Gastroent Hepat Barc
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Gastroent Hepat Barc · Jan 2005
Clinical Trial[Sedation in upper gastrointestinal endoscopy. Analysis of tolerance, complications and cost-effectiveness].
Sedation of patients is an important complement to endoscopic procedures. The aim of this study was to analyze tolerance, complications and cost-effectiveness in patients undergoing diagnostic upper gastrointestinal endoscopy. ⋯ From the point of view of the endoscopist, endoscopy can be performed without sedation, although subjective tolerance is greater in patients sedated with midazolam and meperidine. Non-sedation is more cost-effectiveness than sedation but if sedation is required midazolam and meperidine achieve better results in terms of effectiveness than midazolam alone.
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Gastroent Hepat Barc · Jan 2005
Clinical Trial[Utility of routine use of reversion after sedation in outpatient colonoscopy].
Randomized clinical trials have demonstrated the effectiveness of flumazenil in reducing recovery time in the endoscopy unit after conscious sedation with midazolam and meperidine. However, its effectiveness in routine clinical practice has not been proved and therefore its use is debated. ⋯ Routine use of reversion does not decrease the mean stay in the endoscopy unit but does decrease the number of prolonged stays. Unpleasant memories of the colonoscopy were more frequent in reverted patients. The effectiveness of the routine use of reversion with flumazenil after conscious sedation with midazolam and pethidine depends on the ratio between the number of daily colonoscopies and the capacity of the recovery room.
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Gastroent Hepat Barc · Jan 2005
Case Reports[Primary aortoenteric fistula: a rare cause of gastrointestinal bleeding in young adults].
Aortoenteric fistula is defined as a communication between the native aorta and any portion of the gastrointestinal tract. Depending on previous aortic grafting it can be classified as primary, without previous grafting, or secondary. Primary aortoenteric fistula is less frequent and usually arises from an abdominal aortic aneurysm. ⋯ We report the case of a 46-year-old man who presented to the emergency room with gastrointestinal bleeding and an abdominal pulsatile mass. Although complementary tests and clinical signs suggested a diagnosis of primary aortoenteric fistula, the communication was not observed on gastroscopy and was confirmed by exploratory laparotomy. Despite aggressive surgical treatment, the prognosis of this entity is poor.