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Endoscopy units are considered to be at an increased risk of infection by SARS-CoV-2. Our aim is to assess the correlation between pre-endoscopic screening with reverse-transcription-polymerase-chain-reaction (RT-PCR) in asymptomatic individuals scheduled for elective endoscopy and the epidemiological data published by the local Health Administration.Observational retrospective study collecting the results of our screening strategy spanning June/2020-June/2021, the effective potential growth (EPG), an index measuring the outbreak risk, and the 7 and 14-day cumulative incidence (CI). Indication, delay and the findings of the endoscopic examinations were registered for RT-PCR positive patients.A total of 5808 tests were performed, yielding 125 positive results (2.15%). All positive tests occurred in weeks of high/very high risk (EPG100) with the highest monthly rate being 9.36%, recorded in January/2021. A significant correlation (rho=0.796; p0.001) between weekly positive rates and EPG was observed, and a significantly lower weekly number of positive tests was recorded when EPG100. Planning the screening strategy one week ahead according to EPG100 would have avoided up to 826 tests with only one positive result to account for. One hundred and thirteen individuals tested positive and 89 endoscopies were delayed. The most common findings were colon polyps, colorectal cancer and gastric metaplasia. Oncological diagnosis was delayed 50±3 days.No positive RT-PCR test were registered out of high-risk periods. Epidemiological administrative data in the preceding two weeks showed a significant correlation with screening results and could be useful to plan pre-endoscopic screening and avoid unnecessary tests.

Background The aim of the present study was to develop a rat model of colonic microperforation secondary to thermal injury for future studies to assess new treatments. Methods Twenty-four male Sprague–Dawley rats were used in this study. Hot biopsy forceps were used for all treatments. All lesions were created in proximal left colon using the soft coagulation setting. The power setting tested was 40 W, and the durations of monopolar soft coagulation application evaluated were 2, 3, and 4 s. Results In the acute phase, 48 h after thermal injury, durations of cautery of 2 and 3 s resulted in transmural necrosis, whereas with 4 s microperforation was obtained. In the late phase, 7 d after the damage, only duration of cautery of 4 s showed deep cautery effects, with signs of peritonitis. Conclusions We determined optimal power settings and duration of therapy in a rat model for producing electrocautery that involves transmural necrosis with microperforation.

La estenosis luminal es mas frecuente en la enfermedad de Crohn (EC) dado su compromiso transmural. Antes de proceder a cualquier tratamiento endoscopico se debe descartar la presencia de una estenosis neoplasica. La dilatacion endoscopica con balon se ha utilizado en varias series como tratamiento de las estenosis benignas, principalmente en EC con afectacion del de ileon distal, colon o anastomosis quirurgicas, con un exito de entre el 51 y el 85%, aunque la recurrencia es alta. El uso concomitante de esteroides inyectados (triamcinolona) tras la dilatacion endoscopica muestra unos resultados mas duraderos, aunque la experiencia publicada es escasa. Ante pacientes con estenosis luminal resistente a la tecnica convencional, disponemos de 3 tecnicas endoscopicas emergentes que pueden ser de utilidad: stents metalicos autoexpandibles, endoprotesis biodegradables e inyeccion intralesional de infliximab.

Resumen Introduccion Los criterios europeos para el uso apropiado de la endoscopia (EPAGE) han sido actualizados este ano (EPAGE II), pero aun no han sido evaluados. Objetivos (1) Analizar la adecuacion de las colonoscopias segun los criterios de EPAGE II y (2) evaluar su correlacion con el diagnostico. Pacientes y metodos Analisis retrospectivo de 700 colonoscopias (48% hombres, edad media 58 anos). Se excluyeron 45 (6,4%) por preparacion insuficiente o indicacion electiva. Segun EPAGE II se considero la prueba «apropiada», «no apropiada» o «incierta». Resultados 94% (n=655) fueron evaluables, siendo el cribado de cancer colorectal (CCR) el motivo de indicacion mas frecuente (19%). El 70% de las pruebas fueron «apropiadas», y un 18% «no apropiadas», con diferencias significativas segun el origen de la peticion. Control postpolipectomia fue la indicacion mas inapropiada por acortamiento en los plazos de realizacion. En el 48% se evidencio diagnostico endoscopico, encontrando la presencia lesiones relevantes —CCR, adenomas, enfermedad inflamatoria (EII), angiodisplasias y estenosis benignas—en el 25% de ellas (n=167). El cribado de CCR (17,3%) y el control tras polipectomia (16,7%) fueron las indicaciones mas asociadas con la presencia de diagnostico relevante, aunque sin significacion. La unica indicacion que se asocio al diagnostico de CCR fue la anemia ferropenica (p Conclusion Un 18% de las colonoscopias solicitadas son inapropiadas y un 12% inciertas. La anemia ferropenica es la indicacion con mayor correlacion para el diagnostico de CCR. Los criterios de EPAGE II presentan una buena asociacion con el diagnostico endoscopico de CCR.

Tumors of the ampulla of Vater are called ampullary tumors and can arise from any of the three epithelia (duodenal, pancreatic and biliary) that delimit the papilla. These tumors are clinically important and early identification, appropriate staging and proper treatment are essential. The symptoms of these tumors are non-specific and not always evident. All ampullary tumors must be resected but opinions differ on the optimal method of excision. Currently, controlled trials are lacking and consequently the treatment chosen must be individually tailored according to the characteristics of the patient and the tumor. Curative treatment may be endoscopic or surgical. In patients who are not candidates for curative treatment, palliative treatment through drainage can be performed.