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At least 721 records · Page 40Linked to original sources
PubMedDate not supplied

[Upper gastrointestinal endoscopy in children: indications and results]

OBJECTIVE: To present and discuss the indications, the endoscopic and histologic findings and the complications of upper digestive endoscopies carried out in children and adolescents.METHODS: We have done 228 endoscopies in pediatric patients with ages between 3 months to 19 years (x=5.7 y) during a period of 8 months. General anesthesia was used in 80% of patients (182). Biopsies were done in 210 patients and the Helicobacter pylori was searched for in 130 patients by antral biopsies with Hematoxylin-Eosin coloration.RESULTS: The endoscopy indication was diagnostic in all patients, and in 18 cases there was some therapeutic procedure. Fifty-eight percent of examinations presented endoscopic alteration and 84% had abnormal histologic findings. The most frequent endoscopic findings were esophagitis in 50 patients, gastritis in 44 and duodenitis in 29. Ten peptic ulcers were diagnosed. Between the histologic findings the most frequent ones were gastritis in 87 patients, esophagitis in 50 and atrophy of duodenal mucosa in 9. The H. pylori was positive in 25 (19.2%) patients.CONCLUSION: The upper digestive endoscopy has become an essential procedure to the pediatric gastroenterology practice, amplifying the available diagnostic means and enabling therapeutic endoscopy in the presence of upper digestive lesions. In the present report, 58% of the studied population presented some endoscopic lesion.

Journal Article↗
PubMedDate not supplied

[Use of the upper gastrointestinal endoscopy in dyspeptic patients].

BACKGROUND AND AIMS: Dyspepsia is a common complaint that may signal the presence of diseases like cancer or peptic ulcer. The aim of our study was to assess if the clinical patterns of dyspepsia can be considered a valid guideline for the appropriate use of endoscopy. METHODS: According to the symptomatological patterns, our 243 patients were defined as sufferers from: ulcer-like (93 patients), reflux-like (25) and dismotility-like dyspepsia (125). Erosive gastritis and erosive duodenitis were regarded as minor inflammatory lesions. RESULTS: A negative endoscopy (normal or presenting minor inflammatory lesions) was found in 36.6% of ulcer-like dyspepsia patients: this rate was 52% in the reflux-like group, and 49.6% in the dismotility-like one. Duodenal ulcer was the most frequent abnormal lesion in the three groups. The frequency of negative endoscopies was significantly higher in dismotility-like than in ulcer-like (49.6% vs. 36.6%--P < 0.05) dyspepsia. In those patients with dismotility-like dyspepsia under 41 years, the rate of negative endoscopies was 72.7%, and neoplasms were not observed. CONCLUSION: Our data indicate that endoscopy could be considered inappropriate for patients under 41 years old with dismotility-like dyspepsia. These subjects account for 18.1% of the patients studied, what could lead to a good percentage of reduction in endoscopic service load.

Adolescent↗
PubMed1997

[The usefulness of dye endoscopy in diagnosis esophageal diseases].

OBJECTIVE: To investigate the usefulness of Dye endoscopy in the diagnosis of the esophageal disorders. METHODS: 87 cases with esophageal diseases underwent dye endoscopy examination with Toluidin-staining and Iodine-staining or double-staining method. RESULTS: In the conventional group, the conformity rate of the endoscopy to biopsy results is 80%, but in the Dye one is 95% and the accurate rate of diagnostic is 100%. Under the guiding of Dye endoscopy, the occurrence rate of Ca cell on the incisal edge is 0%. CONCLUSION: The methods enable diffentinal diagnose of benign and malignant lesion, conforming the type of esophagitis. And it is more helpful to conform the area of surgical resection and when conventional endoscopy cannot satisfactorily diagnosis. We think it is a useful and simple diagnostic method for esophageal diseases.

Diagnosis, Differential↗
PubMedDate not supplied

Virtual endoscopy: already a feasible proposition or a future prospect in diagnostics? A review of the literature.

