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Initial Assessment, Risk Stratification, and Early Management of Acute Nonvariceal Upper Gastrointestinal Hemorrhage
Inhospital mortality from nonvariceal upper gastrointestinal bleeding has improved with advances in medical and endoscopy therapy. Initial management includes resuscitation, hemodynamic monitoring, proton pump inhibitor therapy, and restrictive blood transfusion. Risk stratification scores help triage bleeding severity and provide prognosis. Upper endoscopy is recommended within 24  hours of presentation; select patients at lowest risk may be effectively treated as outpatients. Emergent endoscopy within 12 hours does not improve clinical outcomes, including mortality, rebleeding, or need for surgery, despite an i...
Source: Gastrointestinal Endoscopy Clinics of North America - April 17, 2018 Category: Gastroenterology Authors: Jennifer X. Cai, John R. Saltzman Source Type: research

Fish-Mouth Papilla
We examined the patient using a duodenoscope and observed a fish-mouth–like papilla extruding thick mucus (Supplementary Video 1). The fish- mouth appearance of papilla, although not always present (prevalence, 50%), is pathognomonic and specific (91%) for intraductal papillary mucinous neoplasm (IPMN) of the pancreas. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 17, 2018 Category: Gastroenterology Authors: Ravishankar Asokkumar, Yung-Ka Chin Tags: Image of the Month Source Type: research

Noncardiac chest pain: a 2018 update.
Authors: Durazzo M, Gargiulo G, Pellicano R Abstract Noncardiac chest pain (NCCP) is defined as recurring, angina-like, chest pain of noncardiac origin. Studies have estimated that gastroesophageal reflux disease (GERD) is the most common contributing factor for NCCP. In patients with non-GERD related NCCP, esophageal motility disorders, and functional chest pain (FCP) of presumed esophageal origin are the main underlying mechanisms for symptoms. Epidemiologic studies show a high prevalence of panic disorder, anxiety and major depression in NCCP patients. The diagnostic esophageal workup starts only after that card...
Source: Minerva Cardioangiologica - April 15, 2018 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research

Pre-treatment with proton pump inhibitors decreases the success of primary Helicobacter pylori eradication using a vonoprazan-based regimen
In conclusion, pre-treatment with PPIs before eradication therapy decreases the rate of successful eradication. Therefore, it may be desirable to discontinue pre-treatment with PPIs prior to eradication therapy, because of the potential to improve the rate of successful eradication. (Source: The Kaohsiung Journal of Medical Sciences)
Source: The Kaohsiung Journal of Medical Sciences - April 14, 2018 Category: Universities & Medical Training Source Type: research

Prevalence of Eosinophilic Esophagitis in Adult Patients with Upper Gastrointestinal Symptoms in a Locality in Upper Egypt.
Conclusions: We observed a low prevalence of EoE in our locality. The diagnosis of EoE should be considered in patients with dysphagia and/or heartburn. PMID: 29642308 [PubMed - as supplied by publisher] (Source: Clinical Endoscopy)
Source: Clinical Endoscopy - April 13, 2018 Category: Gastroenterology Tags: Clin Endosc Source Type: research

Choledochoduodenal Fistula Secondary to Ulcer Disease Presenting With Gastrointestinal Bleeding
An 84-year-old woman presented with hematemesis and epigastric pain. Her medical history was notable for a cerebrovascular accident, and  she was taking aspirin and nonsteroidal anti-inflammatory drugs. Her serum hemoglobin level decreased to 6.7 g/dL (range, 11–17 g/dL), and her blood urea nitrogen level increased to 107 mg/dL (range, 17–43 mg/dL). An esophagogastroduodenoscopy (EGD) was performed, which showed a large duodenal ulcer (DU) with an adherent clot and an orifice suggestive of perforation (Figure A). (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 9, 2018 Category: Gastroenterology Authors: Rita Jim énez-Rosales, Antonio Caballero-Mateos, Eduardo Redondo-Cerezo Tags: Electronic Image of the Month Source Type: research

