Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Colonoscopes”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,567 records · Page 87Linked to original sources
PubMed2005

Eosinophilic gastroenteritis with severe protein-losing enteropathy: successful treatment with budesonide.

We report the clinical, laboratory, endoscopic and histopathological findings in a 40-year-old woman with watery diarrhoea and hypoproteinaemia. Elevated alpha(1)-antitrypsin clearance confirmed massive protein-losing enteropathy. Gastroscopic and colonoscopic biopsies showed abundant infiltration of the small bowel wall with eosinophils in proximal duodenum and terminal ileum, respectively. These findings established the diagnosis of eosinophilic gastroenteritis. Both the inflammatory alterations and the severe intestinal protein loss were successfully treated with budesonide, a topically active corticosteroid preparation with controlled small bowel release. The case report illustrates that remission of protein-losing enteropathy secondary to eosinophilic gastroenteritis can be achieved with budesonide, thus supporting its use for this uncommon disease characterised by inflammatory intestinal lesions.

Adult↗
PubMed2006

Synchronous gastric and colonic MALT-lymphoma in coeliac disease: a long-term follow-up on gluten-free diet.

We describe the first case of synchronous gastric and colonic mucosa-associated lymphoid tissue lymphoma in coeliac disease. After refusing any other treatment, the patient started a gluten-free diet but a re-evaluation 3 years later failed to demonstrate improvement of the gastric neoplasia on a gluten-free diet, whilst the colonic mucosa-associated lymphoid tissue lymphoma behaviour was unknown (the patient refused a new colonoscopic evaluation).

Celiac Disease↗
PubMed2005

Mucoadhesives in the gastrointestinal tract: revisiting the literature for novel applications.

This article investigates applying mucoadhesives to manipulate friction and to achieve locomotion of an alternative colonoscopic device through the large intestine. Considering that such an application of mucoadhesives is new, the authors recognised the need to revisit the different aspects of mucoadhesion in the gastrointestinal tract on the basis of the literature and to re-evaluate them according to the requirements for intestinal locomotion. First, the material properties, which are critical for the locomotion mechanism and specific categories of mucoadhesives characterised by those critical properties were identified. The next step was to examine the structural characteristics of those categories to specify which of the already synthesised mucoadhesives are promising candidates for friction manipulation. Then, the response of those mucoadhesives to a number of environmental stimuli was examined. At the end, two in vitro experiments were carried out to study the potential of mucoadhesives for intestinal locomotion. A comparative analysis of the role of mucoadhesives in drug delivery and in intestinal locomotion leads to the conclusion that the two applications can be approached to one extent with common principles, but crucial differences are present as well.

Adhesives↗
PubMed2005

A comparison of the immunochemical fecal occult blood test and total colonoscopy in the asymptomatic population.

BACKGROUND & AIMS: The fecal occult blood test (FOBT) is recommended as a screening test for colorectal cancer, but there are few reliable studies on the accuracy of immunochemical FOBT. The aim of this study was to analyze the sensitivity of immunochemical FOBT and to compare the results with the findings from complete colonoscopy. METHODS: Asymptomatic adults underwent 1-time immunochemical FOBT and total colonoscopy simultaneously. The prevalence and location of colorectal neoplasia were determined by colonoscopy. The results of immunochemical FOBT and the colonoscopic findings were compared. RESULTS: Of 21,805 patients, immunochemical FOBT was positive in 1231 cases (5.6%). The sensitivity of 1-time immunochemical FOBT for detecting advanced neoplasia and invasive cancer was 27.1% and 65.8%, respectively. In addition, the sensitivity for invasive cancer according to Dukes' stage showed 50.0% for Dukes' stage A, 70.0% for Dukes' stage B, and 78.3% for Dukes' stages C or D. The sensitivity for detecting advanced neoplasia at the proximal colon was significantly lower than that detected in the distal colon (16.3% vs 30.7%, P = .00007). CONCLUSIONS: Although the screening of asymptomatic patients with immunochemical FOBT can identify patients with colorectal neoplasia to a certain extent, the sensitivity is relatively low and different according to the tumor location. Therefore, programmatic and repeated screening by immunochemical FOBT may be necessary to increase sensitivity for colorectal cancer detection.

