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Juvenile Polyposis Syndrome
Published in Dongyou Liu, Handbook of Tumor Syndromes, 2020
Rafael Parra-Medina, Elizabeth E. Montgomery, Paula Quintero-Ronderos, Edgar Garavito
Follow-up recommendations include surveillance with colonoscopy every year, beginning at age 12 years or earlier if symptoms occur, especially rectal bleeding. Colonoscopy should be repeated every 1–3 years depending on polyp burden, and polyps ≥5 mm should be removed [45,51]. Upper endoscopy is recommended every 1–3 years beginning at age 12 years, or earlier for symptoms, and should be repeated every 1–3 years, depending on severity, with removal of polyps ≥5 mm [51]. Patients with mild polyposis can be managed by frequent endoscopic examinations and polypectomy [25,44,59,60]. Intraoperative enteroscopy to evaluate small intestinal polyps can be considered at the time of colorectal surgery [61].
Tropical Colorectal Surgery
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Meheshinder Singh, Kemal I. Deen
Currently, for intra-abdominal and extraintestinal TB, contrast enhanced computerised tomography of the abdomen with multiplanar imaging and 3-D reconstruction is the imaging modality of choice.8 It is helpful in the delineation of mucosal pathology, stricture and fistula. Upper and lower intestinal endoscopy and enteroscopy will provide a comprehensive view of the entire intestinal tract and allows for biopsy of tissue. Capsule endoscopy is an alternative to enteroscopy, but biopsy of tissue is not possible, only images. Before capsule endoscopy is undertaken, it is essential to exclude intestinal stricture by prior water-soluble contrast study or MRI enteroclysis, lest the capsule becomes impacted at the site of luminal narrowing.
The Small Intestine
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Enteroscopy may reveal jejunal ulceration and stricturing. Capsule endoscopy should not be undertaken where there is a suspicion of stricture, because of the possibility of the capsule becoming stuck in the narrow segment. A biodegradable test capsule can be used if this is a source of concern. Capsule endoscopy has a useful role in those patients with evidence of chronic gastrointestinal symptoms or blood loss where no evidence of ulceration can be found with more conventional endoscopic assessment.
Assessment of small intestinal bacterial overgrowth in chronic pancreatitis patients using jejunal aspirate culture and glucose hydrogen breath test
Published in Scandinavian Journal of Gastroenterology, 2021
Rajesh Sanjeevi, Kapil Dev Jamwal, Sudipta Dhar Chowdhury, Balamurugan Ramadass, R. Gayathri, Amit Kumar Dutta, Anjilivelil Joseph Joseph, Balakrishnan S. Ramakrishna, Ashok Chacko
The jejunal aspirate was obtained using a modified double lumen catheter [18]. The catheter was constructed using principles as described by Ghoshal et al. [19]. Briefly, a double lumen catheter was created by refashioning an endoscopic injection needle. A rubber stopper was placed at the tip of the outer catheter to prevent the contamination of the inner catheter. The entire assembly was then gas sterilized. All patients recruited to the study underwent push enteroscopy using a single balloon enteroscope with minimal air insufflation after 12 h of fasting. Once the enteroscope was positioned 10 cm beyond the DJ flexure (position confirmed using fluoroscopy), the modified double lumen catheter was introduced into the small bowel lumen. The rubber stopper was dislodged by pushing out the inner catheter and small bowel content was aspirated using a sterile vacuum pressure syringe. A portion of the aspirate was then immediately transferred to an anaerobic transport medium and the remaining content was transferred to a sterile tube. No flushing of the biopsy channel/lens was done during the procedure.
Does urgent balloon-assisted enteroscopy impact rebleeding and short-term mortality in overt obscure gastrointestinal bleeding?
Published in Scandinavian Journal of Gastroenterology, 2020
João Carlos Silva, Rolando Pinho, Ana Ponte, Adélia Rodrigues, Jaime Rodrigues, Ana Catarina Gomes, Edgar Afecto, João Carvalho
All procedures were performed with a single-balloon enteroscopy (Olympus® SIF-Q180), using the standard push-and-pull technique [20]. The procedures were performed by three endoscopists experienced in deep enteroscopy (RP, AR, AP). Antegrade (oral) or retrograde (anal) insertion, was chosen according to SBCE findings, using the small bowel transit time cut-off of 0.6, as previously described [21]. When the bleeding source was identified through imaging methods, the route of insertion was chosen according to the topography of the findings. If the selected route of insertion leads to negative findings, the opposite route was used and tattooing was made at the furthest depth of the initial route. Antegrade procedures were performed after an overnight fast, whereas retrograde BAE required bowel preparation with 4 L of polyethylene-glycol solution.
Mapping the distribution of small bowel angioectasias
Published in Scandinavian Journal of Gastroenterology, 2019
Matt Davie, Diana E. Yung, Sarah Douglas, John N. Plevris, Anastasios Koulaouzidis
Of particular interest were the clinical outcomes of those who had high risk (P2s) or actively bleeding AEs. We investigated whether these patients ever re-presented with symptoms following initial management. Our study cohort had high rates of re-presentation to clinic, most commonly with iron deficiency anaemia, regardless of whether patients underwent conservative or interventional management. Of those who received APC therapy, 71.4% re-presented. Most likely, AEs were either missed during intervention or initial CE, or re-bled. Literature relating to patients post-interventional outcomes is varied. A systematic review of 24 papers concluded that endoscopic therapy may only be as effective as conservative management [14]. Another study also reported a high re-presentation rate of patients following deep enteroscopy [7].