BACKGROUND As lifestyles continue to change worldwide,the incidence of digestive tract carcinoma has gradually increased.Digestive endoscopy is an important tool that can assist in the diagnosis,treatment,and surgical...BACKGROUND As lifestyles continue to change worldwide,the incidence of digestive tract carcinoma has gradually increased.Digestive endoscopy is an important tool that can assist in the diagnosis,treatment,and surgical intervention for this disease.However,the examination process is affected by many factors,and patient cooperation is often poor,which can increase the risk of complications.AIM To explore the effects of integrated management and cognitive intervention on cooperation and complications in patients undergoing endoscopy for early gastrointestinal neoplasms.METHODS A total of 354 patients with early stage gastrointestinal cancer who underwent digestive endoscopy procedures between January and December 2023 at our hospital were divided into observation and control groups(177 patients in each group)in a randomized controlled blind trial.The control group received routine interventions,while the observation group received comprehensive integrated management combined with cognitive interventions.We compared the changes in adverse mood,discomfort,examination time,cooperation with the examination,and complications before and after the intervention between the two groups.RESULTS The self-rated anxiety and depression scale scores were lower in the observation group than in the control group(P<0.05).The visual analog scale scores for discomfort during intubation and examination were also lower in the observation group than in the control group(P<0.05).Furthermore,the examination time was shorter in the observation group than in the control group(P<0.05),and the degree of cooperation(94.35%)was higher in the observation group than in the control group(84.75%;P<0.05).Lastly,the incidence rates of gastrointestinal adverse reactions(10.17%vs 20.34%),choking agitation(14.69%vs 24.86%),abdominal pain(8.47%vs 18.08%),and muscle tension(5.08%vs 14.12%)were all lower in the observation group than in the control group(P<0.05).CONCLUSION Integrated management and cognitive intervention in early gastrointestinal neoplasm endoscopy alleviate mood,reduce discomfort,shorten examinations,improve cooperation,and reduce complications.展开更多
Introduction: Upper digestive hemorrhage is one of the main digestive emergencies and remains a major cause of morbidity and mortality in Mali. The aim of this study was to describe the therapeutic profile and outcome...Introduction: Upper digestive hemorrhage is one of the main digestive emergencies and remains a major cause of morbidity and mortality in Mali. The aim of this study was to describe the therapeutic profile and outcome of patients suffering from upper digestive haemorrhage. Methodology: This was a prospective study carried out in the internal medicine department of the Sikasso Regional Hospital from August 2022 to July 2023. All adult patients presenting with upper digestive haemorrhage and having given their consent, were included. Data were analyzed using SPSS version 21 software. Results: Sixty-three patients were enrolled. The mean age was 49.7 ± 18.99 years, with a male-female sex ratio of 2.2. Ruptured esophageal varices (37.5%) and peptic ulcer (25%) were the main etiologies. Pharmacological treatment was dominated by proton pump inhibitors (85.7%). Hemostasis endoscopy accounted for 3.17%. The evolution was marked by hemorrhagic arrest (69.84%), recurrence of hemorrhage (11.11%) and death (19.04%), the main cause of which was hemorrhagic shock (58.3%). We found no statistically significant relationship between prognosis and etiologies (P = 0.11), and length of hospital stay (P = 0.18). Conclusion: Hemostasis endoscopy remains a challenge for Sikasso Hospital. A holistic strategy of communication and community awareness-raising, combined with adequate technical facilities, will help to improve patient care and outcomes.展开更多
<strong>Introduction:</strong> <span><span><span style="font-family:;" "="">Gastritis is a very common and widely distributed condition <span>worldwide. It ...<strong>Introduction:</strong> <span><span><span style="font-family:;" "="">Gastritis is a very common and widely distributed condition <span>worldwide. It represents one of the most common pathological entities in</span> gastroenterology and digestive endoscopy. Our objective was to determine the sociodemographic, clinical, endoscopic, and histological aspects of gastritis in the digestive endoscopy unit of the General Hospital Idrissa Pouye (GHIP).<b> Materials and Method: </b>This was a retrospective study over a period of 4 years (from 1 January 2014 to 31 December 2017) at the digestive endoscopy <span>unit of GHIP. We had collated oesogastroduodenal endoscopy (EGDE) re</span>ports with gastritis appearance with gastric biopsies and reports with normal stomach appearance with gastric biopsies and their histological reports. We collected and analyzed data on age, gender, indications for endoscopy, endoscopic findings and histological results. <b>Results: </b>The reports of 593 patients were analyzed. The mean age was 45 years </span></span></span><span><span><span style="font-family:;" "="">old </span></span></span><span><span><span style="font-family:;" "="">(range 8 - 88 years</span></span></span><span><span><span style="font-family:;" "=""> old</span></span></span><span><span><span style="font-family:;" "="">) and the sex ratio was 0.63 (230 men). The indications for endoscopy were epigastralgia in (91%) of cases, dyspepsia in (22%) of cases, pyrosis in (12%) of <span>cases. The endoscopic appearance was normal in 229 patients (39%). The</span> endoscopic location of the gastritis was antral in 76%, fundic in 22% and pangastric in 2%. The gastritis was erythematous in 327 patients (90%), erosive in 126 patients (35%), congestive in 53 patients (15%), pseudonodular in 14 patients (4%) and atrophic in 10 patients (3%). Histology was normal in 8 patients (1.3%) and showed gastritis in 585 patients (98.7%). Gastritis was chronic in 575 patients (98.2%), acute in 10 patients (1.7%). Gastritis activity was moderate in (52.7%) and mild in (42.9%). Atrophy was absent in 521 patients (88.6%) and mild in 46 patients (8.2%). Intestinal metaplasia was found in 66 patients (11%). Dysplasia was present in 1.7% of cases. This dysplasia was intermediate grade (60%) in 6 patients, low grade (20%) in 2 patients and severe grade (20%). <i>H</i>. <i>pylori</i> was present in 404 patients (68%).<b> Conclusion: </b>Gastritis is </span></span></span><span><span><span style="font-family:;" "="">usually</span></span></span><span><span><span style="font-family:;" "=""> found in the digestive endoscopy unit of the GHIP. The indications for endoscopy are dominated by epigastralgia and histology is necessary for its diagnosis.</span></span></span>展开更多
<strong>Introduction:</strong> <span><span><span style="font-family:;" "="">Thanks to the opening of the digestive endoscopy unit in the Reference General Hospita...<strong>Introduction:</strong> <span><span><span style="font-family:;" "="">Thanks to the opening of the digestive endoscopy unit in the Reference General Hospital of Panzi in Bukavu in the Democratic Republic of the Congo, which inspired our work on the profile of endoscopic lesions observed in a series of 1000 patients correlated with clinical and demographic criteria with the contribution of pathology examinations of the 292 biopsies performed. The aim of our work is to evaluate the prevalence of significant endoscopic lesions as well as that of <i>H. pylori</i> infection. <b>Material and Methods:</b> This is a retrospective, descriptive and analytical study, ranging from the 16<sup>th</sup> of December 2014 to the 16<sup>th</sup> of June 2016. It covered 1000 patients who benefited from a high digestive endoscopy and 292 of them had a biopsy with pathological examination. The data obtained were recorded and analyzed using the Epi-info software and chi-square test. <b>Results:</b> fifty-five percent of these patients were women.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">66% of the patients were under 50</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">years of age. Their major symptom was epigastric pain</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(89.2%),</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">the most observed endoscopic lesion was erythematous gastritis</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(82%) therefore we have noticed 21</span></span></span><span><span><span style="font-family:;" "="">.</span></span></span><span><span><span style="font-family:;" "="">5% of significant lesions. Gastric cancer was present in 3.9% of cases and gastric ulcer in 4.2% of cases. The gastric tumor was correlated with age and sex (P-value at 0.000 and 0.013). The gastroduodenal ulcer was linked to age, <i>NSAID</i> and tobacco use (P-value at 0.0007, 0.001, 0.007). Esophageal mycosis was correlated with HIV status (P-value at 0.000). <i>Helicobacter pylori</i> gastritis was the most frequent (61.30%) and</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><i><span style="font-family:;" "="">Helicobacter pylori</span></i></span></span><span><span><span style="font-family:;" "=""> were present in 63% of gastric biopsies. <b>Conclusion: </b>Upper digestive endoscopy is a major tool for the diagnosis of upper gastrointestinal disorders and should always be followed by a biopsy if there is a suspicious lesion for pathologic confirmation and adequate management.</span></span></span>展开更多
AIM: To evaluate the hemostatic effect of topical hemocoagulase spray in digestive endoscopy.METHODS: Eighty-nine patients who developed oozing bleeding during endoscopic treatment from September 2014 to October 2014 ...AIM: To evaluate the hemostatic effect of topical hemocoagulase spray in digestive endoscopy.METHODS: Eighty-nine patients who developed oozing bleeding during endoscopic treatment from September 2014 to October 2014 at Center for Digestive Endoscopy, Tianjin Medical University General Hospital were randomly divided into either a study group(n = 39) or a control group(n = 50). The study group was given topical hemocoagulase spray intraoperatively, while the control group was given traditional 8% norepinephrine spray. Hemostatic efficacy was compared between the two groups. Bleeding site, wound cleanliness and perforation were recorded, and the rates of perforation and late bleeding were compared.RESULTS: Successful hemostasis was achieved in 39(100%) patients of the study group and in 47(94.0%) patients of the control group, and there was no significant difference in the rate of successful hemostasis between the two groups. Compared with the control group, after topical hemocoagulase spray in the study group, the surgical field was clearer, the bleeding site was more easily identified, and the wound was cleaner. There was no significant difference in the rate of perforation between the study and control groups(16.7% vs 35.0%, P = 0.477), but the rates oflate bleeding(0% vs 15.8%, P = 0.048) and overall complications(P = 0.032) were significantly lower in the study group.CONCLUSION: Topical hemocoagulase spray has a definite hemostatic effect for oozing bleeding in digestive endoscopy, and this method is convenient, safe, and reliable. It is expected to become a new method for endoscopic hemostasis.展开更多
