DOCSLIB.ORG

The GI Endoscopy Atlas: New Bowel Imageing (NBI)-6Th Edition the GI Endoscopy Atlas: New Bowel Imageing (NBI)-6Th Edition

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The GI Endoscopy Atlas: New Bowel Imageing (NBI)-6Th Edition the GI Endoscopy Atlas: New Bowel Imageing (NBI)-6Th Edition The GI Endoscopy Atlas: New Bowel Imageing (NBI)-6th edition The GI Endoscopy Atlas: New Bowel Imageing (NBI)-6th edition Edited by Pradermchai Kongkam Rapat Pittayanon Rungsun Rerknimitr Satimai Aniwan Sombat Treeprasertsuk 6th edition Thai Association for Gastrointestinal Endoscopy (TAGE) First published 2014 ISBN: 978-616-91971-0-2 All endoscopic pictures in this New Bowel image (NBI) atlas.()6th edition were taken by staffs of Excellent Center for GI Endoscopy (ECGE), Division of Gastroenterology, Faculty of Medicine, Chulalongkorn University, Rama 4 road, Patumwan, Bangkok 10330 Thailand Tel: 662-256-4265, Fax: 662-252-7839, 662-652-4219. All rights of pictures and contents reserved. Graphic design @Sangsue Co., Ltd, 17/118 Soi Pradiphat 1, Pradiphat Road, Samsen nai, Phayathai, Bangkok, Thailand, Tel. 0-2271-4339, 0-2279-9636 999 Baht Preface Dear Passionate Endoscopists, Image-enhanced endoscopy has been developed far beyond our expectation. It seems that the quotation by Albert Einstein “imagination is more important than knowledge” is also true for GI Endoscopy. This latest book series of “Atlas in GI Endoscopy” by TAGE provides a case series of GI Endoscopy from top to bottom (upper GI, HPB, and lower GI Endoscopy). It includes many fantastic images with high quality obtained by EVIS EXERA III-190 HD (Olympus Medical). This case series provide not only the advancement in the Art and Knowledge of GI Endoscopy but also all the related radiology and pathology. I would like to take this opportunity to express my deeply thanks to the editors, Professor Rungsun Rerknimitr, Associated Professor Sombat Treeprasertsuk, Dr.Linda Pantongrag-Brown and colleagues who contribute their great efforts to make this important 6th edition of the GI Endoscopy atlas available under the TAGE support. Last but not least, I hope that you will enjoy learning and reading this book and this in turn will ultimately help your daily practice at certain level. Dr. Thawee Ratanachu-Ek, M.D. TAGE President From Editors Gastro-intestinal endoscopy knowledge and technologies have significantly changed over the last few decades. Many new endoscopic findings has been discovered and effectively used for both diagnostic and the treatment purpose. Nevertheless, it is still difficult for beginners to learn about these endoscopic findings within a short period of time. Especially, in uncommon diseases, trainees may have never seen those lesions during their training time. A helpful endoscopic atlas with a brief summary of the case followed by a practical discussion is an invaluable resource for learners including gastroenterologists, surgeons, internists, nurses and all GI paramedics. This book was written by our faculties of the excellence center of GI Endoscopy, Chulalongkorn University. This version is the sixth edition and consists of 4 section including upper GI endoscopy, lower GI endoscopy, ERCP, and EUS. It comes in a package of interesting presentations. Each case will be displayed with an intriguing image findings and followed by the literature review of such case. Systematic indexing of all case scenarios will help the readers to search for the most appropriate cases within a few minutes. However, reading through all cases probably the most valuable way. We hope that the book will help our readers to improve the practice and clinical knowledge and all readers would enjoy the content of this New Bowel image (NBI) atlas. Contributors 1. Kessarin Thanapirom 7. Phonthep Angsuwatcharakon - Division of Gastroenterology, Department - Division of Gastroenterology, Department