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Journal articles on the topic 'Endoscopic spraying'

Author: Grafiati
Published: 28 April 2023

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1

Iacucci, Marietta, Federica Furfaro, Takayuki Matsumoto, Toshio Uraoka, Samuel Smith, Subrata Ghosh, and Ralf Kiesslich. "Advanced endoscopic techniques in the assessment of inflammatory bowel disease: new technology, new era." Gut 68, no. 3 (December 22, 2018): 562–72. http://dx.doi.org/10.1136/gutjnl-2017-315235.

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Endoscopic assessment of inflammation and mucosal healing is crucial for appropriate management in IBD. Current definition of endoscopic mucosal healing has been derived using previous generation of standard white light endoscopes. New endoscopy technologies widely available provide much more detailed images of mucosal and vascular patterns. Novel endoscopic techniques with high definition image, optical and digital enhancement have enhanced the quality and fine details of vascular and mucosal pattern so that endoscopic images have started to reflect histological changes for lesions and inflammation/healing. These technologies can now define subtle inflammatory changes and increase detection and characterisation of colonic lesions in patients with IBD. The best endoscopic technique to detect dysplasia in IBD is still debated. Dye chromoendoscopy with targeted biopsies is considered by Surveillance for Colorectal Endoscopic Neoplasia Detection and Management in inflammatory Bowel Disease Patients: International Consensus Recommendations (SCENIC consensus the standard of care and recommended for adoption by gastroenterologists in practice. In future, it is possible that well-trained colonoscopists using high definition equipment with image enhancements may be able to obtain equivalent yield without pan-colonic dye spraying and characterise lesions. Finally, SCENIC introduced endoscopic resectability of some dysplastic colonic lesions—new techniques may now better characterise endoscopic resectability and limit the number of colectomies. In this review, we will provide a state-of-the-art opinion on the direction of technological advances in the assessment of IBD and how new concepts will refine clinical practice.
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Misumi, A., H. Kondou, A. Murakami, K. Arima, U. Honmyou, K. Baba, and M. Akagi. "Endoscopic Diagnosis of Reflux Esophagitis by the Dye-spraying Method." Endoscopy 21, no. 01 (January 1989): 1–6. http://dx.doi.org/10.1055/s-2007-1012883.

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Mori, Hirohito, Maki Ayaki, Hideki Kobara, Yasuhiro Goda, Noriko Nishiyama, and Tsutomu Masaki. "Rare Primary Esophageal Paget’s Disease Diagnosed on a Large Bloc Specimen Obtained by Endoscopic Mucosal Resection." Journal of Gastrointestinal and Liver Diseases 26, no. 4 (December 1, 2017): 417–20. http://dx.doi.org/10.15403/jgld.2014.1121.264.pag.

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Primary esophageal Paget’s disease is rare. Only a few case reports have described the intraepithelial papillary capillary loop (IPCL) pattern obtained by magnified Narrow Band Imaging (M-NBI) endoscopy in this rare pathology. This report highlights the usefulness of M-NBI and the successful diagnosis using a large bloc specimen obtained by endoscopic mucosal resection with the cap method (EMR−c). A 53-year-old man was referred to endoscopic examination for dysphagia. The endoscopic image revealed a ring-shaped scarring of the esophagus suggestive for eosinophilic esophagitis. The IPCL pattern by M-NBI endoscopy showed an inflammatory pattern, and the entire epithelium of the esophagus was not stained by Lugol iodine spraying. Based on six biopsies randomly performed, a poorly differentiated adenocarcinoma was diagnosed. Since the M-NBI pattern and the histology were completely different, EMR−c was performed to obtain large bloc specimens for a more detailed diagnosis. The pathological findings revealed extensive Paget’s cells infiltration into the epithelium and multifocal invasion from the mucosa to the submucosal layer with adenocarcinoma. In conclusion, a large bloc specimen by EMR-c might be more useful than a small biopsy for an accurate diagnosis of the rare esophageal Paget’s disease.Key words: – – .Abbreviations: EMR−c: endoscopic mucosal resection with cap method; IPCL: intraepithelial papillary capillary loop; LVLs: Lugol-voiding lesions; M-NBI: magnified Narrow Band Imaging; PET-CT: Positron-Emission Tomography and Computed Tomography.
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Mou, Yi, Dingke Wen, Qin Liu, Honglin Chen, Hang Yi, Wei Liu, and Bing Hu. "Endoscopic resection of an esophageal duplication cyst with spraying of anhydrous alcohol." Endoscopy 47, S 01 (July 28, 2015): E348—E349. http://dx.doi.org/10.1055/s-0034-1392502.

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Fujishiro, M., N. Yahagi, M. Oka, S. Enomoto, N. Yamamichi, N. Kakushima, A. Tateishi, et al. "Endoscopic Spraying of Sucralfate Using the Outer Sheath of a Clipping Device." Endoscopy 34, no. 11 (November 2002): 935. http://dx.doi.org/10.1055/s-2002-35306.

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Iacucci, M., T. Uraoka, M. Fort Gasia, and N. Yahagi. "Novel Diagnostic and Therapeutic Techniques for Surveillance of Dysplasia in Patients with Inflammatory Bowel Disease." Canadian Journal of Gastroenterology and Hepatology 28, no. 7 (2014): 361–70. http://dx.doi.org/10.1155/2014/825947.

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The risk for developing dysplasia and colorectal cancer in patients with longstanding inflammatory bowel disease (IBD) involving the colon is well documented. Random biopsies during white-light, standard-definition colonoscopy (33 to 50 biopsies) with or without dye spraying chromoendoscopy has been the recommended strategy in North America to detect dysplastic lesions in IBD. However, there are several limitations to this approach including poor physician adherence, poor sensitivity, increased procedure time and considerable cost. The new generation of high-definition endoscopes with electronic filter technology provide an opportunity to visualize colonic mucosal and vascular patterns in minute detail, and to identify subtle flat, multifocal, polypoid and pseudopolypoid neoplastic and non-neoplastic lesions. The application of these new technologies in IBD is slowly being adopted in clinical practice. In addition, the advent of confocal laser endomicroscopy provides an opportunity to explore real-time histology, thus redefining the understanding and characterization of the lesions in IBD. There is emerging evidence that serrated adenomas are also associated with longstanding IBD colitis and may be recognized as another important contributing factor to colorectal cancer development. The circumscribed neoplastic lesions can be treated using endoscopic therapeutic management such as mucosal resection or, especially, endoscopic submucosal dissection. This may replace panproctocolectomy in selected patients. The authors review the potential of these techniques to transform endoscopic diagnosis and therapeutic management of dysplasia in IBD.
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Resende, Ricardo Hannum, Igor Braga Ribeiro, Diogo Turiani Hourneaux de Moura, Facundo Galetti, Rodrigo Silva de Paula Rocha, Wanderley Marques Bernardo, Paulo Sakai, and Eduardo Guimarães Hourneaux de Moura. "Surveillance in inflammatory bowel disease: is chromoendoscopy the only way to go? A systematic review and meta-analysis of randomized clinical trials." Endoscopy International Open 08, no. 05 (April 17, 2020): E578—E590. http://dx.doi.org/10.1055/a-1120-8376.

