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Chiharu Kawanami - One of the best experts on this subject based on the ideXlab platform.
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a case series of meckel s Diverticulum usefulness of double balloon enteroscopy for diagnosis
BMC Gastroenterology, 2014Co-Authors: Masashi Fukushima, Satoko Inoue, Akihiko Okada, Chiharu Kawanami, Yukihiro Imai, Tetsuro InokumaAbstract:Meckel’s Diverticulum is a congenital anomaly of the gastrointestinal tract. About 98% of affected patients are asymptomatic. Small intestinal examination has become easier since the development of double-balloon enteroscopy. The present case series describes 10 patients with Meckel’s Diverticulum in whom double-balloon enteroscopy was useful for diagnosis. Ten patients (8 men, 2 women) with Meckel’s Diverticulum underwent double-balloon enteroscopy at Kobe City Medical Center General Hospital from May 2004 through May 2013. Their median age was 31.5 years (range, 14–83 years). Ten retrograde and two anterograde double-balloon enteroscopy procedures were performed. Double-balloon enteroscopy showed Meckel’s Diverticulum in nine patients, but an inverted Meckel’s Diverticulum was diagnosed as a lipoma in one patient. Meckel’s Diverticulum was detected by iodinated contrast medium during anterograde double-balloon enteroscopy in one of the two patients who underwent this procedure. Meckel’s Diverticulum was suspected using capsule endoscopy in one of two patients who underwent this procedure. Abdominal computed tomography was performed in all patients and revealed abnormalities in six, but Meckel’s Diverticulum was suspected in only two. Technetium-99 m pertechnetate scintigraphy and a small bowel series were carried out in six patients, revealing Meckel’s Diverticulum in one and three patients, respectively. Surgery was performed in eight patients, and endoscopic resection was carried out in one; the remaining patient was transferred to another hospital. Ulcer formation was found in or near Meckel’s Diverticulum in eight patients. Compared with other modalities, double-balloon enteroscopy is excellent for the diagnosis of Meckel’s Diverticulum because direct observation of both Meckel’s Diverticulum and ulceration is possible. Double-balloon enteroscopy should be used complementarily to other less invasive examinations when needed to confirm or establish the diagnosis.
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successful endoscopic resection of inverted meckel s Diverticulum by double balloon enteroscopy
Clinical Gastroenterology and Hepatology, 2013Co-Authors: Masashi Fukushima, Yoshifumi Suga, Chiharu KawanamiAbstract:t c A woman was referred for a 1-month history of melena in September 2007. Physical examination was unrearkable with the exception of pale conjunctiva. Laboratory tests howed a hemoglobin level of 5.7 g/dL (normal range, 11–15 /dL). Esophagogastroduodenoscopy was carried out, but no leeding lesion was identified. Colonoscopy showed blood clots in he terminal ileum but no bleeding lesion in the terminal ileum or olon. Abdominal computed tomography revealed a long, pedunulated, polypoid lesion with fat density in the ileum. This patient as presented to our hospital for close examination and treatment f the small intestinal lesion. We diagnosed this polypoid lesion as n ileal lipoma by using abdominal computed tomography, and etrograde double-balloon enteroscopy (DBE) was performed for he purpose of endoscopic resection in October 2007. DBE showed pedunculated polyp with ulceration in the distal ileum (Figure ); it almost filled the lumen. Endoscopic snare resection was arried out, and the resection site was closed with 3 clips to prevent emorrhage or perforation (Figures B and C, Supplementary Video). Histologic findings identified a 60 25 20-mm inverted eckel’s Diverticulum with ectopic pancreatic tissue. The postpoypectomy course was uneventful. The patient was discharged in ood condition 15 days after endoscopic resection. Meckel’s Diverticulum is generally asymptomatic, but some atients present with painless gastrointestinal bleeding. How nversion of Meckel’s Diverticulum occurs is unclear. It has been uggested that abnormal peristaltic movement caused by ulcertion or ectopic tissue at the bottom of Meckel’s Diverticulum ay cause it to invert.1 Endoscopic observation of Meckel’s Diverticulum is important, and DBE is highly effective. However, diagnosis of inverted Meckel’s Diverticulum is difficult, especially in adults. When a pedunculated polyp in the distal ileum is observed, inverted Meckel’s Diverticulum should be included as a differential diagnosis. The surface pattern of inverted Meckel’s Diverticulum, which is normal intestinal mucosa, may contribute to the diagnosis. In the present case, we were able to perform endoscopic resection by using DBE, whereas one case of iatrogenic perforation caused by endoscopic resection of inverted Meckel’s Diverticulum has been reported.2 We consider that complicaions were avoided in our case because the resection site was losed by clips.
