Efifcacy of OTSC closure to the acute iatrogenic gastrointestinal perforation / 中国内镜杂志

Objective To evaluate the efifcacy of endoscopic Over-The-Scope-Clip system (OTSC) system for the acute iatrogenic digestive tract perforation. Methods To collect 11 cases with digestive tract perforation closed with the OTSC system, including 7cases of gastric perforation, 1 case of duodenal perforation,3 cases of colorectal perforation. Results 11 cases were successfully closed with OTSC system in time, the average time needed for the endoscopic closure is 6~15 min. And the perforation diameter is 0.6~3.7 cm, average diameter is (1.89 ± 0.27) cm. No intraoperative bleeding and delayed hemorrhages, no deaths occurred. Conclusion Endoscopic OTSC system is a successful method for the digestive tract perforation and is worth to popularize.

Endoscopical and histological changes in bile reflux gastritis / Монголын Анагаах Ухаан

Introduction@#Bile reflux gastritis is due to an excessive reflux of duodenal contents into the stomach. The increasedenterogastric reflux may provide the basis for increased mucosal injury. In clinical practice the symptoms of bile reflux gastritis are nonspecific than the other gastritis. Only endoscopy and biopsy can confirm the diagnosis. Observation demonstrates that, in practice there is tendency to increase the bile reflux gastritis. However, in Mongolia there are much less research and studies in this area. @*Goal@#Evaluate the endoscopical and histological changes caused by duodenal reflux on the gastricmucosa@*Materials and Methods@#We included in our study 70 patients with bile reflux gastritis admitted in Second General Hospital in Ulaanbaatar. In all cases we performed an upper gastrointestinal endoscopy and at least 4 biopsyspecimens were done from antral mucosa and the histological features were scored in accordance with the Sydney system. @*Results@#The average age of the patients with bile reflux gastritis was 61.64±9, 69 years. Reflux gastritis was noted to 15 males and 55 females. Gastroduodenal reflux after chlocystoectomic surgery was noted in 46 cases (65.71%), and biliarytract disease was noted in 16 cases (22.85%). The average time interval from original operation tothe discovery of the bile reflux gastritis was 9.22 years after chlocystoectomic surgery. The commonest endoscopic alterations were: erythema of the gastric mucosa in 41 cases (58.57%),gastric antral atrophy in 20 cases (28.57%), gastric diffuse atrophy in 27 cases (38.57%), thepresence of bile into the stomach in 70 cases (100%), erosions in 3 cases (4.28%), gastric ulcer in2 cases (2.85%), intestinal metaplasia in 10 cases (14.28%).The histologic alterations observed from tissues collected during endoscopic examination were chronic super facial gastritis in 19 cases (27.14%), chronic atrophic gastritis in 51 cases (72.85%),an intestinal metaplasia in 32 cases (14.28%), gastric erosions and ulcer in 4 cases (5.71%),dysplasia in 1case (1.42%), Helicobacter pylori infection in 14 cases (20%).@*Conclusions@#The most frequent risk factors for bile reflux gastritis were chlocystoectomic surgery and biliary tract disease. Histological findings of patients with bile reflux gastritis revealed gastric cancer precursor lesions, therefore follow-up endoscopic examinations and early treatment of bile reflux are essential.

Presencia de la celdilla supra-órbito-etmoidal: revisión de la literatura a partir de un caso / Presence of supraorbital ethmoid cell: literature review from a case

La celdilla supra-órbito-etmoidal es una variación anatómica que se presenta con diferente frecuencia para las distintas poblaciones. Representa un desafío al realizar cirugía endoscópica funcional del seno frontal debido a que su presencia dificulta el drenaje adecuado del receso del frontal mismo y puede ser confundida con el seno. La celdilla supra-órbito-etmoidal presenta relaciones espaciales constantes con la arteria etmoidal anterior, sirviendo como marcador anatómico confiable para el abordaje quirúrgico. Se destaca la importancia de considerar la presencia de tabiques óseos en el seno frontal en el estudio imagenológico que puedan sugerir la presencia de la celdilla supra-órbito-etmoidal. Se presenta el caso clínico de un paciente que consulta por proptosis del ojo derecho debido a un proceso expansivo por mucocele localizado en dicha variante anatómica.

