In 2000,the small bowel capsule revolutionized the management of patients with small bowel disorders.Currently,the technological development achieved by the new models of double-headed endoscopic capsules,as miniaturi...In 2000,the small bowel capsule revolutionized the management of patients with small bowel disorders.Currently,the technological development achieved by the new models of double-headed endoscopic capsules,as miniaturized devices to evaluate the small bowel and colon[pan-intestinal capsule endoscopy(PCE)],makes this non-invasive procedure a disruptive concept for the management of patients with digestive disorders.This technology is expected to identify which patients will require conventional invasive endoscopic procedures(colonoscopy or balloon-assisted enteroscopy),based on the lesions detected by the capsule,i.e.,those with an indication for biopsies or endoscopic treatment.The use of PCE in patients with inflammatory bowel diseases,namely Crohn’s disease,as well as in patients with iron deficiency anaemia and/or overt gastrointestinal(GI)bleeding,after a non-diagnostic upper endoscopy(esophagogastroduodenoscopy),enables an effective,safe and comfortable way to identify patients with relevant lesions,who should undergo subsequent invasive endoscopic procedures.The recent development of magnetically controlled capsule endoscopy to evaluate the upper GI tract,is a further step towards the possibility of an entirely non-invasive assessment of all the segments of the digestive tract,from mouth-to-anus,meeting the expectations of the early developers of capsule endoscopy.展开更多
AIM To investigate the association between a recent gastrointestinal(GI) endoscopy and the subsequent risk of pyogenic liver abscess(PLA).METHODS We designed a nested case control study. Using the Taiwan National Heal...AIM To investigate the association between a recent gastrointestinal(GI) endoscopy and the subsequent risk of pyogenic liver abscess(PLA).METHODS We designed a nested case control study. Using the Taiwan National Health Insurance Research Database, 2135 patients with a first diagnosis of PLA were identified from 1998 to 2011. Another 10675 patients without PLA matched by age and sex were selected as reference controls. We identified and compared the possible risk factors for PLA and GI endoscopies performed before the index date(when PLA was diagnosed) between the two cohorts. Multivariate analysis was conducted to examine the risk of PLA within the 90 d after the GI endoscopies.RESULTS Patients with a history of diabetes [adjusted odds ratio(a OR) = 4.92, 95%CI: 1.78-13.61], end-stage renal disease(a OR = 3.98, 95%CI: 1.45-10.91), biliary tract infection(a OR = 2.68, 95%CI: 2.11-3.40), liver cirrhosis(a OR = 2.19, 95%CI: 1.39-3.46), GI malignancies(a OR = 5.68, 95%CI: 4.23-7.64), appendicitis(a OR = 3.16, 95%CI: 2.27-4.41), diverticulitis(a OR = 1.64, 95%CI: 1.01-2.64), and recent endoscopic retrograde cholangiopancreatography(a OR = 27.04, 95%CI: 11.65-62.72) were significantly associated with an increased risk of PLA. After adjusting for the above risk factors and the frequency of outpatient department visits and abdominal ultrasounds during 90 d before the index date, an upper GI panendoscopy(a OR = 2.75, 95%CI: 2.05-3.69) but not a lower GI endoscopy(a OR = 1.07, 95%CI: 0.62-1.86) was significantly associated with PLA.CONCLUSION An upper GI panendoscopy performed before 90 d may increase the risk of PLA.展开更多
BACKGROUND Complications associated with upper gastrointestinal(UGI)endoscopy are uncommon,and rarely involve those of cardiovascular nature.We report herein a unique case of spontaneous superior mesenteric artery dis...BACKGROUND Complications associated with upper gastrointestinal(UGI)endoscopy are uncommon,and rarely involve those of cardiovascular nature.We report herein a unique case of spontaneous superior mesenteric artery dissection(SMAD)after UGI pandenoscopy.CASE SUMMARY A 45-year-old man who had previously undergone UGI panendoscopy and colonoscopy during a voluntary health check-up at our facility was admitted to the emergency room(ER)at the same facility due to persistent epigastric pain with radiation to the back.At the ER,the patient did not present notable abnormalities upon physical,conscious,or laboratory examinations apart from mild tenderness in the epigastric abdomen.Acute abdominal aortic dissection was suspected,and abdominal contrast-enhanced computed tomography confirmed SMAD.He was then transferred to the cardiovascular ward and treated conservatively with fasting,prostaglandin E1,and aspirin.The patient recovered and returned home soon after,and was symptom-free 6 months after discharge from the facility.CONCLUSION SMAD after UGI panendoscopic procedure is a previously unreported complication.Awareness of this complication and associated sequela is warranted.展开更多
Capsule endoscopy is nowadays the diagnostic technique of choice in the study of small bowel pathologies,allowing the non-invasive study of the entire mucosa.This has led,together with new technical advances,to the cr...Capsule endoscopy is nowadays the diagnostic technique of choice in the study of small bowel pathologies,allowing the non-invasive study of the entire mucosa.This has led,together with new technical advances,to the creation of two new models(PillCam ESO and PillCam Colon)for the study of esophageal and colonic diseases.These two new capsules offer an interesting alternative to conventional endoscopy in the study of the upper and lower digestive tracts,because traditional endoscopy is often unpleasant and uncomfortable for the patient,can be painful,often requires moderate or deep sedation and is not without complications(hemorrhage,perforation,etc.).PillCam Colon is particularly important for its usefulness in the diagnosis of colonic polyps,and is a potentially useful tool in cases of incomplete colonoscopy or in colorectal cancer screening,even more when most patients are reluctant to undergo screening programs due to the said disadvantages of conventional colonoscopy.This article discusses the advantages of capsule endoscopy over conventional endoscopy,its current application possibilities and indications in routine clinical practice.In the various sections of the work,we assess the application of endoscopic capsule in different sections of the digestive tract(esophagus,stomach,and colon)and finally the potential role of panendoscopy with PillCam Colon.展开更多
文摘In 2000,the small bowel capsule revolutionized the management of patients with small bowel disorders.Currently,the technological development achieved by the new models of double-headed endoscopic capsules,as miniaturized devices to evaluate the small bowel and colon[pan-intestinal capsule endoscopy(PCE)],makes this non-invasive procedure a disruptive concept for the management of patients with digestive disorders.This technology is expected to identify which patients will require conventional invasive endoscopic procedures(colonoscopy or balloon-assisted enteroscopy),based on the lesions detected by the capsule,i.e.,those with an indication for biopsies or endoscopic treatment.The use of PCE in patients with inflammatory bowel diseases,namely Crohn’s disease,as well as in patients with iron deficiency anaemia and/or overt gastrointestinal(GI)bleeding,after a non-diagnostic upper endoscopy(esophagogastroduodenoscopy),enables an effective,safe and comfortable way to identify patients with relevant lesions,who should undergo subsequent invasive endoscopic procedures.The recent development of magnetically controlled capsule endoscopy to evaluate the upper GI tract,is a further step towards the possibility of an entirely non-invasive assessment of all the segments of the digestive tract,from mouth-to-anus,meeting the expectations of the early developers of capsule endoscopy.
