Abstract

An observational, descriptive study of the records of 53 endoscopic retrograde cholangiopancreatography (ERCP) performed on 31 patients of paediatric age with suspected biliopancreatic disorders at the National Center for Minimal Access Surgery was performed over a period of 2 years and 7 months, from 11 February 2013 to 28 July 2015. Of the total, 8 patients (27%) were male, and 22 (73%) female; 14 (26%) were diagnostic and 39 (74%) therapeutic. The primary indication was to study pain with elevated enzymes in 27 (50%), and the main diagnosis was postoperative benign common bile duct-anastomosis stricture in 14 patients (26%), followed by 10 normal ERCP (19%). The intervention used was endoscopic sphincterotomy (16) for placement of prosthesis (7), followed in frequency by stone extraction (6). There were complications in 2 cases, one (2%) in 21 therapeutic procedures, and one (2%) at diagnosis. Mortality was zero. Our results show the high diagnostic usefulness and therapeutic success of ERCP with minimal risk and complications in paediatric patients.

Abstract

Endoscopy is an extremely valuable instrument to evaluate the effectiveness of new treatments for patients with ulcerative colitis; however it is necessary to validate the current endoscopic classifications to facilitate meaningful comparisons between them. The Ulcerative Colitis Endoscopic Index of Severity (UCEIS) recommended by European Crohns and Colitis Organisation uses 3 parameters (vascular, bleeding, and ulceration), each with 3-4 levels of severity. However, it has not been validated for the Mexican population. In addition to the colonoscopic features, the establishment of disease activity by histology is performed routinely. The Riley scale shows mainly the density and distribution of neutrophils in mucosal defects. To determine whether there is a correlation between the UCEIS endoscopic classification and the Riley histological classification, and validate their usefulness in the Mexican population. A retrospective, cross-sectional, open study was conducted from January 2012 to December 2014 in the Centro Medico Nacional 20 de Noviembre on patients with a diagnosis of ulcerative colitis sent to the hospital Endoscopy Department. Endoscopic UCEIS and histological Riley classifications were determined and compared using the SPSS program for statistical analysis. A total of 63 cases were included, of whom 33 were male (52%) and 30 (48%) female, with mean age of 50 years (23-78 years). The Spearman correlation coefficient was 89.8%, with a confidence interval of 83.7%-93.7% (P 

Abstract

Autoimmune pancreatitis is a rare chronic form of inflammatory pancreatic disease. There is no specific test for its diagnosis, which is based on the combination of clinical, serological, radiological, morphological, and histopathological changes. Endoscopy is one of the most useful tools for its evaluation. Endoscopic retrograde cholangiography and endoscopic ultrasound can be used to obtain tissue for diagnosis and evaluate steroid treatment response. In this article, a clinical case is presented. General aspects of autoimmune pancreatitis and the role of endoscopists in its diagnosis and treatment are discussed.

Abstract

Digestive tract bleeding is the most frequent cause for emergency upper endoscopy in paediatrics. In patients with portal hypertension bleeding is caused by oesophageal or gastric varices. Bleeding secondary to gastric varices has a low incidence, but it is associated with high morbidity and mortality. The treatment of choice for these varices is with N-butyl-2-cyanoacrylate injection, a tissue adhesive frequently used in adults for primary and secondary prophylaxis. To evaluate the safety and efficacy of cyanoacrylate use in primary and secondary prophylaxis of gastric varices in children in a third-level hospital, and its effect on oesophageal varices. A case series that included 12 paediatric patients with portal hypertension and gastric varices that were treated with cyanoacrylate from January 2011 to February 2016. The study included 4 girls and 8 boys, with a mean age of 7 years old. Cyanoacrylate was used in 3 patients as primary prophylaxis for gastric varices, and as secondary prophylaxis for the rest. Gastric varices eradication was reported in 66.7% of patients, with 75% of those after only one injection. There were no episodes of bleeding or re-bleeding, or major complications. Cyanoacrylate use in primary and secondary prophylaxis of gastric varices in children was shown to be both safe and effective.

Abstract

Evaluation methods for asymptomatic patients with evidence of dilatation of the main bile duct, pancreatic duct, or both ducts simultaneously are currently not well established. There are no guidelines, at present, to direct us on what is the best choice for the correct assessment of this group of patients. Endoscopic ultrasound has demonstrated outstanding performance in addressing the pancreatobiliary, mainly malignant, disease. This review article presents current evidence on the diagnostic performance of endoscopic ultrasound in asymptomatic patients with signs of dilation of the main bile duct, the main pancreatic duct, or both, in different imaging studies.