Sedation in Pediatric Esophagogastroduodenoscopy.
Authors: Oh SH Abstract Pediatric esophagogastroduodenoscopy (EGD) has become an established diagnostic and therapeutic modality in pediatric gastroenterology. Effective sedation strategies have been adopted to improve patient tolerance during pediatric EGD. For children, safety is a fundamental consideration during this procedure as they are at a higher risk of severe adverse events from procedural sedation compared to adults. Therefore, a detailed risk evaluation is required prior to the procedure, and practitioners should be aware of the benefits and risks associated with sedation regimens during pediatric EGD. ...
Source: Clinical Endoscopy - April 7, 2018 Category: Gastroenterology Tags: Clin Endosc Source Type: research

Metastatic Renal Cell Carcinoma Presenting as a Solitary Gastric Polyp
A 77-year-old Caucasian man with a remote history of renal cell carcinoma status post nephrectomy 20 years ago underwent an esophagogastroduodenoscopy for persistent dyspepsia. The esophagogastroduodenoscopy showed a 10-mm friable pedunculated polyp in the gastric body (Figure A). Histopathology of the gastric polyp showed ulcerated mucosa containing large atypical cells with increased mitotic activity and abundant eosinophilic cytoplasm in the lamina propria (Figure B). These cells were positive for PAX8 (Figure  C), with focal reactivity with CAM5.2 (Figure D) and OSCAR cytokeratin, consistent with metastatic renal ...
Source: Clinical Gastroenterology and Hepatology - April 7, 2018 Category: Gastroenterology Authors: Amirali Kiyani, Arnaav Walia, Keng-Yu Chuang Tags: Electronic Image of the Month Source Type: research

Identifying clinically relevant sliding hiatal hernias: a population-based endoscopy study.
CONCLUSIONS: Only reflux symptoms could be attributed to sliding hiatal hernias. Hiatal hernias less than 2 cm should be considered clinically insignificant. PMID: 29616831 [PubMed - as supplied by publisher] (Source: Scandinavian Journal of Gastroenterology)
Source: Scandinavian Journal of Gastroenterology - April 6, 2018 Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research

Value of Preoperative PET-CT in the Prediction of Pathological Stage of Gastric Cancer
ConclusionsPET-CT appears to be a useful complementary modality in the assessment of pStage III/IV because of the high sensitivity of FDG uptake in the primary tumor and the high specificity of FDG uptake in the lymph nodes. (Source: Annals of Surgical Oncology)
Source: Annals of Surgical Oncology - April 6, 2018 Category: Cancer & Oncology Source Type: research

Value of Preoperative PET-CT in the Prediction of Pathological Stage of Gastric Cancer.
CONCLUSIONS: PET-CT appears to be a useful complementary modality in the assessment of pStage III/IV because of the high sensitivity of FDG uptake in the primary tumor and the high specificity of FDG uptake in the lymph nodes. PMID: 29626306 [PubMed - as supplied by publisher] (Source: Ann Oncol)
Source: Ann Oncol - April 6, 2018 Category: Cancer & Oncology Authors: Kudou M, Kosuga T, Kubota T, Okamoto K, Komatsu S, Shoda K, Konishi H, Shiozaki A, Fujiwara H, Arita T, Morimura R, Murayama Y, Kuriu Y, Ikoma H, Nakanishi M, Otsuji E Tags: Ann Surg Oncol Source Type: research

Esophageal lichen planus: An unusual cause of dysphagia in the elderly
Summary An 82-year-old man sought our service with dysphagia and was referred for upper endoscopy with biopsies, which evidenced multiple ulcers of the esophagus and oropharinx. Histopathology confirmed the unusual diagnosis of esophageal lichen planus. The correct clinical suspicion of this disease can facilitate the diagnosis and guide specific treatment, which can drastically change the natural course of the disease.Resumo Paciente do sexo masculino, de 82 anos, com disfagia, foi encaminhado para realiza ção de endoscopia digestiva alta com biópsias, na qual foram evidenciadas múltiplas &uacu...
Source: Revista da Associacao Medica Brasileira - April 5, 2018 Category: General Medicine Source Type: research

Clinical and Endoscopic Remission in a Patient With Cronkhite-Canada Syndrome
A 60-year-old man presented with chronic diarrhea for 9 months, anorexia, a 6-kg weight loss, and dysgeusia. He had hyperpigmentation of his  face, hands (Figure A), and feet; alopecia; and nail dystrophy (Figure A). An esophagogastroduodenoscopy and a colonoscopy showed multiple polyps carpeting the stomach, duodenum, ileum, and the colon (Figure B). Histology showed cystically dilated glands and mixed inflammatory infiltrate comprisin g eosinophils and neutrophils. Cronkhite–Canada syndrome was diagnosed on the basis of clinical and pathologic findings. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 5, 2018 Category: Gastroenterology Authors: Saurabh Dawra, Vishal Sharma, Usha Dutta Tags: Electronic Image of the Month Source Type: research

