Sugar in the reduction of incarcerated prolapsed bowel. Report of two cases.

Incarcerated, prolapsed rectum, colostomies, and ileostomies, when viable, may be reduced using ordinary table sugar. The placing of sugar granules on the incarcerated bowel results in a decrease in tissue edema and spontaneous bowel reduction. The technique, case reports, and a review of the literature are herein reported.

Fiberoptic endoscopy of the gastrointestinal tract in surgical training.

In 1981, the American Board of Surgery encouraged applicants for board certification to be familiar with a variety of endoscopic techniques upon the gastrointestinal tract. In 1983, the Department of General Surgery at Naval Hospital, San Diego established a surgical gastrointestinal endoscopy unit to train physicians to perform endoscopic procedures. Since its inception, more than two thousand procedures have been performed. The results of esophagogastroduodenoscopy and colonoscopy performed between January 1986 and October 1987 provide the numeric basis in our evaluation of our program for endoscopic training and support training in endoscopy as integral to the education of the resident in general surgery.

An evaluation of multiple clinical variables for hypoxia during colonoscopy.

One hundred consecutive patients undergoing routine colonoscopy were evaluated for changes in arterial oxygen saturation levels. All of the patients were monitored with the Nellcor N-200 pulse oximeter (Nellcor Incorporated) by finger probe and received supplemental oxygen when SaO2 levels decreased below 90 per cent. Forty patients demonstrated a decrease in SaO2 to less than 90 per cent after intravenous sedation but prior to colonoscopy, 14 patients demonstrated a decrease in SaO2 to less than 90 per cent during colonoscopy, and 46 patients maintained SaO2 levels greater than 90 per cent at all times. No statistical differences were found when these three groups were compared for age, body surface area, drug dosage, smoking history and a history of pre-existing hypertension, diabetes, arrhythmias, angina or myocardial infarction and pulmonary disease. These data indicate that all patients undergoing colonoscopy should be placed on supplemental oxygen. We further recommend continuous cardiac and pulse oximetry monitoring when available.