China
Africa
Explore chapters and articles related to this topic
Gastrointestinal Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Gareth Davies, Chris Black, Keeley Fairbrass
Diagnosis is made by gastroscopy and biopsies. In Barrett's oesophagus, columnar mucosa is seen lining the distal oesophagus above the gastro-oesophageal junction. The different colours of squamous (pink) and columnar (orange) mucosa allow differentiation by the endoscopist (Figure 10.28a).If biopsies of the distal oesophagus then confirm specialized columnar mucosa with intestinal metaplasia, a diagnosis of Barrett's can be made.
Gastrostomy
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Alejandra M. Casar Berazaluce, Aaron P. Garrison, Todd A. Ponsky
The gastroscope is inserted and the stomach insufflated. The stoma should be away from the ribcage. Under- or overinsufflation should be avoided to minimize the possibility of accidentally piercing the transverse colon. Insufflation of the small intestine tends to push the transverse colon in front of the stomach and should be avoided.
Obese Patient (BMI 32) with Reflux Disease and Diabetes Mellitus
Published in Savio George Barreto, Shailesh V. Shrikhande, Dilemmas in Abdominal Surgery, 2020
The routine use of gastroscopy in the preoperative bariatric patient also remains controversial. The authors believe that in an Roux-en-Y gastric bypass, where the distal stomach will no longer be accessible endoscopically, it seems prudent to exclude any pathology prior to surgery. Additionally, in the setting of long-standing symptoms of gastroesophageal reflux disease, it is important to exclude any associated complications, such as Barrett’s esophagus or peptic strictures. Gastroscopy is also useful to preoperatively identify the presence of a hiatal hernia that will need to be repaired at the time of surgery. The patient presented in our Case Scenario had a normal gastroscopy apart from mild reflux esophagitis.
Magnetically controlled capsule endoscopy as the first-line examination for high-risk patients for the standard gastroscopy: a preliminary study
Published in Scandinavian Journal of Gastroenterology, 2019
Jinlong Hu, Shupeng Wang, Wenzhuang Ma, Duo Pan, Siyu Sun
Although standard gastroscopy can offer higher imaging definition and good overall examination capability, it is an invasive examination. On the one hand, endoscopic procedures can cause hemodynamic aberrations, which can sometimes lead to serious morbidity and mortality [3]. Hypertension can result in a cerebrovascular catastrophe. Sinus tachycardia is probably of clinical significance in patients with coronary artery disease or severe mitral valve stenosis [3] because myocardial infarctions, intracerebral hemorrhage and cerebral air embolism caused by endoscopic procedures have been reported [4,5]. On the other hand, endoscopic procedures can cause perforation and bleeding [6]. Other adverse events, such as jaw dislocation [7], intramural esophageal dissection [8], and periorbital and mediastinal emphysema [9], have been reported.
Intraoperative measurement of pressure gradient in median arcuate ligament syndrome as a rationale for radical surgical approach
Published in Acta Chirurgica Belgica, 2018
Tomas Grus, Lukas Lambert, Tomas Vidim, Gabriela Grusova, Tomas Klika
Apart from standard postoperative care, laboratory tests, and clinical assessment, duplex ultrasound or CT of the abdominal aorta were performed to confirm patency of the reconstruction. The first follow-up was scheduled on the 10th–14th postoperative day to remove the stitches and assess symptoms of the patient. Further follow-ups were 1, 6, and 12 months postoperatively, with CT angiography of the aorta at the 6th and 12th month. Later, the patients were followed annually clinically and by ultrasound (PSV >2.0 m/s, PSV ratio >2) [10]. In the first postoperative months, patients with prior findings on gastroscopy underwent follow-up examination. The mean duration of the follow-up was 6.4 years (2.8–9.7 years).
Linked color imaging-based endoscopic grading of gastric intestinal metaplasia and histological gastritis staging in the assessment of gastric cancer risk
Published in Scandinavian Journal of Gastroenterology, 2022
Jin Zheng, Guanpo Zhang, Chao Gao, Guilin Xu, Wulian Lin, Chuanshen Jiang, Dazhou Li, Wen Wang
This study had the following limitations: first, the sample size of this study was small, the risk factors included in the multi-factor analysis were few, and the risk of sampling error was high. Therefore, the sample size should be expanded, and more studies on the risk of gastric cancer progression should be included to obtain more accurate OR values. Second, all patients with EGC included in this study had intestinal gastric cancer, so the study results cannot be extended to patients with undifferentiated gastric cancer. Third, this was a single-center study, and the reproducibility of the findings should be further verified in a multi-center prospective study. Fourth, the study participants had rich experience in LCI gastroscopy, suggesting that the results can only be generalized to endoscopy centers with LCI gastroscopy and not to those without LCI operation experience. However, the characteristics of intestinal metaplasia under LCI are obvious and easy to distinguish, so the LCI examination method can be quickly mastered through simple pre-examination training. However, further studies are needed to determine whether operating experience affects the accuracy of LCI in intestinal metaplasia patients. Fifth, in comparison with white-light gastroscopy, LCI gastroscopy was used for comprehensive observation of the gastric mucosa and targeted biopsy of patients, which may increase the gastroscopy time for the operator of the gastroscope. All patients included in the study completed gastroscopy under sedation, so the patients cooperated well. Increasing the duration of gastroscopy may not achieve patient cooperation, which may limit its use.