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Fábián A, Bor R, Vasas B, Szűcs M, Tóth T, Bősze Z, Szántó KJ, Bacsur P, Bálint A, Farkas B, Farkas K, Milassin Á, Rutka M, Resál T, Molnár T, Szepes Z. Long-term outcomes after endoscopic removal of malignant colorectal polyps: Results from a 10-year cohort. World J Gastrointest Endosc 2024; 16:193-205. [DOI: 10.4253/wjge.v16.i4.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/28/2024] [Accepted: 03/18/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Choosing an optimal post-polypectomy management strategy of malignant colorectal polyps is challenging, and evidence regarding a surveillance-only strategy is limited.
AIM To evaluate long-term outcomes after endoscopic removal of malignant colorectal polyps.
METHODS A single-center retrospective cohort study was conducted to evaluate outcomes after endoscopic removal of malignant colorectal polyps between 2010 and 2020. Residual disease rate and nodal metastases after secondary surgery and local and distant recurrence rate for those with at least 1 year of follow-up were investigated. Event rates for categorical variables and means for continuous variables with 95% confidence intervals were calculated, and Fisher’s exact test and Mann-Whitney test were performed. Potential risk factors of adverse outcomes were determined with univariate and multivariate logistic regression models.
RESULTS In total, 135 lesions (mean size: 22.1 mm; location: 42% rectal) from 129 patients (mean age: 67.7 years; 56% male) were enrolled. The proportion of pedunculated and non-pedunculated lesions was similar, with en bloc resection in 82% and 47% of lesions, respectively. Tumor differentiation, distance from resection margins, depth of submucosal invasion, lymphovascular invasion, and budding were reported at 89.6%, 45.2%, 58.5%, 31.9%, and 25.2%, respectively. Residual tumor was found in 10 patients, and nodal metastasis was found in 4 of 41 patients who underwent secondary surgical resection. Univariate analysis identified piecemeal resection as a risk factor for residual malignancy (odds ratio: 1.74; P = 0.042). At least 1 year of follow-up was available for 117 lesions from 111 patients (mean follow-up period: 5.59 years). Overall, 54%, 30%, 30%, 11%, and 16% of patients presented at the 1-year, 3-year, 5-year, 7-year, and 9-10-year surveillance examinations. Adverse outcomes occurred in 9.0% (local recurrence and dissemination in 4 patients and 9 patients, respectively), with no difference between patients undergoing secondary surgery and surveillance only.
CONCLUSION Reporting of histological features and adherence to surveillance colonoscopy needs improvement. Long-term adverse outcome rates might be higher than previously reported, irrespective of whether secondary surgery was performed.
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Affiliation(s)
- Anna Fábián
- Department of Internal Medicine, University of Szeged, Szent-Györgyi Albert Medical School, Szeged 6725, Hungary
| | - Renáta Bor
- Department of Internal Medicine, University of Szeged, Szent-Györgyi Albert Medical School, Szeged 6725, Hungary
| | - Béla Vasas
- Department of Pathology, University of Szeged, Szent-Györgyi Albert Medical School, Szeged 6725, Hungary
| | - Mónika Szűcs
- Department of Medical Physics and Medical Informatics, University of Szeged, Szent-Györgyi Albert Medical School, Szeged 6720, Hungary
| | - Tibor Tóth
- Department of Internal Medicine, University of Szeged, Szent-Györgyi Albert Medical School, Szeged 6725, Hungary
| | - Zsófia Bősze
- Department of Internal Medicine, University of Szeged, Szent-Györgyi Albert Medical School, Szeged 6725, Hungary
| | - Kata Judit Szántó
- Department of Internal Medicine, University of Szeged, Szent-Györgyi Albert Medical School, Szeged 6725, Hungary
| | - Péter Bacsur
- Department of Internal Medicine, University of Szeged, Szent-Györgyi Albert Medical School, Szeged 6725, Hungary
| | - Anita Bálint
- Department of Internal Medicine, University of Szeged, Szent-Györgyi Albert Medical School, Szeged 6725, Hungary
| | - Bernadett Farkas
- Department of Internal Medicine, University of Szeged, Szent-Györgyi Albert Medical School, Szeged 6725, Hungary
| | - Klaudia Farkas
- Department of Internal Medicine, University of Szeged, Szent-Györgyi Albert Medical School, Szeged 6725, Hungary
- USZ Translational Colorectal Research Group, Hungarian Centre of Excellence for Molecular Medicine, Szeged 6725, Hungary
| | - Ágnes Milassin
- Department of Internal Medicine, University of Szeged, Szent-Györgyi Albert Medical School, Szeged 6725, Hungary
| | - Mariann Rutka
- Department of Internal Medicine, University of Szeged, Szent-Györgyi Albert Medical School, Szeged 6725, Hungary
| | - Tamás Resál
- Department of Internal Medicine, University of Szeged, Szent-Györgyi Albert Medical School, Szeged 6725, Hungary
| | - Tamás Molnár
- Department of Internal Medicine, University of Szeged, Szent-Györgyi Albert Medical School, Szeged 6725, Hungary
| | - Zoltán Szepes
- Department of Internal Medicine, University of Szeged, Szent-Györgyi Albert Medical School, Szeged 6725, Hungary
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Schulte K, Wolf HW. Occurrence of multiple fistulas decades after ingestion and neglect of numerous thermometers: a case report. Surg Case Rep 2024; 10:4. [PMID: 38165519 PMCID: PMC10761639 DOI: 10.1186/s40792-023-01801-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/24/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Ingestion of thermometers is a very rare occurrence and associated with penetrations of hollow organs. An event decades ago can lead to the development of fistulas. CASE PRESENTATION We present a case of a 62-year-old male who swallowed multiple thermometers with a length of up to 22 cm over a period of 40 years. Diagnostic imaging presented a retroperitoneal abscess due to a duodenal perforation of the longest thermometer as well as multiple other thermometers stuck in the small intestine. After all thermometers were removed and the abscess drained, the patient showed a clinical deterioration. In further operations we found a duodeno-sigmoid fistula and a gastro-thoracal fistula, which were not visible in the initial operations and imaging. CONCLUSION We recommend an active search for fistulas especially in the case of long-foregone ingestion.
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Affiliation(s)
- Katrin Schulte
- General and Visceral Surgery, Cantonal Hospital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland.
| | - Henning Wendelin Wolf
- General and Visceral Surgery, Cantonal Hospital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland
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Quitadamo P, Gragnaniello P, Isoldi S, Bucci C, Esposito F, Russo S, Grella MG, Caldore M. Magnetic foreign body ingestion in pediatric age. Dig Liver Dis 2023:S1590-8658(23)01027-7. [PMID: 37985250 DOI: 10.1016/j.dld.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVES To assess the clinical complications reported after the ingestion of magnetic foreign bodies (FBs) in pediatric age, along with their incidence among all FB ingestions and clinical presentation. STUDY DESIGN We've consecutively recruited all children aged 0-14 years who were admitted for single or multiple magnet ingestion from May 2015 to December 2022. Patient demographics, admission sources and discharge status were accurately recorded, along with their clinical management and outcomes. RESULTS Sixty-one children were enrolled, of whom 49/61 (80.3%) had ingested a single magnet and 12/61 (19.7%) multiple magnets. Only 1/49 children with single magnet required endoscopic removal due to esophageal retention. Among children having ingested multiple magnets, 5/12 (41.7%) undergo endoscopic removal since magnets were amenable to endoscopic retrieval whereas in 7/12 (58.3%) magnets could not be promptly removed. Among these, 4/12 (33.3%) later developed intestinal ischemia/necrosis or perforation and required FB surgical intervention whereas 3/12 (25%) uneventfully evacuated magnets. CONCLUSIONS Our data confirm that multiple magnet ingestion, unlike single magnet ingestion, pose a serious health hazard. Parents and caregivers should remove them from the reach of children. Medical providers should maintain a high index of suspicion of their ingestion since prompt evaluation and likely removal may be lifesaving and intestine saving.
