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A new breakthrough in timing of urgent endoscopy for gastrointestinal bleeding patients
September 10, 2008It is widely accepted that urgent endoscopy for UGIB should be performed within 24 hour from the admission. However, within this period of time, it is still unclear whether it should be performed either very early - i.e. within 2 hour - or in a more delayed interval, such as after 6, 12 or 24 hour. Therefore, optimal timing for urgent endoscopy in UGIB patients has not been yet established.
A research article to be published on August 28, 2008 in the World Journal of Gastroenterology addresses this question. The research team led by Professor, Tammaro from "San Giovanni Addolorata" Hospital in Rome prospectively assessed whether a simplified clinical score prior to endoscopy in UGIB patients was able to predict either active bleeding or endoscopic signs of recent haemorrhage which may deserve an urgent (< 2 h) endoscopy.
When classifying 436 patients according to this score (T-score), active bleeding or signs of recent hemorrhage was detected in 85% of T1 (most severe) patients and only in 5% and 2% of those T2/T3 (less severe), respectively.
This study shows that timing of urgent endoscopy following an episode of UGIB may be differentiated according to a simple score purely reflecting the clinical conditions of the patients. This would allow most of the high-risk patients to be effectively treated, whilst delaying most of the purely diagnostic procedures in low risk clinical patients. A future, randomized study is required to validate this clinical score.
World Journal of Gastroenterology
This study shows that timing of urgent endoscopy following an episode of UGIB may be differentiated according to a simple score purely reflecting the clinical conditions of the patients. This would allow most of the high-risk patients to be effectively treated, whilst delaying most of the purely diagnostic procedures in low risk clinical patients. A future, randomized study is required to validate this clinical score.
World Journal of Gastroenterology
Endoscopy Current Events and Endoscopy News RSSStudy identifies double-balloon enteroscopy as cost-effective approach for obscure GI bleeding
A cost-effectiveness analysis conducted by researchers at Stanford University Hospital in Calif., shows that an initial double-balloon enteroscopy (DBE) is a cost-effective approach for patients with obscure gastrointestinal (GI) bleeding.
New research finds markers for esophageal cancer before it develops
Rhode Island Hospital researchers have identified genetic proteins, also known as biomarkers, capable of distinguishing changes at the microscopic level that can signal a precancerous condition in the esophagus.
Study reports Double Balloon Endoscopy useful for diagnosis and treatment of obscure GI bleeding
A study by researchers in Japan concludes that Double Balloon Endoscopy (DBE) was very useful in the diagnosis of obscure gastrointestinal (GI) bleeding and had a therapeutic impact on the majority of patients.
What is the relationship between laryngopharyngeal reflux and reflux esophagitis?
The association between gastroesophageal reflux disease (GERD) and laryngeal disorders has been recognized since the late 1960s.
Mayo Clinic study tackles labeling errors
With a long-held commitment to continuously improving the quality and safety of patient care, Mayo Clinic researchers are recommending a new technologically-advanced labeling system aimed at reducing specimen labeling errors in a high-volume gastrointestinal endoscopy center
Endoscopic therapy may offer an alternative to surgery
Endoscopic therapy is emerging as an alternative to surgery in patients with esophageal cancer given the low likelihood of spread to the lymph nodes.
Endoscopy may not be necessary in asymptomatic children after caustic ingestion
A new study from researchers in Italy reports that endoscopy may not be necessary in children who show no symptoms after a caustic ingestion.
What is the clinical features of primary aortoenteric fistula?
PAEF is a rare but often life-threatening cause of massive gastrointestinal bleeding. PAEFs have a mortality rate of nearly 100% in the absence of surgical intervention, and in most case, the diagnosis is not established preoperatively.
Risk of colorectal cancer extremely low 5 years after a normal colonoscopy screening
A study appearing in the Sept. 18 issue of the New England Journal of Medicine shows that among individuals with no colorectal neoplasia (abnormal growths) on initial screening colonoscopy, the five-year risk of colorectal cancer is extremely low.
How to diagnoses and treat biliary rhabdomyosarcoma efficiently?
BRMS is an uncommon cause of recurrent jaundice and conjugated hyperbilirubinemia in children. Because its presentation may mimic that of a choledochal cyst, the correct diagnosis is frequently made intraoperatively at a planned choledochal cystectomy.
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