notes2 copy.gif (2951 bytes)

Julio Alejandro Murra-Saca MD.
Gastroenterologist, Coloproctologist
Tel : (503) 2226-3131, (503) 2225-3087, Celular (503) 7887-2507
Email:
drmurrasaca@murrasaca.com
Edificio Centro Scan, Colonia Médica, San Salvador, El Salvador.

 

 

murra2.gif (3687 bytes)

Notes on Cyber Gastroenterology

 

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.
fore more endoscopic details please download the video clip  by clicking on the image
90 year old male with history of having undergone sub-total gastrectomy due to a bleeding ulcer, forty years ago. Note the marginal ulcers.
fore more endoscopic details please download the video clip  by clicking on the image

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.
fore more endoscopic details please download the video clip  by clicking on the image
The endoscopic images show a suture-granuloma as well as silk suture rests. Note the suture granuloma. Biopsy was performed to rule out malignancy.
fore more endoscopic details please download the video clip  by clicking on the image

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.
fore more endoscopic details please download the video clip  by clicking on the image
The right-sided anastomosis was dilated with certain manipulation. Observe the suture-granuloma towards the left side of the image.
fore more endoscopic details please download the video clip  by clicking on the image
Same case as above.
fore more endoscopic details please download the video clip  by clicking on the image

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.
fore more endoscopic details please download the video clip  by clicking on the image

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.
fore more endoscopic details please download the video clip  by clicking on the image

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.
fore more endoscopic details please download the video clip  by clicking on 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.
fore more endoscopic details please download the video clip  by clicking on the image

Same case as above which demonstrates the presence of suture material, cause of ulceration and bleeding of the g.i. tract.
fore more endoscopic details please download the video clip  by clicking on the image

Nodulations caused by suture proved to be of similar appearance as scirrhous carcinoma.
fore more endoscopic details please download the video clip  by clicking on the image
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

 

bt37.gif (3388 bytes)
bt34.gif (3394 bytes)
bt35.gif (3380 bytes)
bt36.gif (3395 bytes)
bt43.gif (3337 bytes)
bt69.gif (3404 bytes)
bt50.gif (3391 bytes)
bt65.gif (3331 bytes)
bt40psd.gif (3401 bytes)
bt39.gif (3380 bytes)
bt70.gif (3383 bytes)
bt58.gif (3377 bytes)
bt52.gif (3388 bytes)
bt45.gif (3364 bytes)
66.gif (3443 bytes)
bt68.gif (3354 bytes)
bt47.gif (3415 bytes)
bt20.gif (3406 bytes)
bt53.gif (3419 bytes)
bt54.gif (3374 bytes)
bt55.gif (3436 bytes)
bt56.gif (3407 bytes)
bt59.gif (3357 bytes)
bt57.gif (3367 bytes)
bt62.gif (3368 bytes)
bt71.gif (3636 bytes)
bt60.gif (3379 bytes)
bt64.gif (3452 bytes)
bt61.gif (3807 bytes)
bt63.gif (3371 bytes)
bt73.gif (3371 bytes)
bt51.gif (3392 bytes)
 
 
 
Main Page