胶囊内镜滞留临床特征及处置策略

目的探讨胶囊内镜滞留的临床特征及处理。方法回顾性分析2008年9月-2013年9月行胶囊内镜检查中出现胶囊滞留的病例特征。结果 559例胶囊内镜检查中,共发生胶囊滞留11例,发生率为2.0%,9例为克罗恩病,2例为小肠肿瘤;其中2例因并发肠梗阻、1例并发消化道穿孔行手术治疗,1例小肠镜下取出胶囊,1例4个月后自行排出,4例仍在继续随访中,无胶囊滞留相关的死亡病例。结论胶囊滞留是胶囊内镜检查中较严重并发症,应尽可能在内镜下取出胶囊或行手术治疗。     

胶囊内镜滞留小肠原因及处理的国内文献回顾与分析

目的探讨胶囊内镜滞留小肠的原因及处理方式。方法回顾性分析2001年-2013年国内有关胶囊内镜滞留小肠的191篇中文文献,分析其滞留原因及处理方式。结果在105例胶囊内镜滞留小肠患者中,滞留原因主要为克罗恩病(CD)(54.3%,57/105),其次是小肠肿瘤(21.9%,23/105)。57.9%(33/57)的CD患者需行手术干预,24.6%(14/57)的CD患者可保守治疗后排出,仅3.5%(2/57)可自行排出。56.5%(13/23)的小肠肿瘤患者需行手术治疗,只有8.7%(2/23)可自行排出。所有滞留患者中,45.7%(48/105)需手术干预,2.9%(3/105)行内镜干预,保守治疗和自行排出者为22.8%(24/105)。结论胶囊内镜滞留小肠是胶囊内镜检查中较严重的并发症,引起滞留的主要原因是CD和小肠肿瘤,多数滞留者需手术干预。     

小肠胶囊内镜检查中胶囊滞留的临床现状

胶囊内镜是一种安全的检查手段,并发症比较少,其最主要的并发症是胶囊滞留和滞留引起的小肠梗阻或穿孔以及误人气道等,现就胶囊内镜滞留相关问题作一综述。一、胶囊内镜滞留的定义2005年国际胶囊内镜会议对胶囊内镜滞留定义为吞服后2周内未排出体外,     

磁控胶囊胃镜：一种新型的舒适化内镜

磁控胶囊胃镜(MCCG)是一种新型胶囊内镜技术,主要通过磁场控制胶囊在胃内运动,进行几乎全方位无盲区的检测。它具有舒适、安全、无需麻醉、无交叉感染等优点。多项研究发现MCCG对胃部疾病的诊断准确性与传统电子胃镜高度一致,是电子胃镜的有益补充,对我国胃癌早发现、早诊断、早治疗发挥着越来越重要的作用。本文就MCCG在胃部疾病检查中的可行性、安全性、局限性及其未来发展方向进行综述。     

放射性回肠炎致胶囊内镜长期滞留一例

患者女,65岁,凶反复腹痛8年余于2008年7月来我院门诊行胶囊内镜检查。患者20年前因子宫内膜癌行子宫全切＋双侧附件切除术,术后常规放化疗。     

经纤维支气管镜取出滞留支气管内10年针头1例

患者为18岁，男性，农民，因反复咳嗽、咳痰9年，加重1周，于2007年11月7日来我院就诊，患者于10年前，玩耍时不慎将针头吸入气管内，当时无明显不适，未予治疗，9年前患者出现阵发性咳嗽、咳白色泡沫痰，受凉后尤著，无咯血、胸痛、胸闷等不适，经服用药物治疗，症状可缓解，但一直未予特殊检查治疗。患者入院前1周受凉后咳嗽、咳痰症状加重，在当地县医院行胸片检查提示左肺下叶金属异物（如图1，2），为进一步诊治入我院，入院查体：T36．8℃，P80次／分，R16次／分，BP105／70mmHg，神志清，精神可，口唇无紫绀，咽部充血，气管居中，双肺呼吸音清，无明显干湿啰音。     

胶囊内镜检查发现贲门失迟缓症1例

<正>笔者最近在临床上遇1例行磁控胶囊内镜检查时出现食管滞留,后进一步检查确诊为贲门失迟缓症的患者,现报告如下。1 病例介绍患者,女,48岁,因胸骨后不适2个月,再发10 d入院。近2个月来患者反复出现胸骨后不适,进固体食物时稍有哽噎感,间断发作,但无吞咽困难、吞咽疼痛,伴嗳气、反酸,1个月前于外院行胃镜检查提示慢性胃炎,给予抑酸、促胃肠动力等治疗后患者症状可缓解,但仍时有反复。10 d前患者出现胸骨后不适加重、进食哽噎感,伴嗳气、纳     