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Abstract Background and study aims Ulcerative colitis (UC) and Crohn’s disease (CD) have higher risk of colorectal cancer (CRC). Guidelines recommend dysplasia surveillance with dye-spraying chromoendoscopy (DCE). The aim of this systematic review and meta-analysis was to review all randomized clinical trials (RCTs) available and compare the efficacy of different endoscopic methods of surveillance for dysplasia in patients with UC and CD. Methods Databases searched were Medline, EMBASE, Cochrane and SCIELO/LILACS. It was estimated the risk difference (RD) for dichotomous outcomes (number of patients diagnosed with one or more dysplastic lesions, total number of dysplastic lesions diagnosed and number of dysplastic lesions detected by targeted biopsies) and mean difference for continuous outcomes (procedure time). Results This study included 17 RCTs totaling 2,457 patients. There was superiority of DCE when compared to standard-definiton white light endoscopy (SD-WLE). When compared with high-definition (HD) WLE, no difference was observed in all outcomes (number of patients with dysplasia (RD 0.06; 95 % CI [–0.01, 0.13])). Comparing other techniques, no difference was observed between DCE and virtual chromoendoscopy (VCE – including narrow-band imaging [NBI], i-SCAN and flexible spectral imaging color enhancement), in all outcomes except procedure time (mean difference, 6.33 min; 95 % CI, 1.29, 11.33). DCE required a significantly longer procedure time compared with WLE (mean difference, 7.81 min; 95 % CI, 2.76, 12.86). Conclusions We found that dye-spraying chromoendoscopy detected more patients and dysplastic lesions than SD-WLE. Although no difference was observed between DCE and HD-WLE or narrow-band imaging, the main outcomes favored numerically dye-spraying chromoendoscopy, except procedure time. Regarding i-SCAN, FICE and auto-fluorescence imaging, there is still not enough evidence to support or not their recommendation.
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Ishiyama, Akiyoshi, Ken Namikawa, Yoshitaka Tokai, Shoichi Yoshimizu, Yusuke Horiuchi, Toshiyuki Yoshio, Toshiaki Hirasawa, Tomohiro Tsuchida, Fumio Itoh, and Junko Fujisaki. "Effect of spraying l ‐menthol on peristalsis resumption during endoscopic submucosal dissection of gastric tumors." JGH Open 5, no. 6 (May 6, 2021): 653–57. http://dx.doi.org/10.1002/jgh3.12549.

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Farhadi, Ashkan, Jeremy Z. Fields, and Seyed Hamid Bozorgnia Hoseini. "The Assessment of Esophagogastroduodenoscopy Tolerance a Prospective Study of 300 Cases." Diagnostic and Therapeutic Endoscopy 7, no. 3-4 (January 1, 2001): 141–47. http://dx.doi.org/10.1155/dte.7.141.

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Background: Esophagogastroduodenoscopy (EGD) is useful in the diagnosis and evaluation of dyspepsia. We investigated factors that might be associated with self-reported patient tolerance of EGD and therefore might serve as objective, reliable and useful surrogates for self-reported patient tolerance. We also investigated factors that might influence EGD tolerance.Study: We prospectively evaluated 300 cases prior, during and after an EGD procedure. None received sedation.Results: Seventy-nine percent of patients reported “good” tolerance of their EGD procedure. Other variables including (1) ease of intubation, (2) number and severity of retching episodes and (3) patient's cooperation during the endoscopic procedure, associated positively and robustly with patient self-reports of EGD tolerance. Evaluating the parameters that might predict EGD tolerance, only (4) age and (5) patient's gagging during Lidocaine throat spraying correlated closely with patient perception of EGD intolerance. Self-reported EGD tolerance did not correlate with gender, education level, body habitus (obesity), prior EGD experience, fear or anxiety about the procedure, procedure type or procedure duration.Conclusions: Several parameters might be used instead of or in addition to patient perception of EGD tolerance. Age and patient gagging during Lidocaine throat spraying, but not patient fear and anxiety about the procedure can be used to predict EGD intolerance and used for selection of patients for sedation.
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Luo, Hui, Xiangping Wang, Rongchun Zhang, Shuhui Liang, Xiaoyu Kang, Xiaofeng Zhang, Qifeng Lou, et al. "Rectal Indomethacin and Spraying of Duodenal Papilla With Epinephrine Increases Risk of Pancreatitis Following Endoscopic Retrograde Cholangiopancreatography." Clinical Gastroenterology and Hepatology 17, no. 8 (July 2019): 1597–606. http://dx.doi.org/10.1016/j.cgh.2018.10.043.

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Gromski, Mark A., and Evan L. Fogel. "End of the Road for Epinephrine Spraying of the Papilla to Prevent Post–Endoscopic Retrograde Cholangiopancreatography Pancreatitis?" Clinical Gastroenterology and Hepatology 17, no. 8 (July 2019): 1446–47. http://dx.doi.org/10.1016/j.cgh.2018.12.043.

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Uozumi, Takeshi, Tetsuya Sumiyoshi, Hitoshi Kondo, Takeyoshi Minagawa, Ryoji Fujii, Masahiro Yosida, Kaho Tokuchi, et al. "Endoscopic submucosal dissection for early squamous cell carcinoma in the anal canal and Lugol chromoendoscopy for assessment of the lateral margin." Endoscopy International Open 06, no. 09 (September 2018): E1130—E1133. http://dx.doi.org/10.1055/a-0584-7060.

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AbstractA 66-year-old man underwent follow-up colonoscopy after colon polypectomy. The retroflexed view of the anal canal with white-light imaging revealed a whitish, slightly elevated lesion on the dentate line and an ill-defined flat lesion. A biopsy of the whitish elevation revealed squamous cell carcinoma (SCC), and endoscopic submucosal dissection (ESD) was planned. The lateral margin of the SCC was identified by spraying with Lugol’s iodine, and the tumor was resected en bloc with no complications. The pathological findings were SCC in situ with parakeratosis in the whitish elevation and high-grade intraepithelial neoplasia in the ill-defined flat lesion, which exhibited a wide iodine-unstained area by chromoendoscopy. Early SCC in the anal canal is a rare gastrointestinal cancer, and Lugol chromoendoscopy helped visualize the tumor margin for ESD.
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Fujinami, Haruka, Shinya Kajiura, Takayuki Ando, Hiroshi Mihara, Ayumu Hosokawa, and Toshiro Sugiyama. "Direct Spraying of Shakuyakukanzoto onto the Duodenal Papilla: A Novel Method for Preventing Pancreatitis following Endoscopic Retrograde Cholangiopancreatography." Digestion 91, no. 1 (2015): 42–45. http://dx.doi.org/10.1159/000368812.

