Pseudoachalasia: A review
U Abubakar, MB Bashir, EB KesiemeNigerian Journal of Clinical Practice 2016 19(3):303-307Pseudoachalasia presents typically like achalasia. It account for only 2.4-4% of patients presenting with achalasia-like symptoms. Clinical, radiologic and endoscopic findings resemble those of achalasia but treatment and prognosis are different in these conditions. The aim of this review is to give an overview of the condition and highlight challenges in diagnosis and distinguishing features between the two conditions. A review of the publications obtained from Medline search, medical libraries, and Google on 'pseudoachalasia' and 'secondary achalasia' was done. A total of 50 articles were retrieved and used for this review. There has been tremendous efforts towards establishing the diagnosis of pseudoachalasia both clinically and with the use of modern investigative modalities but to date its still difficult to distinguish it from achalasia. Endoscopy, endoscopic ultrasonography and computerized tomography scan have shown promising results.
This study was performed to assess PET findings in patients with T1 tumors to see if PET can be used to differentiate T1a from T1b tumors.
In Mexico there are no recommendations for screening of upper gastrointestinal neoplasms in the general population. Identifying gastric premalignant lesions allows timely detection and early treatment 1. Standard white-light endoscopy may miss a significant amount of gastric lesions, virtual chromoendoscopy as I-scan (Pentax, Tokyo, Japan) consists of three different image algorithms: (i) surface enhancement (SE); (ii) tone enhancement (TE); and (iii) contrast enhancement (CE); I-scan 2 mode was established for characterization of lesions.
Medications, such as proton-pump inhibitors (PPIs), have been recommended first line therapy for gastroesophageal reflux disease (GERD), but not all patients receive satisfactory relief with drug therapy, alone. We developed the endoluminal fundoplication by applying ESD (endoscopic submucosal dissection), and named ESD-G (ESD for GERD). We previously reported about efficacy of ESD-G (Scand J Gastroenterol. 2014, 49: 1409-13). We will herein report of novel result including the added patients undergone ESD-G.
Patients with inflammatory bowel disease (IBD) have an increased risk of colorectal dysplasia and cancer. Endoscopically visible lesions with distinct borders and without features of submucosal (SM) invasion should be considered for endoscopic resection. En bloc resection is preferred for these lesions because it allows for precise histologic evaluation. However, it is often not feasible due to the high prevalence of SM fibrosis, particularly for large lesions ( ≥2 cm). Endoscopic submucosal dissection (ESD) has been proposed as one of the therapeutic options for these lesions; however, outcomes data are restricted to a...
Cyst fluid carcinoembryonic antigen (CEA) is a useful marker for differentiating between mucinous from nonmucinous pancreatic cystic lesions (PCLs). However, the role of cyst fluid CEA levels in differentiation between mucinous cystic neoplasms (MCNs) and intraductal papillary mucinous neoplasms (IPMNs) as well as between the low risk (LR) and high risk (HR) mucinous lesions are scanty. We aimed to analyse this subject.
Polypectomy has managed to reduce the incidence of colorectal cancer. It has found that 6% of neoplasms and a 25% of polyps may not have been found without screening colonoscopy. The use of high definition i-scan chromoendoscopy increases the contrast, with optical resolutions up to 1 300 000 pixels.
Pancreatic serous cystadenomas or pancreatic cystic serous neoplasms (SCN) are benign pancreatic cystic neoplasms with rare malignant potential. These account for 1-2% of all pancreatic masses. SCNs will often have a cystic or honeycomb appearance on CT scan and the pathognomonic central scar is only seen in 20% of the lesions. In the past, the mainstay of diagnosing SCN has been via endoscopy ultrasound (EUS) with fine needle aspiration (FNA) to assess fluid for CEA levels and also for cytological analysis.
Current strategies to prevent colorectal cancer (CRC) vary considerably with regard to effectiveness, up-front costs, risks, invasiveness and patient compliance. A known barrier for patients is the cleanse needed for colonoscopy. A non-invassive screening test where structural information could be provided, but not require cleansing of the colon. The C-Scan ® capsule-based system is a preparation-free test for CRC screening. The system is based on a low dose radioactive (RA) sealed source embedded in the C-Scan capsule, which radiates X-Rays through a collimator to all directions.
Achieving adequate bowel preparation is challenging and critical to achieve a good quality colonoscopy.Delays due to inadequate bowel prep interfere with medical care, require repeat procedure, increase length of stay and cost of care.In addition, documentation is scant in relation to bowel prep intake.The American Society of Gastrointestinal Endoscopy (ASGE) guidelines recommend split-dose prep.We aim to study the barriers and implement changes that will improve quality of inpatient bowel prep in a tertiary-care center.
Multiple therapeutic modalities including surgery, rigid and flexible endoscopy have been developed to manage ZD. Minimally invasive flexible endoscopic septotomy (FES) techniques, carried out under deep sedation, have been increasingly favored over the past 20 years. Among FES, CAP-assisted septotomy using the hook knife has been reported as safe and effective even though long-term outcome data are scanty.