Fibreoptic endoscopy and the barium meal--results and implications.

Cotton, Peter B.

doi:10.1136/bmj.2.5859.161

Cited by 86 publications

(16 citation statements)

References 20 publications

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“…These studies were somewhat flawed since the findings at endoscopy were used as the gold standard! 4,5 Endoscopy gradually became the first-line investigation for most patients with suspected upper digestive disease. This evolution was not without its skeptics, especially those who believed (perhaps based on unfortunate experiences with rigid esophagoscopy) that it was dangerous to attempt passage of an endoscope without barium confirmation of a patent oesophagus.…”

Section: Diagnostic Endoscopymentioning

confidence: 99%

Digestive endoscopy in five decades

Cotton

2005

Clinical Medicine

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-The world of gastroenterology changed forever when flexible endoscopes became available in the 1960s. Diagnostic and therapeutic techniques proliferated and entered the mainstream of medicine, not without some controversy. Success resulted in a huge service demand, with the need to train more endoscopists and to organise large endoscopy units and teams of staff. The British health service struggled with insufficient numbers of consultants, other staff and resources, and British endoscopy fell behind that of most other developed countries. This situation is now being addressed aggressively, with many local and national initiatives aimed at improving access and choice, and at promoting and documenting quality. Many more consultants are needed and some should be relieved of their internal medicine commitment to focus on their specialist skills. New instruments and procedures are stretching the diagnostic boundaries and changing the interface with sister disciplines like radiology, surgery and pathology. The old distinctions, particularly between gastroenterology and surgery, are increasingly irrelevant and unhelpful. The future is bright for gastroenterology and for endoscopy, but unpredictable. In this fast-changing world it will be essential to remain flexible, with our goals firmly focused on the best interests of our patients.

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Section: Diagnostic Endoscopymentioning

confidence: 99%

Digestive endoscopy in five decades

Cotton

2005

Clinical Medicine

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“…These include: the investigation of Xray negative dyspepsias, the differentiation of benign from malignant gastric ulcers, acute diagnosis of the source of upper alimentary bleeding, the investigation of symptoms following gastric surgery, the con-firmation of duodenal ulceration and the investigation of biliary and pancreatic disease by means of retrograde cholangiopancreatography. Cotton (1973) has given a recent review of one year's experience of 1020 upper gastrointestinal endoscopies on 956 patients. Ages ranged from 3 months to 86 years and the only contraindication to examination was the possibility of transmitting infection such as active tuberculosis since endoscopes cannot be sterilized.…”

Section: Introductionmentioning

confidence: 99%

Annual review of surgery 1973

Ellis

1974

Postgraduate Medical Journal

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“…Compared with endoscopy, radiological methods have limitations for 20-55 % of duodenal ulcers and 11-14% of benign gastric ulcers escape detection by conventional barium meal examination (Cotton, 1973). Furthermore, many patients with indirect radiological signs suggestive of ulceration, such as pylorospasm and irritability of the duodenal cap, may not have an active ulcer crater when examined endoscopically or at operation.…”

mentioning

confidence: 99%

“…Furthermore, many patients with indirect radiological signs suggestive of ulceration, such as pylorospasm and irritability of the duodenal cap, may not have an active ulcer crater when examined endoscopically or at operation. Since the value of fibreoptic endoscopy in the diagnosis of upper gastrointestinal disease has been clearly demonstrated (McColl, 1972; Morrissey, 1972;Salmon et al, 1972;Cotton, 1973) pandendoscopy and biopsy have become routine in most gastroenterological clinics during the last four years. This present paper reports an analysis of the clinical features and laboratory data in a consecutive series of patients with peptic ulceration in whom an active benign gastric ulcer or duodenal ulcer had been seen endoscopically.…”

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confidence: 99%

Clinical picture of peptic ulceration diagnosed endoscopically.

Sheppard¹,

Holmes²,

Cockel³

1977

Gut

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SUMMARY Clinical features and laboratory data are presented for 100 patients with benign gastric ulceration and 150 patients with duodenal ulceration confirmed endoscopically in a district general hospital unit. Abdominal pain was the commonest indication for endoscopy, but one third of examinations were performed for acute gastrointestinal haemorrhage. Although the patients were selected by referral for endoscopy their clinical presentation, age, and sex distribution were similar to those reported in previous general surveys. There were no clinical features which clearly distinguished gastric from duodenal ulceration. However, of those with gastric ulceration younger patients more often had distal ulcers and presented with pain, while elderly subjects tended to have high lesser curve involvement and presented with haemorrhage. Moreoever, all females presenting with haemorrhage were aged over 50 years, while 6 % of males bleeding from gastric ulceration and 400% of males bleeding from duodenal ulceration were under this age. Anaemia when present, except in two premenopausal females, indicated either a recent acute gastrointestinal haemorrhage or a coexistent second diagnosis.

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Fibreoptic endoscopy and the barium meal--results and implications.

Cited by 86 publications

References 20 publications

Digestive endoscopy in five decades

Digestive endoscopy in five decades

Annual review of surgery 1973

Clinical picture of peptic ulceration diagnosed endoscopically.

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