus standard definition white light endoscopy for detecting dysplasia in patients with Barrett's esophagus.

    Science.gov (United States)

    Sami, S S; Subramanian, V; Butt, W M; Bejkar, G; Coleman, J; Mannath, J; Ragunath, K

    2015-01-01

    High-definition endoscopy systems provide superior image resolution. The aim of this study was to assess the utility of high definition compared with standard definition endoscopy system for detecting dysplastic lesions in patients with Barrett's esophagus. A retrospective cohort study of patients with non-dysplastic Barrett's esophagus undergoing routine surveillance was performed. Data were retrieved from the central hospital electronic database. Procedures performed for non-surveillance indications, Barrett's esophagus Prague C0M1 classification with no specialized intestinal metaplasia on histology, patients diagnosed with any dysplasia or cancer on index endoscopy, and procedures using advanced imaging techniques were excluded. Logistic regression models were constructed to estimate adjusted odds ratios and 95% confidence intervals comparing outcomes with standard definition and high-definition systems. The high definition was superior to standard definition system in targeted detection of all dysplastic lesions (odds ratio 3.27, 95% confidence interval 1.27-8.40) as well as overall dysplasia detected on both random and target biopsies (odds ratio 2.36, 95% confidence interval 1.50-3.72). More non-dysplastic lesions were detected with the high-definition system (odds ratio 1.16, 95% confidence interval 1.01-1.33). There was no difference between high definition and standard definition endoscopy in the overall (random and target) high-grade dysplasia or cancers detected (odds ratio 0.93, 95% confidence interval 0.83-1.04). Trainee endoscopists, number of biopsies taken, and male sex were all significantly associated with a higher yield for dysplastic lesions. The use of the high-definition endoscopy system is associated with better targeted detection of any dysplasia during routine Barrett's esophagus surveillance. However, high-definition endoscopy cannot replace random biopsies at present time. © 2014 International Society for Diseases of the Esophagus.

  2. [Value of endoscopy application in the management of complications after radical gastrectomy for gastric cancer].

    Science.gov (United States)

    Zhang, Yiqun; Zhou, Pinghong

    2017-02-25

    Endoscopy plays an important role in the diagnosis and treatment of postoperative complications of gastric cancer. Endoscopic intervention can avoid the second operation and has attracted wide attention. Early gastric anastomotic bleeding after gastrectomy is the most common. With the development of technology, emergency endoscopy and endoscopic hemostasis provide a new treatment approach. According to the specific circumstances, endoscopists can choose metal clamp to stop bleeding, electrocoagulation hemostasis, local injection of epinephrine or sclerotherapy agents, and spraying specific hemostatic agents. Anastomotic fistula is a serious postoperative complication. In addition to endoscopically placing the small intestine nutrition tube for early enteral nutrition support treatment, endoscopic treatment, including stent, metal clip, OTSC, and Over-stitch suture system, can be chosen to close fistula. For anastomotic obstruction or stricture, endoscopic balloon or probe expansion and stent placement can be chosen. For esophageal anastomotic intractable obstruction after gastroesophageal surgery, radial incision of obstruction by the hook knife or IT knife, a new method named ERI, is a good choice. Bile leakage caused by bile duct injury can be treated by placing the stent or nasal bile duct. In addition, endoscopic methods are widely used as follows: abdominal abscess can be treated by the direct intervention under endoscopy; adhesive ileus can be treated by placing the catheter under the guidance of endoscopy to attract pressure; alkaline reflux gastritis can be rapidly diagnosed by endoscopy; gastric outlet obstruction mainly caused by cancer recurrence can be relieved by metal stent placement and the combination of endoscopy and X-ray can increase success rate; pyloric dysfunction and spasm caused by the vagus nerve injury during proximal gastrectomy can be treated by endoscopic pyloromyotomy, a new method named G-POEM, and the short-term outcomes are

  3. Massive upper gastrointestinal haemorrhage due to direct visceral erosion of splenic artery aneurysm.

    Directory of Open Access Journals (Sweden)

    Shahani R

    1994-10-01

    Full Text Available Six male patients (age group: 30-60 years with aneurysm of the splenic artery presented with massive upper gastrointestinal tract hemorrhage. Five patients presented with hematemesis and one with melena. Chronic pancreatitis was noted in all the patients, four of whom were chronic alcoholics. Endoscopy was not useful in diagnosis. Bleeding through the Ampulla of Vater was seen in the patient with melena. Angiography was diagnostic in all. Pancreatic resection including the aneurysm(2, and bipolar ligation with underrunning of the aneurysm (3 were the operative procedures. Distal pancreatectomy with pancreatogastrostomy was carried out in the patient with hemosuccus pancreaticus. If endoscopy is inconclusive, angiography and early intervention is recommended to reduce the high mortality associated with conservative management.