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14

Iwase, Kyoko, Tomoharu Yajima, Hiroshi Serizawa, Satoshi Tsunematsu, Noriaki Watanabe, Naoki Kumagai, Kanji Tsuchimooto, Toshifumi Hibi, and Hiromasa Ishii. "A case of recurrent simple ulcer after ileocecal resection for which endoscopic treatment with spraying of absolute ethanol was effective." Progress of Digestive Endoscopy 62, no. 2 (2003): 126–27. http://dx.doi.org/10.11641/pde.62.2_126.

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Demirci, Salim, and Akira Gohchi. "A comparative study for fiberoptic and video endoscopic determination of the extent in minimal changes of gastric mucosa using indigo dye spraying." Surgical Endoscopy 4, no. 2 (1990): 80–82. http://dx.doi.org/10.1007/bf00591263.

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Tagaito, Yugo, Shiroh Isono, and Takashi Nishino. "Upper Airway Reflexes during a Combination of Propofol and Fentanyl Anesthesia." Anesthesiology 88, no. 6 (June 1, 1998): 1459–66. http://dx.doi.org/10.1097/00000542-199806000-00007.

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Background The effects of intravenous anesthetics on airway protective reflexes have not been fully explored. The purpose of the present study was to characterize respiratory and laryngeal responses to laryngeal irritation during increasing doses of fentanyl under propofol anesthesia. Methods Twenty-two female patients anesthetized with propofol and breathing through the laryngeal mask airway were randomly allocated to three groups: (1) eight patients who received cumulative total doses of 200 microg fentanyl given in the form of two doses of 50 microg and one dose of 100 microg spaced 6 min under mechanical controlled ventilation while end-tidal carbon dioxide tension (PCO2) was maintained at 38 mmHg (fentanyl-controlled ventilation group), (2) eight patients who received cumulative total doses of 200 microg fentanyl while breathing spontaneously while end-tidal PCO2 was allowed to increase spontaneously (fentanyl-spontaneous ventilation group), and (3) six spontaneously breathing patients who were anesthetized with propofol alone (propofol group). The laryngeal mucosa of each patient was stimulated by spraying the cord with distilled water, and the evoked responses were assessed by analyzing the respiratory variables and endoscopic images. Results Before administration of fentanyl, laryngeal stimulation caused vigorous reflex responses, such as expiration reflex spasmodic panting, cough reflex, and apnea with laryngospasm. Increasing doses of fentanyl reduced the incidences of all these responses, except for apnea with laryngospasm, in a dose-related manner in both the fentanyl-controlled ventilation and the fentanyl-spontaneous ventilation groups. Detailed analysis of endoscopic images revealed several characteristics of laryngeal behavior during the airway reflex responses. Conclusion Incremental doses of fentanyl depress airway reflex responses in a dose-related manner, except for apnea with laryngospasm.
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Prabudoss, G. S., and Neha Prashant Shah. "Prospective comparison of conscious nasal versus oral video upper GI endoscopy in adults." International Surgery Journal 6, no. 5 (April 29, 2019): 1505. http://dx.doi.org/10.18203/2349-2902.isj20191872.

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Background: Endoscopy procedures are now becoming a mandate for any upper or lower abdominal conditions in addition to any radiological investigations. Patients have reluctance. It's mainly because of the painful experience they come across during upper GI endoscopy. If pain can be addressed during endoscope then all patients would smile after this procedure. The main objective of the study is to compare nasal endoscopy vs conventional endoscopy in gastrointestinal disorders.Methods: This prospective study was conducted in the department in the department of bariatric and metabolic surgery, Apollo Spectra Hospitals, Chennai. Totally 200 cases were included in the study for the study. Nasal packing was done with xylocaine and oxymetazoline without oral spraying of 10% xylocaine. Oral mouth gag was not inserted in nasal cases. Pain score was primarily used as a scoring method.Results: Comparative study was done for both groups for pain score, gag reflux, nausea, comfort level, voice change, image clarity, intervention procedures, and overall scoring was done. There was a significant advantage in the nasal endoscopy group.Conclusions: More screening endoscopies can be done for a large patient population to diagnose Gastro diseases at an early stage if a painless endoscopy can be offered instead of regular endoscopy hereafter. But however, the endoscopy suite should have regular scope for therapeutic procedures.
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Fujishiro, Mitsuhiro, Michio Kaminishi, Naoki Hiki, Ichiro Oda, Junko Fujisaki, Noriya Uedo, Mitsuru Kaise, et al. "Efficacy of spraying l-menthol solution during endoscopic treatment of early gastric cancer: a phase III, multicenter, randomized, double-blind, placebo-controlled study." Journal of Gastroenterology 49, no. 3 (June 26, 2013): 446–54. http://dx.doi.org/10.1007/s00535-013-0856-4.

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SHARMA, N., A. Virk, O. Nardone, S. Smith, P. Rimmer, U. Shivaji, S. Ghosh, and M. Iacucci. "P296 Quality of reporting of lesions detected at surveillance colonoscopy for IBD." Journal of Crohn's and Colitis 14, Supplement_1 (January 2020): S301—S302. http://dx.doi.org/10.1093/ecco-jcc/jjz203.425.

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Abstract Background International guidelines of ESGE and ASGE have laid out best practice for documentation of lesions at colonoscopy but few performance indicators have been proposed for surveillance colonoscopy in IBD. A recent publication has highlighted the key performance indicators for surveillance colonoscopy.1 We conducted an audit of current quality of colonoscopy reports documenting lesions detected during surveillance colonoscopy. Methods A retrospective analysis of patients who underwent colonoscopy for IBD surveillance over a five year period (2014–2019) at the Queen Elizabeth Hospital, Birmingham, UK was performed. The reports were analysed by independent academic doctors in the gastroenterology division trained in quality of endoscopic report analysis. Optimum criteria for documentation comprised lesion nature (Paris classification), size, documentation of Kudo classification and pit pattern, borders and ulceration. Results A total of 1028 colonoscopies were performed for IBD surveillance and the procedures were standardised with routine dye spraying since 2016. The mean patient age was 47.9 years (SD 16.8). Visual evidence of colonoscopic lesions was recorded in 273 cases. Key performance indicators documented for each endoscopic criterion and lesion nature is noted in the Table. Low-grade dysplasia was detected in 61 patients, and carcinoma in 4 patients; no patient had high-grade dysplasia. Benign lesions such as pseudopolyps were detected in the rest. 7 patients had sessile serrated lesions. Conclusion At IBD surveillance colonoscopy, documentation of lesions is better for the domains of size, Paris classification and Kudo pit pattern, though not perfect. We also highlight that our colonoscopic documentation of borders and presence of ulcerations is done poorly. It is important that comprehensive training is undertaken to improve documentation as it is essential for the proper choice of management of these lesions. Reference
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Sakai, Yuji, Toshio Tsuyuguchi, Takeshi Ishihara, Kazuki Kato, Masaru Tsuboi, Yoshihiko Ooka, Kiyotake Katsuura, et al. "Confirmation of the antispasmodic effect of shakuyaku-kanzo-to (TJ-68), a Chinese herbal medicine, on the duodenal wall by direct spraying during endoscopic retrograde cholangiopancreatography." Journal of Natural Medicines 63, no. 2 (December 3, 2008): 200–203. http://dx.doi.org/10.1007/s11418-008-0304-6.

