scholarly journals Endoscopic management of non-ampullary duodenal adenomas

2022 ◽  
Vol 10 (01) ◽  
pp. E96-E108
Author(s):  
Romain Coriat ◽  
Maximilien Barret ◽  
Maxime Amoyel ◽  
Arthur Belle ◽  
Marion Dhooge ◽  
...  
Keyword(s):  
Endoscopic Treatment ◽  
Diagnosis And Treatment ◽  
Endoscopic Management ◽  
High Morbidity ◽  
Major Morbidity ◽  
Duodenal Adenomas ◽  
Duodenal Polyps ◽  
Endoscopic Complications ◽  
A Prospective Study ◽  
Duodenal Perforations

AbstractDuodenal polyps are found in 0.1 % to 0.8 % of all upper endoscopies. Duodenal adenomas account for 10 % to 20 % of these lesions. They can be sporadic or occur in the setting of a hereditary predisposition syndrome, mainly familial adenomatous polyposis. Endoscopy is the cornerstone of management of duodenal adenomas, allowing for diagnosis and treatment, primarily by endoscopic mucosal resection. The endoscopic treatment of duodenal adenomas has a high morbidity, reaching 15 % in a prospective study, consisting of bleeding and perforations, and should therefore be performed in expert centers. The local recurrence rate ranges from 9 % to 37 %, and is maximal for piecemeal resections of lesions > 20 mm. Surgical resection of the duodenum is flawed with major morbidity and considered a rescue procedure in cases of endoscopic treatment failures or severe endoscopic complications such as duodenal perforations. In this paper, we review the existing evidence on endoscopic diagnosis and treatment of non-ampullary duodenal adenomas.

scholarly journals Endoscopic management of superficial nonampullary duodenal tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Endoscopy ◽  
2021 ◽  
Author(s):  
Geoffroy Vanbiervliet ◽  
Alan Moss ◽  
Marianna Arvanitakis ◽  
Urban Arnelo ◽  
Torsten Beyna ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
En Bloc Resection ◽  
Endoscopic Management ◽  
Duodenal Adenoma ◽  
En Bloc ◽  
Strong Recommendation ◽  
Delayed Bleeding ◽  
Duodenal Adenomas ◽  
Moderate Quality ◽  
Quality Evidence

Main recommendations 1 ESGE recommends that all duodenal adenomas should be considered for endoscopic resection as progression to invasive carcinoma is highly likely.Strong recommendation, low quality evidence. 2 ESGE recommends performance of a colonoscopy, if that has not yet been done, in cases of duodenal adenoma.Strong recommendation, low quality evidence. 3 ESGE recommends the use of the cap-assisted method when the location of the minor and/or major papilla and their relationship to a duodenal adenoma is not clearly established during forward-viewing endoscopy.Strong recommendation, moderate quality evidence. 4 ESGE recommends the routine use of a side-viewing endoscope when a laterally spreading adenoma with extension to the minor and/or major papilla is suspected.Strong recommendation, low quality evidence. 5 ESGE suggests cold snare polypectomy for small (< 6 mm in size) nonmalignant duodenal adenomas.Weak recommendation, low quality evidence. 6 ESGE recommends endoscopic mucosal resection (EMR) as the first-line endoscopic resection technique for nonmalignant large nonampullary duodenal adenomas.Strong recommendation, moderate quality evidence. 7 ESGE recommends that endoscopic submucosal dissection (ESD) for duodenal adenomas is an effective resection technique only in expert hands.Strong recommendation, low quality evidence. 8 ESGE recommends using techniques that minimize adverse events such as immediate or delayed bleeding or perforation. These may include piecemeal resection, defect closure techniques, noncontact hemostasis, and other emerging techniques, and these should be considered on a case-by-case basis.Strong recommendation, low quality evidence. 9 ESGE recommends endoscopic surveillance 3 months after the index treatment. In cases of no recurrence, a further follow-up endoscopy should be done 1 year later. Thereafter, surveillance intervals should be adapted to the lesion site, en bloc resection status, and initial histological result. Strong recommendation, low quality evidence.

