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At least 1,369 records · Page 76Linked to original sources
PubMed1981

Does bacteremia follow upper gastrointestinal endoscopy?

To determine the risk of bacteremia, 53 patients had blood collected for culture before and five, ten and 15 minutes following fiberoptic endoscopy of the upper digestive tract. One patient had transient bacteremia with Acinetobacter Sp. five minutes after endoscopy. Combining our study with four others, 447 patients have been evaluated of which 6% had bacteremia after upper gastrointestinal endoscopy. Biopsy or other endoscopic operation does not increase the likelihood of bacteremia. We recommend careful attention to instrument and accessory cleaning and prophylactic antibiotics (probably penicillin or oxacillin alone suffices) only for patients with prosthetic heart valves.

Acinetobacter Infections↗
PubMed1995

Endoscopy of the cerebellopontine angle.

The authors present their experience of 191 patients from June 1990 to December 1993 with endoscopy of the cerbellopontine angle using a limited retrosigmoid approach. The advantages of endoscopy of the cerebellopontine angle are the simplicity and efficiency of the procedure, and less invasive surgery. The authors emphasize the importance of the endoscopic procedure: first in acoustic neuroma surgery to get more accurate information about the relationship between the tumour and the adjacent structures, and to control the lateral end of the internal auditory canal; second in hemifacial spasm or facial neuralgia surgery, intraoperative endoscopy is the key point giving a sure and safe way to recognize the offending vessels.

Cerebellopontine Angle↗
PubMed1994

[Neurosurgical endoscopy. Diagnostic and therapeutic indications].

An historical review of neurosurgical endoscopy is evocated. The characteristics of the endoscopic material are discussed: flexible or rigid?, length?, diameter?, irrigation?, free-hand manipulation or fixed arm? A rigid neurosurgical endoscope (STORZ) is described which characteristics are the following: 5 mm/3.7 mm ovale diameter, working length of 21 cm (allowing its use under stereotactic conditions), 5F working channel and articulated arm for solid immobilization in the desired position. All the indications of endoscopy are described and illustrated with a series of 48 patients. Indications for diagnosis are rare and summarised in exceptional help for conventional surgery. 80% of the usual indications of endoscopy were represented by third ventriculostomy. The endoscopic guidance brings safety and allows an increasing of the ventriculostomy's indications. Endoscopic fenestrations of arachnoid cyst are described with a particular interest on suprasellar cysts. The other indications are rare: unilateral hydrocephalus, biopsies of intraventricular tumors, puncture of colloid cysts.

Brain Diseases↗
PubMed1994

Follow-up of patients with inverted papilloma of the nasal cavities: computer tomography, video-endoscopy, acoustic rhinometry?

Seventeen patients were operated suffering from unilateral inverted papilloma of the nasal cavities, in one male associated with malignancy. We investigated these patients pre- and post-operatively by clinical examination, video-endoscopy, acoustic rhinometry, and computed tomography (CT). The aim was to find out which technique delivers reliable information about tumour recurrence in follow-up. By these controls three recurrences could be detected in a period of two-years' follow-up. Our results showed that the combination of CT, video-endoscopy and histological examination of biopsies is reliable to detect recurrence of inverted papilloma. To study the possibilities of detecting tumour recurrence by means of acoustic rhinometry, investigations on models of nasal cavities with various shape, size and location of tumour masses were undertaken. A comparison between the results of the model study and the acoustic rhinometric measurements in patients showed that growth of tumour masses can be detected by this method in an early phase under constant conditions such as nasal models. In patients, however, it is not easy to evaluate the absolute size and site of the growing tumour masses, because there are several factors which lead to false-positive interpretations, such as localized inflammations of the mucosa, crusting and nasal secretion and especially the movements of the soft palate. We conclude from our results that acoustic rhinometry does not deliver more information than obtained by video-endoscopy and CT to detect tumour recurrence in the nasal cavity.

Acoustics↗
PubMed1994

[Clarification and treatment of teat stenosis using endoscopy].

In ten cows ten stenotic teats were endoscopically examined and treated. For this purpose two different methods were performed: Either the endoscopy was performed through the teat canal or through a small incision in the side of the teat. The endoscopy through the teat canal proved to be a simple and practical method. However, the results were not always clear-cut, and a controlled operation was not possible. Endoscopy through a side access is more expensive but has several advantages. It allows a good view on the Fürstenbergsche Rosette, one of the most frequent locations of stenosis. Additionally, controlled operations of the level of the Fürstenbergsche Rosette are possible once a suitable instrument has been introduced through the teat canal. The additional trauma caused by the access hole is a minor problem. All cows examined and treated by this method could be milked without any problems three days after the operation.

