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Miniprobe EUS in management of pancreatic pseudocyst

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World Journal of Gastrointestinal Endoscopy 2013年第5期5卷 255-260页

作者： Paola De Angelis Erminia Romeo Francesca Rea Filippo Torroni Tamara Caldaro Giovanni Federici di Abriola Francesca Foschia Claudia Caloisi Vincenzina Lucidi luigi dall’Oglio Department of Surgery and Transplantation Digestive Surgery and Endoscopy UnitBambino Gesù Children’s HospitalIRCCS00165 RomeItaly Department of Pediatrics University of 'L’Aquila'67100 L’AquilaItaly Cystic Fibrosis Unit Bambino Gesù Children’s HospitalIRCCS00165 RomeItaly

Pancreatic pseudocysts(PP) arise from trauma and pancreatitis;endoscopic gastro-cyst drainage(EGCD) under endoscopic ultrasonography(EUS) in symptomatic PP is the treatment of *** EUS(MEUS) allows EGCD in *** report our experience on MEUS-EGCD in PP,reviewing 13 patients(12 children;male:female = 9:3;mean age:10 years,4 mo;one 27 years,malnourished male Belardinelli-syndrome;PP:10 post-pancreatitis,3 post-traumatic).All patients underwent ultrasonography,computed tomography and magnetic resonance *** treatment was the first *** EGCD was indicated for retrogastric cysts larger than 5 cm,diameter increase,symptoms or ***(stent and/or nasogastrocystic tube) was performed after MEUS(20-MHz-miniprobe) identification of place for diathermy puncture and wire *** 8 cases(61.5%),there was PP disappearance;one,surgical duodenotomy and marsupialization of retro-duodenal *** 4 cases(31%),there was successful MEUS-EGCD;stent removal after 3 *** complications and no PP relapse in 4 years of mean *** EGCD represents an option for PP,allowing a safe and effective procedure.

关键词： Endoscopic ultrasonography Miniprobe Pancreatic pseudocyst Children Endoscopic gastrocyst drainage

Italian survey on non-steroidal anti-inflammatory drugsand gastrointestinal bleeding in children

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World Journal of Gastroenterology 2016年第5期22卷 1877-1883页

作者： Sabrina Cardile Massimo Martinelli Arrigo Barabino Paolo Gandullia Salvatore Oliva Giovanni Di Nardo luigi dall'Oglio Francesca Rea Gian luigi de'Angelis Barbara Bizzarri Graziella Guariso Enzo Masci Annamaria Staiano Erasmo Miele Claudio Romano Gastroenterology and Endoscopic Unit Department of PediatricsUniversity of Messina98100 MessinaItaly Department of Translational Medical Science Section of PediatricsUniversity of Naples“Federico II”80131 NaplesItaly Department of Pediatric Gastroenterology Gaslini Institute16148 GenoaItaly Department of Pediatrics and Infantile Neuropsychiatry Pediatric Gastroenterology and Liver UnitSapienza University of Rome00185 RomeItaly Digestive Surgery and Endoscopy Unit Bambino GesùChildren’s Hospital00165 RomeItaly Gastroenterology and Endoscopy Service University of Parma43126 ParmaItaly Unit of Paediatric Gastroenterology Digestive EndoscopyHepatologyand Care of Children with Liver TransplantationDepartment of Women’s and Children’s HealthUniversity Hospital of Padova35128 PadovaItaly Gastrointestinal Endoscopy Azienda Ospedaliera San Paolo University HospitalUniversity of Milan20142 MilanItaly

AIM: To investigate gastrointestinal complications associated with non-steroidal anti-inflammatory drug(NSAIDs) use in ***: A retrospective, multicenter study was conducted between January 2005 and January 2013, with the participation of 8 Italian pediatric gastroenterology centers. We collected all the cases of patients who refer to emergency room for suspected gastrointestinal bleeding following NSAIDs consumption, and underwent endoscopic evaluation. Previous medical history, associated risk factors, symptoms and signs at presentation, diagnostic procedures, severity of bleeding and management of gastrointestinal bleeding were collected. In addition, data regarding type of drug used, indication, dose, duration of treatment and prescriber(physician or selfmedication) were examined. RESULTS: Fifty-one patients, including 34 males, were enrolled(median age: 7.8 years). Ibuprofen was the most used NSAID [35/51 patients(68.6%)]. Pain was the most frequent indication for NSAIDs use [29/51 patients(56.9%)]. Seven patients had positive family history of Helicobacter pylori(H. pylori) infection or peptic ulcer, and 12 had associated comorbidities. Twenty-four(47%) out of 51 patients used medication inappropriately. Hematemesis was the most frequent symptom(33.3%). Upper gastrointestinal endoscopy revealed gastric lesions in 32/51(62%) patients, duodenal lesions in 17(33%) and esophageal lesions in 8(15%). In 10/51(19.6%) patients, a diagnosis of H. pylori gastritis was made. Forty-eight(94%) patients underwent medical therapy, with spontaneous bleeding resolution, while in 3/51(6%) patients, an endoscopic hemostasis was ***: The data collected in this study confirms that adverse events with the involvement of the gastrointestinal tract secondary to NSAID use are also common in

关键词： Hematemesis Gastrointestinal bleeding non-steroidal anti-inflammatory drug Melena Pediatrics

An uncommon cause of abdominal pain in a child: Meckel diverticulum

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Journal of Acute Disease 2017年第5期6卷 229-231页

作者： Anna Chiara Iolanda Contini Tamara Caldaro Giovanni Federici di Abriola Erminia Romeo Valerio Balassone Francesca Rea Filippo Torroni Paola De Angelis Simona Faraci Giulia Angelino Renato Tambucci luigi dall'Oglio Digestive Surgery and Endoscopy Unit Bambino GesùChildren HospitalIRCCS00165 RomeItaly

Meckel diverticulum, a common congenital anomaly of the small intestine, can be responsible of several complications due to the presence of ectopic gastric mucosa and represents a challenge for diagnosis. We present the case of a 11-year boy suffering from intestinal pain and bleeding in which radiological examinations unexpectedly raised the suspicion of Meckel diverticulum. The diagnosis was confirmed using 99mTc-pertechnetate scintigraphy. At surgery, a fistulous tract between Meckel diverticulum and an inflamed appendix was found. The authors discuss the role of medical nuclear imaging which, notwithstanding its limitations, is of fundamental importance to achieve a correct and timely diagnosis. This is of particular relevance in unusual cases, as the one presented, in which Meckel diverticulum is found concurrently with other intestinal abnormalities.