  4. Organization and logistics of drug-induced sleep endoscopy in a training hospital.

    Science.gov (United States)

    Benoist, L B L; de Vries, N

    2015-09-01

    Drug-induced sleep endoscopy (DISE) is a rapidly growing method to evaluate airway collapse in patients receiving non-CPAP therapies for sleep-disordered breathing (SDB). The growing number of DISEs has consequences for the organization of clinical protocols. In this paper we present our recent experiences with DISE, performed by an ENT resident, with sedation given by a nurse anesthetist, in an outpatient endoscopy setting, while the staff member/sleep surgeon discusses the findings and the recommended treatment proposal on the same day.

  5. [Endoscopy training by using ex vivo and simulators: a new teaching tool].

    Science.gov (United States)

    Artifon, Everson L A; Tchekmedyian, Asadur J; Fernandes, Kaie; Artifon, Aline N; Fonseca, Alvaro; Otoch, Jose P

    2014-01-01

    In recent decades, the traditional teaching model of gastrointestinal endoscopy has been based on the teacher-student tutorial method based on theoretical models. Today, simulators have the advantages of virtual reality. The handling apparatus is similar to that used in clinical practice; it is safe, which allows unlimited use, cost-effective for institutions and with superior performance over other training models. Besides, biological simulators are a viable, accessible and affordable tool to simulate gastrointestinal lesions, allowing training in endoscopy with a high degree of similarity in the endoscopic appearance. In this review, we analyze both models, showing its advantages for the training of the endoscopist of the times.

  6. Registration of free-hand OCT daughter endoscopy to 3D organ reconstruction

    Science.gov (United States)

    Lurie, Kristen L.; Angst, Roland; Seibel, Eric J.; Liao, Joseph C.; Ellerbee Bowden, Audrey K.

    2016-01-01

    Despite the trend to pair white light endoscopy with secondary image modalities for in vivo characterization of suspicious lesions, challenges remain to co-register such data. We present an algorithm to co-register two different optical imaging modalities as a mother-daughter endoscopy pair. Using white light cystoscopy (mother) and optical coherence tomography (OCT) (daughter) as an example, we developed the first forward-viewing OCT endoscope that fits in the working channel of flexible cystoscopes and demonstrated our algorithm’s performance with optical phantom and clinical imaging data. The ability to register multimodal data opens opportunities for advanced analysis in cancer imaging applications. PMID:28018720

  7. [The design and implementation of video processing system for medical electronic endoscopy].

    Science.gov (United States)

    Ge, Jun-jie; Yan, Zhuang-zhi; Wang, Mu-yun

    2009-11-01

    This paper presents a medical electronic endoscopy real-time image acquisition and control system which consists of video codec chip, flash memory and FPGA. The hardware scheme and circuit design of the system is figured out, and the principle of ping-pong operation and the implementation of FPGA program is introduced. Experimental tests show that the designed system performs steadily, is easy to maintain, and reduces the cost greatly. The higher performance price ratio makes it have good application prospect in medical endoscopy.

  8. Comparative study of image registration techniques for bladder video-endoscopy

    Science.gov (United States)

    Ben Hamadou, Achraf; Soussen, Charles; Blondel, Walter; Daul, Christian; Wolf, Didier

    2009-07-01

    Bladder cancer is widely spread in the world. Many adequate diagnosis techniques exist. Video-endoscopy remains the standard clinical procedure for visual exploration of the bladder internal surface. However, video-endoscopy presents the limit that the imaged area for each image is about nearly 1 cm2. And, lesions are, typically, spread over several images. The aim of this contribution is to assess the performance of two mosaicing algorithms leading to the construction of panoramic maps (one unique image) of bladder walls. The quantitative comparison study is performed on a set of real endoscopic exam data and on simulated data relative to bladder phantom.

