Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Unique gastroenterology procedure developed in adults shows promise in pediatrics

27.09.2010
The use of device-assisted enteroscopy, a technique that allows complete examination of the small bowel, may be just as successful pediatrics as it has been in adult medicine, according to a study from Nationwide Children's Hospital.

One of these techniques known as Double-Balloon Enteroscopy (DBE), a procedure readily available in adults, allows doctors to reach parts of the small intestine that cannot be reached using standard endoscopic procedures. Due to access issues and size limitations, DBE is rarely considered an option in pediatrics. As a result, little is known about this technique in children.

"Since the introduction of fiberoptic endoscopy in the 1950s, gastrointestinal endoscopy has undergone dramatic progress in how it can aid in the diagnosis and treatment of patients," said Steven H. Erdman, MD, gastroenterologist and at Nationwide Children's Hospital and one of the study authors.

Yet, even with this progress, endoscopic examination and treatment in the small intestine has remained a challenge, especially in children. "Small intestinal enteroscopy in the pediatric population remains relatively unknown and underutilized," said Dr. Erdman, also a professor of Clinical Pediatrics at The Ohio State University College of Medicine.

To shed light on the indications and possible benefits of DBE in children, physicians from Nationwide Children's reviewed the outcomes of DBE cases performed at the hospital during a two-year period. The physicians performed a total of 13 DBE procedures on 11 pediatric and adolescent patients. Prior to the DBE, all patients underwent a detailed diagnostic evaluation including laboratory testing and diagnostic radiologic imaging along with upper endoscopy, colonoscopy and capsule endoscopy (CE) tests. Abnormal small intestinal CE findings or continued small bowel disease symptoms without diagnosis by conventional methods were used as indications for DBE.

Two of the patients underwent DBE for treatment of small intestinal polyps associated with Peutz-Jeghers Syndrome which dramatically improved their symptoms of abdominal pain and bleeding. Another patient's DBE was done to remove a bleeding small intestinal vascular malformation that had caused years of symptoms resolving chronic anemia. Two other patients had histories of bloody diarrhea, anorexia and weight loss; lower DBE provided evidence leading to the diagnosis of Crohn's disease when other medical techniques had been unsuccessful.

DBE can be associated with abdominal discomfort following the procedure due to gaseous distention as was seen in five of the 13 procedures. Utilizing carbon dioxide rather than regular air to fill the intestine during this procedure has eliminated this issue.

Noting the limitations of this study on a small number of patients from a single institution, Dr. Erdman says that DBE appears to hold promise for pediatrics. "Our experience suggests that DBE shows great potential in the diagnosis and management of pediatric small intestinal disease without undue risk," he said. Since completion of the original report, eight additional DBE procedures have been completed with similar positive outcomes.

Although DBE shows great potential, Dr. Erdman warns that pediatric centers may not be able to devote the necessary resources and time needed to provide this type of service. "DBE remains a resource-intensive procedure requiring multiple staff, general anesthesia and extended procedure time in addition to cost outlays for equipment," he said. "These instruments were designed for use in adults and size is a limitation that remains to be address before DBE can become a more standardized tool in pediatric gastroenterology."

Erin Pope | EurekAlert!
Further information:
http://www.NationwideChildrens.org

More articles from Medical Engineering:

nachricht Visualizing gene expression with MRI
23.12.2016 | California Institute of Technology

nachricht Illuminating cancer: Researchers invent a pH threshold sensor to improve cancer surgery
21.12.2016 | UT Southwestern Medical Center

All articles from Medical Engineering >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

Im Focus: How to inflate a hardened concrete shell with a weight of 80 t

At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).

Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...

Im Focus: Bacterial Pac Man molecule snaps at sugar

Many pathogens use certain sugar compounds from their host to help conceal themselves against the immune system. Scientists at the University of Bonn have now, in cooperation with researchers at the University of York in the United Kingdom, analyzed the dynamics of a bacterial molecule that is involved in this process. They demonstrate that the protein grabs onto the sugar molecule with a Pac Man-like chewing motion and holds it until it can be used. Their results could help design therapeutics that could make the protein poorer at grabbing and holding and hence compromise the pathogen in the host. The study has now been published in “Biophysical Journal”.

The cells of the mouth, nose and intestinal mucosa produce large quantities of a chemical called sialic acid. Many bacteria possess a special transport system...

Im Focus: Newly proposed reference datasets improve weather satellite data quality

UMD, NOAA collaboration demonstrates suitability of in-orbit datasets for weather satellite calibration

"Traffic and weather, together on the hour!" blasts your local radio station, while your smartphone knows the weather halfway across the world. A network of...

Im Focus: Repairing defects in fiber-reinforced plastics more efficiently

Fiber-reinforced plastics (FRP) are frequently used in the aeronautic and automobile industry. However, the repair of workpieces made of these composite materials is often less profitable than exchanging the part. In order to increase the lifetime of FRP parts and to make them more eco-efficient, the Laser Zentrum Hannover e.V. (LZH) and the Apodius GmbH want to combine a new measuring device for fiber layer orientation with an innovative laser-based repair process.

Defects in FRP pieces may be production or operation-related. Whether or not repair is cost-effective depends on the geometry of the defective area, the tools...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

Nothing will happen without batteries making it happen!

05.01.2017 | Event News

 
Latest News

Solar Collectors from Ultra-High Performance Concrete Combine Energy Efficiency and Aesthetics

16.01.2017 | Trade Fair News

3D scans for the automotive industry

16.01.2017 | Automotive Engineering

Nanoparticle Exposure Can Awaken Dormant Viruses in the Lungs

16.01.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>