iGIE最新文献

{"title":"Doubling-down: LAMS-in-LAMS rescue of a migrated cholecystogastrostomy stent","authors":"Stephen A. Firkins MD, Hassan Siddiki MD","doi":"10.1016/j.igie.2023.11.010","DOIUrl":"https://doi.org/10.1016/j.igie.2023.11.010","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 1","pages":"Pages 29-31"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708623001413/pdfft?md5=5d4219a21371b4c12cef7d1986672877&pid=1-s2.0-S2949708623001413-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140290573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dedicated endoscopy for Barrett’s esophagus randomized blinded pilot study: comparing a dedicated Barrett’s surveillance service with standard care","authors":"Elizabeth Ratcliffe PhD ,&nbsp;James Britton PhD ,&nbsp;Richard Keld MD ,&nbsp;Shaheen Hamdy PhD ,&nbsp;John McLaughlin PhD ,&nbsp;Yeng Ang MD","doi":"10.1016/j.igie.2023.11.003","DOIUrl":"https://doi.org/10.1016/j.igie.2023.11.003","url":null,"abstract":"<div><h3>Background and Aims</h3><p>Barrett’s esophagus endoscopic surveillance is prone to poor guideline adherence. This study was undertaken to obtain pilot data comparing standard care with a dedicated Barrett’s endoscopy service.</p></div><div><h3>Methods</h3><p>Adults with nondysplastic Barrett’s esophagus at 2 sites in the northwest of England were randomized to a dedicated service versus a nondedicated service for their routine surveillance. On the dedicated arm, 64% were male; 72% in the nondedicated arm were male. Median ages were 66 years and 63 years in the dedicated and nondedicated arms, and mean Prague circumferential length was 2 cm and 3 cm, respectively. The dedicated service was performed by endoscopists trained in Barrett’s assessment on specific sessions. Data were obtained on dysplasia detection and adherence to British Society of Gastroenterology guidelines.</p></div><div><h3>Results</h3><p>Of 111 recruited cases (80% recruitment rate), 92 underwent endoscopy (39 were correctly performed on the dedicated arm and 25 on the nondedicated arm). In the dedicated arm, 5 (13%) cases of dysplasia were found; 2 (8%) cases of dysplasia were found in the nondedicated arm. Guideline adherence was better in the dedicated arm, particularly Prague classification documentation (37 of 39 [95%] vs 20 of 25 [80%]) and Seattle protocol adherence (34 of 39 [87%] vs 15 of 25 [60%]). Post hoc analysis with χ² test showed improved Seattle protocol adherence (34 of 37 dedicated vs 15 of 24 nondedicated, <em>P</em> = .005), visible lesion documentation (37 of 38 dedicated vs 12 of 23 nondedicated, <em>P ≤</em> .001), and use of targeted biopsies (25 of 39 dedicated vs 3 of 25, nondedicated <em>P</em> ≤ .001).</p></div><div><h3>Conclusions</h3><p>This study is the first pilot randomized trial of dedicated services versus non-dedicated services for Barrett’s surveillance. It shows that the study design is feasible and informs a future powered multicenter study. (Clinical trial registration number: ISRCTN12259569.)</p></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 1","pages":"Pages 58-65"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708623001334/pdfft?md5=f7aa8264accf49c265238812bfeb2b16&pid=1-s2.0-S2949708623001334-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140290878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic diagnosis and treatment of a pyriform sinus-cutaneous fistula in a non-pediatric patient: thinking outside the box","authors":"Diogo Turiani Hourneaux de Moura MD, MSc, PhD, Post-PhD ,&nbsp;Thadeu Rangel Fernandes MD ,&nbsp;Alexandre Moraes Bestetti MD ,&nbsp;Saullo Queiroz Silveira MD ,&nbsp;Maria Luisa do Nascimento Moura MD ,&nbsp;Pedro Henrique Loretti MD ,&nbsp;Eduardo Guimarães Hourneaux de Moura PhD ,&nbsp;Flavio Hojaij PhD","doi":"10.1016/j.igie.2024.01.005","DOIUrl":"10.1016/j.igie.2024.01.005","url":null,"abstract":"<div><h3>Background and Aims</h3><p>Pyriform sinus-cutaneous fistula is often observed in pediatric patients and is very rare in adults. Diagnosing this condition in adults is challenging, and contrast-enhanced CT misdiagnosis is not uncommon. Neck abscess formation secondary to this fistula is treated with surgical incision and drainage, but recurrence can occur due to the fistula. Although surgery is the most effective treatment modality, less-invasive therapies such as electrocauterization or chemocauterization may be indicated. However, treatment with these cauterization techniques has a high treatment failure rate.</p></div><div><h3>Methods</h3><p>This is the first case report of diagnosing, by EGD, a pyriform sinus fistula in an adult treated with autologous abdominal fat transplantation associated with adjunctive conventional endoscopic therapies.