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Piñero, Ramóne, Regina I. Piñero, Francisco Bruni, and Marcos Sierra. "Sa1673 Histological Gastritis in the Antrum Diagnosed With Endoscopic Magnification Combined With Spraying of 5% Acetic Acid and “Flexible Spectral Imaging Colour Enhancement” (FICE). Preliminary Study." Gastrointestinal Endoscopy 77, no. 5 (May 2013): AB287. http://dx.doi.org/10.1016/j.gie.2013.03.724.

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PIñEro, R. A. MóN E., Regina I. PIñEro, and Marcos Sierra. "Sa1674 Endoscopic Magnification in the Gastric Antrum Combined With Spraying of 5% Acetic Acid and Flexible Spectral Imaging Colour Enhancement (FICE) to Identify Mucosa Pit Pattern." Gastrointestinal Endoscopy 77, no. 5 (May 2013): AB287. http://dx.doi.org/10.1016/j.gie.2013.03.725.

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Romano-Munive, Adriana Fabiola, J. Jesus García-Correa, Luis F. García-Contreras, José Ramírez-García, Luis Uscanga, Varenka J. Barbero-Becerra, Carlos Moctezuma-Velázquez, et al. "Can topical epinephrine application to the papilla prevent pancreatitis after endoscopic retrograde cholangiopancreatography? Results from a double blind, multicentre, placebo controlled, randomised clinical trial." BMJ Open Gastroenterology 8, no. 1 (February 2021): e000562. http://dx.doi.org/10.1136/bmjgast-2020-000562.

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Background and study aimsPost-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is a complication associated with important morbidity, occasional mortality and high costs. Preventive strategies are suboptimal as PEP continues to affect 4% to 9% of patients. Spraying epinephrine on the papilla may decrease oedema and prevent PEP. This study aimed to compare rectal indomethacin plus epinephrine (EI) versus rectal indomethacin plus sterile water (WI) for the prevention of PEP.Patients and methodsThis multicentre randomised controlled trial included patients aged >18 years with an indication for ERCP and naive major papilla. All patients received 100 mg of rectal indomethacin and 10 mL of sterile water or a 1:10 000 epinephrine dilution. Patients were asked about PEP symptoms via telephone 24 hours and 7 days after the procedure. The trial was stopped half way through after a new publication reported an increased incidence of PEP among patients receiving epinephrine.ResultsOf the 3602 patients deemed eligible, 3054 were excluded after screening. The remaining 548 patients were randomised to EI group (n=275) or WI group (n=273). The EI and WI groups had similar baseline characteristics. Patients in the EI group had a similar incidence of PEP to those in the WI group (3.6% (10/275) vs 5.12% (14/273), p=0.41). Pancreatic duct guidewire insertion was identified as a risk factor for PEP (OR 4.38, 95% CI (1.44 to 13.29), p=0.009).ConclusionSpraying epinephrine on the papilla was no more effective than rectal indomethacin alone for the prevention of PEP.Trial registration numberThis study was registered with ClinicalTrials.gov (NCT02959112).
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Morishita, Tetsuo, Toshiaki Kamiya, and Hiromasa Ishii. "Magnifying endoscopy of the duodenum with dye scattering method in a case with celiac disease." Arquivos de Gastroenterologia 40, no. 2 (June 2003): 110–13. http://dx.doi.org/10.1590/s0004-28032003000200009.

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AIM: To know the more detailed findings of the small intestinal mucosa with the use of a magnifying endoscope and a vital dye, and the efficacy of the both tools. PATIENT AND METHODS: A 54-year old female patient with celiac disease. The duodenal mucosa downward as far as the descending portion was observed with a magnifying endoscope (Olympus GIF HM) before and after spraying the mucosa with 0.1% indigo carmine. RESULTS: The endoscopy clarified the atrophy and edema of each villus, and scattering of the dye revealed shorter villi with the relatively longer villi remaining in islands. CONCLUSION: The combination of magnifying endoscopy and the dye scattering method is useful for closer observation of the intestinal mucosa in celiac diseases.
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González-Bernardo, O., S. Vivas, R. de Francisco, I. Pérez-Martínez, A. Castaño-García, V. Jiménez-Beltrán, P. Flórez-Díez, et al. "P299 A prospective randomised trial comparing dye-based chromoendoscopy with electronic virtual chromoendoscopy for detection of colonic neoplastic lesions during IBD surveillance colonoscopy." Journal of Crohn's and Colitis 14, Supplement_1 (January 2020): S302—S303. http://dx.doi.org/10.1093/ecco-jcc/jjz203.428.

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Abstract Background Patients with inflammatory bowel disease (IBD) have an increased risk of colorectal cancer. Dye-based chromoendoscopy (CE) is the currently recommended method for the detection of dysplasia in IBD surveillance colonoscopy; the role of virtual chromoendoscopy (VCE) is not yet well defined. To compare CE with VCE using iSCAN1 digital image enhanced colonoscopy in the detection of colonic neoplastic lesions in IBD patients. Methods Randomised, single-centre trial to assess the detection rate of colonic neoplastic lesions in patients with long-standing IBD. Patients were randomised in two arms: dye-spraying CE using indigo carmine and electronic VCE using iSCAN1 digital image. Detection rates of dysplasia or any neoplastic lesion were compared by the two endoscopic techniques. Results A total of 129 patients were studied (67 by CE and 62 by VCE). Demographic and clinical characteristics were homogeneous in the two groups; 26 Crohn′s disease and 103 ulcerative colitis, 52% women, mean age 50 years, median duration of IBD 204 months, family history of colorectal cancer in 10 (8%), associated primary sclerosing cholangitis in 8 (6%), personal history of colorectal dysplastic lesions in 12 (9%), and more than 50% colonic involvement in 72 (56%). In total, 27 lesions (9 hyperplastic, 8 adenomatous and 10 low-grade dysplasia) were detected in 23 patients, without differences between CE and VCE arms (15 [22%] and 12 [19%] lesions, respectively; p = 0.98); on the other hand, neoplastic lesion (dysplasia or adenoma) detection rates was similar (12 [18%] in CE and 6 [10%] in VCE arms, p = 0.2). The duration of the withdrawal time of colonoscopy in minutes for patients in the CE group was median 14 min and in the VCE group was median 10 min (p < 0.001). Conclusion There is no statistical difference between CE and VCE using iSCAN1 in the detection rate of colonic neoplastic lesions in IBD patients. Surveillance colonoscopy with VCE (iSCAN1) spends less time than conventional CE.
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Takeyama, Tomoaki, Yoshiki Hirooka, Hiroki Kawashima, Eizaburo Ohno, Takuya Ishikawa, Takeshi Yamamura, Kazuhiro Furukawa, et al. "Objective evaluation of blood flow in the small-intestinal villous: quantification of findings from dynamic endoscopy with concomitant narrow-band imaging." Endoscopy International Open 06, no. 08 (August 2018): E941—E949. http://dx.doi.org/10.1055/a-0619-4965.