of Medicine, Chulalongkorn University, of Medicine, Chulalongkorn University, Bangkok, Thailand Bangkok, Thailand 2. Kittiyod Poovorawan 8. Piyapan Prueksapanich - Division of Gastroenterology, Department - Division of Gastroenterology, Department of Medicine, Chulalongkorn University, of Medicine, Chulalongkorn University, Bangkok, Thailand Bangkok, Thailand 3. Narisorn Lakananurak 9. Pradermchai Kongkam - Division of Gastroenterology, Department - Division of Gastroenterology, Department of Medicine, Chulalongkorn University, of Medicine, Chulalongkorn University, Bangkok, Thailand Bangkok, Thailand 4. Naruemon Wisedopas-Klaikeaw 10. Rapat Pittayanon - Division of Gastroenterology, Department - Division of Gastroenterology, Department of Medicine, Chulalongkorn University, of Medicine, Chulalongkorn University, Bangkok, Thailand Bangkok, Thailand 5. Nopavut Geratikornsupuk 11. Rungsun Rerknimitr - Division of Gastroenterology, Department - Division of Gastroenterology, Department of Medicine, Chulalongkorn University, of Medicine, Chulalongkorn University, Bangkok, Thailand Bangkok, Thailand 6. Nopporn Anukulkarnkusol 12. Satimai Aniwan - Division of Gastroenterology, Department - Division of Gastroenterology, Department of Medicine, Chulalongkorn University, of Medicine, Chulalongkorn University, Bangkok, Thailand Bangkok, Thailand 13. Sombat Treeprasertsuk 21. Piyachai Orkoonsawat, M.D. - Division of Gastroenterology, Department - Division of Gastroenterology, Department of Medicine, Chulalongkorn University, of Medicine, Chulalongkorn University, Bangkok, Thailand Bangkok, Thailand 14. Tanassanee Soontornmanokul 22. Puth Muangpaisarn, M.D. - Division of Gastroenterology, Department - Division of Gastroenterology, Department of Medicine, Chulalongkorn University, of Medicine, Chulalongkorn University, Bangkok, Thailand Bangkok, Thailand 15. Vichai Viriyautsahakul 23. Yuthana Sattawatthamrong, M.D. - Department of Medicine, King - Division of Gastroenterology, Department Chulalongkorn Memorial Hospital, Thai of Medicine, Chulalongkorn University, Red Cross Society Bangkok, Thailand 16. Wiriyaporn Ridtitid 24. Sukprasert Jutaghokiat, M.D., M.Sc. - Division of Gastroenterology, Department - Division of Gastroenterology, Vejthani of Medicine, Chulalongkorn University, Hospital, Bangkok, Thailand Bangkok, Thailand 25. Khin San Aye, M.D. 17. Sasipim Sallapant, M.D. - Division of Gastroenterology, Department - Division of Gastroenterology, Department of Medicine, Chulalongkorn University, of Medicine, Chulalongkorn University, Bangkok, Thailand Bangkok, Thailand 26. Tanyaporn Chantarojanasiri, M.D. 18. Suppakorn Malikhao, M.D. - Division of Gastroenterology, Department - Division of Gastroenterology, Department of Medicine, Police General Hospital, of Medicine, Chulalongkorn University, Bangkok, Thailand Bangkok, Thailand 27. Sutep Gonlachanvit, M.D., M.Sc. 19. Boonlert Imraporn, M.D.,M.Sc. - Division of Gastroenterology, Department - Division of Gastroenterology, Department of Medicine, Chulalongkorn University, of Medicine, Chulalongkorn University, Bangkok, Thailand Bangkok, Thailand Vejthani Hospital, Bangkok, Thailand 28. Linda Pantongrag-Brown - AIMC, Ramathibodi Hospital, Bangkok, 20. Sayamon Kimtrakool, M.D. Thailand - Division of Gastroenterology, Department of Medicine, Chulalongkorn University, Bangkok, Thailand Content Preface From Editors Contributors Upper 1 Lower 81 ERCP 150 EUS 171 Index 223 1 Upper Piyapan Prueksapanich, M.D. Case 1 Rapat Pittayanon, M.D., M.Sc. Rungsun Rerknimitr, M.D. A 58-year-old male with a history of stage I squamous cell carcinoma of the oral cavity for a year underwent an esophagogastroduodenoscopy (EGD) for esophageal cancer surviellance. He reported no upper GI symptom. The EGD showed an ill-defined salmon-colored patch at the proximal esophagus just below the upper esophageal sphincter. The narrow band imaging (NBI) showed a well-defined pink patch with a clear margin separated from the normal surrounding greenish NBI based mucosa (Figures 1 and 2). Probe-based confocal laser endomicroscopy (pCLE) revealed a columnar epithelium without goblet cells (Figure 3). Biopsy was done and the pathological study showed an area of gastric mucosa (Figure 4) compatible with the diagnosis of an inlet patch. Figures 1 and 2 NBI showed a well-defined pink patch surrounded by normal esophageal mucosa. 