Objectives: To provide a guide to estimate the location of coins within the esophagus based on the pre-operative radiographic image among pediatric patients seen at the East Avenue Medical Center Department of Otorhinolaryngology – Head and Neck Surgery (ORL-HNS) between January 2018 and December 2020. : Methods Design: Retrospective Case Series Setting: Tertiary Government Training Hospital Participants: The records of 99 pediatric patients aged 6 months to 13 years who were diagnosed with esophageal foreign body (coin) impaction and underwent rigid esophagoscopy from January 2018 to December 2020 were retrospectively reviewed. Results: A predictive model was derived from the data using linear regression analysis. The model shows that we can predict the intraoperative location of coin within the esophagus if provided with the patient’s age and vertebral level of the coin on chest radiograph. Prediction values were reported for patients in three age categories (less than 3 years old, 3 to 7 years old, 8 to 13 years old), at 10 radiographic locations (C2, C4, C5, C6, C7, T1, T2, T3, T7, T8), except for these (C1, C3, T4-T6) because of lack of data. For example, the table predicts that a coin will be located 13 cm (or between 11.4cm to 14.8cm) from the central maxillary incisors (CMI) intraoperatively if the coin was located at level C6 vertebrae on chest radiograph, for patients less than 3 years old. Conclusion This study provides a novel guide that may serve as a practical tool for ENT surgeons to estimate the intraoperative location of coin foreign bodies in the esophagus of pediatric patients based on preoperative radiographic imaging.
Foreign Bodies ; Foreign Bodies ; Esophagus ; Esophagoscopes ; Esophagoscopic Surgery ; Esophagoscopic Surgical Procedures ; Esophagoscopy

Objective: To investigate the effects of primary preventive treatment under endoscope for esophageal and gastric varices on bleeding rate and its relevant factors. Methods: 127 cases with liver cirrhosis accompanied with esophageal and gastric varices without bleeding history were included in the endoscopic and non-endoscopic treatment group, respectively. Informed consent was obtained from both groups. Gastric varices (Lgf) and esophageal varices (Leg) were diagnosed according to LDRf classification criteria, and the corresponding treatment scheme was selected according to the recommended principle of this method.The incidence rate of bleeding from ruptured esophageal varices were observed at 3, 6 months, and 1, and 2 years in the treated and the untreated group, and the patients with different Child-Pugh scores were followed-up for 2 years. Gender, age, etiology, varicose degree, Child-Pugh grade, platelet count, prothrombin activity, portal vein thrombosis, collateral circulation, portal vein width and other factors affecting the bleeding rate were assessed. Measurement data were described as mean ± standard deviation (x¯±s), and qualitative data of categorical variables were expressed as percentage (%), and χ² test was used. Results: 127 cases were followed up for 2 years. There were 55 cases in the endoscopic treatment group (18 cases underwent band ligation, 2 cases underwent band ligation combined with tissue adhesive embolization, 28 cases underwent sclerotherapy, and 7 cases underwent sclerotherapy combined with tissue adhesive embolization). Recurrent bleeding and hemorrhage was occurred in 5 (9.1%) and 28 cases (38.9%), respectively (P<0.05). In addition, there were 72 cases in the untreated group (P<0.05). Severe varicose veins proportions in treated and untreated group were 91.1% and 85.1%, respectively (P>0.05). There was no statistically significant difference in liver cirrhosis-related medication and β-blocker therapy between the treated and untreated group (P>0.05). There was no statistically significant difference in the bleeding rate between the different treated groups (P>0.05). The bleeding rates at 3, 6 months, 1, and 2 years in endoscopic treated and untreated group were 2.00% vs. 2.59% (P>0.05), 2.30% vs. 5.88% (P>0.05), 3.10% vs. 7.55% (P>0.05) and 4.00% vs. 21.62% (P<0.05), respectively. All patients with Child-Pugh grade A, B and C in the treated and the untreated group were followed-up for 2 years, and the bleeding rates were 1.8% vs. 8.1% (P<0.05), 1.1% vs. 9.4% (P<0.05) and 9.1% vs. 10.1% (P>0.05), respectively. There were statistically significant differences in the rupture and bleeding of esophageal and gastric varices, varices degree, Child-Pugh grade and presence or absence of thrombosis formation in portal vein (P<0.05); however, no statistically significant differences in gender, age, etiology, platelet count, prothrombin activity, collateral circulation and portal vein width (P>0.05). There was no intraoperative bleeding and postoperative related serious complications in the treated group. Conclusion: The risk of initial episodes of bleeding from esophageal and gastric varices is significantly correlated with the varices degree, Child-Pugh grade, and portal vein thrombosis. Primary preventive treatment under endoscope is safe and effective for reducing the long-term variceal bleeding risk from esophageal and gastric varices.
Endoscopes ; Esophageal and Gastric Varices/complications* ; Gastrointestinal Hemorrhage/surgery* ; Humans ; Hypertension, Portal/complications* ; Ligation ; Liver Cirrhosis/complications* ; Prothrombin ; Sclerotherapy ; Tissue Adhesives ; Varicose Veins ; Venous Thrombosis/complications*

