Subject(s)
Anemia, Iron-Deficiency , Anti-Bacterial Agents/administration & dosage , Endoscopy, Gastrointestinal/methods , Helicobacter Infections , Immunoproliferative Small Intestinal Disease , Intestinal Mucosa , Anemia, Iron-Deficiency/diagnosis , Anemia, Iron-Deficiency/etiology , Disease Management , Helicobacter Infections/diagnosis , Helicobacter Infections/drug therapy , Helicobacter pylori/isolation & purification , Humans , Immunohistochemistry , Immunoproliferative Small Intestinal Disease/complications , Immunoproliferative Small Intestinal Disease/diagnosis , Immunoproliferative Small Intestinal Disease/physiopathology , Immunoproliferative Small Intestinal Disease/therapy , Intestinal Mucosa/diagnostic imaging , Intestinal Mucosa/pathology , Male , Middle Aged , Neoplasm StagingABSTRACT
BACKGROUND: Nowadays, capsule endoscopy is the first-line procedure for the visualization of the small bowel. Although it was primarily designed with this goal, it may also identify other segments of the gastrointestinal tract. The aim of the current study is to evaluate the incidence of esophageal abnormalities detected in patients undergoing small bowel capsule endoscopy and its impact on patient management. PATIENTS AND METHODS: This study is a retrospective analysis of data from 2217 consecutive capsule endoscopy procedures performed at a single tertiary-care centre between January 2008 and February 2016. Patient baseline characteristics, esophageal lesions, diagnosis and management before and after capsule endoscopy were recorded and a descriptive analysis was then performed. RESULTS: 2217 patients were finally included in the analysis. 1070 were male (48.2%) and the mean age was 56.1 ± 19.5 years (12-93). Obscure gastrointestinal bleeding (52.3%) and inflammatory bowel disease (18.3%) were the main procedure indications. Esophageal abnormalities were detected in 105 out of 2217 patients (4.7%). The most common lesions detected were peptic esophagitis (58.1%) and esophageal varices (17.1%). This information had a clinical/diagnostic impact of 3.3% and a therapeutic impact of 3.2%. CONCLUSION: Capsule endoscopy detects not only small bowel lesions, but also significant esophageal lesions that may be overlooked during initial gastroscopy. Therefore, all images of the esophagus should be read during small bowel capsule endoscopy, since it could provide relevant information that may result in changes on patient´s management.
Subject(s)
Capsule Endoscopy , Esophageal Diseases/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Incidence , Incidental Findings , Intestine, Small/pathology , Male , Middle Aged , Retrospective StudiesABSTRACT
Obscure gastrointestinal bleeding accounts for approximately 5-10% of patients presenting with gastrointestinal haemorrhage. The majority of lesions responsible were found to be located in the small bowel. Currently, capsule en-doscopy is the first-line tool to investigate the small bowel as it is a non-invasive, feasible and simple procedure. Howe-ver, capsule endoscopy sometimes identifies the source of bleeding outside the small bowel and within the reach of conventional endoscopy. We present the case of a 46 year-old man with few prior negative endoscopic procedures and iron-deficiency anaemia due to gastric GIST.
Subject(s)
Capsule Endoscopy , Gastrointestinal Hemorrhage/pathology , Humans , Male , Middle AgedABSTRACT
Autoimmune pancreatitis (AIP) is an infrequent pathology, although there is a growing incidence in Eastern countries, which might be due to a greater rate of detection. It can be associated with other auto immune pathologies and its association with IgG4-related systemic disease has been described.Its clinical presentation is varied and the normal treatment is medical, using corticoids.A diagnosed clinical case is described.
Subject(s)
Autoimmune Diseases , Pancreatitis , Autoimmune Diseases/diagnosis , Autoimmune Diseases/therapy , Humans , Immunoglobulin G , Incidence , Pancreatitis/diagnosis , Pancreatitis/therapyABSTRACT
Primary tumors of the small intestine are rare, and metastatic ones are even rarer. It is exceptional for small bowel metastases to manifest before the primary tumor. The clinical presentation may require surgical resection motivated by intestinal perforation, hemorrhage or intestinal obstruction-subocclusion. Survival is scarce and generally does not exceed 20 weeks, regardless of the treatment performed.
Subject(s)
Carcinoma/secondary , Jejunal Neoplasms/secondary , Lung Neoplasms/pathology , Aged, 80 and over , Carcinoma/diagnosis , Fatal Outcome , Female , Humans , Jejunal Neoplasms/diagnosis , Lung Neoplasms/diagnosisABSTRACT
We present the case of a 63-year-old woman with heterotaxy syndrome and polysplenia who presented with clinical signs and symptoms of recurrent acute pancreatitis in which the biliary origin had been seen in the most recent episode. This syndrome is rare in adult patients because it is associated with congenital heart defects. It is important to know the visceral anomalies that are common in this syndrome to avoid confusing them with pathological processes.
Subject(s)
Abnormalities, Multiple/diagnostic imaging , Spleen/abnormalities , Spleen/diagnostic imaging , Viscera/abnormalities , Viscera/diagnostic imaging , Female , Humans , Middle Aged , Syndrome , Tomography, X-Ray ComputedSubject(s)
Colonic Neoplasms/diagnosis , Colonic Polyps/diagnosis , Lymphoma, Mantle-Cell/diagnosis , Humans , Male , Middle AgedABSTRACT
Endoscopic ultrasonography with fine-needle aspiration is a safe technique that allows the collection of tissue samples for histological diagnosis, as well as therapeutic maneuvers. It has better diagnostic accuracy versus other exploration techniques used for the staging of neoplasms in the gastrointestinal tract as well as in other organs. The risk for complications is extremely low, and the procedure has been shown to be cost-effective in many studies. In this paper we attempt to review the main present indications of endoscopic ultrasonography with fine-needle aspiration.
Subject(s)
Biopsy, Fine-Needle , Endosonography , HumansABSTRACT
Esophageal hematoma is a rare entity that usually presents as acute thoracic pain. It may occur spontaneously or in association with an underlying disease or direct esophageal damage. The presence of coagulation disorders plays an important role in the development of hematoma. We describe the case of a female patient treated with low-dose aspirin who was diagnosed through emergency gastroscopy. We also review the literature and discuss possible causes, findings in diagnostic tests and treatment.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Aspirin/adverse effects , Esophageal Diseases/chemically induced , Hematoma/chemically induced , Platelet Aggregation Inhibitors/adverse effects , Aged , Aged, 80 and over , Esophageal Diseases/diagnostic imaging , Esophageal Diseases/therapy , Female , Gastroscopy , Hematoma/diagnostic imaging , Hematoma/therapy , Humans , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Brunner's gland hamartoma is a rare duodenal tumor generally localized in the duodenal bulb. Normally assymptomatic, it might cause upper gastrointestinal bleeding or intestinal obstruction. The diagnosis is based on upper gastrointestinal endoscopic or barium examination findings, and its treatment includes surgical or endoscopic resection, with an optimum prognosis. We present the case of a 59-year-old woman who was admitted to the hospital with an upper gastrointestinal bleeding picture. Endoscopic examination showed an ulcerated polyp in duodenal bulb which was cut with polipectomy wire. Histological slides showed a parasitic granuloma within a Brunner's gland hamartoma. Skin prick test and specific IgE determination were positive for Anisakis. Up to our knowledge, this association has never been described before.