AIM:To assess the adoption of Carbon dioxide(CO2)insufflation by endoscopists from various European countries,and its determinants.METHODS:A survey was distributed to 580 endoscopists attending a live course on digest...AIM:To assess the adoption of Carbon dioxide(CO2)insufflation by endoscopists from various European countries,and its determinants.METHODS:A survey was distributed to 580 endoscopists attending a live course on digestive endoscopy.RESULTS:The response rate was 24.5%.Fewer than half the respondents(66/142,46.5%)were aware of the fact that room air can be replaced by CO2 for gut distension during endoscopy,and 4.2%of respondents were actually using CO2 as the insufflation agent.Endoscopists aware of the possibility of CO2 insufflation mentioned technical difficulties in implementing the system and the absence of significant advantages of CO2 in comparison with room air as barriers to adoption in daily practice(84%and 49%of answers,respectively;two answers were permitted for this item).CONCLUSION:Based on this survey,adoption of CO2 insufflation during endoscopy seems to remain relatively exceptional.A majority of endoscopists were not aware of this possibility,while others were not aware of recent technical developments that facilitate CO2 implementation in an endoscopy suite.展开更多
In 2000,the small bowel capsule revolutionized the management of patients with small bowel disorders.Currently,the technological development achieved by the new models of double-headed endoscopic capsules,as miniaturi...In 2000,the small bowel capsule revolutionized the management of patients with small bowel disorders.Currently,the technological development achieved by the new models of double-headed endoscopic capsules,as miniaturized devices to evaluate the small bowel and colon[pan-intestinal capsule endoscopy(PCE)],makes this non-invasive procedure a disruptive concept for the management of patients with digestive disorders.This technology is expected to identify which patients will require conventional invasive endoscopic procedures(colonoscopy or balloon-assisted enteroscopy),based on the lesions detected by the capsule,i.e.,those with an indication for biopsies or endoscopic treatment.The use of PCE in patients with inflammatory bowel diseases,namely Crohn’s disease,as well as in patients with iron deficiency anaemia and/or overt gastrointestinal(GI)bleeding,after a non-diagnostic upper endoscopy(esophagogastroduodenoscopy),enables an effective,safe and comfortable way to identify patients with relevant lesions,who should undergo subsequent invasive endoscopic procedures.The recent development of magnetically controlled capsule endoscopy to evaluate the upper GI tract,is a further step towards the possibility of an entirely non-invasive assessment of all the segments of the digestive tract,from mouth-to-anus,meeting the expectations of the early developers of capsule endoscopy.展开更多
The pneumonia caused by the coronavirus disease-2019(COVID-19)outbreak in Wuhan,China constitutes a public health emergency of international concern.The gastrointestinal symptoms of vomiting,diarrhea and abdominal pai...The pneumonia caused by the coronavirus disease-2019(COVID-19)outbreak in Wuhan,China constitutes a public health emergency of international concern.The gastrointestinal symptoms of vomiting,diarrhea and abdominal pain and the detection of COVID-19 nucleic acid from fecal specimens in a small number of patients suggest the possibility of transmission via the gastrointestinal tract.People of all ages are vulnerable to this virus,including children.Digestive endoscopy is an invasive procedure during which children cannot wear masks;therefore,they have higher risks of exposure to COVID-19,and the digestive endoscopy center is a relatively high-risk area for COVID-19 infection.Based on these factors and in combination with related policies and regulations,a prevention and control program for the COVID-19 pneumonia in a children's digestive endoscopy center was established to prevent the COVID-19 nosocomial infection.展开更多
<strong>Background:</strong><span><span><span style="font-family:;" "=""> Endoscopy remains the most performant medical exam exploring the upper digestive tract;b...<strong>Background:</strong><span><span><span style="font-family:;" "=""> Endoscopy remains the most performant medical exam exploring the upper digestive tract;but depending on patients, its tolerance is variable.<b> Objective: </b>This study aimed at describing the experience and evaluating the tolerance, acceptability and injuries observed during upper gastrointestinal endoscopy. <b>Methods:</b> This is a prospective and descriptive study carried out from April to July 2017 in the digestive endoscopy unit of the Kara teaching hospital</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(Togo). The gastroscopy was performed by the same operator (Hepatogastroenteroloogist). The premedication was done with direct intravenous injection of 10 mg of Metoclopramide hydrochloride and viscous Lidocaine oral gel. Previously, essential information about the examination course was given to patients after obtaining their verbal consent. Patients’ impressions of the experience, tolerance and acceptability were collected on a survey sheet, before and after the examination.