Role of esophagogastroduodenoscopy in detecting distal duodenal lesions: A single‐center pilot study in Southern China

Qiao, Weiguang; Han, Ze Min; Ren, Yu; Xing, Tong; Tan, Wen Xin; Liu, Si De; Zhi, Fa Chao

doi:10.1111/1751-2980.12549

Cited by 2 publications

(2 citation statements)

References 16 publications

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“…However, pediatric colonoscopes are often not available in hospitals that do not perform endoscopy frequently for pediatric patients, and an oral approach using a conventional colonoscope can cause discomfort to patients. In a previous report, there were no adverse effects when the upper gastrointestinal endoscope was inserted deep into the duodenum to the fourth part compared with insertion to the second part, and in our case, there were no adverse effects related to deep insertion[ 27 ]. Meticulous re-examination by standard upper gastrointestinal endoscopy is usually recommended in patients with obscure gastrointestinal bleeding.…”

Section: Discussionsupporting

confidence: 49%

Three cases of jejunal tumors detected by standard upper gastrointestinal endoscopy: A case series

Lee¹,

Kim²,

Kim³

et al. 2023

World J Clin Cases

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BACKGROUND In patients with obscure gastrointestinal bleeding, re-examination with standard upper endoscopes by experienced physicians will identify culprit lesions in a substantial proportion of patients. A common practice is to insert an adult-sized forward-viewing endoscope into the second part of the duodenum. When the endoscope tip enters after the papilla, which is a marker for the descending part of the duodenum, it is difficult to endoscopically judge how far the duodenum has been traversed beyond the second part. CASE SUMMARY We experienced three cases of proximal jejunal masses that were diagnosed by standard upper gastrointestinal endoscopy and confirmed with surgery. The patients visited the hospital with a history of melena; during the initial upper gastrointestinal endoscopy and colonoscopy, the bleeding site was not confirmed. Upper gastrointestinal bleeding was suspected; thus, according to guidelines, upper endoscopy was performed again. A hemorrhagic mass was discovered in the small intestine. The lesion of the first patient was thought to be located in the duodenum when considering the general insertion depth of a typical upper gastrointestinal endoscope; however, during surgery, it was confirmed that it was in the jejunum. After the first case, lesions in the second and third patients were detected at the jejunum by inserting the standard upper endoscope as deep as possible. CONCLUSION The deep insertion of standard endoscopes is useful for the diagnosis of obscure gastrointestinal bleeding.

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Section: Discussionsupporting

confidence: 49%

Three cases of jejunal tumors detected by standard upper gastrointestinal endoscopy: A case series

Lee¹,

Kim²,

Kim³

et al. 2023

World J Clin Cases

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show abstract

“…However, with advancements in endoscopic devices and techniques, reaching the horizontal section of the duodenum with the endoscope has become feasible in recent years. In such cases, these lesions could be identified much earlier using upper GI endoscopy [ 36 , 37 ]. The identification of predictors for DL was not the focus of this study, as our aim was to elucidate the characteristics of DL through a case series.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of Dieulafoy’s lesion in the small bowel diagnosed and treated by double-balloon endoscopy

Nakamura,

Yamamura,

Maeda

et al. 2023

BMC Gastroenterol

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Background Obscure gastrointestinal bleeding refers to bleeding for which the source cannot be ascertained even through balloon-assisted endoscopy. In certain instances, Dieulafoy’s lesion in the small bowel is presumed to be the underlying cause. Aim This retrospective study aimed to elucidate the clinical characteristics of Dieulafoy’s lesion in the small bowel as diagnosed via double-balloon endoscopy while also exploring the feasibility of predicting bleeding from Dieulafoy’s lesion prior to endoscopy in cases of obscure gastrointestinal bleeding. Methods A comprehensive analysis of our database was conducted, identifying 38 patients who received a diagnosis of Dieulafoy’s lesion and subsequently underwent treatment via double-balloon endoscopy. The clinical background, diagnosis, and treatment details of patients with Dieulafoy’s lesion were carefully examined. Results The median age of the 38 patients was 72 years, and 50% of the patients were male. A total of 26 (68%) patients exhibited a high comorbidity index. The upper jejunum and lower ileum were the most frequently reported locations for the occurrence of Dieulafoy’s lesion in the small bowel. The detected Dieulafoy’s lesions exhibited active bleeding (n = 33) and an exposed vessel with plaque on the surface (n = 5). Rebleeding after endoscopic treatment occurred in 8 patients (21%, median period: 7 days, range: 1-366 days). We conducted an analysis to determine the definitive nature of the initial double-balloon endoscopy diagnosis. Multivariate analysis revealed that hematochezia of ≥ 2 episodes constituted the independent factor associated with ≥ 2 double-balloon endoscopy diagnoses. Additionally, we explored factors associated with rebleeding following endoscopic treatment. Although the number of hemoclips utilized displayed a likely association, multivariate analysis did not identify any independent factor associated with rebleeding. Conclusion If a patient encounters multiple instances of hematochezia, promptly scheduling balloon-assisted endoscopy, equipped with optional instruments without delay is advised, after standard endoscopic evaluation with esophagogastroduodenoscopy and colonoscopy is unrevealing.

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Role of esophagogastroduodenoscopy in detecting distal duodenal lesions: A single‐center pilot study in Southern China

Abstract: EGD may be important in diagnosing distal duodenal lesions. Patients with gastric retention, blood in the stomach or erosion in the proximal duodenum may benefit from the deep insertion of EGD.

Cited by 2 publications

References 16 publications

Three cases of jejunal tumors detected by standard upper gastrointestinal endoscopy: A case series

Three cases of jejunal tumors detected by standard upper gastrointestinal endoscopy: A case series

Clinical characteristics of Dieulafoy’s lesion in the small bowel diagnosed and treated by double-balloon endoscopy

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