1 Figure 3 pCLE revealed columnar Figure 4 Histology confirmed the epithelium without goblet cell. columnar epithelium as gastric mucosa. Diagnosis: Inlet patch of the esophagus Discussion: The inlet patch of the esophagus is a congenital anomaly consisting of ectopic gastric mucosa locates mainly in the upper part of the esophagus or just below the upper esophageal sphincter. The incidence was reported as 1%-20% in routine upper endoscopies. The inlet patches are usually asymptomatic and incidentally detected by EGD.1,2 However, the inlet patch can rarely be associated with some complications such as bleeding, perforation, stricture or malignancy.1,2 References 1. Tang P, McKinley MJ, Sporrer M, et al. Inlet patch: prevalence, histologic type, and association with esophagitis, Barrett esophagus, and antritis. Arch pathol lab Med 2004;128:444-7. 2. Chong VH. Clinical significance of heterotopic gastric mucosal patch of the proximal esophagus. World J Gastroenterol 2013;19:331-8. 2 Kessarin Thanapirom, M.D. Case 2 Rapat Pittayanon, M.D., M.Sc. Rungsun Rerknimitr, M.D. A 66-year-old female presented with melena for 3 weeks. She had a history of NSAIDs usage for knee pain. EGD revealed a 1.5 cm, oval-shaped, well-circumscribed, clean-based esophageal ulcer at mid esophagus without active bleeding (short arrow). The location was adjacent to the aortic arch (long arrow) (Figure1). Figure 1 A clean-based ulcer at mid esophagus. 3 Diagnosis: Pill-induced esophageal ulcer Discussion: Various drugs such as NSAIDs, tetracycline, penicillin, potassium chloride tablet,
Load more

Recommended publications
  • Disseminated Peritoneal Tuberculosis Simulating Advanced Ovarian Cancer: a Retrospective Study of 17 Cases
    Available online at www.sciencedirect.com Taiwanese Journal of Obstetrics & Gynecology 50 (2011) 292e296 www.tjog-online.com Original Article Disseminated peritoneal tuberculosis simulating advanced ovarian cancer: A retrospective study of 17 cases Chen-Hsuan Wu, Chan-Chao ChangChien, Chih-Wen Tseng, Hung-Yaw Chang, Yu-Che Ou, Hao Lin* Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan Accepted 25 March 2010 Abstract Objectives: The abdominopelvic cavity is one of the common sites for extrapulmonary tubercular infections. The rate of preoperative misdi- agnoses between peritoneal tuberculosis (TB) and ovarian cancer is high because of overlapping nonspecific signs and symptoms. We attempted to analyze the experience within our hospital so as to establish the best means of discriminating between peritoneal TB and advanced ovarian cancer. Methods: Seventeen patients diagnosed as having peritoneal TB between July 1986 and December 2008 at the Obstetrics and Gynecology Department of our hospital with the initial presentation simulating advanced ovarian cancer were retrospectively reviewed and evaluated. Results: Patients’ ages ranged from 24 years to 87 years (median, 38 years). Ten of 17 patients (60%) were younger than 40 years. All patients except one had elevated serum cancer antigen-125 levels with a mean of 358.8 U/mL (range, 12e733 U/mL). Computed tomographic (CT) scans showed ascites with mesenteric or omental stranding in all (100%), enlarged retroperitoneal lymph nodes in six (35.3%), and an adnexal mass in three (17.6%). Abdominal paracentesis was performed in seven cases, in which the findings revealed lymphocyte-dominant ascites without malignant cells.
