ABSTRACT
INTRODUCTION: the capsule endoscopy (CE), from his approval, has become a first line diagnostic procedure for the study of the small bowel disease. The aim of this study is to report our experience since the implantation of this technique in our hospital. MATERIAL AND METHODS: retrospective review of the CE undertaken in Department of Endoscopy. There was gathered in every case the age, sex, motive of consultation, previous diagnostic procedures, capsule endoscopy findings and complication of the technique. One took to end a descriptive and analytical analysis. RESULTS: there was achieved a total of 416 explorations in 388 patients. The obscure gastrointestinal bleeding was the most frequent indication (83.30%) followed by suspected Crohn s disease (7.5%). Angiodisplasia was the endoscopic lesion more frequently detected (42.2%), especially, in patients with digestive bleeding of obscure origin (OR 3.13 p < 0.001), followed by the flebectasia (10.6%) and the ulcer suspicious of Crohn s disease (9.9%). The global diagnostic yield as for the detection of injuries was 77.34% with a case of "not defecation of the capsule" and therefore need of laparotomy. CONCLUSIONS: the capsule endoscopy is a technique consolidated and as his potential is known, his indications are extended. The obscure gastrointestinal bleeding is the most frequent indication and the angiodisplasia the most identified injury. Once known his diagnostic yield, larger studies are needed that assess the influence of capsule endoscopy on clinical outcoumes.
Subject(s)
Capsule Endoscopy , Capsule Endoscopy/adverse effects , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Introducción: la cápsula endoscópica desde su aprobación seha convertido en un procedimiento diagnóstico de primera líneapara el estudio del intestino delgado. El objetivo del estudio es exponerla experiencia desde la implantación de esta técnica ennuestro hospital.Material y métodos: se hizo una revisión retrospectiva de losestudios realizados en el Servicio de Endoscopia. Se recogió encada caso la edad, sexo, motivo de consulta, procedimientos diagnósticosprevios, diagnósticos endoscópicos e incidencias inherentesa la técnica y se llevó a cabo un análisis descriptivo y analítico.Resultados: se realizaron un total de 416 exploraciones en388 pacientes. La hemorragia digestiva de origen oscuro fue la indicaciónmás frecuente (83,30%) seguida de la sospecha de enfermedadde Crohn (7,5%). La angiodisplasia fue la lesión endoscópicamás detectada (42,2%) cuando se analizó la hemorragiadigestiva oscura (OR 3.13 p < 0,001) seguida de la flebectasia(10,6%) y las úlceras sugerentes de enfermedad de Crohn (9,9%).La rentabilidad global en cuanto a la detección de lesiones fue del77,34% con un caso de no defecación de la cápsula y por lotanto de necesidad de laparotomía.Conclusiones: la cápsula endoscópica es una técnica consolidaday a medida que se conoce su potencial, se van ampliando susindicaciones. La hemorragia digestiva de origen oscuro es la indicaciónmás frecuente y la angiodisplasia la lesión más identificada.Una vez conocida su eficacia diagnóstica se hace necesario determinarmediante estudios a gran escala y con metodología precisala rentabilidad clínica de la misma
Introduction: the capsule endoscopy (CE), from his approval,has become a first line diagnostic procedure for the study of thesmall bowel disease. The aim of this study is to report our experiencesince the implantation of this technique in our hospital.Material and methods: retrospective review of the CE undertakenin Department of Endoscopy. There was gathered inevery case the age, sex, motive of consultation, previous diagnosticprocedures, capsule endoscopy findings and complication ofthe technique. One took to end a descriptive and analytical analysis.Results: there was achieved a total of 416 explorations in388 patients. The obscure gastrointestinal bleeding was the mostfrequent indication (83.30%) followed by suspected Crohn's disease(7.5%). Angiodisplasia was the endoscopic lesion more frequentlydetected (42.2%), especially, in patients with digestivebleeding of obscure origin (OR 3.13 p < 0.001), followed by theflebectasia (10.6%) and the ulcer suspicious of Crohn´s disease(9.9%). The global diagnostic yield as for the detection of injurieswas 77.34% with a case of not defecation of the capsule andtherefore need of laparotomy.Conclusions: the capsule endoscopy is a technique consolidatedand as his potential is known, his indications are extended.The obscure gastrointestinal bleeding is the most frequent indicationand the angiodisplasia the most identified injury. Once knownhis diagnostic yield, larger studies are needed that assess the influenceof capsule endoscopy on clinical outcoumes
Subject(s)
Male , Female , Humans , Crohn Disease/diagnosis , Endoscopy/methods , Retrospective Studies , Endoscopes, Gastrointestinal , Occult Blood , Anemia, Iron-Deficiency/etiology , Angiodysplasia/diagnosisABSTRACT
No disponible
Subject(s)
Male , Adolescent , Aged, 80 and over , Humans , Nevus, Blue/diagnosis , Gastrointestinal Neoplasms/diagnosis , Anemia, Iron-Deficiency/etiology , Capsules , Endoscopy, GastrointestinalABSTRACT
No disponible
Subject(s)
Middle Aged , Male , Humans , Ampulla of Vater , Time Factors , Carcinoma, Renal Cell , Kidney Neoplasms , Common Bile Duct NeoplasmsABSTRACT
Calcifications are a rare finding described in benign and malignant tumors located in any site of the body. Their presence in stomach and colon carcinomas is very rare. Most of the cases described are mucinous adenocarcinomas. We present the case of one patient with this disease studied with endoscopic ultrasonography. There were punctate calcifications in the submucosa layer that tended to take on a crown-like shape in the outer-most area, producing an acoustic shadow. The pathological study of the surgical specimen showed amorphic calcifications inside some mucin lakes. More cases need to be studied with this technique in order to define their endosonographic characteristics.