Diffuse Esophageal Squamous Papillomatosis Covering the Entire Esophagus
A 23-year-old woman presented to the clinic with complaints of heartburn and dysphagia with solid foods. Her family history was remarkable for gastric and  lung cancer in first-degree relatives. Her physical examination and routine laboratory study results were normal. An upper endoscopy was performed and showed multiple polypoid lesions ranging in size from 3 to 11 mm, involving the entire esophagus (Figure A; Video). An endoscopic polypectomy of se veral of the larger polyps was performed. Histopathologic examination showed the lesions were squamous papillomas with areas of hyperkeratinization. (Source: Clinical Gas...
Source: Clinical Gastroenterology and Hepatology - April 5, 2018 Category: Gastroenterology Authors: Genco Gen çdal, Serife Degirmencioglu, Murat Akyıldız Tags: Electronic Image of the Month Source Type: research

Prolonged Epigastric Pain Caused by a Leaf Stem Embedded in the Gastric Wall.
Authors: Yoshioka T, Iwamuro M, Takeda H, Fujiwara T Abstract A 67-year-old woman underwent esophagogastroduodenoscopy to determine the cause of her prolonged epigastric pain. During the examination, a sharp-pointed foreign body was observed; the edge of the object had been embedded in the gastric wall. The object was removed via an endoscope, and the patients' symptoms improved immediately. Based on a dietary history and an electron microscope examination, we identified the object as a stem of mizuna, a potherb mustard. Our report indicates that commonly eaten leafy green vegetables can act as sharp-pointed foreig...
Source: Internal Medicine - April 4, 2018 Category: Internal Medicine Tags: Intern Med Source Type: research

Diagnostic Trends and Clinical Characteristics of Eosinophilic Esophagitis: A Korean, Single-center Database Study.
Conclusions: The number of patients with EoE appears to have increased significantly over the 9-year period investigated, while the number of endoscopic investigations increased only marginally. Greater awareness of EoE and the role of esophageal biopsies should be considered. PMID: 29605980 [PubMed] (Source: Journal of Neurogastroenterology and Motility)
Source: Journal of Neurogastroenterology and Motility - April 3, 2018 Category: Gastroenterology Tags: J Neurogastroenterol Motil Source Type: research

Environmental Enteropathy in Undernourished Pakistani Children: Clinical and Histomorphometric Analyses.
Abstract Despite nutrition interventions, stunting thought to be secondary to underlying environmental enteropathy (EE) remains pervasive among infants residing in resource-poor countries and remains poorly characterized. From a birth cohort of 380 children, 65 malnourished infants received 12 weeks of nutritional supplementation with ready-to-use therapeutic food (RUTF). Eleven children with insufficient response to RUTF underwent upper endoscopy with duodenal biopsies, which were compared with U.S., age-matched specimens for healthy, celiac disease, non-celiac villous atrophy, non-celiac intraepithelial lymphocy...
Source: The American Journal of Tropical Medicine and Hygiene - April 2, 2018 Category: Tropical Medicine Authors: Syed S, Yeruva S, Herrmann J, Sailer A, Sadiq K, Iqbal N, Kabir F, Ahmed K, Qureshi S, Moore SR, Turner J, Ali SA Tags: Am J Trop Med Hyg Source Type: research

Successful Treatment of Strongyloides stercoralis Hyperinfection in a Kidney Transplant Recipient: Case Report
We report the case of a cadaveric kidney transplant recipient who developed gastrointestinal symptoms and eosinophilia, approximately 3 months after transplantation. Stool examination and esophagogastroduodenoscopy with biopsies were positive for SS larvae. The patient was started on oral ivermectin and immunosuppression was reduced, but still the clinical picture got worse with metabolic ileus and respiratory symptoms, with the need for administration of subcutaneous ivermectin and combined therapy with albendazol. (Source: Transplantation Proceedings)
Source: Transplantation Proceedings - April 1, 2018 Category: Transplant Surgery Authors: J. Rego Silva, R.A. Macau, A. Mateus, P. Cruz, M.J. Aleixo, M. Brito, A. Alcobia, C. Oliveira, A. Ramos Tags: 15th Brazilian Transplantation Congress and 16th Portuguese-Brazilian Transplantation Congress Source Type: research

