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Conservative management of razor blade ingestion

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Gastroenterology Report 2014年第2期2卷 158-159页

作者： mazen albeldawi Sigurbjorn Birgisson Gastroenterology and Hepatology Cleveland ClinicClevelandOH 44195USA

A 30-year-old woman presented to the emergency department complaining of abdominal *** abdominal radiograph was done,revealing ten rectangular razor blades measuring 52 *** patient was taken to the operating room and a flexible esophago-gastroduodenoscopy was *** at retrieval,using both a gastric overtube and an inverted hood,were unsuccessful due to the shape and size of the *** was transferred to a regular medical floor and managed conservatively with serial abdominal *** the next week,she passed the razor blades transanally without further event—all were still wrapped in paper and chewing gum—and was cleared to be discharged home.

关键词： Foreign body ingestion endoscopy razor blades

Kayexalate-induced colonic ulcer

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Gastroenterology Report 2014年第3期2卷 235-236页

作者： mazen albeldawi Varun Gaur Luke Weber Department of Gastroenterology and Hepatology Cleveland ClinicClevelandOHUSA Department of Internal Medicine Cleveland ClinicClevelandOHUSA

A 61-year-old male presents to the emergency room with complaints of fatigue,dizziness and bright red blood per rectum(BRBPR)for 2 *** medical history was significant for gastroesophageal reflux disease,non-steroidal antiinflammatory drug(NSAID)induced ulcer,and end-stage renal disease(GFR<30)status post 2 failed renal *** medications include pantoprazole and sodium polystyrene sulfonate in sorbitol(Kayexalate 30 g/d orally).On esophagogastroduodenoscopy(EGD)there was a single shallow,flat,non-bleeding gastric ulcer(3mm)in the pre-pyloric region of the stomach with no stigmata of bleeding.A colonoscopy was performed showing evidence of colitis and localized ulcerations in the cecum which were *** revealed basophilic,nonpolarizable,rhomboid-like crystals without evidence of necrosis.

关键词： Kayexalate medication side effect gastrointestinal bleed

Utility of urgent colonoscopy in acute lower gastro-intestinal bleeding:a single-center experience

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Gastroenterology Report 2014年第4期2卷 300-305页

作者： mazen albeldawi Duc Ha Paresh Mehta Rocio Lopez Sunguk Jang Madhusudhan R.Sanaka John J.Vargo Department of Gastroenterology and Hepatology Cleveland ClinicClevelandOHUSA Department of Internal Medicine Cleveland ClinicClevelandOHUSA Department of Quantitative Sciences Cleveland ClinicClevelandOHUSA

*** role of urgent colonoscopy in lower gastro-intestinal bleeding(LGIB)remains *** the last two decades,a number of studies have indicated that urgent colonoscopy may facilitate the identification and treatment of bleeding lesions;however,studies comparing this approach to elective colonoscopy for LGIB are *** determine the utility and assess the outcome of urgent colonoscopy as the initial test for patients admitted to the intensive care unit(ICU)with acute *** patients who underwent colonoscopy at our institution for the initial evaluation of acute LGIB between January 2011 and January 2012 were analysed *** were grouped into urgent *** colonoscopy,depending on the timing of colonoscopy after admission to the *** colonoscopy was defined as being performed within 24 hours of admission and those performed later than 24 hours were considered *** included length of hospital stay,early re-bleeding rates,and the need for additional diagnostic or therapeutic *** logistic regression analysis was performed to identify factors associated with increased transfusion ***-seven patients underwent colonoscopy for the evaluation of suspected LGIB,24 of which were *** was no significant difference in patient demographics,co-morbidities,or medications between the two *** who underwent urgent colonoscopy were more likely to present with hemodynamic instability(P=0.019)and require blood transfusions(P=0.003).No significant differences in length of hospital stay,re-bleeding rates,or the need for additional diagnostic or therapeutic interventions were *** requiring blood transfusions(n=27)were more likely to be female(P=0.016)and diabetics(P=0.015).Fourteen patients re-bled at a median of 2 days after index *** with hemodynamic instability were more likely to re-bleed[HR 3.8(CI 1.06–13.

关键词： acute lower gastro-intestinal bleeding urgent colonoscopy elective colonoscopy outcomes

Association of procedure length on outcomes and adverse events of endoscopic retrograde cholangiopancreatography

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Gastroenterology Report 2014年第2期2卷 140-144页

作者： Paresh P.Mehta Madhusudhan R.Sanaka Mansour A.Parsi mazen J.albeldawi John A.Dumot Rocio Lopez Gregory Zuccaro John J.Vargo Digestive Disease Institute Department of Gastroenterology and HepatologyCleveland ClinicCleveland OHUSA Department of Quantitative Health Sciences Cleveland ClinicClevelandOHUSA

Objective:The aims of this study were to determine the effects of length of procedure on endoscopic retrograde cholangiopancreatography(ERCP)outcomes and adverse ***:All ERCP procedures,performed by experienced advanced endoscopists,in patients without prior papillary intervention from 2006 to 2008 were *** were arbitrarily divided into two groups:shorter procedures(SP),with a duration shorter than the overall mean procedure length,and longer procedures(LP),with a duration longer than overall mean procedure *** of procedure was defined as the time from endoscope insertion to endoscope ***:Two hundred and ninety-five procedures were included in the *** procedure length was 45.630.1 *** hundred and seventy-seven procedures(60%)were SP and 118(40%)were *** were no differences between the groups with regard to patients’ages,genders,race,or trainee *** cases were more likely to be biliary vs pancreatic or bi-ductal evaluations(P=0.03).LP had significantly higher complexity scores(34%with>3 vs 13%;P=0.046)and were more likely to require pre-cut papillotomy(39%vs 15%;P<0.001).There was no significant difference between the groups in overall completion rates(91.5%LP vs 96%SP;P=0.10)or adverse events(10.2%LP vs 6.2%SP;P=0.21).However,LP cases were associated with higher rates of post-ERCP bleeding(4.2%vs 0.6%;P=0.029).Conclusion:There was no significant difference in outcomes or overall adverse events between shorter and longer ERCP ***,longer procedures were associated with higher procedure complexity,higher utilization of pre-cut technique,and increased risk of bleeding.

关键词： endoscopic retrograde cholangiopancreatography(ERCP) duration of procedure adverse events pancreatitis