1.
A novel colonoscopic approach for the management of a Malone antegrade continence enema channel, which cannot be catheterized in the immediate postoperative period: a case report.
Szymanski, KM, Keenan, A, Cain, MP, Waseem, S, Kaefer, M
Urology. 2014;(6):1490-1
Abstract
Early Malone antegrade continence enema (MACE) complications are rare, but can be devastating, particularly if they involve loss of the channel. Management of these complications is not well described. We report on a patient who had her MACE channel successfully salvaged in the immediate postoperative period using a colonoscopic retrograde wire and catheter placement after failing antegrade percutaneous endoscopic management. To our knowledge, this is the first report of a novel, colonoscopic, minimally invasive technique of managing select MACE channels, which cannot be otherwise recatheterized. We also review the management of postoperative MACE complications.
2.
Lactobacillus paracasei endocarditis in a consumer of probiotics.
Franko, B, Vaillant, M, Recule, C, Vautrin, E, Brion, JP, Pavese, P
Medecine et maladies infectieuses. 2013;(4):171-3
3.
Glutaraldehyde-induced colitis: case reports and literature review.
Shih, HY, Wu, DC, Huang, WT, Chang, YY, Yu, FJ
The Kaohsiung journal of medical sciences. 2011;(12):577-80
Abstract
Glutaraldehyde-induced colitis is an uncommon colitis in clinical practice. Because the involvement of colonic segment is determined by the endoscopic part where glutaraldehyde remains, a recent history of endoscopy and a demarcated involvement of colonic segment are the most characteristic signs of glutaraldehyde-induced colitis. The typical clinical scenario is acute onset of lower abdominal pain, fever, and bloody stool. Laboratory data usually show leukocytosis and elevated C-reactive protein. The endoscopic pictures of involved segments are compatible with acute colitis, including hyperemic, edematous, with or without multiple erosions. Acute ischemic colitis and infectious colitis should be differentiated at the outset of the disease. Stool pathogen tests are usually negative. Parenteral empiric antibiotic may be considered if severe transmural edema of the involved segment is observed in computed tomography. Conservative treatment, including bowel rest and parenteral hydration, is able to stabilize the condition in a week. Herein, we present two cases of acute proctocolitis caused by glutaraldehyde after uneventful colonoscopy.
4.
Our experience with endoscopic repair of large colonoscopic perforations and review of the literature.
Trecca, A, Gaj, F, Gagliardi, G
Techniques in coloproctology. 2008;(4):315-21; discussion 322
Abstract
BACKGROUND Colonic perforation is the most severe complication of lower gastrointestinal endoscopy. Recently successful closure with endoscopic clips has been reported. However large (>10 mm) perforations and perforations occurring during diagnostic colonoscopy are considered a contraindication to endoscopic closure. METHODS We retrospectively reviewed our own experience with endoscopic closure of colonoscopic perforations. The size of the perforations was determined by comparison with the maximal opening of the clipping device. In addition we reviewed all cases of colonoscopic perforation published in the English language literature. RESULTS From January 2006 we performed closure of three large colonoscopic perforations in three patients. One perforation occurred after en-bloc endoscopic mucosal resection of two polyps in the descending colon. The other two perforations occurred during diagnostic colonoscopy. All three cases were promptly diagnosed and successfully repaired with TriClips. Patients were kept on intravenous antibiotics and a clear liquid diet until bowel movement and were discharged between the 2nd and the 8th day after the procedure. A review of the literature, including our series, revealed 75 reported cases of colonoscopic perforations repaired with endoclips. Of these, four perforations were larger then 10 mm and four occurred during diagnostic colonoscopy. Of the perforations occurring during therapeutic colonoscopy, clip closure was carried out in 55-96% of the immediate perforations and was successful in 69-93% of cases. CONCLUSIONS Nonsurgical management of colonoscopic perforations with endoclips is a highly feasible option. From our initial experience large perforations and perforations occurring during diagnostic colonoscopy are not a contraindication to endoscopic repair, but due to the small number of patients these data must be interpreted with caution.