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At least 1,207 records · Page 67Linked to original sources

PubMed1988

Neoplasia in chronic erosive (varioliform) gastritis.

Chronic erosive gastritis is a gastric mucosal lesion characterized by multiple, small, sessile elevations with central erosions. Symptoms typically resemble those in peptic ulcer disease. The elevations may persist and appear as sessile polyps after the erosions heal and symptoms resolve with therapy. Adenomatous transformation is reported in a patient with chronic erosive gastritis who had serial gastroscopies. This report suggests a possible association between chronic erosive gastritis and gastric neoplasia.

Aged↗

PubMed1994

Equine model of inducing ulceration in alimentary squamous epithelial mucosa.

Ulceration of the gastric squamous epithelial mucosa was induced in 10 horses using a feeding protocol previously shown to expose the gastric mucosa to repeated periods of high acidity. The feeding protocol consisted of alternating feed deprivation with free access to hay. Over a period of seven days, each horse was provided hay for 84 hr and deprived of hay for 84 hr. Hay was never withheld for longer than 24 hr at a time. Gastroscopy was performed on each horse at the beginning of the protocol after 12 hr of feed deprivation, and after a total of 36 hr, 60 hr, and 84 hr of feed deprivation. All horses had normal esophageal and gastric mucosa at the beginning of the protocol. Alternating periods of feeding and feed deprivation resulted in progressive ulceration of the gastric squamous epithelial mucosa in all but one of the horses. Lesions progressed from erosions to ulceration within 36-72 hr of feed deprivation, and by 84 hr of feed deprivation ulcers had developed thickened, raised margins. Esophageal mucosa appeared normal in all horses throughout the study. The protocol of alternating feeding with feed deprivation in horses consistently produced gastric squamous epithelial ulceration and provided a useful model for characterizing temporal transitions in peptic-injured alimentary squamous epithelia.

Animal Feed↗

PubMed1977

Complications of gastrointestinal fiberoptic endoscopy.

Flexible fiberoptic endoscopes are being increasingly used for direct visualization and biopsy of lesions of the gastrointestinal tract. The spectrum of gastrointestinal complications associated with fiber-optic esophagoscopy, gastroscopy, and colonoscopy is reviewed. Radiologic recognition and evaluation of these iatrogenic incidents is of critical importance.

Colon↗

PubMed1995

Significantly lower prevalence of Helicobacter pylori in uremic patients than in patients with normal renal function.

The objective of the study was to evaluate the prevalence of Helicobacter pylori in patients with different degrees of renal function. Two hundred and twenty consecutive patients requiring gastroscopy for upper intestinal symptoms were enrolled in the study: group I (normal renal function, n = 127), group II (chronic renal failure, creatinine clearance > 5 < 90 ml/min, n = 59), and group III (hemodialysis therapy, n = 34). On endoscopy, biopsy specimens were taken for analysis of H. pylori infection by urease test and histology. The prevalence of H. pylori in patients with renal dysfunction proved to be significantly lower than that in patients with normal renal function (22.6% vs 37%, P < 0.05). The incidence of ulcer disease in patients with normal renal function was higher than that in uremic patients (14.2% vs 10.8%, not significant). These findings indicate that uremic patients seem to be partly protected against H. pylori infection.

Biopsy↗

PubMedDate not supplied

A simplified technique for percutaneous endoscopic gastrostomy.

Percutaneous endoscopic gastrostomy (PEG) is the preferred method of establishing long-term enteral access for feeding. Many patients requiring PEG are elderly and at risk for complications. Expeditious placement of the gastrostomy tube will minimize complications, but distorted esophageal anatomy can significantly lengthen the procedure. Some endoscopists abandon conventional repeat gastroscopy in difficult cases to accelerate the procedure. The authors describe a reliable method for quick reinsertion of the endoscope which shortens time required for PEG, and may reduce complications.

Enteral Nutrition↗

PubMed1991

Hemodynamic monitoring and pulse oximetry during percutaneous gastrostomy and jejunostomy: necessity or nuisance?