The aim of this article was to carry out a retrospective analysis of the feasibility of using virtual endoscopy in the field of gastrointestinal diseases. After a retrospective review of the international literature the authors analyse the most controversial aspects of virtual endoscopy such as its effective diagnostic reliability and potential clinical employment with specific reference to diagnosing colon diseases. The international literature shows that virtual endoscopy is currently poorly sensitivity in detecting lesions measuring less than 10 mm in diameter and that the radiologist's experience can negatively condition the trustworthiness of this procedure. Virtual endoscopy is likely to be the future gold standard in the field of diagnostic imaging. Furthermore, it eliminates all the compliance-related problems and any risk of iatrogenic lesions such as perforations and bleedings which are typical of traditional endoscopy. Its current sensitivity, however, is poor and it is unable to detect lesions smaller than 10 mm. Its reliability therefore needs to be improved.

Feasibility Studies↗
PubMed1975

[Comparison between gastric radiology and fiber endoscopy (author's transl)].

This paper summarizes the experience from 1969 to 1972 of a mixed team of radiologists and endoscopists at the Northern Marseilles University Hospital Centre. The patients were unselected and the team were not given all the information. After recalling the clinical and radiological conditions, together with the endoscopic conditions of the examination, the authors define the criteria which they chose to orient patients towards fiber endoscopy, i.e. either frankly abnormal radiology, or a radiological examination classed as normal in 563 cases, but which the team considered doubtful. They then report their results. Under these conditions, the results seem to be less unfavourable for radiology than would have been thought, for only 7% of the results were made by endoscopy alone (96 cases out of 1,500). In both benign and malignant ulcer, fiber endoscopy simply confirmed the radiological diagnosis and, in 54% of all the examinations, fiber endoscopy confirmed the normal character of radiology. However, in deciding whether carcinoma or benign ulcer, i.e. 11% of the cases of carcinoma and 14% of the cases of benign ulcer, radiology completely omitted the diagnosis of the lesion which might seem unacceptable. They conclude by asking radiologists to improve their technique of lesion detection and concentrate their examination on the smallest visible lesion in areas considered diffcult to explore radiologically. They are more and more circumspect about giving a full etiological diagnosis of lesions by radiology, especially in gastric ulceration where fiber endoscopy and direct biopsy seems more and more advisable.

Fiber Optic Technology↗
PubMed2003

[Non-neoplastic tracheal lesions: comparison between virtual CT endoscopy and fiberoptic bronchoscopy].

PURPOSE: To compare virtual endoscopy of the upper airways with fiberoptic bronchoscopic examination in patients affected by non-neoplastic inflammatory disease of the trachea. MATERIALS AND METHODS: Twelve patients with non-neoplastic tracheal stenosis or with tracheo-oesophageal fistula underwent a fiberoptic endoscopy and a spiral CT examination with the following protocol: collimation/table feed/reconstruction increment 3 mm/6 mm/1 mm from the larynx to the carenabronchial septum. Images were sent to a dedicated workstation equipped with a software allowing generation of 3D reconstructions and virtual endoscopic images. Lesion features were compared in the two examinations. RESULTS: In all cases the lesions features visualized with virtual display modality were confirmed by conventional endoscopy. Measurements were easily made on the 3D MPR images while conventional endoscopy allowed only a qualitative assessment of the lesion. In no cases did virtual endoscopy provide information on the mucosa appearance. Swallowing and breathing never caused significant artifacts during the 3D post processing. CONCLUSION: Virtual bronchoscopy is a useful technique for preoperative evaluation and for the follow-up of patients with non-neoplastic inflammatory disease of the upper airways.

Algorithms↗
PubMedDate not supplied

[Diagnosis of reflux esophagitis in infants: histology of the distal esophagus must complement upper gastrointestinal endoscopy].

