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ABSTRACT: Background and aims:
It is difficult to secure the visual field during endoscopy for GI bleeding or colonoscopy without preparation, because the injected water is rapidly mixed with fresh blood or stool. We developed a novel method to secure the visual field in these situations.
Clear gel with the appropriate viscosity to prevent rapid mixing is injected through the accessory channel, instead of water. A vinyl tube was used as an in vitro GI bleeding model. After filling the lumen with indigo carmine dye, air insufflation and water injection are not effective to secure the visual field. However, after gel injection, the bleeding source is observed clearly in the space occupied by the gel. The efficacy of this method was evaluated subjectively in clinical use. From February 2014 until June 2015, gel immersion was used in 17 consecutive patients when the visual field could not be secured with routine insufflation.
In these 17 patients, gel injection was very effective in 10, effective in 5, slightly effective in 1, and not effective in 1. There were no adverse events associated with this method.
Gel immersion endoscopy is safe and effective for securing the visual field, creating a space for endoscopic visualization and treatment in otherwise difficult situations.
Gastrointestinal endoscopy 10/2015; DOI:10.1016/j.gie.2015.09.048 · 5.37 Impact Factor
Gastrointestinal Endoscopy 05/2015; 81(5):AB177. DOI:10.1016/j.gie.2015.03.1935 · 5.37 Impact Factor
01/2015; 86(1):214-215. DOI:10.11641/pde.86.1_214
Digestive Endoscopy 05/2012; 24(3):195-6. DOI:10.1111/j.1443-1661.2011.01193.x · 2.06 Impact Factor
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ABSTRACT: A 51-year-old woman was admitted to our department because of upper abdominal pain. The serum IgG4 concentration was elevated,
and abdominal computed tomography revealed diffuse enlargement of the pancreas associated with a large cyst, measuring 8cm
in diameter. Endoscopic retrograde cholangiopancreatography revealed narrowing of the main pancreatic duct (from the body
to the tail), narrowing of the intrapancreatic bile duct, and dilatation of the bile ducts. The patient was given a diagnosis
of autoimmune pancreatitis (AIP) associated with a pancreatic pseudocyst and intrapancreatic bile duct stenosis. Oral steroid
therapy resulted in reduced pancreatic swelling, complete disappearance of the pancreatic cyst, and an improvement in biliary
stenosis. AIP is rarely associated with pancreatic cyst, and only 13 cases, including ours, have been reported to date. In
our patient, intense inflammation apparently led to cyst formation in association with AIP, which responded remarkably to
corticosteroid therapy. Correct diagnosis of AIP associated with a pancreatic pseudocyst might save patients from undergoing
unnecessary endoscopic and surgical procedures.
Clinical Journal of Gastroenterology 06/2009; 2(3):199-203. DOI:10.1007/s12328-008-0059-3
Gastrointestinal Endoscopy 04/2008; 67(5):AB260. DOI:10.1016/j.gie.2008.03.705 · 5.37 Impact Factor
Gastrointestinal Endoscopy 04/2008; 67(5). DOI:10.1016/j.gie.2008.03.763 · 5.37 Impact Factor