The supraorbital ethmoid cell its an anatomical variation with different frecuency for diverse populations. It represents a challenge for the endoscopical functional :surgery of the frontal sinus. The supraorbital ethmoid cell presents an estable anatomical relationship with the anterior ethmoidal artery, serving as a dependable anatomical marker for the surgical approach. We stand out the importance to consider the presence of bony septations in the frontal sinus that might suggest the presence of the supraorbital ethmoid cell. We introduce a clinical case from a patient who had an expansive process from a mucocele in the supraorbital ethmoid cell.

Comportamiento del cáncer colorrectal esporádico en un hospital provincial / Behavior of sporadic colorectal cancer in a provincial hospital

Introducción: el cáncer colorrectal ocupa la segunda causa entre las neoplasias malignas en todo el mundo y su incidencia se ha ido incrementando. En 2011, el Anuario Estadístico Cubano reportó 2 039 casos nuevos. El pronóstico de la enfermedad está en relación con el diagnóstico temprano. Objetivo: describir el comportamiento del cáncer colorrectal esporádico. Métodos: se realizó un estudio transversal en el Hospital Universitario Manuel Ascunce Domenech, Camagüey, Cuba, desde enero-2009 a diciembre-2010. La muestra estuvo constituida por 106 pacientes con este diagnóstico, por colonoscopia y biopsia, que fueron sometidos a cirugía, con el análisis anatomopatológico posterior de la pieza quirúrgica. Los datos fueron obtenidos del registro primario y procesados mediante el sistema SPSS para Windows. Resultados: aumentaron los casos con el incremento de la edad, predominó el sexo masculino (53,8 porciento) y los pacientes sin antecedentes patológicos familiares (91,5 por ciento), ni personales (76,4 por ciento). El estreñimiento (42,4 por ciento) y la enterorragia (33 por ciento) fueron las manifestaciones más frecuentes para los tumores de colon izquierdo, mientras la anemia (27,4 por ciento) y el tumor palpable (22,6 por ciento) lo fueron para los del colon derecho. Hubo mayor porcentaje de la localización anatómica en el colon izquierdo (66,1 por ciento), la variedad polipoidea (59,4 por ciento) y el adenocarcinoma (97,2 por ciento). El estadio B (62,3 por ciento), según la clasificación de Dukes fue el más representado. Conclusiones: nuestros resultados son similares a las tendencias mundiales. El cáncer colorrectal continúa siendo identificado en estadios avanzados, por eso debe ser considerada la implementación de estrategias de escrutinio para reducir la incidencia y la mortalidad

Introduction: the colorectal cancer holds the second place among the malignant neoplasias worldwide and its incidence is growing. The Cuban Statistical Annals of 2011 reported 2 039 new cases. The prognosis depends on early diagnosis. Objective: to describe the behavior of the colorectal cancer. Methods: a cross-sectional study was made in Manuel Ascunce Domenech university hospital in Camagüey, Cuba, from January 2009 to December 2010. The sample was made up of 106 patients diagnosed by colonoscopy and biopsy. The surgical sample was subjected to the anatomical and pathological analysis. The data were taken from the primary register and processed in Windows-based SPSS system. Results: the number of cases raised as the age increased, males (53.8 percent) and the patients without family history (91.5 percent) or personal history (76.4 percent) of this pathology predominated. Constipation (42.4 percent) and rectal bleeding (33 percent) were the most frequent manifestations of left colon tumors, whereas anemia (27.4 percent) and palpable tumor (22.6 percent) were those of the right colon tumor. The highest percentage of tumors was located in the left colon (66.1 percent); the polypoid variety (59.4 percent) and adenocarcinoma (97.2 percent) prevailed. The staging B accounted for 62.3 percent of cases according to Dukes' classification. Conclusions: these results agree with the international trends. The colorectal cancer continues to be identified at advanced stages, so the implementation of screening strategies to reduce the incidence and the mortality rates must be considered

Principales aspectos clínicos y endoscópicos de la enfermedad degenerativa de la rodilla / Main clinical and endoscopical aspects of the degenerative knee disease