Adult↗
PubMed2006

Endoluminal endosurgery: rivet application in flexible endoscopy.

BACKGROUND: Endoluminal endoscopy could be significantly enhanced by adequate approaches to wound closure. Current solutions are basically confined to clip applications. OBJECTIVE: A new approach to sewing in flexible endoscopy is achieved with an endoluminal rivet system. This system allows the application of several ligatures without withdrawing the rivet application device to reload. For this purpose, a pilot experimental study of the device was conducted, which obtained a tissue approximation and avoided the difficult process of knot tying. DESIGN: Pilot experimental study. SETTING: The rivet application was tested through a 1.8-mm working channel of the endoscope in laboratory and postmortem animal tissues. It consists of a flexible anchor at the front and a lockable bracket at the rear. Both edges of a defect of the GI wall can be aligned and compressed, thus leading to wound closure. INTERVENTIONS: Test samples were evaluated in postmortem gastric tissue by using flexible gastroscopes. The feasibility of applying a series of rivets with 1 instrument to close transmural lacerations of the stomach was demonstrated. Further tests were performed to determine the forces to penetrate the gastric wall. MAIN OUTCOME MEASUREMENTS: Tissue closure, rivet degradation. RESULTS: The penetration force can be brought down to less than 0.57 N by using a magnesium tip. The sharp tip of the rivet, which could potentially lacerate healthy tissue after implantation, is degraded in the stomach within the first few hours because of rapid corrosion. LIMITATIONS: Lack of in vivo feasibility data. CONCLUSIONS: Endoluminal wound closure through common gastroscopes and colonoscopes is possible. Further in vivo data are required for the rivet system.

Endoscopes, Gastrointestinal↗
PubMed2006

Colonoscopy with polypectomy in anticoagulated patients.

BACKGROUND: According to current practice guidelines for performance of colonoscopy in patients requiring long-term anticoagulation, polypectomy is considered a high-risk procedure for which anticoagulation must temporarily be discontinued. However, these guidelines are based on expert opinion, and the bleeding risk after polypectomy in anticoagulated patients is not known. OBJECTIVE: Measure the risk of postpolypectomy bleeding in patients who undergo colonoscopic polypectomy while anticoagulated. DESIGN: Retrospective review of patients who underwent polypectomy without discontinuation of anticoagulation. SETTING: Veterans Administration Palo Alto Health Care System. PATIENTS: Forty-one polypectomies were performed in 21 patients. All patients had been receiving long-term anticoagulation with warfarin; the average international normalized ratio was 2.3 (range 1.4-4.9; normal 0.9-1.2). To prevent supratherapeutic anticoagulation, warfarin was withheld for 36 hours before the procedure while the patients were on a liquid diet. The average polyp size was 5 mm (range 3-10 mm). INTERVENTIONS: All patients underwent polypectomy followed immediately by prophylactic application of one or two clips to prevent bleeding. MAIN OUTCOME MEASUREMENTS: Rate of postpolypectomy bleeding. RESULTS: There were no episodes of postpolypectomy bleeding. The 95% CI for the risk of bleeding was 0% to 8.6% when analyzed per polypectomy and 0% to 15% when analyzed per patient. LIMITATIONS: Small single-center retrospective study. CONCLUSIONS: Our experience suggests that small polyps can be removed with a very low risk of bleeding when clips are applied immediately after polypectomy. If these results can be confirmed in a larger multicenter study, our protocol may become an alternative to withholding anticoagulation in patients at high risk of thrombosis.

Anticoagulants↗
PubMed2006

Endoluminal closure of large perforations of colon with clips in a porcine model (with video).