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Abstract Background and aims We have previously shown that the increase in blood flow volume in jejunum villi after spraying of 10 % dextrose solution correlates with pancreatic exocrine function (PEF). The aim of this study was to establish an objective method to evaluate the amount of jejunum villous blood flow using a novel image analysis system. Patients and methods The subjects were 26 patients who underwent upper gastrointestinal endoscopy with a newly developed small intestine endoscope (SIF-Y0007, Olympus, Tokyo, Japan). By defining the ratio of capillary occupancy in each villus at levels from 1 to 5, villous blood flow was evaluated subjectively on the villous blood flow scale (VBFS). Objective evaluation was performed based on luminance analysis. The morphological opening process was used to make images with leveled brightness. A histogram was prepared from the luminance information and the standard deviation was determined and defined as SDOV (Standard Deviation calculated from a histogram made by luminance analysis Of Villi). PEF was evaluated by measuring the BT-PABA (N-benzoyl-L-tyrosyl-p-aminobenzoic acid) excretion rate. Results There was a significant positive correlation between VBFS and SDOV (P < 0.0001, ρ = 0.5882). SDOV was also positively correlated with PEF (P = 0.0004, ρ = 0.6421). Conclusions SDOV is a new objective index for evaluation of blood flow volume in jejunum villi. SDOV may be useful in clinical practice to estimate PEF and for clarification of the mechanisms underlying the functional correlation between the pancreas and small intestine.
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Masieri, Simonetta, Franco Cavaliere, and Franco Filiaci. "Nasal Obstruction Improvement Induced by Topical Furosemide in Subjects Affected by Perennial Nonallergic Rhinitis." American Journal of Rhinology 11, no. 6 (November 1997): 443–48. http://dx.doi.org/10.2500/105065897780915009.

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Inhaled furosemide decreases bronchial response to several physical and chemical irritants. To evaluate the effect of topical furosemide on nasal resistance in patients affected by perennial nonallergic rhinitis, we studied 12 patients. This diagnosis of perennial nonallergic rhinitis was based on the history of rhinorrhea, sneezing, and nasal obstruction, on anterior rhinoscopy and endoscopy, on negative allergic tests, and on the absence of eosinophilia in nasal secretion. The study was performed on two nonconsecutive days. On the first day, one puff (100 μl) of 0.9% saline was sprayed into both nostrils and nasal resistance was measured by anterior rhinomanometry before the puff and 15 and 30 minutes later. On the second day, one puff (100 μl) of a solution of furosemide (10 mg/mL) was sprayed into both nostrils and nasal resistance was measured before the puff and 15, 30, 45, 60, 90, 120, and 180 minutes later. Initial nasal resistance was abnormally high in all patients on both days. A slight but significant increase was observed after spraying isotonic saline (base: 1.38 ± .69; 15 minutes: 1.47 ± 0.72; 30 minutes: 1.44 ± 0.73); by contrast a marked decrease was observed after spraying the furosemide solution. Nasal resistance was lowest between 30 and 90 minutes after giving furosemide. Then it progressively increased, but values at 180 minutes were still lower than the initial ones (base: 1.43 ± 0.67; 15 minutes: 0.70 ± 0.47; 30 minutes: 0.48 ± 0.24; 45 minutes: 0.49 ± 0.21; 60 minutes: 0.50 ± 0.20; 90 minutes: 0.56 ± 0.23; 120 minutes: 0.62 ± 0.32; 180 minutes: 0.67 ± 0.30). After topical furosemide, all patients had subjective relief of nasal obstruction that lasted more that 12 hours in 9 subjects.
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El-Dallal, Mohammed, Ye Chen, Qianyun Lin, Shana Rakowsky, Lindsey Sattler, Joshua Foromera, Laurie Grossberg, Adam S. Cheifetz, and Joseph D. Feuerstein. "Meta-analysis of Virtual-based Chromoendoscopy Compared With Dye-spraying Chromoendoscopy Standard and High-definition White Light Endoscopy in Patients With Inflammatory Bowel Disease at Increased Risk of Colon Cancer." Inflammatory Bowel Diseases 26, no. 9 (February 8, 2020): 1319–29. http://dx.doi.org/10.1093/ibd/izaa011.

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Abstract Background Patients with inflammatory bowel disease (IBD) have an increased risk of colorectal cancer. We sought to assess the comparative efficacy of virtual chromoendoscopy (VCE) vs high definition white light endoscopy (HDWLE) or dye-spraying chromoendoscopy (DCE) through a meta-analysis and rating the quality of evidence. Methods A systematic review of the literature was performed through February 15, 2019. Primary outcomes were number of patients in whom dysplasia was identified and number of dysplastic lesions identified in these patients. We included only randomized control trials (RCTs) and performed meta-analysis using RevMan5.3. Results Of the 3205 studies identified, 11 RCTs were included, with a total of 1328 patients. Per patient analysis, VCE was not statistically different compared with DCE (risk ratio [RR] 0.77; 95% CI, 0.55–1.08) or HDWLE (RR 0.72; 95% CI, 0.45–1.15). However, per dysplasia analysis, VCE was not statistically different compared with DCE (RR 0.72; 95% CI, 0.47–1.11) and inferior compared with HDWLE (RR 0.62; 95% CI, 0.44–0.88). The quality of evidence was moderate in the HDWLE and low to moderate in the DCE studies. Conclusion Based on this meta-analysis, VCE was as good as HDWLE and DCE in identifying dysplasia per patient analysis. However, per dysplasia analysis, VCE was inferior compared with HDWLE and no different from DCE. Further studies need to examine the efficacy of each individual VCE technique.
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Sedarous, M., I. Balubaid, A. Basden, and A. Rahman. "A242 THE AIR BETWEEN US: A CASE OF PSEUDOCYST PERFORATION POST-ENDOSCOPIC CLIPPING OF A BLEEDING PANCREATIC-COLONIC FISTULA." Journal of the Canadian Association of Gastroenterology 4, Supplement_1 (March 1, 2021): 299–300. http://dx.doi.org/10.1093/jcag/gwab002.240.

