scholarly journals The Yield of Endoscopy and Histology in the Evaluation of Esophageal Dysphagia: Two Referral Centers’ Experiences

Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1336
Author(s):  
Amir Mari ◽  
Fadi Abu Baker ◽  
Helal Said Ahmad ◽  
Ali Omari ◽  
Yazed Jawabreh ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Erosive Esophagitis ◽  
Deficiency Anemia ◽  
Histological Evidence ◽  
Endoscopic Findings ◽  
Esophageal Dysphagia ◽  
Neoplastic Lesions ◽  
Retrospective Multicenter Study ◽  
Esophageal Malignancy ◽  
Rule Out

Background and Objectives: The initial diagnostic test required to evaluate esophageal dysphagia is upper endoscopy (EGD) to assess the structure of the esophagus and the esophageo-gastric junction (EGJ). Taking biopsies during EGD has become a common practice in patients with dysphagia to rule out eosinophilic esophagitis (EoE). The aims of this study were to evaluate the endoscopic findings of patients who underwent EGD for esophageal dysphagia, to assess the rate of biopsy taking from the esophagus to diagnose/exclude EoE, and to report histology outcomes of these biopsies. Materials and Methods: This was a retrospective multicenter study that included individuals ≥18 years who underwent EGD due to esophageal dysphagia between the years 2015 and2020, (with no other alarm signs, such as weight loss, new iron deficiency anemia, and lymphadenopathy). We obtained data from patients’ electronic files. The endoscopy and histology findings were obtained from endoscopy reports saved in our electronic files. Results: A total of 209 patients were included in the study. The average age was 57.1 ± 17.1 years. The most common endoscopic findings were normal endoscopy in 76 patients (36.4%) and erosive esophagitis in 75 patients (35.9%). Barrett’s esophagus and esophageal malignancy were encountered in 11 patients (5.3%) and 2 patients (0.95%), respectively. Esophageal biopsies were taken in 50.2% of patients, and one patient had histological evidence of EoE (0.5%). On univariate analysis, there was a trend for association between proton pump inhibitors (PPIs) use and a normal EGD, but it was not statistically significant (OR 0.28, 95% CI 0.07–1.11, p = 0.07). Conclusions: Endoscopic findings were prevalent in dysphagia patients even when no other alarm symptoms exist. Neoplastic lesions and EOE were rare in our study.

scholarly journals Eosinophilic Esophagitis in Brazilian Pediatric Patients

2013 ◽  
Vol 7 ◽  
pp. CMPed.S12733 ◽  
Author(s):  
Mayra Isabel Correia Pinheiro ◽  
Luciano Pamplona De Góes Cavalcanti ◽  
Rodrigo Schuler Honório ◽  
Luïs Hélder De Alencar Moreno ◽  
Mayara Carvalho Fortes ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Topical Corticosteroid ◽  
Eosinophilic Esophagitis ◽  
Pediatric Patients ◽  
Erosive Esophagitis ◽  
Normal Mucosa ◽  
Patient Treatment ◽  
Therapeutic Approaches ◽  
Endoscopic Findings ◽  
The Mean

We examined 11 pediatric patients with eosinophilic esophagitis with a tardy diagnosis. The symptoms were initially thought to be related to other diseases, leading to the use of inadequate therapeutic approaches. The patients were between 3 and 17 years old (mean 7.8 ± 3.8 years), and 8 of the patients were male. Common symptoms included abdominal pain, regurgitation, difficulty in gaining weight, vomiting, dysphagia, and coughing. The mean age for the onset of symptoms was 4.3 ± 2.9 years. Endoscopic findings included normal mucosa in five (45%) patients, thickening of the mucosa with longitudinal grooves in three (27%), erosive esophagitis in two (18%), and a whitish stippling in one (9%) patient. Treatment included the use of a topical corticosteroid for 10 patients. In eight (73%) cases, the treatment made the symptoms disappear. Ten patients underwent histopathological management after treatment, with a decrease in the number of eosinophils.

scholarly journals P255 Efficacy and safety of a restrictive ferric carboxymaltose infusion strategy for iron deficiency anemia in inflammatory bowel disease patients

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S292-S292
Author(s):  
F Crispino ◽  
M Grova ◽  
M Maida ◽  
S Renna ◽  
A Casà ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Bowel Disease ◽  
Univariate Analysis ◽  
Deficiency Anemia ◽  
Ferric Carboxymaltose ◽  
Good Tolerability ◽  
Inflammatory Bowel ◽  
Rate Of Response