    [Show full text]
  • Subject Index 221 Subject Index
    Subject Index 221 Subject Index 3D-endoanal sonography 207 Crohn’s disease 15, 61 3D-endosonography 205 – disease activity 63 – of the rectum 207 – pathological features 61 3D-ultrasound 199 – sonographic features 62 – of the stomach 202 D A Dapaong tumour 125 Abdominal free fl uid 87 Diaphragmatic hernia 43 Abscess(es), intra-abdominal 68 Diverticulitis Accordion sign 117 – acute colonic 21, 22 Afferent loop syndrome 31 – right-sided 23 Amoebiasis 121 Diverticulosis 19 Antral area 190 – diagnostic methods 20 Antral contractions 193 – sonographic features 20 Antral peristalsis 192 Doughnut sign 49 Appendagitis 8 Duodenogastric refl ux 193, 204 Appendices epiploicae, torsion of 24 Dyspepsia, functional dyspepsia 194, 203 Appendicitis – acute 4, 176 E – clinical features 4 EchoPac3D 201 – computed tomography 6 Echovist 171, see also SHU-454 – magnetic resonance imaging 7 Ectopic pancreas 161 – sonographic signs 5 Ectopic pregnancy 8 Ascariasis 122 Entamoeba hystolitica 121 Ascaris lumbricoides 122 Enteritis 101 Ascites 113, 152 Eosinophilic enteritis 95 B F Bacterial ileocecitis 104, see also Infectious Ileocecitis Familial Mediterranean fever 17 Barber pole sign 46 Femoral hernia 37 Bezoar, small bowel 29 Fine-needle aspiration 156 Bochdaleck hernia 43 Fine-needle biopsy 213 Bull’s-eye sign 141 – accuracy 216 – complications 216, 217 C – contraindications 214 Carcinoid tumor 159 – indications 214 Carcinomatosis, peritoneal 151 – technique 214 – sonographic fi ndings 151 Fistula(e) Clostridium diffi cile 116 – in Crohn’s disease 66 Clostridium
    [Show full text]
  • 100 CASES in Radiology This Page Intentionally Left Blank 100 CASES in Radiology
    100 CASES in Radiology This page intentionally left blank 100 CASES in Radiology Robert Thomas Specialist Registrar, Guy’s and St Thomas’ Hospital, London, UK James Connelly Specialist Registrar, Guy’s and St Thomas’ Hospital, London, UK Christopher Burke Specialist Registrar, Guy’s and St Thomas’ Hospital, London, UK 100 Cases Series Editor: Professor P John Rees MD FRCP Dean of Medical Undergraduate Education, King’s College London School of Medicine at Guy’s, King’s and St Thomas’ Hospitals, London, UK First published in Great Britain in 2012 by Hodder Arnold, an imprint of Hodder Education, Hodder and Stoughton Ltd, a division of Hachette UK 338 Euston Road, London NW1 3BH http://www.hodderarnold.com © 2012 Robert Thomas, James Connelly and Christopher Burke All rights reserved. Apart from any use permitted under UK copyright law, this publication may only be reproduced, stored or transmitted, in any form, or by any means with prior permission in writing of the publishers or in the case of reprographic production in accordance with the terms of licences issued by the Copyright Licensing Agency. In the United Kingdom such licences are issued by the Copyright Licensing Agency: Saffron House, 6–10 Kirby Street, London EC1N 8TS. Hachette UK’s policy is to use papers that are natural, renewable and recyclable products and made from wood grown in sustainable forests. The logging and manufacturing processes are expected to conform to the environmental regulations of the country of origin. Whilst the advice and information in this book are believed to be true and accurate at the date of going to press, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made.
    [Show full text]
  • Abdominal Tuberculosis - Imaging Findings
    Abdominal Tuberculosis - Imaging Findings Poster No.: C-0549 Congress: ECR 2013 Type: Educational Exhibit Authors: E. Rosado, D. Penha, P. Paixao, A. M. D. Costa; Amadora/PT Keywords: Infection, Diagnostic procedure, Ultrasound, MR, CT, Abdomen DOI: 10.1594/ecr2013/C-0549 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to third- party sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. www.myESR.org Page 1 of 29 provided by Repositório do Hospital Prof. Doutor Fernando Fonseca View metadata, citation and similar papers at core.ac.uk CORE brought to you by Learning objectives Tuberculosis is a life-threatening disease that can affect any organ or system.
    [Show full text]
  • Medical Imaging for Health Professionals Medical Imaging for Health Professionals
    Medical Imaging for Health Professionals Medical Imaging for Health Professionals Technologies and Clinical Applications Edited by Raymond M. Reilly, PhD University of Toronto Toronto, Ontario, Canada This edition first published 2019 © 2019 John Wiley & Sons, Inc. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions. The right of Raymond M. Reilly to be identified as the editor of this work has been asserted in accordance with law. Registered Office John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, USA Editorial Office 111 River Street, Hoboken, NJ 07030, USA For details of our global editorial offices, customer services, and more information about Wiley products visit us at www.wiley.com. Wiley also publishes its books in a variety of electronic formats and by print‐on‐demand. Some content that appears in standard print versions of this book may not be available in other formats. Limit of Liability/Disclaimer of Warranty In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of experimental reagents, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each chemical, piece of equipment, reagent, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions.