Hemoglobin desaturation and arrhythmias have been reported during diagnostic gastroscopy and colonoscopy. During endoscopic placement of percutaneous gastrostomy tubes (PEG), the gastroscope is inserted twice and the stomach is markedly distended, thus increasing the potential risk of complications. Also, the procedure is frequently performed in patients exhibiting underlying systemic disease or little respiratory reserve. Patients undergoing PEG or percutaneous endoscopic jejunostomy (PEJ) were studied prospectively. Blood pressure, pulse, pulse oximetry, and lead II ECG tracings were obtained. Measurements were made before sedation, after sedation, at gastroscope insertion, at gastrostomy placement, at gastroscope reinsertion, and at 5 min after the procedure. In all, 50 patients (mean age, 56.8 years; 16 women, 26 men) underwent PEG only (39 cases) or PEG/PEJ (11 cases). The endoscopy suite was the site for the procedure in 38 cases and the intensive care unit was used in 12 cases. The mean time required for PEG and PEG/PEJ was 14.7 +/- 1.1 and 18.9 +/- 2 min, respectively. Blood pressure remained stable throughout the procedure. Sinus tachycardia was observed in 72% of patients. Arterial oxygen saturation decreased after the administration of intravenous sedation but remained constant during the procedure. We reached the following conclusions: (1) desaturation occurs during sedation, (2) saturation remains constant during PEG/PEJ, (3) the mean blood pressure remains constant during PEG/PEJ, and (4) PEG/PEJ are safe procedures and monitoring should be individualized.

Adolescent↗

PubMed2001

Menetrier's disease.

An 8-year-old girl presented with persistent vomiting, pain abdomen and generalized edema. Barium studies and gastroscopy suggested hypertrophic gastropathy. Histopathological examination pointed the diagnosis towards Menetrier's Disease. There was spontaneous remission and the child required only supportive therapy.

Barium Sulfate↗

PubMed1980

Primary carcinoma of the remnant stomach--report of three cases.

Among the 318 patients operated on for gastric carcinoma during the last six years in our department, three patients were operated on for carcinoma which developed in the remnant stomach 25, 22 and 12 years respectively after partial gastrectomy for peptic ulcers. Their surgical results were uniformly poor because of far advanced malignant lesions. Another patient who developed adenomatous polyps near the stoma 23 years after gastrectomy for duodenal ulcer was treated by polypectomy through gastrotomy. Both from our experiences and from review of literatures, it was concluded that patients gastrectomized for benign lesions should be followed up regularly ten or more years after the surgery, especially by gastroscopy, in order to detect remnant stomach carcinoma as early as possible. And any physicians should always be aware of this disease and should not attribute any late appearing abdominal complaints to gastrectomy itself.

Adenocarcinoma↗

PubMed1989

The association of esophageal hiatus hernia with Mallory-Weiss syndrome.

The incidence of esophageal hiatus hernia in Mallory-Weiss syndrome was analyzed from endoscopic findings in order to clarify the association with Mallory-Weiss syndrome. Hiatus hernia was diagnosed from findings of both esophagoscopy and gastroscopy. In 23 patients with Mallory-Weiss syndrome confirmed by endoscopy, hiatus hernia was found 21 cases (91.3%), in which 9 (39.1%) were definite hernias and 12 (52.2%) were minor hernias. In 80 control cases of various gastrointestinal diseases, definite hernia was found in 7 cases (8.8%), and minor hernia was found in 13 cases (16.2%). The incidence of hiatus hernia in Mallory-Weiss syndrome was thus significantly higher than that in the control group. The incidence of hiatus hernia evaluated only by esophageal findings was lower than that evaluated by combined findings from the gastric and esophageal directions. These results indicate that evaluation from the gastric direction is an essential procedure for the diagnosis of esophageal hiatus hernia and that hiatus hernia is one of the predisposing factors for the development of Mallory-Weiss syndrome.

Alcoholic Intoxication↗

PubMed1994

Laparoscopic gastrostomy versus percutaneous endoscopic gastrostomy. A comparison.