</p></div><div><h3>Results</h3><p>A 35-year-old woman with a history of 2 cervical abscesses was admitted due to a recurrent abscess with unknown etiology. She underwent surgical drainage with intraoperative EGD under fluoroscopic assistance, and a pyriform sinus-cutaneous fistula was diagnosed. Subsequently, fistula treatment with unprocessed autologous adipose abdominal tissue collected by lipoaspiration associated with argon plasma coagulation and endoscopic vacuum therapy were successfully performed. Immediately after the procedure, the patient no longer experienced fluid discharge through the skin. The patient had no recurrence within 10 months of follow-up.</p></div><div><h3>Conclusions</h3><p>Autologous abdominal fat transplantation may be an effective minimally invasive therapy for pyriform sinus-cutaneous fistula and has the potential to become an alternative therapy for GI fistulas. We encourage future studies to exploit the role of this therapy for GI fistulas.</p></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 1","pages":"Pages 48-52"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708624000050/pdfft?md5=d736cdd41934bd2680d6d6c319444f4c&pid=1-s2.0-S2949708624000050-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139632599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of a novel ultrathin gastroscope for unsedated transnasal endoscopy in children and adults for evaluation of upper GI disorders","authors":"Aravind Thavamani MD ,&nbsp;Matthew J. Ryan MD ,&nbsp;Kristina Leinwand MD ,&nbsp;Ramya Ramraj MD ,&nbsp;Shauna Schroeder MD ,&nbsp;Paul A. Menard-Katcher MD ,&nbsp;Vrinda Bhardwaj MD ,&nbsp;James P. Franciosi MD ,&nbsp;Joel A. Friedlander MD ,&nbsp;Ramy Sabe MBBCh","doi":"10.1016/j.igie.2023.12.005","DOIUrl":"https://doi.org/10.1016/j.igie.2023.12.005","url":null,"abstract":"<div><h3>Background and Aims</h3><p>Sedation-free transnasal endoscopy (TNE) is a valuable tool for endoscopic evaluation of the upper GI tract without the risk of general anesthesia. In pediatrics, bronchoscopes are often used for TNE, which precludes gastroduodenal evaluation. We evaluated the use of a novel ultrathin (3.5-mm) gastroscope.</p></div><div><h3>Methods</h3><p>This multicenter retrospective study involved 7 U.S. hospitals from May 2022 to July 2023. Data were collected from the electronic medical record. The primary outcome was the safety and efficacy measured by completion rate and adverse events. Secondary outcomes were procedure and encounter duration and biopsy sample adequacy.</p></div><div><h3>Results</h3><p>Fifty-three patients were recruited. Indications were eosinophilic esophagitis surveillance (n = 51) and esophageal variceal evaluation (n = 2). Mean patient age was 15.1 years (range, 6-37 years) with a male predominance (84.9%). Four procedures were unable to be completed. The procedure was successful in 92.4%, and the device success rate was 94.3%. Extent of intended accessibility was transnasal esophagoscopy in 3 patients, transnasal esophagogastroscopy in 42 patients, and transnasal EGD in 4 patients. Almost 40% underwent TNE for the first time. Biopsy samples obtained were adequate for histopathologic analyses. No significant adverse events were observed. Five patients (9.4%) experienced minimal epistaxis, gagging, and nasal pain.</p></div><div><h3>Conclusions</h3><p>Sedation-free TNE using a single-use gastroscope was well tolerated and safe in pediatric and adult age groups with a success rate similar to previous studies. User feedback noted that the single-use gastroscopes provided improved visualization, increased length, and larger working channel to allow for diagnostic EGD in an efficient ambulatory setting without general anesthesia.</p></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 1","pages":"Pages 15-19"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708623001619/pdfft?md5=fe670c190c5ce34ac1f8803853a103ed&pid=1-s2.0-S2949708623001619-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140290574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of diphenhydramine as an adjunct to midazolam and fentanyl use for sedation in young patients undergoing endoscopic evaluation: a single-center retrospective study","authors":"Danyal Imam MD ,&nbsp;Yinglin Gao DO ,&nbsp;Wichit Srikureja MD ,&nbsp;Timothy Allison-Aipa PhD ,&nbsp;Steve Serrao MD ,&nbsp;Manish Shrestha ,&nbsp;Nikhil R. Thiruvengadam MD ,&nbsp;Pejman Solaimani MD","doi":"10.1016/j.igie.2024.01.002","DOIUrl":"10.1016/j.igie.2024.01.002","url":null,"abstract":"<div><h3>Background and Aims</h3><p>Achieving adequate sedation may be difficult for young patients and can be associated with adverse events. Diphenhydramine (DPH) has not been studied in patients &lt;45 years of age undergoing endoscopy. The aim of this study, therefore, was to evaluate the safety and efficacy of DPH as an adjunct to fentanyl/midazolam during endoscopy in this patient population.</p></div><div><h3>Methods</h3><p>A retrospective, single-center cohort study was performed in patients aged 18 to 44 years who underwent EGD, colonoscopy, or both between 2020 and 2021. Patients who received DPH as an adjunct to fentanyl/midazolam (DPH group) were compared with those who received fentanyl/midazolam alone (non-DPH group). Outcomes included the incidence of adverse events, total facility time, total recovery time, total time to adequate sedation, and total sedation dose of midazolam and fentanyl used in both groups.