    [Show full text]
  • Schein's Common Sense Emergency Abdominal Surgery
    Moshe Schein · Paul N. Rogers (Editors) Schein’s Common Sense Emergency Abdominal Surgery Moshe Schein • Paul N. Rogers (Editors) Schein’s Common Sense Emergency Abdominal Surgery Second Edition With 97 Figures and 21 Tables MosheMoshe Schein, Schein, MD, FACS, MD, FACS, FCS(SA) FCS(SA) SurgicalSurgical Specialists Specialists of Keokuk, of Keokuk, Keokuk, Keokuk, IA 52632, IA 52632, USA USA FormerlyFormerly: Professor: Professor of Surgery,Weill of Surgery,Weill College College of Medicine of Medicine CornellCornell University, University, New York, New York, NY,USA NY,USA Paul N.Paul Rogers, N. Rogers, MB ChB, MB MBA,ChB, MBA, MD, FRCS MD, FRCS(Glasgow) (Glasgow) ConsultantConsultant General General and Vascular and Vascular Surgeon, Surgeon, Department Department of Surgery of Surgery GartnavelGartnavel General General Hospital, Hospital, Glasgow, Glasgow, Scotland, Scotland, UK UK EditorialEditorial Adviser: Adviser:RobertRobert Lane, Lane, MD, FRCSA, MD, FRCSA, FACS FACS Graphics:Graphics:EvgenyEvgeny E. (Perya) E. (Perya) Perelygin, Perelygin, MD and MD Alexander and Alexander N. Oparin, N. Oparin, MD MD LibraryLibrary of Congress of Congress Controll Controll Number: Number: 2004104706 2004104706 ISBN ISBN3-540-21536-0 3-540-21536-0 Springer Springer Berlin Berlin Heidelberg Heidelberg New YorkNew York ISBN 3-540-66654-0ISBN 3-540-66654-0 1st ed. 1st Springer-Verlag ed. Springer-Verlag Berlin HeidelbergBerlin Heidelberg New York New York This workThis iswork subject is subject to copyright. to copyright. All rights All arerights reserved, are reserved, whether whether the whole the wholeor part or of part the of the materialmaterial is concerned, is concerned, specifically specifically the rights the ofrights translation, of translation, reprinting, reprinting, reuse of reuse illustrations, of illustrations, recitation,recitation, broadcasting, broadcasting, reproduction reproduction on microfilm on microfilm or in any or inother any way,other and way, storage and storage in data in data banks.banks.
    [Show full text]
  • Cross-‐Sectional Imaging CT, MRI
    Radiology Basics: Cross-sectional Imaging CT, MRI, USS An e-learning resource for medical students and junior doctors Melisa Sia Vikas Shah An e-learning resource for medical students and junior doctors Radiology Basics: Cross-Sec9onal Imaging Foreword Disclaimer Radiology is often a neglected component of the undergraduate This book is intended for educational purposes only. All efforts have curriculum. Plain films are given much more importance than cross- been made to minimise mistakes - if you do find any, please contact us sectional imaging, and rightly so. However, it is important for junior and let us know! Please do not use this book to interpret images doctors to be able to identify certain important pathology on cross- independently - seek the advice of your friendly consultant radiologist! sectional imaging, particularly in the ED where the interpretation of a radiologist may not be immediately available. The aim of this book is to provide an easily accessible resource on Contact Us cross-sectional imaging, aimed at the appropriate level for medical Any feedback and comments are much welcomed and appreciated! students on clinical attachments and junior doctors. An interactive e- Please send any correspondence to: [email protected] book format has been chosen as this is a very visual subject, and also for ease of distribution. This book includes the underlying physics, You can find updates and news about new books on our website: important presentations and common pathologies, with a focus on http://www.RadiologyBasics.net acute conditions. Important cross-sectional anatomy is also presented, this may be useful for more junior students and for revision purposes for Find us on..