<b> Results:</b> One hundred and eleven patients were included, 62 women and 49 men. The average age was 45.9 years (15</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">-</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">88 years), and the sex ratio</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(F/M) was 1.2. Most of the patients (89.2%) were experiencing the gastroscopy for the first time, and the main reason was epigastralgia in 55%. The examination duration was good at 88.3% and tolerance was good at 72.1%. Tingling, irritation, pain or sore throat feelings were noted in 13.5%. Patients agreeing to make an ulterior UDE if necessary were up to 92.8%. Observed injuries were dominated by antral erythematous gastropathy (28.8%).</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><b><span style="font-family:;" "="">Conclusion:</span></b></span></span><span><span><span style="font-family:;" "=""> UDE is well tolerated among our patients and its acceptability is high. Injuries are dominated by inflammatory pathologies of the stomach in our population.</span></span></span>展开更多
Foreign bodies ingestion is regularly observed in gastroenterology context. The evolution is favorable with early extraction. Our main objective was to evaluate foreign bodies managed in digestive endoscopic center of...Foreign bodies ingestion is regularly observed in gastroenterology context. The evolution is favorable with early extraction. Our main objective was to evaluate foreign bodies managed in digestive endoscopic center of University hospital center Gabriel Touré. The study was retrospective from January 2007 to October 2017 in the endoscopic center of the service of gastroenterology of University hospital center Gabriel Touré and concerned the patients who have been addressed at this center for foreign bodies. We collated 44 patients who ingested foreign bodies among 2750 digestive endoscopies</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> that is to say</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> a frequency of 0.16%. In patient’s history, we found caustic obstruction in 2.3% of patients. The foreign body ingestion was accidental in 97.7% of cases. Pieces of money were more frequent (54.4%). In 86.4%, the foreign bodies were into the esophagus. Upper digestive endoscopy performed foreign bodies extraction in 88.6 of cases. In 9.1%</span><span style="font-family:Verdana;">, </span><span style="font-family:Verdana;">the elimination was spontaneous on 72 hours. Surgeon was indicated in 2.3% of patients. The evolution was favorable in 97.7% of patients. One patient died by digestive bleeding. Conclusion: Foreign bodies ingestion is frequent in children. The upper digestive endoscopy can do the diagnosis and the management.展开更多
Coronavirus disease 2019(COVID-19)is caused by infection of the coronavirus severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)with typical respiratory symptoms.SARS-CoV-2 invades not only the respiratory syst...Coronavirus disease 2019(COVID-19)is caused by infection of the coronavirus severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)with typical respiratory symptoms.SARS-CoV-2 invades not only the respiratory system,but also other organs expressing the cell surface receptor angiotensin converting enzyme 2.In particular,the digestive system is a susceptible target of SARS-CoV-2.Gastrointestinal symptoms of COVID-19 include anorexia,nausea,vomiting,diarrhea,abdominal pain,and liver damage.Patients with digestive damage have a greater chance of progressing to severe or critical illness,a poorer prognosis,and a higher risk of death.This paper aims to summarize the digestive system symptoms of COVID-19 and discuss fecal-oral contagion of SARS-CoV-2.It also describes the characteristics of inflammatory bowel disease patients with SARSCoV-2 infection and discusses precautions for preventing SARS-CoV-2 infection during gastrointestinal endoscopy procedures.Improved attention to digestive system abnormalities and gastrointestinal symptoms of COVID-19 patients may aid health care providers in the process of clinical diagnosis,treatment,and epidemic prevention and control.展开更多
From October 1985 to October 1987,weused Jing Jie Lian Oiao Tang(荆芥连翘汤)totreat 168 patients of mucous membrane diseasesof the digestive tract with good therapeutic ef-fect.CLINICAL DATASelection of CasesIn this s...From October 1985 to October 1987,weused Jing Jie Lian Oiao Tang(荆芥连翘汤)totreat 168 patients of mucous membrane diseasesof the digestive tract with good therapeutic ef-fect.CLINICAL DATASelection of CasesIn this series,all 168 cases are inpatientswith diseases of the mucous membrane from themouth to the colon,the diagnosis being con-firmed with endoscopy when necessary.41展开更多
<strong>Backgound: </strong>Aorto-digestive fistulas remain a fatal disease entity often occurring after vascular surgeries. Eso-gastro-duodenal endoscopy is essential to explore the upper digestive bleedi...<strong>Backgound: </strong>Aorto-digestive fistulas remain a fatal disease entity often occurring after vascular surgeries. Eso-gastro-duodenal endoscopy is essential to explore the upper digestive bleeding. The negativity of morphological examinations should not exclude the diagnosis. Diagnosis has benefited in recent years from developments in cross-sectional imaging: computed tomography (CT) and magnetic resonance imaging (MRI). The severity of bleeding is linked to the vital consequences (mortality close to 50% up to 100% in the absence of treatment), functional (30% amputation), and to the underlying infection itself correlated with the attack of the stent and the anastomosis.<strong> Patients: </strong>We report three cases of aorto-digestive fistulas treated at The University Hospital Hassan II to show the challenging diagnosis and therapeutic of such rare causes of upper digestive bleeding. <strong>Results:</strong> three patients were admitted to the emergency endoscopy unit for upper digestive bleeding, 2 of them had a medical history of Behcet Disease and two had past aortic aneurism surgery. The couple’s upper endoscopy and CT scan angiography made the diagnosis. Unfortunately, 2 patients died from fatal bleeding. <strong>Conclusion:</strong> Aortodigestive fistula is an extremely serious complication of aortic aneurisms and a rare cause of gastrointestinal bleeding. This diagnosis should be considered in any patient presenting with digestive bleeding with vascular disease or previous history of vascular stent.展开更多