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Affiliation(s)
- Paolo Quitadamo
- Pediatric Gastroenterology and Epatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy.
| | - Piergiorgio Gragnaniello
- Department of Translational Medical Science, Section of Pediatrics, University "Federico II", Naples, Italy
| | - Sara Isoldi
- Pediatric Gastroenterology and Epatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Cristina Bucci
- Pediatric Gastroenterology and Epatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Francesco Esposito
- Department of Emergency Radiology, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Silvana Russo
- Pediatric Surgery Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | | | - Mariano Caldore
- Pediatric Gastroenterology and Epatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
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Priya M, Doomra S, Angral S, Malhotra M, Bhardwaj A, Varshney S, Moideen A, Gupta MK. Supernumerary Tooth: Endoscopic Removal for a Rare Cause of Recurrent Epistaxis. Indian J Otolaryngol Head Neck Surg 2022; 74:1143-1146. [PMID: 36452607 PMCID: PMC9702100 DOI: 10.1007/s12070-020-02221-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 10/12/2020] [Indexed: 11/28/2022] Open
Abstract
The presence of ectopic (supernumerary) teeth is common odontogenic problem in clinical practice. Its presence in dentate region is common but rare in the non dentate areas such as nose and maxillary sinus. The intranasal teeth generally remain asymptomatic but can get misdiagnosed for foreign body, or may present as complications like headache, epistaxis, nasal obstruction, rhinolith formation, oroantral fistula and sinusitis. Here, we discuss a case of intranasal tooth as a rare cause of profuse and recurrent epistaxis. The clinical, radiological findings and surgical treatment via endoscopic approach of this rare entity has been discussed. This interesting case report highlights the need to look beyond nose as cause for epistaxis. Endoscopic removal for this entity can be a preferred option to help minimize complications.
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Affiliation(s)
- Madhu Priya
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttrakhand India
| | - Sofia Doomra
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttrakhand India
| | - Sumeet Angral
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttrakhand India
| | - Manu Malhotra
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttrakhand India
- Department of ENT, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203 India
| | - Abhishek Bhardwaj
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttrakhand India
| | - Saurabh Varshney
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttrakhand India
| | - Areej Moideen
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Rishikesh, Uttrakhand India
| | - Manish Kumar Gupta
- Department of Paediatric Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand India
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Li G, Wu D, Zhou L, You D, Huang X. Delayed Endoscopic Management of Esophageal Sharp-Pointed Food Impaction: An Analysis of 829 Cases in China. Dig Dis Sci 2022; 67:3166-76. [PMID: 34342753 DOI: 10.1007/s10620-021-07133-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/20/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Esophageal foreign body impaction is the most common cause of endoscopic emergency. However, there are limited available data on delayed endoscopic management of esophageal sharp-pointed food impaction. AIMS To investigate cases of esophageal sharp-pointed food impaction with endoscopic removal findings. METHODS This single-center retrospective study collected medical records to identify patients with esophageal sharp-pointed food impaction who underwent endoscopic removal between April 2018 and April 2020. The patients were divided into the early (endoscopic removal <12 h) and delayed intervention (>12 h) cohorts. RESULTS Overall, 133 and 696 patients received early and delayed intervention, respectively. The success rate of endoscopic foreign body removal was 96.45%. The most common foreign body was fish bone (66.90%), and the most common shape was "I" (56.26%). Patients from the delayed intervention cohort received general anesthesia with a higher risk for perforation, and no foreign body was identified. The duration of endoscopy, distance between the foreign body/wound and the incisor, and longest diameter of the foreign body were not different between the groups. In multivariate analysis, male sex (odds ratio = 1.792 [1.159, 2.771]; P = 0.009), longer duration of impaction (odds ratio = 2.212 [1.121, 4.365]; P = 0.022) and endoscopy (odds ratio = 1.502 [1.253, 1.800]; P < 0.001), and longest diameter of the foreign body (odds ratio = 1.632 [1.329, 2.003]; P < 0.001) were associated with a higher incidence of perforation in patients with foreign body impaction. CONCLUSIONS Endoscopic removal is a safe and effective treatment method for sharp-pointed food impaction. Delayed endoscopic removal can increase the risk of esophageal perforation.
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Kumai M, Hayashi T, Kimiwada T, Tominaga T. Transcortical Endoscopic Removal of Residual Craniopharyngioma in the Third Ventricle: Surgical Video. World Neurosurg 2022; 164:177. [PMID: 35568124 DOI: 10.1016/j.wneu.2022.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 11/24/2022]
Abstract
Excision through craniotomy is used for pediatric craniopharyngioma removal. However, residual tumors can sometimes be found in the blind spot of the microscopic field, such as the third ventricle wall, back of the optic chiasm, and brainstem surface, during surgery. Video 1 demonstrates the surgery using a flexible endoscope for the removal of residual tumor located within the blind spot of the first resection. The written consent was obtained from the patient's family. A 4-year-old child complained of vomiting, and the radiologic findings showed obstructive hydrocephalus and a calcified suprasellar mass lesion that extended to the third ventricle. The tumor was treated with a right frontotemporal craniotomy. The pathologic diagnosis was craniopharyngioma. Postoperative magnetic resonance imaging showed residual tumor detected at the roof of the third ventricle, back of the optic chiasm, and interpeduncular fossa. The residual tumors were removed using a flexible endoscope via a transcortical, transventricular approach. Postoperative magnetic resonance imaging showed no residual tumors. Although histologically benign, craniopharyngiomas may be locally aggressive and their close proximity to vital structures makes them one of our controversial management dilemmas. Recurrence may occur following even a presumed total excision and radiation therapy. Residual tumors located in the third ventricle are resected through various approaches, such as the transsphenoidal or transcallosal approach. Our approach using a flexible endoscope was minimally invasive and useful for the removal of residual tumor of the third ventricle in craniopharyngioma surgery because the approach offered a wide field of view and visual angle and forceps could be applied according to the view.
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Affiliation(s)
- Moe Kumai
- Department of Neurosurgery, Miyagi Children's Hospital, Sendai, Japan; Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Toshiaki Hayashi
- Department of Neurosurgery, Miyagi Children's Hospital, Sendai, Japan; Department of Pediatric Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Tomomi Kimiwada
- Department of Neurosurgery, Miyagi Children's Hospital, Sendai, Japan
| | - Teiji Tominaga
- Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
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Yonemoto S, Uesato M, Aoyama H, Maruyama T, Urahama R, Suito H, Yamaguchi Y, Kato M, Matsubara H. A double-scope technique enabled a patient with an esophageal plastic fork foreign body to avoid surgery: a case report and review of the literature. Clin J Gastroenterol 2021; 15:66-70. [PMID: 34741229 DOI: 10.1007/s12328-021-01549-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/27/2021] [Indexed: 11/28/2022]
Abstract
Foreign body ingestion is a common problem, and endoscopic removal is often performed with ancillary equipment. However, long, sharp foreign bodies are much more difficult to remove endoscopically than other objects and require emergent surgery. A 68-year-old man with a history of distal gastrectomy accidentally swallowed a plastic fork. He complained of chest pain at the visit. The plastic fork was located between the thoracic esophagus and remnant stomach. Endoscopic removal of the plastic fork was considered difficult, and surgery was deemed necessary. However, we were able to avoid surgery to remove the object using two endoscopes with hoods and a polypectomy snare. The first endoscope covered the sharp edge with a hood, and the snare grasped the neck of the plastic fork. The second endoscope covered the remaining sharp tip. A single operator held the two endoscopes and the snare and pulled them out together. This new double-scope technique is simple and useful for removing long, sharp foreign bodies, such as forks, from the esophagus.
