scholarly journals Palliation with Oesophageal Metal Stent of Pseudoachalasia from Gastric Carcinoma at the Cardia: A Case Report

2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Salvatore Maria Antonio Campo ◽  
Roberto Lorenzetti ◽  
Marina de Matthaeis ◽  
Cesare Hassan ◽  
Angelo Zullo ◽  
...  
Keyword(s):  
Old Age ◽  
Iron Deficiency Anaemia ◽  
Gastrointestinal Endoscopy ◽  
Barium Swallow ◽  
Upper Gastrointestinal Endoscopy ◽  
Metal Stent ◽  
History Of ◽  
Upper Gastrointestinal ◽  
Progressive Dysphagia

We present an 82-year-old woman with a 3-month history of progressive dysphagia and a normal initial upper gastrointestinal endoscopy. The diagnosis of pseudoachalasia was suspected by oesophageal manometric and barium swallow studies, and confirmed by biopsies revealing an intestinal type carcinoma of the stomach at a repeated endoscopy. In view of the history of heart disease, diabetes, and old age, this patient was treated by a partially covered Ultraflex self-expanding metal stent (Boston Scientific, Natick, MA, USA) placed into the oesophageal body with no direct complications and obtaining the relief from dysphagia. During the 11-month follow-up she was treated for an iron deficiency anaemia due to reflux oesophagitis with ulcerations in the oesophageal body and died from myocardial infarction. According to the localization of the cancer, the old age, and the presence of comorbidities, we should recommend the insertion of a partially covered self-expanding metal stent as a reasonable palliative treatment in selected subjects with pseudoachalasia.

scholarly journals Severe Chest Pain due to N-Acetylcysteine-Induced Esophagitis

2019 ◽  
Vol 2019 ◽  
pp. 1-2 ◽  
Author(s):  
Weihong Wang ◽  
Yu Zhang ◽  
Yi Liu ◽  
Lei Xu ◽  
Dingmei Shi
Keyword(s):  
Chest Pain ◽  
Gastrointestinal Endoscopy ◽  
Unusual Case ◽  
Upper Gastrointestinal Endoscopy ◽  
Shortness Of Breath ◽  
Severe Chest Pain ◽  
History Of ◽  
Upper Gastrointestinal ◽  
Powdered Form

We report an unusual case of severe chest pain caused by N-acetylcysteine-induced esophagitis. An 81-year-old Chinese man with a history of interstitial lung disease was admitted to our hospital with intermittent arrhythmia that began 5 days ago. The patient presented with complaints of cough, sputum, and shortness of breath. Cefminox injections and N-acetylcysteine tablets were prescribed to improve respiratory symptoms. The patient developed severe chest pain and odynophagia 4 hours after swallowing the N-acetylcysteine tablet while in the decubitus position. Upper gastrointestinal endoscopy revealed four discrete areas of ulcerations measuring approximately 1 cm at the midesophageal level. The distance between the foci and the incisors was approximately 24 cm. The patient continued the N-acetylcysteine orally, which was administered in powdered form with more water while in the upright position. Pantoprazole and hydrotalcite were also administered to the patient. The symptoms subsided, and a follow-up endoscopy after 20 days showed that the ulcers healed. This case highlights that seemingly safe drugs such as N-acetylcysteine can lead to severe chest pain if ingested inappropriately.

scholarly journals Outcome of Esophageal Variceal Ligation in Cirrhotic Patients: Experience in a Tertiary Care Hospital in Dhaka

2019 ◽  
Vol 9 (1) ◽  
pp. 63-69
Author(s):  
Shireen Ahmed ◽  
Md Nazmul Hoque ◽  
Tareq Mahmud Bhuiyan
Keyword(s):  
Adverse Events ◽  
Esophageal Varices ◽  
Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal Endoscopy ◽  
Care Hospital ◽  
Esophageal Variceal ◽  
Band Ligation ◽  
Esophageal Variceal Ligation ◽  
Upper Gastrointestinal

