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At least 55 records · Page 3Linked to original sources

PubMed1976

Upper gastrointestinal endoscopy in surgical practice.

The use of fiberoptic endoscopy provides an accurate diagnosis in more than 90% of patients with lesions in the oesophagus, stomach and proximal duodenum. It is, however, an expensive and time-consuming investigation and is not always necessary when a satisfactory diagnosis has been made after radiological examination. Groups of patients have now been identified in which endoscopy is of particular value to the surgeon. When there is doubt about the diagnosis after radiological examination, particularly regarding the malignancy of a gastric ulcer, when an upper gastrointestinal haemorrhage occurs, when postgastrectomy patients present with symptoms, and when persistent symptoms occur in the absence of radiological findings, endoscopy is mandatory for an accurate diagnosis to be achieved and rational treatment instituted.

Dyspepsia↗

PubMed1978

[Gastroenterological endoscopy--fascination and obligation (author's transl)].

The development of fiber endoscopy has made possible routine endoscopic bioptic examination of the upper (including the duodenum) and lower digestive tract (with the terminal ileum). Biopsy material can be obtained in the necessary quantities with forceps or a loop. In many centers endoscopy is already the basic method for the diagnosis of diseases of the upper digestive tract. A similar tendency is also becoming apparent in colo-ileoscopy. The increase in the frequency of endoscopic investigations is accompanied by a decrease in the number of complications. The increasing importance and dissemination of gastrointestinal fiber endoscopy demands greater and better training facilities and adequate control of qualifications together with an integrated cooperation with the pathologists.

Biopsy↗

PubMed1976

An acrylic dental protector in peroral endoscopy.

A simple acrylic dental prosthesis is described which achieves successful dental protection during peroral endoscopy. This prosthesis is not advocated for all cases, but certainly is well warranted for those patients whose upper dentition is at risk during endoscopy because of the prominence of the incisors, the presence of loose teeth, or with extensive restorative work. In present experience, approximately 10 per cent of patients undergoing endoscopy have such an acrylic prosthesis prepared pre-operatively. The commercially available flexible plastic dental guard is used in approximately 25 per cent of cases, and the remaining cases need no specific attention. It is felt that this prosthesis could be constructed by any dentist conversant with the technique.

Acrylic Resins↗

PubMed1976

Upper gastrointestinal endoscopy in the pediatric patient.

The value of upper gastrointestinal endoscopy in adults is well established. This study of 50 children demonstrates that upper gastrointestinal endoscopy can be performed safely and effectively in this age group without general anesthesia. Endoscopy appears more sensitive than radiology in the detection not only of superficial mucosal lesions, but of gastric and duodenal ulcers as well.

Age Factors↗

PubMed1977

[Emergency endoscopy: its application in the department of medicine of a city hospital (author's transl)].

In about 90% of cases of active gastrointestinal hemorrage, sources and nature of bleeding can be identified exactly by means of emergency endoscopy. With time passing from the beginning of hemorrhage, diagnosis established by endoscopy is getting less precise. The most common cases of bleeding are peptic lesions, either esophageal, gastric, or duodenal; the most common site of hemorrhage is the stomach. Different potential points bleeding at the same time have to be take in account. A case report of Mallory-Weiss syndrome (13 episodes of hemorrhage) illustrated the method's value in establishing diagnosis of acute gastrointestinal bleeding. Special applications of emergency endoscopy in mental patients are described.

Emergencies↗

PubMed1978

[Methods and possibilities of surgical endoscopy].

In a number of diseases, operative or therapeutic endoscopy permits an effective therapy without the necessity to open up the abdominal wall and the digestive organs themselves. Included here are the removal of foreign bodies, haemostasis, papillotomy with concrement dislodgement, polypectomy and the obliteration of the excretory pancreas. The evaluation of the achieved results and the examination of operative endoscopy in respect of its clinical value cooperation with the pathologisz should not be neglected. The refined endoscopic methods and the highly developed technology can only be applied successfully, when it is possible to get enough skillful endoscopists and to prevent an everyman's endoscopy by which the new methods could be brought into discredit.

Cholelithiasis↗

PubMed1979

[Value of endoscopy in the diagnosis of upper digestive tract hemorrhage].

In 11 years experience (67-78) we studied the importance of endoscopy in HDA. Were carried out 8300 esophagogastroduodenal endoscopies of which 2837 were HDA. The main reasons to follow these studies were: 1) Diagnostic of the HDA location; 2) Diagnostic of type of injury; 3) Injury intensity. Referring to the findings 30% were duodenal ulcer; 27% hemorrhagic gastritis; 17% gastric ulcer and 10% were due to VE. From the remaining 10% the most frequent were the esophagitis and gastric cancer. It is most important to show that aspiring added to alcohol in the most common cause of hemorrhagic gastritis. We have to point out that in 42 endoscopies performed in Intensive Care Service 10 of them were due to non-digestive causes. Through this method of diagnosis the Endoscopist has an important role to play in defining the prognosis and conduct to be followed.