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Affiliation(s)
- Shohei Yonemoto
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8677, Japan
| | - Masaya Uesato
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8677, Japan.
| | - Hiromichi Aoyama
- Japan Community Healthcare Organization Chiba-Hospital, Chiba, 260-8710, Japan
| | - Tetsuro Maruyama
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8677, Japan
| | - Ryuma Urahama
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8677, Japan
| | - Hiroshi Suito
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8677, Japan
| | - Yukiko Yamaguchi
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8677, Japan
| | - Manami Kato
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8677, Japan
| | - Hisahiro Matsubara
- Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8677, Japan
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Jain D, Stein A, Hasan MK. Stepwise Algorithmic Approach to Endoscopic Removal of Biliary Partially Covered and Uncovered Self-Expanding Metal Stents. Clin Endosc 2020; 54:608-612. [PMID: 33296959 PMCID: PMC8357580 DOI: 10.5946/ce.2020.189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 07/27/2020] [Indexed: 11/14/2022] Open
Abstract
Self-expanding metal stents play a crucial role in the management of patients with biliary obstruction. Endoscopic extraction of uncovered metal stents (UCMSs) and partially covered metal stents (PCMSs) could be challenging because of tissue ingrowth. No standardized technique can guarantee universal success. We present our technique and experience of endoscopic extraction of biliary stents in two patients with a UCMS and three patients with a PCMS. Three of the five patients had a previous failed attempt of stent extraction at an outside hospital. Overall, our composite success rate was 80% (4/5). The individual success rate was 100% (3/3) for PCMSs and 50% (1/2) for UCMSs. The stent-in-stent technique, in which a fully covered metal stent is placed through an existing UCMS/PCMS, was used in 60% (3/5) of the cases, with a success rate of 66.7% (2/3). We share our algorithmic approach to each case, with detailed emphasis on the technical aspects of the procedure.
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Affiliation(s)
- Deepanshu Jain
- Center for Interventional Endoscopy, Advent Health, Orlando, FL, USA
| | - Assaf Stein
- Center for Interventional Endoscopy, Advent Health, Orlando, FL, USA
| | - Muhammad K Hasan
- Center for Interventional Endoscopy, Advent Health, Orlando, FL, USA
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Akaishi T, Ishizawa K, Fukutomi T, Yamamoto Y, Ichikawa H, Watanabe S, Mori N, Saito M, Takayama S, Abe M, Hatsugai K, Ishii T. Penetration of a swallowed fish bone into pulmonary vein: diagnosis and management. Heliyon 2020; 6:e05611. [PMID: 33294720 DOI: 10.1016/j.heliyon.2020.e05611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 11/24/2022] Open
Abstract
We present a case of a 71-year-old woman who accidently swallowed a large fish bone that penetrated into the pulmonary vein. She visited the hospital the next day with a complaint of mild chest discomfort with slight pain and fever of 37.4 °C. Contrast-enhanced chest computed tomography (CT) scan revealed a large fish bone with a length of 35 mm impacted in the middle esophagus. The bone had penetrated into the pulmonary vein, causing mediastinitis. Blood tests revealed elevation in the white blood cell count and C-reactive protein level. Because intractable bleeding from pulmonary vein after endoscopic removal can be lethal, endoscopic removal of the fish bone in an operating room under general anesthesia with cardiovascular surgical standby for possible emergency surgery was selected. After endoscopic removal, mediastinal hematoma was absent with a follow-up chest CT scan, and the mediastinitis was treated with intravenous antibiotics. The patient shortly became afebrile with normalized blood test findings. After confirming the normal findings on the follow-up chest CT scan and endoscopic inspection in the next week, she was discharged from the hospital 10 days after hospitalization without any complications. When the swallowed bone penetrates into the major pericardial vessels, unprepared endoscopic removal may result in fatal sequelae such as intractable mediastinal hemorrhage. Urgent consultation with cardiovascular or thoracic surgeons for a possible emergent surgery is needed before endoscopic removal is attempted.
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Sleiman A, Studer AS, Garneau PY, Denis R, Magdy M, Alanazi M, Pescarus R. Case Report: Endoscopic Removal of an Eroded Gastric Band Causing Small Bowel Obstruction upon Migration into the Proximal Jejunum. Obes Surg 2020; 30:5153-5156. [PMID: 32779076 PMCID: PMC7417257 DOI: 10.1007/s11695-020-04906-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 12/03/2022]
Abstract
Background Adjustable gastric banding (AGB) is on the decline due to its relatively modest amount of expected weight loss, coupled with high rates of revision and complications such as band erosion. Management of eroded gastric bands can be challenging especially when complete intra-gastric erosion is followed by distal migration causing small bowel obstruction. Methods We present an endoscopic option of using a pediatric colonoscope to remove an eroded AGB causing jejunal obstruction. Result Endoscopic removal of an eroded ABG causing bowel obstruction was successful. Conclusion Endoscopy remains a safe and relatively non-invasive approach to deal with such complications.
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Affiliation(s)
- Amir Sleiman
- Department of Minimally Invasive and Bariatric Surgery, Hôpital du Sacré-Coeur, CIUSSS du Nord de l'île de Montréal, 5400 Boulevard Gouin Ouest H4J 1C5, Québec, Montréal, Canada
| | - Anne Sophie Studer
- Department of Minimally Invasive and Bariatric Surgery, Hôpital du Sacré-Coeur, CIUSSS du Nord de l'île de Montréal, 5400 Boulevard Gouin Ouest H4J 1C5, Québec, Montréal, Canada
| | - Pierre Y Garneau
- Department of Minimally Invasive and Bariatric Surgery, Hôpital du Sacré-Coeur, CIUSSS du Nord de l'île de Montréal, 5400 Boulevard Gouin Ouest H4J 1C5, Québec, Montréal, Canada
| | - Ronald Denis
- Department of Minimally Invasive and Bariatric Surgery, Hôpital du Sacré-Coeur, CIUSSS du Nord de l'île de Montréal, 5400 Boulevard Gouin Ouest H4J 1C5, Québec, Montréal, Canada
| | - Mark Magdy
- Department of Minimally Invasive and Bariatric Surgery, Hôpital du Sacré-Coeur, CIUSSS du Nord de l'île de Montréal, 5400 Boulevard Gouin Ouest H4J 1C5, Québec, Montréal, Canada
| | - Majed Alanazi
- Department of Minimally Invasive and Bariatric Surgery, Hôpital du Sacré-Coeur, CIUSSS du Nord de l'île de Montréal, 5400 Boulevard Gouin Ouest H4J 1C5, Québec, Montréal, Canada
| | - Radu Pescarus
- Department of Minimally Invasive and Bariatric Surgery, Hôpital du Sacré-Coeur, CIUSSS du Nord de l'île de Montréal, 5400 Boulevard Gouin Ouest H4J 1C5, Québec, Montréal, Canada.
