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Gastroenterology Report

Kianoush Ansari-Gilani, Babak Seddigh Tonekaboni, Dean A Nakamoto, Jamak Modaresi Esfeh
OBJECTIVE: Portal pressure gradient (PPG) after transjugular intrahepatic portosystemic shunt (TIPS) <12 mmHg has been reported as the only factor predictive of increase in platelet count. As flow velocities measured on Doppler ultrasound are related to pressure gradient based on the Bernoulli equation, we used this parameter to predict increased platelet count after TIPS placement. METHODS: A total of 161 consecutive patients who underwent TIPS placement entered this retrospective study...
October 2, 2016: Gastroenterology Report
Ganglei Liu, Xianrui Wu, Yi Li, Yuanyi Rui, Luca Stocchi, Feza H Remzi, Bo Shen
BACKGROUND: There are no published studies on the impact of visceral adipose tissue (VAT) change on outcomes of restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA). The aim of this historic cohort study was to evaluate the impact of excessive VAT gain on the outcomes of inflammatory bowel disease (IBD) patients with IPAA. METHODS: We evaluated all eligible patients with at least two sequential CT scans after pouch construction from our prospectively maintained Pouchitis Registry between 2002 and 2014...
September 25, 2016: Gastroenterology Report
Dan Xie, Kunpeng Hu, Ying Xian, Ying Wang, Xiaofeng Yuan, Mingliang Li, Xiaogang Bi, Kouxing Zhang
Peptic ulcer bleeding due to primary hyperparathyroidism is extremely rare. We report a case of a 42-year-old male with life-threatening acute upper gastrointestinal bleeding secondary to a duodenal ulcer and a history of kidney stones. Gastroscopic therapy, Billroth II gastrointestinal anastomosis and angiographic embolization were sequentially conducted to arrest the hemorrhage. A complete investigative work-up revealed that the duodenal ulcer bleeding was due to primary hyperparathyroidism coexisting with a parathyroid adenoma...
September 10, 2016: Gastroenterology Report
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No abstract text is available yet for this article.
November 2016: Gastroenterology Report
Charumathi Raghu Subramanian, George Triadafilopoulos
Inflammatory bowel disease (IBD) comprises two distinct conditions: ulcerative colitis and Crohn's disease, both of which are chronic, relapsing disorders carrying significant morbidity, mortality and healthcare costs. With growing attention to coordinated healthcare for patients with chronic systemic diseases, this review focuses on the care of IBD patients in remission, their concerns, quality of life, follow-up, the role of primary care physicians and the IBD-specific aspects of long-term care. We did an extensive PubMed search for articles pertaining to IBD patients in remission and, along with the authors' experience, formulated a comprehensive review...
November 2016: Gastroenterology Report
Darshan Kothari, Joseph D Feuerstein, Laureen Moss, Julie D'Souza, Kerri Montanaro, Daniel A Leffler, Sunil G Sheth
BACKGROUND AND AIMS: Open-access scheduling is highly utilized for facilitating generally low-risk endoscopies. Preprocedural screening addresses sedation requirements; however, procedural safety may be compromised if screening is inaccurate. We sought to determine the reliability of our open-access scheduling system for appropriate use of conscious sedation. METHODS: We prospectively and consecutively enrolled outpatient procedures booked at an academic center by open-access using screening after in-office gastroenterology (GI) consultation...
November 2016: Gastroenterology Report
Shishira Bharadwaj, Shaiva Ginoya, Parul Tandon, Tushar D Gohel, John Guirguis, Hiren Vallabh, Andrea Jevenn, Ibrahim Hanouneh
Malnutrition is an independent risk factor for patient morbidity and mortality and is associated with increased healthcare-related costs. However, a major dilemma exists due to lack of a unified definition for the term. Furthermore, there are no standard methods for screening and diagnosing patients with malnutrition, leading to confusion and varying practices among physicians across the world. The role of inflammation as a risk factor for malnutrition has also been recently recognized. Historically, serum proteins such as albumin and prealbumin (PAB) have been widely used by physicians to determine patient nutritional status...