OBJECTIVE: The aim of this study was to validate the endoscopic findings against histologic features of the distal esophageal mucosa for the diagnosis of reflux esophagitis in infants. METHODS: The data records of 167 patients (88 M; 79F) aged 38-364 days, referred for investigation of reflux esophagitis, between January 1995 and December 2000 were retrospectively reviewed. The association between nominal (presence or absence of esophagitis) and ordinal (grades of esophagitis) variables was analyzed through a correlation between the results of endoscopic findings and histology. RESULTS: Endoscopy when compared with histologic analysis had a sensitivity of 45%; specificity of 71%; positive and negative predictive value of 89% and 21% respectively; and accuracy of 50%. Additionally, this study demonstrated that there was a poor correlation between endoscopic and histologic findings when endoscopy was normal or when endoscopic grade I esophagitis was observed (p = 0.10). Normal esophageal appearance failed to identify 79.2% of patients with histologic esophagitis. Conversely, amongst patients with endoscopic grade I esophagitis, 12.1% had normal histology. CONCLUSIONS: We concluded that whilst endoscopy had a specificity of 71%, it did not attain an acceptable range of sensitivity (45%) to justify performing an endoscopy without biopsy, as many true cases of esophagitis would not be detected; and that the presence of grade I (non-erosive) esophagitis at endoscopy did not increase the value of the test in predicting histologic abnormality.

Biopsy↗
PubMedDate not supplied

Yield of endoscopy in children with hematemesis.

Upper gastrointestinal (UGI) endoscopy is an important tool in the evaluation of patients presenting with haematemesis. The objective of this study was to report the yield of this procedure in a Saudi Arabian population. We analysed the result UGI endoscopy in children and adolescents of 0-18 years of age who presented with haematemesis over a period of 10 years. From 1993 to 2003, endoscopy was performed on 60 consecutive children presenting with haematemesis. This group represented 12% of the indications during the same period. The majority (98%) were Saudi nationals, with an age range from 4 days to 18 years, and a male to female ratio of 1:1.5. The overall yield of endoscopy was 75%; however, the yield was higher (91%) in children below 12 years of age. Gastritis was the commonest cause of haematemesis (44%), followed by oesophagitis (36%). However, age-related analysis shows that oesophagitis was a more common cause of haematemesis in the younger age group (45%) than gastritis in adolescents (30%). In contrast, gastritis was more common in older children (56%) than oesophagitis (28%). Peptic ulcer disease and oesophageal varices were seen in only 3 (7%) and 2 children (4.3%), respectively. The overall yield of endoscopy in our patients is similar to that in most reports. However, oesophagitis and gastritis were the commonest causes of haematemesis, whereas oesophageal varices and peptic ulcer disease were much less common.

Adolescent↗
PubMed2005

Wireless capsule endoscopy in a community gastroenterology practice.

GOALS: This study was performed to evaluate the use of wireless capsule endoscopy in a community gastroenterology practice. BACKGROUND: Experience with wireless capsule endoscopy at referral centers has been reported, but little has been reported about community gastroenterologists' experience. STUDY: A retrospective review of charts and wireless capsule endoscopies performed at a community hospital was performed. RESULTS: A total of 99 wireless capsule endoscopies were reviewed and complete data were available in 72 cases. Indications included suspected obscure GI bleeding in 97% of cases; 55% of patients were taking anti-platelet or anti-coagulant medications; 71% of examinations were complete. Pathologic findings included angioectasias (36%), gastritis/erosions (21%), bleeding (18%), small bowel ulcers (16%), duodenitis (7%), and small bowel erosions (6%). Strictures, Crohn's disease, and tumors were each seen in 3%. There were no abnormal findings in 37%. One complication, nonnatural excretion of the capsule, caused a transient bowel obstruction but passed without endoscopic intervention or surgery. CONCLUSIONS: In a community-based gastroenterology setting, wireless capsule endoscopy is a safe tool that shows abnormalities in a significant proportion of exams.

