Carcinoembryonic antigen level during colonoscopy preparation

Serum carcinoembryonic antigen [CEA] level was measured in 24 patients at the time [immediately before and immediately after] of colonoscopic examination after bowel cleansing and compared with resting level in serum sample taken from the same patient two weeks later after the colonoscopy. A significant rise of the level at the time of the procedure was seen. The rise was particularly significant in a small group of patients with colonic polyps [benign adenomatous] or prevoius colonic resection for carcinoma, suggesting a need for careful timing in taking blood samples. These findings may have diagnostic significance in the identification of patients at higher risk of malignant disease of the colon

Endoscopic sclerotherapy [EST] for oesophageal varices: comparison of three different schedules

This study presents analysis of 125 patients with oesophageal varices to compare the efficacy and complications of various schedules of endoscopic sclerotherapy [EST] of the varices. The schedule for the first three injections was as follows: [A]3-5 ml of 5% ethanolamine oleate solution injected at interval of four weeks [Group I, n = 28], two weeks [Group II, n = 30] and one week [Group III a, n = 33]. [B] 1-2 ml of the same sclerosant at each site at interval of 1 - week [Group III b, n = 34]. Subsequent injections were given at four weeks interval for all groups. Varices could be obliterated significantly earlier [p < 0.001] in patients injected at 1 - week interval [9.12 +/- 5.95 weeks] as compared with those injected at 2- weeks [13.5 +/- 10.3 weeks] and 4- weeks [20.55 +/- 7.8 weeks] interval. The rebleeding rate was not significantly less in the one - week interval group [Group IlIa-18.2% and Group Illb 14.1%] as compared with the 2-weeks [23.3%] and 4-weeks [28.5%] groups. However, the mortality due to rebleed was significantly less [p < 0.05] in patients injected at 1-week interval [nil], as compared with patients injected at 2-weeks [13.3%] and 4-weeks [10.7%] interval. Mucosal ulcerations and stricture formation were observed significantly [p < 0.001] more frequently in patients undergoing EST at 1-week interval [Group IlIa - 51.5% and 18.2% respectively] with 3-5 ml of sclerosant as compared with those injected with similar volume at 2-weeks [16.6% and 3.3%] and 4-weeks [7.1% and 3.5%] interval respectively. However, the incidence of mucosal ulcerations and oesophageal strictures decreased significantly [p < 0.001] in the 1-week group [Group Illb] on reducing to 1-2 ml volume of sclerosant injected at each site [17.6% and 2.9%]. The number of EST sessions required to obliterate the varices was not different in the four groups. The 1-week schedule of initial endoscopic sclerotherapy [injecting 1-2ml of 5% ethanolamine oleate at each site] appears to be safe and superior to the 2-weeks and 4-weeks schedules