Postpolypectomy lower gastrointestinal bleeding: potential role of aspirin.

Introduction: Limited data exist on the role of aspirin in increasing the risk of clinically significant postpolypectomy bleeding (PPB), which is defined as lower gastrointestinal (GI) hemorrhage following colonoscopic polyp removal requiring transfusion, hospitalization, endoscopic intervention, angiography, or surgery.

Objectives: To determine if aspirin use prior to colonoscopy increases the risk of clinically significant PPB.

Methods: A case-control study of patients with clinically significant PPB at Mayo Clinic Scottsdale and Rochester was performed.

Unsedated endoscopy.

Unsedated endoscopy will likely play an increasingly important role in the daily practice of GI endoscopy. Although there is adequate evidence that un-sedated endoscopy is technically feasible in selected patient populations, there area number of obstacles preventing its widespread adoption. Small-caliber endoscopy is not as accurate as conventional EGD.

Strategies to address increased demand for colonoscopy: Guidelines in an open endoscopy practice.

Background And Aims: Since Medicare approval for reimbursement of screening colonoscopies, the number of colonoscopy requests has increased. Physician resources have often been inadequate to meet the demand. We sought to reduce the demand for colonoscopy in an open endoscopy system by using a guideline-based triage system to eliminate inappropriate procedures and to align the timing of surveillance colonoscopies with recommendations made by national organizations.

An assessment of the management of acute bleeding varices: a multicenter prospective member-based study.

Objective: Bleeding from esophagogastric varices is a major complication of portal hypertension. Despite recent practice guidelines for the management of bleeding esophageal or gastric varices, the widespread application of these measures by gastroenterologists has not been evaluated. The purpose of this study was to continue the concept of membership-based research within diverse practice settings by expanding the American College of Gastroenterology (ACG) GI Bleeding Registry to assess the management and outcome of acute variceal bleeding.

Nonsurgical approaches to esophageal malignancy.

Esophageal cancer remains one of the leading causes of cancer death worldwide. Patients generally present with progressive dysphagia, malnutrition, and weight loss. The diagnosis commonly involves radiologic studies and conventional esophagogastroduodenoscopy.

A simple phantom for learning EUS-guided FNA.

Background: The learning curve for EUS-guided FNA (EUS-FNA) is formidable. Development of a phantom to assist in teaching the technique may be beneficial. This study assessed the feasibility of using a low-cost phantom made of commonly available materials to practice EUS-FNA.

Endoscopic identification and quantification of aberrant crypt foci in the human colon.

Background: Aberrant crypt foci may be precancerous lesions in the human colon. The occurrence of aberrant crypt foci was compared in patients with an endoscopically normal colon, known adenomatous polyps, and known colorectal cancer.

Methods: In 90 patients (30 colonoscopically normal, 30 with adenomatous polyps, 30 with colorectal cancers) magnification chromoscopy was performed to identify aberrant crypt foci in the distal 10 cm of the rectum.

Comparative performance in the porcine esophagus of different solutions used for submucosal injection.

Background: Before endoscopic mucosal resection and polypectomy of sessile lesions, injection of fluid into the submucosa cushions and isolates the tissue and thereby reduces thermal injury and the risk for perforation and hemorrhage. This study investigated the performance of 5 different solutions when used to form submucosal fluid cushions in the porcine esophagus.

Methods: Five groups of 5 pigs were studied.