Gastrointestinal (GI) defects such as fistulas and leaks can be potentially closed endoscopically using hemo-clips and loops. However, hemoclips may not allow for closure of large defects and they do not exert enough ...Gastrointestinal (GI) defects such as fistulas and leaks can be potentially closed endoscopically using hemo-clips and loops. However, hemoclips may not allow for closure of large defects and they do not exert enough tensile force to keep fibrotic defects larger than 5 mm approximated. Herein we present a case of successful endoscopic closure of a gastrocolic fistula in a severely malnourished patient with complex post-surgical upper GI anatomy. We strongly believe that this device is a major breakthrough for the management of various types of discontinuity defects or fistulas. In addition, we show the usefulness of placing a direct jejunostomy using the double balloon enteroscopy (DBE) technique during the same procedure. The concept of providing direct jejunal feedings while allowing for upper gas-trointestinal bowel rest to promote the healing of the minimally invasive endoscopic operation is novel. Thus, our case is unique and exemplifies the utility of mini-mally invasive endoscopic endoluminal surgery.展开更多
With the chief aim to list a brief description on business writing,such thesis mainly deal with the content and skill in this field.Business writing locates a role in business world which cannot be ignored by any othe...With the chief aim to list a brief description on business writing,such thesis mainly deal with the content and skill in this field.Business writing locates a role in business world which cannot be ignored by any other means.In case a successful business manager desires to be achievable,the business letters ought to be treated seriously.Some popular forms of writing are also included and simply illustrated in lieu the basic requirement meeting from some of those readers.Obviously we learners and teachers are hopefully required to set great store by the mentioned scope of utilization.展开更多
文摘Gastrointestinal (GI) defects such as fistulas and leaks can be potentially closed endoscopically using hemo-clips and loops. However, hemoclips may not allow for closure of large defects and they do not exert enough tensile force to keep fibrotic defects larger than 5 mm approximated. Herein we present a case of successful endoscopic closure of a gastrocolic fistula in a severely malnourished patient with complex post-surgical upper GI anatomy. We strongly believe that this device is a major breakthrough for the management of various types of discontinuity defects or fistulas. In addition, we show the usefulness of placing a direct jejunostomy using the double balloon enteroscopy (DBE) technique during the same procedure. The concept of providing direct jejunal feedings while allowing for upper gas-trointestinal bowel rest to promote the healing of the minimally invasive endoscopic operation is novel. Thus, our case is unique and exemplifies the utility of mini-mally invasive endoscopic endoluminal surgery.
文摘With the chief aim to list a brief description on business writing,such thesis mainly deal with the content and skill in this field.Business writing locates a role in business world which cannot be ignored by any other means.In case a successful business manager desires to be achievable,the business letters ought to be treated seriously.Some popular forms of writing are also included and simply illustrated in lieu the basic requirement meeting from some of those readers.Obviously we learners and teachers are hopefully required to set great store by the mentioned scope of utilization.