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Abstract Background Pancreatic fistula is an uncommon complication of pancreatitis and is associated with increased morbidity. We discuss a case of pancreatic-colonic fistulization followed by the first reported case of pseudocyst perforation post-colonoscopy. Aims Case Methods A 51 year-old female with decompensated alcoholic cirrhosis admitted with hepatic encephalopathy developed large volume hematochezia during admission. Past medical history includes pancreatic pseudocyst, GERD and remote hernia repairs. For the hematochezia, she was investigated with an EGD and colonoscopy. In the distal descending colon, a bleeding lesion was identified and treated with clips and epinephrine injection (Figures 1 and 2). Five hours post-procedure, she developed abdominal distention. CT abdomen pelvis revealed large volume of free air and simple fluid within the abdominal cavity likely secondary to rupture pseudocyst rupture. The previously visualized pseudocyst was filled with gas plastered against the descending colon. She remained medically stable with conservative management. Results Discussion Conclusions Pancreatic-colonic fistula is an uncommon but potentially life-threatening complication of acute pancreatitis associated with high risk of complications. They are found in 4% of admitted inpatients with acute pancreatitis. There are three proposed mechanisms for their development: firstly, inflammation and activated pancreatic lytic enzymes; secondly, pressure necrosis from a contiguous mass; thirdly, localized portal hypertension. Classically, pancreatic-colonic fistulas present with diarrhea, fever and hematochezia. Gastrointestinal bleeding occurs in 60% of cases. The source of bleed has been described to be originating most commonly from the splenic artery and to a lesser extent, the margin of the fistula or, rarely, erosion of splenic parenchyma. Reported therapeutic management strategies include: hemoclippings and Greenplast sprayings, endoscopic pancreatic stent, transgastric nasocystic drainage catheter placements, injection of N-butyl-2-cyanocrylate and transpapillary nasopancreatic drainage. Pseudocysts arise in 25% of patients with chronic pancreatitis. Pseudocysts may regress through a variety of mechanisms: spontaneously after inflammation from pancreatitis resolves, natural drainage through the pancreatic duct into the duodenum, or through a complicating fistulous tract connecting to the gastrointestinal tract. Rarely, the pseudocyst can resolve as it leaks or perforates into the abdominal cavity. Pancreatic pseudocysts may perforate spontaneously into the free peritoneal cavity, stomach, duodenum, colon, portal vein, pleural cavity, or through the abdominal wall. We report the first case, to our knowledge, of pancreatic pseudocyst perforation post-clipping of bleeding pancreatic-colonic fistula. Funding Agencies None
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Kagemoto, Kaizo, Koichi Okamoto, Toshi Takaoka, Yasushi Sato, Shinji Kitamura, Tetsuo Kimura, Masahiro Sogabe, et al. "Detection of aberrant crypt foci with image-enhanced endoscopy." Endoscopy International Open 06, no. 08 (August 2018): E924—E933. http://dx.doi.org/10.1055/a-0621-8794.

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Abstract Background and study aims Conventional detection of aberrant crypt foci (ACF) with dye-spraying and magnifying observation is labor- and skill-intensive. We performed a prospective non-inferiority study to investigate the utility of image-enhanced endoscopy (IEE) for detection of ACF. Patients and methods Patients with a history of colorectal neoplasm were eligible. The number of ACF in the lower rectum was counted first using IEE magnification with narrow-band imaging (NBI) or blue-laser imaging (BLI), and subsequently using the methylene blue method. The primary endpoint was the ACF detection rate with IEE, i. e., the number of ACF detected with IEE relative to the number of ACF detected with methylene blue. The secondary endpoints were bowel preparation time, ACF detection time, and the detection rate with NBI or BLI. Results A total of 40 patients were enrolled (NBI 20 and BLI 20). The overall detection rate for ACF with IEE was 81.7 % (503/616; 95 %CI 78.8 – 84.6 %), meeting the primary endpoint. The detection rate for ACF with BLI (84.9 %, 258/304) was significantly higher than with NBI (78.5 %, 245/312; P < 0.05). Both bowel preparation time and ACF detection time were significantly shorter with IEE versus the methylene blue method (P < 0.01, respectively). The detection rates for dysplastic and non-dysplastic ACF with IEE were 84.4 % (27/32) and 80.3 % (469/584), respectively. Conclusion IEE is able to detect ACF during colonoscopy with sensitivity non-inferior to that of the conventional methylene blue method. IEE is simpler than the methylene blue method and is therefore a potentially useful new tool for ACF detection.
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Patel, Rajan, Louis Tapper, Holly Lyne, Saadiq Moledina, Rigers Cama, and Kalpesh Besherdas. "P010 FIRST SURVEILLANCE COLONOSCOPY FOR INFLAMMATORY BOWEL DISEASE – ARE WE GETTING IT RIGHT FROM THE START?" Inflammatory Bowel Diseases 26, Supplement_1 (January 2020): S49—S50. http://dx.doi.org/10.1093/ibd/zaa010.125.

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Abstract Background Surveillance for colorectal cancer (CRC) is necessary in patients with inflammatory bowel disease (IBD). Patients with ulcerative colitis (UC) have a similar CRC risk to those with Crohn’s colitis (CC). British Society of Gastroenterology (BSG) guidelines from 2010 outlined recommendations for screening including surveillance intervals and pancolonic dye spraying with targeted biopsies. We aimed to identify reasons why the first surveillance colonoscopy is not being performed as advised, including the role of poor bowel preparation and disease activity. Methods Retrospective study of all IBD colonoscopies over a 7 year period (2011–2018) across two sites at a tertiary London based hospital trust. 214 patients were identified and exclusion criterion was applied (not first surveillance/diagnosis prior to year 2000/PSC/inadequate data). 93 patients were included for analysis. Results 26 (28.0%) surveillance colonoscopies were performed prior to 10 years of diagnosis (ie. before BSG guideline recommendation). 22 (23.7%) surveillance colonoscopies performed after the recommended interval. Dye spray was performed in only 2 patients (2%). Reasons cited for not dying were only given in 4 (4.3%) cases, and included poor bowel prep or active disease. No reason was given in 87 (93%) cases. Targeted biopsies were performed in 24 (25.8%) patients, with random biopsies in 56 (60.2%) patients. Conclusion The first IBD surveillance colonoscopy is only being performed at the correct time interval in approximately 50% of cases with over a quarter being performed too soon and almost a quarter being performed too late. Pan-colonic dye spray is used in only 2% and targeted biopsies are taken in only 1 in 4 patients. Poor bowel preparation and disease activity do not appear to be limiting factors in the use of dye spray. We conclude that appropriate initial colitis surveillance is not being performed in the majority despite published guidelines. Organisational factors such as sufficient time allocated to dye spray colonoscopy, along with endoscopist skill, may be contributing factors.
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Lee, Yeontaek, Yong-Woo Chung, Jaeho Park, Kijun Park, Youngmin Seo, Seung-No Hong, Seung Hoon Lee, Hojeong Jeon, and Jungmok Seo. "Lubricant-infused directly engraved nano-microstructures for mechanically durable endoscope lens with anti-biofouling and anti-fogging properties." Scientific Reports 10, no. 1 (October 15, 2020). http://dx.doi.org/10.1038/s41598-020-74517-8.

