Post-surgical endoscopic evaluation has become a rewarding procedure to evaluate the outcome of certain surgical procedures. In patients that have undergone gastrectomy , endoscopy proves to be an invaluable method to visually examine the sites of anastomosis and to look for marginal ulcers as well as to rule out the existance of residual carcinoma.at a later period. Surgical procedures of the colon also benefit from this method.

90 year old male with history of having undergone sub-total gastrectomy due to a bleeding ulcer, forty years ago. Note the marginal ulcers.

57 year old female patient who underwent colon surgery with ileo-transverse anastomosis over a year ago because of a cecum carcinoma. After presenting signs of intestinal obstruction over a course of three days, patient was admitted to hospital for further evaluation.

The endoscopic images show a suture-granuloma as well as silk suture rests. Note the suture granuloma. Biopsy was performed to rule out malignancy.

The cause of intestinal obstruction can be seen when examining the ileo-transverse anastomosis which is totally occluded, due to an unspecific inflammatory reaction. See the image on the right. The suture granuloma can be found towards the left side, at the end of the colon.

The right-sided anastomosis was dilated with certain manipulation. Observe the suture-granuloma towards the left side of the image.

Same case as above.

The endoscope was introduced into the ileon, over a distanced of more than one meter. The colonoscopy had a therapeutic effect and the patient evolved satisfactorily, with resolution of the obstruction.

99 year old patient showed this endoscopic image of the duodenal bulb. Patient had a history of cholecystectomy and bilio-digestive surgery forty years ago. Note the small fistula towards the left side of the image which displays some bubbleing.

Same case as above. The two holes seen in the image correspond to the biliodigestive fistula, which was performed forty years earlier. The duodenum can be found towards the right side of the image.

Patient presents with a history of melena. Prior gastric surgery for unknown reasons is referred. The endoscopic image reveals silk suture which caused nodulations and ulcers.

Same case as above which demonstrates the presence of suture material, cause of ulceration and bleeding of the g.i. tract.

Nodulations caused by suture proved to be of similar appearance as scirrhous carcinoma.

The suture material was extracted by use of special scissors which were introduced through the endoscope. Patient evolved satisfactorily and endoscopic control after 60 days proved normal.

72 year old male who was diagnosed with a pre-pyloric carcinoma in 1991. Findings are commensurate with subtotal gastrectomy. Note the small granulomas caused by suture material.

Patient with total gastrectomy after a carcinoma of the fundus was detected.

Same case as above. Observe the esophageal-jejunal anastomosis