Se realizó un estudio descriptivo y transversal de 100 pacientes atendidos en el Servicio de Reumatología del Hospital Provincial Docente Saturnino Lora de Santiago de Cuba con el diagnóstico de artropatía degenerativa de la rodilla, durante el período 2003-2007, a fin de caracterizarles según los principales aspectos clínicos y endoscópicos de esta afección. Entre los principales resultados sobresalieron: los pacientes con más de 60 años y el sexo femenino. La gonartrosis y la condromalacia constituyeron los hallazgos endoscópicos fundamentales y como opciones terapéuticas más empleadas, predominaron el legrado y el lavado articularAU)

A descriptive and cross-sectional study with one-hundred patients having a diagnosis of degenerative knee arthropathy treated at the Rheumatology Service in Saturnino Lora University Hospital from Santiago de Cuba was carried out between 2003 and 2007 in order to characterize them according to the main clinical and endoscopical aspects of this disorder. Among the most important results, 60-year-old and over patients and female gender were relevant. Gonarthrosis and condromalacy constituted the main endoscopical findings while curettage and articular wash-out, being the therapeutical alternatives most used, were predominant.

Atresia de coanas, tratamiento quirúrgico endoscópico, 5 años de experiencia / Choanal atresia, endoscopic surgical repair, a 5 year experience

Atresia de coanas es la obstrucción congénita de la región posterior de las fosas nasales. Múltiples técnicas quirúrgicas han sido empleadas para su reparación. En el presente estudio se recopiló la información de 5 años de trabajo en el Hospital Universitario del Valle en la ciudad Santiago de Cali - Colombia, entre los años 2003 y 2008. Se obtuvo un total de 16 casos.La información demográfica documentada incluyó datos como edad, sexo, síntomas iniciales, método diagnóstico, lateralidad, tipo de atresia de coanas, comorbilidades, tratamiento inicial, edad de intervención quirúrgica, técnica quirúrgica usada. La técnica quirúrgica consistió en el fresado y apertura de la placa atrésica vía endoscópica transnasal utilizando taladro, previa realización de colgajos mucosos en cruz y resecando parcialmente paredes del vómer.La experiencia observada en estos 5 años de trabajo demuestra que el abordaje endoscópico transnasal presenta grandes ventajas, entre ellas la baja tasa de reestenosis.

Choanal atresia is a congenital disorder where the back of the nasal passage is blocked. Many surgical techniques have been used to repair this disorder. In this study we collected information from 5 years of work at the Hospital Universitario del Valle in the city of Santiago de Cali - Colombia, between 2003 and 2008. A total of 16 cases were obtained. The documented data included demographic information like age, sex, initial symptoms, diagnostic methods, laterality, type of atresia, comorbilities, initial treatment and surgical technique used. The surgical technique consisted in endoscopic opening of the atretic plate using drill. Mucosal flaps and resection of partial plate of vomer were made previously.The experience observed in these 5 years of work shows that the endoscopic transnasal approach has major advantages, including low restenosis rate.

Endoscopical appearances of nonsteroidal anti inflammatory drug (NSAID)-enteropathy.

Non Steroidal Anti Inflammatory Drugs (NSAID) have been associated with a sudden and sustained rise in the incidence of gastrointestinal ulcer complications. The aim of the study was to reveal the endoscopical abnormalities found in the duodenum & proximal jejunum due to NSAID. Thirty eight patients taking NSAID for their arthritis or rheumatism were included in this study. Gastro-duodeno-jejunoscopy was done with Olympus PCF-10. The endoscopical appearances of NSAID entero gastropathy were evaluated with a scoring system. The NSAID-entero-gastropathy appearances were endoscopically seen as hyperemia, erosion and ulcer. From all patient recruited, 7.9% complaint of diarrhea and 71.1% complaint of dyspepsia. Endoscopically, in the duodenal bulb we found 79% cases of hyperemia, 39.5% cases of erosion and 7.9% cases of ulcer. In the second part (descending part) of the duodenum we found 28.9% cases of hyperemia, 15.8% cases of erosion and 2.6% case of ulcer. In the jejunum, we found 7.9% cases of hyperemia, 2.6% case of erosion and no ulcer. It is concluded that the most frequent abnormal endoscopical appearances in NSAID- enteropathy was hyperemia. The most frequent site of NSAID-enteropathy abnormal findings was in the duodenal bulb.