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Buried bumper syndrome - a complication of percutaneous endoscopic gastrostomy
Cyrany, Jiří ; Kopáčová, Marcela (advisor) ; Dítě, Petr (referee) ; Procházka, Vlastimil (referee)
Percutaneous endoscopic gastrostomy is a widely used method of nutrition delivery for patients with long-term insufficiency of oral intake. Buried bumper syndrome belongs to severe complications of this method, in which the internal fixation device migrates along the tract of the stoma outside the stomach. Even though all the precautions are respected - including adequate positioning of the outer fixator - this complication does occur. The buried bumper syndrome can be managed surgically or endoscopicaly in many modifications. Published series of this syndrome are not robust enough; they differ in its incidence. Some published results indicate increase of the incidence in time, however there is no explanation for this change. Until now there is no universal diagnostic and therapeutic algorithm based on the degree of disc submersion determined by reliable and feasible methods. Dissection of the overgrowing tissue is the determinant for a successful endoscopic therapy, nevertheless methods described until now are clumsy and bear a significant risk of complications such as bleeding and perforation. Forty cases of the buried bumper syndrome in 38 patients were identified in this study based on the retrospective analysis of 1248 procedures with percutaneous endoscopic gastrostomy implantation during...
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Buried bumper syndrome - a complication of percutaneous endoscopic gastrostomy
Cyrany, Jiří ; Kopáčová, Marcela (advisor) ; Dítě, Petr (referee) ; Procházka, Vlastimil (referee)
Percutaneous endoscopic gastrostomy is a widely used method of nutrition delivery for patients with long-term insufficiency of oral intake. Buried bumper syndrome belongs to severe complications of this method, in which the internal fixation device migrates along the tract of the stoma outside the stomach. Even though all the precautions are respected - including adequate positioning of the outer fixator - this complication does occur. The buried bumper syndrome can be managed surgically or endoscopicaly in many modifications. Published series of this syndrome are not robust enough; they differ in its incidence. Some published results indicate increase of the incidence in time, however there is no explanation for this change. Until now there is no universal diagnostic and therapeutic algorithm based on the degree of disc submersion determined by reliable and feasible methods. Dissection of the overgrowing tissue is the determinant for a successful endoscopic therapy, nevertheless methods described until now are clumsy and bear a significant risk of complications such as bleeding and perforation. Forty cases of the buried bumper syndrome in 38 patients were identified in this study based on the retrospective analysis of 1248 procedures with percutaneous endoscopic gastrostomy implantation during...
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Wireless Capsule Endoscopy in Experimental and Clinical Diagnostics of Enteropathy Induced by Nonsteroidal Anti-inflammatory Drugs
Tachecí, Ilja ; Kopáčová, Marcela (advisor) ; Lata, Jan (referee) ; Zavoral, Miroslav (referee)
Introduction Non-steroidal anti-inflammatory drug (NSAID)-induced enteropathy represents an important complication related to one of the most commonly used drugs worldwide. The prevalence has been underestimated for a long time due to previous diagnostic difficulties. Objective The main goal of our project was to evaluate the basic characteristics of NSAID- induced enteropathy as well as the benefit of capsule endoscopy in its diagnostics. Methods and results In the first, experimental, part of the dissertation, we elaborated methodology of capsule endoscopy in an experimental animal and checked it on 7 healthy pigs. Although normal enteroscopy pictures were found in all the animals, some limitations were identified. The markedly worse visibility of the small bowel mucosa, and incomplete evaluation were the main ones. A model of NSAID-induced enteropathy (using a 10-day per oral indomethacin administration - 400 mg/day) was projected and verified in 8 healthy pigs consecutively. The endoscopy findings were confirmed by means of autopsy. We revealed the presence of small intestinal mucosal lesions on capsule endoscopy in the majority of the experimental pigs (87.5%). The most frequent findings were mild mucosal injury (red spots and erosions) in 6/8 animals. These findings were confirmed in 50.0% at...
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