http://blogs.najah.edu/author/yasserabusafieh An-Najah Blogs :: Dr. Yasser Abu Safieh\'s Blog en-us Sat, 27 Jul 2024 14:58:36 IDT Sat, 27 Jul 2024 14:58:36 IDT [email protected] [email protected] http://blogs.najah.edu/staff/yasserabusafieh/article/Food-and-Foreign-Body-Impaction-In-Upper-GI-TractPublished Articles Food and Foreign Body Impaction In Upper GI Tract M Yasser F Abu-Safieh Gastrointestinal Endoscopy April 2004 Vol 59 Issue 5 Page P242 Background: Ingestion of foreign bodies and food impaction are the most common cause of esophageal obstruction which is considered as acute emergency this obstruction can be caused by soft blunt and sharp objects Endoscopy is considered as the main therapeutic procedure surgical intervention is rarely needed Methods: a retrospective study of all patients records with acute esophageal obstruction or presence of radio-opaque foreign body in esophagus or stomach Urgent EGD used to be done in outpatient clinic or elective if the patient has the foreign body days in the stomach XQ10 XV10 and Q20 Olympus gastroscopes were used retrieval was carried out by snare or tetrapode grasper over tube was used once indicated Conscious sedation by using titrated doses of Medazolam or GA if sedation was not enough Patients were classified according to esophageal pathology and type of obstructing object Results: All records of 77patients from 1992-Nov 2003 presented with either esophageal obstruction or a radio-opaque shadow were reviewed mean age 282 years 1-80 years total events 81 M:F 38:39 total number of EGD in that period 4522 Cause of obstruction and management were as follows:- Insert table Soft Blunt Sharp Four patients with gastric bezoars 3 were removed and one trichobezoar was fragmented and pushed completely on 3rd sessions Three pins in 3 patients were embedded in full stomach and could not be seen passed with stool The bladewas removed by snare with over tube protection And in 3 patients negative EGD Conclusion: foreign bodies and impacted food can be successfully managed by gastroscopy in most cases 93 Failure is due to embedded bones in upper esophagus and surgery is the treatment Either extracting or pushing techniques are effective Coins and coins like impaction occurred in normal esophagus mainly in children while soft bolus impaction occurred in an abnormally narrowed esophagus http://blogs.najah.edu/staff/yasserabusafieh/article/Lye-induced-esophagitis-Course-and-follow-up-of-29-patientsPublished ArticlesLYE-INDUCED ESOPHAGITIS: COURSE AND FOLLOW UP OF 29 PATIENTS M Yasser F Abu Safieh MD Nablus -West Bank Introduction: Lye is a household detergent used in small villages in the West Bank for home made soap accidental ingestion of this corrosive during childhood will induce acute alkaline esophagitis followed by a stricture in lower and middle esophagus Aim: The aim of this study is to evaluate the chronic sequel of lye esophagitis management of the stricture morbidity and mortality of repeated dilation and colonic interposition Materials Methods: Twenty nine patients were diagnosed between 1990- 1997 All have had accidental ingestion of lye during childhood The majority presented to a pediatrician or general practitioner immediately after ingestion and used to be referred for:- I- Dilation after development of the stricture 2-Urgent gastroscopy for impacted food in upper esophagus and 3- Dilation of post colonic interposition stricture All patients have had gastroscopy and Ba-swallow to estimate the size of the stricture Patients with impacted food and dysphagia to fluids had emergency gastroscopy and removal of impacted food by a snare Dilation of the stricture by Savary-Gilliard dilators{5-18 mm} passed over a guide wire was done under fluoroscopy Results: Twenty nine patients are: {20 M 9 F} Age at ingestion 125--5 mean 3year Age at referral 2--55 mean 11 year All presented with dysphagia ten patients had impacted food pieces that needed urgent gastroscopy to relieve obstruction All strictures were in middle and distal esophagus average length 1-6cm Twenty two patientsgroup A were below 12 years and 7 patients group B were above 12 years In group A 1822 had repeated dilation with average last size achieved by 9--14mm dilators One child died post thoracotomy for perforation after the first dilation 8 patients had minimal bleeding 4 children didnt come for the first dilation 3 of them presented with more than one episode of impacted food For the last 30 months 1317pts 76 of group A did not have dilation Group B 7 pts above 12 yrs 4 had colonic interposition because of failed or complicated dilation 3 of them had post operative stricture and undergo dilation the most severe one has had injection of steroid in 4 quadrant of the stricture and 15 mm dilator could pass easily after 3 weeks of injection While 3 patients had the first dilation at age 22 25 and 55 years In group B 2 pts were admitted for observation because of severe chest pain after dilation but perforation could not be confirmed 2pts had minimal bleeding The average last size achieved by 12--16mm dilators From this group only 47 pts 57 didnot come for dilation for the last 20 months Conclusion: Accidental ingestion of lye occurs in young children it is clear that some sort of adaptation to dysphagia occurs with age The majority have good dilation of the stricture by Savary-Gilliard dilators childhood strictures have a better success rate of dilation The risk of perforation and death or minor inevitable complications will not preclude dilation Colonic interposition is a modality of treatment with postoperative stricture which requires dilation Published in Gastroenterology Vol: 114 supplement April 1998 Presented as a poster in DDW http://blogs.najah.edu/staff/yasserabusafieh/article/COLD-SNARE-POLYPECTOMY-OUT-PATIENT-TREATMENTPublished Articles COLD SNARE POLYPECTOMY; OUT PATIENT TREATMENT OF JUVENILE RECTAL POLYP BY : M YASER F ABU SAFIEH MD NABLUS - WEST BANK INTRODUCTION :- Juvenile rectal polyp JRP: Considered as the most common cause of rectal bleeding in children cold snare polypectomy can be used for small size polyp 05 cm ; but larger polyps need electrocautery to be removed METHODS: Twenty-eight 28 children were referred for sigmoidoscopy because of rectal bleeding from Dec 1993 - Jul 1995 prepared by Bisacodyl enema Olympus OSF-2 sigomoidoscope was used or XQ 10 gastroscopr when difficulty of introducing OSF-2 Olympus SD-9L 11L snare used without sedation and a wtitten consent was signed by one of the parents RESULTS: Out of the 28 patients 18 13 male 5 female were found to have pedunculatcd rectal polyp the mean age was 433 years the diameter of the polyps ranged between 06 - 3 cm all the 18 had solitary polyp that was easily snared out with minimal bleeding less than 5 mL came out with the polyp by defecation No coagulation or cutting current has been applied cold snare All polyps were sent to histopathology and reported by the pathologist as JRP No complication reported in the group and follow up from 6- months to 2 years showed no single recurrence of rectal bleeding CONCLUSION:- Cold snare polypectomy is safe easy done in outpatient clinic without sedation and no hazards of electrocautery Cold snare polypectomy; Out patient treatment of juvenile rectal polyp M Yasser F Abu Safieh Gastrointestinal EndoscopyApril 1996 Vol 43 Issue 4 Page 374 Presented as a poster in DDW in SF California