Journal of interventional gastroenterology最新文献

{"title":"Gastric antral vascular ectasia (GAVE) in two non- cirrhotic patients involved large area of stomach: case report and literature review","authors":"F. Liu, F. Ji, X. Jin, Y. Du","doi":"10.4161/JIG.113","DOIUrl":"https://doi.org/10.4161/JIG.113","url":null,"abstract":"Gastric antral vascular ectasia (GAVe) is a rare clinical disease which can cause recurrent upper gastrointestinal (GI) tract bleeding. It is responsible for about 4% of non-variceal upper GI haemorrhages. GAVe was also named as watermelon stomach (WS) for its characteristic endoscopic performance. Though the etiology of GAVe is unknown, it received several presumptions according to its histopathological features. Treatments of GAVe can be separated into three categories: pharmacologic, endoluminal, and surgical approaches. here we will introduce the disease systematically through two cases.","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"3 1","pages":"107"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70641716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic therapy for significant gastric outlet obstruction caused by a small pancreatic pseudocyst with a unique shape and location.","authors":"Muhammad Z Bawany,&nbsp;Ehsan Rafiq,&nbsp;Safia Ahmad,&nbsp;Quratulain Chaudhry,&nbsp;Ali Nawras","doi":"10.4161/jig.23746","DOIUrl":"https://doi.org/10.4161/jig.23746","url":null,"abstract":"<p><p>Large perigastric or periduodenal pseudocysts are a potential cause of gastric outlet obstruction, usually requiring interventional drainage of the pseudocysts. In contrary most of the small pseudocysts are asymptomatic and require no therapy. However, certain small pseudocysts can produce clinically significant problem depending on their location. Here we report a case of small pseudocyst (12.0 mm in width) with a unique shape and location causing significant Gastric outlet obstruction treated successfully with endoscopy.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 4","pages":"196-198"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655394/pdf/jig0204_0196.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31441727","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":"Successful endoscopic treatment of iatrogenic biloma as a complication of endosonography-guided hepaticogastrostomy: The first case report.","authors":"Varayu Prachayakul,&nbsp;Pitulak Aswakul","doi":"10.4161/jig.23750","DOIUrl":"https://doi.org/10.4161/jig.23750","url":null,"abstract":"<p><p>Endosonography (EUS)-guided biliary drainage is a novel therapeutic option for patients with biliary obstruction after failed endoscopic retrograde cholangiopancreatography (ERCP). Many case reports and series worldwide have shown satisfactory clinical outcomes in terms of technical and clinical success rates, which approach 80%-100%. However, these procedures need to be performed by experts to minimize the possible complications, which have been reported in as many as 14-35% of patients. The most common complications encountered in these procedures are bile leakage, pneumoperitoneum, peritonitis, and stent related complications such as stent migration. Here, we report the case of a female patient who had cholangiocarcinoma and underwent EUS-guided hepaticogastrostomy after failed ERCP; stent malposition occurred during the procedure, leading to biloma formation that was successfully treated with EUS-guided biloma drainage.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 4","pages":"202-204"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655396/pdf/jig0204_0202.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31441729","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":"Does the urgency of endoscopic retrograde cholangiopancreatography (ercp)/percutaneous biliary drainage (pbd) impact mortality and disease related complications in ascending cholangitis? (deim-i study).","authors":"Shaffer R S Mok, Christie L Mannino, Jessica Malin, Matthew E Drew, Patricia Henry, Punitha Shivaprasad, Barry Milcarek, Adam B Elfant, Thomas A Judge","doi":"10.4161/jig.23744","DOIUrl":"10.4161/jig.23744","url":null,"abstract":"<p><strong>Background: </strong>The Tokyo Guidelines have greatly impacted the management of ascending cholangitis. Though ERCP is the favored modality for biliary decompression, no evidence exists for the timing of ERCP. The DEIM-I study set out to determine if the time from patient presentation to biliary decompression impacted in hospital all cause mortality in ascending cholangitis.</p><p><strong>Method: </strong>DEIM-I cohort study was a single-blinded and consisted of 250 subjects with moderate to severe ascending cholangitis who underwent ERCP/PBD. Subjects were randomized into quartiles based upon time from presentation until ERCP/PBD. The primary outcome utilized logistic regression to estimate relative risk (RR) of all cause, in hospital mortality with time to procedure as the predictive covariate. Secondary outcomes were analyzed using multivariate logistic regression and included; multiple organ failure (MOF), sepsis, systemic inflammatory response syndrome (SIRS), surgical incidence, hospital readmission and length of stay (LOS).