Lumen reconstruction with magnetic compression anastomosis technique in a patient with complete esophageal stricture.

Background: Complete esophageal obstruction (CEO) is a rare condition of which treatment options are challenging. Surgery is the main treatment with high morbidity and mortality rates. Magnetic compression anastomosis (MCA) is a novel technique developed to restore lumen patency in gastrointestinal and biliary tracts. However, MCA experience is limited in respect of esophageal strictures. Case Report: We present a 26-year-old patient having CEO. Magnets are inserted endoscopically to both sides of the obstructed area via oral and retrograde (through the gastrostomy tract) route. On day 8, magnets stuck together and were removed endoscopically through the oral route. Subsequently, sessions of balloon dilatations and triamcinolone injection were performed. The patient's complaint of aphagia resolved after the treatment process. Conclusion: In conclusion, MCA is an alternative technique that can be used to restore lumen patency in esophageal strictures and also avoids complications of surgical interventions.

Diffuse nodular duodenitis in a woman presenting with dyspepsia and weight loss.

Duodenal nodularity is an uncommon endoscopic finding charac-trized by numerous visible mucosal nodules in the duodenum. It is important to consider giardiasis in patients with symptoms include abdominal pain, nausea, anorexia, diarrhea, vomiting, weight loss and abdominal distension. It is also important to remind giardiasis in patients with duodenal nodularity.

Barrett's esophagus and endoscopically assessed esophagogastric junction integrity in 1000 consecutive Turkish patients undergoing endoscopy: a prospective study.

Barrett's esophagus (BE) appears to be more common in Western than in Asian countries. BE is a complication of gastroesophageal reflux disease (GERD). Anatomical abnormalities of the esophagogastric junction (EGJ) are an important factor in the pathogenesis of GERD. We aimed to determine the prevalence of BE in Turkey, which is geographically located between Europe and Asia, and to investigate the frequency of BE according to the degree of anatomical disruption in the EGJ. This prospective study was performed on 1000 consecutive patients referred for endoscopy for any clinical indication. All patients underwent a structured interview that assessed major symptoms of GERD (regurgitation and heartburn). BE was diagnosed when specialized intestinal metaplasia was detected histologically in the esophageal biopsy specimens. Endoscopically assessed integrity of the EGJ was classified as one of three types, as follows: 1 Normal EGJ. The endoscope shaft was gripped tightly by the cardia in retroflexed endoscopy, or it was gripped less tightly but the cardia was seen to open and close with respiration. 2 Widened EGJ. The cardia was open during all phases of respiration in retroflexed endoscopy, but there was no endoscopic evidence of hiatal hernia (HH) on the antegrade view. 3 HH. The axial length from the EGJ to the diaphragmatic hiatus was at least 2 cm. BE was found in 12 patients (1.2%). Normal EGJ was seen in 90.7% of patients, widened EGJ in 4.3%, and HH in 5%. Patients with widened EGJ had a significantly higher incidence of major reflux symptoms and erosive esophagitis compared with those with normal EGJ (P= 0.001). BE was found in 14% of patients with HH and in 0.5% of patients with a normal EGJ (P= 0.001). None of the patients with widened EGJ had BE. In terms of BE frequency, these patients did not differ significantly from those with normal EGJ (P= 0.793) but did differ significantly from those with HH (P= 0.014). The prevalence of BE was 1.2% in a Turkish population undergoing endoscopy for any reason. In terms of EGJ integrity, comparison of the groups showed that even in the absence of HH, patients with widening of the EGJ had an increased prevalence of major reflux symptoms and erosive esophagitis. However, histologically confirmed BE was not seen among patients with widened EGJ.

Fulminant hepatic failure due to secondary amyloidosis.

Systemic amyloidosis frequently involves liver, however, clinically apparent liver disease is rare and, if observed, is usually mild. Rarely, primary amyloidosis may present with evidence of portal hypertension or hepatic failure. Although secondary amyloidosis may involve the liver and rarely causes liver pathologies such as cholestatic hepatitis and portal hypertension, to our knowledge, hepatic failure due to secondary amyloidosis has been reported once before. Herein, we presented a woman with subacute fulminant hepatic failure who had no known history of a chronic disease other than episodes of urinary tract infection, and secondary amyloidosis was diagnosed with post-mortem liver biopsy.