[Ethical and medicolegal problems in digestive endoscopy].
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The linear ultrasound probe should be viewed as an adjunct to conventional endoscopic ultrasonography with combined ultrasound endoscopes. It certainly does not replace these instruments for staging neoplasms and imaging extraintestinal organs such as the pancreas. It can be a simpler alternative to these instruments when applied at the time of endoscopy to obtain more information about wall thickness and the cause of an intramural mass. It can add information when used to image within impassable malignant strictures. Further development of the linear probes with the addition of a balloon over the transducer and the advent of new probes that utilize other scanning mechanisms is anticipated and should make this imaging system even more useful.
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The aims are to present a uniform terminology (terms), which can be suitably used throughout the world for enumeration of characteristics by which an item can be identified and distinguished. Nomenclature is a list of terms classified in a logical system. Description must be as objective as possible and the terms used must be specific for the method. Terminology, definitions, and diagnostic criteria in digestive endoscopy have been published in several languages.
A postoperative biliary fistula is a rare but severe complication of biliary surgery. Clinical signs, ultrasound and ERC lead to the diagnosis. Within three years, 37 patients with postoperative bile duct fistulas after cholecystectomy underwent endoscopic therapy. In all patients the biliary fistula healed completely within seven days after insertion of a nasobiliary tube. The nasobiliary tube for postoperative biliary fistulas offers regular radiological controls and reduces the necessity of operative reinterventions on the biliary system.
As endoscopy of the upper gastrointestinal tract becomes available to more and more physicians, questions may arise about its use. For example, what is the endoscopic approach to gastrointestinal bleeding? When is endoscopic follow-up useful? In this article, Dr Sivak describes the indications for upper gastrointestinal endoscopy, pointing out its advantages and limitations in each of six broad categories.
40 patients were examined by peroral endoscopic ultrasonography with two new prototypes (Prototype II and III, Olympus Optical Co., Tokyo, Japan). Indications were given by various intestinal diseases. Topographical orientation could be difficult, but was facilitated by standard positions of the instrument. The organs identified included liver, gallbladder, common bile duct, pancreas, spleen and kidneys. Pathological lesions of the mentioned organs were characterized by the reflex pattern known from external ultrasonography. Up till now endoscopic sonography is not a routine method but may give additional information to peroral endoscopy and external ultrasonography without replacing these methods.
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The purpose of this study was to evaluate two methods of obtaining culture material under direct visualization through a fiberoptic upper gastrointestinal endoscope. Collections were made both with a wash pipe and a sterile brush through a sterilized Olympus D panendoscope. Paired aspirate collections were made on 20 occasions from 10 postgastrectomy and six nonoperated patients. Significant bacterial overgrowth was identified equally well by both methods, the the wash tube, which can be reused, is cheaper. The endoscopic method for collecting proximal fluid for culture is simple and can be performed during a routine endoscopy.
PURPOSE: To attempt to quantify the potential for success of tele-endoscopy as a component of the VTMEDNET Plus telemedicine implementation, a multi-part prospective study was undertaken by faculty of the Vermont Initiative for Rural Health Informatics and Telemedicine. METHOD: The study was comprised of three separate parts, evaluation of image quality, cost analysis, and identification of referring providers needs and attitudes regarding tele-endoscopy. FINDINGS: The image quality was satisfactory to support remote diagnosis in most cases; there was significant cost savings in a managed care environment; referring providers were generally positive about the attributes of tele-endoscopy. CONCLUSION: Tele-endoscopy is a viable and cost-effective component within a telemedicine system.
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