Push-enteroscopy series: diagnostic and therapeutic efficacy.

OBJECTIVE: To analyse the diagnostic efficacy of oral push-type enteroscopy (PE) according to indications. To assess evolution in patients with occult gastrointestinal bleeding (OGIB) according to findings and endoscopic therapy. METHODS: 204 PE performed in 167 patients: OGIB: 117, Crohn's disease: 34, radiological abnormalities: 21; chronic diarrhoea: 12; intestinal sub-occlusion: 11; polyposis: 7; other: 2. We followed clinical outcome in 72 patients after PE for OGIB. They were separated according to findings and endoscopic therapy: no findings: 32; no treated angiodysplasia: 10; treated angiodysplasia: 20; other lesions: 10. We evaluated the number of admissions and transfusional requirements before and after PE, re-bleeding and surgical treatment. Statistics were performed using Student's t test and Chi-square test (statistical significance p < 0.05). RESULTS: We diagnosed lesions in 65.8% PE for OGIB, angiodysplasia being the more frequent finding (33.3%). We found lesions before Treitz in 15.4% A higher diagnostic efficacy was seen in active bleeding (83.4%) versus anaemia (52.2%), p < 0.05. After PE both admissions and transfusional requirements decreased in all subgroups specially in treated angiodysplasias and other lesions, nearly reaching statistical significance (p = 0.07). Re-bleeding occurred in 50% of non-treated lesions versus 20-25% in treated lesions. We found lesions in 47% of PE for Crohn's disease, in 52.4% for radiological abnormalities, in 41.6% for chronic diarrhoea and in 0% for intestinal sub-occlusion. CONCLUSIONS: PE is efficient in the diagnosis and therapy of patients with OGIB, Crohn's disease and radiological abnormalities. Its usefulness is controversial in the study of chronic diarrhoea and intestinal sub-occlusion.

[Oral video enteroscopy: a prospective study of 30 cases]. / Videoenteroscopia oral: estudio prospectivo sobre 30 casos.

UNLABELLED: The main indication of oral enteroscopy is gastrointestinal bleeding. The literature does not include many references to oral, as opposed to peroperative enteroscopy. OBJECTIVE: To determine the usefulness and the sensitivity of the technique in small bowel diseases in a prospective series of 30 consecutive patients. Included were 3 cases of Crohn's disease, 3 acute gastrointestinal lesions in patients under SNAIDS and a normal gastroscopy, 1 polyp, 3 small bowel tumors and 13 cases of bleeding of unknown origin. RESULTS: Findings included jejunal leiomyomas, tubular adenomas of the jejunum, isolated jejunal erosions, angiodysplasia, mesenteric thrombosis, nodular lymphoid hyperplasia and jejuno-ileal isolated Crohn's disease. Tolerance was good without complications. Sensitivity was only 53%, therefore the evaluation of the diagnostic efficacy needs further assessments.

[Complications of the intragastric balloon prosthesis]. / Complicaciones de la prótesis balón intragástrica.

The intragastric balloon prosthesis (PBIG) is being used as a mechanical treatment for obesity; an evaluation of its physiopathological implications, efficiency, and complications is still incomplete. In order to investigate in our area the incidence of complications of this endoscopic treatment, we have used the Danish model "Danish Obesity Treatment" (DOT) (Ballobes) inflated with air, in a prospective study in which forty obese patients were treated during three months. We draw the attention upon a gastric ulcer, a spontaneous anal extrusion-migration, and a duodenal ulcer. We establish the safety of the method, the literature is reviewed, we discuss the cause and treatment of these lesions, and we conclude indicating the low morbidity and the absence of major complications such as oesophageal perforation or intestinal obstruction occurring with other prosthesis models.

Réplica a la carta al director "prevención de hematomas de pared abdominal cuando se emplean heparinas de bajo peso molecular" / Prevention of abdominal wall hematomas in patients receiving low molecular weight heparin therapy

No disponible

No disponible

Eficacia diagnóstica y terapéutica en una sere de enteroscopia de pulsión oral / Push-enteroscopy series: diagnostic and therapeutic efficacy

Objetivo: analizar la eficacia diagnóstica de la videoenteroscopia de pulsión oral (VPO) según la indicación y la evolución de pacientes con hemorragia digestiva de origen oscuro (HDOO) según hallazgos y tratamiento endoscópico. Métodos: 204 VPO realizadas a 167 pacientes: HDOO: 117; enfermedad de Crohn: 34; anormalidades radiológicas: 21; diarrea crónica: 12; suboclusión intestinal: 11; poliposis: 7; otros: 2.Fueron seguidos 72 pacientes tras VPO por HDOO dividiéndolos según hallazgos y tratamiento endoscópico: sin hallazgos: 32; angiodisplasias no tratadas: 10; tratadas: 20; lesiones distintas a angiodisplasias: 10. Se valoró el número de ingresos y requerimientos trasfusionales pre y post-VPO, resangrados y cirugía. Estudio estadístico mediante t de Student y Chi cuadrado (significación estadística p<0,05). Resultados: se diagnosticaron lesiones en 65,8 por ciento VPO por HDOO, siendo las angiodisplasias las más frecuentes (33,3 por ciento) y las lesiones pre-Treitz (15,4 por ciento). Existe tendencia a mayor eficacia diagnóstica en pacientes con sangrado activo (83,4 por ciento) frente anemia (52,2 por ciento) alcanzando significación estadística p<0,05. Tras VPO disminuyen los ingresos y requerimientos trasfusionales en todos los grupos, más en el de angiodisplasias tratadas y otras lesiones sin alcanzar significación estadística p=0,07. Resangró el 50 por ciento de pacientes con lesiones no tratadas frente un 20-25 por ciento en tratados. Se observaron lesiones en 47 por ciento de VPO por enfermedad de Crohn, 52,4 por ciento por alteraciones radiológicas, 41,6 por ciento por diarrea crónica y 0 por ciento por suboclusión intestinal. Conclusión: la VPO es eficaz en el diagnóstico y tratamiento de pacientes con HDOO, enfermedad de Crohn y alteraciones radiológicas, siendo cuestionable su utilidad en estudio de diarrea crónica y suboclusión intestinal (AU)