BACKGROUND Dental injury is the leading cause of litigation in anaesthesia but an underrecognized preventable complication of endoscopy.AIM To determine frequency and effects of dental injury in endoscopy,we present f...BACKGROUND Dental injury is the leading cause of litigation in anaesthesia but an underrecognized preventable complication of endoscopy.AIM To determine frequency and effects of dental injury in endoscopy,we present findings from an audit of outpatient endoscopy procedures conducted at a tertiary university hospital and a systematic review of literature.METHODS Retrospective review of 11265 outpatient upper endoscopy procedures over the period of 1 June 2019 to 31 May 2021 identified dental related complications in 0.284%of procedures.Review of literature identified a similar rate of 0.33%.RESULTS Pre-existing dental pathology or the presence of prostheses makes damage more likely but sound teeth may be affected.Pre-endoscopic history and tooth examination are key for risk stratification and may be conducted succinctly with limited time outlay.Tooth retrieval should be prioritized in the event of dental injury to minimize aspiration and be followed by prompt dental consultation for specific management.CONCLUSION Dental complications occur in approximately 1 in 300 of upper endoscopy cases.These are easily preventable by pre-endoscopy screening.Protocols to mitigate dental injury are also suggested.展开更多
文摘BACKGROUND As lifestyles continue to change worldwide,the incidence of digestive tract carcinoma has gradually increased.Digestive endoscopy is an important tool that can assist in the diagnosis,treatment,and surgical intervention for this disease.However,the examination process is affected by many factors,and patient cooperation is often poor,which can increase the risk of complications.AIM To explore the effects of integrated management and cognitive intervention on cooperation and complications in patients undergoing endoscopy for early gastrointestinal neoplasms.METHODS A total of 354 patients with early stage gastrointestinal cancer who underwent digestive endoscopy procedures between January and December 2023 at our hospital were divided into observation and control groups(177 patients in each group)in a randomized controlled blind trial.The control group received routine interventions,while the observation group received comprehensive integrated management combined with cognitive interventions.We compared the changes in adverse mood,discomfort,examination time,cooperation with the examination,and complications before and after the intervention between the two groups.RESULTS The self-rated anxiety and depression scale scores were lower in the observation group than in the control group(P<0.05).The visual analog scale scores for discomfort during intubation and examination were also lower in the observation group than in the control group(P<0.05).Furthermore,the examination time was shorter in the observation group than in the control group(P<0.05),and the degree of cooperation(94.35%)was higher in the observation group than in the control group(84.75%;P<0.05).Lastly,the incidence rates of gastrointestinal adverse reactions(10.17%vs 20.34%),choking agitation(14.69%vs 24.86%),abdominal pain(8.47%vs 18.08%),and muscle tension(5.08%vs 14.12%)were all lower in the observation group than in the control group(P<0.05).CONCLUSION Integrated management and cognitive intervention in early gastrointestinal neoplasm endoscopy alleviate mood,reduce discomfort,shorten examinations,improve cooperation,and reduce complications.
文摘Introduction: Upper digestive hemorrhage is one of the main digestive emergencies and remains a major cause of morbidity and mortality in Mali. The aim of this study was to describe the therapeutic profile and outcome of patients suffering from upper digestive haemorrhage. Methodology: This was a prospective study carried out in the internal medicine department of the Sikasso Regional Hospital from August 2022 to July 2023. All adult patients presenting with upper digestive haemorrhage and having given their consent, were included. Data were analyzed using SPSS version 21 software. Results: Sixty-three patients were enrolled. The mean age was 49.7 ± 18.99 years, with a male-female sex ratio of 2.2. Ruptured esophageal varices (37.5%) and peptic ulcer (25%) were the main etiologies. Pharmacological treatment was dominated by proton pump inhibitors (85.7%). Hemostasis endoscopy accounted for 3.17%. The evolution was marked by hemorrhagic arrest (69.84%), recurrence of hemorrhage (11.11%) and death (19.04%), the main cause of which was hemorrhagic shock (58.3%). We found no statistically significant relationship between prognosis and etiologies (P = 0.11), and length of hospital stay (P = 0.18). Conclusion: Hemostasis endoscopy remains a challenge for Sikasso Hospital. A holistic strategy of communication and community awareness-raising, combined with adequate technical facilities, will help to improve patient care and outcomes.