Aged↗
PubMedDate not supplied

[The sedation role in upper digestive endoscopy].

OBJECTIVES: Determine the variation of the vital constants during endoscopy in the sedate and non-sedate patients. Evaluate the anxiety in the patient. Evaluate the doctor attitude at the procedure. Evaluate the patient satisfaction and inquire about the patient disposition to repeat in the future the procedure in the same conditions. METHODS: This is a prospective, descriptive, and double blind randomize comparative study with 197 patients subjected to upper digestive endoscopy, 101 received endovenous sedation and 96 local anesthesia. RESULTS: Sedation in upper digestive endoscopy showed a significant lower complaints perception (p<0.0001), pain, nausea and lack of air sensation (p<0.001) with a better endoscopist appraisal with respect the non sedated (p<0.015). The sedated patient had a significant decrease of his basal systolic and diastolic pressures (p<0.0001). Non sedated patient present a significant difficult endoscopy insertion at the first attempt (p<0.001). CONCLUSION: Upper digestive endoscopy with sedation was significantly better both for the doctor as for the patient in general well-being as in less pain, nausea and lack of air sensation. The most sedated patients agreed without doubts to repeat the exam if it was necessary.

Adult↗
PubMedDate not supplied

CT-virtual endoscopy of the urinary tract.

OBJECTIVE: To demonstrate the various applications of CT-virtual endoscopy, for the assessment of urinary tract abnormalities. MATERIALS AND METHODS: Sixty-three patients were evaluated by CT-virtual endoscopy (49 CT-cystoscopy; 14 CT-pyeloureteroscopy). CT-cystoscopy was obtained for follow-up of bladder tumor (n=21), radiologic suspicion (n=12) or radiologic evidence of urinary tract lesion (n=16). CT-pyeloureteroscopy was done due to neoplasm (n=5), calculi (n=3) and extrinsic compressions (n=3). RESULTS: In 49 patients submitted to CT-cystoscopy, 27 tumors were detected intraoperatively (ranging 0.5-4.8cm). CT-cystoscopy revealed 21 tumors (78%); all tumors larger than 0.6 cm were detected. Tumor within a bladder diverticulum was seen by CT-cystoscopy but not by endoscopy, in two patients. Useful additional information such as extension of tumors into the anterior portion of the bladder neck (n=2) and adequate characterization of bladder diverticulum in a child (n=1) was also obtained. CT-pyeloureteroscopy detected 6 of 9 tumors (67%), and was useful in the differential diagnosis of pelvic/ureteral tumor versus calculi (n=8) and intrinsic versus extrinsic ureteral lesion (n=3). CONCLUSION: CT-virtual endoscopy is a useful procedure, particularly in the following situations: a)- Follow-up of bladder tumors; b)- Complimentary evaluation of areas of difficult approach by endoscopy; c)- Differential diagnosis of intrinsic versus extrinsic lesion of the renal pelvis and ureter.

Journal Article↗
PubMed2005

[Magnification endoscopy diagnosis of Barrett's esophagus with methylene blue and acetic acid].

Intestinal metaplasia of Barrett's esophagus is pre-cancerous lesion and it is important to diagnose intestinal metaplasia by endoscopic examination. Predefined 4 quadrant sampling technique is popular in western countries. However, chromoendoscopy or magnification endoscopy have been tried to diagnose intestinal metaplasia. We have carried out magnification endoscopy with methylene blue and magnification endoscopy with acetic acid. In magnification endoscopy with methylene blue, intestinal metaplasia showed blue-staining area with tubulaous or cavernous pattern. In magnification endoscopy with acetic acid, all of epithelium of Barrett's esophagus changed to whitening surface and it was easy to observe the structure of each epithelium. Intestinal metaplasia showed tubulaous or villous, although fundic type showed pits of small round and cardiac type showed oval pattern with central-slit pits.

Acetic Acid↗
PubMed2005

Predictors of endoscopy in minority women.