</p><p><strong>Results: </strong>The risk for hospital mortality was significantly less when biliary drainage was performed within 11 h, compared to >42 h (RR 0.34, 95%CI 0.12 to 0.99, p=0.049). Hospital readmission was lower in subjects who underwent biliary decompression less than 11 h, when compared to those greater than 22 h. Subjects who underwent biliary decompression within 21 h had significant higher risk for surgery compared to those 22-42 h.</p><p><strong>Conclusion: </strong>The relative risk of all cause in hospital mortality was lower in subjects who underwent biliary decompression in under 11 h compared to greater than 42 h.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 4","pages":"161-167"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655387/pdf/jig0204_0161.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31442280","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":"Successful management of recurrent biliary colic caused by pancreatic stent migration after Whipple procedure.","authors":"Muhammad Z Bawany,&nbsp;Ehsan Rafiq,&nbsp;Raja Thotakura,&nbsp;Michael D McPhee,&nbsp;Ali Nawras","doi":"10.4161/jig.23740","DOIUrl":"https://doi.org/10.4161/jig.23740","url":null,"abstract":"","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 4","pages":"205-206"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655397/pdf/jig0204_0205.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31441730","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":"Effectiveness of a simplified \"patient friendly\" split dose polyethylene glycol colonoscopy prep in Veterans Health Administration patients.","authors":"Benjamin Cohen,&nbsp;Raymond S Tang,&nbsp;Erik Groessl,&nbsp;Ann Herrin,&nbsp;Samuel B Ho","doi":"10.4161/jig.23748","DOIUrl":"https://doi.org/10.4161/jig.23748","url":null,"abstract":"<p><strong>Background and objectives: </strong>Adequate colon cleansing is an important factor in performing quality colonoscopy. Split dose Polyethylene Glycol (PEG) solutions have been shown to improve colon cleansing, but the effectiveness in a large clinical practice of elderly co-morbid patients has not been demonstrated. The aim of this study was to assess the efficacy of a simplified split PEG bowel prep in Veterans Health Administration (VHA) patients.</p><p><strong>Methods: </strong>Prospective pre-post study design of VHA patients undergoing routine colonoscopy. Bowel prep quality was assessed using a standardized semi-quantitative 5-point scale. \"Standard\" 4L PEG prep was consumed once the evening before the procedure. \"Split\" prep was consumed half in the early evening and half in the late evening or early morning depending on procedure time.</p><p><strong>Results: </strong>Right colon preps were Excellent/Good in 81.4% of split preps (n=199) vs. 63% of standard preps (n=447, p<0.001). Left colon preps were Excellent/Good in 85.9% of split preps vs. 71.6% of standard preps (p<0.001). Diabetics (n=133) had significantly more right colon preps rated fair or worse compared to non-diabetics irrespective of prep (39.9% vs. 29.0%, p=0.02). Split prep in diabetics resulted in fewer right colon preps rated fair or worse compared to diabetics using standard prep (28.3% vs. 45.9%, p=0.049). Average adenomas detected per colonoscopy were 1.04 for split prep vs. 0.85 for standard prep (p=NS). Patient satisfaction was higher for split preps.</p><p><strong>Conclusion: </strong>System-wide implementation of a split PEG prep resulted in significantly improved bowel cleansing in VHA patients, particularly in the right colon. Improved bowel cleansing with split preps was associated with higher patient satisfaction.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 4","pages":"177-182"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4161/jig.23748","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31442283","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 case of mesenteric ischemia secondary to Fibromuscular Dysplasia (FMD) with a positive outcome after intervention.","authors":"Neal C Patel,&nbsp;William C Palmer,&nbsp;Kanwar R S Gill,&nbsp;Michael B Wallace","doi":"10.4161/jig.23747","DOIUrl":"https://doi.org/10.4161/jig.23747","url":null,"abstract":"<p><p>Fibromuscular dysplasia (FMD) is a non-inflammatory, non-atherosclerotic angiopathy, which commonly affects the renal and internal carotid arteries. Although rare, FMD has the potential of involving the mesenteric vasculature. Due its low incidence and relatively little knowledge concerning its risk factors and etiology, actual diagnosis of FMD involving the mesenteric vessels requires a very high degree of suspicion. Upon review of the few reported cases of FMD causing mesenteric ischemia, it is clear that therapeutic interventions are rarely discussed and that positive outcomes are even more uncommon. Herein, we present the case of a 47 year-old female with mesenteric ischemia secondary to FMD, which was diagnosed and treated originally with angioplasty, then repeat angioplasty with stent placement, and finally with a bypass graft. Ultimately, the patient had a positive outcome, including eight month follow-up.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 4","pages":"199-201"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655395/pdf/jig0204_0199.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31441728","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":"Which patients with dilated common bile and/or pancreatic ducts have positive findings on EUS?","authors":"Vernon Carriere,&nbsp;Jason Conway,&nbsp;Jerry Evans,&nbsp;Susanne Shokoohi,&nbsp;Girish Mishra","doi":"10.4161/jig.23739","DOIUrl":"https://doi.org/10.4161/jig.23739","url":null,"abstract":"<p><strong>Background: </strong>Patients with dilated common bile duct (CBD) (>7mm) and/or pancreatic duct (PD) on abdominal imaging are often referred for endoscopic ultrasound (EUS). In many cases, the EUS shows no obvious etiology for the dilated ducts.