文摘AIM To investigate the association between a recent gastrointestinal(GI) endoscopy and the subsequent risk of pyogenic liver abscess(PLA).METHODS We designed a nested case control study. Using the Taiwan National Health Insurance Research Database, 2135 patients with a first diagnosis of PLA were identified from 1998 to 2011. Another 10675 patients without PLA matched by age and sex were selected as reference controls. We identified and compared the possible risk factors for PLA and GI endoscopies performed before the index date(when PLA was diagnosed) between the two cohorts. Multivariate analysis was conducted to examine the risk of PLA within the 90 d after the GI endoscopies.RESULTS Patients with a history of diabetes [adjusted odds ratio(a OR) = 4.92, 95%CI: 1.78-13.61], end-stage renal disease(a OR = 3.98, 95%CI: 1.45-10.91), biliary tract infection(a OR = 2.68, 95%CI: 2.11-3.40), liver cirrhosis(a OR = 2.19, 95%CI: 1.39-3.46), GI malignancies(a OR = 5.68, 95%CI: 4.23-7.64), appendicitis(a OR = 3.16, 95%CI: 2.27-4.41), diverticulitis(a OR = 1.64, 95%CI: 1.01-2.64), and recent endoscopic retrograde cholangiopancreatography(a OR = 27.04, 95%CI: 11.65-62.72) were significantly associated with an increased risk of PLA. After adjusting for the above risk factors and the frequency of outpatient department visits and abdominal ultrasounds during 90 d before the index date, an upper GI panendoscopy(a OR = 2.75, 95%CI: 2.05-3.69) but not a lower GI endoscopy(a OR = 1.07, 95%CI: 0.62-1.86) was significantly associated with PLA.CONCLUSION An upper GI panendoscopy performed before 90 d may increase the risk of PLA.
文摘BACKGROUND Complications associated with upper gastrointestinal(UGI)endoscopy are uncommon,and rarely involve those of cardiovascular nature.We report herein a unique case of spontaneous superior mesenteric artery dissection(SMAD)after UGI pandenoscopy.CASE SUMMARY A 45-year-old man who had previously undergone UGI panendoscopy and colonoscopy during a voluntary health check-up at our facility was admitted to the emergency room(ER)at the same facility due to persistent epigastric pain with radiation to the back.At the ER,the patient did not present notable abnormalities upon physical,conscious,or laboratory examinations apart from mild tenderness in the epigastric abdomen.Acute abdominal aortic dissection was suspected,and abdominal contrast-enhanced computed tomography confirmed SMAD.He was then transferred to the cardiovascular ward and treated conservatively with fasting,prostaglandin E1,and aspirin.The patient recovered and returned home soon after,and was symptom-free 6 months after discharge from the facility.CONCLUSION SMAD after UGI panendoscopic procedure is a previously unreported complication.Awareness of this complication and associated sequela is warranted.
文摘Capsule endoscopy is nowadays the diagnostic technique of choice in the study of small bowel pathologies,allowing the non-invasive study of the entire mucosa.This has led,together with new technical advances,to the creation of two new models(PillCam ESO and PillCam Colon)for the study of esophageal and colonic diseases.These two new capsules offer an interesting alternative to conventional endoscopy in the study of the upper and lower digestive tracts,because traditional endoscopy is often unpleasant and uncomfortable for the patient,can be painful,often requires moderate or deep sedation and is not without complications(hemorrhage,perforation,etc.).PillCam Colon is particularly important for its usefulness in the diagnosis of colonic polyps,and is a potentially useful tool in cases of incomplete colonoscopy or in colorectal cancer screening,even more when most patients are reluctant to undergo screening programs due to the said disadvantages of conventional colonoscopy.This article discusses the advantages of capsule endoscopy over conventional endoscopy,its current application possibilities and indications in routine clinical practice.In the various sections of the work,we assess the application of endoscopic capsule in different sections of the digestive tract(esophagus,stomach,and colon)and finally the potential role of panendoscopy with PillCam Colon.
