Postgastrostomy deformity of the stomach

Temporary postoperative tube gastrostomy may produce permanent deformity of the stomach as visualized on an upper gastrointestinal series. Six cases were studied illustrating two configurations of the gastric deformity. These appear to be related to the location of the gastrostomy opening in the stomach. The findings were either anterior displacement of the gastric antrumwith adherence to the anterior abdominal wall or acute angulation of the gastric body in a medial and anterior direction.     

Complications of upper GI endoscopy

This is one of a series of statements discussing the utilization of gastrointestinal endoscopy in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy prepared this text. In preparing this guideline, a MEDLINE literature search was performed, and additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants. When little or no data exist from well-designed prospective trials, emphasis is given to results from large series and reports from recognized experts. Guidelines for appropriate utilization of endoscopy are based on a critical review of the available data and expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data appear. Clinical consideration may justify a course of action at variance to these recommendations.     

Acute gastritis clinically classified in accordance with data from both upper GI series and endoscopy

Detailed studies have been made of the X-ray, endoscopic, and biopsy findings in 160 Japanese patients with acute gastritis. We classified these patients clinically into three types: type I, edematous; type II, hemorrhagic; and type III, ulcerous type, on the basis of X-ray, endoscopic and biopsy findings. Type I is the mildest and seems to be completely cured within 1 week; however, type III requires a longer time to heal.     

A perplexing cause of upper GI Bleed

Valleculae is one of a potential source of GI bleed. The lesions in the valleculae may potentially be missed during the routine endoscopies and due diligence is required especially among patients with GI bleed where no source of bleed could be identified.     

Endoscopic detection of early upper GI cancers

The detection of early-stage neoplastic lesions in the upper GI tract is associated with improved survival and the potential for complete endoscopic resection that is minimally invasive and less morbid than surgery. Despite technological advances in standard white-light endoscopy, the ability of the endoscopist to reliably detect dysplastic and early cancerous changes in the upper GI tract remains limited. In conditions such as Barrett's oesophagus, practice guidelines recommend periodic endoscopic surveillance with multiple biopsies, a methodology that is hindered by random sampling error, inconsistent histopathological interpretation, and delay in diagnosis. Early detection may be enhanced by several promising diagnostic modalities such as chromoendoscopy, magnification endoscopy, and optical spectroscopic/imaging techniques, as these modalities offer the potential to identify in real-time lesions that are inconspicuous under conventional endoscopy. The combination of novel diagnostic techniques and local endoscopic therapies will provide the endoscopist with much needed tools that can considerably enhance the detection and management of early stage lesions in the upper GI tract.