Upper gastrointestinal endoscopy

Standard Of Care ◽

Oesophageal Varices ◽

Abdominal Symptoms ◽

Obscure Bleeding ◽

Recent Developments ◽

Upper Abdominal Symptoms ◽

Upper Abdominal ◽

Endoscopy is the procedure of choice in patients with retrosternal or upper abdominal symptoms who require investigation, and is essential in significant gastrointestinal bleeding to identify and—in most cases—treat the cause, with various therapeutic methods possible for erosions, ulcers, and oesophageal varices. More recent developments in the practice of upper gastrointestinal endoscopy include the use of enteroscopy for direct vision of the small bowel, video capsule endoscopy for diagnosis of obscure bleeding lesions, and an expanding range of minimally invasive therapeutic techniques. Endoscopic retrograde cholangiopancreatography is the standard of care for the removal of gallstones from the common bile duct, and palliating obstructing pancreatobiliary tumours.

Appropriateness of Indications of Upper Gastrointestinal Endoscopy and its Association With Positive Finding

Journal of Nepal Medical Association ◽

10.31729/jnma.3121 ◽

2018 ◽

Vol 56 (209) ◽

pp. 504-509 ◽

Cited By ~ 1

Author(s):

Tanka Prasad Bohara ◽

Uttam Laudari ◽

Abishek Thapa ◽

Shail Rupakheti ◽

Mukund Raj Joshi

Keyword(s):

Odds Ratio ◽

Positive Finding ◽

Significant Finding ◽

Cross Sectional ◽

Abdominal Symptoms ◽

Clinically Significant ◽

Upper Abdominal ◽

Introduction: Upper Gastrointestinal Endoscopy(UGIE) is a frequently advised investigation for upper abdominal symptoms. Studies have questioned the appropriateness of indications for UGIE and have shown that inappropriate indications range from 5% to 49%. The unnecessary UGIE expose patients to the risk. The number of UGIE is rising in our region and we assume so is the number of unnecessary UGIE. With an aim to evaluate the appropriateness of the indications of UGIE and compare its association with positive findings, we conducted a cross-sectional descriptive study. Methods: All patients undergoing diagnostic UGIE during the study period were included in the study. Appropriateness of indications for UGIE was defined as per American Society for Gastrointestinal Endoscopy(ASGE) criteria as “appropriate” and “inappropriate”. UGIE endoscopy findings were classified as “significant” and “insignificant” based on endoscopy findings. The extent of this association between the appropriateness of indications and UGIE findings was expressed as the odds ratio (OR) of finding a relevant diagnosis in patients with an ‘‘appropriate’’ indication compared with those with an ‘inappropriate’’ indication. Results: Seventy-nine patients were included in the study. Fifty- two (65.8 %) of the indications were considered appropriate as per ASGE guidelines. Thirty-three (63.5%) of the appropriate indications has clinically significant finding as compared to seven (25.9%) of inappropriate indication with an odds ratio of 4.962 (95%CI:1.773 – 13.890, p=0.002) which is statistically significant. Conclusions: Appropriate indications have significantly higher rates of clinically significant findings. Use of guidelines may decrease the number of unnecessary procedures.

Acute Gastric Volvulus on Hiatal Hernia

Case Reports in Surgery ◽

10.1155/2020/4141729 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Abdessamad EL KAOUKABI ◽

Mohamed MENFAA ◽

Samir HASBI ◽

Fouad SAKIT ◽

Abdelkrim CHOHO

Keyword(s):

Hiatal Hernia ◽

Epigastric Pain ◽

Gastric Volvulus ◽

Rare Entity ◽

Midline Laparotomy ◽

Acute Gastric Volvulus ◽

Upper Abdominal ◽

The gastric volvulus is defined as an abnormal rotation of all or part of the stomach around one of its axes, creating the conditions of an upper abdominal obstruction with gastric dilation and risk of strangulation. It is a rare entity that requires a surgical treatment, and its diagnosis is often delayed due to frequently aspecific symptoms. We will describe the observation of a 62 year old patient who presented to the emergency department for acute epigastric pain with dyspnea. The thoracoabdominal CT has demonstrated a stasis stomach on pyloric obstacle evoking a gastric torsion. An upper gastrointestinal endoscopy (EGD) and an upper gastrointestinal contrast made it possible to diagnose an acute gastric volvulus on hiatal hernia. A midline laparotomy was performed with detorsion of the stomach and repair of the hiatal hernia. The patient recovered gradually and was discharged on the sixth postoperative day. Three months after the operation, the patient remained asymptomatic.

