RESUMEN
BACKGROUND/AIMS: In capsule endoscopy (CE), the capsule does not always reach the cecum within its battery life, which may reduce its diagnostic yield. We evaluated the effect of mosapride citrate, a 5-hydroxytryptamine-4 agonist that increases gastrointestinal motility, on CE completion. METHODS: In a retrospective study, we performed univariate and multivariate analyses for 232 CE procedures performed at our hospital. To identify factors that affect CE completion, the following data were systematically collected: gender, age, gastric transit time (GTT), nonsteroidal anti-inflammatory drug administration, previous abdominal surgery, hospitalization, use of a polyethylene glycol solution, use of mosapride citrate (10 mg), body mass index (BMI), and total recording time. RESULTS: The univariate analysis showed that oral mosapride citrate, GTT, and BMI were associated with improved CE completion. Multivariate analyses showed that oral mosapride citrate (odds ratio [OR], 1.99; 95% confidence interval [CI], 1.01 to 3.91) and GTT (OR, 2.34; 95% CI, 1.13 to 4.87) were significant factors for improving the CE completion. Oral mosapride citrate significantly shortened the GTT and small bowel transit time (SBTT). CONCLUSIONS: Oral mosapride citrate reduced the GTT and SBTT during CE and improved the CE completion rate.
Asunto(s)
Administración Oral , Benzamidas , Índice de Masa Corporal , Endoscopía Capsular , Ciego , Ácido Cítrico , Motilidad Gastrointestinal , Hospitalización , Morfolinas , Análisis Multivariante , Polietilenglicoles , Estudios RetrospectivosRESUMEN
BACKGROUND/AIMS: A flexible spectral imaging color enhancement system was installed in new capsule software for video capsule endoscopy. Contrast image capsule endoscopy (CICE) is a novel technology using light-emitting diodes selected for the main absorption range of hemoglobin. We assessed the feasibility and diagnostic effi cacy for small bowel surveillance in patients with polyposis syndromes. METHODS: Six patients with polyposis syndromes, four with familial adenomatous polyposis and one each with Cowden syndrome (CS) and Cronkhite-Canada syndrome (CCS) were examined using CICE. We conducted three evaluations to assess the effect on the numbers of the detected polyps; compare polyp diagnostic rates between adenoma and hamartoma; and assess polyp visibility. RESULTS: The numbers of detected polyps and diagnostic accuracy did not differ signifi cantly between pre-contrast and contrast images. However, 50% of the adenomatous polyps displayed enhanced visibility on contrast images. CICE contrast images exhibited clearly demarcated lesions and improved the visibility of minute structures of adenomatous polyps. Hamartomatous polyp micro-structures in patients with CS and CCS were more clearly visualized on contrast than pre-contrast images. CONCLUSIONS: CICE is an effective tool for enhancing the visibility of polyps in patients with polyposis syndrome.
Asunto(s)
Humanos , Absorción , Adenoma , Poliposis Adenomatosa del Colon , Pólipos Adenomatosos , Endoscopios en Cápsulas , Endoscopía Capsular , Síndrome de Hamartoma Múltiple , Hemoglobinas , Poliposis Intestinal , PóliposRESUMEN
Large colonic polyps have large vessels, which often cause post-polypectomy hemorrhage. Some of the stalks of large pedunculated polyps are formed by the weight of the polyps and disappear after polypectomy. There are some reports suggesting that pre-ligation with Endoloop(R) may minimize the risk of post-polypectomy hemorrhage. However, the current density increases more at the site of pre-ligation as compared with that at the site of polypectomy, because polypectomy is carried out with gradual snaring. This implies that burn injury may also occur at the site of pre-ligation, causing the loss of pre-ligation and, consequently, post-polypectomy hemorrhage. Ligation of stalks after polypectomy is very difficult. The Endoloop(R) rolls back when it is tightened, because of the lack of torsional stiffness. We have developed a simple and improved post-polypectomy ligation technique using the Anchor clip. Before polypectomy, an Endoclip(R) is placed partially at the base of the pedunculated polyp. When the stalk is tightened completely with the Endoclip(R) before polypectomy, burn injury occurs around the Endoclip(R) . The Anchor clip at the base of the pedunculated polyp holds the stalk after polypectomy and the constricted part formed by the Anchor clip prevents the rolling up of the Endoloop(R) and helps in easy ligation of the stalk. We have used the Anchor clip for 50 patients. Application of the Endoloop(R) after polypectomy was impossible in two patients. The remaining 48 patients underwent Endoloop(R) -assisted polypectomy with the Anchor clip, and in none of the cases did bleeding occur after polypectomy.
Asunto(s)
Pólipos del Colon/cirugía , Hemorragia Gastrointestinal/prevención & control , Hemostasis Quirúrgica/instrumentación , Complicaciones Posoperatorias/prevención & control , Instrumentos Quirúrgicos , HumanosRESUMEN
Reported herein is a case of mucosa-associated lymphoid tissue (MALT) lymphoma of the terminal ileum with a large-cell component, which regressed spontaneously. To the best of our knowledge, only five cases of spontaneously regressing MALT lymphoma have been reported in the English-language literature, and all of these cases were low-grade lymphomas. Spontaneous regression of a MALT lymphoma with a high-grade component is very rare. The present case suggests that MALT lymphoma cells have a reversible nature, even in the presence of a high-grade component.