Endoscopic Management of Duodenal Adenomas in Familial Adenomatous Polyposis—A Single-Center Experience

2011 ◽  
Vol 57 (3) ◽  
pp. 732-737 ◽  
Author(s):  
Sathya Jaganmohan ◽  
Patrick M. Lynch ◽  
Ramu P. Raju ◽  
William A. Ross ◽  
Jeffrey E. Lee ◽  
...  
Keyword(s):  
Familial Adenomatous Polyposis ◽  
Endoscopic Management ◽  
Adenomatous Polyposis ◽  
Single Center ◽  
Duodenal Adenomas ◽  
Single Center Experience

scholarly journals A study of rotavirus infection in acute diarrhoea in children less than 5 years of age

2021 ◽  
Vol 8 (4) ◽  
pp. 321-326
Author(s):  
Pramod N Sambrani ◽  
Pooja Mansabdar ◽  
Mahesh Kumar S
Keyword(s):  
Acute Diarrhoea ◽  
High Sensitivity ◽  
Childhood Mortality ◽  
Major Morbidity ◽  
Rotavirus Infection ◽  
Stool Samples ◽  
Diarrhoeal Diseases ◽  
Rotavirus Diarrhea ◽  
A Prospective Study ◽  
Children Under 5

: Diarrhoeal diseases account for an estimated 1.5 million deaths globally every year making it the second leading cause of childhood mortality. In India 1 out of every 250 children die of rotavirus diarrhea each year.: To find out the incidence of rotavirus infection in acute diarrhoeal cases in children under 5 years of age.: A prospective study was conducted on 100 non repetetive stool samples of Children under 5 years of age, presenting with acute diarrhea and hospitalized in the pediatric ward, during December 2015 to November 2016. Stool samples were processed according to premier rotaclone enzyme immunoassay protocol for the detection of rotavirus antigen, adhering to standard laboratory precautions.: The incidence of acute diarrhoeal diseases was 5.86% in our setting. was detected in 29% cases by ELISA method.The antigen detection by EIA is a reliable test, as it is quantitative and also has high sensitivity and specificity. Hence, can be routinely employed to prevent major morbidity and mortality among children, especially less than 5 years of age.

COVID-19 WITH RHINO-ORBITO-CEREBRAL MUCORMYCOSIS : A SUDDEN SURGE

2021 ◽  
pp. 130-133
Author(s):  
Seema Patel ◽  
A. Z. Nitnaware ◽  
R. T. Pawar ◽  
Ashish Keche ◽  
Tanvi Rekhade
Keyword(s):  
Diabetes Mellitus ◽  
Early Diagnosis ◽  
Prospective Study ◽  
Previous History ◽  
Diagnosis And Treatment ◽  
Temporal Association ◽  
Concomitant Infection ◽  
History Of ◽  
A Prospective Study

Recently an increase in the incidence of mucormycosis is noticed in COVID-19 cases. The main aim of this study is to present our experience of rhino-orbito-cerebral mucormycosis in COVID-19 patients and thereby aid its early diagnosis and treatment. This is a prospective study of 12 cases diagnosed as Rhino-orbito-cerebral mucormycosis . Presentation of mucormycosis in COVID-19, their temporal association and outcome of treatment was studied. Pre-existing comorbidities were seen in 91.67% patients, Diabetes Mellitus (83.33%). Previous history of COVID-19 infection and treatment for the same in 41.67% cases, concomitant infection in 16.67% and asymptomatic undiagnosed covid (antibodies positive) was detected in 41.67%. All patients showed improvement in general and nasal condition (100%). Early diagnosis is must.