  9. Diagnostic Performance of Magnifying Endoscopy for Helicobacter pylori Infection: A Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Qingqing Qi

    Full Text Available Diagnosis of Helicobacter pylori (H. pylori infection using magnifying endoscopy offers advantages over conventional invasive and noninvasive tests.This meta-analysis aimed to assess the diagnostic performance of magnifying endoscopy in the prediction of H. pylori infection.A literature search of the PubMed, Medline, EMBASE, Science Direct and the Cochrane Library databases was performed. A random-effects model was used to calculate the diagnostic efficiency of magnifying endoscopy for H. pylori infection. A summary receiver operator characteristic curve was plotted, and the area under the curve (AUC was calculated.A total of 18 studies involving 1897 patients were included. The pooled sensitivity and specificity of magnifying endoscopy to predict H. pylori infection were 0.89 [95% confidence interval (CI 0.87-0.91] and 0.82 (95%CI 0.79-0.85, respectively, with an AUC of 0.9461. When targeting the gastric antrum, the pooled sensitivity and specificity were 0.82 (95%CI 0.78-0.86 and 0.72 (95%CI 0.66-0.78, respectively. When targeting the gastric corpus, the pooled sensitivity and specificity were 0.92 (95%CI 0.90-0.94 and 0.86 (95%CI 0.82-0.88, respectively. The pooled sensitivity and specificity using magnifying white light endoscopy were 0.90 (95%CI 0.87-0.91 and 0.81 (95%CI 0.77-0.84, respectively. The pooled sensitivity and specificity using magnifying chromoendoscopy were 0.87 (95%CI 0.83-0.91 and 0.85 (95%CI 0.80-0.88, respectively. The "pit plus vascular pattern" classification in the gastric corpus observed by magnifying endoscopy was able to accurately predict the status of H. pylori infection, as indicated by a pooled sensitivity and specificity of 0.96 (95%CI 0.94-0.97 and 0.91 (95%CI 0.87-0.93, respectively, with an AUC of 0.9872.Magnifying endoscopy was able to accurately predict the status of H. pylori infection, either in magnifying white light endoscopy or magnifying chromoendoscopy mode. The "pit plus vascular pattern

  10. [Clinical value of wireless capsule endoscopy in diagnosis of small bowel disease in children].

    Science.gov (United States)

    Ma, Ming; Zhang, Bing-ling; Chen, Chun-xiao; Li, Fu-bang; Huang, Xiao-lei; Wang, Pei-xin; Chen, Jie

    2009-10-01

    The pathological change of small bowel is difficult to examine because it is anatomically unique. The development of wireless capsule endoscopy provides an unique opportunity to visualize the entire small bowel in a minimally invasive manner. The aim of this study was to assess the safety and clinical value of wireless capsule endoscopy in children. During the last 4 years (June, 2004-June, 2008), 46 times of wireless capsule endoscopy were performed in 43 patients with suspected small bowel disease, including obscure gastrointestinal bleeding (n = 11), recurrent abdominal pain (n = 20), chronic diarrhea (n = 9), protein losing enteropathy (n = 2), recurrent vomiting (n = 1). Of the 43 cases, 28 were male and 15 were female, the age ranged from 6 to 18 years, 8 of these cases were capsule passing through the stomach and the small intestine, the tolerance to and complication of wireless capsule endoscopy in patients, the image quality of capsule endoscopy, and the cleanliness of small intestine after fasting for 8 hours were observed and recorded. All the patients could easily swallow the capsule and had good tolerance. The overall success rate was 94% (43/46). The median time of capsule passing through the stomach and small intestine was 73 min (range, 3 - 600 min) and 246 min (range, 73 - 413 min), respectively. The diagnostic yield of pathological change in small intestine was 90% (37/41), and the diagnostic accordance rate was 84% (31/37). Based on the wireless capsule endoscopy, diagnostic findings included Crohn's diseases (15), lymph follicular hyperplasia (4), nonspecific enteritis (4), vascular malformations (3), small bowel tumour (2), primary intestinal lymphangiectasia (2), gastrointestinal motility disorders (2), Meckel's diverticulum (1), angioma (1), small intestinal worm disease (1), duodenal ulcer (1), and polyposis syndromes (1). The capsule of 1 patient remained in the stomach. The cleanliness of small intestine after 8 hours fasting was good. And

  11. A Simple Evaluation Tool (ET-CET) Indicates Increase of Diagnostic Skills From Small Bowel Capsule Endoscopy Training Courses: A Prospective Observational European Multicenter Study.