Alcoholic Beverages↗

PubMed1979

[Therapeutic endoscopy in the gastrointestinal tract].

In selected chapters of the therapeutic endoscopy we tried to represent secure knowledge, actual tendencies and partly future prognoses. Hereby completeness cannot be expected. However, it became clear that numerous physical principles became useful for the therapy with the endoscope. Chemical techniques, such as the litholysis of gall-stones are only at present used in our field. With all scepticism against the own field of interest one may say that the operative therapeutic endoscopy, as it is seen at the instance of the classification of polyps, has led to an improvement of the diagnostics, Its advantages in the therapeutic field are based on the fact that it substitutes larger operations. In the polypectomy- the intervention, avoiding laparotomy and colotomy, is reduced on the minimum given by the size of the polyp. The risk of endoscopic operations is small, compared with the alternative surgical interventions. Shortening of the duration of the disease and hospitalisation leads to lower expenses. Methods, such as the endoscopic haemostypsis or the obliteration of the pancreatic duct, need further detailed examinations. There is no doubt that the modern endoscopy has a strong technical fascination for many young physicians. It gets the greatest value in the hands of a clinically experienced physician.

Cholelithiasis↗

PubMed1978

Cardiovascular responses to upper gastrointestinal endoscopy.

Continuous Holter monitoring and serial blood pressure recordings were obtained during upper gastrointestinal endoscopy on 51 unselected patients, 18 with cardiovascular disease. Sedation with intravenous diazepam produced a small but significant fall (P is less than .001) in blood pressure, heart rate and rate-pressure product. During endoscopy, the blood pressure rose only to base line levels but the heart rate and rate-pressure product went significantly higher (P is less than .001). Nine subjects (fice with pre-existing cardiovascular disease, four normal) exhibited electrocardiographic changes, including supraventricular arrhythmias, ventricular ectopy and significant ST segment depression. None of the patients had bradycardia or significant vagal symptomatology. The difference in incidence of abnormalities between the normal patients (4/33) and those with cardiovascular disease (5/18) was not statistically significant (P = 0.3). Endoscopy can be safely performed even in patients with cardiovascular diseasebut attention to the reduction of cardiac stress would further increase its safety.

Adolescent↗

PubMed1977

Vascular endoscopy: useful tool or interesting toy.

A prospective protocol was designed to evaluate the efficacy and practically of intraluminal endoscopy in vascular reconstructive procedures. The choledochoscope and the arthroscope which utilize the Hopkins Optical System, as well as other available fiberoptic endoscopy units, were evaluated in 91 vascular reconstructions, including 42 carotid endarterectomies, 24 femoral artery reconstructions, 13 popliteal artery anastomoses, seven aortic and iliac procedures, one renal reconstruction, and one tibial reconstruction. In three cases the internal surface of an occluded limb of an aortic graft was examined endoscopically following thrombectomy. The optical resolution of the Hopkins Optical System was superior to the fiberoptic units. Vascular endoscopy required 5 minutes or less in 53 cases, between 5 to 10 minutes in 29 cases, and more than 10 minutes in nine. There were no infections. The single complication was a 1 cm linear tear in the intima of an internal artery. Positive findings were noted in 60 endoscopic studies, for an incidence of 66%. These consisted of intimal shreds in 47, elevated or irregular intimal flaps in 25, clot in five, and stenosis in three. In 26 cases the endoscopic findings were considered to be significant enough to possibly affect the ultimate outcome of the reconstruction.

Carotid Arteries↗

PubMed1977

[Gastrointestinal endoscopy in surgical patients (author's transl)].

Gastrointestinal endoscopy with flexible glass fiber instruments is of increasing importance in surgery. Preoperative endoscopic examinations bring good progress in planning the operative procedure, especially concerning proximal selective vagotomy, pancreas surgery and reoperations on the large intestine. By applying postoperative endosocopic controls mucosal alterations can earlier be detected in the area concerned than by radiological methods; this has to be emphasized especially in view of patients operated upon for cancer. Emergency endoscopy in massive gastrointestinal bleeding is one of the outstanding tasks. Under certain circumstances risky abdominal operations can be avoided by therapeutic endoscopy.

Biliary Tract Diseases↗

PubMed1976

Disinfection procedures of fiberscopes in endoscopy departments.

Disinfection of fibre endoscopes was examined in 5 endoscopy departments during endoscopy sessions. On the endoscopes, especially in the instrument channels, Pseudomonas aeruginosa and Proteus species could be regularly found, in some cases also Enterobacter cloacae and Candida albicans. With the results of disinfection experiments, proposals are made to reduce the infection risk due to insufficiently disinfected instruments in endoscopy departments.

