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81.
Aline Moraes MENACHO Adriano REIMANN Lie Mara HIRATA Caroline GANZERELLA Flavio Heuta IVANO Ricardo SUGISAWA 《Brazilian archives of digestive surgery》2014,27(1):9-12
Background
Colonoscopy is the most frequent exam used to evaluate colonic mucosa, allowing the diagnosis and treatment of many diseases. The appropriate bowel preparation is indispensable for the realization of colonoscopy. Therefore, it is necessary the use of laxative medications, preferentially by oral administration.Aim
To compare two medications used in bowel preparation in adult patients going to ambulatory colonoscopy and to analyze the patients'' profile.Methods
A double-blind prospective study with 200 patients, randomized in two groups: one that received polyethilene glycol and another that received lactulose. The patients answered to questionnaires to data compilation, as tolerance, symptoms and complications related to preparation. Besides, it was also evaluated the prepare efficacy related to the presence of fecal residue.Results
Intestinal habit alterations and abdominal pain were the main reasons to realize the exams and hypertension was the most prevalent comorbidity. Ten percent of the ones who received lactulose didn''t get to finish the preparation and 50% considered the taste "bad, but tolerable". The most common subjective symptom after the medication was nausea, especially after lactulose. During the exam, most of the patients who used lactulose had a "light discomfort" and the ones who used polyethilene glycol considered the discomfort as "tolerable". The quality of the preparation was good in 75%, undependable of the medication that was used.Conclusion
Polyethilene glycol was more tolerable when compared to lactulose, without difference on the quality of the preparation. 相似文献82.
Tafadzwa Patrick Makarawo Amir Damadi Vijay K. Mittal Ed Itawi Gurteshwar Rana 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2014,18(1):20-27
Background and Objectives:
The role of laparoscopy in the management of iatrogenic colonoscopic injuries has increased with surgeons becoming facile with minimally invasive methods. However, with a limited number of reported cases of successful laparoscopic repair, the exact role of this modality is still being defined. Drawing from previous literature and our own experiences, we have formulated a simple algorithm that has helped us treat colonoscopic perforations.Methods:
A retrospective review was undertaken of patients treated for colonoscopic perforations since the algorithm''s introduction. For each patient, initial clinical assessment, management, and postoperative recovery were carefully documented. A Medline search was performed, incorporating the following search words: colonoscopy, perforation, and laparoscopy. Twenty-three articles involving 106 patients were identified and reviewed.Results:
Between May 2009 and August 2012, 7 consecutive patients with colonoscopic perforations were managed by 2 surgeons using the algorithm. There were no complications and no deaths, with a mean length of stay of 4.43 days (range, 2–7 days). Of the 7 patients, 6 required surgery. A single patient was managed conservatively and later underwent an elective colon resection.Conclusions:
Traditionally, laparotomy was the preferred method for treating colonoscopic perforations. Our initial experience reinforces previous views that laparoendoscopic surgery is a safe and effective alternative to traditional surgery for managing this complication. We have formulated a simple algorithm that we have found helpful for surgeons considering a laparoscopic approach to managing this condition. 相似文献83.
84.
Antonella Maimone Antonella De Ceglie Peter D. Siersema Todd H. Baron Massimo Conio 《Clinics and research in hepatology and gastroenterology》2021,45(6):101592
The clinical and endoscopic features of colon ischemia (CI) are non-specific. CI is correctly identified at the time of presentation in only 9% of patients is. The true incidence is likely underestimated because many mild cases resolve spontaneously without medical treatment. Furthermore, since most cases of CI are transient, and no specific cause is detected they are often considered to be “idiopathic”. In the setting of severe CI correct diagnosis and prompt recognition and therapy as well as identification of underlying causes are crucial for a favourable outcome. Although less severe, mild cases may present with similar symptoms, the prognosis and management are completely different and managed conservatively rather than with surgery. Unfortunately, data from most studies and current guidelines do not provide recommendations on the long-term management of CI or about the need for endoscopic follow-up to detect the development chronic, recurrent and/or ischemic colonic strictures. In this review, we focus on the definition of CI, its aetiology, and patterns of presentation. We highlight the pharmacological and/or endoscopic management as determined severity of disease that allow for improved outcomes. Prompt recognition and treatment using a multidisciplinary approach are essential for successful management of severe CI because mortality rates are significantly higher when the diagnosis is delayed. 相似文献
85.
