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Biomedical subjects

J S Delmotte

Publications and source records attributed to J S Delmotte.

At least 19 recordsLinked to original sources
PubMed1999

Intraoperative endoscopy.

Intraoperative endoscopy (IOE) is accepted as the ultimate diagnostic procedure for the complete evaluation of small bowel. Until recent years, operative endoscopy was the complement of sonde enteroscopy. The difficulties of this long and fastidious type of examination, for both the patient and the medical team are well known. It provides incomplete exploration (detubing of certain loops is too rapid), and renders impossible any diagnostic or therapeutic procedure (biopsies, electrocoagulation). The indications of IOE have diminished over recent years during the development of push enteroscopy by upper or double way. Indeed, the latter method makes it possible in a number of cases to obtain complete exploration of the small bowel with biopsies and therapeutic procedures, or an exploration enabling screening for lesions in the first jejunal loops of the lat ileal loops.

Adult↗
PubMed1999

Enteroscopy in small intestinal inflammatory diseases.

The development of new semilong enteroscopes, videopush enteroscope (VPE), has modified the diagnostic and therapeutic approach to inflammatory intestinal diseases owing to the biopsy and therapeutic capacities. In Crohn's Disease, VPE is useful in nonusual clinical presentations: occult intestinal bleeding and in the treatment by dilatation of jejunal and ileal strictures. In atrophic coeliac disease (ACD) VPE is mandatory each time oesogastroduodenoscopy biopsies are noninformative in order to obtain pathologic jejunal biopsis. In addition, in refractory ACD and in the case of jejunal blood loss ACD, VPE is mandatory in the search for ulcerative jejunitis and lymphoma. The management of chronic diarrhea of the adult, classic endoscopy remains the gold standard procedure and is carried out first but in patients with negative results, VPE can proceed immediately. Good results can only be obtained if VPE is performed by endoscopist who is highly interested in this field of investigation.

Adult↗
PubMed1993

Perioperative endoscopy of the whole small bowel in Crohn's disease.

The aim of this study was to search for small bowel lesions by means of a perioperative endoscopy in 20 patients operated on for Crohn's disease. Seven women and 13 men (mean age 29 years) had a total retrograde exploration to the angle of Treitz during an ileocolectomy (16 of 20 patients) or a colonic or ileal resection (four of 20 patients). Endoscopic exploration was completed, through an enterotomy, from the surgical area to the angle of Treitz. Periendoscopic biopsy samples were taken on macroscopic lesions and every 20 cm systematically. In 13 of 20 cases, various lesions scattered over the whole small intestine were found. These were aphthoid ulcerations (10 patients), superficial ulcerations (seven patients), mucosal oedema (three patients), non-ulcerative stenosis (three patients), erythema (two patients), pseudopolyps (two patients), deep ulcerations (two patients), and ulcerative stenosis (one patient). In seven patients none of the lesions detected at perioperative endoscopy had been recognised by preoperative evaluation or surgical inspection of the serosal surface. A typical granuloma was found at biopsy of lesions identified by endoscopy in three cases and at biopsy of an apparently healthy area in one case. Thus 65% of patients operated on for Crohn's disease had lesions of the small intestine detected by endoscopy, which were unrecognised before surgery in more than half of the cases.

Adolescent↗
PubMed1992

Hidden damage revealed.

Nonsteroidal anti-inflammatory drug (NSAID)-induced gastrointestinal lesions should be suspected when a patient receiving NSAID therapy has pain or signs of hemorrhage that are severe enough to warrant an emergency endoscopy. However, with endoscopy, patients receiving NSAID therapy with no particular gastrointestinal symptoms may also be found to have lesions. These lesions are polymorphic in character and lack clear anatomic and clinical parallels with spontaneous lesions. Endoscopically, they are of three types: (1) Advanced focal or diffuse lesions, uncommon and not usually seen in ambulatory patients; (2) large or diffuse, ulcerated or hemorrhagic lesions, that can be differentiated from those seen in typical digestive system pathology; and (3) microlesions, often responsible for false-negative examinations and now detectable through advances in electronic endoscopy. Lower bowel or ileocolonic damage is also a common finding but has only recently come to clinical attention. The endoscopic appearance of these intestinal lesions suggests a superficial inflammatory bowel disease such as hemorrhagic rectocolitis or Crohn's disease.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1981

Argon laser photocoagulation for upper gastrointestinal haemorrhage: is technique the key to success?

Reports of endoscopic laser photocoagulation have been enthusiastic. However, many technical factors influence the results and discussion of these in the literature has been very limited. We describe the problems encountered in treating 71 patients with bleeding peptic ulcers, and our solutions to them. Failures were due to problems of access and identification of bleeding points, as much as to the laser itself. Results were improved by meticulous endoscopic washing of the ulcer crater and care in setting the laser. These technical factors must be optimised before the true efficacy of this treatment can be assessed in a controlled, randomised clinical trial.

Argon↗