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At least 199 records · Page 11Linked to original sources
PubMed1996

Complications of upper gastrointestinal endoscopy.

Complications of upper gastrointestinal endoscopy are uncommon. Approximately one complication occurs with every 1000 procedures. The mortality rate is estimated to be between 0.5 and 3 per 10,000 cases. Cardiopulmonary events comprise 50% of all major complications, and most of these events result from the medications used for conscious sedation. Diagnosis, treatment, and prevention of common complications are discussed; rare complications are mentioned.

Endoscopy, Digestive System↗
PubMed1996

Complications of pediatric endoscopy.

In pediatric patients, UGI endoscopy and colonoscopy may provide essential information for diagnosis and management. Diagnostic endoscopic procedures generally are safe with a rate of less than 1% of serious complications. Therapeutic procedures carry higher rates of complications, but usually are also accomplished without problems. The rarity of complications creates a unique situation: many endoscopists encounter problems infrequently. Their personal experience is limited. When evaluating a patient for a potentially serious complication, the endoscopist struggles with maintaining objectivity and clear judgment. The responsible physician re-examines and re-evaluates the preceding events: Were risks explained clearly? Were correct decisions made during the procedure? Were early problems overlooked? Simultaneously, the physician endeavors to discern the seriousness of the patient's apparent problem and to design appropriate intervention. Dealing with these multiple issues may impair decision-making. In these trying situations, experienced colleagues and consultants can provide invaluable advice and counsel. Each physician must recognize situations in which soliciting help represents a critical initial step in the process of correcting or treating the complication. Optimal patient care results from review of the procedural details, assessment of the patient's current status, discussion of potential interventions, and evaluation of the effectiveness of interventions with trusted and experienced colleagues. The knowledge of who and when to call for support and guidance provides a final measure of insurance for minimizing the risk of procedure-related complications.

Biopsy↗
PubMed1996

[Intraoperative abdominal echography].

Experience with and the impressions of adopting intraoperative abdominal echography in eighteen patients, aged 26 to 73 years, 9 men and 9 women, are shared. The distribution of patients by pattern of diseases is as follows: colorectal carcinoma--4 cases, liver echinococcus--one, gastric carcinoma--one, hepatocellular carcinoma--one, cholangitis acuta purulenta-one, echinococcus of lung and liver--one, calculous cholecystitis with choledocholithiasis--five, and carcinoma of ductus choledochus--one. Fifty intraoperative abdominal echographies and one intrathoracic supradiaphragmatic echography of the liver are performed. Intraoperative abdominal echography of tumors involving organs of the digestive tract contributes to specify the staging of the neoplastic process. In liver echinococcus it determines precisely the number of cysts and diagnoses impalpable cystic formations, while in choledocholithiasis it documents the presence of calculi in the biliary tracts and eventual dilatation of intrahepatic ones. In five patients intraoperative abdominal echographic is done in conjunction with intraoperative fiber choledochoscopy.

Abdomen↗
PubMed1997

Endoscopic ultrasonography: a new diagnostic imaging modality.

Endoscopic ultrasonography uses high-frequency ultrasound to visualize the gut wall and the surrounding structures of the mediastinum, the abdomen and the pelvis. Echoendoscopes are available in two different designs. A radial scanning echoendoscope produces a 360 degree real-time view perpendicular to the shaft of the echoendoscope. A linear-array instrument produces a 100 degrees real-time view parallel to the shaft of the echoendoscope, permitting direct ultrasonographic guidance of fine needles exiting the biopsy channel. Endoscopic ultrasonography has been established as the preferred diagnostic tool for the evaluation of submucosal masses of the upper gastrointestinal tract and the rectosigmoid, for differentiating benign from pathologic thickened gastric folds and for locating pancreatic endocrine tumors. The widest application of endoscopic ultrasonography is in the diagnosis and staging of esophageal, gastric, rectal and pancreaticobiliary neoplasms. Endosonography is the most accurate modality available for determining the T and N stages of these tumors. The recent development of endoscopic ultrasound-guided fine-needle aspiration provides physicians with the ability to cytologically diagnose lesions visualized endosonographically and to confirm cancer staging with tissue.

