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1.
Endoscopy ; 53(SUPPL 1):S262, 2021.
Article in English | EMBASE | ID: covidwho-1254070

ABSTRACT

Aims Determine the impact of the covid 19 pandemy on the emergency endoscopic activity. Methods The is a retrospective, descriptive and comparative study of epidemiological, clinical and endoscopic characteristics of patients who had emergency ERCP over two successive 8 months:Period(1):01/03/2019-31/10/2019 andPeriod(2):01/03/2020-31/10/2020 in our department of hepatogastroenterology of university hospital Mohammed VIOujda. Results The average age of patients was 62 years(12-93) during period(2) versus 67 years(25-104)during period(1),there were a female predominance in two groups.During period(2) 145 ERCP were performed,87(60 %) were in emergencycontext for acute cholangitis,9 had acute pancreatitis associated,12.6 % were in grade III of acute cholangitis and theaverage of bilirubin before the procedure was 115 mg/l and 54 mg/l after versus 166 ERCP during the period(1),93(56 %)having emergency ERCP for acute cholangitis, and acute pancreatitis was associated in 9 patients,17.2 % were in gradeIII, and the average of bilirubin before the procedure was 130 mg/l and 64 mg/l after during period(1),52.9 % patients whohad placement of prosthesis in period(2) versus 47.3 % in period(1),and 57.5 % patients had an endoscopic sphincterotomyversus 57 % respectively.In period(2),the etiology was lithiasis in 51.7 % patients, tumoral in 43.7 % patients, and hydatidcyst in 4.6 % patients, In period(1)the lithiasis patholology was in 58 % patients, tumoral in 36.8 % patients, two cases ofprosthesis dysfunction,1 with hydatid cyst and 1 with sump syndrom.In period(2),failed drainage was noted in 3(3.4 %)patients:2 patients:surgical drainage,1 patient:nasobiliary drainage, in period(1) 5(5.3 %)patients:3 patients:surgicaldrainage 2 patients:percutaneous drainage. Conclusions The results of our comparative study between period (1) and (2) are the age was around 60, female sexpredominate over male, therefore lithiasis pathology was the most predominant cause due to not having cholecystectomy, followed by the tumoral cause which is tardily diagnosed after complications and requiring drainage, placement of prosthesis was preferred during the covid period to reduce the risk of recurrence, the delay to perform ERCP, complications post-ERCP and hospital staying are decreased during the period(2), given the constraints of the pandemy.

2.
Endoscopy ; 53(SUPPL 1):S261-S262, 2021.
Article in English | EMBASE | ID: covidwho-1254069

ABSTRACT

Aims To identify the endoscopic findings in patients with severe SARS COV2 admitted in ICU and presenting GI bleeding. Methods A retrospective case series, including all patients with SARS COV2 admitted in ICU presenting GI bleedingbetween March 2020 and November 2020. Data regarding clinical presentations were analysed by SPSS. Results 12 patients were included. The median age was 65 years [38-93] with a male predominance of 91,7 % .Comorbidites were: hypertension 41,6 %, obeisity 41,6 %, diabetes type II 33,4 %, cardiomyopathy 25 %, cirrhosis 8,1 %.All patients needed respiratory support,25 % with mechanical ventilation, 8,3 % noninvasive ventilation, 41,7 %nonrebreather mask and 16,7 % nasal oxygen cannula .Empiric Full dose anticoagulation was administred in 91,6 % and58,3 % received prophylactic PPIs therapy. 60 % had Naso gastric tube. Upper GI bleeding was diagnosed in 83,4 % andlower GI bleeding in 16,6 %. Mean delay between GI bleeding and anticoagulant intake was 8 days. Mean Hemoglobin level was 9,2 g/dl. Endoscopy was performed in 66,6 %, 25 % died before endoscopy by respiratory worsening and 8,4 % had noemergency indication for endoscopy . Endoscopic findings were ulcers in 75 %: gastric 33,3 %, duodenal bulb 66,6 %,multiple 66,6 %, unique 33,3 %,classified as Forrest IIa 16,6 %, IIb 33,3 %, III 50 % with the mean size at 22 mm . Otherfindings were: oesophagitis 25 %, erosive gastritis 12,5 %, gastric tumor 12,5 %, esophageal blood clot with no GI bleedingorigin 12,5 %. Hemostasis clip was placed in 33,3 %,blood transfusion in 58,3 % associated to PPIs therapy in all patients.No recurrence of GI bleeding in 33,3 % while 66,6 % died by respiratory complications. Conclusions In our study, main endoscopic findings were ulcers in 75 % .Prophylactic PPIs should be considered in patients with severe SARS COV2 in ICU requiring anticoagulation therapy.

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