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Robinson TJ, Soriano C, Larsen M, Mallipeddi MK, Hunter JA, Chang L. Endoscopic removal of eroded laparoscopic adjustable gastric bands: a preferred approach. Surg Obes Relat Dis 2020; 16:1030-1034. [PMID: 32540149 DOI: 10.1016/j.soard.2020.04.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/09/2020] [Accepted: 04/23/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Complications related to laparoscopic adjustable gastric banding (LAGB) have led to an increased number of removals. An uncommon but potentially devastating complication is gastric band erosion into the gastric lumen, which can be managed by open surgical, laparoscopic, and endoscopic approaches. OBJECTIVE A wide array of management techniques has been reported for removal of LAGB that have eroded into the stomach. We describe the preferred method for successful endoscopic band removal at our institution. SETTING Community tertiary-care referral hospital accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. METHODS A single-center, retrospective review of a prospectively maintained database was used to identify patients who underwent LAGB removal from 2009 to 2019. We identified the subset of patients with band erosion. We analyzed patient characteristics, presenting symptoms, diagnostic modalities, and method of band extraction. RESULTS A total of 132 patients underwent LAGB removal, among whom 22 (16.7%) patients were diagnosed with erosion. Seven (32%) patients underwent laparoscopic removal, 14 (64%) patients underwent endoscopic removal, and 1 patient (4%) underwent combined laparoscopic and endoscopic approach. These latter patients had variable amounts of erosion and buckle visibility, but all underwent endoscopic retrieval. We found that using an endoscopic retrograde cholangiopancreatography guidewire with an endoscopic retrograde cholangiopancreatography mechanical lithotriptor for band transection and snare for retrieval have been effective. CONCLUSIONS A standardized, multidisciplinary, and minimally invasive endoscopic approach for LAGB erosion has been found to be successful without the need for further surgical intervention and may be offered to patients upon discovery of erosion.
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Affiliation(s)
- Todd J Robinson
- Department of General, Thoracic, and Vascular Surgery, Virginia Mason Medical Center, Seattle, Washington
| | - Celine Soriano
- Department of General, Thoracic, and Vascular Surgery, Virginia Mason Medical Center, Seattle, Washington
| | - Michael Larsen
- Department of Gastroenterology, Virginia Mason Medical Center, Seattle, Washington
| | - Mohan K Mallipeddi
- Department of General, Thoracic, and Vascular Surgery, Virginia Mason Medical Center, Seattle, Washington
| | - Jeffrey A Hunter
- Department of General, Thoracic, and Vascular Surgery, Virginia Mason Medical Center, Seattle, Washington
| | - Lily Chang
- Department of General, Thoracic, and Vascular Surgery, Virginia Mason Medical Center, Seattle, Washington.
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Jiménez Gómez J, Gómez Cervantes JM, Encinas Hernández JL, Hernández Oliveros F, Castro Parga L, De la Serna Blázquez OR, Alcolea Sánchez A, Martínez Martínez L, López Santamaría M, De la Torre Ramos CA. Efficacy of endoscopic removal in the treatment of subglottic ductal cysts. Cir Pediatr 2020; 33:43-46. [PMID: 32166923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Subglottic cyst is a rare cause of airway obstruction, and there is a lack of evidence about the best treatment in the literature. This report describes our experience with endoscopic removal. MATERIAL AND METHODS A retrospective study of all patients undergoing endoscopic removal of subglottic cyst at our healthcare facility between 2014 and 2019 was performed. Clinic and demographic data regarding gestational age, intubation, comorbidities, surgical procedures, first symptoms, endoscopic findings, treatment, and follow-up were collected. RESULTS Four patients were identified. Two out of four (50%) were preterm, and all patients were intubated during their neonatal period. Median age and weight at diagnosis were 6.5 months (6-8) and 5.9 kg (3.6-7). Median time between last intubation and diagnosis was 119.5 days (71-171). Biphasic stridor and progressive respiratory distress were the most common clinical symptoms. Airway obstruction of at least 50% was found during upper airway endoscopy in all patients. Endoscopic removal was performed as a first-line treatment in 3 patients, and as a second-line treatment in 1 patient. Median intubation time after treatment and hospital stay were 13.5 hours (0-48) and 7 days (6-9). All four patients are free of disease, with a median follow-up of 17.5 months (6-42). CONCLUSION Subglottic cyst is a rare cause of post-extubation stridor. Endoscopic removal seems to be a feasible and effective treatment with a low recurrence rate.
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Affiliation(s)
- J Jiménez Gómez
- Pediatric Surgery Department. Hospital Universitario La Paz. Madrid (Spain)
| | | | | | | | - L Castro Parga
- Pediatric Surgery Department. Hospital Universitario La Paz. Madrid (Spain)
| | | | - A Alcolea Sánchez
- Pediatric Surgery Department. Hospital Universitario La Paz. Madrid (Spain)
| | | | - M López Santamaría
- Pediatric Surgery Department. Hospital Universitario La Paz. Madrid (Spain)
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13
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Limpias Kamiya KJL, Hosoe N, Takabayashi K, Hayashi Y, Sun X, Miyanaga R, Fukuhara K, Fukuhara S, Naganuma M, Nakayama A, Kato M, Maehata T, Nakamura R, Ueno K, Sasaki J, Kitagawa Y, Yahagi N, Ogata H, Kanai T. Endoscopic removal of foreign bodies: A retrospective study in Japan. World J Gastrointest Endosc 2020; 12:33-41. [PMID: 31942232 PMCID: PMC6939123 DOI: 10.4253/wjge.v12.i1.33] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 08/09/2019] [Accepted: 11/19/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The ingestion of foreign bodies (FBs) and food bolus impaction (FBI) in the digestive tract are commonly encountered clinical problems. Methods to handle such problems continue to evolve offering advantages, such as the avoidance of surgery, reduced cost, improved visualization, reduced morbidity, and high removal success rate. However, to date, no studies have evaluated the endoscopic management of FBs in Japan.
AIM To elucidate level of safety and efficacy in the endoscopic management of FBs and FBI.
METHODS A total of 215 procedures were performed at Keio University Hospital between November 2007 and August 2018. Data were collected from medical charts, and endoscopic details were collected from an endoscopic reporting system. Procedures performed with a flexible gastrointestinal endoscope were only taken into account. Patients who underwent a technique involving FB or FBI from the digestive tract were only included. Data on patient sex, patient age, outpatient, inpatient, FB type, FB location, procedure time, procedure type, removal device type, success, and technical complications were reviewed and analyzed retrospectively.
RESULTS Among the 215 procedures, 136 (63.3%) were performed in old adults (≥ 60 years), 180 (83.7%) procedures were performed in outpatients. The most common type of FBs were press-through-pack (PTP) medications [72 (33.5%) cases], FBI [47 (21.9%)], Anisakis parasite (AP) [41 (19.1%) cases]. Most FBs were located in the esophagus [130 (60.5%) cases] followed by the stomach [68 (31.6%) cases]. AP was commonly found in the stomach [39 (57.4%) cases], and it was removed using biopsy forceps in 97.5% of the cases. The most common FBs according to anatomical location were PTP medications (40%) and dental prostheses (DP) (40%) in the laryngopharynx, PTP (48.5%) in the esophagus, AP (57.4%) in the stomach, DP (37.5%) in the small intestine and video capsule endoscopy device (75%) in the colon. A transparent cap with grasping forceps was the most commonly used device [82 (38.1%) cases]. The success rate of the procedure was 100%, and complication were observed in only one case (0.5%).
CONCLUSION Endoscopic management of FBs and FBI in our Hospital is extremely safe and effective.
