scholarly journals Study on incidence of hiatus hernia in patients undergoing upper gastrointestinal endoscopy for upper gastrointestinal symptoms in a secondary care hospital

2021 ◽  
Vol 8 (3) ◽  
pp. 935
Author(s):  
Shashidhara Puttaraju ◽  
Sanhitha Purushotham
Keyword(s):  
Hiatal Hernia ◽  
Hiatus Hernia ◽  
Gastrointestinal Endoscopy ◽  
Gastrointestinal Symptoms ◽  
Upper Gastrointestinal Endoscopy ◽  
Type I ◽  
Care Hospital ◽  
Upper Gi ◽  
Upper Gastrointestinal Symptoms ◽  
Upper Gastrointestinal

Background: Hiatus hernia refers to condition in which elements of the abdominal cavity, most commonly the stomach, herniate through the oesophageal hiatus into the mediastinum.Hiatal hernia is a frequent finding during upper gastrointestinal endoscopy. Type I hiatal hernia is the sliding hiatal hernia, which accounts for more than 95% of all hiatal hernias with the remaining 5% being paraesophageal hiatal hernias taken together. Surgical therapy is recommended for patients with severe and refractory GERD symptoms such as poor compliance to long-term medical therapy and young patients wishing to avoid lifetime medical treatment. The objective of this study was to identify the associated symptoms and to determine diagnostic accuracy of endoscopic evaluation in patients with hiatus hernia.Methods: Current retrospective study comprised of 250 patients who presented with complaints of upper gastrointestinal symptoms and underwent upper gastrointestinal endoscopy in JSS hospital, Chamarajnagar during the period of October 2018 to May 2020.Results: Out of 250 patients, 162 males (64.8%) and 88 females (35.2%) were part of the study, who presented with upper GI symptoms, 12 (4.8%) patients were diagnosed with hiatus hernia. Out of these 12 cases, 9 patients (75%) were found to be having sliding type of hiatus hernia and 3 patients (25%) having rolling type.Conclusions: Early diagnosis and timely management or surgical intervention reduces morbidity associated with hiatus hernia and acid reflux. Hence, all patients presenting with persistent upper gastrointestinal symptoms should undergo upper GI endoscopy managed accordingly.

scholarly journals Prevalence of Asymptomatic Hiatal Hernia in Obese Patient in Routine Upper Gastrointestinal Endoscopy Screening and Correlation with BMI

2020 ◽  
Author(s):  
Bandar Saad Assakran ◽  
Khaled Mohammed Alrakbi ◽  
Meshari Abdulrahman Alharbi ◽  
Moath Abdullah Almatroudi ◽  
Asim Nizar Alshowaiman ◽  
...  
Keyword(s):  
Hiatal Hernia ◽  
Hiatus Hernia ◽  
Protective Factor ◽  
Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal Endoscopy ◽  
Obese Patients ◽  
Chi Square ◽  
Chi Square Test ◽  
Upper Gi Endoscopy ◽  
Upper Gastrointestinal

Abstract Background In obese patients, hiatus hernia (HH) can be asymptomatic or it may present with one or few symptoms such as heartburn, nausea, or vomiting. Routine upper gastrointestinal endoscopy is the most frequent method to determine the presence of any abnormalities including hiatus hernia.Aim The aim of this study is to assess the prevalence of asymptomatic hiatal hernia in obese patients in routine upper GI endoscopy screening and correlation with BMI.Materials and Methods This was an observational retrospective cohort study conducted at King Fahad Specialist hospital-Buraydah, Qassim, Saudi Arabia. The data were extracted from the medical records and electronic charts of all obese patients who had upper gastrointestinal endoscopy screening between January 2017 – December 2019. Data were tabulated in MS Excel and were analyzed using SPSS version 21.Results Among the 690 obese patients, the prevalence of HH was 103 yielding an overall percentage of 14.3%. Chi-square test revealed that the use of Proton-pump inhibitors (PPI) (X2=6.876; p=0.009) and abdominal pain (X2=3.885; p=0.049), shortness of breath (X2=8.057; p=0.005), vomiting (X2=4.302; p=0.038), nausea (X2=4.090; p=0.043) and other HH symptoms (X2=3.897; p=0.048) significantly influenced HH but the BMI level did not (X2=2.126; p=0.345). In multivariate regression model, the use of PPI medication (AOR=0.237; CI=0.074 – 0.760; p=0.023) significantly decreased the risk of HH while vomiting (AOR=1.722; CI=1.025 – 2.890; p=0.040) and nausea (AOR=1.698; CI=1.012 – 2.849; p=0.045) significantly increased the risk of HH.Conclusion Asymptomatic HH among obese patients is not widely prevalent in our region. The use of PPI medications was a protective factor of HH while symptoms such as vomiting and nausea increased the risk of HH. However, there was no evidence found linking BMI to HH as shown in this study.

scholarly journals Prevalence of Asymptomatic Hiatal Hernia in Obese Patient in Routine Upper Gastrointestinal Endoscopy Screening and Correlation with BMI