BACKGROUND: Endoluminal clip closure of small perforations of the colon is possible. It is unclear whether large perforations of the colon can be closed with clips deployed through a colonoscope. OBJECTIVES: To evaluate the technical feasibility and outcome of endoluminal closure of large perforations of the colon with clips. DESIGN: Pilot study. SUBJECTS: Eight pigs. INTERVENTIONS: Endoluminal clip closure of large perforations of the colon. MAIN OUTCOME MEASUREMENTS: Technical feasibility of endoluminal closure was evaluated in 8 animals. A dye leak test was performed to evaluate quality of endoluminal sealing immediately after closure and 2 weeks after closure. The animals in the survival group were monitored daily for 2 weeks for sepsis and peritonitis. Necropsy was done on day 14 to check for fecal peritonitis, wound dehiscence, and histological healing of perforation. RESULTS: Endoscopic closure of colon perforation was successful in 6 of 8 animals; in 2 animals closure was unsuccessful due to prolapse of adjacent viscera into the colon (n = 1) and severe bleeding that obscured the view (n = 1). There was a leak-proof sealing of the perforation site in 2 animals tested immediately and in all the animals tested (n = 3) 2 weeks after closure. All 4 animals in the survival group recovered well, without any sepsis or peritonitis. Necropsy did not reveal fecal peritonitis or pericolonic abscess formation. The perforation site demonstrated a thin scar and there was histological healing. CONCLUSIONS: Endoluminal application of clips is successful in the closure of a large perforation of the colon in a porcine model.

Animals↗
PubMed2006

Colorectal neoplasia in Asia: a multicenter colonoscopy survey in symptomatic patients.

BACKGROUND: The incidence of colorectal cancer is rising rapidly in some Asian countries. OBJECTIVE: To determine the prevalence and the distribution of colorectal neoplasm in Asian populations. DESIGN: A multicenter colonoscopy survey. PATIENTS: Between July 2004 and April 2005, consecutive symptomatic patients undergoing colonoscopic examinations in 10 different Asian countries. SETTING: The location and the histologic features of all colonic neoplasms were recorded. Advanced neoplasm was defined as adenoma larger than 10 mm in size, with >25% villous features or with high-grade dysplasia or invasive carcinoma. MAIN OUTCOME MEASUREMENTS: The prevalence and the distribution of colorectal neoplasm and advanced neoplasm. RESULTS: A total of 5464 eligible patients underwent colonoscopy. Advanced neoplasm was found in 512 patients (9.4%). Factors associated with the presence of advanced neoplasm in this symptomatic Asian population included male sex (relative risk [RR] 1.52, 95% confidence interval [CI] 1.26-1.84), older age (RR 1.05, 95% CI 1.04-1.06), and ethnicity (P = .001). Advanced proximal neoplasm was detected in 136 patients (2.5%); 83 (61.0%) of the patients had normal distal colon. The RR of proximal advanced neoplasm was 2.5, 95% CI 1.7-3.7 in those with any adenoma in the distal colon compared with those with normal distal colon. LIMITATIONS: Possible underrepresentation of some ethnic groups because of uneven ethnic group distribution and the lack of population-based registry. CONCLUSIONS: This was the first multicenter colonoscopy survey that examined the characteristics of colorectal neoplasm in Asia. The results will have important implications on the planning for future colorectal cancer screening in this region.

Adenoma↗
PubMed2005

Endoluminal palliation.

Endoluminal palliation involves the application of endoscopic techniques or devices to relieve the symptoms of malignant gastrointestinal obstruction. This is most often achieved with the use of self-expandable metal stents (SEMS). SEMS can be deployed as far distally or proximally in the gastrointestinal tract as the reach of an adult colonoscope. This article outlines the use of endoscopic techniques to provide endoluminal palliation.

Brachytherapy↗
PubMed2005

Confocal laser endomicroscopy.

A miniaturized confocal microscope was developed that could be integrated in the distal tip of a conventional colonoscope. With this technique, denoted confocal endomicroscopy, subsurface analysis of the gut mucosa and in-vivo histology during ongoing endoscopy are possible in full resolution by point scanning laser analysis. The diagnostic spectrum of confocal endomicroscopy is expanding from screening and surveillance for colorectal cancer to Barrett's esophagus, Helicobacter pylori-associated gastritis, and gastric cancer. The new detailed images seen with confocal laser endomicroscopy allow a unique look on cellular structures at and below the surface of the gut. This review describes the optical and diagnostic possibilities of confocal laser endomicroscopy.