Animals↗
PubMed1994

The use of video in ENT endoscopy: its value in teaching.

Videography is the most practical and effective method of documenting and teaching ENT endoscopy. Videography allows: (1) documentation of anatomy, physiology and pathology of deep structures of the ear, nose and throat; (2) teaching of delicate surgical procedures such as functional endoscopic sinus surgery (FESS), laryngeal surgery, and other endoscopic procedures; (3) instantaneous production of high quality hard copies of video images for teaching and patient records; (4) instant replay and repeated viewing by a slow motion or frame-by-frame analysis; (5) simultaneous viewing by a small or large audience; and (6) image digitalization for storage in the computer for later analysis. The author describes the value of videography in ENT endoscopy, namely video-otoscopy, video rhinoscopy and videolaryngoscopy. The use of video in endoscopy will continue to play a vital role in Continuing Medical Education (CME).

Ear, Inner↗
PubMed1994

Electronic endoscopy in perspective.

Electronic endoscopy, developed in 1983, enables the endoscopic image to be transmitted through electric signals that can be easily processed by computer. An electronic endoscope is composed of three vital parts, i.e., a charge-coupled device (CCD) that converts the image to electric signals, a video processor that converts analog electric signals to the digital and processes them to become video signals, and a television monitor. The introduction of electronic endoscopy has enabled computer management of endoscopic images, on one hand, and provided an opportunity for image processing and analysis, on the other. A digital image management system will further develop into a database of endoscopic images. Combined with the technologies of remote control and remote sensing, the introduction of CCD to endoscopy has made it possible to transform the endoscope, so that it could become a capsule. Future advances in the research of image processing and analysis will lead to the development of a system of automated endoscopic diagnosis.

Electronics, Medical↗
PubMedDate not supplied

[Nasal endoscopy associated with coronal CT in the diagnosis of non- allergic chronic nasal obstruction].

Twenty-eight non-allergic subjects suffering from mono- and bilateral chronic nasal respiratory obstruction underwent investigation employing routine semeiological examination. The real cause of the obstruction, however, was not ascertained. The subjects underwent nasal endoscopy employing rigid fiberoptics and, on the grounds of the findings, a cat scan of the nasal fossae in coronal projection, was made. The results of the study revealed involvement of the middle meatal area in 63% of bilateral nasal obstructions (B.N.O.) and in 77.7% of the monolateral obstructions (M.N.O.). Choanal pathology was evident in 21% of the B.N.O., while isolated upper and posterior deviations of the septum were present in 23.6% of the B.N.O. and in 22.5% of the M.N.O. Meatal involvement was due to the presence of anatomic changes of the middle turbinate (m.t.) such as concha bullosa, paradoxical deviation of the m.t. and of the uncinate process. Moreover, small "mucosal polyps" were also noticed in this meatal area. Cat scans, performed on 18 of these 28 patients, confirmed and defined meatal alterations found with endoscopy in 16 cases. In the remaining 2 cases, cat scans showed a thickening of the mucosal+bony tissues of the m.t. The Authors did not consider CT necessary in 10 subjects in that endoscopy sufficed in explaining obstruction symptoms.

Adult↗
PubMed1994

Changes in blood glucose induced by upper GI diagnostic endoscopy: the influence of various premedications.

In this study we measured the blood glucose before and after diagnostic upper GI endoscopy as an index of the stress induced by the procedure. The possible influence of various premedications in the blood glucose was also studied. One hundred and twenty consecutive non-diabetic patients of both sexes aged 20-75 years were randomly allocated into four groups (A,B,C,D) according to the premedication used. Sixty non-diabetic patients, who were not endoscoped, were allocated into three groups (C1, C2, C3) and served as controls. Blood glucose increased significantly in the patients but not in the controls. No correlation was found between the changes in the blood glucose and the time needed for the endoscopy. Changes in the blood glucose did not differ among the patients (F = 0.214; p = 0.886) irrespective of the premedication; however the increase was numerically less when 10% lidocaine spray was used as a premedication (Groups A and C). It is concluded that diagnostic upper GI endoscopy induced a significant increase in blood glucose, irrespective of the premedication. This increase seemed to be mainly the result of the stress induced by the irritation of the pharynx during the intubation.

Adult↗
PubMed1994

Upper gastrointestinal endoscopy in the pediatric patient.

During a 4 year period (January 1988 to December 1991), 237 pediatric patients (mean age +/- SD, 9.75 +/- 5.17 years) underwent 289 upper gastrointestinal endoscopies. Premedication was used in only 102 of the endoscopic examinations, mostly in children between 2 and 10 years of age. Patients who were examined without sedation tolerated the procedure well. Abdominal pain was the most frequent indication, accounting for 57.4% of all procedures. Gastritis, esophagitis, duodenitis and duodenal ulcer were the most common endoscopic findings. Seventy-five endoscopies were performed to obtain small bowel biopsies. We found this procedure to be easy and safe and preferable to capsule biopsies. In our experience, upper gastrointestinal endoscopy with or without sedation is a safe and effective diagnostic procedure in the pediatric age group.

