Study on Endoscopic Insertion of the Enteral Feeding Tube for Patients with Anastomotic Impassability After Gastrectomy
Hak-Chol Ju,
Gyong-Hui Ri,
Gwang-Il Kim,
Un-Gyong Ri
Issue:
Volume 1, Issue 1, December 2017
Pages:
1-4
Received:
1 December 2016
Accepted:
17 December 2016
Published:
14 January 2017
DOI:
10.11648/j.ijg.20170101.14
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Abstract: We have investigated about the enteral feeding tube for anastomotic impassability caused by anastomotic inflammation, ulcer, failure after gastrectomy. Subjects: 67 patients who needed enteral feeding because of anastomotic impassability among 1865 patients after gastrectomy from gastric and duodenal ulcer, gastric carcinoma at Pyongyang Medical College Hospital of Kim Il Sung University and other hospitals from February 2007 to August 2015. Method: The aim is to place the enteral feeding tube into the jejunum. At first we inserted the upper gastrointestinal endoscope into the jejunum beyond the anastomotic site and pulled out the it after inserting the guide wire into jejunum through the endoscope. Then we inserted the enteral feeding tube into the jejunum following the guidewire and pulled out it either. Finally we confirmed it by radiography. Results: 71 insertions were applied for 67 patients, among them the number of successes was 67 (94.4%), and required time was 14.4±3.8min, the length of the guidewire inserted into the jejunum was 23.1±2.8cm. The gastric juice output of the patients with anastomotic inflammation and ulcer was 1218±181mL/d before insertion of the tube, but 0 mL/d after insertion. And it was 1218±181mL/d before insertion in anastomotic failure, and it decreased by 5.8±3.0mL/d on the 7th day after insertion. 2 patients (3.0%) underwent reoperation. Conclusion: This procedure is very high successful and takes a short time, can prevent the pooling of intragastric juice and reoperation.
Abstract: We have investigated about the enteral feeding tube for anastomotic impassability caused by anastomotic inflammation, ulcer, failure after gastrectomy. Subjects: 67 patients who needed enteral feeding because of anastomotic impassability among 1865 patients after gastrectomy from gastric and duodenal ulcer, gastric carcinoma at Pyongyang Medical Co...
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Doppler Evaluation of Esophageal Variceal Bleeding in Patients with Cirrhosis
Gyong-Hui Ri,
Hak-Chol Ju,
Gyang-Il Kim,
Un-Gyong Ri,
Un-Hua Ri
Issue:
Volume 1, Issue 1, December 2017
Pages:
5-8
Received:
1 February 2017
Accepted:
30 March 2017
Published:
3 May 2017
DOI:
10.11648/j.ijg.20170101.15
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Abstract: Esophageal Varices develops by the changes in portal hemodynamics. So, characterizing both the qualitative and quantitative changes in hemodynamics in the portal system is important in patients with Esophageal Variceal Bleeding caused by liver cirrhosis. We undertook this study to investigate the discriminant for estimate of esophageal variceal bleeding by significant Doppler parameters. The purpose of our study was to evaluate the significant Doppler parameters in patients with cirrhosis and to make a discriminant for estimate of esophageal variceal bleeding, and to predict the dangers of bleeding. Significant differences were found in main portal vein diameter(MPVD), MPV velocity max(MPV Vmax), blood flow rate of MPV and spleen vein, MPV congestion index(MPVCI), Right Portal Vein Vmax(RPVVmax), reflux of MPV, flat pattern of MPV between control group, none of varices group, EVB positive group and EVB negative group. MPVD, MPVVmax in EVB(+) group were significantly higher than in EVB(-) group(P<0.01). Any significant differences were not found in SV:MPV blood flow ratio between control goup and no varices group. Significant differences were found in MPVCI, RPVVmax between no varices group and EVB(-) group, EVB(+) group and EVB(+) group. MPVCI in EVB(+) group were higher than the EVB(-) group(p<0.05) and RPVVmax in EVB(+) group were lower than EVB(-) group. We had found the significant color and impulse Doppler parameters to evaluate the esophageal varices and predicted danger of esophageal variceal bleeding by discriminant. In the patient with portal hypertension caused by cirrhosis significant Doppler parameters for evaluation of esophageal varices were MPVD, MPVVmax, CI, SV/MPV, RPVVmax, reflux of MPV, flat pattern of EVB. We made discriminant by 7 parameters and predicted dangers of EVB. Reliability of discriminant was 90% and 91.2% respectively in EVB positive group, EVB negative group.
Abstract: Esophageal Varices develops by the changes in portal hemodynamics. So, characterizing both the qualitative and quantitative changes in hemodynamics in the portal system is important in patients with Esophageal Variceal Bleeding caused by liver cirrhosis. We undertook this study to investigate the discriminant for estimate of esophageal variceal ble...
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Surgical Clip Migration Following Laproscopic Cholecystectomy as a Cause of CBD Stone
Waseem Raja,
Sunil K. Mathai,
Benoy Sebastian,
Ashfaq Ahmad,
Shiraz Salim Khan,
Mary George
Issue:
Volume 1, Issue 1, December 2017
Pages:
9-11
Received:
3 January 2017
Accepted:
17 May 2017
Published:
10 July 2017
DOI:
10.11648/j.ijg.20170101.16
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Abstract: Foreign bodies in the common bile duct (CBD) are either iatrogenic or accidental. Increasing number of biliary interventional procedures both surgical and endoscopic are responsible for iatrogenic foreign bodies in the CBD. Here we report an unusual case of 59 year old female who presented with upper abdominal pain, jaundice and altered LFT with significant past history of laproscopic cholecystectomy. Endoscopic ultrasound revealed a linear hyper-echoic lesion with acoustic shadowing in the distal CBD, suggestive of a stone with central hyperechoic nidus, which was later confirmed by ERCP and removed by Dormia basket. The stone was crushed and two surgical clips were isolated fron the stone.
Abstract: Foreign bodies in the common bile duct (CBD) are either iatrogenic or accidental. Increasing number of biliary interventional procedures both surgical and endoscopic are responsible for iatrogenic foreign bodies in the CBD. Here we report an unusual case of 59 year old female who presented with upper abdominal pain, jaundice and altered LFT with si...
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