Algorithms↗
PubMedDate not supplied

[The efficacy of the early diagnosis of digestive tract diseases in flight personnel].

In the Air Force, the alimentary canal (AC) morbidity in flying personnel (FP) ranks second among diseases of the internal organs, as evidenced by epidemiologic studies over six years (1988-1993). Data are submitted of examination of 1438 individuals (pilots, navigators, other aircrew members) under conditions of the flight-surgeon's appraisal division. Procedures of active fibroesophagogastroduodenoscopy permit early detection of AC disorders. 18.7-50% of FP presenting with AC disorders displayed Helicobacter pylori, as per histologic sections of biopsies from mucosa of the pyloric portion of the stomach. To the authors' thinking, AC disorders in FP may result from exposure to (stress, in-flight emergency) factors of flight.

Adult↗
PubMed1989

Surgical endoscopy.

Explore the source record for details and available documents.

Digestive System Surgical Procedures↗
PubMed2006

Management of pancreatic endocrine tumors in multiple endocrine neoplasia type 1.

INTRODUCTION: Pancreatic endocrine tumors (PETs) occur in at least 50% of patients with multiple endocrine neoplasia type 1 (MEN1) and are the leading cause of disease-specific mortality. However, the timing and extent of surgery for MEN1-related PETs is controversial owing to the indolent tumor growth seen in most patients and the desire to avoid complications associated with insulin dependence. To help resolve this controversy, we retrospectively analyzed the clinical characteristics, surgical treatment, and clinical outcome of patients with MEN1-related PETs. METHODS: All patients had histologic or radiographic confirmation of a PET in the setting of MEN1. Disease progression was defined radiographically as the development of new pancreatic tumors or distant metastases. Progression-free survival (PFS) and overall survival (OS) were used as the endpoints of this analysis. RESULTS: We identified 98 patients with MEN1, 55 (56%) of whom had PETs, including 27 women and 28 men with a median age of 37 years (range 8-69 years) at the time of diagnosis. Functioning PETs were present in 35 (64%) of 55 patients, and nonfunctioning tumors were present in 20 (36%). Pancreatic surgery was performed in 38 (69%) of the 55 patients; and the first operation included enucleation (n = 4), total pancreatectomy (n = 3), Whipple procedure (n = 4), and distal pancreatectomy (n = 27). The median size of the resected tumors was 2.8 cm (range 0.6-11.0 cm). Recurrent disease developed in the residual pancreas in 7 (20%) of 35 at-risk patients a median of 7.8 years after the first operation, and distant metastases occurred in 5 (14 %) of 36 surgically treated patients without distant metastasis (2 patients had distant metastases when surgery on the primary tumor was performed) at a median of 2.7 years following surgery. At last follow-up, 16 (29%) of 55 patients with PETs had died, 12 (22%) were alive with disease, 26 (47%) were alive without evidence of disease, and 1 (2%) was lost to follow-up. The median OS was 19.5 years (range 13-26 years) and was significantly longer for patients who had functioning PETs versus those with nonfunctioning tumors (P = 0.0007), for patients who underwent surgical resection of their PETs versus those who did not (P = 0.0043), and for patients with localized versus metastatic PETs at the time of diagnosis (P < 0.0001). Multivariate analysis revealed that younger age, hormonal function, and PET resection were independently associated with longer OS. CONCLUSIONS: Our data suggest that early diagnosis and surgical excision of MEN1-related PETs improves survival. However, translating these data into a surveillance strategy for the early detection of PETs is complex owing to the potential morbidity of pancreatic resection and the risk of long-term insulin dependence.

Adolescent↗