</p></div><div><h3>Results</h3><p>A total of 714 patients met the inclusion criteria: DPH group (n = 375) versus non-DPH group (n = 339). There was no difference in the incidence of adverse events (<em>P</em> = .29), total facility time (<em>P</em> = .97), recovery time (<em>P</em> = .28), time to reach adequate sedation (<em>P</em> = .95), or amount of midazolam required (<em>P</em> = .53). However, the non-DPH group needed significantly more fentanyl than the DPH group (<em>P</em> = .01).</p></div><div><h3>Conclusions</h3><p>This study found that DPH as an adjunctive sedative is safe and well tolerated in patients aged &lt;45 years undergoing endoscopy and does not prolong the procedure or recovery time. Further prospective studies are needed to assess if DPH improves patient comfort, tolerance, and overall experience during endoscopic procedures.</p></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 1","pages":"Pages 104-109"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708624000025/pdfft?md5=3682e3fc7586ce1647dfc4e95c6f5535&pid=1-s2.0-S2949708624000025-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139539739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histoacryl glue injection in walled-off necrosis impression on gastric wall mistaken as gastric varix: an unintended adverse event having therapeutic benefit","authors":"Kishalaya DM,&nbsp;Dipankar Mondal DM,&nbsp;Mousam Dey MD,&nbsp;Souveek Mitra DM,&nbsp;Srijan Mazumdar DM","doi":"10.1016/j.igie.2023.11.005","DOIUrl":"10.1016/j.igie.2023.11.005","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 1","pages":"Pages 25-27"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708623001358/pdfft?md5=8fe5ed691896038caa50824e6e298f9c&pid=1-s2.0-S2949708623001358-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138618958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A fatal adverse event of a lumen-apposing metal stent placement for a benign luminal stricture","authors":"Jack Mlabasati MD ,&nbsp;Gregory Grimaldi MD ,&nbsp;Arvind J. Trindade MD","doi":"10.1016/j.igie.2023.11.008","DOIUrl":"https://doi.org/10.1016/j.igie.2023.11.008","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 1","pages":"Page 28"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708623001383/pdfft?md5=88d6c5e8dd4fca0375e40d44311b02d8&pid=1-s2.0-S2949708623001383-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140290572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A gastroenterologist’s enigma: unraveling an unusual case of melena and recurrent infective endocarditis","authors":"Asaf Levartovsky MD ,&nbsp;Emad Sakhnini MD ,&nbsp;Marianne M. Amitai MD","doi":"10.1016/j.igie.2024.01.003","DOIUrl":"10.1016/j.igie.2024.01.003","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 1","pages":"Pages 43-44"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708624000037/pdfft?md5=d9a4b9042304ec13cedbc856182425ca&pid=1-s2.0-S2949708624000037-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139540414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoughts during my last colonoscopy","authors":"Sidney J. Winawer MD","doi":"10.1016/j.igie.2024.01.007","DOIUrl":"10.1016/j.igie.2024.01.007","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 1","pages":"Pages 126-131"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708624000074/pdfft?md5=aa1c57f6aa9b9f2b91da3b7bef4c1faf&pid=1-s2.0-S2949708624000074-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139540568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-reassuring findings in adjacent independent pancreatic cysts","authors":"Daniel Conceição MD ,&nbsp;Sandra Faias PhD ,&nbsp;Isabel Duarte MD ,&nbsp;Ricardo Fonseca MD ,&nbsp;António Figueiredo MD ,&nbsp;Luís Bicho MD","doi":"10.1016/j.igie.2023.11.001","DOIUrl":"10.1016/j.igie.2023.11.001","url":null,"abstract":"<div><p>The higher number of imaging examinations (CT and magnetic resonance imaging) being performed and their improved definition are increasing the number of incidental diagnoses of pancreatic cystic lesions. It is therefore necessary to differentiate benign cysts from those with a potential for malignancy that may require surveillance or further treatment. To do so, lesions that present risk stigmata (worrisome features) must be stratified, integrating the findings with the patient age, comorbidities, and performance status. We describe a case of difficult interpretation of the risk stigmata because there were 2 adjacent independent cysts of distinct nature. We emphasize the role of EUS with FNA as crucial for decision-making at the multidisciplinary meeting.</p></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 1","pages":"Pages 20-24"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708623001310/pdfft?md5=d465df4b5a8b4ed47ba4afb1e7083af1&pid=1-s2.0-S2949708623001310-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135515998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}