Endoscopic Management of Postbariatric Fistulae and Leaks

2015 ◽  
Author(s):  
Yana Cavanagh ◽  
Sohail N. Shaikh
Keyword(s):  
Bariatric Surgery ◽  
Diagnostic Algorithm ◽  
Therapeutic Endoscopy ◽  
Late Complications ◽  
Endoscopic Management ◽  
High Morbidity ◽  
Management Options ◽  
Radiographic Findings ◽  
Computed Tomographic ◽  
American Society

The number of bariatric procedures performed annually is increasing along with the number of complications. Gastrointestinal leak after bariatric surgery generally portends high morbidity and mortality, and its management depends on clinical and radiographic presentation. A leak is defined as an enteric defect with extravasation of luminal contents. Fistulae are abnormal connections between two epithelialized surfaces, are usually chronic, and may develop from long-standing leaks. Endoscopic therapies may offer an attenuated risk profile compared with surgical intervention and play a growing role in the management of postbariatric complications. Leak resolution may require multiple endoscopic sessions and modalities (e.g., stents, adhesives, plugs, clips, suturing, and VAC-assisted closure); therefore, it is critical to have appropriate follow-up and surveillance after therapeutic endoscopic intervention. This review discusses endoscopic leak and fistula management through endoscopic procedures, addressing indications and candidates for procedure, contraindications, recipient evaluation, and aspects of procedure, including proper timing, equipment, and types. Figures show Roux-en-Y gastric bypass, sleeve gastrectomy, management options for leaks after bariatric surgery, a diagnostic algorithm for leaks, upper gastrointestinal series performed with Gastrografin, and computed tomographic scans that demonstrate extraluminal air extending along the diaphragmatic surface of the spleen and a perisplenic gas and fluid-filled collection on the lateral margin. Tables list complications that follow bariatric surgery; an excerpt from the 2008 American Society for Gastrointestinal Endoscopy Guidelines; recommended equipment for endoscopic defect management; classification system based on duration after bariatric surgery; classification and approach to management based on clinical presentation and radiographic findings; summary of recommendations for pre-endoscopy, index endoscopy, therapeutic endoscopy, and posttherapeutic endoscopy; and early and late complications of stent placement. This review contains 7 highly rendered figures, 7 tables, and 104 references.

Asian consensus statements on endoscopic management of walled-off necrosis Part 1: Epidemiology, diagnosis, and treatment

2016 ◽  
Vol 31 (9) ◽  
pp. 1546-1554 ◽  
Author(s):  
Hiroyuki Isayama ◽  
Yousuke Nakai ◽  
Rungsun Rerknimitr ◽  
Christopher Khor ◽  
James Lau ◽  
...  
Keyword(s):  
Diagnosis And Treatment ◽  
Endoscopic Management ◽  
Consensus Statements ◽  
Walled Off Necrosis

scholarly journals Immune Parameters for Diagnosis and Treatment Monitoring in Invasive Mold Infection

2019 ◽  
Vol 5 (4) ◽  
pp. 116 ◽  
Author(s):  
Jeffrey Jenks ◽  
Stephen Rawlings ◽  
Carol Garcia-Vidal ◽  
Philipp Koehler ◽  
Toine Mercier ◽  
...  
Keyword(s):  
Treatment Monitoring ◽  
Antifungal Prophylaxis ◽  
Antifungal Treatment ◽  
Diagnosis And Treatment ◽  
Response To Treatment ◽  
Successful Outcome ◽  
High Morbidity ◽  
Immune Parameters ◽  
Immunologic Markers ◽  
Invasive Mold Infections

Infections caused by invasive molds, including Aspergillus spp., can be difficult to diagnose and remain associated with high morbidity and mortality. Thus, early diagnosis and targeted systemic antifungal treatment remains the most important predictive factor for a successful outcome in immunocompromised individuals with invasive mold infections. Diagnosis remains difficult due to low sensitivities of diagnostic tests including culture and other mycological tests for mold pathogens, particularly in patients on mold-active antifungal prophylaxis. As a result, antifungal treatment is rarely targeted and reliable markers for treatment monitoring and outcome prediction are missing. Thus, there is a need for improved markers to diagnose invasive mold infections, monitor response to treatment, and assist in determining when antifungal therapy should be escalated, switched, or can be stopped. This review focuses on the role of immunologic markers and specifically cytokines in diagnosis and treatment monitoring of invasive mold infections.

Sign in / Sign up

Export Citation Format

Share Document