关键词： Appendix Meckel Scintigraphy

Endoscopic management of esophageal stenosis in children:New and traditional treatments

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World Journal of Gastrointestinal Endoscopy 2016年第4期8卷 212-219页

作者： luigi dall rsquo Oglio Tamara Caldaro Francesca Foschia Simona Faraci Giovanni Federici di Abriola Francesca Rea Erminia Romeo Filippo Torroni Giulia Angelino Paola De Angelis Digestive Endoscopy and Surgery Unit Bambino GesùChildren HospitalIRCCS00165 RomaItaly

Post-esophageal atresia anastomotic strictures and postcorrosive esophagitis are the most frequent types of cicatricial esophageal stricture. Congenital esophageal stenosis has been reported to be a rare but typical disease in children; other pediatric conditions are peptic, eosinophilic esophagitis and dystrophic recessive epidermolysis bullosa strictures. The conservative treatment of esophageal stenosis and strictures(ES) rather than surgery is a well-known strategy for children. Before planning esophageal dilation, the esophageal morphology should be assessed in detail for its length, aspect, number and level, and different conservative strategies should be chosen accordingly. Endoscopic dilators and techniques that involve different adjuvant treatment strategies have been reported and depend on the stricture's etiology, the availability of different tools and the operator's experience and preferences. Balloon and semirigid dilators are the most frequently used tools. No high-quality studies have reported on the differences in the efficacies and rates of complications associated with these two types of dilators. There is no consensus in the literature regarding the frequency of dilations or the diameter that should be achieved. The use of adjuvant treatments has been reported in cases of recalcitrant stenosis or strictures with evidence of dysphagic symptoms. Corticosteroids(either systemically or locally injected), the local application of mitomycin C, diathermy and laser ES sectioning have been reported. Some authors have suggested that stenting can reduce both the number of dilations and the treatment length. In many cases, this strategy is effective when either metallic or plastic stents are utilized. Treatment complications, such esophageal perforations, can be conservatively managed, considering surgery only in cases with severe pleural cavity involvement. In cases of stricture relapse,even if such relapses occur following the execution of well-conducted c

关键词： Esophageal stenosis Esophageal stricture Esophageal dilation Esophageal stent Caustic stricture

ConservativeapproachinPeutz-JeghersSyndrome:Single-balloon enteroscopyandsmallbowelpolypectomy

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World Journal of Gastrointestinal Endoscopy 2014年第7期6卷 318-323页

作者： Torroni F Romeo E Rea F De Angelis P Foschia F Faraci S Federici di Abriola G Contini AC Caldaro T dall’Oglio L Filippo Torroni Erminia Romeo Francesca Rea Paola De Angelis Francesca Foschia Simona Faraci Giovanni Federici di Abriola Anna Chiara Contini Tamara Caldaro Luigi Dall’Oglio Department of Surgery and Transplantation Digestive Surgery and Endoscopy Unit Bambino Gesù Children’s Hospital IRCCS 00165 Rome Italy

AIM: To assess the usefulness of the balloon assisted enteroscopy in preventing surgical intervention in pa-tients with Peutz-Jeghers syndrome (PJS) having a small bowel large polyps. METHODS: Seven consecutive asymptomatic pts(age 15-38 years) with PJS have been collected; six under-went polypectomy using single balloon enteroscopy(Olympus SIF Q180) with antegrade approach using push and pull technique. SBE system consists of the SIF-Q180 enteroscope, an overtube balloon control unit(OBCU Olympus Balloon Control Unit) and a dispos-able silicone splinting tube with balloon(ST-SB1). All procedures were performed under general anesthesia. Previously all pts received wireless capsule endos-copy(WCE). Prophylactic polypectomy was reservedmainly in pts who had polyps > 15 mm in diameter. The balloon is inflated and deflated by a balloon control unit with a safety pressure setting range from-6.0 kPa to +5.4 kPa. Informed consent has been obtained from pts or parents for each ***: Six pts underwent polypectomy of small bowel polyps; in 5 pts a large polyp > 15 mm(range 20-50 mm in diameter) was resected; in 1 patient with WCE negative, SBE was performed for previous surgi-cal resection of gastrointestinal stromal tumors. In 2 pts endoscopic clips were placed due to a polypectomy. No surgical complication have been reported. SBE with resection of small bowel large polyps in PJS pts was useful to avoid gastrointestinal bleeding and emergency laparotomy due to intestinal intussuscep-tions. No gastrointestinal tumors were found in sub-sequent enteroscopic surveillance in all seven pts. In order surveillance, all pts received WCE, upper en-doscopy, ileocolonoscopy every 2 years. No pts had extraintestinal malignant lesions. SBE was performed when WCE was positive for significant polyps(> 15 mm).CONCLUSION: The effective of prophylactic polyp-ectomy of small bowel large polyps(> 15 mm) could be the first line treatment for conservative approach in management of PJS

关键词： Peutz-Jeghers syndrome Balloon assisted enteroscopy Polypectomy