Adolescent↗
PubMed1994

Indications and contraindications for upper gastrointestinal endoscopy.

Upper endoscopy is currently one of the most frequently performed procedures. The most common indications for diagnostic EGD include dyspepsia unresponsive to medical therapy or associated with systemic signs, dysphagia or odynophagia, persistent gastroesophageal reflux symptoms, occult gastrointestinal bleeding, and surveillance for malignancy. These guidelines, however, are largely based on consensus opinion, and few controlled trials have evaluated the effect of endoscopy on patient outcome, medical expenditures, and management. It appears that the benefits of therapeutic upper endoscopy for such conditions as acute gastrointestinal bleeding, foreign-body removal, and stricture dilatation are more well defined. Future studies should be directed at the most cost-effective and beneficial management strategies for many of these common conditions.

Contraindications↗
PubMed1994

[Usefulness of respiratory endoscopy in patients with severe rhonchi and/or sleep apnea syndrome].

BACKGROUND: Obstruction of the upper respiratory tract is the most common cause of the sleep apnea syndrome (SAS). Different methods have been used to localize this obstruction and give the appropriate treatment. The aim of this study was to evaluate the usefulness of respiratory endoscopy performed during arousal to identify the site and cause of the obstruction in patients with severe rhoncopathy and/or SAS. METHODS: Sixty-eight patients with acute rhoncopathy were included in the study with 36 also fulfilling polysomnographic criteria of SAS (36%). The endoscopy was performed via the upper respiratory tract with inspiratory collapse at each level being evaluated in both easy respiration and during the Müller manoeuver. RESULTS: The site and cause of the obstruction was identified in 61 patients (90%, CI 95%, 79.9 +/- 95.8). In most cases the Müller manoeuver best demonstrated the collapse. The predominant obstruction was in the nasopharyngeal region (72%, mainly associated to changes in soft palate), followed by obstruction in the oropharyngeal region at the base of the tongue (29%). Multiple localization of the obstruction was observed in 19 patients. CONCLUSIONS: Endoscopy performed during arousal may allow the identification of the site and cause of obstruction in most of the patients with rhoncopathy and sleep apnea syndrome, thus aiding in the selecting the most adequate treatment for the patient.

Endoscopy↗
PubMed1994

Fetoscopy-guided fetal endoscopy in a sheep model.

Video-endoscopic surgical treatment of the fetus may, in the future, become an alternative to open fetal operation. Six 95-day-old fetal lambs were examined through intrauterine endoscopy using amnioinfusion and specially designed balloon-tipped cannulas. The fetuses were monitored endoscopically for oxygen saturation, heart rate and temperature throughout the procedure. With a rigid 5 millimeter telescope and a flexible 3 millimeter endoscope, the respiratory and upper gastrointestinal tracts could be examined. No mucosal or other trauma was noted upon completion of the endoscopy; all lambs survived the procedure. While the applications of fetal endosurgery are likely to be similar to those of open fetal operation, fetal endoscopy (looking in the fetus) is a new entity for which clinical relevance (rather than mere feasibility) remains to be demonstrated. This technique, however, could become a valuable research tool to study fetal gastrointestinal and pulmonary physiologic factors in situ.

Animals↗
PubMed1994

Upper gastrointestinal endoscopy: its clinical use and safety at a transplant center.

Upper gastrointestinal endoscopy is a widely practiced clinical procedure that has become routine in even the most remote medical environments. Its application at a liver transplant center represents the use of this particular technology at the opposite extreme of medical practice and its use in a unique and severely ill group of patients. The following is a description of the author's experience with upper gastrointestinal endoscopy at the University of Pittsburgh's liver transplant center. Despite the severity of illness of the patients seen at this center, documented by the high frequency of patients seen with abnormal prothrombin times and low platelet counts, upper gastrointestinal endoscopy performed either for diagnostic or therapeutic procedures has been found to be safe. The disease processes that affect transplant patients both before and after transplantation are not seen frequently in the general practice of gastroenterology. Thus the endoscopist at a transplant center has to be able to recognize, identify, and treat the unique problems seen in a transplant population.

Endoscopy, Gastrointestinal↗
PubMed1993

[Is your scalpel correctly adjusted? The correct use of electric scalpels in digestive system endoscopy].