</p><p><strong>Objective: </strong>Find clinical factors that may predict which patients are more likely to have positive findings on EUS to explain the etiologies for the dilated ducts.</p><p><strong>Design: </strong>Retrospective database analysis.</p><p><strong>Setting: </strong>Tertiary-care university hospital.</p><p><strong>Patients: </strong>Patients referred for EUS for dilated CBD and/or PD from January 2004 to February 2010 were included in this study. Only patients without an obvious etiology for the dilated ducts on abdominal imaging were included.</p><p><strong>Interventions: </strong>An EUS was performed by using either a radial echoendoscope or a linear endoscope to evaluate the common bile duct and/or the pancreatic duct. When appropriate fine needle aspiration of the mass or cyst was performed.</p><p><strong>Main outcome measurements: </strong>The characteristics of patients who had positive findings on EUS to explain the etiology of their dilated PD and/or CBD.</p><p><strong>Results: </strong>A total of 140 patients were included in the study with a mean age of 64 years, 51 (36%) male and 115 (82%) white. The majority of our patients had a presenting symptom of abdominal pain 105 (75%). 49 (36%) had elevated AST or ALT, 25 (8%) had an elevated bilirubin and 13 (23%) had an elevated lipase. EUS findings explained the dilated ducts in 54 (39%) of our patients, most common diagnoses included: CBD stone in 11 (8%), non-calcific chronic pancreatitis in 9 (6%), pancreatic mass in 8 (6%), IPMN in 7 (5%). On bivarate analysis patients who were older (p = 0.006), male (p = 0.001), had elevated LFTs (p = <0.001), had elevated lipase (p = 0.021) or had dilated CBD and PD (p = 0.007) were more likely to have an etiology for their dilated duct(s) discovered on EUS.</p><p><strong>Limitations: </strong>A retrospective study with a small number of patients.</p><p><strong>Conclusion: </strong>Older patients, males and those patients presenting with concurrent elevations in the AST/ALT and/or lipase were more likely to have an underlying etiology discovered on EUS. Furthermore, EUS may detect an undiagnosed pancreatic malignancy in patients presenting with unexplained duct dilation.</p>","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 4","pages":"168-171"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655388/pdf/jig0204_0168.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31442281","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 combination of snare polypectomy and apc therapy for prolapsing common bile duct adenoma.","authors":"Ehsan Rafiq,&nbsp;Osama Alaradi,&nbsp;Muhammad Bawany,&nbsp;Ali Nawras","doi":"10.4161/jig.23743","DOIUrl":"https://doi.org/10.4161/jig.23743","url":null,"abstract":"","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 4","pages":"193-195"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655393/pdf/jig0204_0193.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31441726","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":"The role of endoscopic ultrasound-guided fine needle aspiration (eus-fna) for the diagnosis of intra-abdominal lymphadenopathy of unknown origin.","authors":"Jason Korenblit,&nbsp;Archana Anantharaman,&nbsp;David E Loren,&nbsp;Thomas E Kowalski,&nbsp;Ali A Siddiqui","doi":"10.4161/jig.23742","DOIUrl":"https://doi.org/10.4161/jig.23742","url":null,"abstract":"BACKGROUND AND AIMS The diagnosis of intra-abdominal lymphadenopathy of is difficult, especially when no primary lesion has been identified. We aimed to evaluate the diagnostic yield of EUS-FNA cytology in patients with enlarged intra-abdominal lymph nodes of unknown etiology. PATIENT AND METHODS 147 patients with abdominal lymphadenopathy on imaging in whom EUS-FNA was performed with a 22-gauge needle. Performance characteristics of EUS-FNA including the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were compared between the 2 groups. RESULTS AThe location of the enlarged lymph nodes was the celiac axis (8.2%), peri-gastric (34%), peri-pancreatic (25.2%), peri-portal (27.9%), and other intra-abdominal locations (4.8%). The median number of EUS-FNA passes was 5. The final diagnosis were lymphoma in (n=27), metastatic adenocarcinoma (n=44) patients, other miscellaneous malignancies (n=22) and benign disease (n=54). The sensitivity, specificity, and accuracy of EUS-FNA were 89.7, 98.3, and 93.5% respectively. A false positive FNA result was present in only 1 case (0.7%); false negative FNA results were present in eight cases (5.8%). Lymph node morphologic features of roundness, echogenicity, and homogeneity on EUS were not a predictor of lymph node malignancy. CONCLUSION In a retrospective cohort trial, EUS-FNA was found to be highly accurate and safe in diagnosing patients with intra-abdominal lymphadenopathy of unknown etiology.","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"2 4","pages":"172-176"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655389/pdf/jig0204_0172.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31442282","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}