RESUMO
We report an 82-year-old woman with severe iron deficiency anemia who was found to have gastric antral vascular ectasia (GAVE). As she required repeated blood transfusion for the anemia and did not respond to various medical treatments, she was referred for antrectomy. The pathogenesis of GAVE is still obscure and may involve many factors. In our patient, immunohistochemical studies of the resected stomach disclosed a marked increase of neuroendocrine cells. The majority of these hyperplastic neuroendocrine cells, furthermore, showed immunoreactivity for 5-hydroxytryptamine (serotonin). These findings suggest that neuroendocrine mediators, serotonin in particular, may have been responsible for the local vasodilation.
Assuntos
Anemia Ferropriva/etiologia , Mucosa Gástrica/irrigação sanguínea , Hemorragia Gastrointestinal/etiologia , Gastropatias/complicações , Gastropatias/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Capilares/patologia , Feminino , Gastrectomia , Mucosa Gástrica/metabolismo , Mucosa Gástrica/patologia , Gastroscopia , Humanos , Sistemas Neurossecretores/citologia , Sistemas Neurossecretores/metabolismo , Antro Pilórico/irrigação sanguínea , Antro Pilórico/patologia , Serotonina/biossíntese , Gastropatias/fisiopatologia , Gastropatias/terapiaRESUMO
Although a sliding tube made of plastics is very effective to keep the sigmoid colon in a straight position, there is some difficulty in handling the colonoscope, being restricted by the length of the scope. For the purpose of covering the demerits of the conventional sliding tube, a new slit sliding tube which is made up of three parts was devised by us. After straightening the sigmoidal loop, the three parts of the apparatus are joined together. Then the slit sliding tube is inserted into the descending colon with safety and ease. By using the slit sliding tube, handling of the colonoscope is scarcely restricted and becomes easy. Moreover, the slit sliding tube can be used even for the shorter scopes, by which the distal parts of the colon can be more easily examined in comparison with conventional techniques.
Assuntos
Colo Sigmoide , Colo , Endoscópios , Endoscopia , HumanosRESUMO
Early endoscopy was performed in six cases of acute gastric anisakiasis. Immediately after detecting the larva of anisakis, the larval body was extracted together with its surrounding mucosa by a biopsy forceps. With the removal of the larva, severe colic pain subsided rapidly. Two cases in our series were identified as the stage IV larvae of the anisakis, type I. It was presumed that the stage III larva had exuviated in the human stomach. It is emphasized that endoscopic extraction of larva is the most effective procedure in dealing with acute gastric anisakiasis.
Assuntos
Infecções por Nematoides/diagnóstico , Gastropatias/diagnóstico , Adulto , Animais , Endoscopia , Feminino , Peixes/parasitologia , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Nematoides/transmissão , Gastropatias/etiologiaRESUMO
Five years experience of Endoscopic Sphincterotomy (EST) in Japan has been analyzed in 468 collective cases from 25 centres. In the indication of EST, biliary tract stones were the main reason, and shared in 92.5% of the success of EST. Other applications were benign stenosis of the papilla of Vater, ascaris of the common bile duct and so on where these formed a small group in the indication of EST. Complete removal of stones had been observed spontaneously in 62.3% of the cases, and with the help of a basket or balloon catheter in 23.7% of successful EST. However, fourteen percent of EST had no effect on the delivery of gallstones. Complications during and after EST were observed in 8.5% of all cases where hemorrhage, pancreatitis and cholangitis were the main hazards. The mortality rate was 0.4%, a considerably low rate when the figure is simply compared with that of cases involving surgical intervention. Finally, the term of Endoscopic Sphincterotomy (EST) was proposed for this procedure because it proved to be the best expression of the actual procedure.
Assuntos
Ampola Hepatopancreática/cirurgia , Endoscopia , Esfíncter da Ampola Hepatopancreática/cirurgia , Ascaríase/cirurgia , Doenças Biliares/cirurgia , Colelitíase/cirurgia , Ducto Colédoco , Endoscopia/efeitos adversos , Endoscopia/mortalidade , Humanos , JapãoRESUMO
Endoscopic electromyography of the human sphincter of ODDI has provided useful information for the patho-physiological studies on the choledocho-duodenal junction. The pattern and rhythm of the electromyogram observed on the spincter of ODDI were different from those of the duodenum recorded simultaneously in basal tracings of our initial four cases. In the half of other ten cases with consecutive tracings, the different pattern and rhythm of electromyograms between the sphincter of ODDI and the duodenum were also confirmed. It was possible, from our results, to speculate that the functional independence of the sphincter of ODDI from the duodenal wall muscles was in existence.