Gastrointestinal therapy techniques

2011 ◽  
Author(s):  
Carl Waldmann ◽  
Neil Soni ◽  
Andrew Rhodes
Keyword(s):  
Critical Care ◽  
Gastrointestinal Endoscopy ◽  
Gastric Varices ◽  
Definitive Treatment ◽  
Oesophageal Perforation ◽  
Upper Gastrointestinal Endoscopy ◽  
Oesophageal Ulceration ◽  
Nasojejunal Feeding ◽  
Upper Gastrointestinal ◽  
Critical Care Patients

Insertion of a Sengstaken–Blakemore tube in critical care 74Upper gastrointestinal endoscopy 76Nasojejunal feeding in critical care patients 78The Sengstaken–Blakemore tube is very effective at controlling torrential bleeding from oesophago-gastric varices. Its use is associated with serious complications such as oesophageal ulceration, oesophageal perforation and aspiration pneumonia in 15–20% of cases. Up to 50% of patients will re-bleed once the balloon is deflated. so its primary function is to control bleeding initially prior to further definitive treatment....

Gastrointestinal therapy techniques

2019 ◽  
pp. 81-86
Author(s):  
Carl Waldmann ◽  
Andrew Rhodes ◽  
Neil Soni ◽  
Jonathan Handy
Keyword(s):  
Critical Care ◽  
Medical Therapy ◽  
Gastrointestinal Endoscopy ◽  
Endoscopic Therapy ◽  
Hospital Management ◽  
Upper Gastrointestinal Endoscopy ◽  
Clinical Approach ◽  
Upper Gastrointestinal

This chapter discusses gastrointestinal therapy techniques and includes discussion on insertion of a Sengstaken–Blakemore tube in critical care (discussing aspects of the procedure such as indication, equipment, preparation, insertion, post-insertion, pharmacological measures, complications, follow-up therapy) and upper gastrointestinal endoscopy (including presentation, causes, hospital management, clinical approach, resuscitation, initial investigations, endoscopy, endoscopic therapy, medical therapy, and follow-up).

scholarly journals Rare presentation of TB oesophagus: a case report

2018 ◽  
Vol 5 (9) ◽  
pp. 3180 ◽  
Author(s):  
Nagella Pradeep Kumar Reddy ◽  
S. Sabu Jeyasekharan ◽  
Nithila C. ◽  
A. Sai Kishore
Keyword(s):  
Case Report ◽  
Gastrointestinal Endoscopy ◽  
Tuberculosis Patient ◽  
Oesophageal Perforation ◽  
Upper Gastrointestinal Endoscopy ◽  
Rare Presentation ◽  
Upper Gi ◽  
Rare Case Report ◽  
Upper Gastrointestinal

This is a rare case report of Tb oesophagus presenting as upper GI bleeding. Patient was subjected to upper gastrointestinal endoscopy, which revealed an ulcerative growth in the mid oesophagus. Biopsy revealed oesophageal tuberculosis. Patient was managed conservatively with Anti-Tuberculosis Treatment (ATT). Follow up endoscopy after six months revealed resolution of the ulcer and patient was symptomatically better. In spite of the rare nature of the disease, it can be managed effectively with ATT to avoid complications (fistula, stricture, and oesophageal perforation), which might warrant surgery.

Endoscopic variceal sclerotherapy in patients with Symmers periportal fibroses

2007 ◽  
Vol 37 (3) ◽  
pp. 179-181 ◽  
Author(s):  
H M Y Mudawi ◽  
K B Ibrahim
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Gastric Varices ◽  
Oesophageal Varices ◽  
Upper Gastrointestinal Endoscopy ◽  
Predictive Risk Factor ◽  
Predictive Risk ◽  
One Year ◽  
A Prospective Study ◽  
Upper Gastrointestinal

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.

scholarly journals Endoscopic Insufflation–Induced Gastric Barotrauma during Percutaneous Endoscopic Gastrostomy: A Report of Three Patients and Review of Literature

2021 ◽  
Vol 12 (02) ◽  
pp. 103-106
Author(s):  
Avnish Kumar Seth ◽  
Rinkesh Kumar Bansal
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Gastrointestinal Endoscopy ◽  
Gastroesophageal Junction ◽  
Upper Gastrointestinal Endoscopy ◽  
Proximal Stomach ◽  
Endoscopic Gastrostomy ◽  
Lesser Curvature ◽  
Upper Gastrointestinal ◽  
New Onset

Abstract Background We report three patients with endoscopic insufflation–induced gastric barotrauma (EIGB) during upper gastrointestinal endoscopy (UGIE) for percutaneous endoscopic gastrostomy (PEG). A definition and classification of EIGB is proposed. Materials and Methods Records of patients undergoing UGIE over 7 years (April 2013–March 2020) were reviewed. Patients who developed new onset of bleeding or petechial spots in proximal stomach, in an area previously documented to be normal during the same endoscopic procedure, were studied. Results New onset of bleeding or petechial spots in proximal stomach occurred in 3/286 (0.1%) patients undergoing PEG and in none of the 19,323 other UGIE procedures during the study period. All patients were men with median age 76 years (range 68–80 years), with no coagulopathy. Aspirin and apixaban were discontinued 1 week and 3 days prior to the procedure. Fresh blood was noted in the stomach at a median of 275 seconds (range 130–340) seconds after commencement of endoscopy. At retroflexion, multiple linear mucosal breaks of up to 3 cm, with oozing of blood, were noted in the proximal stomach along the lesser curvature, close to the gastroesophageal junction in two patients. In the third patient, multiple petechial spots were noticed in the fundus. The plan for PEG was abandoned and the stomach deflated by endoscopic suction. There was no subsequent hematemesis, melena, or drop in hemoglobin. One week later, repeat UGIE in the first two patients revealed multiple healing linear ulcers of 1 to 3 cm in the lesser curvature and PEG was performed. Conclusion Overinsufflation over a short duration during UGIE may lead to EIGB. Early detection is key and in the absence gastric perforation, patients can be managed conservatively.

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