Editor-in-Chief, Deputy Editor 2017-2019

 

Editor-in-Chief:

Tom MOREELS

 

Deputy Editor:

Nicolas LANTHIER

 

Letters



Abdominal cocoon with imaging findings : Importance of radiology


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Abdominal cocoon is a rare disease characterized by a thick fibrous membrane surrounding and compressing the small intestines completely or partially, which results in mechanical small bowel obstruction. The clinical findings of the disease include recurrent ileus and subileus episodes, colicky abdominal pain, weight loss, and abdominal distension. The etiology and pathogenesis of abdominal cocoon is not clearly defined. Detection of the disease is essential for accurate treatment. Imaging modalities come into prominence due to the nonspecific clinical findings of the disease. (Acta gastroenterol. belg., 2015, 78, 346-347). [Product Details...]



Dysphagia and esophageal ulcerations in HIV patient


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A 41 years-old caucasian male with AIDS-associated progressive multifocal leukoencephalopathy, suddenly developed persistent painless dysphagia for solid foods. No other symptoms were present, namely fever, abdominal pain, vomiting or regurgitation. The patient had abandoned medical care and had stopped his anti-retroviral therapy several months before admission. On physical examination, he was slender and afebrile, with normal vital signs. No lymphadenopathy was present and no oropharyngeal mucosal lesions were seen. The physical examination of the neck was unremarkable. Cardiopulmonary examination was normal and the abdomen had no tenderness or organomegaly. [Product Details...]



Endoscopic closure of a rectal diverticulum perforation during a diagnostic colonoscopy


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Finding of rectal diverticula is particularly infrequent, with a frequency s from 0.005% and 0.7% with differences between diagnostic and therapeutic procedures (2). Perforation of a rectal diverticulum during a colonoscopy has been described in only one report (3). Managements of endoscopic perforation vary from conservative treatment to surgical intervention with the majority of patients requiring laparotomy for repair the defect. Immediate closure of a perforation is mandatory to limit bacterial contamination and consequent sepsis. Endoscopic closure of an iatrogenic perforation smaller than 20 mm is performed both with Through- The-Scope (TTS) clipping-devices and Over-The-Scope Clips (OTSC) System. Both techniques are likely to be effective with similar success rates (93% and 89% respectively) (4). The most recent endoloop/clips technique, successfully used for the first time by Endo et al. (5) to close gastric perforations, in some reports has been documented to have satisfactory results in closing iatrogenic perforations (6). In this report, we describe a successful repair of a rectal perforation caused by the maneuver of retro-flexion of the colonoscope during a diagnostic colonoscopy by using the endoloop/clips technique. [Product Details...]



Endoscopic Treatment of Biloma : Bilo-gastric drainage


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Bile tree injury and biliary leakage are common and serious complications after cholecystectomy, cyst hydatid surgery, pancreaticoduodenectomy, and hepatic segmentectomy. Bilomas are extrabiliary encapsulated cystic collections of bile, most often in perihepatic space but also elsewhere in the abdomen (1). Percutaneous or surgical drainage is the standart of care (2). Herein we present a novel transgastric endoscopic drainage of a biloma. [Product Details...]



Pancreatic cystic lymphangioma diagnosed with endoscopic ultrasonographic fine-needle aspiration; a rare mesenchymal tumor


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Cystic lymphangioma is the benign proliferation of lymphatic vessels due to lymphatic system obstruction forming cysts filled with fluid. It is mostly seen in neonatal and early childhood period, and rarely in adults. Major localisations of occurrence are cervical and axillary regions where it can be rarely seen in soft tissues abdominal region (1). Cystic lymphangioma of the pancreas is a very rare benign neoplastic lesion counting for less than 1% of all lymphangiomas and around 0.2% of all pancreatic tumors (2). Traditional radiological techniques are mostly insufficient for the evaluation of pancreatic cystic lesions. Therefore, the histopathological diagnosis of pancreatic cystic lymphangiomas used to be established by classical surgical incision in the past (3). Endoscopic ultrasound (EUS) has been shown to be an effective technique providing high definition images of the pancreas. Cases of pancreatic cystic lymphangioma diagnosed with EUS guided fine needle aspiration (EUS-FNA) have recently been reported (2-5). We present a case of pancreatic cystic lymphangioma diagnosed with EUSFNA in this report. [Product Details...]



Primary B-cell non-Hodgkin’s lymphoma of the papilla major and papilla minor as a cause of biliary obstruction


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There are many causes of malign biliary obstructions such as pancreatic adenocarcinoma, cholangiocarcinoma and malign lymphadenopathies. However malign biliary obstruction from lymphomas is quite rare (1). The most common cause of jaundice in lymphomas is enlarged lymph node compression of the biliary tree. Here we present a non-Hodgkin’s lymphoma which involves papilla major and papilla minor without any lymphadenopathies. [Product Details...]



Re-audit of patient information about the ethanol content of anaesthetic sprays used in gastroscopies


Price: €10,00

It is customary to offer patients undergoing gastroscopy intravenous sedation, an oral local anaesthetic spray or a combination of both. However, the presence of alcohol within these sprays is seldom discussed. Traditionally, Muslims, Baptists, Salvationists and members of many fundamentalist Christian groups abstain completely from alcohol. During 2013 patients’ views on use of oral anaesthetic sprays with an alcohol base were investigated in Leicester (1). The proportion of patients who rejected the spray was 8% for Asians and 17% for Europeans with no difference between Hindus and Muslims. Reasons included ineffectiveness and the erroneous belief alcohol would interfere with other medications. In only two cases were objections religious. In one a Christian had signed the Pledge and the other was a Muslim (2). Clearly our preconceptions as to how people will respond to the issue of alcohol in medications can be wrong. However, together with others, this study demonstrated most patients believe we should provide them with this information so they can make informed choices (1,3). [Product Details...]


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