Endoscopic Findings in Children with Isolated Lower Gastrointestinal Bleeding.
Conclusion: s: Single left-sided juvenile polyps were the most common cause of isolated lower gastrointestinal bleeding in our study. It was rare to find multiple polyps and polyps proximal to the splenic flexure in our cohort. A full colonoscopy is still recommended in all patients in order to properly diagnose the small but significant group of patients with pathologies found proximal to the splenic flexure. PMID: 31085966 [PubMed - as supplied by publisher]
ConclusionThe performance of colonoscopy in young patients with benign anal diseases and hematochezia resulted in a high rate of detection of neoplastic lesions. The method might be considered as a valid strategy of investigation in this frequent clinical situation.
Endosc Int Open 2019; 07: E1528-E1536 DOI: 10.1055/a-1007-1578 Background and study aims Endoscopic mucosal resection (EMR) is a standard method for removing sessile colorectal polyps ≥ 10 mm. Recently, underwater EMR (UEMR) has been introduced as a potential alternative. However, the effectiveness and safety of UEMR compared with conventional EMR is un clear. Patients and methods In this 1:1 propensity score (PS) matched retrospective cohort study, we compared the en bloc resection rates, procedure time, intraprocedural and delayed bleeding rates, and incidence of muscle layer injury. We also perfo...
The sequence of events leading to the development of colorectal cancer, currently the third most common malignancy in Western countries, is effectively disrupted by the resection of its precursor lesions. Colonoscopy is the mainstay in lesion detection, and endoscopic polypectomy is the conventional therapeutic response for the overwhelming majority of identified polyps. Approximately 2% of lesions are larger (>20 mm) and are laterally spreading lesions (LSLs). EMR is considered the standard of care for the majority of these because it has been proved to be safer, less resource-intensive, and less expensive than surgery.
ConclusionsA focused training intervention was associated with a strong trend toward increased ADRs among certified endoscopists. While the described training interventions definitely show promise, further efforts around continuing professional developments activities are needed to more consistently improve ADRS among certified endoscopists.
An 85-year-old woman was admitted for examination of anemia and black stools. A blood test revealed a reduction in her hemoglobin level from 12.7 to 6.6 g/dL (7.9×103 to 4.1×103 mol/L) over a month, suggesting upper gastrointestinal bleeding. Esophagogastroduodenoscopy revealed a large esophageal polyp near the esophagogastric junction (Figure 1). The polyp that was fragile was accidentally resected and removed endoscopically. Histopathological examination of the resected specimen revealed a hematoma containing numerous Enterococcus faecalis bacterial masses without epithelial tissue (Figure 2).
I read with interest the article by Lin et al.1 The authors conducted a risk assessment to evaluate the relationship between anticoagulation or antiplatelet medications and postpolypectomy bleeding according to 2 epidemiologic study designs. In a retrospective cohort study, the authors observed 59 cases. Thereafter, the authors conducted a case-control study with 174 matched control individuals. In multivariate logistic regression analysis, the adjusted odds ratios (95% confidence interval [CI]) of heparin bridge and polyp size ≥2 cm in patients with warfarin medication were 10.27 (2.51-42.1) and 8.8 (1.28-60.7), respectively.
ConclusionsOur study affirms the recommendations of JGES for the management of anticoagulants in patients who undergo colonic polypectomy regarding post-polypectomy bleeding.
This study aimed to compare rates of delayed bleeding after CSP and hot snare polypectomy (HSP). Patients and methods We conducted a multicenter, randomized controlled trial. Participants scheduled to undergo endoscopic resection of colorectal polyps ≤ 10 mm were enrolled and randomly assigned to CSP or HSP. Prophylactic clipping was performed at the endoscopists’ discretion. The primary outcome was delayed bleeding rate. Secondary outcomes included immediate bleeding rate and clipping rate. Sample size calculation showed that 451 patients were required in each arm. Results At the end of the st...
ConclusionOsseous metaplasia of the gastrointestinal tract is a rare occurrence that can be associated with benign polyps or malignancy. Certain markers have been shown to be linked to this process and polypectomy remains the gold standard of treatment; however, further research is warranted.
Authors: Miwa T, Ibuka T, Ozawa N, Sugiyama T, Kubota M, Imai K, Sakai H, Takai K, Araki H, Shimizu M Abstract Colonic varices are usually associated with portal hypertension. Idiopathic colonic varices are extremely rare. A 68-year-old man with a positive fecal occult blood test result underwent colonoscopy. We detected idiopathic ileocolonic varices and a coexisting ascending colon polyp. While reviewing the literature, we found cases of biopsies and polypectomies resulting in significant bleeding. We herein report a case of idiopathic ileocolonic varices coexisting with a colon polyp treated successfully by endo...