STUDY OF UPPER GASTROINTESTINAL ENDOSCOPY FINDINGS AND PRESENCE OF HELICOBACTER PYLORI INFECTION AMONG ADULT PATIENTS OF UPPER ABDOMINAL PAIN AND DYSPEPSIA

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2017/257 ◽

2017 ◽

Vol 4 (23) ◽

pp. 1318-1322

Author(s):

Manju Singh ◽

Amit Agrawal ◽

Nishant Bhagwan Karwade

Keyword(s):

Helicobacter Pylori ◽

Abdominal Pain ◽

Helicobacter Pylori Infection ◽

Adult Patients ◽

Upper Abdominal ◽

Prevalence of Upper Abdominal Complaints in Patients Who Have Undergone Partial Gastrectomy

Canadian Journal of Gastroenterology ◽

10.1155/2000/161406 ◽

2000 ◽

Vol 14 (8) ◽

pp. 681-684 ◽

Cited By ~ 10

Author(s):

RJLF Loffeld

Keyword(s):

Symptom Score ◽

Bile Reflux ◽

Partial Gastrectomy ◽

Billroth Ii ◽

Billroth I ◽

Abdominal Symptoms ◽

Upper Abdominal Symptoms ◽

Upper Abdominal

Little is known about the long term occurrence and prevalence of upper abdominal complaints after previous partial gastrectomy. Therefore, a retrospective, uncontrolled, cross-sectional, descriptive, clinical, endoscopic study was done. A questionnaire was mailed to patients who had undergone partial gastrectomy and been sent for upper gastrointestinal endoscopy. Eight questions were scored on a five-point Likert scale, and a symptom score was calculated. During the five-year study period, 189 patients (137 men, 52 women) were identified as having had a partial gastrectomy -- 143 (76%) received the Billroth II operation and 46 (24%) received the Billroth I operation. The questionnaire was mailed to 124 patients, of whom 79 (64%) responded. Eighty-eight per cent of patients had undergone surgery more than 15 years earlier. Fifty-nine patients (75%) suffered from upper abdominal symptoms. Regurgitation of food, retrosternal heartburn and bile reflux occurred significantly more often in patients who underwent the Billroth II operation. The mean symptom score of patients who underwent Billroth I resection was significantly lower (4.5 [SD 3.6]) than that of patients who underwent Billroth II resection (7.1 [SD 4.4])(P=0.04). One or more symptoms indicative of dumping were found in 70% of patients who underwent Billroth II resection and in 59% of patients who underwent Billroth I resection (not significant). Many patients who had undergone a partial gastrectomy developed upper abdominal symptoms during long term follow-up that were not specifically linked to dumping.

The Predictive Value of Pre-Operative Symptoms Including Upper Gastrointestinal Endoscopy Before Laparoscopic Cholecystectomy for Elective Symptomatic Cholecystolithiasis

Kathmandu University Medical Journal ◽

10.3126/kumj.v11i4.12526 ◽

2015 ◽

Vol 11 (4) ◽

pp. 300-304 ◽

Cited By ~ 4

Author(s):

A Karmacharya ◽

BR Malla ◽

HN Joshi ◽

RB Gurung ◽

M Rajbhandari

Keyword(s):

Gall Stone ◽

Age Groups ◽

Gastrointestinal Symptoms ◽

Stone Disease ◽

Ulcer Disease ◽

Abdominal Symptoms ◽

Gall Stones ◽

Background It has always been a challenge to distinguish between upper gastrointestinal symptoms due to gall stones or any other causes. The persistence of abdominal symptoms even after cholecystectomy is highly discouraging for surgeons. Objective To evaluate the value of preoperative (UGE) as a routine investigative tool in patients with gall stone disease and to assess the outcome of cholecystectomy in patients with gallstones on preoperative abdominal symptoms.Methods This is a prospective study conducted on 96 cases at the Department of Surgery, Dhulikhel Hospital among ultrasonographically proven gall bladder stones irrespective of age and sex. After the examination, all the patients were subjected to UGE, and biopsy were obtained for histopathology if required. The statistical analysis were performed using spss version 16.Results Out of total patients, 84(87.5%) were females and 12(12.5%) were males with a M: F ratio of 1:7. Both the sexes were comparable in age groups. Out of total 96 patients, 53(55.2%) presented with typical pain and 43(44.8%) presented with atypical pain. All the patients were subjected to upper gastrointestinal endoscopy (UGE) and 53(55.2%) had normal findings and 43(44.8%) had various lesions. Patients with typical pattern of pain had normal endoscopic findings and those with atypical pain had pathology in upper gastroendoscopy (p<0.001). Serious pathology resulting to change of the planned treatment was found in three cases (3.12%). Among them two had gastric carcinoma and one had active peptic ulcer disease. The relief rate after the cholecystectomy was significant in patients with typical pain than among those with atypical pain (p<0.001). The commenest post cholecystectomy symptoms were heart burn (10%), abdominal discomfort (9%) and dyspepsia (7%).Conclusion Presence of atypical pain in patients with gall stones is highly likely to have other coexisting upper gastrointestinal pathologies. Hence, upper gastrointestinal endoscopy prior to elective cholecystectomy in patients with gall stones can be clinically helpful.Kathmandu Univ Med J 2013; 11(4): 300-304