Abstract Background Iron deficiency anemia (IDA) is a common condition in patients with inflammatory bowel disease (IBD) and ferric carboxymaltose (FCM) has shown fast correction of hemoglobin (Hb) levels and good tolerability. We evaluated the response to FCM in IBD patients with IDA. The primary outcome was the assessment of the rate of response to single or multiple FCM infusions after 12 months from the first infusion. Secondary outcomes were the response to a single FCM infusion after 3 months and the assessment of FCM safety. Methods We retrospectively included 185 consecutive patients from IBD Unit of “Villa Sofia-V. Cervello” Hospital who received at least a dose of 500 mg FCM infusion between 2015 and 2018. Complete response (CR) was defined as Hb ≥13 g/dL (men) or ≥12 g/dL (women) or Hb increase ≥2 g/dL; partial response (PR) was defined as Hb increase ≥1 and <2 g/dl, without anemia correction; response was considered either CR or PR. Failure was defined as Hb increase <1 g/dl. A univariate analysis was performed among complete responders, partial responders and failures at 3 and 12 months. Results After 12 months the mean number of FCM infusions was 1.7 ± 1.1 and the rate of response was 139/185 (75.1%; CR: 48.6%; PR: 26.4%). Concerning our secondary endpoint, 169/185 patients received a single infusion of FCM within 3 months, and 134/169 patients (79.2%) achieved response (CR: 56.8%; PR: 22.4%). At univariate analysis low ferritin was the only variable associated with failure at 12 months (p < 0.003). No adverse events were reported. Conclusion A restrictive FCM infusion strategy is effective in most IBD patients with IDA. Interestingly, no association was found with Hb and weight at baseline, so further studies are needed to assess their effective role in deciding dosage of FCM.

Prevalence of Endoscopic Findings of Erosive Esophagitis in Children: A Population-based Study

2008 ◽  
Vol 47 (2) ◽  
pp. 141-146 ◽  
Author(s):  
Mark A Gilger ◽  
Hashem B El-Serag ◽  
Benjamin D Gold ◽  
Craig L Dietrich ◽  
VM Tsou ◽  
...  
Keyword(s):  
Erosive Esophagitis ◽  
Population Based ◽  
Population Based Study ◽  
Endoscopic Findings

Mesenchymal cell atypicality in inflammatory polyps

1977 ◽  
Vol 91 (9) ◽  
pp. 751-756 ◽  
Author(s):  
Bruce H. Klenoff ◽  
Max L. Goodman
Keyword(s):  
Medical Therapy ◽  
Nasal Polyps ◽  
Mesenchymal Cell ◽  
Surgical Excision ◽  
Histological Changes ◽  
Nasal Symptoms ◽  
Neoplastic Lesions ◽  
The Subject ◽  
Mesenchymal Stroma Cells ◽  
Rule Out

Excised nasal polyps should be examined histologically for classification as to aetiological process. Recently a ‘pseudosarcomatous’ change was reported in nasal polyps. We reviewed one hundred excised polyps for mesenchymal atypicality and found a wide degree of mesenchymal atypicality in the majority of nasal polyps.Nasal and choanal inflammatory polyps are the most frequent nasal masses which the otolaryngologist has to treat. Surgical excision is frequently required to alleviate the nasal symptoms of polyps unresponsive to medical therapy. Excised nasal polyps should be examined histologically for classification as to possible aetiological mechanisms and to rule out neoplastic lesions (Shea, 1947).Smith, Echevarria, and McLelland (Smith, 1974) recently described ‘pseudosarcomatous changes’ in nasal polyps. This stimulated us to investigate our inflammatoru nasal polyps for these histological changes. Casual observations demonstrated an impressive number of inflammatory polyps with varying amounts of atypical mesenchymal stroma cells. To quantitate these alterations, we reviewed the histological slides from one hundred patients with excised inflammatory polyps and the results are the subject of this report.

Laryngocele and Saccular Cysts

1978 ◽  
Vol 87 (5) ◽  
pp. 675-685 ◽  
Author(s):  
Lauren D. Holinger ◽  
David R. Barnes ◽  
Lojze J. Smid ◽  
Paul H. Holinger
Keyword(s):  
Infants And Children ◽  
Excision Biopsy ◽  
External Approach ◽  
Endoscopic Findings ◽  
Aryepiglottic Fold ◽  
Carcinoma Of The Larynx ◽  
Laryngeal Saccule ◽  
False Vocal ◽  
Repeated Aspiration ◽  
Rule Out

The symptoms, endoscopic findings, treatment and results of 46 patients with laryngoceles and saccular cysts are presented. Thirty-four were adults; 12 were infants and children under three years of age. Twenty-two adults had anterior saccular cysts, nine had lateral saccular cysts; three had laryngoceles. Ten infants and children had saccular cysts; two had laryngoceles. A laryngocele is an abnormal dilatation of the saccule which communicates with the lumen of the larynx, fills with air but on occasion may be temporarily distended with mucus; laryngoceles may be congenital or acquired. A saccular cyst is a mucus-filled dilatation of the saccule which does not communicate with the laryngeal lumen; saccular cysts are classified as lateral or anterior. Laryngoceles and saccular cysts represent abnormalities of the laryngeal saccule; a developmental spectrum exists among the normal saccule, large saccule, laryngocele and saccular cyst. The treatment of saccular cysts in infants and children is primarily repeated aspiration. In adults, symptomatic laryngoceles and large lateral saccular cysts are treated by an external approach; endoscopic aspiration and unroofing of small lateral saccular cysts is sometimes adequate and is attempted first. Anterior saccular cysts are treated by endoscopic excision biopsy. Carcinoma of the larynx may be found in association with a laryngocele or saccular cyst and must be diligently searched for by biopsies in the region of the saccular orifice. A smooth mass involving the area of the false vocal cord and aryepiglottic fold cannot be assumed to be a lateral saccular cyst; biopsies of the ventricle and saccule and deep incisional biopsies of the mass are indicated to rule out a carcinoma originating in the ventricle or saccule.

scholarly journals Severe acute ischemic colitis: What is the place of endoscopy in the management strategy?