Iatrogenic atrio-esophageal fistula following a video-assisted thoracoscopic maze procedure: Is esophageal instrumentation justified even when the diagnosis is equivocal?
Abstract A 74-year-old female underwent an uneventful bilateral thoracoscopic maze procedure for persistent atrial fibrillation with continuous transesophageal echocardiographic (TEE) guidance. She presented six weeks later with persistent fever and focal neurological signs. Computed tomography of the thorax revealed air in the posterior LA, raising suspicion for an abscess versus an atrioesophageal fistula (AEF). Before undergoing an exploratory median sternotomy, an esophagogastroduodenoscopy (EGD) was performed by the surgeon to check for any esophageal pathology. This however, resulted in sudden hemodynamic co...
Source: Annals of Cardiac Anaesthesia - April 1, 2018 Category: Anesthesiology Authors: Agarwal S, Tahir Janjua MS, Singh P, Odo N, Castresana MR Tags: Ann Card Anaesth Source Type: research

Evaluation of the Upper Gastrointestinal Tract in Ulcerative Colitis Patients.
Abstract To analyze the clinical characteristics of patients with ulcerative colitis who have upper gastrointestinal lesions, we retrospectively reviewed the data of 216 patients with ulcerative colitis who underwent esophagogastroduodenoscopy at our institute in April 2008-March 2016. We investigated the endoscopic features and compared the clinical characteristics between the patients with and without upper gastrointestinal lesions. Forty-two patients (19.4%) had upper gastrointestinal lesions, including multiple erosions (n=18), bamboo joint-like appearance (n=17), mucosa with white spots (n=4), friable mucosa ...
Source: Acta Med Okayama - April 1, 2018 Category: Universities & Medical Training Authors: Kato R, Iwamuro M, Hiraoka S, Takashima S, Inokuchi T, Takahara M, Kondo Y, Tanaka T, Okada H Tags: Acta Med Okayama Source Type: research

Migration of Spinal Pedicle Screw with Aerodigestive Perforation and Subsequent Device Expectoration
Conclusion This case presents an rare occurrence of aerodigestive perforation of a spinal pedicle screw which was self-removed. (Source: International Journal of Surgery Case Reports)
Source: International Journal of Surgery Case Reports - March 30, 2018 Category: Surgery Source Type: research

Accuracy of probe-based confocal laser endomicroscopy (pCLE) compared to random biopsies during endoscopic surveillance of Barrett ’s esophagus
Conclusions pCLE demonstrates high specificity for detecting dysplasia and cancer, but lower sensitivity may limit its utility in routine BE surveillance. pCLE may have a role in confirming LGD in real-time before eradication therapy. [...] © Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text (Source: Endoscopy International Open)
Source: Endoscopy International Open - March 29, 2018 Category: Gastroenterology Authors: Shah, Tilak Lippman, Robert Kohli, Divyanshoo Mutha, Pritesh Solomon, Sanjeev Zfass, Alvin Tags: Original article Source Type: research

Jejuno-gastric Intussusception: A Case Report of Unusual Cause of Food Intolerance after Roux-En-Y Gastric Bypass
Conclusion JGI is a rare of cause of abdominal pain, nausea and vomiting after RYGB. Early diagnosis is crucial, a thorough work up is needed to make diagnosis of JGI including EGD. Revision of GJ anastomosis is necessary to address this phenomenon. (Source: International Journal of Surgery Case Reports)
Source: International Journal of Surgery Case Reports - March 26, 2018 Category: Surgery Source Type: research

[Endoscopic Treatment for Esophageal Cancer].
Abstract Esophageal cancer incidence rate per 100,000 is 4.7 in 2013, which accounts for 1.1% of the total cancer incidence in Korea. Superficial esophageal squamous cell carcinoma is frequently detected in persons undergoing upper endoscopy for gastrointestinal symptoms or for gastric cancer screening. Esophagectomy with lymph node dissection is the standard treatment for esophageal cancer. However, given the considerable morbidity and mortality of esophagectomy, endoscopic resection has become the standard of care for most cases of superficial esophageal squamous cell carcinoma without metastasis. In addition, e...
Source: Korean J Gastroenter... - March 25, 2018 Category: Gastroenterology Authors: Min YW Tags: Korean J Gastroenterol Source Type: research

