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Objective: To determine accuracy of SAGES, ASGE and ESGE criteria for predicting presence of common bile duct (CBD) stones. Methods: In a prospective study at Jinnah Hospital Lahore from March 2021 to February 2022, patients with suspected CBD stone were stratified in High risk (HR), intermediate risk (IR) and low risk (LR) for SAGES, ASGE and ESGE criteria. All patients underwent ERCP and risk strata were analyzed using SPSS 22® for sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Results: In 90 patients with mean age 45.18(±14.87) and male/female ratio 0.64(35/55), area Under Curve (AUC) for predicting CBD stones was 0.75, 0.81and 0.83 for HR and 0.28, 0.52 and 0.52 for IR group while it was 0.53, 0.81 and 0.53 for absence of stone in LR group of SAGES, ASGE and ESGE criteria respectively. HR groups had accuracy of 81.1%, 86.7% and 87.8% in predicting CBD stone while LR criteria had 68.8%, 86.7% and 68.1% accuracy in predicting absence of CBD stone for SAGES, ASGE and ESGE respectively. Conclusion: HR strata of SAGES, ASGE and ESGE scores have excellent accuracy in predicting CBD stones whereas IR and LR criteria are suboptimal for excluding CBD stones. [ABSTRACT FROM AUTHOR]

BackgroundThe quality of gastrointestinal (GI) endoscopy has been recently identified as a major priority being associated with many outcomes and patient's experience.ObjectiveTo assess adherence of endoscopists to the European Society of Gastrointestinal Endoscopy (ESGE) quality performance measures for upper and lower GI endoscopy in Italy.MethodsAll endoscopist members of the Italian Society of Digestive Endoscopy (SIED) were invited from October 2018 to December 2018 to participate to a self-administered questionnaire-based survey. The questionnaire included questions on demographics and professional characteristics, and the recent ESGE quality performance measures for upper and lower GI endoscopy.ResultsA total of 392 endoscopists participated in the study. Only a minority (18.2%) of participants recorded the duration of esophagogastroduodenoscopy (EGD) and 51% provided accurate photo documentation in the minimum standard of 90% of cases. Almost all endoscopists correctly used Prague and Los Angeles classifications (87.8% and 98.2%, respectively), as well as Seattle and Management of precancerous conditions and lesions in the stomach (MAPS) biopsy protocols (86.5% and 91.4%, respectively). However, only 52.8% of participants monitored complications after therapeutic EGD, and 40.8% recorded patients with a diagnosis of Barrett's esophagus (BE). With regard to colonoscopy, almost all endoscopists (93.9%) used the Boston Bowel Preparation Scale for measuring bowel preparation quality and reported a cecal intubation rate ≥90%. However, about a quarter (26.2%) of participants reported an adenoma detection rate of

Résumé: L'endoscopie d'urgence s'adresse à des maladies graves à toute heure de prise en charge. Les indications sont essentiellement le traitement de l'hémorragie digestive et l'extraction des corps étrangers supérieurs. Mais elle peut aussi être nécessaire en cas de volvulus du sigmoïde et de syndrome d'Ogilvie résistant au traitement médical. La plupart des indications urgentes doivent conduire à une endoscopie dans les 24 heures mais, dans de rares cas, le délai doit être de moins de 12 heures voire de moins de 2 heures. Elle est souvent réalisée en dehors des heures ouvrables, la nuit, le week-end et les jours fériés. Elle doit cependant être réalisée dans de bonnes conditions avec une équipe entraînée. La bonne connaissance des indications des endoscopies d'urgence, ainsi que du délai et de ses modalités de réalisation est nécessaire à tout hépato-gastroentérologue pour prendre les bonnes décisions avec les correspondants urgentistes, réanimateurs, radiologues et chirurgiens et conduire à une prise en charge optimale du patient. Emergency endoscopy is mandatory at all times for critically ill patients. Emergency endoscopy is mainly performed for the management of digestive bleeding and for the extraction of foreign bodies. But it may also be necessary in case of sigmoid volvulus and Ogilvie syndrome resistant to medical treatment. Most urgent indications must lead to an endoscopy within 24 hours, and in rare cases within 12 hours or even less than 2 hours. It is therefore often be carried out outside working hours; at night, weekends and holidays. However, it should be performed by a properly trained team in an adequate environment. A knowledge of validated indications for emergency endoscopies, appropriate timing and procedures should therefore be mastered by any hepatogastroenterologist on duty, in order to take the appropriate decisions with emergency intensivists, radiologists and surgeons, and to obtain an optimal care for patients. [ABSTRACT FROM AUTHOR]

The new ESHRE/ESGE classification system of female genital anomalies is presented, aiming to provide a more suitable classification system for the accurate, clear, correlated with clinical management and simple categorization of female genital anomalies. Congenital malformations of the female genital tract are common miscellaneous deviations from normal anatomy with health and reproductive consequences. Until now, three systems have been proposed for their categorization, but all of them are associated with serious limitations. The European Society of Human Reproduction and Embryology (ESHRE) and the European Society for Gynaecological Endoscopy (ESGE) have established a common Working Group, under the name CONUTA (CONgenital UTerine Anomalies), with the goal of developing a new updated classification system. A scientific committee has been appointed to run the project, looking also for consensus within the scientists working in the field. The new system is designed and developed based on: (1) scientific research through critical review of current proposals and preparation of an initial proposal for discussion between the experts, (2) consensus measurement among the experts through the use of the DELPHI procedure and (3) consensus development by the scientific committee, taking into account the results of the DELPHI procedure and the comments of the experts. Almost 90 participants took part in the process of development of the ESHRE/ESGE classification system, contributing with their structured answers and comments. The ESHRE/ESGE classification system is based on anatomy. Anomalies are classified into the following main classes, expressing uterine anatomical deviations deriving from the same embryological origin: U0, normal uterus; U1, dysmorphic uterus; U2, septate uterus; U3, bicorporeal uterus; U4, hemi- uterus; U5, aplastic uterus; U6, for still unclassified cases. Main classes have been divided into sub-classes expressing anatomical varieties with clinical significance. Cervical and vaginal anomalies are classified independently into sub-classes having clinical significance. The ESHRE/ESGE classification of female genital anomalies seems to fulfil the expectations and the needs of the experts in the field, but its clinical value needs to be proved in everyday practice. The ESHRE/ESGE classification system of female genital anomalies could be used as a starting point for the development of guidelines for their diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Background: Endoscopic procedures are commonly performed in patients taking antithrombotic agents., Objective: To examine the correlation between the management of antithrombotic drugs for colonoscopic polypectomies and the published guidelines., Design and Settings: A structured survey delivered to gastroenterologists in 15 major Israeli hospitals and three central HMO clinics., Results: We collected 100 filled out surveys. Polypectomies on aspirin were performed by 78%. Most physicians did not perform polypectomies on clopidogrel. None of the physicians performed polypectomies on warfarin. Cessation of aspirin for ≥ 3 days post-polypectomy was recommended by 60%. Renewal of LMWH or warfarin was recommended ≥ 2 days post-polepectomy in 91% and 71%, respectively. The greatest variation in recommendations was found for clopidogrel, where the majority of gastroenterologists advised renewal after 1-2 days (38%). Years in practice and increasing colonoscopy volume work had no significant association with management of antithrombotic agents. Working in a HMO clinic was associated with lower rates of polypectomies on aspirin (P=0.036)., Discussion: When the guidelines are clear, most gastroenterologists practice according to the existing recommendation. However, lack of prospective studies limits the ability to publish evidence-based recommendation and guidelines. We found that the practice of our cohort study varies in these situations., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)