2021 ◽  
Vol 09 (11) ◽  
pp. E1770-E1777
Author(s):  
Diane Lorenzo ◽  
Marc Barthet ◽  
Mélanie Serrero ◽  
Laura Beyer ◽  
Stéphane Berdah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Decision Making ◽  
Ct Scan ◽  
Ischemic Colitis ◽  
Univariate Analysis ◽  
Hemodynamic Instability ◽  
Endoscopic Findings ◽  
Scan Data ◽  
Mucosal Necrosis ◽  
Grade 3

Abstract Background and study aims Ischemic colitis (IC) is potentially lethal. Clinical and biology information and results of computed tomography (CT) scan and/or colonoscopy are used to assess its severity. However, decision-making about therapy remains a challenge. Patients and methods This was a retrospective, single-center study between 2006 and 2015. Patients with severe IC who underwent endoscopic evaluation were included. The aims were to determine outcomes depending on endoscopic findings and assess the role of endoscopy in the management. Results A total of 71 patients were included (men = 48 (68%), mean age = 71 ± 13 years). There was hemodynamic instability in 29 patients (41 %) and severity signs on CT scan in 18 (38 %). Twenty-nine patients (41 %) underwent surgery and 24 (34 %) died. The endoscopic grades were: 15 grade 1 (21 %), 32 grade 2 (45 %), and 24 grade 3 (34%). Regarding patients with grade 3 IC, 55 % had hemodynamic instability, 58 % had severity signs on CT scan, 68 % underwent surgery, and 55 % died. The decision to perform surgery was based on hemodynamic status in 62 % of cases, CT scan data in 14 %, endoscopic findings in 10 %, and other in 14 %. Colectomy was more frequent in patients with grade 3 IC (P < 0.05). A mismatch between mucosal aspect (necrosis) and serous (normal) was observed in 13 patients (46 %). Risk factors for colectomy in univariate analysis were aortic aneurysm surgery, hemodynamic instability, no colic enhancement on CT scan, and endoscopic grade 3. Risk factors for mortality in multivariate analysis were hemodynamic instability, colectomy, and Charlson score > 5 (P < 0.05). Conclusions This study suggests a low impact of endoscopy on surgical decision making. Hemodynamic instability was the first indication for colectomy. A discrepancy between endoscopic mucosal (necrosis) and surgical serous (normal) aspects was frequently noted.

scholarly journals OP05.07: Just images on sono-endoscopic findings of adnexal torsion: A retrospective multicenter study by the IOTA group

2008 ◽  
Vol 32 (3) ◽  
pp. 327-327
Author(s):  
F. P. G. Leone ◽  
L. Valentin ◽  
D. Jurkovic ◽  
D. Timmerman ◽  
A. C. Testa ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Adnexal Torsion ◽  
Endoscopic Findings ◽  
Retrospective Multicenter Study

scholarly journals The histological diagnosis of dysplastic and neoplastic lesions in inflammatory bowel disease: A pathological perspective

2004 ◽  
Vol 51 (2) ◽  
pp. 109-116 ◽  
Author(s):  
Slavica Usaj-Knezevic ◽  
Dino Tarabar ◽  
Vladimir Cuk ◽  
Snezana Cerovic ◽  
Goran Brajuskovic ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Accurate Diagnosis ◽  
High Grade ◽  
Surveillance Colonoscopy ◽  
Histological Evidence ◽  
Multiple Biopsies ◽  
Increased Risk ◽  
Neoplastic Lesions ◽  
Inflammatory Bowel

Patients with inflammatory bowel disease (IBD), both ulcerative colitis (UC) and Crohn?s disease (CD), are at an increased risk for developing colorectal carcinoma (CRC). The accurate diagnosis of dysplasia in biopsies taken during periodic surveillance of long-standing IBD patients is most important in prevention of UC and CD related cancer. Distinction of low from high grade IBD-related dysplasia and differential diagnosis between IBD-related dysplasia and dysplasia in sporadic adenoma as well as distinction from pseudodysplastic lesions in inflammatory pseudopolyps or reparative lesions is often very subtle and difficult and demands expertise of second experienced gastrointestinal pathologist. Although surveillance colonoscopy with multiple biopsies does not reduce the cancer mortality, it offers a reasonable chance of detecting precancer and performed prophylactic colectomy. Novel methods of detecting dysplasia are continuously being evaluated, including chromoscopy and molecular biology markers. In the future, one may expect, from these new markers to detect the dysplasia in IBD patients before development of histological evidence of neoplastic changes.

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