Search results for "Endoscopy"

Performing Double-Balloon Enteroscopy: The Utility of the Erlangen EndoTrainer

2008

Double-balloon enteroscopy (DBE) is now an established method for endoscopic visualization of the deep small bowel. DBE is not only a diagnostic tool, but also makes it possible to take biopsy samples and perform endoscopic therapeutic interventions. However, DBE is a complex examination and should therefore only be performed by experienced endoscopists after appropriate training. The best method of teaching DBE and improving the acquisition of competence appears to be through step-by-step training. Lectures and videos are very useful during the initial steps, whereas hands-on training with animal models and demonstration of live DBE procedures are the main components used for providing tra…

How much importance do we have to place on complete enteroscopy?

2011

2015

Primary intestinal lymphangiectasia (PIL) is a rare disorder, especially in adults. It causes a local disruption of chylus transport and is part of the exudative gastroenteropathies. Conservative therapy includes dietary measures or somatostatin medication. Taking the differential diagnosis of PIL into consideration is a major challenge, since patients suffering from PIL may present with diarrhoea and lymphedema or chylous ascites. This can be explained by the chronic lymphedema of the bowel leading to dilation of the vessels (intraluminal loss) and sometimes even to a rupture (peritoneal loss). Push–pull enteroscopy and capsule endoscopy are the proper interventional diagnostic tools to di…

Balloon Enteroscopy: Single- and Double-Balloon Enteroscopy

2009

Balloon enteroscopy is a method that allows endoscopic inspection of the entire small bowel, or large parts of it, while simultaneously making it possible to obtain histologic samples and carry out treatment measures. Studies of double-balloon enteroscopy (DBE) have confirmed the high diagnostic yield of the procedure, with an acceptably low complication rate (approximately 1% for diagnostic DBE and 3% to 4% for therapeutic DBE). The principal indication for the procedure is midgastrointestinal bleeding, that is, when the bleeding source is located in the small bowel. With good patient selection, the diagnostic yield here is 70% to 80%, and this has a substantial influence on subsequent tre…

Massive gastrointestinale Blutung eines 28-jährigen Patienten mit intestinalem Befall eines Morbus Behçet

2006

A 28-year-old man was admitted to the emergency room of our hospital after syncope and acute gastrointestinal bleeding. On the basis of numerous oral and genital ulcerations as well as uveitis anterior and erythema nodosum, the diagnosis of Behcet's disease had been confirmed previously. The bleeding focus could not be detected by endoscopy. During the next days recurrent massive hemorrhages occurred in spite of immunosuppressive therapy with steroids. Angiography revealed a circumscribed bleeding source in the colon transversum near the left colonic flexure, which was treated by superselective coil embolization. A massive hemorrhage reoccurred and required a surgical approach with a Hartma…

Angiofibroma nasofaríngeo juvenil con extensión orbitaria

2015

Resumen Caso clinico Varon de 21 anos con historia de exoftalmos izquierdo y diplopia de 2 semanas de evolucion. La resonancia magnetica mostro una lesion muy vascularizada etmoido-orbitaria con invasion de base del craneo anterior y extension orbitaria. La biopsia etmoidal confirmo un tejido fibrovascular compatible con angiofibroma. Discusion El angiofibroma nasofaringeo juvenil (ANJ) es un tumor benigno con caracteristicas locales de malignidad debido a su capacidad de invadir areas adyacentes. En nuestro caso, el comienzo se presenta con manifestaciones de extension orbitaria. Consideramos necesario un conocimiento amplio y un abordaje multidisciplinario con el fin de mejorar el pronost…

Review article: in vivo imaging by endocytoscopy

2011

Aliment Pharmacol Ther 2011; 33: 1183–1193 Summary Background  Endocytoscopy (EC) enables in vivo microscopic imaging at 1400-fold magnification, thereby allowing the analysis of mucosal structures at the cellular level. In contrast to fluorescence imaging with confocal laser endomicroscopy which allows analysis of mucosal structures up to 250 μm in depth, EC is based on the principle of contact light microscopy and only allows visualisation of the very superficial mucosal layer. Aim  To systematically review the feasibility and diagnostic yield of EC for in vivo diagnosis of diseases. Methods  A systematic search of the literature on diagnostic interventions in the gastrointestinal tract u…

Frame-based and frameless endoscopic procedures in the third ventricle.

1997

Stereotactic guidance is useful for planning an accurate trajectory to the third ventricle. A guiding block with a ball joint was developed for frame-based endoscopy and adaptors for arm-based and armless navigation systems. Between 1992 and 1996, 52 patients were operated on endoscopically in the third ventricle under stereotactic guidance. Thirty-eight ventriculostomies, 13 biopsies and 10 cystic lesions were performed. The coordinates of two points were calculated; one in the foramen of Monro and the second in the third ventricle. The ventriculostomy was performed under endoscopic control bluntly with a Fogarty catheter in front of the basilar artery. Twenty-seven (71%) of the patients h…

Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European Society of Gastrointestinal Endoscopy (ESGE), Europea…

2019

Main RecommendationsPatients with chronic atrophic gastritis or intestinal metaplasia (IM) are at risk for gastric adenocarcinoma. This underscores the importance of diagnosis and risk stratification for these patients. High definition endoscopy with chromoendoscopy (CE) is better than high definition white-light endoscopy alone for this purpose. Virtual CE can guide biopsies for staging atrophic and metaplastic changes and can target neoplastic lesions. Biopsies should be taken from at least two topographic sites (antrum and corpus) and labelled in two separate vials. For patients with mild to moderate atrophy restricted to the antrum there is no evidence to recommend surveillance. In pati…

TGF-β Suppresses Tumor Progression in Colon Cancer by Inhibition of IL-6 trans-Signaling

2004

Alterations of TGF-beta signaling have been described in colorectal cancer, although the molecular consequences are largely unknown. By using transgenic mice overexpressing TGF-beta or a dominant-negative TGF-betaRII, we demonstrate that TGF-beta signaling in tumor infiltrating T lymphocytes controls the growth of dysplastic epithelial cells in experimental colorectal cancer, as determined by histology and a novel system for high-resolution chromoendoscopy. At the molecular level, TGF-beta signaling in T cells regulated STAT-3 activation in tumor cells via IL-6. IL-6 signaling required tumor cell-derived soluble IL-6R rather than membrane bound IL-6R and suppression of such TGF-beta-depende…