BACKGROUND: Colorectal cancer (CRC) is the second leading cause of cancer related deaths in the United States. Underrepresented minorities suffer disproportionately from CRC largely because of disparities in CRC screening rates, particularly by endoscopic methods. This study evaluates the association between socioeconomic, medical and psychosocial factors and the use of endoscopy in low-income minority women. METHODS: The participants were recruited from community health fairs, tenant association meetings, senior centers and local medical clinics. A survey instrument was administered to the minority women. RESULTS: Eighty-one women age >50 were included in this analysis (44 African Americans and 37 Hispanics). The two ethnic groups were demographically similar. The factors associated with having had endoscopy were language spoken (English versus Spanish), physician recommendation, cancer cons and decisional balance (difference between cancer cons and cancer pros). When endoscopy was modeled as a function of decisional balance and language spoken, only decisional balance was a significant predictor of endoscopy. CONCLUSIONS: Physician recommendation and decisional balance have a tremendous influence on whether minority women undergo endoscopy. These data suggest that if physicians increase their communication with patients regarding the benefits of screening and address patients concerns, adherence with endoscopic CRC screening can be improved in minority women.

Black or African American↗
PubMed2004

[The effect of diclofenac on the small intestine studied by wireless endoscopy.].

INTRODUCTION: It is well known that NSAIDs cause erosions and ulcers in the stomach and duodenum but little is known about a possible damage to the small intestine. Direct visualization of the small intestine has not been possible until recently with the introduction of wireless endoscopy. OBJECTIVES OF STUDY: Primary. To assess the effect of diclofenac on the small intestine using wireless endoscopy and measurement of calprotectin in the stools. Secondary. To assess the possible effect of diclofenac on gastro-intestinal symptoms and on the level of hemoglobin. METHODS: Twenty healthy volunteers 21-61 years of age, 10 males and 10 women, received diclofenac 75 mg twice daily for 14 days. Wireless endoscopy was performed before and after diclofenac and also measurements of calprotectin in the stools. The volunteers kept a diary of gastro-intestinal related symptoms during the treatment. In order to eliminate injury and symptoms from the stomach and duodenum, omeprazole 20 mg twice daily was given with the diclofenac. RESULTS: Wireless endoscopy before diclofenac showed no abnormalities in the 20 volunteers. After diclofenac treatment wireless endoscopy showed injuries in 14 volunteers but six had no injury. The number of small intestinal injuries found in each volunteer varied from 2-30. The injuries were equally distributed throughout the small intestine. Two volunteers had an injury in the caecum (ulcer, free blood). Stool calprotectin (normal value <60 mg/L) before diclofenac was 29 mg/L (+/-28) but increased to 148 mg/L (+/-108) (p<0.01) after diclofenac. Fourteen volunteers had gastro-intestinal related symptoms. The mean Hemoglobin concentration decreased from 145.1 to 136.8 g/L (p<0.05) with diclofenac treatment. CONCLUSIONS: The administration of diclofenac is associated with injuries in the small intestine similar as have been described in the stomach and duodenum. The symptoms associated with diclofenac in this study could be related to the small intestinal injury.

English Abstract↗
PubMed2000

A retrospective analysis of spinal canal endoscopy and laminectomy outcomes data.

Disability from back pain has continued to increase at a steady pace since the 1950's. While no study has associated chronic disability with physical factors, numerous studies have correlated chronic disability with psychological factors and surgical intervention. Even though most common surgical interventions for spinal pain pertain to the herniated disc, numerous studies have indicated that only 1% of severe episodes of low back pain is attributable to herniated discs. With the advent of spinal canal endoscopy, an additional option is available for medical management of disc disease, which facilitates irrigation, dilution, and removal of inflammatory mediators, thus decreasing the chance of reactivity to chemical and biological mediators, and facilitating administration of corticosteroid medication with specificity to site of action. This pilot study included two groups of patients, Group 1 with 22 patients treated via spinal endoscopy and Group 2 with 13 patients treated via laminectomy. After spinal canal endoscopy, only 31.8% of Group 1 patients were continued on opioid medication, whereas, 92.3% of Group 2 patients were continued on opioid medication after laminectomy. In addition, 72% from spinal canal endoscopy group and only 28% from laminectomy group returned to work. In conclusion, this study suggested remarkable differences in outcomes when comparing patients who underwent spinal canal endoscopy to a similar population who underwent lumbar laminectomy.

