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"Latar belakang: Tingginya insidensi penyakit saluran cerna, bilier, dan pankreas pada pasien usia lanjut membuat kebutuhan endoskopi tinggi. Komplikasi kardiopulmoner intra- dan pascatindakan endoskopi pada pasien usia lanjut lebih tinggi dari kelompok usia lebih muda. Penilaian faktor-faktor risiko komplikasi penting untuk menimbang risiko dan manfaat endoskopi pada pasien usia lanjut. Tujuan: Mengetahui insidensi dan faktor-faktor yang memengaruhi komplikasi kardiopulmoner intra- dan pascatindakan endoskopi pada pasien usia lanjut. Metode: Studi kohort prospektif dilakukan terhadap subjek berusia ≥60 tahun yang menjalani endoskopi di PESC RSUPN-CM sejak Agustus-Oktober 2023. Dilakukan analisis bivariat antara usia, komorbiditas, kelas ASA, status nutrisi, status fungsional, durasi tindakan, jenis sedasi, jenis tindakan, dan tingkat kompleksitas tindakan terhadap komplikasi kardiopulmoner intra- dan pascatindakan endoskopi. Selanjutnya, analisis multivariat dilakukan untuk mengetahui faktor risiko independen. Hasil: Dari 194 subjek, sebanyak 49,52% subjek mengalami komplikasi kardiopulmoner. Komplikasi tersering adalah takikardia (23,20%), hipoksemia (15,03%), dan hipotensi (6,20%). Hasil analisis multivariat menemukan bahwa tingkat kompleksitas tindakan ASGE kelas ≥3 merupakan faktor independen dengan RR 1,505 (IK 95% 1,039 – 2,179), p=0,03; sedangkan sedasi ringan-sedang memiliki RR 0,668 (IK 95% 0,458 – 0,975), p=0,037 terhadap komplikasi kardiopulmoner intra- dan pascatindakan endoskopi pada pasien usia lanjut. Kesimpulan: Insidensi komplikasi kardiopulmoner intra- dan pascatindakan endoskopi pada pasien usia lanjut adalah 49,52%. Tingkat kompleksitas tindakan tinggi menjadi faktor independen, sedangkan sedasi ringan-sedang menurunkan risiko komplikasi kardiopulmoner intra- dan pascatindakan endoskopi. Sementara itu, usia lanjut, komorbiditas banyak, kelas ASA buruk, durasi tindakan lama, status nutrisi buruk, status fungsional buruk, dan jenis tindakan tidak berpengaruh.

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Background/Aims: High incidence of gastrointestinal and pancreaticobiliary diseases in elderly prompts high need of endoscopy. Intra- and post-endoscopy cardiopulmonary complications were higher in elderly compared to younger population. This study aimed to investigate the incidence and affecting factors of intra- and post-endoscopy cardiopulmonary complications in elderly population. Methods: This prospective cohort study was conducted in endoscopy subjects aged ≥60 years at Gastrointestinal Endoscopy Center in Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia from August-October 2023. Results: Among 194 subjects, 49.52% experienced cardiopulmonary complications. The most common complications included tachycardia (23.20%), hypoxemia (15.03%), and hypotension (6.20%). Multivariate analysis revealed that complexity of procedure ASGE level ≥ 3 (RR 1.505 [95% CI 1.039 – 2.179]; p=0.03) and mild-moderate sedation (RR 0.668 [95% CI 0.458 – 0.975]; p=0.037) were significantly related to intra- and post-endoscopy cardiopulmonary complications. Conclusion: The incidence of intra- and post-endoscopy cardiopulmonary complications in elderly in Indonesia is high. Complexity of procedure ASGE level ≥ 3 is an independent factor, whereas mild-moderate sedation reduces the risk of intra- and post-endoscopy cardiopulmonary complications. On the contrary, old age, multicomorbidities, high ASA class, long duration of procedure, poor nutritional status, poor functional status, and type of procedure have no impacts."

"Oessofago-gastro-duodenoscopy (OGD) dilakukan pada pasien yang diterima melalui sistem "open access" dan sistem biasa."

"Oesofago-Gastro-Duodenoscopy (OGD) dilakukan pada pasien yang diterima melalui sistem "open acces " dan sistem biasa. Keluhan dapat berbeda pada pasien yang berumur < 45 tahun atau yang berumur > 45 tahun. Diagnosis rujukan, umur, gender dan faklor lingkungan dapat menimbulkan implikasi penting. Studi ini ditujukan untuk mempelajari profil pasien yang datang untuk OGD berdasarkan usia (< 45 tahun atau > 45 tahun) antara Januari 2004 - Desember 2004 yang dirujuk berdasarkan "open acces system" di wilayah sub-Himalaya, India Utara. Studi ini dilakukan di Indira Gandhi Medical College. Pasien dibagi dua kelompok: kelompok I usia < 45 tahun dan kelompok II usia > 45 tahun. Dari 1186 pasien, 451 (38%) adalah perempuan, 735 (62%) adalah laki-laki. Enam ratus enambelas pasien (52%) berusia < 45 tahun dan 570 (48%) berusia > 45 tahun. Dari kelompok /, 431 (70%) menunjukkan gambaran endoskopi yang normal dan 185 (30%) menunjukkan kelainan. Pada kelompok II 302 (53%) menunjukkan gambaran endoskopi yang normal, dan 268 (47%) memperlihatkan kelainan pada endoskopi. Ulkus gaster dan masa lebih sering terlihat pada kelompok > 45 tahun. "Gastro-esophageal reflex disease" (GERD) lebih sering pada usia muda. Gejala subjektif sama pada kedua kelompok. Disimpulkan bahwa untuk gejala yang sama, kelainan OGD lebih sering pada kelompok usia > 45 tahun. Hasil positif meningkat dari 30% menjadi 47% antara usia < 45 dan > 45 tahun. Disimpulkan bahwa semua pasien usia > 45 Tahun perlu dirujuk untuk endoskopi pada kali pertama kelainan gastrointestinal atau adanya alarm simtom. (MedJ Indones 2006; 15:90-3).