November 2016: Gastroenterology Report
Arjun Gupta, Darrell S Pardi, Larry M Baddour, Sahil Khanna
OBJECTIVE: Hospital- and population-based studies demonstrate an increasing incidence of Clostridium difficile infection (CDI) in adults and children; although pediatric CDI outcomes are incompletely understood. We analysed United States National Hospital Discharge Survey (NHDS) data to study CDI in hospitalized children. METHODS: NHDS data for 2005-2009 (demographics, diagnoses and discharge status) were obtained; cases and comorbidities were identified using ICD-9 codes...
November 2016: Gastroenterology Report
Andre Fialho, Andrea Fialho, Aldo Schenone, Prashanthi Thota, Arthur McCullough, Bo Shen
OBJECTIVE: Small intestinal bacterial overgrowth (SIBO) has been associated with several diseases. The association between SIBO and deep vein thrombosis (DVT) has not been investigated. This study was aimed to investigate the frequency and risk factors for the development of DVT in patients tested for SIBO. METHODS: All 321 eligible patients were included from the Cleveland Clinic Gastrointestinal Motility Lab databank from January 2008 to January 2014. Patients who were evaluated with glucose hydrogen/methane breath test as well as Doppler ultrasonography for suspected DVT were included...
November 2016: Gastroenterology Report
Jing Li, Xingshun Qi, Han Deng, Ying Peng, Lichun Shao, Jiaxin Ma, Xiaolin Sun, Hongyu Li, Xiaozhong Guo
OBJECTIVE: A retrospective study was performed to compare the difference in platelet count (PLT), prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (APTT), between cirrhotic patients with and without acute upper gastrointestinal bleeding (AUGIB) or acute oesophageal variceal bleeding (AEVB). METHODS: Between January 2012 and June 2014, a total of 1734 cirrhotic patients were enrolled and were classified into 'AUGIB' (n = 497) and 'no AUGIB' (n = 1237) groups according to their disease history...
November 2016: Gastroenterology Report
Bela Horvath, Prabhdeep Singh, Hao Xie, Prashanthi N Thota, Xingwen Sun, Xiuli Liu
BACKGROUND AND AIMS: Patients with Barrett's esophagus (BE) are at an increased risk for developing esophageal adenocarcinoma (EAC); thus they may undergo regular endoscopic surveillance. If epithelial changes cannot be unequivocally classified as negative or positive for dysplasia, a diagnosis of indefinite for dysplasia (IND) is recommended. Several biomarkers have been proposed as markers or predictors of neoplasia in the general BE population; however, their significance is not clear in patients with BE-IND...
November 2016: Gastroenterology Report
Richard H Cartabuke, Rocio Lopez, Prashanthi N Thota
OBJECTIVES: Few studies have evaluated the long-term complications and outcomes of esophageal atresia with or without tracheoesophageal fistula (EA/TEF) beyond childhood. The aim of our study was to characterize the esophageal and respiratory morbidity of EA/TEF through evaluation of clinical symptoms, diagnostic testing and therapeutic intervention at a tertiary care center. METHODS: Patients with congenital EA/TEF evaluated from 2011 to 2014 were included. Demographic characteristics, type and mode of repair of EA/TEF, clinical symptoms, radiographic, endoscopic, bronchoscopic and medication use data were obtained...
November 2016: Gastroenterology Report
Andre Fialho, Andrea Fialho, Gursimran Kochhar, Bo Shen
OBJECTIVE: Vitamin D deficiency is common in patients with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC). Whether vitamin D levels are further lowered in patients with concomitant IPAA and primary sclerosing cholangitis (PSC) is not known. The aim of this study was to evaluate the presence of PSC as a risk factor for vitamin D deficiency in patients with UC and IPAA. METHODS: In this case control study, 74 patients with concurrent IPAA and PSC were included in the study group, and 79 patients with IPAA, but without PSC, served as controls...