Background: Bleeding from esophageal varices in cirrhosis is an emergency condition. Esophageal varices band ligation has shown better results in terms of variceal obliteration as well as having fewer side effects like ulceration, perforation and stricture formation. Methods: This observational study was conducted at the gastroenterology department of BIRDEM general hospital, from September 2014 to March 2015. Subjects were eligible if they had a diagnosis of cirrhosis based on history, physical examination, biochemical parameters and presence of esophageal varices in upper gastrointestinal endoscopy. All patients were tested to determine the cause of liver cirrhosis. All patients under-went upper gastrointestinal endoscopy after consent. Esophageal variceal ligation was done at appropriate situation and patients were followed up later on. SPSS 23 was used for statistical analysis. Results: The sample size was 69. The cumulative mean age was 55.58±14.462 years (range: 20-90), with gender-based mean age of 54.76±15.704 years for males and 57.22±11.739 years for female. Mild portal hypertensive gastropathy (PHG) was found 31 (44.9%) patient and severe PHG 36 (52.2%). Patients were followed up for mean period of 8.52±3.6 months. Variceal obliteration was achieved in 25 (36.2%) patients, while 06 (8.7%) cases developed re-bleeding during the study period and this type of patients were managed by other modalities or combination therapies. Recurrence of varices occurred in 13 (18.8%). 25 (36.2%) patients reduction of varix size occured after esophageal variceal ligation (EVL), 32 (46.4%) required second session and 12 (17.4%) required more than second session (Table-2). Thirty nine (56.5%) patients experienced minor adverse events like GI discomfort (retrosternal pain or dysphagia), while severe adverse events were noticed in 13 (18.8%) patients. Fundal varix was found among 8 (11.6%) patient on follow up endoscopy and GAVE found in 6 (8.69%) patients. All patient developed PHG during follow up endoscopy. Conclusion: Band ligation eradicates esophageal varices with less complications and a lower re-bleeding rate, but at the same time eradication is associated with more frequent development of PHG and fundal varices. Birdem Med J 2019; 9(1): 63-69

scholarly journals Quality indicators in diagnostic upper gastrointestinal endoscopy

2020 ◽  
Vol 13 ◽  
pp. 175628482091669
Author(s):  
Wladyslaw Januszewicz ◽  
Michal F. Kaminski
Keyword(s):  
Quality Control ◽  
Performance Measures ◽  
Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal Endoscopy ◽  
High Quality ◽  
Quality Performance ◽  
Screening And Surveillance ◽  
Therapeutic Procedures ◽  
Upper Gastrointestinal

Upper gastrointestinal (UGI) endoscopy contributes a major clinical service with consistently growing demand around the world. Its utility corresponds to varying epidemiological issues throughout the globe, with cancer screening and surveillance being of the utmost priority. Despite high accuracy in neoplasia detection, UGI endoscopy remains a highly operator-dependent procedure, characterized by a substantial rate of missed pathology. Despite an overall lack of high-quality performance measures, there is an increased level of awareness about the need for quality control of this procedure, which is reflected in several guidelines and position statements published in recent years. It is widely recognized that quality assessment should go beyond mere technical aspects of the examination, and include both pre- and post-procedural factors. By this means, quality control encompasses the entire patient experience with the health care provider, from appropriate indication and physical assessment, through high-quality endoscopy service, to appropriate follow up and patient satisfaction. This article aims to review the available and emerging quality metrics for UGI endoscopy, taken mostly from Western endoscopy societies, with references to Asian recommendations where appropriate. The paper is limited solely to diagnostic UGI endoscopy and does not include performance measures for therapeutic procedures.

Endoscopic Diagnosis of a Pylorogastric Intussusception with Spontaneous ResolutionS

2011 ◽  
Vol 47 (6) ◽  
pp. e156-e161 ◽  
Author(s):  
Joao Felipe de Brito Galvao ◽  
Susan E. Johnson ◽  
Robert G. Sherding ◽  
Mieke Baan ◽  
Rebecca L. Ball ◽  
...  
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Gastric Biopsy ◽  
Spontaneous Resolution ◽  
Upper Gastrointestinal Endoscopy ◽  
Intact Female ◽  
Endoscopic Appearance ◽  
Vascular Congestion ◽  
Abdominal Radiographs ◽  
Upper Gastrointestinal