Masashi Fukushima - One of the best experts on this subject based on the ideXlab platform.
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a case series of meckel s Diverticulum usefulness of double balloon enteroscopy for diagnosis
BMC Gastroenterology, 2014Co-Authors: Masashi Fukushima, Satoko Inoue, Akihiko Okada, Chiharu Kawanami, Yukihiro Imai, Tetsuro InokumaAbstract:Meckel’s Diverticulum is a congenital anomaly of the gastrointestinal tract. About 98% of affected patients are asymptomatic. Small intestinal examination has become easier since the development of double-balloon enteroscopy. The present case series describes 10 patients with Meckel’s Diverticulum in whom double-balloon enteroscopy was useful for diagnosis. Ten patients (8 men, 2 women) with Meckel’s Diverticulum underwent double-balloon enteroscopy at Kobe City Medical Center General Hospital from May 2004 through May 2013. Their median age was 31.5 years (range, 14–83 years). Ten retrograde and two anterograde double-balloon enteroscopy procedures were performed. Double-balloon enteroscopy showed Meckel’s Diverticulum in nine patients, but an inverted Meckel’s Diverticulum was diagnosed as a lipoma in one patient. Meckel’s Diverticulum was detected by iodinated contrast medium during anterograde double-balloon enteroscopy in one of the two patients who underwent this procedure. Meckel’s Diverticulum was suspected using capsule endoscopy in one of two patients who underwent this procedure. Abdominal computed tomography was performed in all patients and revealed abnormalities in six, but Meckel’s Diverticulum was suspected in only two. Technetium-99 m pertechnetate scintigraphy and a small bowel series were carried out in six patients, revealing Meckel’s Diverticulum in one and three patients, respectively. Surgery was performed in eight patients, and endoscopic resection was carried out in one; the remaining patient was transferred to another hospital. Ulcer formation was found in or near Meckel’s Diverticulum in eight patients. Compared with other modalities, double-balloon enteroscopy is excellent for the diagnosis of Meckel’s Diverticulum because direct observation of both Meckel’s Diverticulum and ulceration is possible. Double-balloon enteroscopy should be used complementarily to other less invasive examinations when needed to confirm or establish the diagnosis.
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successful endoscopic resection of inverted meckel s Diverticulum by double balloon enteroscopy
Clinical Gastroenterology and Hepatology, 2013Co-Authors: Masashi Fukushima, Yoshifumi Suga, Chiharu KawanamiAbstract:t c A woman was referred for a 1-month history of melena in September 2007. Physical examination was unrearkable with the exception of pale conjunctiva. Laboratory tests howed a hemoglobin level of 5.7 g/dL (normal range, 11–15 /dL). Esophagogastroduodenoscopy was carried out, but no leeding lesion was identified. Colonoscopy showed blood clots in he terminal ileum but no bleeding lesion in the terminal ileum or olon. Abdominal computed tomography revealed a long, pedunulated, polypoid lesion with fat density in the ileum. This patient as presented to our hospital for close examination and treatment f the small intestinal lesion. We diagnosed this polypoid lesion as n ileal lipoma by using abdominal computed tomography, and etrograde double-balloon enteroscopy (DBE) was performed for he purpose of endoscopic resection in October 2007. DBE showed pedunculated polyp with ulceration in the distal ileum (Figure ); it almost filled the lumen. Endoscopic snare resection was arried out, and the resection site was closed with 3 clips to prevent emorrhage or perforation (Figures B and C, Supplementary Video). Histologic findings identified a 60 25 20-mm inverted eckel’s Diverticulum with ectopic pancreatic tissue. The postpoypectomy course was uneventful. The patient was discharged in ood condition 15 days after endoscopic resection. Meckel’s Diverticulum is generally asymptomatic, but some atients present with painless gastrointestinal bleeding. How nversion of Meckel’s Diverticulum occurs is unclear. It has been uggested that abnormal peristaltic movement caused by ulcertion or ectopic tissue at the bottom of Meckel’s Diverticulum ay cause it to invert.1 Endoscopic observation of Meckel’s Diverticulum is important, and DBE is highly effective. However, diagnosis of inverted Meckel’s Diverticulum is difficult, especially in adults. When a pedunculated polyp in the distal ileum is observed, inverted Meckel’s Diverticulum should be included as a differential diagnosis. The surface pattern of inverted Meckel’s Diverticulum, which is normal intestinal mucosa, may contribute to the diagnosis. In the present case, we were able to perform endoscopic resection by using DBE, whereas one case of iatrogenic perforation caused by endoscopic resection of inverted Meckel’s Diverticulum has been reported.2 We consider that complicaions were avoided in our case because the resection site was losed by clips.