    Science.gov (United States)

    Albert, J G; Humbla, O; McAlindon, M E; Davison, C; Seitz, U; Fraser, C; Hagenmüller, F; Noetzel, E; Spada, C; Riccioni, M E; Barnert, J; Filmann, N; Keuchel, M

    2015-10-01

    Small bowel capsule endoscopy (SBCE) has become a first line diagnostic tool. Several training courses with a similar format have been established in Europe; however, data on learning curve and training in SBCE remain sparse.Between 2008 and 2011, different basic SBCE training courses were organized internationally in UK (n = 2), Italy (n = 2), Germany (n = 2), Finland (n = 1), and nationally in Germany (n = 10), applying similar 8-hour curricula with 50% lectures and 50% hands-on training. The Given PillCam System was used in 12 courses, the Olympus EndoCapsule system in 5, respectively. A simple evaluation tool for capsule endoscopy training (ET-CET) was developed using 10 short SBCE videos including relevant lesions and normal or irrelevant findings. For each video, delegates were required to record a diagnosis (achievable total score from 0 to 10) and the clinical relevance (achievable total score 0 to 10). ET-CET was performed at baseline before the course and repeated, with videos in altered order, after the course.Two hundred ninety-four delegates (79.3% physicians, 16.3% nurses, 4.4% others) were included for baseline analysis, 268 completed the final evaluation. Forty percent had no previous experience in SBCE, 33% had performed 10 or less procedures. Median scores for correct diagnosis improved from 4.0 (IQR 3) to 7.0 (IQR 3) during the courses (P endoscopy may be useful before attending an SBCE course.

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

    Science.gov (United States)

    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 μg/kg along with a single bolus dose of ketamine (1 mg/kg). This was followed by a dexmedetomidine infusion at 0.5 μg/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.

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

    OpenAIRE

    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). G...

  14. Feasibility of Capsule Endoscopy for Direct Imaging of Drug Delivery Systems in the Fasted Upper-Gastrointestinal Tract

    DEFF Research Database (Denmark)

    Pedersen, Pernille Barbre; Bar-Shalom, Daniel; Baldursdottir, Stefania

    2014-01-01

    To develop a minimally-invasive method for direct visualization of drug delivery systems in the human stomach and to compare the obtained results with an established in vitro model. The method should provide the capsule rupture, dispersion characteristics, and knowledge regarding the surrounding ...

  15. Upper gastrointestinal Kaposi's sarcoma in HIV-infected patients: ten years of endoscopy observation at a single Brazilian center

    Directory of Open Access Journals (Sweden)

    Rosamar Eulira Fontes Rezende

    2015-10-01

    Conclusions: GI KS is an infrequent finding in patients with HIV infection. Among those with GI KS, 80% had concomitant skin lesions. Immunohistochemical methods for CD31, CD34, and LNA-1 were important tools in the diagnostic assessment of lesions suggestive of KS in the GI tract. Further studies are required to confirm these data, and the need for routine endoscopic investigation of the GI tract in HIV-infected patients with cutaneous KS should be assessed.

  16. Is non-Helicobacter pylori, non-NSAID peptic ulcer a common cause of upper GI bleeding? A prospective study of 977 patients.

    Science.gov (United States)

    Chan, H L; Wu, J C; Chan, F K; Choi, C L; Ching, J Y; Lee, Y T; Leung, W K; Lau, J Y; Chung, S C; Sung, J J