Journal Article↗
PubMed1991

[Foreign body aspiration in children. The advantages of emergency endoscopy and foreign body removal].

In the last 15 years, 124 children with a history and clinical signs of aspiration have been managed by emergency rigid endoscopy under general anesthesia. In 115 (93%) of them a foreign body could be identified, which was successfully removed by forceps extraction in 114. Only 1 patient required a thoracotomy for removal of a distally located aspirated needle. The remaining 9 patients (7%) had a typical history and clinical signs of an aspiration, but no aspirated foreign body was found on endoscopy. Most of the children (102, or 82%) were admitted within 12 h after aspiration, while 22 (18%) had a history of foreign body aspiration between 2 days and 5 weeks before. Complications occurred in only 3% (3 children) of the 102 who underwent endoscopy within 12 h as against 50% (11 patients) of the 22 children in whom this was delayed. In all cases of foreign body aspiration and endoscopical removal within 12 h, the patients were discharged after a plain chest X-ray the following day. In children with chronic endotracheal foreign bodies, in 80% a second endoscopy after 48 h was indicated, and the mean stay in hospital was extended to 7 days. Emergency rigid tracheobronchoscopy and forceps removal of aspirated foreign bodies under general anesthesia and with meticulous perioperative monitoring is a safe and effective procedure with no mortality. Even in suspected aspiration or chronic bronchopulmonary infections, liberal use of endoscopy is recommended.

Anesthesia, General↗
PubMed1990

[Evaluation of decontamination procedures used at digestive endoscopy units in Gironde].

Decontamination procedures used for endoscopes were noted in 23 digestive endoscopy units, public and private, in the department of Gironde and compared to recommended procedures. Serial, bacteriological samples were obtained from one esogastroscope and one colonoscope in each unit, after upper endoscopy and colonoscopy diagnostic procedures at the end of the endoscopy session. Six units of 23 used complete decontamination procedures. In the 17 other units, principal errors of decontamination procedures were: inadequate cleaning of internal channel of scopes (12 units) and lack of utilization of glutaraldehyde between each endoscopy (8 units). Bacteriological samples were negative in 11/12 endoscopes after a complete decontamination procedure and in 8/39 after an inadequate procedure (p less than 0.01). Complete procedures are efficacious but not used often enough. Information and changes in endoscopic practices are necessary in digestive endoscopy units.

Bacterial Infections↗
PubMed1990

Evaluation of upper gastrointestinal endoscopy as a primary investigation in patients with acute upper abdominal pain.

Fifty-six consecutive patients presenting to one general surgical unit with acute upper abdominal pain were submitted to early diagnostic endoscopy after exclusion of perforation, pancreatitis and gallstone disease. Endoscopy was performed within 48 h of admission in 84% of patients and 68% of the study group were discharged within 48 h of the procedure. In 26 patients a definite causative pathology was identified. In 13 patients there were mucosal changes of doubtful significance, while in 17 patients the examination was normal. Endoscopy in patients admitting to excess alcohol intake was generally unrewarding and there was poor correlation between the clinical diagnosis of peptic ulcer and endoscopic findings. The clinical diagnosis was revised in 64% of patients following endoscopy. The data from this study suggest that early endoscopy in acute upper abdominal pain results in a high yield of positive findings, permits rapid correction of diagnostic errors and facilitates early institution of management and discharge.

Abdominal Pain↗