The accuracy of patients' symptom localization in dysphagia is not clear. This study aims to determine the accuracy of patient localization and to determine the correlation of localization with motility disorders. We reviewed 100 patients after completion of EGD, manometry, and a dysphagia questionnaire. Proximal and midesophageal localization were rarely associated with a proximal cause of dysphagia. Distal localization correlated in 80% of cases. Fifty-seven percent of patients reporting diffuse symptoms had manometric abnormalities, but only 9% of patients with manometric abnormalities reported diffuse symptoms. In conclusion, patient localization in esophageal dysphagia is not accurate. The data suggest that proximal localization is especially inaccurate, whereas distal localization may be more accurate. Finally, there is no correlation between diffuse localization and diagnosis of motility disorders.

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The objective of this study was to examine if G-tube (G-tube) placement in patients with ventriculoperitoneal (VP) shunts results in shunt infection or impacts patient survival. We performed a retrospective cohort study. Patients underwent VP shunt and G-tube placement. Incidence of shunt infection and patient survival were calculated. Fifty-five patients qualified for the study. Shunt infection occurred in seven patients (12.5%). The incidence of shunt infection did not differ between surgically placed G-tubes (2/7=29%) and PEG tubes (5/7=71%; P=0.69). There was no difference in the risk of VP infection based on the order of placement (OR=0.61 [0.12-3.02]; P=0.69). No predictors for shunt infection were identified. Kaplan-Meier mortality estimates demonstrated a 21% 1-year mortality rate. There were no predictors of patient survival. We conclude that placement of G-tubes in patients with shunts is safe. The order of placement of G-tube and VP shunt does not affect the incidence of shunt infection or survival.

CT colonography has adenoma miss rates similar to miss rates historically found with optical colonoscopy, with most missed adenomas being <10 mm and sessile in shape.

No abstract