A retrospective study was carried out at our institution to compare patients who underwent percutaneous endoscopic gastrostomy (PEG) to those who underwent laparoscopic gastrostomy (LG). There were 17 patients who had a PEG with a mean age of 81 years (43-97 years). The procedure time, including complete esophago-gastroduodenoscopy, averaged 28 min. There were four deaths (23%) in a 30-day period, but none of these were directly related to the procedure. The LG group consisted of 14 patients with a mean age of 66 years (20-94 years). Mean duration of the procedure was 18 minutes. Thirty-day mortality rate was 35% (five patients) with one death (7%) directly related to the tube. Indications for gastrostomy were similar in both groups, being predominantly inability to eat and/or recurrent aspiration. However, LG was done because of 4 technical failures, 5 patients with tumors of the head and neck, 2 patients with esophageal obstruction and radiation stenosis precluding safe PEG, and 1 patient with hiatal hernia; 2 LGs were performed at the surgeon's preference. Outcomes for LG and PEG were comparable. LG is a suitable, safe alternative to PEG in selected patients who cannot undergo gastroscopy and should be considered the procedure of choice in patients with head and neck tumors or intrathoracic pathology that prevents PEG.

Adult↗

PubMedDate not supplied

HpSA: assessment of a new non-invasive diagnostic assay for Helicobacter pylori infection in an Irish population.

BACKGROUND: The diagnosis of Helicobacter pylori is an essential element in the management of many common gastrointestinal pathologies. Previously diagnosis was dependent on the availability of endoscopic biopsy samples. The advent of non invasive assays such as the C13Urea breath test and Elisa serology have enabled diagnosis and treatment to be undertaken in the primary care setting. The isolation of Helicobacter pylori antigen from stool has led to the development of a new non-invasive test. AIM: A prospective study was designed to assess and compare the performance of Premier Platinum HpSA with current gold standard tests. METHODS: Consecutive patients undergoing a gastroscopy for investigation of dyspepsia at the Meath and Adelaide hospitals were enrolled. At endoscopy gastric biopsies were taken for histology, microbiology and rapid urease testing. In addition all subjects had C13UBT, serology and stool tests performed. Individuals who were H. pylori positive received standard proton pump inhibitor based triple therapy. Following treatment all tests, apart from serology were repeated. RESULTS: 54 patients were enrolled, 46 per cent were H. pylori positive. HpSA had a sensitivity and specificity and positive and negative predicted values of 96 per cent, 75 per cent and 80.6 per cent, 75.8 per cent respectively and compared favourably with all other tests. The sensitivity and specificities of the other tests were, histology 79.2 per cent and 100 per cent, culture 68 per cent and 100 per cent, rapid urease test 75 per cent and 100 per cent, serology 75 per cent and 96 per cent and C13 urea breath test 100 per cent and 96.6 per cent. CONCLUSION: The detection of H. pylori antigen in stool by means of a HpSA assay is a new and effective non-invasive means of diagnosis which can be performed in a routine laboratory setting. It is simple to perform and has possible advantages over other non-invasive tests, detecting actual antigen indicating current active infection.

Adult↗

PubMed1997

Gastric fluid measurement by blind aspiration in paediatric patients: a gastroscopic evaluation.

PURPOSE: Numerous investigators have estimated gastric fluid volume using blind aspiration through multi-orificed catheters, but none have confirmed the validity of this technique in infants and children. We sought to validate the accuracy of this technique in a fasted paediatric population by using gastroscopy. Data from several studies were then combined to generate a gastric fluid volume frequency distribution for healthy paediatric patients fasted for surgery. METHODS: This is a prospective study of 17 patients aged six months to 11 yr who underwent elective upper endoscopy at a paediatric teaching hospital. Gastric contents were aspirated blindly with a syringe and a 16 or 18F multi-orificed orogastric tube, and the volume of gastric contents removed in the supine and decubitus positions was measured. Residual gastric fluid was aspirated using an endoscope. Data from 611 infants and children enrolled in previously published studies utilizing the same blind aspiration technique were pooled and a gastric fluid volume frequency distribution was created. RESULTS: Blind aspiration removed 97 +/- 8% of the total gastric fluid volume. In 661 children presenting for elective surgery, the gastric fluid volume was 0.40 +/- 0.45 ml.kg-1. Median volume was 0.27 ml.kg-1, with the 95%ile at 1.25 ml.kg-1 and an upper limit of 4.1 ml.kg-1. CONCLUSION: Blind aspiration of gastric contents accurately estimates gastric fluid volume for paediatric patients fasted for surgery. Population estimates for gastric fluid volume in otherwise healthy fasted paediatric patients are shown.

Child↗

PubMed2003

Posttraumatic splenic artery aneurysm presenting as occult gastrointestinal bleeding.