Bacteriological Techniques↗

PubMed1979

Upper gastrointestinal endoscopy: its effects on patient management.

Out of 95 patients referred for upper gastrointestinal endoscopy after a barium-meal examination, 44 underwent a change in management. Some changes were minor but in 12 patients a decision on surgery was required. Seven of these patients were among a group of 13 for whom the referring consultant would have recommended laparotomy had endoscopy not been available, while the other five were subjected to an unplanned laparotomy. These findings support the practice of performing endoscopy on patients whose symptoms are not fully explained by barium-meal examination, especially patients aged over 45. In such cases the procedure also seems to be cost-effective.

Adult↗

PubMed1979

[Emergency endoscopy in acute upper gastrointestinal hemorrhage: Does the effectiveness justify the effort?].

On the basis of a common care of patients with acute upper gastrointestinal haemorrhage by internists, surgeons, and anaesthetists lasting several years advantages and disadvantages of emergency endoscopy are analysed from the standpoint of effectivity. High diagnostic ability, help in the decision concerning operative or conservative activity, the influence of the operative-tactic approach and the furthering influence on the close cooperation of the specialities are to be emphasized. Criteria of effectivity, such as mortality rates, duration of the stay in the hospital and frequency of relapsing haemorrhages underlie many factors of influence. They express results of therapy, to which emergency endoscopy may at present contribute only limitedly. The basic decision to medical activity -- active striving for a rapid, exact diagnosis or waiting when the diagnosis is uncertain -- does not inessentially influence the standpoint in the controversy about the emergency endoscopy.

Acute Disease↗

PubMed1977

[Examinations of upper gastrointestinal bleeding - value of emergency endoscopy (author's transl)].

The treatment of the acute upper gastrointestinal bleeding can be improved by using standardized immediate actions, as there is endoscopy in emergency diagnostics. Endoscopy gives much higher certainty in pre-operative diagnostic, better possibility of planning and more exact timing of the operation. Therefore emergency endoscopy should be done in any case of acute upper gastro-intestinal bleeding.

Acute Disease↗

PubMed1979

Salmonella typhimurium. Transmission by fiberoptic upper gastrointestinal endoscopy.

During a four-month period, Salmonella typhimurium developed in seven persons within five days of fiberoptic upper gastrointestinal (GI) endoscopy. A retrospective cohort study confirmed the association between S typhimurium infection and fiberoptic upper GI endoscopy. Salmonella typhimurium was cultured from the endoscopic equipment and the accessory suction equipment. The Salmonella isolated from the endoscopic and accessory suction equipment was identical to that recovered from the seven patients with salmonellosis by serotype, antimicrobial susceptibility pattern, and bacteriophage lysis pattern. Salmonella transmission was attributed to inadequate disinfection of the endoscope and accessory equipment between procedures. The original source of the contamination was not discovered.

Aged↗

PubMed1976

The role of upper gastrointestinal endoscopy in patients with cancer.

The last decade has seen considerable advance in the application of fiberoptic endoscopy to the diagnosis and management of patients with cancer. Forward and side-viewing instruments have been developed that have complete tip control, potential for obtaining directed biopsies, brush and lavage cytology, and for aspiration of material for assay of enzymes and tumor-associated antigens. These features have provided a high degree of diagnostic capability in the esophagus, stomach, and duodenum. Accurate histologic diagnoses require multiple biopsies and brush cytology from each lesion. Lavage cytology has been useful in selected patients, especially those with diffusely infiltrating lesions. Brush cytology has been especially helpful in patients with stenotic esophageal cancer. These techniques have also provided a diagnosis in a high percentage of patients with lymphoma involving the stomach. Endoscopy has also been very useful in patients with nongastrointestinal cancer who have major gastrointestinal problems such as bleeding stress ulcers or monilial esophagitis.

Biopsy↗

PubMed1976

Endoscopy and the detection of genitourinary carcinoma.

Endoscopy in the detection of urinary tract cancer is one of the primary tools of the urologist. It is used in the localization of bleeding sites, the systematic follow-up in detecting recurrent malignancies, the pathologic staging of carcinoma of the bladder through transurethral biopsy, and the identification and biopsy of primary transitional cell carcinoma of the prostate. It is also a prime tool in the diagnosis of ureteral and pelvic tumors through retrograde pyelography, brush biopsy, and urine collection for cytology. Nephroscopy is now also possible for the obscure lesions difficult to diagnose otherwise. Urethroscopy is also important in detecting malignant changes. The various sites for urologic cancer, their incidence, and the role of endoscopy in relation to other means of diagnosis and management are discussed.

Age Factors↗