Endoscopic variceal sclerotherapy in patients with Symmers periportal fibroses

Tropical Doctor ◽

10.1258/004947507781524719 ◽

2007 ◽

Vol 37 (3) ◽

pp. 179-181 ◽

Cited By ~ 8

Author(s):

H M Y Mudawi ◽

K B Ibrahim

Keyword(s):

Gastric Varices ◽

Oesophageal Varices ◽

Predictive Risk Factor ◽

Predictive Risk ◽

One Year ◽

A Prospective Study ◽

This is a prospective study, carried out in patients with portal hypertension and bleeding oesophageal varices secondary to Symmers (Schistosomal) periportal fibroses, to determine the efficacy of sclerotherapy, the number of sessions needed to achieve full sclerosis, the complications associated with sclerotherapy and the incidence and risk factors for rebleeding. In total, 85 patients were studied with a mean age of 38 years, 76.5% were males. All underwent upper gastrointestinal endoscopy, had different grades of oesophageal varices and underwent intravariceal injection with 5% ethanolamine oleate until they achieved full sclerosis or were referred to surgery. Complications of sclerotherapy included oesophageal strictures, deep oesophageal ulcers, pleural effusion and ascites. Following obliteration of oesophageal varices, 3.5% and 20% developed new gastric varices and portal gastropathy, respectively. Rebleeding occurred in 32% - the only significant predictive risk factor for which was patients with GIII varices following the first sclerotherapy session. Varices recurred in 6% of patients after a mean follow-up period of one year. In total, 93% of our patients achieved full sclerosis after an average of four sessions, and 3.5% were referred for surgery. Three patients (3.5%) died, all from massive rebleeding. In conclusion, sclerotherapy is a safe effective method for treating patients with oesophageal varices due to periportal fibroses.

The Hole in the Stomach

Diagnostic and Therapeutic Endoscopy ◽

10.1155/2008/257185 ◽

2008 ◽

Vol 2008 ◽

pp. 1-2

Author(s):

Hans Bödeker ◽

Steffen Leinung ◽

Henning Wittenburg ◽

Julia Fischer ◽

Ingolf Schiefke ◽

...

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Diaphragmatic Hernia ◽

Gastric Fundus ◽

Chest Discomfort ◽

Partial Necrosis ◽

Upper Abdominal ◽

A 57 year old woman was presented to the emergency department with upper abdominal pain and left sided chest discomfort. No cardiac or pulmonary cause could be determined and the patient underwent upper gastrointestinal endoscopy. Inversion of the scope to the fundus and subsequent fluoroscopy revealed a diaphragmatic hernia with a large herniation of the gastric fundus. Immediate laparotomy showed a 3 cm orifice of the diaphragm. The orifice was widened and a partial necrosis of the incarcerated fundus was resected. The patient recovered fully and was discharged 12 days after laparotomy.

Clinical correlation between Child Pugh’s score and oesophageal varices in upper gastrointestinal endoscopy in cirrhotic patient

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v4i4.18255 ◽

2017 ◽

Vol 4 (4) ◽

pp. 135-139 ◽

Cited By ~ 1

Author(s):

Prabin Bikram Thapa ◽

Dhiresh Kumar Maharjan ◽

Tseten Yonjon Tamang ◽

Suman Kumar Shrestha

Keyword(s):

Cirrhotic Patient ◽

Major Complication ◽

Oesophageal Varices ◽

History Of ◽

Grade Ii ◽

Cirrhotic Patients ◽

One Year ◽

Background: Bleeding oesophageal varices are a major complication of portal hypertension following liver cirrhosis. Child Pugh’s score has been used as a prognostic tool while managing a patient with liver cirrhosis.Objective: To clinically correlate Child Pugh’s score and oesophageal varices in upper gastrointestinal endoscopy in cirrhotic patient.Methods: This is a prospective descriptive study done from January 2014 to January 2015. Cirrhotic patients who were referred for upper gastrointestinal endoscopy with or without history of upper GI bleeding were included. Patients were categorized according to Child Pugh’s score into A, B, C and correlated with their endoscopic finding of grading of varices.Results: A total of 50 cirrhotic patients underwent upper gastrointestinal endoscopy during one year. Out of which 60% were in Child Pugh’s category A, 30 % in category B and 10 % in category C. Among them 62% had grade I varices, 20% had grade II varices and 18 % had grade III varices. Those who presented with history of hematemesis had higher grades of oesophageal varices in comparison to those without hematemesis.Conclusion: Cirrhotic patients with higher Child Pugh’s score had higher grades of oesophageal varices leading presentation with hematemesis. Hence, routine screening of cirrhotic patient is necessary before the development of varices.