A 7 mo old intact female golden retriever was evaluated for acute vomiting. Abdominal radiographs revealed a possible gastric foreign body. Upper gastrointestinal endoscopy revealed an edematous, tubular antral mass, which on further evaluation was determined to be a pylorogastric intussusception based on radiographic, endoscopic, and surgical findings. Spontaneous resolution of the intussusception occurred upon surgical exploration of the abdomen. Histopathology of a full-thickness gastric biopsy revealed vascular congestion consistent with an intussusception, but did not indicate the primary cause. The dog recovered uneventfully from surgery and had no further vomiting during the 6 mo follow-up period. This case was significant as it was the first report of pylorogastric intussusception diagnosed using endoscopy. This description of the unique endoscopic appearance of pylorogastric intussusception will be useful for the veterinary endoscopist.

scholarly journals Retropharyngeal space lipoma: an unusual cause of dysphagia

2021 ◽  
Vol 7 (2) ◽  
pp. 379
Author(s):  
Chinyere N. Asoegwu ◽  
Nkiruka A. Wakwe ◽  
Clement C. Nwawolo
Keyword(s):  
Neck Region ◽  
Positive Sign ◽  
Barium Swallow ◽  
Retropharyngeal Space ◽  
Head And Neck Region ◽  
Solid Foods ◽  
Presenting Symptoms ◽  
History Of ◽  
Progressive Dysphagia

<p class="abstract">Lipomas are uncommon in the head and neck region and rare in the retropharyngeal space. Lipoma of the retropharyngeal space may cause aerodigestive tract obstruction presenting as dyspnea and or dysphagia. The presenting symptoms will depend on the size and site of the lipoma in the retropharyngeal space. We present the case of a 57 years old male with 6 months’ history of progressive dysphagia to solid foods only and no positive sign on clinical examination. The barium swallow was normal. The computed tomography (CT) scan showed a moderate-sized homogenous mass of fat density in the hypopharyngeal section of the retropharyngeal space. Diagnosis of dysphagia caused by retropharyngeal lipoma was made. This was surgically excised via the trans-cervical route with no complications, complete resolution of symptoms, and no recurrence 2 years after on follow-up. In the dysphagia of unknown cause, retropharyngeal space lipoma should be considered.</p>

scholarly journals A rare cause of abdominal pain with fever

2019 ◽  
Vol 12 (3) ◽  
pp. e228401
Author(s):  
Diana Martins Oliveira ◽  
Catarina Correia ◽  
Flávia Cunha ◽  
Patrícia Dias
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Acute Cholangitis ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Upper Gastrointestinal Endoscopy ◽  
Laboratory Findings ◽  
Reactive Protein ◽  
Elevated Liver Enzymes ◽  
History Of ◽  
Lemmel’S Syndrome ◽  
Upper Gastrointestinal

An 89-year-old man presented to the emergency department with a 1-month history of upper right quadrant pain, worsened in the last 3 days and accompanied by fever and chills. On physical examination, he had scleral icterus and right upper quadrant tenderness. Laboratory findings showed hyperbilirubinemia, elevated liver enzymes and C reactive protein. The patient was admitted, suspecting of an acute cholangitis and started on antibiotics. An upper gastrointestinal endoscopy revealed the presence of a juxtapapillary diverticulum in the second portion of the duodenum, which was confirmed by a magnetic resonance cholangiopancreatography, along with upstream biliary tract ectasia. The imaging findings allowed us to diagnose a Lemmel’s syndrome. Due to potential surgical risk, we decided for a conservative approach. The patient had a favourable course and was discharged home.

scholarly journals Ligation assisted endoscopic mucosal resection of neuroendocrine tumor of duodenal bulb: a case report with a follow up of 24 months

2019 ◽  
Vol 8 (1) ◽  
pp. 18-20
Author(s):  
Umid Kumar Shestha ◽  
Gopi Aryal
Keyword(s):  
Neuroendocrine Tumor ◽  
Distant Metastasis ◽  
Gastrointestinal Endoscopy ◽  
Duodenal Bulb ◽  
Upper Gastrointestinal Endoscopy ◽  
Solitary Lesion ◽  
Free Margin ◽  
Mucosal Resection ◽  
Upper Gastrointestinal