This study introduces a non-invasive gastrointestinal early cancer magnetic anchor ablation electrode endoscopy system, including a magnetic anchor module and ablation electrode module. The magnetic anchoring module is composed of an external guide magnet and an internal magnet, made of permanent magnet material NdFeB; the ablation electrode module is based on the modification of the front end lens hood of the existing endoscope (CMD-90D LED electronic upper gastrointestinal endoscope). The new endoscope system not only includes all the functions of the original endoscope, but also introduces magnetic anchoring to enable the ablation electrode to be accurately positioned and controllable in the process of treating tumors, avoiding the phenomenon of gastric perforation; the introduction of steep pulse electric field ablation electrodes realizes the purpose of non-invasive treatment. Its clinical application will become a new method to treat early cancer of the digestive tract.
Electrodes ; Endoscopes ; Gastrointestinal Tract ; Humans ; Magnetic Phenomena ; Neoplasms

Esophagus/surgery* ; Foreign Bodies/surgery* ; Gastroscopes ; Humans ; Ultrasonography

Foreign body (FB) ingestion of children is a common pediatric emergency requiring medical attention. Pediatric emergency physicians and gastroenterologists often encounter nervous and distressed situations, because of children presenting with this condition in the common clinical practice. When determining the appropriate timing and indications for intervention, physicians should consider multiple patient- and FB-related factors. The utilization of a flexible endoscopy is considered safe and effective to use in these cases, with a high success rate, for the effective extraction of FBs from the gastrointestinal tract of a child. Additionally, a Foley catheter and a magnet-attached Levin tube have been used for decades in the case of FB removal. Although their use has decreased significantly in recent times, these instruments continue to be used for several indications. Using a Foley catheter for this purpose does not require special training and does not necessarily require sedation of the patient or fluoroscopy, which serve as advantages of utilizing this method for foreign object retrieval. An ingested magnet or iron-containing FB can be retrieved using a magnet-attached tube, and can be effective to retrieve an object from any section of the upper gastrointestinal tract that can be reached. Simple and inexpensive devices such as Foley catheters and magnet-attached tubes can be used in emergencies such as with the esophageal impaction of disk batteries if endoscopy cannot be performed immediately (e.g., in rural areas and/or in patients presenting at midnight in a facility, especially in those without access to endoscopes or emergency services, or in any situation that warrants urgent removal of a foreign object).
Catheters ; Child ; Eating ; Emergencies ; Endoscopes ; Endoscopy ; Esophagus ; Fluoroscopy ; Foreign Bodies ; Gastrointestinal Tract ; Humans ; Methods ; Upper Gastrointestinal Tract ; Urinary Catheterization

