scholarly journals Endoscopic Delivery Method Using a Retrieval Net for Patients with Small-Bowel Capsule Endoscopy Stagnation in the Stomach

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Akihiko Sumioka ◽  
Shiro Oka ◽  
Akiyoshi Tsuboi ◽  
Issei Hirata ◽  
Sumio Iio ◽  
...  
Keyword(s):  
Small Bowel ◽  
Surgical Resection ◽  
Capsule Endoscopy ◽  
Lesion Detection ◽  
University Hospital ◽  
Screening Tests ◽  
Delivery Method ◽  
Minimal Invasiveness ◽  
Entire Small Bowel ◽  
History Of

With the increasing use of capsule endoscopy (CE), screening tests for the small bowel can be performed with minimal invasiveness. However, occasionally, the entire small bowel cannot be observed because of decreased peristalsis of the stomach. For such cases, we perform delivery of CE by an endoscope. We retrospectively examined the usefulness of the endoscopic delivery method using a retrieval net for patients with CE stagnation in the stomach. From 2,270 patients who underwent small-bowel CE at Hiroshima University Hospital from January 2013 to January 2020, 29 consecutive patients (1.3% of the total number) in whom the small bowel could not be observed due to CE stagnation in the stomach at the time of the initial CE underwent the endoscopic delivery method using a retrieval net for secondary small-bowel CE. This study included 16 male (55%) and 13 female (45%) patients with a mean age of 69.2 ± 13.2   years . 11 patients (38%) had a history of gastrointestinal surgical resection. The entire small bowel could be observed in 19 patients (66%), and CE reached the terminal ileum in the remaining patients. A history of gastrointestinal surgical resection was significantly more frequent in the group where the entire small bowel could not be observed. The rate of small-bowel lesion detection was 55% (16/29). There were no adverse events associated with our endoscopic delivery method. Thus, the endoscopic delivery method using a retrieval net for patients with initial CE stagnation in the stomach may be safe and useful for the detection of small-bowel lesions.

scholarly journals Internal hernia following total gastrectomy with Roux-en-Y reconstruction

2011 ◽  
Vol 93 (6) ◽  
pp. e71-e73 ◽  
Author(s):  
JO Larkin ◽  
F Cooke ◽  
N Ravi ◽  
JV Reynolds
Keyword(s):  
Gastric Bypass ◽  
Small Bowel ◽  
Total Gastrectomy ◽  
Internal Hernia ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Postoperative Recovery ◽  
Entire Small Bowel ◽  
History Of ◽  
Swirl Sign

Internal herniation is a well-described complication after a gastric bypass, particularly when performed laparoscopically, although it is rarely described following a total gastrectomy. A 55-year-old lady presented with a 24-hour history of vomiting and rigors 10 months after a radical total gastrectomy with Roux-en-Y reconstruction for a gastric adenocarcinoma. Computed tomography (CT) showed a complete small bowel obstruction and a mesenteric swirl sign, indicating a possible internal hernia. The entire small bowel was found at laparotomy to have migrated through the mesenteric defect adjacent to the site of the previous jejunojejunostomy and was dark purple and aperistaltic. The small bowel was reduced through the defect. At a second laparotomy, the small bowel looked healthy and the defect was repaired. Postoperative recovery was unremarkable. Of numerous signs described, the mesenteric swirl sign is considered the best indicator on CT of an internal hernia following Roux-en-Y reconstruction in gastric bypass surgery. A swirl sign on CT in a patient with abdominal pain should always raise the suspicion of an internal hernia.

scholarly journals Aortoenteric fistula: a rare but critical cause of small bowel bleeding discovered on capsule endoscopy

2019 ◽  
Vol 12 (5) ◽  
pp. e230083
Author(s):  
Matt Davie ◽  
Diana E Yung ◽  
John N Plevris ◽  
Anastasios Koulaouzidis
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Abdominal Aortic Aneurysm Repair ◽  
Sudden Onset ◽  
Aortoenteric Fistula ◽  
Good Effect ◽  
Stent Grafting ◽  
Abdominal Aortic ◽  
History Of ◽  
Small Bowel Bleeding

A 78-year-old man attended for outpatient capsule endoscopy, to investigate a recent history of unexplained small bowel bleeding. His previous medical history included an abdominal aortic aneurysm repair 6 years ago. Soon after capsule ingestion, he experienced sudden onset abdominal pain and collapsed on hospital grounds. He was rapidly transferred to the emergency department as he was haemodynamically unstable, and a significant per rectum (PR) bleed was found on examination. The patient was quickly stabilised following fluid resuscitation. CT angiography was performed which did not show active bleeding. However, use of the real-time capsule viewer indicated a profuse active jejunal bleed originating from the aortic graft, suggestive of an aortoenteric fistula. The patient underwent emergency endovascular cuff placement, and subsequent endovascular abdominal aortic stent grafting, to good effect.