Gastric granular cell tumor in a youth excised by endoscopic submucosal dissection : A case report and literature review.
We report a case of gastric GCT in a 16-year-old male who presented with nausea and abdominal discomfort. Esophagogastroduodenoscopy (EGD) revealed an elastic hard and yellowish submucosal tumor of the gastric cardia anterior wall. GCT was suspected upon biopsy ; after total endoscopic submucosal dissection, histology of the resected tumor confirmed the diagnosis. Endoscopic treatment should be considered in youths with GCT. PMID: 29560700 [PubMed - in process] (Source: Acta Gastro-Enterologica Belgica)
Source: Acta Gastro-Enterologica Belgica - March 23, 2018 Category: Gastroenterology Tags: Acta Gastroenterol Belg Source Type: research

The association between gastroesophageal flap valve function and gastroesophageal reflux symptoms.
Authors: Keskin O, Kalkan Ç, Yaman A, Tüzün A, Soykan I Abstract BACKGROUND AND STUDY AIMS: Upper gastrointestinal endoscopic examination is usually the first step in the evaluation of patients with suspected gastroesopageal reflux disease. The primary aim of this study was to investigate the association between gastroesophageal flap valve function (GEFV) and gastroesophapgeal reflux symptoms in patients undergoing routine upper endoscopy. Patients and methods: 1507 patients were included into the study and the GEFV graded I to IV as follows: Hill I-II: normal GEFV, and Hill I...
Source: Acta Gastro-Enterologica Belgica - March 23, 2018 Category: Gastroenterology Tags: Acta Gastroenterol Belg Source Type: research

An Alarming but Benign Appearance, A Case of Pseudomelanosis Duodeni
A 77-year-old woman with hypertension, hyperlipidemia, diabetes mellitus, and hypothyroidism presented with a complaint of epigastric pain. An esophagogastroduodenoscopy was performed that showed a deep ulcerated mass in the antrum covered in old heme with biopsy specimens consistent with an adenocarcinoma. The duodenal bulb and second portion of the duodenum showed a speckled highly pigmented black pattern in the wall of the duodenum (Figures A and B). Duodenal biopsy specimens showed focal pigmented macrophages in the lamina propria consistent with pseudomelanosis duodeni. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 22, 2018 Category: Gastroenterology Authors: Ayush Sutaria, Manoop S. Bhutani Tags: Electronic Image of the Month Source Type: research

Jejunogastric Intussusception With Jejunojejunal Intussusception (Double Telescoping)
A 62-year-old man with a history of adenocarcinoma of the stomach status post subtotal gastrectomy and Billroth II gastrojejunostomy 5 years ago presented with an acute onset of severe epigastric pain associated with bloody emesis. A computed tomography scan of the abdomen suggested a retrograde intussusception of the small-bowel anastomosis into the stomach in addition to pneumatosis of the intussusceptum (Figures A and B). He underwent upper endoscopy, which showed a large protuberant mass in the stomach with edematous mucosa (Figure C). (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 22, 2018 Category: Gastroenterology Authors: Ramprasad Jegadeesan, Tharani Sundararajan, Elena Sidorenko Tags: Electronic Image of the Month Source Type: research

Gastric Mucormycosis in a Liver and Kidney Transplant Recipient: Case Report and Concise Review of Literature
We describe a rare case of gastric mucormycosis in a patient with a combined liver-kidney transplant affected by glycogen storage disease type Ia.A 42-year-old female patient presented with gastric pain and melena 26 days after transplantation. Evaluation with upper endoscopy showed two bleeding gastric ulcers. (Source: Transplantation Proceedings)
Source: Transplantation Proceedings - March 22, 2018 Category: Transplant Surgery Authors: G. Alfano, F. Fontana, D. Francesca, G. Assirati, P. Magistri, G. Tarantino, R. Ballarin, G. Rossi, E. Franceschini, M. Codeluppi, G. Guaraldi, C. Mussini, F. Di Benedetto, G. Cappelli Source Type: research