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Abstract While a clear operating field during endoscopy is essential for accurate diagnosis and effective surgery, fogging or biofouling of the lens can cause loss of visibility during these procedures. Conventional cleaning methods such as the use of an irrigation unit, anti-fogging surfactant, or particle-based porous coatings infused with lubricants have been used but proven insufficient to prevent loss of visibility. Herein, a mechanically robust anti-fogging and anti-biofouling endoscope lens was developed by forming a lubricant-infused directly engraved nano-/micro-structured surface (LIDENS) on the lens. This structure was directly engraved onto the lens via line-by-line ablation with a femtosecond laser. This directly engraved nano/microstructure provides LIDENS lenses with superior mechanical robustness compared to lenses with conventional particle-based coatings, enabling the maintenance of clear visibility throughout typical procedures. The LIDENS lens was chemically modified with a fluorinated self-assembled monolayer (F-SAM) followed by infusion of medical-grade perfluorocarbon lubricants. This provides the lens with high transparency (> 70%) along with superior and long-lasting repellency towards various liquids. This excellent liquid repellency was also shown to be maintained during blood dipping, spraying, and droplet condensation experiments. We believe that endoscopic lenses with the LIDENS offer excellent benefits to endoscopic surgery by securing clear visibility for stable operation.
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Feng, Ji, Shixue Xu, Xiaozhong Guo, and Xingshun Qi. "Ectopic Embolism after Endoscopic Glue Injection." International Journal of Gastroenterology and Hepatology Diseases 01 (June 28, 2021). http://dx.doi.org/10.2174/2666290601666210628161946.

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: A 55-year-old male with a 7-year history of liver cirrhosis was admitted to our department due to recurrent hematemesis and melena. He had been treated with endoscopic tissue glue injection and/or band ligation for gastroesophageal variceal bleeding. He denied any history of viral hepatitis infection or alcohol abuse. At this admission, his pulse rate was 88b.p.m., and blood pressure was 110/51mmHg. Hemoglobin concentration was 81g/L, platelet count was 38X109/L, total bilirubin was 28.4umol/L, and albumin was 24.2g/L. Except for ascites, splenomegaly, and portal vein thrombosis, contrast-enhanced computed tomography scans showed high density within gastric fundal varices, gastro-renal shunt, left renal vein, and inferior vena cava (arrows), suggesting a diagnosis of ectopic embolism from tissue glue injected during a prior endoscopic procedure. Upper gastrointestinal endoscopy demonstrated esophageal varices, post-endoscopic gastric fundal glue removal, and portal hypertensive gastropathy. Esophageal variceal ligation was performed. After that, he was discharged without any other complaints. Currently, endoscopic variceal therapy, mainly including variceal band ligation, sclerotherapy, glue injection, and haemostatic powder spraying is the mainstay treatment option of acute variceal bleeding in liver cirrhosis [1]. There is a benefit of endoscopic glue injection for gastric fundal variceal bleeding in terms of increasing the rate of initial hemostasis and reducing the rate of rebleeding as compared to variceal band ligation [2-3]. Therefore, endoscopic glue injection has been widely employed in cirrhotic patients with gastric variceal bleeding. However, there are some severe complications related to endoscopic glue injection [4-5], especially thromboembolism. The current case further showed a possibility of asymptomatic ectopic embolism after endoscopic glue injection, suggesting that a close surveillance of embolism within portosystemic collateral vessels should be necessary.
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GERÇEKER, Emre, Serkan CERRAH, Ahmet Ramiz BAYKAN, and Hakan YÜCEYAR. "Evaluation of direct epinephrine injection into the major papilla in the prevention of post ERCP pancreatitis." Akademik Gastroenteroloji Dergisi, August 25, 2022. http://dx.doi.org/10.17941/agd.1136078.

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Background and Aims: Acute pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography, and has remarkable rates of morbidity and mortality. The aim of this study is to investigate the effect of local epinephrine administration alone in reducing the frequency and severity of post-endoscopic retrograde cholangiopancreatography pancreatitis. Materials and Methods: The data of 979 patients who underwent endoscopic retrograde cholangiopancreatography were evaluated retrospectively. Age, gender, indications for endoscopic retrograde cholangiopancreatography procedure, technique, conditions that increase the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis, presence of post-endoscopic retrograde cholangiopancreatography pancreatitis and it’s severity, serum amylase, leukocyte and C-reactive protein levels (before and after endoscopic retrograde cholangiopancreatography) were recorded. The data were compared between two groups as 473 patients who received only local epinephrine prophylaxis and 506 patients that did not. Results: Post-endoscopic retrograde cholangiopancreatography pancreatitis rate was 6.8% in all patients and 13.6% in patients with high risk. Post-endoscopic retrograde cholangiopancreatography pancreatitis was observed less frequently in the group that received local epinephrine prophylaxis when compared to the group that did not (9.1% vs 4.4%; p = 0.004). Post-endoscopic retrograde cholangiopancreatography amylase, leukocyte and C-reactive protein levels were significantly lower in the epinephrine group when compared to the null group (p = 0.001, p = 0.004, p = 0.001). Less severe and moderate pancreatitis was observed in the epinephrine group (p = 0.003). Local epinephrine irrigation was observed to reduce the rate of post-endoscopic retrograde cholangiopancreatography pancreatitis in patients with high risk (18.9% vs 7.9%; p = 0.002). Conclusion: Epinephrine irrigation with direct spraying method to major papillae is an easy-to-apply, safe and promising method in prevention of post- endoscopic retrograde cholangiopancreatography pancreatitis. Further studies with large populations are needed to investigate its effectiveness.
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35

Bojarski, Christian, Maximilian Waldner, Timo Rath, Sebastian Schürmann, Markus F. Neurath, Raja Atreya, and Britta Siegmund. "Innovative Diagnostic Endoscopy in Inflammatory Bowel Diseases: From High-Definition to Molecular Endoscopy." Frontiers in Medicine 8 (July 21, 2021). http://dx.doi.org/10.3389/fmed.2021.655404.

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High-definition endoscopy is one essential step in the initial diagnosis of inflammatory bowel disease (IBD) characterizing the extent and severity of inflammation, as well as discriminating ulcerative colitis (UC) from Crohn's disease (CD). Following general recommendations and national guidelines, individual risk stratification should define the appropriate surveillance strategy, biopsy protocol and frequency of endoscopies. Beside high-definition videoendoscopy the application of dyes applied via a spraying catheter is of additional diagnostic value with a higher detection rate of intraepithelial neoplasia (IEN). Virtual chromoendoscopy techniques (NBI, FICE, I-scan, BLI) should not be recommended as a single surveillance strategy in IBD, although newer data suggest a higher comparability to dye-based chromoendoscopy than previously assumed. First results of oral methylene blue formulation are promising for improving the acceptance rate of classical chromoendoscopy. Confocal laser endomicroscopy (CLE) is still an experimental but highly innovative endoscopic procedure with the potential to contribute to the detection of dysplastic lesions. Molecular endoscopy in IBD has taken application of CLE to a higher level and allows topical application of labeled probes, mainly antibodies, against specific target structures expressed in the tissue to predict response or failure to biological therapies. First pre-clinical and in vivo data from label-free multiphoton microscopy (MPM) are now available to characterize mucosal and submucosal inflammation on endoscopy in more detail. These new techniques now have opened the door to individualized and highly specific molecular imaging in IBD in the future and pave the path to personalized medicine approaches. The quality of evidence was stated according to the Oxford Center of evidence-based medicine (March 2009). For this review a Medline search up to January 2021 was performed using the words “inflammatory bowel disease,” “ulcerative colitis,” “crohn's disease,” “chromoendoscopy,” “high-definition endoscopy,” “confocal laser endomicroscopy,” “confocal laser microscopy,” “molecular imaging,” “multiphoton microscopy.”
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Herz, Marion, Andreas Rank, Güenter E. M. Tovar, Thomas Hirth, Dominik Kaltenbacher, Jan Stallkamp, and Achim Weber. "In vitro study of mouse fibroblast tumor cells with TNF coated and Alexa488 marked silica nanoparticles with an endoscopic device for real time cancer visualization." MRS Proceedings 1190 (2009). http://dx.doi.org/10.1557/proc-1190-nn11-23.