scholarly journals Non-steroidal anti-inflammatory drug-induced enteropathy as a major risk factor for small bowel bleeding

2020 ◽  
Author(s):  
Doo-Ho Lim ◽  
Kyoungwon Jung ◽  
Seung Bum Lee ◽  
In Kyu Park ◽  
Hee Jeong Cha ◽  
...  
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
University Hospital ◽  
Deficiency Anemia ◽  
Gi Bleeding ◽  
Inflammatory Drug ◽  
Korean Patients ◽  
Common Etiology ◽  
Anti Inflammatory

Abstract Background: Small bowel (SB) bleeding accounts for 5% of all gastrointestinal (GI) bleeding cases and 80% of obscure GI bleeding cases. Although angioectasia is the common etiology of SB bleeding, nonsteroidal anti-inflammatory drug (NSAID)-induced SB lesions are also reported as a major cause in studies from Eastern countries. Herein, we assessed the frequency of occurrence of NSAID-induced SB lesions in Korean patients with obscure GI bleeding.Methods: We retrospectively analyzed medical records of all consecutive patients aged ≥18 years that underwent capsule endoscopy from March 2018 to February 2019 at Ulsan University Hospital and Kosin University Gospel Hospital.Results: Of the 83 subjects (all were Korean; mean age ± standard deviation: 59 ± 18 years; age range: 18–84 years; men: n=52; women: n=31), 55 (66.2%) had stools with clear blood and 28 (33.8%) had normal stools with iron deficiency anemia . The detection rate of SB bleeding and lesions using capsule endoscopy was 72.3% (60 of 83 patients). A significantly higher frequency (40 of 51) of ulcerative/erosive lesions than other causes was observed in patients with inactive bleeding but visible SB lesions. As a result, NSAID-induced enteropathy accounted for 41.7% (25 of 60) of all SB bleeding cases.Conclusions: Contrary to what is reported for patients in Western countries, this study in Korean patients showed an improved diagnostic yield of capsule endoscopy for obscure GI bleeding and that NSAID-induced enteropathy was the most common etiology of SB bleeding. Aggressive small intestine examination is required for patients with unexplained GI bleeding.

scholarly journals Capsule endoscopy: Beyond small bowel

2012 ◽  
Vol 03 (S 05) ◽  
pp. 071-073
Author(s):  
Samuel N. Adler
Keyword(s):  
Small Bowel ◽  
Digestive Tract ◽  
Capsule Endoscopy ◽  
Diagnostic Performance ◽  
Non Invasive ◽  
Invasive Method ◽  
History Of ◽  
Technological Improvements

AbstractIn this article the brief and dramatic history of capsule endoscopy of the digestive tract is reviewed. Capsule endoscopy offers a non invasive method to diagnose diseases that affect the esophagus, small bowel and colon. Technological improvements relating to optics, software, data recorders with two way communication have revolutionized this field. These advancements have produced better diagnostic performance.

Non-steroidal anti-inflammatory drug-induced enteropathy as a major risk factor for small bowel bleeding: A retrospective study

2020 ◽  
Author(s):  
Doo-Ho Lim ◽  
Kyoungwon Jung ◽  
Seung Bum Lee ◽  
In Kyu Park ◽  
Hee Jeong Cha ◽  
...  
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
University Hospital ◽  
Deficiency Anemia ◽  
Gi Bleeding ◽  
Inflammatory Drug ◽  
Korean Patients ◽  
Common Etiology ◽  
Anti Inflammatory