Acriflavine↗
PubMed2004

Outcome of aggressive surveillance colonoscopy in ruptured abdominal aortic aneurysm.

PURPOSE: Emergent repair of ruptured abdominal aortic aneurysms (rAAAs) is associated with high perioperative morbidity and mortality. One of the significant complications of this surgery is bowel ischemia. Reports detail mortality as high as 80% when this condition is realized. The objective of this project was to determine both the incidence and the effect of mandatory postoperative colonoscopy on outcome of colon ischemia after rAAA. METHODS: From July 1995 to September 2002 all patients with an rAAA who underwent emergent aortic reconstruction were included in this review. All colonoscopies were performed within 48 hours, ischemia was graded consistently, and treatment was initiated per protocol based on grade of ischemia. Patients with grades I and II ischemia were followed up with medical management and repeat colonoscopy. All patients with grade III ischemia underwent bowel resection. Preoperative, intraoperative, and postoperative variables were collected to assess possible independent risk factors for and predictors of bowel ischemia. RESULTS: Eighty-eight patients underwent emergent aortic reconstruction because of rAAA in the study period. Their mean age was 73 years, and 64 patients (72%) were men. Operative mortality was 42%. Eighteen percent of patients died within 24 hours, and 24% died between 1 and 30 days after surgery. Colonoscopy was performed in 62 of 72 patients who survived more than 24 hours. Bowel ischemia was documented in 26 of the 72 patients (36%). Of these, 16 patients had grade I or grade II ischemia at both initial and repeat endoscopy. Nine patients underwent exploratory laparotomy with bowel resection because of grade III ischemia; two procedures were performed because of worsening ischemia discovered at repeat colonoscopy. In patients with colonoscopic findings of bowel ischemia the mortality rate was 50% (13 of 26 patients). In those with grade III necrosis who underwent resection the mortality rate was 55%. Elevated lactate levels, immature white blood cells, and increased fluid sequestration were all variables associated with the occurrence of colon ischemia. CONCLUSIONS: Bowel ischemia is a frequent postoperative complication (42%) of repaired rAAA. Performing mandatory surveillance colonoscopy in these patients may be associated with a decrease in overall mortality and improved survival in patients with transmural bowel necrosis with no comorbid condition.

Aged↗
PubMed2005

The pathophysiology, clinical presentation, and diagnosis of colon cancer and adenomatous polyps.

A review of the pathophysiology, clinical presentation, and diagnosis of colon cancer and colonic polyps is important and timely. This field is rapidly changing because of breakthroughs in the molecular basis of carcinogenesis and in the technology for colon cancer detection and treatment. This article reviews colon cancer and colonic polyps, with a focus on recent dramatic advances, to help the pri-mary care physician and internist appropriately refer patients for screening colonoscopy and intelligently evaluate colonoscopic findings to reduce the mortality from this cancer.

Adenomatous Polyps↗
PubMed2005

Localized lymphoid hyperplasia of the rectum resembling polypoid mucosa-associated lymphoid tissue lymphoma: a report of three cases.

Histologically, benign lymphoid hyperplasia of the rectum is usually characterized by large lymphoid follicles with active germinal centers and by a narrow surrounding mantle zone and marginal zone (MZ). We report here three cases of benign lymphoid hyperplasia of the rectum associated with prominent marginal zone hyperplasia, which caused serious difficulty in the differential diagnosis from the polypoid type of mucosa-associated lymphoid tissue (MALT) lymphoma. Colonoscopy demonstrated small sessile polyps in all three cases. Histologically, the lesions were characterized by a hyperplastic germinal center and expanded MZs. The expanded MZs contained numerous monocytoid B-cells (MBC) and scattered large transformed B-cells. Initially, combined colonoscopic and histological findings strongly supported a diagnosis of polypoid MALT-type lymphoma of the rectum. However, there were neither colonized lymphoid follicles nor lymphoepithelial lesions in any of the three lesions. MBCs and large transformed B-lymphocytes were CD43- and bcl-2-. Moreover, immunohistochemical and genotypic studies proved the polytypic nature of the B-lymphocytes in all three lesions. The present cases indicated that benign lymphoid hyperplasia of the rectum should be included in the differential diagnosis for polypoid MALT-type lymphoma of the rectum.

