Efficacy and safety of oral sodium phosphate versus polyethylene glycol solution for bowel preparation for colonoscopy.

OBJECTIVE: To assess the acceptability, safety and effectiveness of an oral sodium phosphate solution (Exelyte) for colon preparation prior to colonoscopy, compared with a polyethylene glycol solution (Peglec). METHOD: A colonoscopist-blinded, prospective, randomized, observational clinical study. PATIENTS: One hundred patients undergoing colonoscopy for various indications were randomized (n = 50 each) to receive either 90 mL of oral sodium phosphate mixed with 300 mL clear liquid and then consume about 4-5 glasses of water, or 2 liters of polyethylene glycol solution. RESULT: Sodium phosphate showed a safety profile similar to that of polyethylene glycol. However, patients tolerated it better. The colonoscopist reported similar cleansing of bowel in both groups. CONCLUSION: Oral sodium phosphate is well tolerated, is safe and provides bowel cleansing similar to that with a polyethylene glycol solution.

Gall bladder agenesis, pancreas divisum and undescended testes: a rare association.

Gall bladder agenesis is a rare congenital biliary anomaly that may be associated with other biliary and extrabiliary congenital anomalies. We report the association of gall bladder agenesis with pancreas divisum and undescended testes.

Teratocarcinoma presenting with duodenal metastases diagnosed on endoscopic fine needle aspiration.

Upper gastrointestinal bleed as the first symptom of metastatic testicular tumors is rare. We describe a 17-year-old man who presented with upper gastrointestinal bleed; endoscopic fine needle aspiration cytology from a duodenal mass suggested germ cell tumor, which was later confirmed on histology of the testis.

Endoscopic management of pancreatic diseases.

Endoscopic management has recently been used for a variety of chronic pancreatic diseases. We used this approach in five patients with pancreatic diseases (calcific pancreatitis 2, pancreatic pseudocyst 3). Nasocystic drain was placed in a patient with pancreatic pseudocyst at the tail end of the pancreas; a 5 Fr stent was placed over 0.021"/0.035" guide wire in the main pancreatic duct in the others. All patients had relief of pain. Nasocystic drain led to resolution of pseudocyst, perisplenic collection and pleural effusion. Endoscopic treatment is safe and effective in various pancreatic disorders.

Primary duodenal tuberculosis diagnosed by endoscopic biopsy.

Tuberculosis involves the duodenum very rarely and is usually secondary to lymph node involvement. Endoscopic biopsy usually shows nonspecific changes necessitating laparotomy for confirmation of diagnosis and relief of obstruction. We report a case of duodenal tuberculosis diagnosed by endoscopic biopsy and treated successfully.

Endoscopic stenting of minor papilla for symptomatic pancreas divisum.

Pancreatitis is one of the presentations of pancreas divisum. Endoscopic treatment by dorsal pancreatic duct stenting relieves symptoms in a majority of patients. We report a patient with pancreas divisum and calcific chronic pancreatitis in whom successful drainage of the dorsal duct with a stent through the minor papilla relieved the pain.