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Affiliation(s)
- Kenji JL Limpias Kamiya
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Naoki Hosoe
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kaoru Takabayashi
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Yukie Hayashi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Xi Sun
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo 160-8582, Japan
- Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing 100853, China
| | - Ryoichi Miyanaga
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kayoko Fukuhara
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Seiichiro Fukuhara
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Makoto Naganuma
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Atsushi Nakayama
- Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Motohiko Kato
- Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Tadateru Maehata
- Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Rieko Nakamura
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Koichi Ueno
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Junichi Sasaki
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Naohisa Yahagi
- Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Haruhiko Ogata
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Takanori Kanai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
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Karim SS, Pietropaolo A, Skolarikos A, Aboumarzouk O, Kallidonis P, Tailly T, de Coninck V, Keller EX, Somani BK. Role of endoscopic management in synthetic sling/mesh erosion following previous incontinence surgery: a systematic review from European Association of Urologists Young Academic Urologists (YAU) and Uro-technology (ESUT) groups. Int Urogynecol J 2019; 31:45-53. [PMID: 31468095 PMCID: PMC6949195 DOI: 10.1007/s00192-019-04087-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 08/08/2019] [Indexed: 11/05/2022]
Abstract
Introduction and hypothesis Foreign body (FB) erosion is now recognized as a major long-term complication following previous incontinence surgery. The aim of our systematic review was to ascertain the outcomes of endoscopic management in synthetic sling/mesh erosion following previous gynaecological surgery. Methods A systematic review in line with PRISMA and Cochrane guidelines was conducted for all English language articles between 1996 and December 2018 for all articles reporting on endoscopic surgical management for eroded FB following previous sling/mesh procedure for incontinence. Results Our search produced 931 articles of which 20 articles (198 patients) were included in our review; 149 (75%) had tension-free vaginal tapes (TVT) or tension-free obturator tapes (TOT) as their initial procedure. The site of mesh erosion was the bladder in 134 patients (68%) of which 12 (6%) were in the bladder neck. Urethral mesh erosion was seen in 63 patients (32%) across all studies. The treatment of eroded mesh was by laser and endoscopic excision using an electrode loop or laparoscopic scissors in 108 (55%) and 90 (45%) patients respectively. The initial/final success rate with laser and endoscopic excision was 67%/92% and 80%/98% respectively. The overall complication rates were 24% and 28% in laser and endoscopic groups respectively of which 21% in each group were stress urinary incontinence. Conclusions Endoscopic management of FB erosion is an effective minimally invasive technique with good outcomes and minimal morbidity. Management with the use of holmium laser is gaining momentum and could be attempted before open surgical removal. There is a need for comparative data between open surgical excision and endoscopic excision to help better describe the patient’s most likely to benefit from the endoscopic technique.
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Affiliation(s)
| | | | - Andreas Skolarikos
- 2nd Department of Urology, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Omar Aboumarzouk
- Department of Urology, Queen Elizabeth University Hospital, Glasgow, UK
| | | | | | | | - Etienne Xavier Keller
- Department of Urolog, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Bhaskar Kumar Somani
- University Hospital Southampton NHS Trust, Southampton, UK. .,Department of Urology, University Hospital Southampton NHS Trust, Southampton, SO16 6YD, UK.
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15
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Hayashi T, Karibe H, Akamatsu Y, Narisawa A, Shoji T, Sasaki T, Kameyama M, Tominaga T. Endoscopic Hematoma Evacuation for Intracerebral Hemorrhage Under Local Anesthesia: Factors That Affect the Hematoma Removal Rate. World Neurosurg 2019; 126:e1330-e1336. [PMID: 30898753 DOI: 10.1016/j.wneu.2019.03.089] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/08/2019] [Accepted: 03/09/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Recent advances in endoscopic surgery have led to more patients being able to undergo endoscopic removal of hypertensive intracerebral hemorrhage (HICH). However, because of the minimal invasiveness, endoscopic HICH removal through a narrow surgical window can result in a low removal rate. The goal of the present study was to investigate the factors that affect the removal rate of HICH evacuation. METHODS The data from 28 patients with supratentorial HICH who had undergone endoscopic hematoma evacuation were retrospectively analyzed. The inclusion criteria were spontaneous supratentorial HICH with a hematoma volume >30 mL, admission to the hospital within 24 hours of ictus, and a Glasgow coma scale score of ≥4. RESULTS Of the 28 patients, 9 were women and 19 were men, ranging in age from 41 to 86 years (mean, 60.7 ± 12.7). The hematoma location was the basal ganglia in 25 patients and subcortical in 3 patients. The mean preoperative hematoma volume was 62.4 ± 22.5 mL. The hematoma removal rate was <60% for 11 patients (poor evacuation group) and ≥60% for in 17 patients (good evacuation group). Comparing the 2 groups, chronic renal failure treated with hemodialysis (P = 0.0072, χ2 test), liver cirrhosis (P = 0.023, χ2 test), and surgeon experience with ≥10 cases of endoscopic HICH removal (P = 0.016, χ2 test) were significant factors related to the HICH removal rate. CONCLUSION To achieve a good removal rate, surgeons should have experience performing the endoscopic procedure. Also, patients with end-stage chronic renal failure or liver cirrhosis should be excluded.
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Affiliation(s)
- Toshiaki Hayashi
- Department of Neurosurgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
| | - Hiroshi Karibe
- Department of Neurosurgery, Sendai City Hospital, Sendai, Japan
| | - Yosuke Akamatsu
- Department of Neurosurgery, Sendai City Hospital, Sendai, Japan
| | - Ayumi Narisawa
- Department of Neurosurgery, Sendai City Hospital, Sendai, Japan
| | - Takuhiro Shoji
- Department of Neurosurgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Tatsuya Sasaki
- Department of Neurosurgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | | | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
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16
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Gashi Z, Polloshka AF, Veliu A, Kurshumliu F, Bahtiri E. Endoscopic Removal of a Giant Complicated Hyperplastic Gastric Polyp. Open Access Maced J Med Sci 2017; 5:1047-1048. [PMID: 29362643 PMCID: PMC5771277 DOI: 10.3889/oamjms.2017.188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 09/20/2017] [Accepted: 09/29/2017] [Indexed: 02/06/2023] Open
Abstract
The patient, a 40-year-old male, was referred to our clinic with intermittent nausea, vomiting and symptomatic anemia for 4 months. Notable hematological indices were low hemoglobin levels of 9.6 g/dl and hematocrit levels of 35.8%, while after receiving two units of concentrated red blood cells, at discharge; they achieved levels of 15.2 g/dl and 42.3%, respectively. Esophagogastroduodenoscopy revealed a 3 cm antral pedunculated polyp, prolapsing into pylorus thus causing intermittent pyloric obstruction and anemia. Histological examination revealed a hyperplastic polyp without evidences of malignancy. No atrophy, metaplasia, dysplastic changes or Helicobacter pylori infection were detected in samples taken from the antrum and the corpus; however, the examination provided evidence for gastritis. Follow-up endoscopy was provided after 12 weeks to see polypectomy site after a course of Pantoprazole administration, and to define symptom-free time after polypectomy. Endoscopic removal of complicated gastric polyps should be considered at the time of initial diagnostic endoscopy. Endoscopic resection of polyps enables to determine the exact histopathologic type as well as to effectively treat symptomatic gastric outlet obstruction and anemia.