Tetsuro Inokuma - One of the best experts on this subject based on the ideXlab platform.
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a case series of meckel s Diverticulum usefulness of double balloon enteroscopy for diagnosis
BMC Gastroenterology, 2014Co-Authors: Masashi Fukushima, Satoko Inoue, Akihiko Okada, Chiharu Kawanami, Yukihiro Imai, Tetsuro InokumaAbstract:Meckel’s Diverticulum is a congenital anomaly of the gastrointestinal tract. About 98% of affected patients are asymptomatic. Small intestinal examination has become easier since the development of double-balloon enteroscopy. The present case series describes 10 patients with Meckel’s Diverticulum in whom double-balloon enteroscopy was useful for diagnosis. Ten patients (8 men, 2 women) with Meckel’s Diverticulum underwent double-balloon enteroscopy at Kobe City Medical Center General Hospital from May 2004 through May 2013. Their median age was 31.5 years (range, 14–83 years). Ten retrograde and two anterograde double-balloon enteroscopy procedures were performed. Double-balloon enteroscopy showed Meckel’s Diverticulum in nine patients, but an inverted Meckel’s Diverticulum was diagnosed as a lipoma in one patient. Meckel’s Diverticulum was detected by iodinated contrast medium during anterograde double-balloon enteroscopy in one of the two patients who underwent this procedure. Meckel’s Diverticulum was suspected using capsule endoscopy in one of two patients who underwent this procedure. Abdominal computed tomography was performed in all patients and revealed abnormalities in six, but Meckel’s Diverticulum was suspected in only two. Technetium-99 m pertechnetate scintigraphy and a small bowel series were carried out in six patients, revealing Meckel’s Diverticulum in one and three patients, respectively. Surgery was performed in eight patients, and endoscopic resection was carried out in one; the remaining patient was transferred to another hospital. Ulcer formation was found in or near Meckel’s Diverticulum in eight patients. Compared with other modalities, double-balloon enteroscopy is excellent for the diagnosis of Meckel’s Diverticulum because direct observation of both Meckel’s Diverticulum and ulceration is possible. Double-balloon enteroscopy should be used complementarily to other less invasive examinations when needed to confirm or establish the diagnosis.
Jong Myung Park - One of the best experts on this subject based on the ideXlab platform.
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acquired pharyngeal Diverticulum after anterior cervical fusion operation misdiagnosed as typical zenker Diverticulum
The Korean Journal of Thoracic and Cardiovascular Surgery, 2016Co-Authors: Jong Myung ParkAbstract:A pharyngeal Diverticulum is a rare complication of an anterior cervical discectomy and fusion (ACDF). We present a case of a pharyngeal Diverticulum after an A CDF, which was misdiagnosed as a typical Zenker Diverticulum. A 54-year-old woman presented with dysphagia and a sense of irritation in the neck following C5 through C7 cervical fusion 3 years prior. The patient underwent open surgery to resect the Diverticulum with concurrent cricopharyngeal myotomy. An ACDF-related Diverticulum is difficult to distinguish from a typical Zenker Diverticulum.
Huay Ben Pan - One of the best experts on this subject based on the ideXlab platform.
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imaging of female urethral Diverticulum an update
Radiographics, 2008Co-Authors: Chen Pin Chou, Robin B Levenson, Khaled M Elsayes, Yih Huie Lin, You Shin Chiu, Jer Shyung Huang, Huay Ben PanAbstract:Female urethral Diverticulum is an uncommon pathologic entity and can manifest with a variety of symptoms involving the lower urinary tract. Selection of the appropriate imaging modality is critical in establishing the diagnosis. Urethrography has traditionally been used in the evaluation of urethral Diverticulum but provides only intraluminal information. Ultrasonography is advantageous in that it does not involve ionizing radiation and has the capacity to help detect a Diverticulum without contrast agent filling. Multidetector computed tomographic (CT) voiding urethrography yields urethral images during micturition. In addition, the Diverticulum and diverticular orifice can be visualized on two- and three-dimensional reformatted CT images. Interactive virtual urethroscopy provides simulated visualization of the intraluminal anatomy and the diverticular orifice. New magnetic resonance imaging techniques that make use of a surface or endoluminal coil have higher diagnostic accuracy and can delineate the diverticular cavity and help detect related complications. Clinicians should consider the possibility of a urethral Diverticulum in women with chronic or recurrent lower urinary tract symptoms. Moreover, because female urethral Diverticulum is becoming more prevalent in clinical practice, radiologists should be familiar with its imaging features and with the imaging techniques that are optimal for its evaluation.