Abstract Background: Small bowel (SB) bleeding accounts for 5% of all gastrointestinal (GI) bleeding cases and 80% of obscure GI bleeding cases. Although angioectasia is the common etiology of SB bleeding, nonsteroidal anti-inflammatory drug (NSAID)-induced SB lesions are also reported as a major cause in studies from Eastern countries. Herein, we assessed the frequency of occurrence of NSAID-induced SB lesions in Korean patients with obscure GI bleeding. Methods: We retrospectively analyzed medical records of all consecutive patients aged ≥18 years who underwent capsule endoscopy from March 2018 to February 2019 at Ulsan University Hospital and Kosin University Gospel Hospital. Results: Of the 83 subjects (all Korean; mean age ± standard deviation: 59 ± 18 years; age range: 18–84 years; men: n=52; women: n=31), 55 (66.2%) had stool with clear blood and 28 (33.8%) had normal stool with iron deficiency anemia. The detection rate of SB bleeding and lesions using capsule endoscopy was 72.3% (60 of 83 patients). A significantly higher frequency (40 of 51) of ulcerative/erosive lesions than other causes was observed in patients with inactive bleeding but visible SB lesions. As a result, NSAID-induced enteropathy accounted for 30.1% of 83 patients with obscure GI bleeding (25 of the all 60 SB bleeding cases).Conclusions: Contrary to what is reported for patients in Western countries, this study in Korean patients showed an improved diagnostic yield of capsule endoscopy for obscure GI bleeding and that NSAID-induced enteropathy was the most common etiology of SB bleeding. Aggressive small intestine examination is required for patients with unexplained GI bleeding.

Optimizing lesion detection in small-bowel capsule endoscopy: from present problems to future solutions

2014 ◽  
Vol 9 (2) ◽  
pp. 217-235 ◽  
Author(s):  
Anastasios Koulaouzidis ◽  
Dimitris K Iakovidis ◽  
Alexandros Karargyris ◽  
John N Plevris
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Lesion Detection

scholarly journals Fatal course of idiopathic chronic ulcerative enteritis with panenteritis and perforation: a case report and review of literature

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chang-Yeon Jung ◽  
Jung-Min Bae
Keyword(s):  
Small Bowel ◽  
Case Reports ◽  
Abdominal Distension ◽  
Multiple Organ ◽  
Case Presentation ◽  
Entire Small Bowel ◽  
Free Air ◽  
Fatal Course ◽  
History Of ◽  
Transmural Inflammation

Abstract Background Idiopathic chronic ulcerative enteritis (ICUE) is a very rare disease with high mortality. Because of clinical rarity, several small case reports have been published and there is a lack of large sample study. Preoperative definite diagnosis is difficult. Although definite treatment for ICUE is radical surgical resection, surgical decision in operative field is difficult. Case presentation A 77-year-old man came to the emergency department with complaints of a 1-day history of abdominal pain and abdominal distension. Abdominal computed tomography revealed ileus and focal free air. Laparotomy revealed multiple small bowel tiny perforations in the ileum. The serosa surface in the whole small bowel had small multiple yellowish tiny discolored lesions. Despite the presence of multiple mucosal ulcers in entire small bowel, the ileum including perforation site was resected segmentally. Microscopically, mucosal ulcers in resected small bowel demonstrated transmural inflammation, no granuloma, and no lymphoid aggregates. These features were consistent with a diagnosis of ICUE with panenteritis and perforation. After surgery, the patient’s general condition gradually aggravated. Unfortunately, the patient died of multiple organ failure on post-operative day 14. Conclusion Surgically, the decision including resection range, anastomosis or enterotomy becomes difficult in ICUE with panenteritis. According to recent 40 year’s revised data, the post-operative mortality of ICUE is about 53.4%. Although ICUE is rare, its recognition is important for appropriate diagnosis and treatment. Retrospective multicenter case studies are required to determine proper treatment and improve prognosis.

scholarly journals Successful management of ultra short bowel syndrome in an elderly patient

2019 ◽  
Vol 12 (12) ◽  
pp. e229531
Author(s):  
Cathal Hayes ◽  
Waqar Khan ◽  
Kevin Barry
Keyword(s):  
Small Bowel ◽  
Parenteral Nutrition ◽  
Hospital Setting ◽  
Home Setting ◽  
Entire Small Bowel ◽  
Artery Thrombosis ◽  
Remarkable Recovery ◽  
History Of ◽  
Acute Hospital Setting ◽  
Ischaemic Insult

An 83-year-old woman presented emergently with a 1-week history of increasing abdominal pain and vomiting. Imaging confirmed an incarcerated incisional hernia containing viable small bowel. Laparotomy revealed profound ischaemic insult extending beyond the hernial contents, affecting virtually the entire small bowel, consistent with acute superior mesenteric artery thrombosis. The patient underwent resection of the entire small bowel except for 20 cm of the jejunum and 15 cm of the terminal ileum. Her duodenum and large bowel were unaffected. Despite her age, comorbidities and only 35 cm of the remnant small bowel, this patient made a remarkable recovery. She transitioned from total parenteral nutrition dependence in an acute hospital setting to being discharged into the community, relying on partial parenteral nutrition two times per week in a home setting.

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