Dieulafoy's-like lesions (DLs-like) represent a cause of obscure gastrointestinal bleeding, enteroscopy being the main diagnostic and therapeutic procedure. Frequently, more than one enteroscopy is needed to ident...Dieulafoy's-like lesions (DLs-like) represent a cause of obscure gastrointestinal bleeding, enteroscopy being the main diagnostic and therapeutic procedure. Frequently, more than one enteroscopy is needed to identify the bleeding vessel. In our practice, video capsule endoscopy (VCE) identified and guided therapy in four cases of DLs-like; three of them were localized on the small bowel. We report, for the first time, a diagnosis of colonic DL-like performed by colon capsule endoscopy. Two patients presented with severe cardiovascular disorders, being hemodynamically unstable during VCE examination. Based on the VCE findings, only one invasive therapeutic procedure per patient was necessary to achieve hemostasis. VCE and enteroscopy may be regarded as complementary procedures in patients with gut DLs-like.展开更多
AIM To evaluate the endoscopic treatment efficacy and prognostic factors of long-term response to treatment for painful chronic pancreatitis.METHODS This retrospective analysis identified 168 patients with painful chr...AIM To evaluate the endoscopic treatment efficacy and prognostic factors of long-term response to treatment for painful chronic pancreatitis.METHODS This retrospective analysis identified 168 patients with painful chronic pancreatitis hospitalized during January 2010-January 2015 in a Romanian tertiary referral center.Data on demographics,medical history,alcohol consumption,smoking habit,clinical parameters,type and number of endoscopic procedures and hospital admissions number were collected from the medical charts and analyzed.The absence or substantial reduction of pain(mild pain)at the end of the follow-up associated with the technical success of endotherapy was considered as clinical success.RESULTS Among the 168 patients with painful chronic pancreatitis admitted to our department during the study period,39(23.21%)had optimal response to the medical therapy.One hundred and twenty-nine patients required endoscopic treatment.The median follow-up period was 15 mo(range,0-60 mo).Overall,technical success of endotherapy was achieved in 105 patients(81.39%).More than two-thirds of patients(82.78%)had substantial improvement of pain after the endoscopic treatment,including frequency and severity of the pain attacks.Patients younger than 40 years had significantly more successful endoscopic procedures(P=0.041).Clinical success was higher in non-smoking patients(P=0.003).The hospital admission rate was higher in patients with recognized alcohol consumption(P=0.03)and in smokers(P=0.027).The number and location of pancreatic stones and locations of strictures did not significantly influence the technical success(P>0.05)or the clinical success(P>0.05).CONCLUSION Younger age than 40 years can be considered an important factor positively influencing endoscopic treatment outcome in patients with painful chronic pancreatitis.展开更多
文摘Dieulafoy's-like lesions (DLs-like) represent a cause of obscure gastrointestinal bleeding, enteroscopy being the main diagnostic and therapeutic procedure. Frequently, more than one enteroscopy is needed to identify the bleeding vessel. In our practice, video capsule endoscopy (VCE) identified and guided therapy in four cases of DLs-like; three of them were localized on the small bowel. We report, for the first time, a diagnosis of colonic DL-like performed by colon capsule endoscopy. Two patients presented with severe cardiovascular disorders, being hemodynamically unstable during VCE examination. Based on the VCE findings, only one invasive therapeutic procedure per patient was necessary to achieve hemostasis. VCE and enteroscopy may be regarded as complementary procedures in patients with gut DLs-like.
文摘AIM To evaluate the endoscopic treatment efficacy and prognostic factors of long-term response to treatment for painful chronic pancreatitis.METHODS This retrospective analysis identified 168 patients with painful chronic pancreatitis hospitalized during January 2010-January 2015 in a Romanian tertiary referral center.Data on demographics,medical history,alcohol consumption,smoking habit,clinical parameters,type and number of endoscopic procedures and hospital admissions number were collected from the medical charts and analyzed.The absence or substantial reduction of pain(mild pain)at the end of the follow-up associated with the technical success of endotherapy was considered as clinical success.RESULTS Among the 168 patients with painful chronic pancreatitis admitted to our department during the study period,39(23.21%)had optimal response to the medical therapy.One hundred and twenty-nine patients required endoscopic treatment.The median follow-up period was 15 mo(range,0-60 mo).Overall,technical success of endotherapy was achieved in 105 patients(81.39%).More than two-thirds of patients(82.78%)had substantial improvement of pain after the endoscopic treatment,including frequency and severity of the pain attacks.Patients younger than 40 years had significantly more successful endoscopic procedures(P=0.041).Clinical success was higher in non-smoking patients(P=0.003).The hospital admission rate was higher in patients with recognized alcohol consumption(P=0.03)and in smokers(P=0.027).The number and location of pancreatic stones and locations of strictures did not significantly influence the technical success(P>0.05)or the clinical success(P>0.05).CONCLUSION Younger age than 40 years can be considered an important factor positively influencing endoscopic treatment outcome in patients with painful chronic pancreatitis.