胶囊内镜滞留肠道1例

<正>患者,男,49岁,于2014-09-21因左中腹胀痛半日伴排便减少入院。既往有反复肠梗阻病史,2013年11月因消化道出血入院治疗,多次胃镜未发现病灶,出院后至外院行胶囊肠镜进一步检查,术后未明确胶囊排出情况。患者入院前半日无明显诱因下自觉左中腹胀痛,疼痛不剧烈,无停止排气、无恶心呕吐、无发热、无腰酸、无腰痛及肉眼血尿等不适,于我院门诊查腹部立卧位平片提示小肠不全梗阻(图     

异物滞留支气管18年1例

病例资料 患者,男性,27岁,因反复咳嗽咳痰伴胸痛10年,于2013年12月15日入院,既往无特殊病史。入院查体：右侧胸廓呼吸运动度减弱,右下肺叩诊浊音,语颤及呼吸音减弱,左肺呼吸音清,双肺未闻及干湿罗音及胸膜摩擦音。胸部CT示：①右肺下叶肺炎、肺不张;②右肺下叶支气管走形区见管状高密度影（约1．7cm×1cm）,支气管异物可能。     

胶囊内镜诊断门脉高压性肠病并出血1例

门脉高压性肠病（portal hypertensive enteropathy,PHE）并出血临床少见。本文报道1例肝硬化合并门脉高压性肠病并出血的临床特点和内镜特征,并结合复习文献,以期提高临床医师对PHE的认识水平。     

Occult plastic intravitreal foreign body retained for 30 years: a case report

A 41-year-old man had suffered trauma to the right eye 30 years ago. In March 1996, he underwent trabeculectomy and peripheral iridectomy under the diagnosis of open angle glaucoma in the right eye. Autoperimetry at that time revealed visual field constriction. In addition, ocular examination showed that the cup/disc ratio of his right eye was increased. Cataract was diagnosed in September 2002 and cataract extraction was performed on October 22, 2002. Aplastic intravitreal foreign body was detected during the operation. However, preoperative B-scan ultrasonography had failed to detect an intraocular foreign body (IOFB), and the previous fluorescein angiography had shown only retinal pigment epithelium changes. This case reminded us that we should be alert to an occult IOFB in the event of ocular trauma, even if none had been detected during prior imaging examinations.     

Colonoscopic appendectomy: Report of a case

A persistent appendix occurred after inversion appendectomy. Colonoscopic removal was straightforward and would appear to be the treatment of choice in this unusual circumstance.     

Colonoscopic removal of hemangiomas

A case is reported in which a colonic hemangioma was successfully removed endoscopically. The authors recommend that the colonoscopist be skilled and use the technique only for polypoid lesions     

经脐软式内镜腹腔粘连松解术初步临床应用

目的探讨经脐软式内镜完成腹腔粘连松解术的可行性和安全性。方法对1例因子宫肌瘤子宫切除术后腹腔粘连腹痛入院患者,经脐开口（1．5cm）入腹腔,置入普通胃镜,经内镜送气系统送入CO2建立气腹。探查腹腔,见下腹正中刀VI处腹膜与肠管和大网膜粘连,下腹部粘连较重。经内镜活检通道,分别用IT刀和Hook刀贴腹壁至上而下分离粘连带。分离大部分粘连后,发现分离过的大网膜和肠管粘连创面有新鲜渗血,内镜寻找出血点困难。遂经左下腹部布置1个5mm鞘管,腹腔镜协助寻找出血点,但未见出血部位,后自行止血。腹腔镜协助完成残余粘连松解。脐部切口用可吸收线缝合1针,左下腹部小切口不缝合。结果手术过程耗时40min,术中少量出血。患者术后脐部切口微痛,无需处理。术后当天进食并下床活动,观察2d无异常出院。结论经脐软式内镜腹腔粘连松解术是安全可行的,但有效性还有待进一步证实。     

Colonoscopic removal of a polypoid arteriovenous malformation

A 53-year-old male presenting with a 3-month history of intermittent mild rectal bleeding was found, on double contrast barium enema, to have a large polyp on a long stalk in the sigmoid colon. Large bowel endoscopy confirmed the presence of a 2 cm pedunculated polyp which was removed using a diathermic snare, with slight bleeding following the procedure that did not require endoscopic haemostasis. Only after histologic examination was the polyp shown to be a colonic arteriovenous malformation. Endoscopically, arteriovenous malformations generally appear as flat or elevated bright red lesions. A pedunculated polypoid appearance is extremely uncommon. In this case, no gastrointestinal bleeding or polypoid recurrence was observed during the 12 months of clinical and endoscopic follow-up.