Gastric Ulcers, El Salvador Atlas of Gastrointestinal VideoEndoscopy. A Large Database of Images and Video Clips with Cases Reported.
El Salvador Atlas of Gastrointestinal VideoEndoscopy
Hourglass Stomach. This 62 year-old female, have been presented with severe abdominal pain since two moths, in addition to the ulcer, she has choledocolitiasis and a big abdominal hernia.

Video Endoscopic Sequence 1 of 14.

Hourglass Stomach.

 This 62 year-old female, have been presented with severe
 abdominal pain since two moths, in addition to the ulcer,
 she has choledocolitiasis and a big abdominal hernia.

 For more endoscopic details, download the video clip
 by clicking on the endoscopic image. Wait to be
 downloaded complete then press Alt and Enter for full
 screen for windows media and Ctrl and 3 for Real player.

 All endoscopic images shown in this Atlas contain
 video clips. We recommend seeing the video clips in full
 screen mode.
Hourglass Stomach. Hourglass Stomach, a stomach more or less completely and permanently divided into two parts, so that it resembles an hourglass in shape; the deformity is due to scarring which complicates gastric ulcer or neoplasia.

Video Endoscopic Sequence 2 of 14.

Hourglass Stomach.

 Hourglass Stomach, a stomach more or less completely
 and permanently divided into two parts, so that it
 resembles an hourglass in shape; the deformity is due to
 scarring which complicates gastric ulcer or neoplasia.

 

 
Retraction of the gastric wall adjacent to lesser-curve ulcers may lead to the formation of smooth, symmetric folds that radiate from the ulcer crater. The opposite wall may also be retracted; this produces an incisura of the greater curvature and, ultimately, an hourglass stomach.

Video Endoscopic Sequence 3 of 14.

 Retraction of the gastric wall adjacent to lesser-curve
 ulcers may lead to the formation of smooth, symmetric folds
 that radiate from the ulcer crater. The opposite wall may
 also be retracted; this produces an incisura of the greater
 curvature and, ultimately, an hourglass stomach.

 

 
The image and the video clip show retraction of the gastric walls, therefore giving us the formation of an invagination. With little of resistance, the endoscope, it is advanced to the antrum.

Video Endoscopic Sequence 4 of 14.

 The image and the video clip show retraction of the gastric
 walls, therefore giving us the formation of an invagination.
 With little of resistance, the endoscope, it is advanced
 to the antrum.

 

 
Hourglass Stomach.

Video Endoscopic Sequence 5 of 14.

Hourglass Stomach.
Due to the retraction of the gastric wall, to overcome some difficulties, some maneuver to look the pylorus were achieved.

Video Endoscopic Sequence 6 of 14.

 Due to the retraction of the gastric wall, to overcome some
 difficulties, some maneuver to look the pylorus were
 achieved.

 
Follow up Endoscopy. After four days of treatment with lanzoprazol 30 mg twice a day, a follow up Endoscopy was performed.

Video Endoscopic Sequence 7 of 14.

 Follow up endoscopy.

 After four days of treatment with lanzoprazol 30 mg twice a
 day, a follow up endoscopy was performed.
In spite of a short treatment of four days with PPI´s, there are generative epithelium and less resistance to the passage of the endoscope through narrowness.

Video Endoscopic Sequence 8 of 14.

 In spite of a short treatment of four days with PPI´s, there
 are generative epithelium and less resistance to the
 passage of the endoscope through narrowness.

 

Video Endoscopic Sequence 9 of 14.

 Hourglass Stomach.

 A close up of generative epithelium at the border of the
 ulcer, magnifying image.
Hourglass Stomach. A close up of generative epithelium at the border of the ulcer, magnifying image.

Video Endoscopic Sequence 10 of 14.

 Hourglass Stomach.

 A close up of generative epithelium at the border of the
 ulcer, magnifying image.
Chromoendoscopy using indigo carmine.

Video Endoscopic Sequence 11 of 14.

Chromoendoscopy using indigo carmine.
High-resolution Chromoendoscopy. Chromoendoscopy, the intravital staining of gastrointestinal. epithelia, provides additional diagnostic information with respect to the epithelial morphology and pathophysiology. Based on experience gathered, Chromoendoscopy is now in more widespread use, in particular to identify preneoplastic and neoplastic lesions.

Video Endoscopic Sequence 12 of 14.

High-resolution chromoendoscopy.

