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Accuracy of virtual chromoendoscopy in differentiating gastric antral vascular ectasia from portal hypertensive gastropathy:A proof of concept study

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World Journal of Hepatology 2021年第12期13卷 2168-2178页

作者： Ahmad M Al-Taee Mark P Cubillan Alice Hinton Lindsay A Sobotka Alex S Befeler christine y hachem Hisham Hussan Division of Gastroenterology and Hepatology NYU Langone HealthNew YorkNY 10016United States Department of Internal Medicine Saint Louis UniversitySt LouisMO 63110United States Division of Biostatistics The Ohio State UniversityColumbusOH 43210United States Division of Gastroenterology Hepatologyand NutritionThe Ohio State UniversityColumbusOH 43210United States Division of Gastroenterology and Hepatology Saint Louis UniversitySt LouisMO 63110United States

BACKGROUND Accurate detection of gastric antral vascular ectasia(GAVE)is critical for proper management of cirrhosis-related gastrointestinal ***,endoscopic diagnosis of GAVE can be challenging when GAVE overlaps with severe portal hypertensive gastropathy(PHG).AIM To determine the added diagnostic value of virtual chromoendoscopy to high definition white light for real-time endoscopic diagnosis of GAVE and *** We developed an I-scan virtual chromoendoscopy criteria for diagnosis of GAVE and *** tested our criteria in a cross-sectional cohort of cirrhotic adults with GAVE and PHG when high-definition white light endoscopy(HDWLE)diagnosis was in *** then compared the accuracy of I-scan vs HDWLE alone to *** Twenty-three patients were included in this study(65.2%Caucasians and 60.9%males).Chronic hepatitis C was the predominant cause of cirrhosis(43.5%)and seven adults(30.4%)had confirmed GAVE on histology.I-scan had higher sensitivity(100%vs 85.7%)and specificity(75%vs 62.5%)in diagnosing GAVE compared to *** translates into a higher,albeit not statistically significant,accuracy of I-scan in detecting GAVE compared to HDWLE alone(82%vs 70%).I-scan was less likely to lead to an accurate diagnosis of GAVE in patients on dialysis(Py to HDWLE in detecting *** This pilot work supports that virtual chromoendoscopy may obviate the need for biopsies when the presence of GAVE is in *** studies are needed to assess the impact of virtual chromoendoscopy on success of endoscopic therapy for GAVE.

关键词： Portal hypertensive gastropathy Gastric antral vascular ectasia Virtual chromoendoscopy Endoscopy

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Predictors of double balloon endoscopy outcomes in the evaluation of gastrointestinal bleeding

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World Journal of Gastrointestinal Endoscopy 2014年第6期6卷 248-253页

作者： Hisham Hussan Nicholas R Crews Caroline M Geremakis Soubhi Bahna Jennifer L LaBundy christine hachem Section of Intestinal Neoplasia and Hereditary Polyposis(INHP) Department of GastroenterologyHepatology and NutritionThe Ohio State University Medical Center Division of Gastroenterology and Hepatology Saint Louis University School of Medicine School of Medicine Saint Louis University School of Medicine Center for Outcomes Research Saint Louis University Department of Internal Medicine Saint Louis University School of Medicine

AIM:To identify patients' characteristics associated with double balloon endoscopy(DBE)outcomes in investigation of obscure gastrointestinal bleeding(OGIB).METHODS:Retrospective study performed at an academic tertiary referral *** endpoints were clinical factors associated with no diagnostic yield or non-therapeutic intervention of DBE performed for OGIB ***:We included fifty-five DBE between August 2010 and April *** mean age of the sample was 67 with 32 males(58.2%).Twenty-four DBE had no diagnostic yield and 30 DBE did not require ***-diagnostic yield was associated with performing two or more DBE studies in one day [odds ratio(OR):13.72,P=0.008],absence of blood transfusions within a year of the DBE(OR:7.16,P=0.03)and absence of ulcers or arteriovenous malformations(AVMs)on prior esophagogastroduodenoscopy(EGD)or colonoscopy(OR:19.30,P=0.033).Non-therapeutic DBE was associated with performing two or more DBE per day(OR:18.579,P=0.007),gastrointestinal bleeding episode within a week of the DBE(OR:11.48,P=0.003),fewer blood transfusion requirements prior to DBE(OR:4.55,P=0.036)and absence of ulcers or AVMs on prior EGD or colonoscopy(OR:8.47,P=0.027).CONCLUSION:Predictors of DBE yield and therapeutic intervention on DBE include blood transfusion requirements,previous endoscopic findings and possibly endoscopist fatigue.

关键词： Double balloon endoscopy Enteroscopy Obscure gastrointestinal bleeding Small bowel Anemia Arteriovenous malformations Arteriovenous malformations

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