Masking of colon vascular ectasias by cold water lavage

Brandt, Lawrence J.; Mukhopadhyay, D.

doi:10.1016/s0016-5107(99)70472-4

Cited by 11 publications

(5 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The time lapse was only a few days in the group with persistent obscure/overt bleeding, as they had acute and ongoing bleeding. It is possible that the lesions missed in this group during the initial endoscopy may have been due to active bleeding that obscured the lesion, or due to the potentially transient behavior of angiectasias [13,30]. Estimating the time interval between EGD and push enteroscopy in the other two groups was not possible, as the endoscopy unit is an open−access one, so that some of these patients were referred to the institu− tion specifically for push enteroscopy and then returned to their primary−care physician.…”

Section: Discussionmentioning

confidence: 99%

The Rate of Lesions Found within Reach of Esophagogastroduodenoscopy during Push Enteroscopy Depends on the Type of Obscure Gastrointestinal Bleeding

Lara¹,

Bloomfeld²,

Pineau³

2005

Endoscopy

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

The Rate of Lesions Found within Reach of Esophagogastroduodenoscopy during Push Enteroscopy Depends on the Type of Obscure Gastrointestinal Bleeding

Lara¹,

Bloomfeld²,

Pineau³

2005

Endoscopy

View full text Add to dashboard Cite

show abstract

“…IBCA is not sensitive to radiotherapy or chemotherapy, and advanced patients lack effective treatment. Radiotherapy and chemotherapy are suitable for patients with advanced tumors, unresectable operations, or late remission of symptoms (18,19). In a study by Zhao et al (20), patients with advanced IBCA were treated with docetaxel combined with cisplatin and hyperthermia, and after six cycles of treatment, the lesions did not progress.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Low-Dose Apatinib in the Treatment of Intrahepatic Biliary Cystadenoma With Recurrence and Malignant Transformation

et al. 2021

View full text Add to dashboard Cite

Apatinib is a new oral tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor-2. It has been proven effective in treating multiple solid tumors. Herein, we report the case of a 67-year-old Chinese patient who was diagnosed with recurrent and malignant transformation of intrahepatic biliary cystadenoma. After multidisciplinary team discussion, the team considered that the remaining liver volume was insufficient for surgical resection. The patient refused chemotherapy and radiotherapy and was willing to take apatinib. Initially, the patient experienced severe tongue ulcers and difficulty eating. The dose of apatinib was then adjusted to 250 mg/day. To date, he has been taking apatinib for 48 months. Regular re-examination showed that the tumor had significantly decreased in size. On January 16, 2021, a CT scan revealed a tumor diameter of 4.5 cm. In our case, the patient achieved partial response and progression-free survival(PFS) of 48.0 months. During treatment, the patient’s appetite and mental state were expected. The treatment did not induce hypertension, fatigue, hand-foot syndrome, or liver and kidney damage. Apatinib may be an option for the treatment of advanced intrahepatic biliary cystadenocarcinoma. Its toxicity is controllable and tolerable. The exact curative effect still needs to be evaluated in more cases.

show abstract

“…Still on the subject of vascular ectasia in the colon, the same authors [40] presented a convincing set of photo graphs of a lesion in the ascending colon that was tempora rily rendered virtually invisible by squirting relatively cold water (at room temperature) over the lesion to clear away adherent faecal matter. They state that colonic lavage with a jet of cold water up the biopsy channel of an endoscope adds yet another physical factor that can alter the appear ance of these vascular lesions.…”

Section: Drugs Other Than Benzodiazepinesmentioning

confidence: 99%

“…They state that colonic lavage with a jet of cold water up the biopsy channel of an endoscope adds yet another physical factor that can alter the appear ance of these vascular lesions. It has been recently shown that instilling 150-200 ml of water into the sigmoid colon can significantly speed up left-sided colonoscopy [41], Based on the observations by Brandt and Mukhopadhyay [40], if one is looking for vascular ectasia one should per haps either use water at 37° C or wait a few minutes after instilling water at room temperature, before commenting on the presence or absence of these notoriously capricious structures from the left side of the colon.…”

Section: Drugs Other Than Benzodiazepinesmentioning

confidence: 99%

Premedication, Preparation, and Surveillance

Bell¹

2000

Endoscopy

View full text Add to dashboard Cite

Once again the staggering variation in IV sedation practice between different countries is highlighted. This year the "to sedate or not sedate" debate focuses on colonoscopy. Several papers on the use of Propofol are reviewed. It remains this authors' opinion that propofol is an anaesthetic agent to be used by (or at least in the presence of) an anaesthetist. Informed consent and the question of what to do if a patient withdraws consent halfway through the procedure are discussed. Predictably further recent papers on the relative merits of midazolam and diazepam are presented plus another report on the use of flumazenil in the recovery period. The use of 3% hydrogen peroxide solution to aid the visualization of acutely bleeding gastro-duodenal lesions is presented in two papers along with a discussion of its possible mode of action. The use of antispasmodics to aid colonoscopy is further discussed: this year concentrating on the use of hyoscyamine sulphate (as opposed to hyoscine butylbromide, the preferred agent in the UK). The patients receiving hyoscyamine sulphate had significantly shorter caecal intubation times, better sedation and easier colonic insertion. The "downside" was drug-induced tachycardia and the authors caution against the widespread use of this drug until this situation is further clarified. The subject of hypoxaemia at the time of gastroscopy, colonoscopy and ERCP was reviewed last year and further papers are presented in which the incidence of various levels of hypoxia are given. In anaesthetic circles it would be considered totally unacceptable to allow a patient's oxygen saturation to fall below 85 %, and yet we continue to have papers reporting its incidence. This level of desaturation is potential dangerous and the routine use of supplemental oxygen would greatly reduce this unneccessary risk to patients.

show abstract

Masking of colon vascular ectasias by cold water lavage

Cited by 11 publications

References 1 publication

The Rate of Lesions Found within Reach of Esophagogastroduodenoscopy during Push Enteroscopy Depends on the Type of Obscure Gastrointestinal Bleeding

The Rate of Lesions Found within Reach of Esophagogastroduodenoscopy during Push Enteroscopy Depends on the Type of Obscure Gastrointestinal Bleeding

Case Report: Low-Dose Apatinib in the Treatment of Intrahepatic Biliary Cystadenoma With Recurrence and Malignant Transformation

Premedication, Preparation, and Surveillance

Contact Info

Product

Resources

About