Capsule endoscopy (CE) is a preferred diagnostic method for analyzing small bowel diseases. However, capsule endoscopes capture a sparse number of images because of their mechanical limitations. Post-procedural management using computational methods can enhance image quality. Additional information, including depth, can be obtained by using recently developed computer vision techniques. It is possible to measure the size of lesions and track the trajectory of capsule endoscopes using the computer vision technology, without requiring additional equipment. Moreover, the computational analysis of CE images can help detect lesions more accurately within a shorter time. Newly introduced deep leaning-based methods have shown more remarkable results over traditional computerized approaches. A large-scale standard dataset should be prepared to develop an optimal algorithms for improving the diagnostic yield of CE. The close collaboration between information technology and medical professionals is needed.
Capsule Endoscopes ; Capsule Endoscopy ; Cooperative Behavior ; Dataset ; Methods

No abstract available.
Common Bile Duct* ; Diverticulum* ; Duodenoscopes* ; Humans ; Stents*

A duodenoscope is complex instrument with an elevator and an elevator wire channel which are difficult to access and not readily amenable to cleaning and disinfection. Lapses in endoscope reprocessing have been regarded as a major cause of duodenoscope-associated transmission of infection. However, recent outbreaks of carbapenem-resistant Enterobacteriaceae or other multidrug-resistant organisms have emerged in spite of proper adherence to the manufacturer's reprocessing instructions. It is the time to reestablish reprocessing protocol appropriate for duodenoscope and revise a new design of duodenoscope that makes reprocessing easier in order to prevent cross-transmission of infection by duodenoscope. This manuscript reviews current state of duodenoscope-associated infections, recent measures from the United States government agencies and its limitations, and future strategies to prevent duodenoscope-associated infections.
Disease Outbreaks ; Disinfection ; Duodenoscopes ; Elevators and Escalators ; Endoscopes ; Enterobacteriaceae ; United States Government Agencies

An 89-year-old man was referred to our hospital for treatment of hepatolithiasis causing recurrent cholangitis. He had undergone a prior Whipple procedure. Computed tomography demonstrated left-sided hepatolithiasis. First, we conducted peroral direct cholangioscopy (PDCS) using an ultraslim endoscope. Although PDCS was successfully conducted, it was unsuccessful in removing all the stones. The stones located in the B2 segment were difficult to remove because the endoscope could not be inserted deeply into this segment due to the small size of the intrahepatic bile duct. Next, we substituted the endoscope with an upper gastrointestinal endoscope. After positioning the endoscope, the SpyGlass digital system (SPY-DS) was successfully inserted deep into the B2 segment. Upon visualizing the residual stones, we conducted SPY-DS-guided electrohydraulic lithotripsy. The stones were disintegrated and completely removed. In cases of PDCS failure, a treatment strategy using the SPY-DS can be considered for patients with hepatolithiasis after a Whipple procedure.
Aged, 80 and over ; Bile Ducts, Intrahepatic ; Cholangitis ; Endoscopes ; Endoscopes, Gastrointestinal ; Humans ; Lithotripsy

Intussusception after colonoscopy is an unusual complication. A MEDLINE search revealed only 7 reported cases. We present a report of a 28-year-old man who developed abdominal pain several hours after routine colonoscopy and in whom computed tomography (CT) revealed colocolic intussusception. We postulate that this condition is iatrogenic and induced by suctioning of gas on withdrawal of the colonoscope. A common observation among the reported cases was abdominal pain several hours after colonoscopy and right-sided intussusception. All cases had colonoscopy reaching the right side of the colon. Treatment for adult intussusception remains controversial with regard to reduction versus resection, especially given the high association with a pathological cause and malignancy. Among the 8 reported cases, only the current case did not require surgery. A combination of benign colonoscopy, CT, and the clinical picture should provide sufficient information to initially choose a more conservative treatment approach.
Abdominal Pain ; Adult ; Colon ; Colonoscopes ; Colonoscopy* ; Humans ; Iatrogenic Disease ; Intussusception* ; Suction