Laparoscopic Resection of a Jejunal Inflammatory Fibroid Polyp that Caused Occult Gastrointestinal Bleeding, Diagnosed via Capsule Endoscopy and Double-Balloon Enteroscopy: A Case Report.
Authors: Kameda C, Miwa H, Kawabata R, Marukawa D, Murakami M, Noura S, Shimizu J, Hasegawa J Abstract An inflammatory fibroid polyp (IFP) is a mesenchymal tumor of the gastrointestinal tract. IFPs in the small intestine are the most frequently detected with symptoms, such as abdominal pain and tarry stool due to intussusception. Accordingly, few studies have reported jejunal IFP as a cause of occult gastrointestinal bleeding (OGIB) diagnosed via both of capsule endoscopy (CE) and double-balloon enteroscopy (DBE). A 68-year-old woman presented with a progression of anemia and a positive fecal occult blood test resu...
Source: Clinical Endoscopy - March 21, 2018 Category: Gastroenterology Tags: Clin Endosc Source Type: research

Curative resection of advanced esophageal cancer with metachronous stage IV breast cancer: a case report
Conclusion Curative resection could be considered for patients with esophageal cancer who have an additional cancer with distant metastasis when the prognosis of the additional cancer is not poor. (Source: International Journal of Surgery Case Reports)
Source: International Journal of Surgery Case Reports - March 20, 2018 Category: Surgery Source Type: research

Ampullary Dieulafoy: An Unusual Cause of Obscure Gastrointestinal Bleeding
A 65-year-old woman presented with multiple episodes of melena and a 5 g/mL decrease in hemoglobin level over a 6-month period. Three esophagogastroduodenoscopies and 2 colonoscopies were unremarkable. A capsule showed blood in the duodenum without an obvious source. Repeat upper endoscopy showed blood from the major papilla. Further studies were obtained including computed tomography, magnetic resonance imaging/magnetic resonance cholangiopancreatography, endoscopic ultrasound, bleeding scan, and an angiography —all were unremarkable. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 20, 2018 Category: Gastroenterology Authors: Dennis Han, Michael E. Adler, Divyesh V. Sejpal Tags: Image of the Month Source Type: research

Cirrhosis Following Single Anastomosis Duodeno-ileal Switch: A Case Report
Conclusion Close laboratory monitoring is important after SADI-S in order to detect worsening hepatic dysfunction, which may occur many years after the surgery in the absence of other etiologies for liver failure. (Source: International Journal of Surgery Case Reports)
Source: International Journal of Surgery Case Reports - March 19, 2018 Category: Surgery Source Type: research

Sporadic Minute Pharyngeal Xanthomas Detected Incidentally During Esophagogastroduodenoscopy: A Case Series
We report three cases of asymptomatic sporadic pharyngeal xanthoma that were detected incidentally during routine esophagogastroduodenoscopy. All the patients were men and had a solitary lesion of about 1  mm in size. Two of the lesions were located in the oropharynx, while one was in the hypopharynx. Non-magnifying endoscopy showed yellowish lesions, and magnifying endoscopy showed an aggregation of minute yellowish nodules with tortuous microvessels on their surface. Histopathological examination revealed foam cells filling the intraepithelial papillae. The foam cells were strongly immunopositive for cluster of diff...
Source: Head and Neck Pathology - March 19, 2018 Category: Pathology Source Type: research

Current Trends in Anticoagulation Bridging for Patients with Chronic Atrial Fibrillation on Warfarin Undergoing Endoscopy
For warfarin-treated patients with Atrial Fibrillation (AF) at low thromboembolic risk, recent studies have shown harm associated with peri-procedural bridging using low-molecular-weight heparin (LMWH). Clinician surveys have indicated a preference towards excessive bridging, especially among non-cardiologists; however, little is known about actual practice patterns in these patients. We performed a retrospective evaluation of bridging in the setting of gastrointestinal endoscopy. We identified 938 patients with AF on warfarin undergoing esophagogastroduodenoscopy or colonoscopy between 2012 and 2016 at a tertiary health c...
Source: The American Journal of Cardiology - March 16, 2018 Category: Cardiology Authors: Jeremy A. Slivnick, Raymond Y. Yeow, Colin McMahon, David G. Paje, Jacob E. Kurlander, Geoff D. Barnes Source Type: research

The use of the forceps biopsy as an auxiliary technique for the visualization of the major duodenal papilla using the foward-viewing upper endoscopy
CONCLUSION: The use of the biopsy forceps significantly increased the total major duodenal papilla visualization rate by 14%, reaching 604/671 (90%) of the patients (P
Source: Arquivos de Gastroenterologia - March 15, 2018 Category: Gastroenterology Source Type: research