Duodenal neuroendocrine tumor (NET) is a rare solitary lesion arising from the mucosa and submucosa of the duodenum, which is found incidentally during upper gastrointestinal endoscopy. Eendoscopic Mucosal Resection (EMR) has been the commonly used endoscopic procedure for duodenal carcinoid tumors, but the conventional EMR done to resect duodenal NET s is likely to have positive vertical margins. However, the ligation assisted EMR has recently been shown to be a promising technique for the treatment of duodenal NET that can have a negative free margin. In our study, we present a patient of 51-year-old male, who presented with pain over epigastrium and upper gastrointestinal endoscopy revealed a small submucosal lesion of 10 mm in the duodenal bulb. The endoscopic ultrasound showed the lesion arising from the echo layer three. The biopsy was taken which showed the duodenal NET. The computed tomography of abdomen did not show any evidence of distant metastasis. The EMR of duodenal NET was done by band ligation technique. The biopsy from the resected duodenal lesion confirmed the duodenal NET with the margin free of the tumor. The patient was followed at 6, 12, 18 and 24 months. During the follow up visits, the repeat upper gastrointestinal endoscopy did not show recurrence of the lesion and there was no any evidence of distant metastasis either. Ligation assisted EMR is an acceptable treatment in the hands of expert for small duodenal NET without the evidence of metastasis and can ensure the complete removal of the lesion with vertical free margin.

One Patient, Two Lymphomas

2004 ◽  
Vol 128 (9) ◽  
pp. 1035-1038 ◽  
Author(s):  
Zuoqin Tang ◽  
Wen Jing ◽  
Neal Lindeman ◽  
Nancy Lee Harris ◽  
Judith A. Ferry
Keyword(s):  
Follicular Lymphoma ◽  
Lymphoid Tissue ◽  
Gastrointestinal Endoscopy ◽  
B Cell Lymphoma ◽  
Tissue Type ◽  
Gastric Disease ◽  
Upper Gastrointestinal Endoscopy ◽  
H Pylori ◽  
Upper Gastrointestinal

Abstract We report the case of a 73-year-old man who presented with a 2- to 3-month history of epigastric discomfort and guaiac-positive stool. An upper gastrointestinal endoscopy revealed a diffuse erythematous nodular mucosa and submucosal thickening in the stomach. Diffuse mucosal nodularity was also found in the second portion of the duodenum. A complete workup with histologic, immunohistochemical, and molecular studies revealed 2 distinct, apparently unrelated lymphomas, namely, a gastric marginal zone B-cell lymphoma (mucosa-associated lymphoid tissue type) in a background of Helicobacter pylori gastritis and a grade 1/3 duodenal follicular lymphoma. The patient was then treated with an H pylori eradication regimen. No therapy was given for his duodenal follicular lymphoma because his symptoms were thought to be due to the gastric disease and because the duodenal lesion was small. A 6-month follow-up with upper gastrointestinal endoscopy revealed only focal biopsy scarring in the stomach and an apparently normal duodenum. The follow-up biopsies revealed significant regression of his mucosa-associated lymphoid tissue lymphoma, but persistence of his duodenal follicular lymphoma. The combination of these 2 lymphomas in the same patient and the different clinical responses to antibiotic treatment make this case unique.

scholarly journals Missed duodenal web with foreign body impaction in an operated case of midgut malrotation with Down′s syndrome - A diagnosis delayed by endoscopy

2013 ◽  
Vol 04 (01) ◽  
pp. 010-012
Author(s):  
Krushnakumar Kesan ◽  
Abhaya Gupta ◽  
Rahul Kumar Gupta ◽  
Paras Kothari ◽  
Ritesh Ranjan ◽  
...  
Keyword(s):  
Foreign Body ◽  
Duodenal Obstruction ◽  
Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal Endoscopy ◽  
Foreign Body Removal ◽  
Midgut Malrotation ◽  
Foreign Body Impaction ◽  
Duodenal Web ◽  
Upper Gastrointestinal

ABSTRACT“Always look for duodenal obstruction in a case of malrotation”, this dictum has to be followed. The patient was operated for midgut malrotation at day 2 of life followed by foreign body removal by upper gastrointestinal endoscopy at 2 years of age. We report atwo and half year male child with Down′s syndrome who presented to us with history suggestive of recurrent upper gastrointestinal tract obstruction. During surgery a post sphincteric duodenum web was confirmed and foreign body (berry seed) which had impacted proximal to it was removed. The web was excised and the duodenum, split longitudinally, sutured transversely. The postoperative course was uneventful and patient is asymptomatic at follow up. This case illustrates that diagnosis was delayed for 2΍ years after initial presentation in early neonatal age. (Dig Endosc 2013;4(1):10–12)

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