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Biomedical subjects

M Achiam

Publications and source records attributed to M Achiam.

3 recordsLinked to original sources

[Quality of colonoscopy and surgical treatment of perforations].

INTRODUCTION: Perforation during colonoscopy is a well-known complication. The purpose of our study was to evaluate the incidence of acute surgical intervention due to colonic perforations during endoscopy at our department, and evaluate the rate of incomplete examinations. METHODS: The latest 4000 colonoscopies performed at Hvidovre Hospital were examined for possible complications and success rate. RESULTS: Seventeen percent of the colonoscopies were incomplete, mostly due to anatomical difficulties, incomplete bowel preparation, and pain. Twelve (0.3%) of the 4000 patients were operated on due to perforation which occurred during the examination. The mortality rate in these 12 patients was 17% and the survivors had a median hospital stay of eight days. DISCUSSION: Future strategy should focus on improving the quality of colonoscopy, thereby increasing the success rate and lowering patient discomfort. Furthermore, the new non-invasive modalities virtual colonoscopy (CT or MRI) should be developed further so that they might substitute all the diagnostic colonoscopies.

Aged↗

[Transnasal gastroscopy].

The use of transnasal endoscopy has not been reported earlier in Denmark. This study describes the preliminary experiences with transnasal gastroscopy using the Olympus XGIF-N200 prototype. Patients scheduled for diagnostic gastroscopy were examined transnasally. The patients answered questions regarding anxiety and discomfort, and the endoscopist commented on the quality of the procedure. Of sixty patients included, 56 (93%) were examined transnasally. Two patients did not have nasal passage and were examined orally, and two patients were examined with standard gastroscope because of technical difficulties. Sixty-eight percent of the procedures were unsedated, 55% of the patients did not experience gag-reflexes. The procedure was described by most patients as "slightly uncomfortable". Twenty-five percent had uncomplicated epistaxis. Pulse rate and saturation levels were stable. Transnasal gastroscopy seems to be well tolerated by the patients, as both subjective and objective criteria were better than those for conventional gastroscopy.

Gastroscopes↗

Transnasal gastroscopy.

INTRODUCTION: The use of transnasal gastroscopy (TNG) has not previously been described in a Danish hospital. The method seems to be better tolerated compared with conventional oral gastroscopy. METHODOLOGY: Patients scheduled for diagnostic gastroscopy were included, and examined with a thin endoscope transnasally (Olympus XGIF-N200 prototype, diameter 6 mm). RESULTS: Sixty patients were included, and transnasal gastroscopy was possible in 56 patients (93%). Two patients were examined transorally, as there were no passage through the nose. One patient had fluid retention in the stomach, and in another patient the endoscope looped continuously in the esophagus, preventing introduction into the stomach. The quality in 48 examinations (80%) was satisfactory. Unsedated examination was possible with 38 patients (68%), and 55% of patients did not have gag-reflexes or nausea. The unpleasantness of TNG was rated on a scale from 1 to 4, and the median score was 2 (slightly unpleasant). TNG would be the method of choice in 88% of patients, if they should undergo another gastroscopy in the future. Fifteen patients had uncomplicated epistaxis as the only complication. Pulse rate and oxygen saturation values were stable during the TNG examinations. CONCLUSION: TNG with a thin endoscope seems to be well tolerated by the patients, this is supported by the subjective experience of the patients, and also by the stable values of oxygen saturation and heart rate during the examinations.

Adult↗