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Affiliation(s)
- Zaim Gashi
- Clinic of Gastroenterology, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - Aida Ferri Polloshka
- Clinic of Gastroenterology, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - Arber Veliu
- Clinic of Gastroenterology, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - Fisnik Kurshumliu
- Institute of Pathology, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - Elton Bahtiri
- Department of Pharmacology, Faculty of Medicine, University of Prishtina, Prishtina, Kosovo.,Clinic of Endocrinology, University Clinical Center of Kosovo, Prishtina, Kosovo
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17
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Aydoseli A, Unal TC, Aras Y, Sabanci PA, Altunrende E, Izgi N. Endoscopic Removal of a Bullet That Migrated to the Third Ventricle Causing Hydrocephalus. World Neurosurg 2017. [PMID: 28645596 DOI: 10.1016/j.wneu.2017.06.078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Hydrocephalus caused by an intraventricular bullet is a rare event. We report a case of endoscopic removal of an intraventricular bullet. CASE DESCRIPTION A 66-year-old man was admitted with a gunshot wound to the head after a suicide attempt. The bullet migrated from the frontal parenchyma to the third ventricle day 4 of admission. On day 21 of admission, the patient developed hydrocephalus with obstruction of the cerebral aqueduct. The bullet was accessed through an endoscopic third ventriculostomy and removed using an endoscope. CONCLUSIONS Hydrocephalus may develop in patients with intraventricular foreign objects. When such objects must be removed, the endoscopic approach is a safe, efficient, and minimally invasive procedure. To our knowledge, this is the first case in the literature of foreign object removal from the ventricle via a transcortical endoscopic approach.
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Affiliation(s)
- Aydın Aydoseli
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Tugrul Cem Unal
- Department of Neurosurgery, Tunceli State Hospital, Tunceli, Turkey.
| | - Yavuz Aras
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Pulat Akın Sabanci
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Emre Altunrende
- Department of Neurosurgery, Gaziosmanpasa Taksim Training and Research Hospital, Istanbul, Turkey
| | - Nail Izgi
- Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
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18
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Das KK, Gosal JS, Singh S, Mehrotra A, Jaiswal A, Jaiswal S, Kumar R. Solitary Cysticercal Cyst Inside the Blake's Pouch Remnant of Mega Cisterna Magna with Associated Aqueductal Stenosis: Clinical and Management Implications. World Neurosurg 2017; 102:693.e1-693.e5. [PMID: 28434960 DOI: 10.1016/j.wneu.2017.04.067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 04/05/2017] [Accepted: 04/07/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Intraventricular and subarachnoid forms represent the relatively complex, albeit uncommon, manifestations of central nervous system involvement by cysticercal cysts. Cysticercal encystation inside the Blake's pouch remnant of mega cisterna magna (MCM) remains an extremely rare clinical scenario that, to the best of our knowledge, has not been reported previously. CASE PRESENTATION A 12-year-old boy presented with acute worsening and subsequent spontaneous resolution of his compensated hydrocephalus. Neuroimaging revealed features consistent with a MCM with septum inside, indicating remnants of the embryologic fourth ventricular diverticulum, the Blake's pouch. It also revealed a free-floating intact cysticercal cyst inside the MCM limited by the septum with aqueductal stenosis. The spontaneous clinicoradiologic resolution of hydrocephalus raised the possibility of ball valve obstruction of the cerebrospinal fluid outflow, i.e., Bruns syndrome. We successfully treated this patient with endoscopic extraction of the viable cysticercal cyst through a suboccipital burrhole. CONCLUSIONS The clinical scenario presented here has not been described previously. Endoscopic cyst removal in such a situation is an effective and low-risk procedure that obviates the further need for antihelminthic medications.
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Affiliation(s)
- Kuntal Kanti Das
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
| | - Jaskaran Singh Gosal
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Suyash Singh
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Anant Mehrotra
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Awadhesh Jaiswal
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Sushila Jaiswal
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Raj Kumar
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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19
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Sorleto M, Timmer-Stranghöner A, Wuttig H, Engelhard O, Gartung C. Brunner's Gland Adenoma - A Rare Cause of Gastrointestinal Bleeding: Case Report and Systematic Review. Case Rep Gastroenterol 2017; 11:1-8. [PMID: 28203131 PMCID: PMC5301130 DOI: 10.1159/000454711] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 11/22/2016] [Indexed: 11/19/2022] Open
Abstract
Brunner's gland adenoma is an extremely rare benign small bowel neoplasm, often discovered incidentally during upper gastrointestinal endoscopy or radiological diagnostics. In few cases, it tends to cause gastrointestinal hemorrhage or intestinal obstruction. We report here our experience with a 47-year-old woman with a Brunner's gland adenoma of more than 6 cm in size, located in the first part of the duodenum and causing gastrointestinal bleeding. Initially, we performed a partial endoscopic resection using endoloop and snare alternatively to prevent severe bleeding. A rest endoscopic polypectomy with the submucosal dissection technique was planned. However, on request of the patient, an elective surgical duodenotomy with submucosal resection of the remaining small duodenal tumor was performed. To better define the patient's characteristics and treatment options of such lesions, we performed a systematic review of the available literature in PubMed. Recently, an endoscopic removal is being increasingly practiced and is considered as a safe treatment modality of such lesions.
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Affiliation(s)
- Michele Sorleto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Johannes-Wesling-Klinikum Minden, Minden, Germany
| | - Annette Timmer-Stranghöner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Johannes-Wesling-Klinikum Minden, Minden, Germany
| | - Helge Wuttig
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Johannes-Wesling-Klinikum Minden, Minden, Germany
| | - Oliver Engelhard
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Johannes-Wesling-Klinikum Minden, Minden, Germany
| | - Carsten Gartung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Johannes-Wesling-Klinikum Minden, Minden, Germany
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20
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Kim J, Ahn JY, So S, Lee M, Oh K, Jung HY. Fluoroscopy-Guided Endoscopic Removal of Foreign Bodies. Clin Endosc 2016; 50:197-201. [PMID: 28008164 PMCID: PMC5398372 DOI: 10.5946/ce.2016.085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 10/10/2016] [Accepted: 10/12/2016] [Indexed: 01/08/2023] Open
Abstract
In most cases of ingested foreign bodies, endoscopy is the first treatment of choice. Moreover, emergency endoscopic removal is required for sharp and pointed foreign bodies such as animal or fish bones, food boluses, and button batteries due to the increased risks of perforation, obstruction, and bleeding. Here, we presented two cases that needed emergency endoscopic removal of foreign bodies without sufficient fasting time. Foreign bodies could not be visualized by endoscopy due to food residue; therefore, fluoroscopic imaging was utilized for endoscopic removal of foreign bodies in both cases.
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Affiliation(s)
- Junhwan Kim
- Department of Internal Medicine, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yong Ahn
- Department of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seol So
- Department of Internal Medicine, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mingee Lee
- Department of Internal Medicine, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyunghwan Oh
- Department of Internal Medicine, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hwoon-Yong Jung
- Department of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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21
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Wang L, Wen W, Huang J, Hu W, Zhou R, Li X, Wang X. Endoscopic Removal of a Duodenal-Perforating Leg of Glasses with Dormia Basket. Case Rep Gastroenterol 2016; 10:679-684. [PMID: 27920661 PMCID: PMC5126602 DOI: 10.1159/000452205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 10/03/2016] [Indexed: 01/08/2023] Open
Abstract
Ingestion of foreign bodies is common in clinical practice. Most ingested foreign bodies will pass through the gastrointestinal (GI) tract without any problems. While GI tract injury due to the ingested foreign body such as a toothpick, a fishbone, a date pit, or a chicken bone, is common, duodenal perforation is rare. In this report, our experience with this rare entity is shared. We present a 38-year-old male patient with GI tract perforation in the bulbus of the duodenum due to a leg of glasses. The patient was admitted to our hospital with severe abdominal pain. Right upper quadrant tenderness was detected at physical examination, and leukocytosis on the laboratory test results. Plain X-ray and computerized tomography showed an ingested foreign body in the bulbus of the duodenum. A leg of glasses perforating the duodenum was removed with endoscopy. The patient was managed nonoperatively, and discharged without any complications on the eighth day after endoscopy. Endoscopic removal and nonoperative management may be feasible in carefully selected patients with duodenal-perforating foreign bodies.
