scholarly journals A Rare Cause of Dyspepsia: A Case Report of Gastric Diverticulum

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Ren Yi Kow ◽  
Dhauiddin Hai Ismail ◽  
Khatrulnada Md Saad ◽  
Ed Simor Khan Mor Japar Khan
Keyword(s):  
Medical Therapy ◽  
Gastrointestinal Endoscopy ◽  
Laparoscopic Resection ◽  
Upper Gastrointestinal Endoscopy ◽  
Contrast Study ◽  
Definite Diagnosis ◽  
Barium Study ◽  
Gastric Diverticulum ◽  
Upper Gastrointestinal ◽  
Rule Out

A gastric diverticulum is an outpouching from the gastric mucosa. It is extremely rare. It is normally asymptomatic, but some may present with non-specific abdominal pain. A combination of upper gastrointestinal endoscopy and radiological contrast study such as oral barium study and computed tomography are needed to make a definite diagnosis and to rule out other associated pathology. Although treatment with medical therapy has been reported to be effective, the use of open and laparoscopic resection also yields a good outcome in the management of complicated gastric diverticulum. We present a case of symptomatic gastric diverticulum which has been successfully treated with medical therapy.

Accuracy of Radiologic and Endoscopic Diagnosis of Gastric Ulcer

1987 ◽  
Vol 28 (4) ◽  
pp. 421-423 ◽  
Author(s):  
T. Gjørup ◽  
E. Agner ◽  
L. Bording Jensen ◽  
A. Mørup Jensen ◽  
K.-M. Møllmann
Keyword(s):  
Gastric Ulcer ◽  
Diagnostic Criteria ◽  
Predictive Value ◽  
Gastrointestinal Endoscopy ◽  
Point Of View ◽  
Upper Gastrointestinal Endoscopy ◽  
Contrast Study ◽  
Double Contrast ◽  
Upper Gastrointestinal ◽  
Test Result

Patients with upper abdominal pain are often examined with both double contrast study of the stomach and endoscopy. On the basis of the results of the two examinations four diagnostic criteria of an ulcer can be formed: 1) radiography reveals an ulcer, 2) endoscopy reveals an ulcer, 3) both radiography and endoscopy reveal an ulcer, and 4) radiography and/or endoscopy reveals an ulcer. In a prospective study the accuracy of each of the four diagnostic criteria was examined. Eighty-two randomly selected outpatients had a double contrast barium examination and an upper gastrointestinal endoscopy performed by staff personnel. The diagnosis of a specialist in upper gastrointestinal endoscopy was used as the standard. For the four diagnostic criteria the overall accuracy ranged from 0.80 to 0.88. The predictive value of a positive test result was around 0.70 and the predictive value of a negative test result ranged from 0.81 to 0.96. The specificity ranged from 0.87 to 0.95, and the sensitivity from 0.38 to 0.90. It is concluded that from a clinical point of view, the accuracy of the four diagnostic criteria does not differ to an extent that justifies recommendation of one diagnostic criterion of gastric ulcer rather than the other.

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 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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