Aged↗
PubMedDate not supplied

Self-expandable metal stents to treat gastric leaks.

OBJECTIVES: Anastomotic leak is a major complication after gastric bypass (GBP) surgery, and it usually necessitates reoperation and is associated with long-term recovery and death. We present our experience with the use of self-expandable metal stents (SEMS) to treat this complication. METHODS: Seventeen patients (14 males and 3 females, mean body mass index of 43.7 kg/m(2)) with gastro-jejunal leak after GBP underwent covered SEMS placement 1 to 3 weeks after surgery: 8 laparoscopic, 5 open, and 4 revisional procedures. All patients who underwent laparoscopic and revisional procedures had abdominal drains placed at surgery. No drains were placed in the open cases. Five patients required surgery to drain an abdominal abscess. RESULTS: Tolerance for oral feeding was achieved between 2 and 3 days after SEMS placement. One patient persisted with a minimal leak for 2 weeks. To date, all stents have been removed endoscopically 3.2 +/- 1.2 months after placement. Four patients needed a second session to complete removal of the uncovered top of the stent. Two esophageal mucosal tears occurred; both were managed conservatively. Sixteen patients had a totally sealed leak. One remained with a gastro-gastric fistula. One stent spontaneously migrated to the splenic flexure and was removed colonoscopically. CONCLUSIONS: SEMS placement for gastro-jejunal leaks is a safe therapeutic option.

Adult↗
PubMedDate not supplied

Colonoscopy is a useful diagnostic tool for transplant recipients with lower abdominal symptoms.

Transplant recipients are at higher risk for infection and malignancy due to therapies aimed at preventing rejection. Early detection and successful treatment of such complications is of pivotal importance for both patient and graft survival. In this study, we evaluated findings of 91 colonoscopies and colonic histopathologic findings in recipients who presented with lower gastrointestinal system complaints between January 1996 and January 2003. The study group included 79 renal and liver transplant patients. The indications for colonoscopy were diarrhea (n = 58), abdominal pain (n = 5), hematochezia (n = 19), unexplained anemia (n = 5), thickening of a colonic segment detected on computerized tomography (n = 2), screening for lymphoma (n = 1), and Kaposi's sarcoma (n = 1). During the procedures, all suspicious lesions were biopsied and specimens of normal-appearing mucosa collected when deemed necessary in relation to the clinical complaints. The endoscopic findings were classified as follows: 0 = "normal," with clear visualization of the vascular network and normal-appearing mucosa; 1 = "erythema", with tissues showing erythema, edema, hyperemia, and loss of normal vascular network; 2 = "ulcerative," with tissues exhibiting ulceration and fragility; and 3 = "coincidental findings," such as polyp or angiodysplasia. Colonoscopic and/or histopathologic abnormalities were detected in 44.5% of the 91 colonoscopy procedures. The results indicate that colonoscopy is a valuable diagnostic tool for evaluation of transplant recipients with lower gastrointestinal complaints. After an initial workup colonoscopy is important to establish an accurate diagnosis.

Adolescent↗
PubMed2005

The role of early colonoscopy in CMV colitis of transplant recipients.