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The Oesophago-Gastro-Duodenoscopy (OGD) is done in patients received by either open access system or the conventional system. The presenting complaints and OGD findings may differ among patients with age < 45 yrs and those who are more than 45 yrs old. The referral diagnosis, age, sex, and environmental factors have important implications on the chances of finding and objective abnormality on endoscopy in a patient. This study was aimed to evaluate to evaluate the profile of ! 186 patients divided into younger (<45 yrs) and older age (45 or > 45 yrs) groups presenting for oesophago gastroduodenoscopy through open access referral system in sub-Himalayan region of North India. This is a retrospective study carried out on patients who underwent the OGD from Jan, 2004-Dec, 2004. The study was conducted in Indira Gandhi Medical College situated at a moderate altitude in North India. All patients presenting in Medical College during the study period for OGD were taken into study. The patients were divided into two groups based on age; less than 45 yrs and 45 yrs or more than 45 yrs. Their presenting complaint, age, sex, and OGD findings were recorded. The profile was compared between the two groups. A total of 7186 patients underwent OGD; the females were 451(38%) and males were 735(62%); 616(52%) were < 45 yrs old and 570(48%) of the patients were 45 yrs or older. In the group I 431(70%) had a normal endoscopy and 185(30%) showed abnormal endoscopic findings. In group II 302(53%) had a normal endoscopy, and 268(47%) had abnormal findings on endoscopy. Gastric ulcers, mass lesion/new growth were more common in elderly group, Gastro-esophageal reflux disease (GERD) was more common in younger group. The presenting complaints were similar in both groups. It is concluded that for the same presenting diagnosis the yield of OGD was more in patients > 45 yrs old. The positivity rate increased from 30% in < 45 yrs to 47% in the elderly cohort. So, all people >45 yrs should go for endoscopy at the first hint of upper Gl pathology, or appearance of alarm symptoms. (MedJ Indones 2006; 15:90-3)."

"Backgrounds: Gastrointestinal bleeding such as hematemesis or melena are common conditions in clinical practice and endoscopic service. The mortality rate due to gastrointestinal bleeding is relatively high. In this study, we evaluate the causes of hematemesis melena for the last 5 years and the factors associated with the bleeding.Methods: The study was done retrospectively. We obtained data from medical record of patients that performed endoscopy of upper gastrointestinal tract in Division of Gastroenterology, Department of Internal medicine, Cipto Mangunkusumo hospital (Jakarta, Indonesia) during the period of 2001 to 2005.Results: Of 4.154 patients who underwent upper gastrointestinal tract endoscopy from 2001 to 2005, we found that 837 patients (20.1%) were due to upper gastrointestinal bleeding. They were 552 male (65.9%) and 285 female patients (34.1%). Mean age of male patients was 52.7 ± 15.82 years, while for female patients was 54.46 ± 17.6 years. Of 837 patients who came due to hematemesis were 150 patients (17.9%), melena were 310 patients (37.8%), both melena and hematemesis were 371 patients (44.3%), 557 cases (66.5 %) due to non varices. Endoscopic results showed that 280 cases (33.4%) were due to esophageal varices. In general, this study had demonstrated that esophageal varices was the most frequent cause of upper gastrointestinal bleeding. We found 229 cases of esophageal varices were coincidence with portal hypertensive gastropathy. While ulcer was found in 225 cases (26.9%) and most of them were gastric ulcer (51.1%). Of gastrointestinal bleeding caused by esophageal varices, most were grade HI in 138 cases (49.3%). The incidence of bleeding of bleeding were found more frequently in patients age group of 40 - 60 years (389 cases; 46.5%), > 60 years (305 cases; 36.2%), < 40 years (242 cases; 16.8%). The causes of bleeding in patients whose age > 60 years, most were caused by ulcer (37.4%). In this study, we also found that cancer as the cause of gastrointestinal bleeding in 26 cases (3.1%). Gastrointestinal cancer comprised of gastric cancer in 15 cases (57.7%), duodenal cancer in 7 cases (26.9%), and esophageal cancer in 4 patients (15.4%).Conclusion: The most frequent cause of upper gastrointestinal bleeding was esophageal varices and usually had reached stage HI. The non variceal cause of bleeding was gastric cancer. Upper gastrointestinal malignancy was also found to be the etiology of bleeding in this study."

"We report a case of carcinoma of the esophagus in a 58 years old woman with achalasia, who has been diagnosed since 30 years ago, which initiated by surgical treatment (myotomy) and the symptoms recurred since 3 years ago. According to the progress of the disease, malignancy was strongly suspected due to prolonged stasis and mucosal irritation caused by achalasia (achalasia carcinoma sequence). Because of these contributing factors for the development of serious complications such as malignancy the diagnosis of achalasia must be systematically diagnosed and treated agressively. Surveillance endoscopy in patients with achalasia should be performed every 1-2 years."

"Upper gastrointestinal bleeding is one of the emergency conditions in the field of gastroenterology and variceal blending is the. most common cause of it. Gastric varices accounts only 5% to 10% of all causes of upper gastrointestinal bleeding respectively, but it could be fatal and difficult to control despite provision of adequate therapy. Early diagnosis and appropriate management may decrease the morbidity and mortality of gastric variceal bleeding."