文摘<strong>Introduction:</strong> <span><span><span style="font-family:;" "="">Gastritis is a very common and widely distributed condition <span>worldwide. It represents one of the most common pathological entities in</span> gastroenterology and digestive endoscopy. Our objective was to determine the sociodemographic, clinical, endoscopic, and histological aspects of gastritis in the digestive endoscopy unit of the General Hospital Idrissa Pouye (GHIP).<b> Materials and Method: </b>This was a retrospective study over a period of 4 years (from 1 January 2014 to 31 December 2017) at the digestive endoscopy <span>unit of GHIP. We had collated oesogastroduodenal endoscopy (EGDE) re</span>ports with gastritis appearance with gastric biopsies and reports with normal stomach appearance with gastric biopsies and their histological reports. We collected and analyzed data on age, gender, indications for endoscopy, endoscopic findings and histological results. <b>Results: </b>The reports of 593 patients were analyzed. The mean age was 45 years </span></span></span><span><span><span style="font-family:;" "="">old </span></span></span><span><span><span style="font-family:;" "="">(range 8 - 88 years</span></span></span><span><span><span style="font-family:;" "=""> old</span></span></span><span><span><span style="font-family:;" "="">) and the sex ratio was 0.63 (230 men). The indications for endoscopy were epigastralgia in (91%) of cases, dyspepsia in (22%) of cases, pyrosis in (12%) of <span>cases. The endoscopic appearance was normal in 229 patients (39%). The</span> endoscopic location of the gastritis was antral in 76%, fundic in 22% and pangastric in 2%. The gastritis was erythematous in 327 patients (90%), erosive in 126 patients (35%), congestive in 53 patients (15%), pseudonodular in 14 patients (4%) and atrophic in 10 patients (3%). Histology was normal in 8 patients (1.3%) and showed gastritis in 585 patients (98.7%). Gastritis was chronic in 575 patients (98.2%), acute in 10 patients (1.7%). Gastritis activity was moderate in (52.7%) and mild in (42.9%). Atrophy was absent in 521 patients (88.6%) and mild in 46 patients (8.2%). Intestinal metaplasia was found in 66 patients (11%). Dysplasia was present in 1.7% of cases. This dysplasia was intermediate grade (60%) in 6 patients, low grade (20%) in 2 patients and severe grade (20%). <i>H</i>. <i>pylori</i> was present in 404 patients (68%).<b> Conclusion: </b>Gastritis is </span></span></span><span><span><span style="font-family:;" "="">usually</span></span></span><span><span><span style="font-family:;" "=""> found in the digestive endoscopy unit of the GHIP. The indications for endoscopy are dominated by epigastralgia and histology is necessary for its diagnosis.</span></span></span>
文摘<strong>Introduction:</strong> <span><span><span style="font-family:;" "="">Thanks to the opening of the digestive endoscopy unit in the Reference General Hospital of Panzi in Bukavu in the Democratic Republic of the Congo, which inspired our work on the profile of endoscopic lesions observed in a series of 1000 patients correlated with clinical and demographic criteria with the contribution of pathology examinations of the 292 biopsies performed. The aim of our work is to evaluate the prevalence of significant endoscopic lesions as well as that of <i>H. pylori</i> infection. <b>Material and Methods:</b> This is a retrospective, descriptive and analytical study, ranging from the 16<sup>th</sup> of December 2014 to the 16<sup>th</sup> of June 2016. It covered 1000 patients who benefited from a high digestive endoscopy and 292 of them had a biopsy with pathological examination. The data obtained were recorded and analyzed using the Epi-info software and chi-square test. <b>Results:</b> fifty-five percent of these patients were women.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">66% of the patients were under 50</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">years of age. Their major symptom was epigastric pain</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(89.2%),</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">the most observed endoscopic lesion was erythematous gastritis</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(82%) therefore we have noticed 21</span></span></span><span><span><span style="font-family:;" "="">.</span></span></span><span><span><span style="font-family:;" "="">5% of significant lesions. Gastric cancer was present in 3.9% of cases and gastric ulcer in 4.2% of cases. The gastric tumor was correlated with age and sex (P-value at 0.000 and 0.013). The gastroduodenal ulcer was linked to age, <i>NSAID</i> and tobacco use (P-value at 0.0007, 0.001, 0.007). Esophageal mycosis was correlated with HIV status (P-value at 0.000). <i>Helicobacter pylori</i> gastritis was the most frequent (61.30%) and</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><i><span style="font-family:;" "="">Helicobacter pylori</span></i></span></span><span><span><span style="font-family:;" "=""> were present in 63% of gastric biopsies. <b>Conclusion: </b>Upper digestive endoscopy is a major tool for the diagnosis of upper gastrointestinal disorders and should always be followed by a biopsy if there is a suspicious lesion for pathologic confirmation and adequate management.</span></span></span>
文摘AIM: To evaluate the hemostatic effect of topical hemocoagulase spray in digestive endoscopy.METHODS: Eighty-nine patients who developed oozing bleeding during endoscopic treatment from September 2014 to October 2014 at Center for Digestive Endoscopy, Tianjin Medical University General Hospital were randomly divided into either a study group(n = 39) or a control group(n = 50). The study group was given topical hemocoagulase spray intraoperatively, while the control group was given traditional 8% norepinephrine spray. Hemostatic efficacy was compared between the two groups. Bleeding site, wound cleanliness and perforation were recorded, and the rates of perforation and late bleeding were compared.RESULTS: Successful hemostasis was achieved in 39(100%) patients of the study group and in 47(94.0%) patients of the control group, and there was no significant difference in the rate of successful hemostasis between the two groups. Compared with the control group, after topical hemocoagulase spray in the study group, the surgical field was clearer, the bleeding site was more easily identified, and the wound was cleaner. There was no significant difference in the rate of perforation between the study and control groups(16.7% vs 35.0%, P = 0.477), but the rates oflate bleeding(0% vs 15.8%, P = 0.048) and overall complications(P = 0.032) were significantly lower in the study group.CONCLUSION: Topical hemocoagulase spray has a definite hemostatic effect for oozing bleeding in digestive endoscopy, and this method is convenient, safe, and reliable. It is expected to become a new method for endoscopic hemostasis.