Cytomegalovirus (CMV)-associated diseases remain a major problem in transplant recipients. Early diagnosis is critical. Presentation of early CMV colitis can be mild and nonspecific in transplant recipients. Although serology is helpful in the diagnosis, sometimes it is inadequate. Because the endoscopic features of CMV colitis are specific, colonoscopy facilitates the histopathologic examination. We present the clinical properties and advantages of early colonoscopy in transplant recipients with CMV colitis. The study group included seven patients (six men, one woman of mean age, 36.7 years (range, 22 to 64 years) whose mean transplant duration was 12.3 months (range, 1 to 72 months). Six of the seven patients experienced an acute graft rejection treated with high doses of steroids; one patient had a herpes simplex virus infection. All patients were on steroid treatment with a various combinations of immunosuppressive agents, including cyclosporine, mycophenolate mofetil, and tacrolimus. All patients presented with mild diarrhea without any blood or mucous discharge. Four patients had fever exceeding 38 degrees C; two had abdominal pain. Stool examinations revealed normal findings in six patients, while one patient had white blood cells and amoebic cysts. Serum CMV IgM and CMV pp65 antigenemia were negative in five of seven patients and two had positive results. All patients showed typical colonoscopic and histopathologic findings compatible with CMV colitis. Standard ganciclovir treatment was successful in all patients. Early and rapid colonoscopy is beneficial for the early diagnosis and management of CMV colitis in transplant recipients.

Adult↗
PubMed1996

Human enteric infection with Ancylostoma caninum: hookworms reappraised in the light of a "new" zoonosis.

Recent studies in northeastern Australia indicate that enteric infection with Ancylostoma caninum is a leading cause of human eosinophilic enteritis. Much more frequent accompaniments of this infection are obscure abdominal pain with or without blood eosinophilia, while a large part of the population is probably infected asymptomatically. These conclusions are based on extensive serological investigations in patients and control subjects, as well as 15 cases in which single, adult hookworms were identified in situ in patients. In no case has more than one worm been identified, and none has been fully mature, so the infections have never been patent. Aphthous ulcers of the terminal ileum, caecum and colon have been seen in association with this infection and have also been observed in almost 5% of patients who are colonoscoped in north Queensland. Serodiagnosis has relied on an IgG and IgE ELISA using excretory-secretory antigens from adult A. caninum, but Western blot using these antigens to identify IgG4 antibodies to a protein of molecular weight 68 kDa (Ac68) promises to be more specific and sensitive. However, identical antigens appear to be secreted by the anthropophilic hookworms as well. The clinical, public health and biological significance of these findings are discussed in detail.

Adult↗
PubMed1997

Prospective evaluation of the gastrointestinal tract in patients with iron deficiency and no systemic or gastrointestinal symptoms or signs.

BACKGROUND: Although endoscopic evaluation of the gastrointestinal tract is commonly performed to evaluate iron deficiency, little data is available regarding the underlying causes, yield of evaluation, and long-term outcome for those in whom gastrointestinal and systemic symptoms and signs are absent. METHODS: In- or out-patients seen by the gastroenterology consultative service at a large inner-city hospital over a 56-month period were considered eligible for the study when iron deficiency (serum ferritin <50 ng/mL) was documented. Exclusion criteria included: any gastrointestinal or systemic symptoms/signs, radiographic or endoscopic examinations of the gastrointestinal tract within 3 and 5 years, respectively, or obvious source of blood loss. Patients underwent colonoscopy and if no lesions other than carcinoma were found, upper endoscopy was then performed with a pediatric colonoscope. RESULTS: Fifty-two patients were evaluated (mean age, 66 +/- 13 years; range, 20 to 89 years; 32 men/20 women). At the time of evaluation, the mean (+/-SD) hematocrit was 25% +/- 7% (range, 14% to 42%). Overall, 23 patients (44%; 95% CI 30% to 59%) had an identifiable gastrointestinal lesion considered the cause of iron deficiency, including: colonic carcinoma, 11 (21%); colonic and/or esophagogastric/duodenal vascular ectasias, 9 (17%); and gastric carcinoma, colonic polyposis, and colonic ulcers in 1 patient each. Long-term follow-up (median 24 months, range 2 to 63 months) identified only 1 patient with a cause found (colonic carcinoma), and in this patient, complete colonoscopy was not technically possible at the time of initial evaluation. There were no clinical or laboratory features that distinguished patients with an etiology for iron deficiency to the idiopathic group. CONCLUSIONS: Approximately half of patients with iron deficiency in whom gastrointestinal or systemic signs or symptoms are absent have an underlying gastrointestinal lesion. Nevertheless, despite a thorough endoscopic evaluation, some patients will have no etiology found; the prognosis for these patients is excellent.

Adult↗