A 53-year-old man presented with a 19-month history of gastrointestinal bleeding. Repeated endoscopic investigation of the upper and lower intestine showed no source of bleeding. When the patient collapsed due to massive gastrointestinal hemorrhage he was referred to our center. Gastroscopy showed a large, bulging tumor protruding from the posterior gastric wall. The consistency of this tumor was soft and the overlying mucosa appeared smooth and intact. Endoscopic ultrasound and contrast-enhanced computerized tomography scan identified a partly thrombosized splenic artery aneurysm (SAA). Arteriography of the celiac trunk confirmed the SAA diagnosis; the SAA was subsequently occluded by coils. So far, four months after discharge, the patient is in excellent health and no further episode of gastrointestinal bleeding has occurred. SAA is a very rare cause of upper gastrointestinal bleeding, but it must be considered when no other common bleeding source can be detected.

Accidents, Traffic↗

PubMed2004

Epidemiology and costs of gastroesophageal reflux disease in Switzerland: a population-based study.

OBJECTIVES: Assessment of the prevalence, health care resource use and cost of gastroesophageal reflux disease in Switzerland. METHODS: A population-based telephone survey was conducted in German and French speaking Switzerland. Reflux cases were defined using a questionnaire proposed by the German Gastro League and answered additional questions on their personal characteristics and resource use. RESULTS: 1,274 out of 7,222 participants were positively screened. The prevalence of reflux disease in Swiss adults was estimated at 17.6% (95% CI: 15.6%-19.7%) or 993,000 individuals. Regular treatment with medication was reported by 38.0% of the reflux positive sample. Reflux-induced general practitioner consultations during the last year were reported by 25.9%. On average, there were 0.84 general practitioner consultations, 0.19 specialist consultations, 0.08 gastroscopies and 0.01 hospitalisations annually. Mean direct medical costs, dominated by medication costs, were CHF 185 per patient-year (95% CI: CHF 140-230) or 0.5% of Switzerland's total health care expenditures. Total costs were CHF 234 (95% CI: CHF 185-284) per patient-year. CONCLUSIONS: The prevalence of reflux disease in Switzerland is similar to that in other industrialised countries. Reflux disease causes considerable costs, in the medical system and at the societal level.

Adolescent↗

PubMed2003

[Value of endosonography in diagnostic staging of primary gastric lymphoma (MALT type)].

BACKGROUND AND AIMS: The incidence of gastric MALT (mucosa-associated lymphoid tissue) lymphomas has significantly increased during the past few years. Especially when MALT lymphomas are treated conventionally, e.g., with eradication or chemotherapy, an exact classification of the lymphoma is required. The goal of this study was to compare the accuracy of endoscopic ultrasound (EUS) with other imaging techniques used in the staging of MALT lymphomas. PATIENTS AND METHODS: In the setting of a prospective trial with a conservative therapeutic approach (Münster Study for GIT-NHL), altogether 44 patients diagnosed with a low-grade or high-grade malignant non-Hodgkin's lymphoma (NHL) were included in the study and classified according to their relative tumor stage using special diagnostic measures, which comprised gastroscopy (esophagogastroduodenoscopy), abdominal ultrasound, computed tomography (CT), and EUS. RESULTS: In 42 out of 44 patients, EUS identified the lymphoma (in two cases, final diagnosis was possible only by histologic analysis). Concerning the identification of a thickening of the stomach wall or a fusion of the layers of the stomach wall, EUS had a significantly superior score over conventional ultrasound or CT, respectively (p < 0.001). In the detection of pathologic lymph nodes, EUS was again significantly superior to ultrasound imaging. CT, however, had a statistically similar detection rate (p > 0.05). In four cases, EUS underrated a less advanced tumor stage with tumor manifestations outside the stomach (IVE). In one case, pathologic lymph nodes could be detected only with thoracic CT. In 70% of the cases, EUS imaging resulted in higher-grade tumor ranking. In 57% of cases, EUS was the only imaging technique to achieve a classification of the tumor stage at all. CONCLUSION: In the diagnosis of gastric NHLs, EUS imaging is superior to conventional imaging techniques (ultrasound and CT). Therefore, the use of endoscopic ultrasound for staging can be regarded as a prerequisite for the exact tumor stage classification required in more recent conventional therapeutic approaches.