    2001-04-01

    Non-Helicobacter pylori, non-NSAID ulcer is relatively common in Western countries. Whether it is a significant problem in the Orient is unclear. The aim of this study was to investigate the incidence of non-H pylori, non-NSAID ulcers presenting with GI bleeding. A prospective study was done of 1675 consecutive patients presenting with upper GI bleeding over a period of 12 months. Upper endoscopy was performed with biopsy specimens taken from the antrum and body of the stomach for a biopsy urease test (BUT) and histology for detection of H pylori. Exposure to nonsteroidal anti-inflammatory drugs (NSAID) or aspirin within 4 weeks of hospitalization was carefully scrutinized. A 6-week course of treatment with an H2-receptor antagonist was prescribed for patients who did not use an NSAID and had a negative BUT result. Follow-up endoscopy was performed to confirm H pylori status with a BUT and histology. Positive histology at either initial or follow-up endoscopy was used as the standard for diagnosing H pylori infection. Among 977 patients who were found to have ulcer bleeding, 434 (44%) had exposure to aspirin or an NSAID. Of the 543 non-NSAID users, 431 (79.4%) had a positive BUT and 112 (20.6%) were BUT negative on initial endoscopy. Eighty-nine of 112 patients who were NSAID negative, BUT negative returned for follow-up endoscopy. Forty-nine of 89 (55.1%) were found to have a positive BUT and positive histology at follow-up endoscopy. Only 40 of 977 (4.1%) patients admitted with ulcer bleeding were confirmed to have non-H pylori, non-NSAID ulcers. Non-H pylori, non-NSAID bleeding ulcer is uncommon. A negative BUT is unreliable for exclusion of H pylori infection during the acute phase of ulcer bleeding.

  17. A wireless capsule endoscopy steering mechanism using magnetic field platform.

    Science.gov (United States)

    Alsunaydih, Fahad N; Redoute, Jean-Michel; Yuce, Mehmet R

    2017-07-01

    In this paper, a new steering mechanism for wireless capsule devices is presented. The proposed system consists of a platform generating a magnetic field to direct and control the motion of a capsule. The platform contains an upper and a lower set of electromagnets. A permanent magnet is implanted inside the capsule to initiate the movement, which is set by the magnetic field delivered by the electromagnets. The total magnetic field at the capsule's location is the sum of the contributions of each electromagnet. An experimental setup has been designed for testing and comparing between the performance of the capsule mobility in practice and simulations.

  18. Correlation between predicted and actual consequences of capsule endoscopy on patient management

    NARCIS (Netherlands)

    Westerhof, J.; Weersma, R. K.; Thijs, W. J.; Limburg, A. J.; Koornstra, J. J.; de Graaf, A.P.

    Background. Capsule endoscopy (CE) is a relatively new diagnostic modality in the evaluation of patients with suspected small bowel pathology. It is unclear to what extent physicians are able to predict the clinical consequences of CE on patient management. Methods. In this prospective study, 180

  19. Fabry-Perot micro-structured polymer optical fibre sensors for opto-acoustic endoscopy

    DEFF Research Database (Denmark)

    Broadway, Christian; Gallego, Daniel; Woyessa, Getinet

    2015-01-01

    Opto-Acoustic Endoscopy (OAE) requires sensors with a high sensitivity and small physical dimensions in order to facilitate integration into an endoscope of less than 1mm in diameter. We present fibre Bragg grating (FBG) and Fabry- Perot intrinsic fibre sensors for ultrasound detection. We present...

  20. Time to Endoscopy in Patients with Colorectal Cancer: Analysis of Wait-Times

    Directory of Open Access Journals (Sweden)

    Renée M. Janssen

    2016-01-01

    Full Text Available Objective. The Canadian Association of Gastroenterology Wait Time Consensus Group recommends that patients with symptoms associated with colorectal cancer (CRC should have an endoscopic examination within 2 months. However, in a recent survey of Canadian gastroenterologists, wait-times for endoscopy were considerably longer than the current guidelines recommend. The purpose of this study was to evaluate wait-times for colonoscopy in patients who were subsequently found to have CRC through the Division of Gastroenterology at St. Paul’s Hospital (SPH. Methods. This study was a retrospective chart review of outpatients seen for consultation and endoscopy ultimately diagnosed with CRC. Subjects were identified through the SPH pathology database for the inclusion period 2010 through 2013. Data collected included wait-times, subject characteristics, cancer characteristics, and outcomes. Results. 246 subjects met inclusion criteria for this study. The mean wait-time from primary care referral to first office visit was 63 days; the mean wait-time to first endoscopy was 94 days. Patients with symptoms waited a mean of 86 days to first endoscopy, considerably longer than the national recommended guideline of 60 days. There was no apparent effect of length of wait-time on node positivity or presence of distant metastases at the time of diagnosis. Conclusion. Wait-times for outpatient consultation and endoscopic evaluation at the St. Paul’s Hospital Division of Gastroenterology exceed current guidelines.