November 2016: Gastroenterology Report
Carolyn Hanna, John Mullinax, Mark S Friedman, Julian Sanchez
Small bowel diverticulosis is a rare finding within the general population and jejunal diverticulosis, specifically, is even rarer. Clinical manifestations can range from post-prandial pain, constipation and malabsorption to serious complications, such as gastro-intestinal hemorrhage, perforation and acute intestinal obstruction. Here we describe the case of an 81-year-old gentleman who presented with a three-year history of abdominal pain and weight loss. Despite unremarkable physical examination and laboratory tests, persistent pneumoperitoneum and dilated loops of small bowel were found on imaging...
November 2016: Gastroenterology Report
Custon T Nyabanga, Joseph Veniero, Bo Shen
Ileal pouch-anal anastomosis surgery can be complicated by anastomotic leaks, leading to the formation of abscess and chronic sinus that have been routinely managed by a surgical approach. We developed the endoscopic needle knife sinusotomy (NKSi) technique, which has become a valid alternative. The basic principle of endoscopic NKSi is dissection and drainage of the sinus through its orifice internally into the lumen of pouch body. The success of NKSi requires an access to the sinus from the pouch side. One of the most challenging situations for NKSi is a closed orifice of the sinus, which leaves an isolated chronic abscess cavity...
November 2016: Gastroenterology Report
Zubin Arora, Saurabh Mukewar, Xianrui Wu, Bo Shen
BACKGROUND AND AIMS: Superimposed Campylobacter jejuni infection (CJI) has been described in patients with ulcerative colitis (UC). Its risk factors and impact on the disease course of UC are not known. Our aims were to evaluate the risk factors for CJI in UC patients and the impact of the bacterial infection on outcomes of UC. METHODS: Out of a total of 918 UC patients tested, 21 (2.3%) of patients were found to be positive for CJI (the study group). The control group comprised 84 age-matched UC patients who had tested negative for CJI...
November 2016: Gastroenterology Report
Thomas Curran, Vitaliy Poylin, Robert Kane, Anna Harris, Jeffrey D Goldsmith, Deborah Nagle
Traumatic neuroma is a well-recognized complication of lower extremity amputation, yet has also been noted to occur elsewhere. We report a clinical case and English-language literature review of traumatic rectal neuroma, a well-known pathologic entity not previously reported in this anatomic location.
November 2016: Gastroenterology Report
Aditya Kalakonda, Shashank Garg, Suraj Tandon, Rakesh Vinayak, Sudhir Dutta
Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for numerous infectious processes. Gastrointestinal tract involvement is rather rare and only a handful of cases of MRSA colitis have been reported in North America. We present a case of MRSA colitis in an adult without apparent risk factors. Abdominal computed tomography (CT) showed thickening of the sigmoid colon, indicative of colitis, and empiric therapy with ciprofloxacin and metronidazole was started. Initial work-up for infection-including blood and stool cultures, and stool Clostridium difficile toxin assay-was negative...
November 2016: Gastroenterology Report
Narendra Pandit, Harjeet Singh, Hemanth Kumar, Rajesh Gupta, G R Verma
Intestinal loop stoma is a common surgical procedure performed for various benign and malignant abdominal problems, but it rarely undergoes spontaneous closure, without surgical intervention. Two male patients presented to our emergency surgical department with acute abdominal pain. One of them was diagnosed as having rectosigmoid perforation and underwent diversion sigmoid loop colostomy after primary closure of the perforation. The other was a known case of carcinoma of the rectum who had already undergone low anterior resection with covering loop ileostomy; the patient underwent second loop ileostomy, this time for complicated intestinal obstruction...
November 2016: Gastroenterology Report
Khaled Ali Jadallah, Enas Walid Sarsak, Yara Mohammad Khazaleh, Rawan Mohammad Khair Barakat
We report a case of Budd-Chiari syndrome occurring in a patient with coeliac disease, who presented with symptoms of increased abdominal girth, right upper quadrant pain and shortness of breath for three weeks prior to admission. Initial assessment revealed the presence of moderate ascites, hepatosplenomegaly and right-sided pleural effusion. Further diagnostic work-up established a diagnosis of chronic Budd-Chiari syndrome. Interestingly, complete screening for pro-thrombotic factors was negative. A review of the literature on this association disclosed only 28 similar cases, with the majority of them describing individuals of North African origin...
September 7, 2016: Gastroenterology Report
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