文摘AIM:To assess the adoption of Carbon dioxide(CO2)insufflation by endoscopists from various European countries,and its determinants.METHODS:A survey was distributed to 580 endoscopists attending a live course on digestive endoscopy.RESULTS:The response rate was 24.5%.Fewer than half the respondents(66/142,46.5%)were aware of the fact that room air can be replaced by CO2 for gut distension during endoscopy,and 4.2%of respondents were actually using CO2 as the insufflation agent.Endoscopists aware of the possibility of CO2 insufflation mentioned technical difficulties in implementing the system and the absence of significant advantages of CO2 in comparison with room air as barriers to adoption in daily practice(84%and 49%of answers,respectively;two answers were permitted for this item).CONCLUSION:Based on this survey,adoption of CO2 insufflation during endoscopy seems to remain relatively exceptional.A majority of endoscopists were not aware of this possibility,while others were not aware of recent technical developments that facilitate CO2 implementation in an endoscopy suite.
文摘In 2000,the small bowel capsule revolutionized the management of patients with small bowel disorders.Currently,the technological development achieved by the new models of double-headed endoscopic capsules,as miniaturized devices to evaluate the small bowel and colon[pan-intestinal capsule endoscopy(PCE)],makes this non-invasive procedure a disruptive concept for the management of patients with digestive disorders.This technology is expected to identify which patients will require conventional invasive endoscopic procedures(colonoscopy or balloon-assisted enteroscopy),based on the lesions detected by the capsule,i.e.,those with an indication for biopsies or endoscopic treatment.The use of PCE in patients with inflammatory bowel diseases,namely Crohn’s disease,as well as in patients with iron deficiency anaemia and/or overt gastrointestinal(GI)bleeding,after a non-diagnostic upper endoscopy(esophagogastroduodenoscopy),enables an effective,safe and comfortable way to identify patients with relevant lesions,who should undergo subsequent invasive endoscopic procedures.The recent development of magnetically controlled capsule endoscopy to evaluate the upper GI tract,is a further step towards the possibility of an entirely non-invasive assessment of all the segments of the digestive tract,from mouth-to-anus,meeting the expectations of the early developers of capsule endoscopy.
文摘The pneumonia caused by the coronavirus disease-2019(COVID-19)outbreak in Wuhan,China constitutes a public health emergency of international concern.The gastrointestinal symptoms of vomiting,diarrhea and abdominal pain and the detection of COVID-19 nucleic acid from fecal specimens in a small number of patients suggest the possibility of transmission via the gastrointestinal tract.People of all ages are vulnerable to this virus,including children.Digestive endoscopy is an invasive procedure during which children cannot wear masks;therefore,they have higher risks of exposure to COVID-19,and the digestive endoscopy center is a relatively high-risk area for COVID-19 infection.Based on these factors and in combination with related policies and regulations,a prevention and control program for the COVID-19 pneumonia in a children's digestive endoscopy center was established to prevent the COVID-19 nosocomial infection.
文摘<strong>Background:</strong><span><span><span style="font-family:;" "=""> Endoscopy remains the most performant medical exam exploring the upper digestive tract;but depending on patients, its tolerance is variable.<b> Objective: </b>This study aimed at describing the experience and evaluating the tolerance, acceptability and injuries observed during upper gastrointestinal endoscopy. <b>Methods:</b> This is a prospective and descriptive study carried out from April to July 2017 in the digestive endoscopy unit of the Kara teaching hospital</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(Togo). The gastroscopy was performed by the same operator (Hepatogastroenteroloogist). The premedication was done with direct intravenous injection of 10 mg of Metoclopramide hydrochloride and viscous Lidocaine oral gel. Previously, essential information about the examination course was given to patients after obtaining their verbal consent. Patients’ impressions of the experience, tolerance and acceptability were collected on a survey sheet, before and after the examination.<b> Results:</b> One hundred and eleven patients were included, 62 women and 49 men. The average age was 45.9 years (15</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">-</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">88 years), and the sex ratio</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><span style="font-family:;" "="">(F/M) was 1.2. Most of the patients (89.2%) were experiencing the gastroscopy for the first time, and the main reason was epigastralgia in 55%. The examination duration was good at 88.3% and tolerance was good at 72.1%. Tingling, irritation, pain or sore throat feelings were noted in 13.5%. Patients agreeing to make an ulterior UDE if necessary were up to 92.8%. Observed injuries were dominated by antral erythematous gastropathy (28.8%).</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span><span><b><span style="font-family:;" "="">Conclusion:</span></b></span></span><span><span><span style="font-family:;" "=""> UDE is well tolerated among our patients and its acceptability is high. Injuries are dominated by inflammatory pathologies of the stomach in our population.</span></span></span>
文摘Foreign bodies ingestion is regularly observed in gastroenterology context. The evolution is favorable with early extraction. Our main objective was to evaluate foreign bodies managed in digestive endoscopic center of University hospital center Gabriel Touré. The study was retrospective from January 2007 to October 2017 in the endoscopic center of the service of gastroenterology of University hospital center Gabriel Touré and concerned the patients who have been addressed at this center for foreign bodies. We collated 44 patients who ingested foreign bodies among 2750 digestive endoscopies</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> that is to say</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> a frequency of 0.16%. In patient’s history, we found caustic obstruction in 2.3% of patients. The foreign body ingestion was accidental in 97.7% of cases. Pieces of money were more frequent (54.4%). In 86.4%, the foreign bodies were into the esophagus. Upper digestive endoscopy performed foreign bodies extraction in 88.6 of cases. In 9.1%</span><span style="font-family:Verdana;">, </span><span style="font-family:Verdana;">the elimination was spontaneous on 72 hours. Surgeon was indicated in 2.3% of patients. The evolution was favorable in 97.7% of patients. One patient died by digestive bleeding. Conclusion: Foreign bodies ingestion is frequent in children. The upper digestive endoscopy can do the diagnosis and the management.
