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At least 793 records · Page 44Linked to original sources
PubMed1994

Safer colonoscopic polypectomy with local submucosal injection of hypertonic saline-epinephrine solution.

BACKGROUND: In view of the popular acceptance of the adenoma-carcinoma sequence, endoscopic polypectomy is indicated for the removal of colorectal adenomas. Larger or sessile lesions should be removed by an experienced endoscopist, but complications such as hemorrhage and perforation still may occur. METHODS: To render the removal of sessile lesions feasible by endoscopic polypectomy and to reduce the risk of complications, we attempted local submucosal injection of hypertonic saline-epinephrine solution [(HSE) a mixture of 4.7% sodium chloride and 0.005% epinephrine] before electrosurgical snare excision; 0.5-2 ml HSE were injected into the base and immediate vicinity of polyps to produce mucosal bulging. RESULTS: Between August 1990 and April 1992, 645 polyps in 403 patients were removed by this method; sessile lesions could be more readily removed. Of these, 17 (2.6%) revealed invasive carcinoma and 19 (3.0%) carcinoma in situ. The largest sessile polyp removed was 40 mm in diameter and 7 mm in height and contained a carcinoma in situ. Even a 6-mm depressed adenoma and two rectal carcinoid tumors could be excised completely. No serious complications were encountered with this method. CONCLUSION: We conclude that local injection of HSE makes the endoscopic removal of colorectal polyps much easier and safer.

Adenocarcinoma↗
PubMed1994

Ethnic differences in the recurrence of adenomatous polyps after colonoscopic polypectomy.

A retrospective study was done of polyp recurrence rates following an initial clearing colonoscopy for adenomatous polyps. The intent of the study was to identify risk factors that would predict a greater risk for recurrence in Hawaii's ethnically diverse population. When the initial exam detected multiple polyps, a higher recurrence rate was found in Caucasian patients.

Adenomatous Polyps↗
PubMed1995

Mycobacterium paratuberculosis and inflammatory bowel disease: frequency distribution in serial colonoscopic biopsies using the polymerase chain reaction.

An association between Mycobacterium paratuberculosis and Crohn's disease is suspected but the evidence remains controversial. Using a one-step DNA extraction procedure with the thermophilic protease PRETAQ and amplification by the polymerase chain reaction, M. paratuberculosis DNA was detected in 22% of patients with Crohn's disease, and in 13% of patients with ulcerative colitis. M. paratuberculosis DNA was not found in any biopsy tissue from control non-inflammatory bowel disease patients. The biopsy tissues in which M. paratuberculosis was detected all came from regions which were inflamed when viewed microscopically. Overall, 7.7% of biopsies from such inflamed areas were positive. This low frequency of detection could be explained on the basis of extremely low abundance of the organism in relation to the area of mucosa sampled, or be consistent with a non-aetiological role for M. paratuberculosis in inflammatory bowel disease.

Animals↗
PubMed1995

[Ogilvie's syndrome. Benefits of repeat colonoscopic decompression on its developmental course].

Seven cases of Ogilvie's syndrome are described. In six of ther good recovery was related to repeated endoscopic colonic decompressions. This is the safest and most precise procedure in the diagnosis and treatment of the disease. We emphasize the usefulness of repeated decompressions in the outcome of Ogilvie's syndrome. One of patients in which decompression was not attempted died of a colonic rupture.

Aged↗
PubMed1977

Colonoscopic excision of large sessile polyps.

Experience with 80 consecutively-encountered large sessile colon polypoid lesions is reviewed in order to document the salient principles involved with safe and total endoscopic excision of certain of these lesions. The endoscopic physical characteristics of the polypoid lesion is the single most important factor in determining the method of removal of sessile polypoid lesions. Considerable experience with diagnostic colonoscopy and endoscopic removal of pedunculated and small sessile lesions is most important before considering the technic of piece-meal polypectomy for large sessile benign lesions.

Adenoma↗
PubMed1997

Transient radiological and colonoscopic features of inflammatory bowel disease in a patient with severe Salmonella gastroenteritis.

Salmonella is the most commonly reported cause of food-borne outbreaks of gastroenteritis. We report a case of a severe and toxic form of enteritis caused by Salmonella enteritidis. Findings of colonoscopy, an upper G1 tract series, and small bowel follow-through were consistent with those of inflammatory bowel disease, but the enteritis was self-limited, and the patient recovered after supportive treatment only and has remained well.

Acute Disease↗
PubMed1997

Genes driving the colonoscope.

Recent molecular genetic studies have significantly advanced our understanding of colorectal tumorigenesis. Important genetic alterations have been characterized with practical as well as biologic implications. Presymptomatic genetic testing is now available for two major inherited colorectal cancer predisposition syndromes. Genetic markers are also emerging with potentials to provide additional diagnostic or prognostic information. New avenues to design improved therapeutic agents and preventive strategies are now available.

Adenomatous Polyposis Coli↗
PubMed1997

Colonoscopic resection of large colonic polyps--a prospective study.

Forty-five patients who were referred for surgical resection of large colonic polyps after index colonoscopy were considered for endoscopic polypectomy. Eighteen of these patients were ultimately referred for surgery. Twenty-five patients with 25 large polyps underwent endoscopic polypectomy; there were 9 females and 16 males with a mean age of 69 years. Among the polypectomy patients, polyp size was 3.0-6.0 cm, found mostly in the left colon. There were 21 pedunculated and 4 sessile polyps. Follow-up was carried out for a mean of 48 months (range, 12-171 months). Polypectomy was possible on a single attempt in 12 (48%) cases and in 13 (52%) cases by a piecemeal technique. Pathological examination revealed malignancy in 11 (44%), adenomatous polyp in 11 (44%), and inflammatory, hyperplastic and harmartoma in 1 patient each. Complications included bleeding in 3 (12%) patients and diarrhea and fever in 1 (4%). All complications were successfully treated conservatively without sequellae. Two patients were referred for surgery, 1 with invasion of the base of the polyp and 1 because of a synchronous malignant polyp. During follow-up, 8 metachronous polyps were detected. In 1 of these, a carcinoma was found and treated with endoscopic polypectomy. In conclusion, endoscopic polypectomy of large polyps is safe and can defer surgical treatment. Regular follow-up is required. Endoscopic polypectomy of large polyps should be considered before referral for surgical treatment.

Adenomatous Polyps↗