Progress has been made in electric scalpel technology, as applied to endoscopy, over recent years. Lamp or spark gap scalpels have been replaced by more reliable transistor scalpels fitted with a return electrode avoiding any defective circuits. Before using an electric scalpel, it is essential to understand the basic physical laws governing their use with section, coagulation or mixed currents. Any interference with other electrical apparatuses in the surgical endoscopy room must be avoided and precautions must also be taken in patients with cardiac pacemakers. Different settings are required for colonic polypectomy and endoscopic sphincterotomy in order to ensure a clean cut without oedema and with perfect haemostasis. Although monopolar currents are generally used, some haemostatic or tumour destruction electrodes use a bipolar current which avoids deep necrosis. Diathermy is a precise technique in interventional endoscopy, but surgeons must adapt their knowledge to the equipment used.

Electrocoagulation↗
PubMed1993

Is there a role for upper gastrointestinal endoscopy in the evaluation of patients with occult blood-positive stool and negative colonoscopy?

OBJECTIVE: To determine the role of upper gastrointestinal endoscopy in the clinical investigation of patients with occult blood-positive and negative colonoscopy. METHODS: This is a retrospective study of 211 consecutive patients who were investigated by upper gastrointestinal endoscopy for occult blood-positive stool and negative colonoscopy. Patients were categorized into four groups: asymptomatic (n = 117), symptomatic (n = 37), severe anemia (hemoglobin < 10 g/dl) (n = 33), and incomplete (CBC not obtained or insufficient documentation regarding the presence or absence of symptoms) (n = 24). RESULTS: Eighty-eight of the 211 patients (42%) had abnormal upper gastrointestinal endoscopic findings: 43% of the "asymptomatic" group, 35% of the "symptomatic" group, 45% of the "severe anemia" group, and 42% of the "incomplete" group. The number of patients with abnormal upper gastrointestinal findings increased with age (p = 0.0002). Furthermore, there was a significant difference in upper gastrointestinal lesions between the patients who were 60 yr of age or older, and the patients less than 60 yr of age: 51% compared to 22% (p = 0.00003). All upper gastrointestinal endoscopic findings were benign, with 53 of the 88 patients (60%) having erosive gastritis. However, only 25 of those 88 patients (28%) had a lesion for which a specific treatment was available. CONCLUSIONS: Upper gastrointestinal endoscopy in patients with occult blood-positive stool and negative colonoscopy has a very low yield for significant lesions, not only from a therapeutic standpoint, but also for detection of malignant lesions. Prospective studies are needed to determine which specific groups of patients deserve further investigation.

Aged↗
PubMed1993

Endonasal endoscopy and posterior epistaxis.

The availability of a comprehensive range of endonasal telescopes facilitates systematic examination of the nasal cavity. Epistaxis is normally divided into anterior and posterior. Posterior epistaxis is diagnosed when anterior rhinoscopy fails to visualize anterior-located bleeding points. With the aid of endonasal endoscopy the exact location of bleeding points can be identified and diathermy applied under direct vision. Twenty-seven cases of the so-called posterior epistaxis were treated successfully by endonasal endoscopy. The technique is particularly useful during acute nose bleeds, it shortens hospital stay, and reduces the discomfort inflicted by the presence of nasal packing. The need for blood transfusion is reduced by using endonasal endoscopy in the acute stage of epistaxis.

Adult↗
PubMed1994

Upper gastrointestinal endoscopy in central Australian aborigines.

OBJECTIVES: To examine the upper gastrointestinal endoscopic findings in Australian Aborigines in central Australia; to determine if peptic ulceration occurs in this group; and to discover whether this population shares Helicobacter pylori as a risk factor for peptic ulceration. METHODS: A retrospective analysis of the records of all Aboriginal patients undergoing endoscopy at a general hospital over a two-year period. RESULTS: Eighty-five endoscopies were performed in 64 patients. Haematemesis and melaena was the indication for 24 patients (more commonly in men) and a cause was identified in 83% of these patients; varices were the cause in 17%. Pain was an indication for 25 patients (more commonly in females) and abnormalities were detected in 64%. Peptic ulceration was found in nine patients and a further 23 had gastritis or duodenitis. Cases of oesophageal, gastric and duodenal malignancy were seen, as well as late complications of simple diseases, including gastric outlet obstruction, oesophageal stricture and cholecystoduodenal fistula formation. Of 17 gastric biopsies with evidence of inflammation, H. pylori was found in 15 (88%). CONCLUSION: This, the first study of upper gastrointestinal endoscopy in Aborigines, shows its usefulness in the investigation of their gastrointestinal complaints. Oesophageal varices were found to be an important cause of bleeding. Peptic ulceration associated with H. pylori was found to be common.

Abdominal Pain↗