    [Show full text]
  • Peritoneal Tuberculosis Mimicking Ovarian Cancer: Gynecologic Ultrasound Evaluation with Histopathological Confirmation
    Case Report Peritoneal Tuberculosis Mimicking Ovarian Cancer: Gynecologic Ultrasound Evaluation with Histopathological Confirmation Francesca Arezzo 1,†, Gerardo Cazzato 2,*,† , Vera Loizzi 3 , Giuseppe Ingravallo 2 , Leonardo Resta 2 and Gennaro Cormio 1 1 Department of Biomedical Sciences and Human Oncology, Gynecologic and Obstetrics Clinic, University of Bari “Aldo Moro”, 70124 Bari, Italy; [email protected] (F.A.); [email protected] (G.C.) 2 Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; [email protected] (G.I.); [email protected] (L.R.) 3 Interdisciplinar Department of Medicine, Obstetrics and Gynecology Unit, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy; [email protected] * Correspondence: [email protected]; Tel.: +39-340-5203641 † These authors contributed equally. Abstract: Peritoneal tuberculosis (TBP) is a very rare condition, accounting for about 1–2% of all tuberculosis cases. The diagnosis of TBP can be easily mistaken for advanced ovarian cancer (AOC) or peritoneal carcinoma because of overlapping laboratory and clinical findings. We reported the Citation: Arezzo, F.; Cazzato, G.; ultrasound characteristics of a case of TBP in a 67-year-old woman who presented to our institute Loizzi, V.; Ingravallo, G.; Resta, L.; with a 1-month history of intermittent lower abdominal pain, fever, and asthenia. Overall, 20 biopsy- Cormio, G. Peritoneal Tuberculosis retrieved specimen histopathological features were suggestive of peritoneal tuberculosis. Gynecologic Mimicking Ovarian Cancer: Gynecologic Ultrasound Evaluation ultrasound revealed increased adnexa with multiple nodular formations spread across the surface, with Histopathological Confirmation. suggestive of caseous nodules.
    [Show full text]
  • Single-Port Access for Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC): Technique, Feasibility and Safety
    Pleura and Peritoneum 2016; 1(4): 217–222 Marco Vaira*, Manuela Robella, Alice Borsano and Michele De Simone Single-port access for Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC): technique, feasibility and safety DOI 10.1515/pap-2016-0021 Introduction Received November 3, 2016; accepted November 28, 2016; previously published online December 15, 2016 In patients with tumors confined to the peritoneal Abstract cavity, there is established pharmacokinetic and tumor biology-related evidence that intraperitoneal drug Background: Pressurized IntraPeritoneal Aerosol administration is advantageous [1]. However, there are Chemotherapy (PIPAC) is a drug delivery system for treat- pharmacokinetic problems linked to intraperitoneal che- ment of peritoneal metastasis (PM). A limitation of this tech- motherapy (IPC), in particular poor tissue penetration nique is the non-access rate (10–15 %) due to peritoneal and limited surface exposure [2]. The first problem is adhesions. The aim of the study was to assess feasibility very limited penetration of the drug into tissue. Many and safety of the single-port access technique for PIPAC. solid tumors show an increased interstitial fluid pres- Methods: Single-center, pilot study. Case series, retro- sure (IFP), which creates a formidable obstacle to trans- spective analysis on 17 patients with PM of various origin peritoneal transport. This elevated intratumoral treated with intraperitoneal cisplatin, doxorubicin and/or pressure results into an inefficient uptake of therapeutic oxaliplatin administered as PIPAC. Single-port access agents [3]. The second problem is limited exposure of was attempted in all patients by minilaparotomy. the peritoneal surface to the therapeutic solution. It has Results: Twenty-nine PIPAC procedures were performed.
    [Show full text]
  • A Tuberculosis Guide for Specialist Physicians
    A Tuberculosis Guide for Specialist Physicians 2004 José A. Caminero Luna International Union Against Tuberculosis and Lung Disease (IUATLD) 68 boulevard Saint Michel, 75006 Paris - France ii © International Union Against Tuberculosis and Lung Disease (IUATLD) 68 boulevard Saint Michel, 75006 Paris – France September 2004 Author: J.A. Caminero ISBN: 2-914365-13-6 iii i Dedication To my parents, for their unconditional support, humanity, honesty, hard work, and sacrifice. Their teachings and tolerance have been the best guides in my life. Acknowledgements First, I especially wish to express my most sincere gratitude to Drs. Paula Fujiwara (USA) and Dr. Victorino Farga (Chile), professors and friends, whose exhaustive review of this Guide has greatly improved it in terms of content and clarity. I also wish to thank: Dr. Nils E. Billo, Director of the International Union Against Tuberculosis and Lung Disease, for his unconditional support of my daily work and for his constant encouragement in the preparation of this book. Dr. Raúl Díaz, an excellent professional and friend, for his constant help and excellent editing activities in relation to the Guide. Dr. Rodolfo Rodríguez (Cuba), Regional Advisor for Tuberculosis (Pan American Health Organization/World Health Organization), who was largely responsible for the improvements in tuberculosis control throughout Latin America in the past six years. My thanks for his constant support of the Tuberculosis Updating Courses for Specialist Physicians, which have helped to ensure improved tuberculosis control in Latin America. The development of these courses has generated the material presented in the present Guide. My colleagues in the Pneumology Service of “Dr.