2020 ◽  
Author(s):  
Bandar Saad Assakran ◽  
Khaled Mohammed Alrakbi ◽  
Meshari Abdulrahman Alharbi ◽  
Moath Abdullah Almatroudi ◽  
Asim Nizar Alshowaiman ◽  
...  
Keyword(s):  
Hiatal Hernia ◽  
Hiatus Hernia ◽  
Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal Endoscopy ◽  
Obese Patients ◽  
Microsoft Excel ◽  
Chi Square ◽  
Chi Square Test ◽  
Upper Gi Endoscopy ◽  
Upper Gastrointestinal

Abstract Background In obese patients, hiatus hernia (HH) can be asymptomatic or it may present with one or few symptoms such as heartburn, nausea, or vomiting. Routine upper gastrointestinal endoscopy is the most frequent method to determine the presence of any abnormalities including hiatus hernia. The aim of this study is to assess the prevalence of asymptomatic hiatal hernia in obese patients in routine upper GI endoscopy assessment and correlation with BMI. Methods This was an observational retrospective cohort study conducted at King Fahad Specialist hospital - Buraydah, Qassim, Saudi Arabia. The data were extracted from the medical records and electronic charts of all obese patients who had preoperative upper gastrointestinal endoscopy assessment between January 2017 – December 2019. Data were tabulated in Microsoft Excel and were analyzed using SPSS version 21. Results Among the 690 obese patients, the prevalence of HH was 103 yielding an overall percentage of 14.9%. Chi-square test revealed that the abdominal pain (X2=3.885; p=0.049), shortness of breath (X2=8.057; p=0.005), vomiting (X2=4.302; p=0.038), nausea (X2=4.090; p=0.043) and other HH symptoms (X2=3.897; p=0.048) significantly influenced HH but the BMI level did not (X2=2.126; p=0.345). In multivariate regression model, the use of PPI medication (AOR=0.237; CI=0.074 – 0.760; p=0.023), while vomiting (AOR=1.722; CI=1.025 – 2.890; p=0.040) and nausea (AOR=1.698; CI=1.012 – 2.849; p=0.045) significantly increased the risk of HH. Conclusion Asymptomatic HH among obese patients is not widely prevalent in our region. The use of PPI medications was found to decrease the symptoms associated with HH while symptoms such as vomiting and nausea increased the risk of HH. However, there was no evidence found linking BMI to HH as shown in this study.

scholarly journals Special Issue “The Next Generation of Upper Gastrointestinal Endoscopy”

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 152
Author(s):  
Hiroki Kurumi ◽  
Hajime Isomoto
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Gastrointestinal Symptoms ◽  
Upper Gastrointestinal Endoscopy ◽  
Next Generation ◽  
Special Issue ◽  
First Line ◽  
The World ◽  
Upper Gastrointestinal Symptoms ◽  
Upper Gastrointestinal

Upper gastrointestinal endoscopy is now widely used as a first-line procedure to investigate upper gastrointestinal symptoms in most countries around the world [...]

scholarly journals Study of upper gastrointestinal endoscopy in patients with gastrointestinal symptoms

2019 ◽  
Vol 6 (10) ◽  
pp. 3595
Author(s):  
Shashidhara Puttaraju ◽  
Sudarshana Sreramaseshadri R. M.
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Gastrointestinal Symptoms ◽  
Significant Risk ◽  
Upper Gastrointestinal Endoscopy ◽  
Therapeutic Tool ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
Gi Symptoms ◽  
Upper Gi Endoscopy ◽  
Upper Gastrointestinal

Background: Upper gastrointestinal (GI) symptoms are the commonest complaints among the general population and the diseases associated with them carries a significant risk of morbidity and mortality. Hence early diagnosis and appropriate management of the condition can prevent life threatening complications. Upper GI endoscopy is an effective diagnostic as well as therapeutic tool for the patients presenting with upper GI symptoms. The objective of the study is to show the effectiveness of upper gastrointestinal endoscopy as an initial diagnostic, screening and therapeutic tool in patients with upper GI symptoms.Methods: Present study comprises of 100 patients presenting with upper gastrointestinal symptoms at JSS Hospital, Chamarajanagar (both out-patients and referred patients) during the period of October 2018 to June 2019, who underwent upper GI endoscopy.Results: Out of 100 patients, 60 were males and 40 were females. In the study majority of the patients were found to have gastritis, esophagitis and acid peptic disease. Other patients had malignant changes, reflux disease, hiatus hernia, perforation, foreign body, obstruction and esophageal varices.Conclusions: Upper GI endoscopy is a simple, safe, more reliable and valuable tool with easy learning curve. It will remain as the initial investigation of choice for the patients with upper GI symptoms. It plays a significant role as a screening, diagnostic as well as therapeutic tool.

scholarly journals Study on incidence of oesophageal carcinoma in patients undergoing upper gastrointestinal endoscopy for upper gastrointestinal symptoms in a secondary care hospital

