Sohaib Faruqi

Recent advances in cell biology, diagnosis and therapy of gastrointestinal stromal tumor (GIST)

No abstract yet available.

Endoscopic sonographically guided fine-needle aspiration yield in submucosal tumors of the gastrointestinal tract.

Objective. To study the yield of endoscopic ultrasonographically guided fine‐needle aspiration cytologic examination in the diagnosis of submucosal masses. Methods. From 1999 to 2003, 10 patients underwent ultrasonographically guided fine‐needle aspiration for the cytologic diagnosis of submucosal masses in our institution. The endoscopic ultrasonography records and the cytology database were consulted, and the reports were analyzed, as were slide material and the technical aspects related to these procedures. All procedures were performed under conscious sedation and cardiorespiratory monitoring on an outpatient basis. Ten patients (4 men and 6 women; mean age, 60.8 years) were studied. Results. Eight lesions were located in the stomach, and 2 were located in the esophagus, with a mean diameter of 3.3 cm. An experienced cytopathologist was present on‐site during all procedures for assessment of adequacy and preliminary cytologic examination. Cytologic diagnoses were obtained in 8 cases as follows: 6 gastrointestinal stromal tumors, 1 organizing submucosal hematoma, and 1 low‐grade mucosa‐associated lymphoid tissue–associated lymphoma. Two cases consisted of scant gastric epithelium only and were considered nondiagnostic. The cytologic diagnoses guided further clinical treatment. Conclusions. Ultrasonographically guided fine‐needle aspiration with cytopathologic analysis has a high accuracy rate (80%) for diagnosing submucosal lesions. These findings potentially affect clinical decision making.

Cap-assisted endoclip placement for recurrent ulcer hemorrhage after repeatedly unsuccessful endoscopic treatment and angiographic embolization: case report

The endoscopic management of patients with bleeding ulcer has advanced substantially during recent decades. Hemostasis is achieved in most patients with bleeding ulcer. However, recurrent hemorrhage remains a significant challenge. The rate of recurrent bleeding has remained essentially unchanged, at approximately 20% over the last decade. For most lesions, recurrent bleeding is readily treatable, although those in certain anatomic sites are not easily accessible for endoscopic therapy, and the risk of perforation increases with repeated thermal coagulation. Alternatives to endoscopy include surgery and angiography with embolization. This report describes a patient with recurrent bleeding from a gastric ulcer under the incisura, despite 3 prior endoscopic hemostatic therapies and angiographic embolization, that was controlled by cap-assisted hemoclip application.

A prospective comparison of enteroclysis and capsule endoscopy in the diagnosis of obscure gastrointestinal bleeding

Purpose: Enteroclysis is considered the gold standard for evaluation of small bowel diseases. Small bowel series is preferred because of its simplicity and lack of patient (pt) discomfort. Recently, capsule endoscopy (CE) was shown to be superior to small bowel radiography for evaluation of small bowel diseases. (Gastroenterol 2002; 123; 999–1005) This study was undertaken to prospectively study the diagnostic yield of enteroclysis compared with CE in pts with obscure gastrointestinal bleeding.

High-frequency ultrasound probe-guided hemoclipping of colonic Dieulafoy's lesion

Hemoclipping of a visible vessel feeding the bleeder in a thin walled duodenal diverticulum has been shown to prevent recurrence of bleeding (Gastrointest Endosc 2003;57:116–117). Submcuosal vessels not easily seen in other areas of the gastrointestinal tract can be easily identified on high frequency ultrasound probe sonography (HFUPS) and hemostatic therapy could be directed to the feeding vessel. We report a case to demonstrate the utility of HFUPS guided hemoclipping of a submucosal feeding vessel in the prevention of rebleeding from a colonic Dieulafoys lesion.