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AbstractTumor resection done by minimally invasive procedure owns the challenge of a fast and reliable differentiation between healthy and tumorous tissue. We aim at investigating and developing a method for an intraoperative visualization of tumor cells with functionalized nanoparticles. The goal is to use this technique for the intraoperative use. Our so-called biohybrid systems consist of nanoparticles that are produced by Stöber synthesis and coupled with bio active proteins. Such biomimetic nanostructures are capable of imitating the effects of membrane-bound cytokines, which bind to tumor cells for labeling them. A flexible and modular test environment has been developed to evaluate the spraying properties of the particles and to study tissue probes. It enables a fast investigation of different particle configurations and spraying parameters like pressure, spray volume, nozzle geometry, etc.
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Ikenoyama, Yohei, Kyosuke Tanaka, Yuhei Umeda, Yasuhiko Hamada, Hiroki Yukimoto, Reiko Yamada, Junya Tsuboi, et al. "Effect of Adding Acetic Acid When Performing Magnifying Endoscopy with Narrow Band Imaging for Diagnosis of Barrett’s Esophageal Adenocarcinoma." Endoscopy International Open, September 21, 2022. http://dx.doi.org/10.1055/a-1948-2910.

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Background and Study Aims: Magnifying endoscopy with narrow band imaging (M-NBI) was developed to diagnose Barrett’s esophageal adenocarcinoma (BEA); however, this method remains challenging for inexperienced endoscopists. We aimed to evaluate a modified M-NBI technique that included spraying acetic acid (M-AANBI). Patients and Methods: Eight endoscopists retrospectively examined 456 endoscopic images obtained from 28 patients with 29 endoscopically resected BEA lesions using three validation schemes: Validation 1 (260 images), wherein the diagnostic performances of M-NBI and M-AANBI were compared—the dataset included 65 images each of BEA and non-neoplastic Barrett’s esophagus (NNBE) obtained using each modality; validation 2 (112 images), wherein 56 pairs of M-NBI and M-AANBI images were prepared from the same BEA and NNBE lesions, and diagnoses derived using M-NBI alone were compared to those obtained using both M-NBI and M-AANBI; and validation 3 (84 images), wherein the ease of identifying the BEA demarcation line (DL) was scored via a visual analog scale in 28 patients using magnifying endoscopy with white-light imaging (M-WLI), M-NBI, and M-AANBI. Results: For validation 1, M-AANBI was superior to M-NBI in terms of sensitivity (90.8% vs. 64.6%), specificity (98.5% vs. 76.9%), and accuracy (94.6% vs. 70.4%) (all P<0.05). For validation 2, the accuracy of M-NBI alone was significantly improved when combined with M-AANBI (from 70.5% to 89.3%; P<0.05). For validation 3, M-AANBI had the highest mean score for ease of DL recognition (8.75) compared to M-WLI (3.63) and M-NBI (6.25) (all P<0.001). Conclusion: Using M-AANBI might improve the accuracy of BEA diagnosis.
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38

Lui, Ka Yin, and Changjie Cai. "Abernethy malformation." Journal of Clinical Images and Medical Case Reports 3, no. 6 (June 28, 2022). http://dx.doi.org/10.52768/2766-7820/1914.

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A 59-years-old woman presented to the emergency department with sudden onset of intermittent hematemesis and melena. The patient had a history of stage IV cervical cancer, sigmoid colostomy (because of rectovaginal fistula). A complete blood count showed normocytic anemia (79 g/l) and other laboratory evaluation showed the elevation of ammonia (38 µmol/l). The total bilirubin, transaminase and creatinine level were normal. Upper endoscopy revealed hemorrhage of esophageal varices that was stopped by local treatment with the combinations of spraying hemostatic and sclerotherapy (Figure 1). The CT-scan revealed no cirrhosis and liver lesion but did 10 show the absence of the portal vein with a complete extrahepatic shunt of the portal blood, considered Abernethy Malformation Ib (Figure 2,3), determined to be the possible reason of esophageal varices and megalosplenia. The old patient suffered from first-onset gastrointestinal bleeding and was diagnosed the only curative treatment is liver transplantation. This patient was stopped bleeding and transferred to cancer center for tumor therapy.
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Li, Wei, Mingming Xiao, Yujia Chen, Jiaxing Yang, Donghui Sun, Jian Suo, and Daguang Wang. "Serious postoperative complications induced by medical glue: three case reports." BMC Gastroenterology 19, no. 1 (December 2019). http://dx.doi.org/10.1186/s12876-019-1142-6.

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Abstract Background Various types of medical glues/adhesives/topical coagulants’ (referred to as MG hereinafter) have widespread application as surgical adhesives, and have been shown to be safe and effective for a broad range of usage, such as in hemostasis, reinforcement of intestinal anastomoses or sites of potential fluid leakage, adhesion of two surfaces, wound closure, and vascular embolization. However, inappropriate application of MG may sometimes lead to serious complications. Herein, we describe three cases of serious postoperative complications induced by a possible inappropriate use of N-butyl-2-cyanoacrylate MG (NBCA MG). Case presentation Three patients presented with abdominal pain (chronic pain in cases 1 and 2, and acute pain in Case 3), hematochezia (Case 2), and intestinal obstruction (Case 3). All patients had a history of abdominal surgery and intraoperative use of NBCA MG. Abdominal computed tomography and gastroenterological endoscopy revealed foreign bodies (solidified MG in cases 1 and 2) and intestinal obstruction related to a mass of residual non-absorbed MG causing an internal hernia from a dense adhesion (Case 3). All patients underwent exploratory laparotomy, which revealed duodenal perforation, colonic erosion, and an internal hernia, all of which was related to MG use. We undertook removal of the foreign bodies (cases 1 and 2), surgical closure of the site of duodenal erosion (Case 1), partial colectomy (Case 2), and partial enterectomy (Case 3). Conclusion Inappropriate application of MG may induce serious complications. We emphasize the importance of careful evaluation of the indications, dosage, and spraying thickness of MG in clinical practice. Serious complications caused by inappropriate application of MG should be reported to raise awareness in the surgical fraternity.
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