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J D Waye

Publications and source records attributed to J D Waye.

At least 91 records · Page 5Linked to original sources
PubMed1989

Granulomatous gastritis: a case report and review of the literature.

A 69-yr-old white female presented to her physician with a 3-yr history of epigastric pain. Gastric biopsies revealed noncaseating granulomas in the mucosa and submucosa. No definite etiological factor could be detected. A diagnosis of idiopathic granulomatous gastritis was made. In the past, this condition has prompted surgery. Steroids have also been advocated. Our patient was managed successfully with symptomatic treatment, without the use of steroids or surgical intervention. She remains well 4 yr later.

Aged↗
PubMed1988

The lost polyp: a guide to retrieval during colonoscopy.

Polyps resected during colonoscopy should be recovered and sent for pathologic examination. Unfortunately retrieval is incomplete ranging from 85-100% in reported series. There are several specific techniques aimed to increase the retrieval rate which in our experience amounted to 94.5% of a series of 182 polypectomies in 100 consecutive patients. All lost polyps were small and were thought to have been aspirated through the suction channel of the endoscope. In our study 10% of the initially "lost" polyps were within the instrument prior to cleaning. Various forms of polyp retrieval are reviewed with special attention to locating the aspirated polyp.

Colonic Polyps↗
PubMed1988

Chronic gastrointestinal bleeding of obscure origin: role of small bowel enteroscopy.

The source of blood loss remains undetermined in 5% of patients with chronic gastrointestinal bleeding. A new technique of small bowel enteroscopy with a prototypic sonde-type enteroscope 9 ft in length was used to examine 60 patients referred to the hospital with gastrointestinal bleeding of obscure origin. With an average procedure time of 6 h, the enteroscope migrated to the ileum or beyond in 77% of patients. Thirty-three percent (20 of 60 patients) had the source of blood loss identified within the small bowel at enteroscopy. Small bowel enteroscopy is a useful tool in patients with chronic gastrointestinal bleeding of obscure origin and can be considered when standard invasive and noninvasive modalities have failed to diagnose a site of bleeding.

Adult↗
PubMed1988

Use of percutaneous gastrostomy in the intensive care patient.

We evaluated the use of percutaneous endoscopic gastrostomy in 30 ICU patients. There was a 14% incidence of minor complications, no major complications, and no mortality. We conclude that percutaneous endoscopic gastrostomy is a useful alternative to operative gastrostomy in the ICU patient.

Aged↗
PubMed1988

Small bowel enteroscopy in 1988: pros and cons.

Endoscopic visualization of the small bowel is now feasible with a recently developed long, small-caliber, transnasal endoscope. Previously, with standard instruments, endoscopic views of the small intestine were limited to the most proximal and distal portions or required laparotomy and intraoperative endoscopy. Small bowel enteroscopy with the new transnasal sondetype flexible endoscope now allows most of the small bowel to be examined as a relatively short, ambulatory procedure. The literature pertaining to endoscopic evaluation of the small intestine is reviewed.

Endoscopes↗
PubMed1988

Small colon polyps.

One thousand forty-eight small (up to 6 mm) colorectal polyps, removed during colonoscopy, have been analyzed. Sixty-one percent of these small polyps were neoplastic, the remainder being equally divided between hyperplastic polyps and polypoid mucosa with normal-appearing glands. The number of polyps was evenly distributed throughout the colon. Proximally, neoplastic polyps predominated, accounting for 73% of all polyps in the right colon. This was reversed in the distal colon where non-neoplastic polyps comprised 65% of all polyps in the rectum. The incidence of carcinoma was extremely low in small colon polyps, 0.1%. All polyps should be removed when encountered during colonoscopy due to the high prevalence of adenomas among small colon polyps.

Adult↗
PubMed1988

Colonic neoplasms in asymptomatic first-degree relatives of colon cancer patients.

First-degree relatives of colon cancer patients are at elevated risk for developing colorectal neoplasms. In order to assess the potential usefulness of screening by colonoscopy in this high-risk population, we reviewed the records of 48 colonoscopies performed on asymptomatic patients who were self- or physician-referred for colonoscopy because of a history of one or more first-degree relatives with colon cancer. Twelve (25%) had at least one adenomatous polyp, but no significant atypia was detected. No cancers were detected. One third of the lesions were beyond the reach of a flexible sigmoidoscope. This apparent increase in the prevalence of adenomas was most striking (46%) among men over the age of 50. These preliminary results demonstrate that colonoscopy is effective in detecting and removing adenomatous polyps in a substantial fraction of asymptomatic patients whose sole risk-factor is being a first-degree relative of a patient with colon cancer. Further studies in larger populations are warranted to determine the use of colonoscopy in screening these high-risk individuals.

Adult↗
PubMed1986

Treatment of colonic polyps--practical considerations.

The adenomatous colonic polyp, a neoplastic lesion, is the precursor of most if not all carcinomas of the colon and rectum. Confirmatory evidence is derived from epidemiological, histological and clinical data demonstrating a close parallelism between adenomas and cancer of the colon. Based on current knowledge, all colonic polyps should be removed to prevent the development of colonic cancer. However, since the risk of malignancy within an adenoma is related to its size, histology and the degree of dysplasia, practical considerations dictate that all polyps 1 cm in diameter or larger should be removed upon their detection by barium enema or colonoscopy since such adenomas are the ones most likely to contain malignancy. The endoscopic removal of colon polyps can be efficiently and safely accomplished when established principles of colonoscopy and electrosurgery are followed. This technique requires the proper equipment, a skilled endoscopy assistant, and an experienced endoscopist with the ability to adeptly perform colonoscopy, an understanding of the basic concepts of electrocautery and knowledge of the various structural configurations of colonic polyps. Colonoscopic polypectomy will avoid the need for surgical resection in most instances. Management of the malignant colonic polyp remains controversial. The patient with a sessile or pseudo-pedunculated polyp containing invasive cancer should undergo colonic resection. Surgery is not necessary for the majority of patients whose pedunculated adenomas contain invasive cancer, unless the malignancy is poorly differentiated, the cancer invades lymphatics or vascular channels, or tumour is seen at or near the resection margin. Surveillance colonoscopy after endoscopic polypectomy should be performed in most instances within one year to look for recurrent tumour, missed polyps or a metachronous adenoma. Subsequently, colonoscopy should be performed every two years in patients with multiple index polyps, and every three years after removal of a single index adenoma.

Adenoma↗