Wajeeh Salah
Case Western Reserve University
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Surgical Endoscopy and Other Interventional Techniques | 2013
Constantinos P. Anastassiades; Wajeeh Salah; Eric M. Pauli; Jeffrey M. Marks; Amitabh Chak
BackgroundERCP, especially therapeutic, is difficult in patients with Billroth II surgical reconstruction and is associated with a higher rate of complications. This has led to controversy on the choice between a forward-viewing and side-viewing endoscope for performing the procedure. A previous case series from Asia reported a high rate of success with a cap-fitted ERCP technique. To our knowledge, the utility of cap-assisted ERCP with a forward-viewing gastroscope when other techniques fail has not been reported. We describe and demonstrate a novel rescue approach using a cap-fitted, forward-viewing gastroscope in patients with Billroth II anatomy, when attempts with duodenoscopes, pediatric colonoscopes, and gastroscopes previously failed.MethodsRetrospective case series. Inclusion criteria were: (a) documented Billroth II anatomy; and (b) use of cap-assisted ERCP as a rescue intervention on the first endoscopic encounter after failed attempts to perform ERCP with a duodenoscope. Patients were excluded if they successfully underwent ERCP with a duodenoscope. One advanced endoscopist and one advanced endoscopy fellow performed all but one of the procedures.ResultsFive cap-assisted ERCP procedures were performed in three patients with Billroth II anatomy. A wide variety of diagnostic and therapeutic endoscopic maneuvers were technically feasible and successful, including the endoscopic treatment of an afferent limb perforation caused by a duodenoscope.ConclusionsCap-assisted ERCP is a novel and underutilized technique that adds to the armamentarium of experienced therapeutic endoscopists. This approach may help ensure a successful endoscopic outcome and spare patients with Billroth II anatomy a percutaneous or surgical approach when ERCP with a duodenoscope, pediatric colonoscope or non-cap-fitted gastroscope fails.
BMC Gastroenterology | 2013
Linda C. Cummings; Ninad Shah; Santo Maimone; Wajeeh Salah; Vijay S. Khiani; Amitabh Chak
BackgroundPrior studies suggest that obstructive sleep apnea may be associated with gastroesophageal reflux disease, a strong risk factor for Barrett’s esophagus. The goals of this pilot case–control study were to determine whether Barrett’s esophagus patients have an increased likelihood of obstructive sleep apnea and to determine whether nocturnal gastroesophageal reflux symptoms affect the relationship between Barrett’s esophagus and obstructive sleep apnea risk.MethodsPatients with Barrett’s esophagus completed the Berlin Questionnaire, a validated survey instrument identifying subjects at high risk for obstructive sleep apnea. Two outpatient control groups were recruited: 1) EGD Group, subjects matched to Barrett’s esophagus cases by age, race, and gender with esophagogastroduodenoscopy negative for Barrett’s esophagus; and 2) Colonoscopy Group, patients getting colonoscopy. Rates of scoring at high risk for obstructive sleep apnea were compared. Respondents were also questioned regarding severity of their typical gastroesophageal reflux symptoms and presence of nocturnal gastroesophageal reflux symptoms.ResultsThe study included 287 patients (54 Barrett’s esophagus, 62 EGD, and 171 colonoscopy subjects). Barrett’s esophagus patients were slightly older than colonoscopy patients and more obese. 56% (n = 30) of Barrett’s esophagus subjects scored at high risk for obstructive sleep apnea, compared with 42% (n = 26) of EGD subjects (OR 1.73, 95% CI [0.83, 3.62]) and 37% (n = 64) of colonoscopy patients (OR 2.08, 95% CI [1.12, 3.88]). The association between Barrett’s esophagus and scoring at high risk for obstructive sleep apnea compared with colonoscopy patients disappeared after adjusting for age. Barrett’s esophagus patients reported more severe typical heartburn and regurgitation symptoms than either control group. Among all subjects, patients with nocturnal reflux symptoms were more likely to score at high risk for obstructive sleep apnea than patients without nocturnal reflux.ConclusionsIn this pilot study, a high proportion of Barrett’s esophagus subjects scored at high risk for obstructive sleep apnea. Having Barrett’s esophagus was associated with more severe gastroesophageal reflux symptoms, and nocturnal reflux symptoms were associated with scoring at high risk for obstructive sleep apnea. The need for obstructive sleep apnea screening in Barrett’s esophagus patients with nocturnal gastroesophageal reflux symptoms should be further evaluated.
Gastrointestinal Endoscopy | 2008
Vijay S. Khiani; Santo Maimone; Wajeeh Salah; Linda C. Cummings; Amitabh Chak
Archive | 2016
Vijay S. Khiani; Wajeeh Salah; Santo Maimone; Linda C. Cummings; Amitabh Chak
Gastrointestinal Endoscopy | 2013
Wajeeh Salah; Prachi S. Biyani; George J. Ata; Fabio Cominelli
Gastrointestinal Endoscopy | 2013
Constantinos P. Anastassiades; Aditi Saxena; Wajeeh Salah; Ashley L. Faulx; Richard C.K. Wong; Gerard Isenberg; John A. Dumot; Amitabh Chak
Gastrointestinal Endoscopy | 2013
Wajeeh Salah; John A. Dumot
Gastrointestinal Endoscopy | 2013
Wajeeh Salah; Todd H. Baron
Gastrointestinal Endoscopy | 2012
Constantinos P. Anastassiades; Wajeeh Salah; Eric M. Pauli; Jeffrey M. Marks; Amitabh Chak
Gastrointestinal Endoscopy | 2011
Aparna Repaka; Wajeeh Salah; Ashley L. Faulx; Gerard Isenberg; Amitabh Chak; Richard C.K. Wong