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Affiliation(s)
- Li Wang
- Department of Gastroenterology, the Affiliated 81st Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Wei Wen
- Department of Gastroenterology, the Affiliated 81st Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jiamiao Huang
- Department of Gastroenterology, the Affiliated 81st Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Weijie Hu
- Department of Gastroenterology, the Affiliated 81st Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Renrong Zhou
- Department of Gastroenterology, the Affiliated 81st Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xin Li
- Department of Gastroenterology, the Affiliated 81st Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiaojiang Wang
- Department of Anesthesiology, the Affiliated 81st Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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Bauder M, Meier B, Caca K, Schmidt A. Endoscopic removal of over-the-scope clips: Clinical experience with a bipolar cutting device. United European Gastroenterol J 2016; 5:479-484. [PMID: 28588877 DOI: 10.1177/2050640616671846] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 09/05/2016] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Over-the-scope clips (OTSCs) are increasingly used for the closure of perforations/fistulae, hemostasis and endoscopic full-thickness resection (FTRD system). When OTSC-associated complications occur or re-therapy at the OTSC site is needed, OTSC removal may be indicated. An experimental study in an animal model and a case series have shown good results for OTSC removal with a bipolar cutting device. We present a larger clinical study using this device. METHODS Data of all consecutive patients with indication for OTSC removal were collected and analyzed retrospectively. OTSCs were cut at two opposing sites using a bipolar grasping device to apply short direct current impulses. OTSC fragments were extracted with a standard forceps and a cap at the tip of the endoscope to avoid tissue damage. RESULTS Between December 2012 and February 2016 a total of 42 OTSC removals in the upper (n = 25) and lower (n = 17) gastrointestinal tract have been performed at our department. Overall technical success, defined as cutting the OTSC at two opposing sites and extraction of both fragments, was achieved in 92.9% (39/42) of all cases. Successful fragmentation of the OTSC was achieved in 97.6% (41/42). Minor bleedings were rare and could be managed endoscopically in all cases. There were no perforations and no major or delayed bleedings. CONCLUSION Endoscopic OTSC removal with a bipolar cutting device is feasible, effective and safe. This technique can be applied in the upper and lower gastrointestinal tract.
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Affiliation(s)
- Markus Bauder
- Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, Ludwigsburg, Germany
| | - Benjamin Meier
- Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, Ludwigsburg, Germany
| | - Karel Caca
- Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, Ludwigsburg, Germany
| | - Arthur Schmidt
- Department of Gastroenterology and Oncology, Klinikum Ludwigsburg, Ludwigsburg, Germany
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Tateno Y, Suzuki R. Cut endotracheal tube for endoscopic removal of an ingested push-through pack. World J Gastrointest Endosc 2016; 8:472-476. [PMID: 27433294 PMCID: PMC4937163 DOI: 10.4253/wjge.v8.i13.472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 04/08/2016] [Accepted: 05/09/2016] [Indexed: 02/05/2023] Open
Abstract
A 52-year-old female presented to our clinic after accidentally ingesting a push-through pack (PTP). After determining that the PTP was present in the stomach, we successfully and safely removed it endoscopically by using a handmade endoscopic hood fashioned from a cut endotracheal tube. Foreign body ingestion is a common clinical problem, and most ingested foreign bodies pass spontaneously. However, the ingestion of sharp objects, such as PTPs, increases the risk of complications, and urgent endoscopy is recommended to remove such objects. Previous studies have reported the use of other devices, both commercial and handmade, for the safe endoscopic removal of foreign bodies. The novel design of our handmade hood for the removal of the PTP, which was fashioned from a cut endotracheal tube, was beneficial in terms of maintaining a wide visual field, patient safety and tolerance, and easy preparation compared to previously reported commercial and handmade devices. It may be a viable and safe device for the retrieval of PTPs and other sharp foreign bodies.
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Ruggeri AG, Cappelletti M, Fazzolari B, Marotta N, Delfini R. Frontobasal Midline Meningiomas: Is It Right To Shed Doubt on the Transcranial Approaches? Updates and Review of the Literature. World Neurosurg 2016; 88:374-82. [PMID: 26555506 DOI: 10.1016/j.wneu.2015.11.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 11/01/2015] [Accepted: 11/02/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Traditionally, the surgical removal of tuberculum sellae meningioma (TSM) and olfactory groove meningioma (OGM) requires transcranial approaches and microsurgical techniques, but in the last decade endoscopic expanded endonasal approaches have been introduced: transcribriform for OGMs and transtuberculum-transplanum for TSM. A comparative analysis of the literature concerning the two types of surgical treatment of OGMs and TSM is, however, difficult. METHODS We conducted a literature search using the PubMed database to compare data for endoscopic and microsurgical techniques in the literature. We also conducted a retrospective analysis of selected cases from our series presenting favorable characteristics for an endoscopic approach, based on the criteria of operability of these lesions as generally accepted in the literature, and we compared the results obtained in these patients with those in the endoscopic literature. RESULTS We believe that making the sample more homogeneous, the difference between microsurgical technique and endoscopic technique is no longer so striking. A greater radical removal rate, a reduced incidence of cerebrospinal fluid fistula and, especially, the possibility of removing lesions of any size are advantages of transcranial surgery; a higher percentage of improvement in visual outcome and a lower risk of a worsening of a pre-existing deficit or onset of a new deficit are advantages of the endoscopic technique. CONCLUSION At present, the microsurgical technique is still the gold standard for the removal of the anterior cranial fossa meningiomas of all sizes, and the endoscopic technique remains a second option in certain cases.
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Gero D, Chosidow D, Marmuse JP. An unusual cause of solid food intolerance and gastric pouch dilation 5 years after Roux-en-Y gastric bypass: agar-agar bezoar. Surg Obes Relat Dis 2015; 11:1184-5. [PMID: 26077699 DOI: 10.1016/j.soard.2015.05.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 05/18/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Daniel Gero
- Department of General and Digestive Surgery, University Hospital Bichat - Claude-Bernard, Paris, France.
| | - Denis Chosidow
- Department of General and Digestive Surgery, University Hospital Bichat - Claude-Bernard, Paris, France
| | - Jean-Pierre Marmuse
- Department of General and Digestive Surgery, University Hospital Bichat - Claude-Bernard, Paris, France
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Watanabe T, Aoyagi K, Tomioka Y, Ishibashi H, Sakisaka S. Endoscopic removal of a tablespoon lodged within the duodenum. World J Gastroenterol 2015; 21:5096-5098. [PMID: 25945026 PMCID: PMC4408485 DOI: 10.3748/wjg.v21.i16.5096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 09/30/2014] [Accepted: 12/16/2014] [Indexed: 02/06/2023] Open
Abstract
Here we report the case of a 34-year-old man who underwent endoscopic removal of a tablespoon from the stomach that was lodged within the duodenum. Removal required the use of a two-channel upper endoscope and polypectomy snares. Using the double-snare technique, the spoon was grasped at the proximal and distal parts of the handle. The double-snare was first pulled unsuccessfully and then pulled with simultaneous manual abdominal compression of the bulbus from the body surface. Compression was gently applied towards the stomach. As a result, the head of the spoon prolapsed from the bulbus, and was easily retracted from the stomach without any complications. In cases of foreign body lodging within the duodenum, the manual abdominal compression technique may help clinicians pull out the object and avoid surgery. The usefulness of manual compression is dependent on the foreign body’s sharpness and the location.