86.
Endoscpists always have tried to pursue a perfect colonoscopy, and application of artificial intelligence (AI) using deep-learning algorithms is one of the promising supportive options for detection and characterization of colorectal polyps during colonoscopy. Many retrospective studies conducted with real-time application of AI using convolutional neural networks have shown improved colorectal polyp detection. Moreover, a recent randomized clinical trial reported additional polyp detection with shorter analysis time. Studies conducted regarding polyp characterization provided additional promising results. Application of AI with narrow band imaging in real-time prediction of the pathology of diminutive polyps resulted in high diagnostic accuracy. In addition, application of AI with endocytoscopy or confocal laser endomicroscopy was investigated for real-time cellular diagnosis, and the diagnostic accuracy of some studies was comparable to that of pathologists. With AI technology, we can expect a higher polyp detection rate with reduced time and cost by avoiding unnecessary procedures, resulting in enhanced colonoscopy efficiency. However, for AI application in actual daily clinical practice, more prospective studies with minimized selection bias, consensus on standardized utilization, and regulatory approval are needed. (Gut Liver 2021;15:-353) 相似文献
87.
Zi Qin Ng Jih Huei Tan Henry Chor Lip Tan Mary Theophilus 《World journal of gastrointestinal endoscopy》2021,13(3):82-89
BACKGROUNDPost-colonoscopy diverticulitis is increasingly recognized as a potential complication. However, the evidence is sparse in the literature.AIMTo systematically review all available evidence to describe the incidence, clinical course with management and propose a definition.METHODSThe databases PubMed, EMBASE and Cochrane databases were searched using with the keywords up to June 2020. Additional manual search was performed and cross-checked for additional references. Data collected included demographics, reason for colonoscopy, time to diagnosis, method of diagnosis (clinical vs imaging) and management outcomes.RESULTSA total of nine studies were included in the final systematic review with a total of 339 cases. The time to diagnosis post-colonoscopy ranged from 2 h to 30 d. Clinical presentation for these patients were non-specific including abdominal pain, nausea/vomiting, per rectal bleeding and chills/fever. Majority of the cases were diagnosed based on computed tomography scan. The management for these patients were similar to the usual patients presenting with diverticulitis where most resolve with non-operative intervention (i.e., antibiotics and bowel rest).CONCLUSIONThe entity of post-colonoscopy diverticulitis remains contentious where there is a wide duration post-procedure included. Regardless of whether this is a true complication post-colonoscopy or a de novo event, early diagnosis is vital to guide appropriate treatment. Further prospective studies especially registries should include this as a complication to try to capture the true incidence. 相似文献
88.
We present a 26-year-old man with edema, ascites and bloody diarrhea that later proved to be due to gastrointestinal and renal amyloidosis. Interestingly, he was also diagnosed as having ankylosing spondylitis,-possibly after a delay of 12 years. The obscure diagnosis and challenging treatment of secondary amyloidosis are further discussed.Electronic Supplementary Material Supplementary material (with figures in color) is available in the online version of this article at .Abbreviations AS
ankylosing spondylitis 相似文献
89.
Kamar M Portnoy O Bar-Dayan A Amitai M Munz Y Ayalon A Zmora O 《Diseases of the colon and rectum》2004,47(7):1242-1246
Computed tomography colonography, also termed virtual colonoscopy, is a new imaging method to investigate the colon, which may be a potential alternative to the conventional endoscopic colonoscopy in some cases. The high safety profile of this imaging method was considered as an additional advantage of this procedure. A case of colonic perforation in computed tomography colonography is presented, highlighting a potential risk related to this procedure. It is assumed that perforation was the result of overinflation of air into an obstructed colon caused by a lesion at the rectosigmoid junction. Thus, it is suggested that in such cases, air insufflation should be gradual, thereby minimizing the risk of perforation. 相似文献
90.
10081例大肠镜检查无肠穿孔的经验总结 总被引:4,自引:2,他引:4
沈俊 《中华消化内镜杂志》1997,14(3):143-145
为总结大肠镜检查无肠穿孔的经验,搜集1981年至1994年共进行大肠镜检查10081例,其中3531例(35.2%)有腹部手术史的大肠镜检查,研究创立了应用力学原理,避免袢曲形成,体位改变大肠镜的操作技巧和方法,至今检查过程中无一例肠穿孔并发症的发生。 相似文献