Review of celiac disease presentation in a pediatric tertiary centre
CONCLUSION: Our finding s outline the diverse clinical presentations of pediatric celiac disease that should be considered irrespective of age. Increased clinician ’ s awareness will enable an early diagnosis and treatment, with subsequent symptom and nutritional status improvement.RESUMO CONTEXTO: A doen ça celíaca é uma doença imuno-mediada com uma apresentação multiforme constituindo, por isso, um desafio diagnóstico. OBJETIVO: O objetivo deste trabalho foi identificar as características epidemiológicas, clínicas, laboratoriais e histológ...
Source: Arquivos de Gastroenterologia - March 15, 2018 Category: Gastroenterology Source Type: research

Transoral endoscopic base of tongue mucosectomy for investigation of unknown primary cancers of head and neck
This article is protected by copyright. All rights reserved. (Source: Clinical Otolaryngology)
Source: Clinical Otolaryngology - March 15, 2018 Category: ENT & OMF Authors: Sebastian Wallis, Lorcan O'Toole, Laszlo Karsai, Jose Jemy Tags: Our Experience Source Type: research

Gastric Arteriovenous Malformation with Characteristic Endoscopic Findings.
Authors: Hirayama Y, Takai C, Korekawa K, Saitoh M, Akasaka A, Nagasawa H, Iwai W, Hachimori H, Satoh M, Yajima N, Oki M Abstract Gastric arteriovenous malformation (AVM) is an uncommon cause of upper gastrointestinal bleeding, and the endoscopic findings are unclear. We herein describe a case of gastric AVM in a 28-year-old man. Esophagogastroduodenoscopy showed a Dieulafoy lesion surrounded by a red mucosa with a sharp margin, which implied blood vessel malformation. Computed tomography angiography and conventional angiography revealed aggregated vessels on the greater curvature. Partial gastrectomy was performed...
Source: Internal Medicine - March 14, 2018 Category: Internal Medicine Tags: Intern Med Source Type: research

Detection of cavernous transformation of the portal vein by contrast-enhanced ultrasound
ConclusionsWe describe a case of cavernous transformation of the portal vein missed on initial color Doppler, CTA and MRA, but detected with contrast-enhanced ultrasound technique. (Source: Journal of Ultrasound)
Source: Journal of Ultrasound - March 13, 2018 Category: Radiology Source Type: research

Silent invasion of Hem-O-Lok clip.
Authors: Park DJ, Kim BG, Jeong ID, Kim GY Abstract A 58-year-old man underwent laparoscopy-assisted distal gastrectomy (LADG) with Billroth I gastroduodenostomy due to early gastric cancer. During surgery, the perigastric vessels were ligated with Hem-o-Lok clips. Esophagogastroduodenoscopy (EGD) 6 months later showed a fungating mass at the anastomosis site. Repeat EGD 1 year after LADG showed a Hem-o-Lok clip at the fungating mass lesion. Because the patient was asymptomatic, with no major abnormalities on clinical examination, and endoscopic removal of the clip would have been difficult due to the presence of a...
Source: Annals of Surgical Treatment and Research - March 10, 2018 Category: Surgery Tags: Ann Surg Treat Res Source Type: research

Pancreas-sparing and superior mesenteric artery first approach in duodenal adenocarcinoma of the fourth portion of duodenum: A case report
Conclusion Artery-first approach of the SMA should be considered by surgeons in adenocarcinoma of the distal duodenum to identify any contra-indications to proceed further. (Source: International Journal of Surgery Case Reports)
Source: International Journal of Surgery Case Reports - March 10, 2018 Category: Surgery Source Type: research

Synchronous gastric leiomyoma and intramuscular abdominal wall granular cell tumor with similar imaging features: A case report
Conclusion Laparoscopic-endoscopic cooperative surgery can be an effective minimally invasive approach to resect some lesions. This is first report of the patient with a synchronous gastric leiomyoma and an intramuscular granular cell tumor in the abdominal wall. (Source: International Journal of Surgery Case Reports)
Source: International Journal of Surgery Case Reports - March 7, 2018 Category: Surgery Source Type: research

