Magnetic resonance cholangiopancreaticography with esomeprazole: comparison between single and double oral dose

The aim of this study was to compare patient's Magnetic Resonance Cholangiopancreaticography [MRCP] control images with the same patient's images after taking 40mg or 80mg Esomeprazole, and to define the medication role in improving visualization quality of images. Seventy patients attending gastroenterology clinic at Jordan University Hospital during the period first of January 2007 till the end of December 2007 were in a consecutive manner control images, then either 40 mgs or 80 mgs Esomeprazole was given and images re-obtained compared with control images for each patient. Improvement of Contrast effect on stomach and duodenum in Esomeprazole single dose group was 72.5% and in double dose group was 78.5%, while image effect of pancreatic duct was the same for single dose Esomeprazole and double dose [60%], and their statistical results were in concordance with no considerable difference, and the image effect of the biliary tree didn't show any significant difference between imaging and statistical results in both groups. Esomeprazole improves images and gives superior quality of Magnetic Resonance Cholangiopancreaticography especially the contrast effect of duodenum and stomach and image effect of pancreaticobiliary ducts. But images obtained from patients given a double dose showed no significant difference to those patients given a single dose except some advantage is seen in favor of double dose group in improving intrahepatic duct images

Magnetic resonance cholangiopancreaticogram: outcomes at Jordan university hospital

Objectives: To evaluate the experience of Jordan University Hospital in magnetic resonance cholangiopancreaticogram over the period of three years and to compare the results with upper GI endoscopy, surgery, liver biopsy and endoscopic retrograde cholangiopancreaticogram

Methods: Conventional abdominal magnetic resonance examination [CAMRE] of the upper abdomen followed by Magnetic Resonance Cholangiopancreaticogram [MRCP] was performed in 174 patients. Endoscopic Retrograde Cholangioanpereaticogram [ERCP] was performed in 84 patients, upper GI endoscopy [UGIE] in 60 patients, liver biopsy in 9 patients and surgery in 40 patients

Results: Eighteen patients were excluded. In 156 patients MRCP and CAMRE were adequate. Ninety four patients [60.3%] had abnormal MRCP; 40 patients [25.6%] showed abnormality in the CAMRE. Fifty patients [55.3%] had cholidocolithiasis and 30 patients [31.9%] had malignant stricture. MRCP was normal in 62 patients [39.8 %] when ERCP_was abnormal; two patients had gallstones from this group. ERCP was successful in 77 patients out of 84 [91.7%] with endoscopic sphincterotomy and 30 patients had abnormal UGIE

Conclusion: MRCP is a very good technique in detection of pancreatic and biliary ducts pathology, its diagnostic accuracy is increased if combined with CAMRE, it should be done prior to diagnostic ERCP particularly in patients with previous un successful attempt

Results of lower gastrointestinal endoscopy in one hundred and fifty clinical cases

Sigmoidoscopy [rigid and fiber] was carried out on 150 patients, 97 male and 53 female. The ages ranged between seven and 75 years, the mean age being 36.4 with a standard deviation of +/- 14.5 years. The majority of cases presented with rectal bleeding [77] and bloody diarrhea [24]. The most significant findings were: hemorrhoids [46.7%], polyps [11.3%], amebic colitis [11.3%], ulcerative colitis [6.7%], and rectosigmoid cancer [5.3%]. The results are tabulated according to findings and symptoms, and point out the importance of early lower gastrointestinal [GI] endoscopy even if Entamoeba histolytica is present in the stool. Although visualization of the rectum was discussed long ago by Hippocrates[1] rigid sigmoidoscopy was introduced as a new method of examination much later by Kelly in 1895[2], and became a routine procedure in 1950[3]. The fiberoptic sigmoidoscopes and colonoscopes were developed since then, making some surgical procedures possible under optical control. Moreover, through photographic documentation of clinical findings as well as histologic and cytologic examination of specimens, diagnosis became more accurate[4-6]. The aim of this study was to correlate clinical symptoms and endoscopic findings in cases with complaints related to the GI tract or to any intra-abdominal pathology