Adult↗

PubMed2001

[Intra-gastric penetration of an adjustable gastric band].

Between November 1995 and August 2000 we performed adjustable silicone gastric banding laparoscopically in 252 patients. The body mass index varied from 37 to 86 kg/m2. We report on a 38-year-old woman who was operated on in 1997 with a body mass index of 47 kg/m2 (167 cm, 132 kg). The postoperative follow-up was uneventful until January 2000. The patient lost weight until she weighed 78 kg. Then she complained of diffuse epigastric pain. Gastroscopy revealed gastritis. Omeprazol was prescribed. No amelioration occurred. Endoscopic control showed partial intragastric migration of the band. After laparoscopic removal of the band, the patient was free of symptoms. Band erosion is a possible complication of adjustable gastric banding. As is known from intragastric penetration of the Angelchik prosthesis, the clinical symptoms of this complication may be mild. Since the follow-up of most patients with gastric banding is less than 5 years, more complications similar to that one described may be diagnosed in the future.

Adult↗

PubMed2000

Stress-induced gastric findings in critically ill newborn infants: frequency and risk factors.

OBJECTIVE: To evaluate whether infants treated in neonatal intensive care units have stress-induced bleeding from gastrointestinal tract or gastric lesions and to define risk factors for these findings. DESIGN: Part one: retrospective; part two: prospective. SETTING: Tampere University Hospital, neonatal intensive care unit. PATIENTS AND INTERVENTIONS: In part one, 100 consecutive newborn infants treated in intensive care were retrospectively evaluated for gastrointestinal tract bleeding and risk factors, and in part two 89 gastroscopied and mechanically ventilated infants were prospectively evaluated for further risk factors for gastric mucosal lesions. The statistical evaluation of risk factors was made by multivariate analysis using logistic regression modeling. MAIN RESULTS: Of infants treated in the neonatal intensive care unit 20 % had signs of gastrointestinal bleeding. Mechanical ventilation was the only risk factor (OR = 4.06, 95 % confidence interval 1.21-12.3). In part two, when mechanically ventilated infants were prospectively evaluated, 53 % had remarkable gastric mucosal lesions. The analysis showed three other risk factors: abnormal and delayed delivery and hypotension after birth. CONCLUSIONS: Newborn infants treated in the intensive care unit had a high frequency of stress-induced gastric hemorrhage with gastric lesions similar to adults and children treated in intensive care. Mechanical ventilation is the main risk factor. Also mode of delivery and hypotension after birth increase the risk of stress-induced gastric lesions. These infants should be the target for prophylactic gastroprotective treatment.

Critical Illness↗

PubMed1999

3D MR gastrography: exoscopic and endoscopic analysis of the stomach.

The aim of this study was to evaluate the feasibility of MR gastrography, based on 3D MRI following the oral administration of Gd-DOTA-enriched blueberry juice, in order to depict alterations of the gastric wall. The stomachs of three volunteers and three patients were examined on a 1.5-T MR system. Following ingestion of 400 ml of blueberry juice spiked with 2 ml of Gd-DOTA, each subject underwent 3D MR imaging in three positions: 45 degrees left lateral decubitus, supine, and 45 degrees right lateral decubitus. In each position, a coronal 3D SPGR acquisition consisting of 60 continuous 2-mm slices was acquired over a 35-s breathhold (TR/TE = 4.0/1.8 ms, 40 degrees flip angle, 0.5 excitations, voxel size of 1.25 x 1.66 x 2.00 mm). Multiplanar reformats (MPR), maximum intensity projections (MIP), surface shaded displays (SSD), and virtual intraluminal endoscopic views (VIE) were calculated. Magnetic resonance gastroscopy was tolerated well by all subjects without adverse effects. Based on the 3D MRI data sets acquired in various patient positions, all regions of the stomach and the proximal duodenum were visualized to good advantage. Whereas MPR and MIP provided a morphologic overview, SSD and VIE images permitted analysis of the gastric mucosa. Normal mucosa could be differentiated from the course and irregular pattern characterizing carcinomatous infiltration. The 3D SPGR data sets acquired following ingestion of oral Gd-DOTA-spiked blueberry juice permits exoscopic and virtual endoscopic viewing of the stomach.

Adult↗