Gastrointestinal endoscopy
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Gastrointest. Endosc. · Mar 1996
Randomized Controlled Trial Comparative Study Clinical TrialPremedication with intravenous antispasmodic speeds colonoscope insertion.
Use of antispasmodic medication prior to colonoscopy is controversial but may improve visualization of colonic mucosa and ease colonoscope insertion. ⋯ Premedication with intravenous hyoscine n-butyl bromide reduces colonic spasm and in this study made colonoscope insertion significantly quicker and easier.
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Gastrointest. Endosc. · Feb 1996
A prospective outcome study of patients with clot in an ulcer and the effect of irrigation.
The proper management of patients with clots in an ulcer base has not been clearly defined by prospective studies. Variable prevalence and rebleeding rates may be explained by differing degrees of vigor used to clear the clot, as removal may reveal other stigmata. We prospectively assessed the natural histories of patients with clots after vigorous irrigation, employing a management strategy of endoscopic therapy for patients with high-risk stigmata and observation of those with clots resistant to washing or low-risk findings. ⋯ Irrigation appears to be useful in patients with upper gastrointestinal bleeding who have ulcers with clots. The endoscopic findings present after washing can be used to dictate the appropriate management at initial endoscopy. Application of hemostatic therapy in patients with active bleeding or nonbleeding visible vessels and observation of patients with other stigmata, including clots resistant to washing, resulted in an excellent outcome.