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Prospective evaluation of small bowel preparation with bisacodyl and sodium phosphate for capsule endoscopy

World Journal of Gastroenterology 2008年第13期14卷 2061-2064页

作者： Andreas Franke Frank Hummel Phillip Knebel christoph antoni Ulrich Bcker Manfred V Singer Matthias Lhr Department of Medicine Ⅱ (Gastroenterology Hepatology and Infectious Diseases) University Hospital of Heidelberg at Mannheim Mannheim D-68167 Germany Department of Medicine Ⅱ (Gastroenterology Hepatology and Infectious Diseases) University Hospital of Heidelberg at Mannheim Mannheim D-68167 Germany Department of Medicine Rotes Kreuz Krankenhaus Kassel Kassel D-34121 Germany

AIM： To determine the effect of Prepacol, a combination of sodium phosphate and bisacodyl, on transit and quality of capsule endoscopy （CE）. METHODS： Fivety two consecutive patients were included in this prospective study. CE was performed following a 12 h fasting period. Twenty six patients were randomized for additional preparation with Prepacol. The quality of CE was assessed separately for the proximal and the distal small bowel by 3 experienced endoscopists on the basis of a graduation which was initially developed with 20 previous CE. RESULTS： Preparation with Prepacol accelerated small bowel transit time （262 ± 55 rain vs 287 ± 97 min）, but had no effect on the quality of CE. Visibility was significantly reduced in the distal compared to the proximal small bowel. CONCLUSION： The significantly reduced visibility of CE in the distal small bowel allocates the need for a good preparation. Since Prepacol has no beneficial effect on CE the modality of preparation and the ideal time of application remains unclear. Further standardized examinations are necessary to identify sufficient preparation procedures and to determine the impact of the volume of the preparation solution.

关键词： Small bowel Capsule endoscopy Preparation Laxative Visibility Transit time

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Sclerosing cholangitis following severe trauma: Description of a remarkable disease entity with emphasis on possible pathophysiologic mechanisms

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World Journal of Gastroenterology 2005年第27期11卷 4199-4205页

作者： Johannes Benninger Rainer Grobholz Yurdaguel Oeztuerk christoph H.antoni Eckhart G.Hahn Manfred V.Singer Richard Strauss Department of Medicine Ⅰ Department of Pathology Department of Medicine II Department of Medicine Ⅱ

MM： Persistent cholestasis is a rare complication of severe trauma or infections. Little is known about the possible pathomechanisms and the clinical ***： Secondary sclerosing cholangitis was diagnosed in five patients with persistent jaundice after severe trauma （one burn injury, three accidents, one power current injury）. Medical charts were retrospectively reviewed with regard to possible trigger mechanisms for cholestasis, and the clinical course was ***： Diagnosis of secondary sclerosing cholangitis was based in all patients on the primary sclerosing cholangitis （PSC）-Iike destruction of the intrahepatic bile ducts at cholangiography after exclusion of PSC. In four patients, arterial hypotension with subsequent ischemia may have caused the bile duct damage, whereas in the case of power current injury direct thermal damage was assumed to be the trigger mechanism. The course of secondary liver fibrosis was rapidly progressive and proceeded to liver cirrhosis in all four patients with a follow-up 〉2 years. Therapeutic possibilities were ***： Posttraumatic sderosing cholangitis is a rare but rapidly progressive disease, probably caused by ischemia of the intrahepatic bile ducts via the peribiliary capillary plexus due to arterial *** should be aware of this disease in patients with persistent cholestasis after severe trauma.

关键词： Life-threatening trauma Arterial hypotension Cholestasis Ischemia of intrahepatic bile ducts Secondary sclerosing cholangitis Posttraumatic sclerosing cholangitis

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