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Iwamuro M, Okada H, Matsueda K, Inaba T, Kusumoto C, Imagawa A, Yamamoto K. Review of the diagnosis and management of gastrointestinal bezoars. World J Gastrointest Endosc 2015; 7:336-345. [PMID: 25901212 PMCID: PMC4400622 DOI: 10.4253/wjge.v7.i4.336] [Citation(s) in RCA: 163] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Revised: 10/19/2014] [Accepted: 01/20/2015] [Indexed: 02/05/2023] Open
Abstract
The formation of a bezoar is a relatively infrequent disorder that affects the gastrointestinal system. Bezoars are mainly classified into four types depending on the material constituting the indigestible mass of the bezoar: phytobezoars, trichobezoars, pharmacobezoars, and lactobezoars. Gastric bezoars often cause ulcerative lesions in the stomach and subsequent bleeding, whereas small intestinal bezoars present with small bowel obstruction and ileus. A number of articles have emphasized the usefulness of Coca-Cola® administration for the dissolution of phytobezoars. However, persimmon phytobezoars may be resistant to such dissolution treatment because of their harder consistency compared to other types of phytobezoars. Better understanding of the etiology and epidemiology of each type of bezoar will facilitate prompt diagnosis and management. Here we provide an overview of the prevalence, classification, predisposing factors, and manifestations of bezoars. Diagnosis and management strategies are also discussed, reviewing mainly our own case series. Recent progress in basic research regarding persimmon phytobezoars is also briefly reviewed.
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28
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Lee SW, Ahn JY, Choi WJ, Kim EJ, Bae SH, Choi YS, Jung HY, Kim JH. A needle penetrating the stomach cavity after acupuncture. Clin Endosc 2014; 47:258-61. [PMID: 24944991 PMCID: PMC4058545 DOI: 10.5946/ce.2014.47.3.258] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 06/06/2013] [Indexed: 11/14/2022] Open
Abstract
Although acupuncture is known as a safe procedure that is widely used in many countries, complications including infection, hemorrhage, hematoma, pneumothorax, nerve damage, and cardiac tamponade have been reported. A needle penetrating the stomach after acupuncture, however, is very rare. Here, we report the case of 47-year-old woman who experienced abdominal pain 2 days after receiving acupuncture. Upper gastrointestinal endoscopy identified an approximately 2.5-cm long needle in the posterior wall of the antrum. The needle was removed endoscopically using rat tooth forceps with no complications.
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Affiliation(s)
- Sin Won Lee
- Asan Digestive Disease Research Institute, Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yong Ahn
- Asan Digestive Disease Research Institute, Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Jung Choi
- Asan Digestive Disease Research Institute, Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Jin Kim
- Asan Digestive Disease Research Institute, Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung-Hyeon Bae
- Asan Digestive Disease Research Institute, Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yun Sik Choi
- Asan Digestive Disease Research Institute, Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hwoon-Yong Jung
- Asan Digestive Disease Research Institute, Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin-Ho Kim
- Asan Digestive Disease Research Institute, Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kim DJ, Park SW, Choi SH, Lee JH, You KW, Lee GS, Moon HC, Hong GY. A case of endoscopic removal of a giant appendicolith combined with stump appendicitis. Clin Endosc 2014; 47:112-4. [PMID: 24570893 PMCID: PMC3928483 DOI: 10.5946/ce.2014.47.1.112] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 06/09/2013] [Accepted: 07/18/2013] [Indexed: 11/24/2022] Open
Abstract
Stump appendicitis is an acute inflammation of the residual appendix and is a rare complication after appendectomy. The physician should be aware of the possibility of stump appendicitis in patients with right lower abdominal pain after appendectomy so that delayed diagnosis and treatment can be prevented. Stump appendicitis is usually treated by surgical resection, and endoscopic treatment has not been reported previously. A 48-year-old man who had undergone appendectomy 35 years earlier presented to the hospital because of right lower quadrant discomfort. A computed tomography scan showed a large stone in the residual appendix. Colonoscopic findings revealed a large, smooth, protruding lesion at the cecum with a stone inside the appendiceal orifice. Endoscopic removal after incision of the appendiceal orifice was performed successfully.
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Affiliation(s)
- Du Jin Kim
- Department of Internal Medicine, Kwangju Christian Hospital, Gwangju, Korea
| | - Sang Wook Park
- Department of Internal Medicine, Kwangju Christian Hospital, Gwangju, Korea
| | - Seung Ho Choi
- Department of Internal Medicine, Kwangju Christian Hospital, Gwangju, Korea
| | - Jong Hoon Lee
- Department of Internal Medicine, Kwangju Christian Hospital, Gwangju, Korea
| | - Kyoung Wan You
- Department of Internal Medicine, Kwangju Christian Hospital, Gwangju, Korea
| | - Geum Soo Lee
- Department of Internal Medicine, Kwangju Christian Hospital, Gwangju, Korea
| | - Hyeung Cheol Moon
- Department of Internal Medicine, Kwangju Christian Hospital, Gwangju, Korea
| | - Gun Young Hong
- Department of Internal Medicine, Kwangju Christian Hospital, Gwangju, Korea
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Omoya T, Shiba M, Hibino S, Aoki R, Kitamura S, Muguruma N, Takayama T. Twig tea impaction in the colon causing abdominal pain. Clin J Gastroenterol 2013; 6:438-41. [PMID: 26182134 DOI: 10.1007/s12328-013-0429-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 09/17/2013] [Indexed: 01/08/2023]
Abstract
We describe a case of lower abdominal pain caused by a twig tea impaction at the rectosigmoid junction after inadvertent ingestion. The foreign body was detected and successfully dislodged from the colonic wall with grasping forceps during colonoscopy. The post-procedural course was uneventful, and the patient was discharged 10 days after the removal. Colonic injury, including perforation due to foreign body ingestion, must be considered in patients presenting with unexplained symptoms and findings, even when they do not recall any foreign body ingestion.
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Affiliation(s)
- Toshihiro Omoya
- Department of Gastroenterology, Anan Central Hospital of the Medical Association, Tokushima, Japan
| | - Masako Shiba
- Department of Gastroenterology, Anan Central Hospital of the Medical Association, Tokushima, Japan
| | | | - Rika Aoki
- Tokushima Health Screening Center, Tokushima, Japan
| | - Shinji Kitamura
- Department of Gastroenterology and Oncology, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan
| | - Naoki Muguruma
- Department of Gastroenterology and Oncology, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan.
| | - Tetsuji Takayama
- Department of Gastroenterology and Oncology, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan
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Abstract
We describe the extrusion of a ventriculo peritoneal shunt tube from the anus into a 6-year-old boy following the placement of a ventriculo peritoneal shunt for postoperative periventricular tumor-induced hydrocephalus. He was admitted with a complaint of extrusion of a tube through anus on and off during bowel evacuation. He was evaluated with an X-ray of the abdomen which was showing a coiled tube in descending and sigmoid colon, confirmed by sigmoidoscopy. The proximal end was exposed for external ventricular drainage and distal end was removed endoscopically. The patient was watched for peritonitis and managed conservatively. The proximal end of the tube was removed after 5 days of external ventricular drainage and after ruling out ventriculitis and meningitis. Bowel perforation by a ventriculo peritoneal tube is a rare complication. Diagnosis is often difficult and delayed. Most of the bowel perforation is seen in young patients.
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Affiliation(s)
- Sreedhar Vuyyuru
- Departments of Neurosurgery and Medical Gasroeterology, Nizam's Institute of Medical Sciences, Panjagutta, Hyderabad, India
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