Subject(s)
Calcinosis/diagnostic imaging , Carcinoma, Signet Ring Cell/diagnostic imaging , Endosonography , Stomach Neoplasms/diagnostic imaging , Calcinosis/pathology , Carcinoma, Signet Ring Cell/pathology , Female , Humans , Middle Aged , Stomach Neoplasms/pathologyABSTRACT
We report the case of a patient with hemobilia resulting from a liver biopsy where the performance of the endoscopic sphincterectomy solved the jaundice and the pain of the patient. ERCP has been used previously in the diagnosis of biliary and pancreatic tumors that manifested themselves as an hemobilia. The therapeutic utilization of endoscopic sphincterotomy had been described rarely in this type of bleedings. We recommend endoscopic retrograde cholangiopancreatography and sphincterotomy in the cases of hemobilia with severe abdominal pain resulting from the accumulation of clots inside the biliary tract.
Subject(s)
Abdominal Pain/etiology , Cholangiopancreatography, Endoscopic Retrograde , Endoscopy , Hemobilia/complications , Jaundice/etiology , Sphincter of Oddi/surgery , Biopsy/adverse effects , Hemobilia/diagnosis , Hemobilia/surgery , Humans , Jaundice/diagnosis , Jaundice/surgery , Liver/pathology , Male , Middle AgedABSTRACT
The different therapeutic methods for persistent or recurrent hemorrhage due to portal hypertension gastric lesions are discussed from the clinical experience with 5 cases. In 2 cases endoscopic sclerosis was carried out and in one antrectomy was performed with stabilization of the bleeding and improvement in the clinical situation being achieved in long term follow up. Two patients underwent liver transplantation which led to disappearance of the lesions.
Subject(s)
Esophageal and Gastric Varices/complications , Esophageal and Gastric Varices/therapy , Gastrointestinal Hemorrhage/therapy , Hypertension, Portal/complications , Hypertension, Portal/therapy , Adult , Aged , Esophageal and Gastric Varices/surgery , Female , Gastrointestinal Hemorrhage/etiology , Humans , Hypertension, Portal/surgery , Liver Transplantation , Male , Middle Aged , Portacaval Shunt, Surgical , Pyloric Antrum/surgery , Recurrence , SclerotherapySubject(s)
Carcinoma, Squamous Cell/complications , Deglutition Disorders/therapy , Esophageal Neoplasms/complications , Ethanol/administration & dosage , Gastrointestinal Hemorrhage/therapy , Palliative Care , Deglutition Disorders/etiology , Female , Gastrointestinal Hemorrhage/etiology , Humans , Injections, Intralesional , Middle AgedABSTRACT
28,500 fiberoptic endoscopies were reviewed. 97 cancers of the stump were found in 1,119 patients who had had gastric resection (8.66%), in contrast to the 3.9% of cancers found in nonoperated patients. This suggests that the gastric remnant has a higher tendency to develop cancer than the nonresected stomach. A policy of periodic follow-up of these patients must be considered in order to detect the tumor at an early stage.
Subject(s)
Gastrectomy , Peptic Ulcer/surgery , Postoperative Complications/pathology , Stomach Neoplasms/pathology , Adult , Aged , Biopsy , Carcinoma, Squamous Cell/pathology , Duodenal Ulcer/surgery , Esophageal Neoplasms/pathology , Female , Follow-Up Studies , Gastric Mucosa/pathology , Humans , Male , Middle Aged , Neoplasm Staging , Neoplasms, Multiple Primary/pathology , Polyps/pathology , Stomach Ulcer/surgeryABSTRACT
Spontaneous intramural oesophageal perforation appears at any level, but preferably on the posterior wall, and is usually longitudinal. Unlike the Mallory Weiss and the Boerhaave syndromes, females are more frequently affected. It appears with sudden retrosternal pain radiating to the epigastrium, neck and back, followed by haematemesis of small quantity and dysphagia. Vomiting is rare. In contrast to complete rupture, neither pneumomediastinum nor emphysema is observed, barium swallow being the diagnostic test of choice whenever this pathology is suspected. However, when the symptoms are not typical, endoscopy is a useful method for diagnosis. Treatment must be conservative, while surgery is suggested in the case of recurrent symptoms or big intramural haematomas with a high risk of perforation. A 74-year-old woman is presented. Endoscopy was performed as an emergency in suspected food impaction in the oesophagus. This case was diagnosed as spontaneous intramural oesophageal perforation. The patient also presented with oesophageal diverticulum and hiatal hernia. Conservative treatment was given, and the lesion cured.