Evaluation of Patients with an Apparent False Positive Stool DNA Test: The Role of Repeat Stool DNA Testing
ConclusionsRepeat positive sDNA testing may identify a subset of patients with missed or occult colorectal neoplasia after negative colonoscopy for an initially positive sDNA. High-quality colonoscopy with careful attention to the right colon in patients with positive sDNA is critically important and may avoid false negative colonoscopy. (Source: Digestive Diseases and Sciences)
Source: Digestive Diseases and Sciences - March 7, 2018 Category: Gastroenterology Source Type: research

Oral capnography is more effective than nasal capnography during sedative upper gastrointestinal endoscopy
This study first measured capnographic data via the nasal or oral cavity during sedated EGD. Secondly, we investigated the influence of supplementary oxygen through the oral cavity on the capnographic reading. Patients with ASA class I or II status admitted for routine EGD exams were enrolled. End-tidal carbon dioxide measurements were performed simultaneously via nasal catheter and oral catheter with standard oral bite and nasal cannula supplementary oxygen when the patient is awake, during sedation and during sedation with endoscopy. The influence of oral supplementary oxygen, oral capnography were recorded using a mandi...
Source: Journal of Clinical Monitoring and Computing - March 6, 2018 Category: Information Technology Source Type: research

Quality of Endoscopy Reports for Esophageal Cancer Patients: Where Do We Stand?
This study evaluates the compliance of esophagogastroduodenoscopy (EGD) and endoscopic ultrasound (EUS) reporting with the current national guidelines.MethodsCombining the National Comprehensive Cancer Network and Society of Thoracic Surgeons guidelines, 11 quality indicators (QIs) for EGD and 8 for EUS were identified. We evaluated initial EGD and EUS reports from our institution (Memorial Sloan Kettering [MSK]) and outside hospitals (OSHs) and calculated individual and overall quality measure scores. Scores between locations were compared using the Wilcoxon signed-rank test and McNemar ’s test for paired data.Resul...
Source: Journal of Gastrointestinal Surgery - March 5, 2018 Category: Surgery Source Type: research

A Gastric Follicular Lymphoma Presenting as a Submucosal Tumor with a Diagnosis Determined by Endoscopic Resection.
Authors: Fujimoto A, Akimoto T, Nakayama A, Mikami S, Tsujikawa H, Kameyama K, Okamoto S, Maehata T, Ochiai Y, Goto O, Kato M, Sasaki M, Uraoka T, Yahagi N Abstract We herein report the case of 74-year-old man with gastric follicular lymphoma resected by endoscopic submucosal dissection (ESD). A submucosal tumor 7 mm in diameter was detected at the gastric middle body. Endoscopic ultrasonography (EUS) showed a homogenous hypoechoic tumor localized in the submucosa. The tumor was removed by ESD immediately, before further tumor growth would preclude endoscopic resection. The pathological findings indicated follicula...
Source: Internal Medicine - March 3, 2018 Category: Internal Medicine Tags: Intern Med Source Type: research

Melena as an unusual presentation of gastrointestinal stromal tumour, a case report
Conclusion We conclude that GIST should be considered as a possible differential in rare cases of GI bleeding where more common causes have been ruled out. (Source: International Journal of Surgery Case Reports)
Source: International Journal of Surgery Case Reports - March 2, 2018 Category: Surgery Source Type: research

Overt gastrointestinal bleeding caused by hookworm infection, diagnosed by capsule endoscopy
This article is protected by copyright. All rights reserved. (Source: Digestive Endoscopy)
Source: Digestive Endoscopy - March 2, 2018 Category: Gastroenterology Authors: Gerardo Blanco ‐Velasco, Omar Solorzano‐Pineda, Oscar Víctor Hernández‐Mondragón Tags: DEN Video Article Source Type: research

Worming Your Way Through the Gastrointestinal Tract: A Case of Strongyloidiasis
A 45-year-old man originally from Peru was referred for endoscopic evaluation for ongoing symptoms of generalized abdominal pain and bloating. His symptoms had been present for more than 20 years but had worsened recently. His last travel to Peru was 4 years ago. Stool examination for ova and parasite were negative. Stool cultures for Salmonella, Shigella, Campylobacter, Escherichia coli O157, and Yersinia infections also were  negative. Esophagogastroduodenoscopy showed normal-appearing stomach and duodenum. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 2, 2018 Category: Gastroenterology Authors: Priyanka Kanth, Kajsa Affolter Tags: Image of the Month Source Type: research