 Chromoendoscopy, the intravital staining of
 gastrointestinal. epithelia, provides additional diagnostic
 information with respect to the epithelial morphology and
 pathophysiology. Based on experience gathered,
 chromoendoscopy is now in more widespread use, in
 particular to identify preneoplastic and neoplastic lesions.
 
More images and video clips of Hourglass Stomach with indigo carmin stain.

Video Endoscopic Sequence 13 of 14.

 More images and video clips of Hourglass Stomach with
 indigo carmin stain.

Chromoendoscopy. Is a technique used to study the fine details of the mucosa throughout the gastrointestinal tract. Chromoendoscopy combines high resolution Endoscopy with various methods of vital staining of epithelial structures. In these methods, during Endoscopy, tissues are colored by a stain introduced through a spray catheter. The staining techniques are technically simple, economical and easy to perform.

Video Endoscopic Sequence 14 of 14.

 Chromoendoscopy.

 Is a technique used to study the fine details of the mucosa
 throughout the gastrointestinal tract.
 Chromoendoscopy combines high resolution endoscopy
 with various methods of vital staining of epithelial
 structures. In these methods, during endoscopy, tissues
 are coloured by a stain introduced through a spray
 catheter. The staining techniques are technically simple,
 economical and easy to perform.
Hourglass ulcers constriction at the proximal gastric corpus A 42-year-old patient, with a history of vomiting which later presented hematemesis. A failed upper endoscopy was performed at a Public Hospital, which it was given diagnose of an obstructive stomach. We performed an upper endoscopy and observed blood remains and signs of Mallory Weiss Syndrome, which it was treated with Plasma Argon Coagulator. After maneuvering, we were able to overcome the obstruction at the gastric body. Hourglass ulcers constriction was observed which cause the obstruction.

Video Endoscopic Sequence 1 of 5.

 Hourglass Ulcers constriction at the proximal gastric corpus

 A 42-year-old patient, with a history of vomiting which later
 presented hematemesis. A failed upper endoscopy was
 performed at a Public Hospital, which it was given diagnose
 of an obstructive stomach. We performed an upper
 endoscopy and observed blood remains and signs of
 Mallory Weiss Syndrome, which it was treated with Plasma
 Argon Coagulator. After maneuvering, we were able to
 overcome the obstruction at the gastric body. Hourglass
 ulcers constriction was observed which causes the
 obstruction.
Hourglass stricture of the proximal gastric corpus. The image and the video display a proximal hourglass stricture of the gastric corpus. The video clip displays resistance to pass the endoscope through the stenosis.

Video Endoscopic Sequence 2 of 5.

Hourglass stricture of the proximal gastric corpus.

 The image and the video display a proximal  hourglass
 stricture of the gastric corpus.
 The video clip displays resistance to pass the endoscope
 through the stenosis.

 Retraction of the gastric wall adjacent to lesser-curve
 ulcers may lead to the formation of smooth, symmetric folds
 that radiate from the ulcer crater. The opposite wall may
 also be retracted; this produces an incisura of the greater
 curvature and, ultimately, an hourglass stomach.

 
Another image and video of this endoscopic sequence. The antrum is observed with diffuse redness and rest of blood.

Video Endoscopic Sequence 3 of 5.

 Another image and video of this endoscopic sequence.
 The antrum is observed with diffuse redness and rest of
 blood.
 Occasionally, a gross horizontal fibrous contracture in association
 with long-standing ulceration can cause a permanent hourglass
 constriction, or the lesser curvature can shorten longitudinally.

 
The pre-pyloric antrum.

Video Endoscopic Sequence 4 of 5.

 The pre-pyloric antrum.
A Mallory Weiss tear was found, and argon plasma coagulator APC was used to the point of bleeding.

Video Endoscopic Sequence 5 of 5.


 A Mallory Weiss tear was found, and argon plasma
 coagulator APC was used to the point of bleeding.
Gastric Erosion observed with The narrow band imaging (NBI) system consists of a sequential electronic endoscope system and a source of light equipped with new narrow band filters, yielding very clear images of microvessels on mucosal surfaces.

Video Endoscopic Sequence 1 of 3.

 Gastric Erosion observed with The narrow band imaging
 (NBI) system consists of a sequential electronic endoscope
 system and a source of light equipped with new narrow
 band filters, yielding very clear images of microvessels on
 mucosal surfaces.
Narrow Band Imaging, This image displays a erosion cover with fibrin.

Video Endoscopic Sequence 2 of 3.

Narrow Band Imaging

This image displays a erosion cover with fibrin.

 
Pre-Piloric Erosion.

Video Endoscopic Sequence 3 of 3.

Pre-Piloric Erosion.