An unusual digestive foreign body.

Foreign digestive bodies present unusual circumstances because they are associated with various degrees of local trauma and may lead to direct perforation or delayed local injury. Patients with foreign bodies should be evaluated upon admission for signs of impaction and perforation. While all objects impacted in the esophagus require urgent treatment, rectal foreign bodies are usually removable through the anus.

Colorectal anastomotic stenosis after elective laparoscopic sigmoidectomy for diverticular disease: a prospective evaluation of 68 patients.

Purpose: This prospective study was designed to find the incidence of symptomatic anastomotic stenosis after elective laparoscopic sigmoidectomy for diverticular disease.

Methods: Sixty-eight patients who underwent elective laparoscopic sigmoidectomy with double-stapling colorectal anastomosis between November 1998 and June 2007 were included. Follow-up after hospitalization was performed by using sequential rectoscopy for all patients.

Neoadjuvant radiochemotherapy for locally advanced gastric cancer: long-term results of a phase I trial.

Purpose: To assess the long-term results of radiation therapy (RT) when added preoperatively to systemic chemotherapy in patients with locally advanced gastric cancer.

Methods And Materials: Patients presenting with T3-4 or N+ gastric cancer received two cycles of cisplatin 100 mg/m2 d1, 5FU 800 mg/m2 d1-4, and Leucovorin 60 mg twice daily d1-4; one cycle before and one concomitantly with hyperfractionated RT (median dose, 38.4; range, 31.

Neoadjuvant radiochemotherapy for locally advanced gastric cancer: a phase I-II study.

Background: To study in a phase I-II trial the maximum tolerated dose, the toxicity, and the tolerance of adding radiotherapy to systemic chemotherapy administered preoperatively in patients with locoregionally advanced gastric adenocarcinoma.

Patients And Methods: Patients with adenocarcinoma of the stomach (T(3)(-)(4)N(any) or T(any)N+), performance status View Article and Find Full Text PDF

Erythromycin intravenous bolus infusion in acute upper gastrointestinal bleeding: a randomized, controlled, double-blind trial.

Background & Aims: Emergency endoscopy may be difficult in upper gastrointestinal bleeding when blood obscures the visibility. Erythromycin, a motilin agonist, induces gastric emptying. We investigated whether an intravenous bolus infusion of erythromycin would improve the yield of endoscopy in these patients.

Choledocholithiasis and bile duct stenosis: diagnostic accuracy of MR cholangiopancreatography.

Purpose: To evaluate the accuracy of magnetic resonance (MR) cholangiopancreatography for detecting bile duct calculi and stenosis.

Materials And Methods: At MR cholangiopancreatography, 108 patients suspected of having bile duct calculi or stenosis were examined with two-dimensional fast spin-echo MR sequences and respiratory gating. On the basis of findings at surgery and/or intraoperative, endoscopic retrograde, and/or percutaneous cholangiography, final diagnoses were normal bile ducts (n = 38), choledocholithiasis (n = 23), Mirizzi syndrome (n = 3), benign or malignant bile duct stenosis (n = 40), choledochal cyst (n = 1), and bile duct dilatation without calculi or stenosis (n = 3).

MR cholangiopancreatography: technique, potential indications, and diagnostic features of benign, postoperative, and malignant conditions.

The objective of this article is to review technical aspects, discuss potential clinical indications for MR cholangiopancreatography (MRCP) and demonstrate the spectrum of diagnostic findings in benign, postoperative, and malignant conditions. We describe our current imaging protocol in comparison with other available techniques. Using a non-breath-hold, heavily T2-weighted fast-spin-echo (FSE) sequence with or without respiratory gating we obtained coronal and axial source images and maximum intensity projections (MIPs) in 102 patients with suspected abnormalities of the biliary or pancreatic ducts.

[Enterocolitis due to a saponin-containing drug. Apropos of a case].

The case of a 60-year-old female patient with watery diarrhea is reported. The history was characterized by prolonged diagnostic vagaries, due in part to histological features of ileal, rectal and duodenal biopsies which were suggestive of celiac disease. This was clinically excluded.

[Gallbladder dyskinesia and manometry of Oddi's sphincter].

Sphincter of Oddi activity partly regulates bile flow into the small intestine. This regulation is mainly controlled by phasic contractions and basal tone of the sphincter, together with gallbladder contraction. Manometric studies of the sphincter have permitted a better understanding of its physiological role and implication in biliary dyskinesia symptoms.

[Conservative treatment of esophageal perforations following pneumatic dilatation].

Over a 15-year period we have treated 50 patients with achalasia by pneumatic dilatation (61 dilatations). Perforation occurred in 5 patients, 2 of whom required surgery while the other 3 were successfully managed by conservative means. These 3 patients are reported on with reference to the indications and modalities of the medical treatment.

[Terminal constipation: priority for anorectal manometry].

Terminal constipation is a common ailment which may be readily suspected by appropriate questioning of the patient. Investigation is by function tests such as anorectal manometry and measurement of colonic transit time. The goal of this investigation was to explore the relative merits of these two methods in terminal constipation.

[The value of endoscopic sclerotherapy in the treatment of gastroduodenal hemorrhagic ulcers].

Mortality in upper GI tract bleeding has not been affected by the introduction of diagnostic fibre optic endoscopy. Recently, however, several modes of treatment delivered through the endoscope have been shown to be effective in improving the outcome of bleeding ulcers. We have retrospectively evaluated the course of 58 patients who underwent endoscopic treatment of a bleeding ulcer.

[Constipation and incontinence: significance of colonic transit time, anorectal manometry and defecography].

Constipation and fecal incontinence are frequent motives of gastroenterological consultation. An etiological diagnosis can often be suspected from the history and can be confirmed by functional testing. We here report our experience with the measurement of colonic transit time (TTC), anorectal manometry (MAR) and defecography (D).

[Treatment of achalasia using balloon dilatation].

40 patients with achalasia underwent pneumatic dilatation. 25 were followed up for a mean duration of 3.96 years.

[Questionable usefulness of the edrophonium test in the diagnosis of non-cardiac retrosternal pain].

Of 69 patients with non-cardiac chest pain, one third had abnormal esophageal motility as evidenced by basal esophageal manometry. 8 patients (12%) reported chest pain during a provocation test (edrophonium). While this pain seemed similar to the spontaneous chest pain described by 7 patients, it was not associated with manometric changes in 30% of these cases.

[Biliary diseases in acquired immunodeficiency syndrome. Apropos of 2 cases].

Biliary complications have recently been reported in patients with AIDS. This may take the form of acalculous cholecystitis or more commonly cholangitis, which may or may not be associated with stenosis of the papilla. These conditions must be sought in patients presenting with right hypochondrial pain and elevated alkaline phosphatase.

[Endoscopic sclerotherapy and esophageal varices].

60 consecutive patients underwent sclerotherapy for hemorrhage from ruptured esophageal varices. Sclerosis was always started within the first 48 hours. 12 patients (20%) died during initial hospitalization, but only 5 from recurrent bleeding.