文摘Coronavirus disease 2019(COVID-19)is caused by infection of the coronavirus severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)with typical respiratory symptoms.SARS-CoV-2 invades not only the respiratory system,but also other organs expressing the cell surface receptor angiotensin converting enzyme 2.In particular,the digestive system is a susceptible target of SARS-CoV-2.Gastrointestinal symptoms of COVID-19 include anorexia,nausea,vomiting,diarrhea,abdominal pain,and liver damage.Patients with digestive damage have a greater chance of progressing to severe or critical illness,a poorer prognosis,and a higher risk of death.This paper aims to summarize the digestive system symptoms of COVID-19 and discuss fecal-oral contagion of SARS-CoV-2.It also describes the characteristics of inflammatory bowel disease patients with SARSCoV-2 infection and discusses precautions for preventing SARS-CoV-2 infection during gastrointestinal endoscopy procedures.Improved attention to digestive system abnormalities and gastrointestinal symptoms of COVID-19 patients may aid health care providers in the process of clinical diagnosis,treatment,and epidemic prevention and control.
文摘From October 1985 to October 1987,weused Jing Jie Lian Oiao Tang(荆芥连翘汤)totreat 168 patients of mucous membrane diseasesof the digestive tract with good therapeutic ef-fect.CLINICAL DATASelection of CasesIn this series,all 168 cases are inpatientswith diseases of the mucous membrane from themouth to the colon,the diagnosis being con-firmed with endoscopy when necessary.41
文摘<strong>Backgound: </strong>Aorto-digestive fistulas remain a fatal disease entity often occurring after vascular surgeries. Eso-gastro-duodenal endoscopy is essential to explore the upper digestive bleeding. The negativity of morphological examinations should not exclude the diagnosis. Diagnosis has benefited in recent years from developments in cross-sectional imaging: computed tomography (CT) and magnetic resonance imaging (MRI). The severity of bleeding is linked to the vital consequences (mortality close to 50% up to 100% in the absence of treatment), functional (30% amputation), and to the underlying infection itself correlated with the attack of the stent and the anastomosis.<strong> Patients: </strong>We report three cases of aorto-digestive fistulas treated at The University Hospital Hassan II to show the challenging diagnosis and therapeutic of such rare causes of upper digestive bleeding. <strong>Results:</strong> three patients were admitted to the emergency endoscopy unit for upper digestive bleeding, 2 of them had a medical history of Behcet Disease and two had past aortic aneurism surgery. The couple’s upper endoscopy and CT scan angiography made the diagnosis. Unfortunately, 2 patients died from fatal bleeding. <strong>Conclusion:</strong> Aortodigestive fistula is an extremely serious complication of aortic aneurisms and a rare cause of gastrointestinal bleeding. This diagnosis should be considered in any patient presenting with digestive bleeding with vascular disease or previous history of vascular stent.
文摘BACKGROUND Dental injury is the leading cause of litigation in anaesthesia but an underrecognized preventable complication of endoscopy.AIM To determine frequency and effects of dental injury in endoscopy,we present findings from an audit of outpatient endoscopy procedures conducted at a tertiary university hospital and a systematic review of literature.METHODS Retrospective review of 11265 outpatient upper endoscopy procedures over the period of 1 June 2019 to 31 May 2021 identified dental related complications in 0.284%of procedures.Review of literature identified a similar rate of 0.33%.RESULTS Pre-existing dental pathology or the presence of prostheses makes damage more likely but sound teeth may be affected.Pre-endoscopic history and tooth examination are key for risk stratification and may be conducted succinctly with limited time outlay.Tooth retrieval should be prioritized in the event of dental injury to minimize aspiration and be followed by prompt dental consultation for specific management.CONCLUSION Dental complications occur in approximately 1 in 300 of upper endoscopy cases.These are easily preventable by pre-endoscopy screening.Protocols to mitigate dental injury are also suggested.