    [Show full text]
  • The Mesenteric Organ: New Anatomical Concepts and an Imaging-Based Review on Its Diseases Hanna R.F
    The Mesenteric Organ: New Anatomical Concepts and an Imaging-based Review on Its Diseases Hanna R.F. Dalla Pria, MD,* Ulysses S. Torres, MD, PhD,† Fernanda Velloni, MD,*,z Rafael A. Santiago, MD,*,z Marina S. Zacarias, MD,* Luis F.D. Silva, MD,* Fernando Tamamoto, MD,* Dara Walsh,x Augusto C. von Atzingen, MD, PhD,*,{ John C. Coffey, MB., B.Ch., BAO., B.MedSci., PhD, FRCSI,x and Giuseppe D’Ippolito, MD, PhD*,† The proposal of reclassifying the mesentery as an organ prompts clinicians and radiologists to reappraise their approach to it and to mesenteric diseases (mesenteropathies). Recent updates in mesenteric anatomy and the better comprehension of its structure constitute a basis to push forward the process of disease management and allow the development of less radical (including endoscopic, radiological, and pharmacotherapeutic) treatments. Radiological evaluation currently plays a pivotal role in the noninvasive characterization of abdominal diseases. Mesenteric-based radiological assessments form an essential compo- nent in planning radiological interventions and postoperative surveillance programs. The purpose of this article, therefore, is to provide an update on the new anatomical concepts related to the mesentery, also performing an imaging-based review of mesenteric diseases by categorizing them as primary and secondary. Semin Ultrasound CT MRI 40:515-532 © 2019 Elsevier Inc. All rights reserved. Introduction descending colon region (ie, the right and left mesocolon, respectively) did not occur in adults, instead, these regions ecent data suggest that the classic model of mesenteric of mesentery were described as fusing with the posterior R anatomy should be revised. The mesentery is now abdominal wall.3 According to this model, persistence of a regarded as continuous, substantive, distinctive, and has mesentery associated with the right and left in these regions fi essential, as well as speci c, functions.
    [Show full text]
  • Ultrasound Scanning of the Pelvis and Abdomen for Staging of Gynecological Tumors: a Review
    Ultrasound Obstet Gynecol 2011; 38: 246–266 Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/uog.10054 Ultrasound scanning of the pelvis and abdomen for staging of gynecological tumors: a review D. FISCHEROVA Gynecological Oncology Centre, Department of Obstetrics and Gynecology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic KEYWORDS: cervical cancer; endometrial cancer; gynecological oncology; ovarian cancer; staging; ultrasound; vaginal cancer; vulvar cancer ABSTRACT or mixed vascularity or displacement of vessels seems to be the sole criterion in the diagnosis of metastatic or This Review documents examination techniques, sono- lymphomatous nodes. graphic features and clinical considerations in ultrasound In the investigation of distant metastases, if a nor- assessment of gynecological tumors. The methodology mal visceral organ or characteristic diffuse or focal of gynecological cancer staging, including assessment of lesions (such as a simple cyst, hepatic hemangioma, renal local tumor extent, lymph nodes and distant metastases, angiomyolipoma, fatty liver (steatosis)) are identified on is described. ultrasound, additional examinations using complemen- With increased technical quality, sonography has tary imaging methods are not required. If, however, less become an accurate staging method for early and characteristic findings are encountered, especially when advanced gynecological tumors. Other complementary the examination result radically affects subsequent ther- imaging techniques, such as computed tomography and apeutic management, an additional examination using a magnetic resonance imaging, can be used as an adjunct complementary imaging method (e.g. contrast-enhanced to ultrasound in specific cases, but are not essential to ultrasound, computed tomography, magnetic resonance tumor staging if sonography is performed by a specialist imaging, positron emission tomography) is indicated.
    [Show full text]