Subcutaneous Emphysema, Pneumothorax and Pneumomediastinum Following Endoscopic Sphincterotomy.

Retroperitoneal perforation during therapeutic endoscopic retrograde cholangiopancreatography (ERCP) is uncommon and is usually manifested by abdominal pain, fever and leukocytosis. We report the case of a patient with post-ERCP subcutaneous emphysema, pneumomediastinum and pneumothorax treated conservatively. A 79-year-old woman with a diagnosis of choledocholitiasis was referred to our institution for an elective outpatient therapeutic ERCP.

Comparative results of gastric submucosal injection with hydroxypropyl methylcellulose, carboxymethylcellulose and normal saline solution in a porcine model.

Context: Endoscopic mucosal resection is an established modality for excision of sessile lesions in the gastrointestinal tract. Submucosal fluid injection creates a cushion and may prevent thermal injury and perforation.

Objectives: This blind study investigated the performance of three different solutions to create submucosal fluid cushions in porcine stomach.

Endoscopic treatment of gastroesophageal reflux disease: effect of gender on clinical outcome.

Objective: Gender differences in gastroesophageal reflux disease have been reported. Higher frequency and severity of symptoms, lower esophageal acid exposure and lower incidence of reflux-related complications have been observed in women. The aim of this study was to determine whether there are any gender differences in clinical presentation, diagnostic evaluations and response to endoscopic therapy in patients with gastroesophageal reflux disease.

Prospective trial of endoscopic clips versus combination therapy in upper GI bleeding (PROTECCT--UGI bleeding).

Background: It is not known if combination therapy of epinephrine injection and multipolar electrocoagulation or hemoclips are a more efficient or effective treatment for patients with acute nonvariceal upper gastrointestinal (GI) bleeding.

Methods: Adult patients with active nonvariceal upper GI bleeding, a nonbleeding visible vessel, or after removal of an adherent clot findings of active bleeding or a visible vessel were studied. Patients were randomized to either therapy and the outcomes were assessed at 30 days.

Obstructive jaundice secondary to bile duct involvement with Hodgkin's disease: a case report.

Context: Obstructive jaundice due to lymphoma is very rare. It may be difficult to distinguish between this condition and a large number of causes of extrahepatic bile duct obstruction, even by endoscopic retrograde cholangiography. Its prognosis is poor.

[How many procedures are necessary to achieve competency in colonoscopy?].

Background: Competency for colonoscopy implies technical and cognitive skills. The American Society for Gastrointestinal Endoscopy has suggested 100 supervised procedures might be necessary. There are no specific recommendations in Brazil.