2019 ◽  
Vol 7 (1) ◽  
pp. 222
Author(s):  
Shashidhara Puttaraju ◽  
Deva Keerthana Yesudian Gnanakumar
Keyword(s):  
Early Stage ◽  
Gastrointestinal Symptoms ◽  
Oesophageal Carcinoma ◽  
Upper Gastrointestinal Endoscopy ◽  
High Morbidity ◽  
Care Hospital ◽  
Multiple Biopsies ◽  
Upper Gastrointestinal Symptoms ◽  
Upper Gastrointestinal ◽  
Suspicious Lesions

Background: Oesophageal carcinoma is one of the leading causes of cancer related deaths worldwide and is also associated with high morbidity. Hence early diagnosis and treatment are the only effective way to improve survival and quality of life in oesophageal carcinoma patients. Early-stage oesophageal carcinoma are often asymptomatic and may also present with common upper gastrointestinal symptoms hence diagnosis of early oesophageal carcinoma is only based on detection of suspicious lesions through endoscopy and histopathological evaluation of biopsies from these suspicious lesions. The study is designed to see whether using alarming upper gastrointestinal symptoms, risk of oesophageal carcinoma in patients can be predicted.Methods: Present study comprises of 200 patients presenting with upper gastrointestinal symptoms at JSS Hospital, Chamarajanagar (both out patients and referred patients) during the period of October 2018 to December 2019, who underwent upper gastrointestinal endoscopy.Results: Out of 200 patients, 135 patients were males and 65 patients were females. According to the study, dysphagia was found to be a significant predictive factor and in contrary to the global statistics this study showed females aged more than 60 years were significantly at higher risk of developing oesophageal carcinoma.Conclusions: We recommend to do an early endoscopy for any patient presenting with upper gastrointestinal symptoms and to take multiple biopsies from any suspicious lesion especially for male gender older than 50 years and female gender older than 60 years presenting with dysphagia.

A Comparative study between Dexmedetomidine versus Propofol for sedation in upper GI endoscopy procedure considering effect on intraoperative vital data, patient amnesia and onset of recovery after the procedure

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Eslam Ahmed Mohamed Elsamahi ◽  
Bassem P Ghobrail ◽  
Ghada Mohamed Samir ◽  
Hany Victor Zaki
Keyword(s):  
Heart Rate ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal Endoscopy ◽  
Day Case ◽  
Upper Gi ◽  
Significant Difference ◽  
Upper Gi Endoscopy ◽  
Upper Gastrointestinal

Abstract Background In the modern medicine, upper gastrointestinal endoscopy has become a definitive tool for diagnosis and management of many diseases. It is usually preformed in separate unit as day-case procedure and for outpatient clinic. The search of a safe and effective sedation for these patients is still an open topic. Objective The aim of the study is to compare the use of propofol and dexmedetomedine in upper GI endoscopy regarding the hemodynamics, sedative effect and the patient satisfaction. Methods Double – blinded, randomized controlled trial with allocation ratio 1:1 arranged in two parallel groups. This study was conducted in the endoscopy unit of Ainshams University Hospital, Cairo, Egypt within a period of 6 months started from April 2019. All recruited patients were adults undergoing upper gastrointestinal endoscopy. They were included in the study according to the following criteria: Age 21-60 years; elective procedures under general anesthesia with patients who completed eight hours of fasting; and physical Status: ASA I and II Patients after taking written and informed consent. Results Concerning the results of the study, there was no statistically significant difference considering the heart rate in relation to base line readings. The changes of heart rate between the two groups were significantly different with dexmedetomidine associated with lower readings. Respiratory rate and oxygen saturation were insignificantly different in both groups. Time of induction was significantly shorter in propofol than dexmedetomidine (P < 0.001) and time to reach full recovery identified by modified Alderete’s score 10/10 was significantly shorter in dexmedetomidine than propofol (P < 0.014). There was a significant difference between the two dugs concerning the patients and endoscopists satisfaction. The patients were more satisfied with propofol (P 0.047), while the endoscopists were more satisfied with dexmedetomidine (P 0.034). Conclusion Dexmedetomidine and propofol are equally effective and safe to provide enough sedation for upper gastrointestinal endoscopy in a day-case manner. Advantages of dexmedetomidine were providing analgesic effect, rapid recovery from sedation and stability of respiratory rate and oxygen saturation. However, there were some disadvantages such as the bradycardia and patient dissatisfaction although the bradycardia can be utilized in cardiac patients as a safety factor against myocardial ischemia. Other point noticed that using dexmedetomidine for sedation was more costly than propofol and requires the usage of a syringe pump for accurate dosing. On the contrary, propofol is cheap and available in all centers with rabid onset of induction but it causes hypotension and respiratory depression which might be risky in cardiac patients.

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 Acute Gastric Volvulus on Hiatal Hernia

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Abdessamad EL KAOUKABI ◽  
Mohamed MENFAA ◽  
Samir HASBI ◽  
Fouad SAKIT ◽  
Abdelkrim CHOHO
Keyword(s):  
Hiatal Hernia ◽  
Gastrointestinal Endoscopy ◽  
Epigastric Pain ◽  
Gastric Volvulus ◽  
Upper Gastrointestinal Endoscopy ◽  
Rare Entity ◽  
Midline Laparotomy ◽  
Acute Gastric Volvulus ◽  
Upper Abdominal ◽  
Upper Gastrointestinal

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.

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