The role of a novel self-expanding metal stent in variceal bleeding: a multicenter Australian and New Zealand experience.

Refractory variceal bleeding is associated with high mortality in patients with chronic liver disease. A fully-covered self-expanding metal stent (SEMS) has been reported to have excellent rates of technical success and initial bleeding control; however, studies to date are small and limited to Europe and Asia. Our aim was to evaluate the efficacy and safety of this SEMS for control of refractory variceal bleeding (VB).

Tamoxifen Therapy for Recurrent Mucosal Bleeding in Hereditary Hemorrhagic Telangiectasia.

A 60-year-old Caucasian man had a 55-year history of recurrent severe epistaxis and later presented with multiple gastrointestinal (GI) bleeding from hereditary hemorrhagic telangiectasia (HHT). Bleeding was exacerbated due to coexistent mild hemophilia A. Despite repeated conventional surgical interventions, tranexamic acid and recombinant factor VIII (FVIII) prophylaxis, bleeding episodes worsened in frequency and severity, resulting in the patient becoming transfusion dependent.

A case of oesophageal varices and portal hypertension in an HIV-positive patient with no evidence of cirrhosis.

We present a case of portal hypertension and variceal bleeding in the absence of cirrhosis, in an HIV-positive patient on long-term antiretroviral treatment with didanosine. We believe this to be the first such case identified in New Zealand (NZ).

A pilot study of intrastricture steroid versus placebo injection after balloon dilatation of Crohn's strictures.

Background & Aims: Restricturing after ileocolonic resection for Crohn's disease is common. Colonoscopic balloon dilatation is effective but repeated dilatations often are required. Intrastricture steroid injection after balloon dilatation has been reported to reduce the need for repeat dilatation in retrospective series, but no randomized data are available.

Colonoscopic balloon dilation of Crohn's strictures: a review of long-term outcomes.

Objective: To study the long-term outcomes of patients who have had endoscopic balloon dilation of Crohn's strictures.

Design: Retrospective case-note review over a 16-year period.

Patients: Patients with a Crohn's stricture causing obstructive symptoms and who had at least 6 months' follow-up data or a surgical outcome following dilation were sought; 59 patients (124 dilations) were identified.

Haemorrhagic radiation proctitis: endoscopic severity may be useful to guide therapy.

Background And Aims: Management of haemorrhagic radiation proctitis remains controversial. Both endoscopically delivered argon plasma coagulation and rectal administration of formalin have been recommended. We evaluated the efficacy of argon plasma coagulation according to endoscopic severity of radiation proctitis.

Use of video and magnetic endoscope imaging for rating competence at colonoscopy: validation of a measurement tool.

Background: Counting the number of procedures performed provides at best a crude measure of technical competence in colonoscopy. The aim of this study was to develop and validate a qualitative and a quantitative score for measuring technical competency in colonoscopy using videotape evaluation.

Methods: Eighteen endoscopists with varying levels of experience were prospectively videotaped during colonoscope insertion.

Total colonic dye-spray increases the detection of diminutive adenomas during routine colonoscopy: a randomized controlled trial.

Background: Small adenomas may be missed during colonoscopy, but chromoscopy has been reported to enhance detection. The aim of this randomized-controlled trial was to determine the effect of total colonic dye spray on adenoma detection during routine colonoscopy.

Methods: Consecutive outpatients undergoing routine colonoscopy were randomized to a dye-spray group (0.

The variable stiffness colonoscope: assessment of efficacy by magnetic endoscope imaging.

Background: Variable-stiffness colonoscopes combine the flexibility of pediatric instruments for negotiation of the sigmoid colon with the ability to stiffen the insertion tube to prevent or control looping after straightening. Previous studies have found wide variation in the efficacy of the stiffening mechanism. Thus, two studies were conducted to assess the potential benefit of the stiffening device and its optimal use.

Effect of magnetic endoscope imaging on patient tolerance and sedation requirements during colonoscopy: a randomized controlled trial.

Background: Pain during colonoscopy is primarily related to mesenteric stretching from looping of the colonoscope insertion tube. Prompt recognition and removal of loops reduces patient discomfort and may lessen sedation requirements. Magnetic endoscope imaging allows real-time visualization of the colonoscope during insertion.

Treatment with argon plasma coagulation reduces recurrence after piecemeal resection of large sessile colonic polyps: a randomized trial and recommendations.

Background: Recurrence is frequent after piecemeal snare resection of large sessile colorectal polyps. The aim of this study was to evaluate the safety and efficacy of argon plasma coagulation (APC) in preventing recurrence when applied to the edge and base of the polypectomy site after apparently complete piecemeal resection.

Methods: Patients with large (>1.