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Gastroenterology Report

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https://www.readbyqxmd.com/read/28533912/portal-vein-thrombosis-in-patients-with-cirrhosis
#1
Leona von Köckritz, Andrea De Gottardi, Jonel Trebicka, Michael Praktiknjo
Portal vein thrombosis (PVT) is frequent in patients with liver cirrhosis and possible severe complications such as mesenteric ischemia are rare, but can be life-threatening. However, different aspects of clinical relevance, diagnosis and management of PVT are still areas of uncertainty and investigation in international guidelines. In this article, we elaborate on PVT classification, geographical differences in clinical presentation and standards of diagnosis, and briefly on the current pathophysiological understanding and risk factors...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28533911/hepatic-encephalopathy
#2
Peter Ferenci
Hepatic encephalopathy (HE) is a reversible syndrome of impaired brain function occurring in patients with advanced liver diseases. The precise pathophysiology of HE is still under discussion; the leading hypothesis focus on the role of neurotoxins, impaired neurotransmission due to metabolic changes in liver failure, changes in brain energy metabolism, systemic inflammatory response and alterations of the blood brain barrier. HE produces a wide spectrum of nonspecific neurological and psychiatric manifestations...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28533910/renal-dysfunction-in-cirrhosis-acute-kidney-injury-and-the-hepatorenal-syndrome
#3
Theresa Bucsics, Elisabeth Krones
Renal dysfunction is a common complication of liver cirrhosis and of utmost clinical and prognostic relevance. Patients with cirrhosis are more prone to developing acute kidney injury (AKI) than the non-cirrhotic population. Pre-renal AKI, the hepatorenal syndrome type of AKI (HRS-AKI, formerly known as 'type 1') and acute tubular necrosis represent the most common causes of AKI in cirrhosis. Correct differentiation is imperative, as treatment differs substantially. While pre-renal AKI usually responds well to plasma volume expansion, HRS-AKI and ATN require different specific approaches and are associated with substantial mortality...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28533909/recent-advances-in-the-management-of-variceal-bleeding
#4
Ihteshamul Haq, Dhiraj Tripathi
Acute haemorrhage from ruptured gastroesophageal varices is perhaps the most serious consequence of uncontrolled portal hypertension in cirrhotic patients. It represents a medical emergency and is associated with a high morbidity and mortality. In those who survive the initial bleeding event, the risks of further bleeding and other decompensated events remain high. The past 30 years have seen a slow evolution of management strategies that have greatly improved the chances of surviving a variceal haemorrhage...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28533908/ascites-refractory-ascites-and-hyponatremia-in-cirrhosis
#5
Brett Fortune, Andres Cardenas
Ascites is the most common complication related to cirrhosis and is associated with increased morbidity and mortality. Ascites is a consequence of the loss of compensatory mechanisms to maintain the overall effective arterial blood volume due to worsening splanchnic arterial vasodilation as a result of clinically significant portal hypertension. In order to maintain effective arterial blood volume, vasoconstrictor and antinatriuretic pathways are activated, which increase overall sodium and fluid retention...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28533907/novel-treatment-options-for-portal-hypertension
#6
Philipp Schwabl, Wim Laleman
Portal hypertension is most frequently associated with cirrhosis and is a major driver for associated complications, such as variceal bleeding, ascites or hepatic encephalopathy. As such, clinically significant portal hypertension forms the prelude to decompensation and impacts significantly on the prognosis of patients with liver cirrhosis. At present, non-selective β-blockers, vasopressin analogues and somatostatin analogues are the mainstay of treatment but these strategies are far from satisfactory and only target splanchnic hyperemia...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28533906/diagnosis-of-cirrhosis-and-portal-hypertension-imaging-non-invasive-markers-of-fibrosis-and-liver-biopsy
#7
REVIEW
Bogdan Procopet, Annalisa Berzigotti
The concept of 'cirrhosis' is evolving and it is now clear that compensated and decompensated cirrhosis are completely different in terms of prognosis. Furthermore, the term 'advanced chronic liver disease (ACLD)' better reflects the continuum of histological changes occurring in the liver, which continue to progress even after cirrhosis has developed, and might regress after removing the etiological factor causing the liver disease. In compensated ACLD, portal hypertension marks the progression to a stage with higher risk of clinical complication and requires an appropriate evaluation and treatment...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28567286/re-appraisal-and-consideration-of-minimally-invasive-surgery-in-colorectal-cancer
#8
REVIEW
Mahmoud Abu Gazala, Steven D Wexner
Throughout history, surgeons have been on a quest to refine the surgical treatment options for their patients and to minimize operative trauma. During the last three decades, there have been tremendous advances in the field of minimally invasive colorectal surgery, with an explosion of different technologies and approaches offered to treat well-known diseases. Laparoscopic surgery has been shown to be equal or superior to open surgery. The boundaries of laparoscopy have been pushed further, in the form of single-incision laparoscopy, natural-orifice transluminal endoscopic surgery and robotics...
February 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28130375/selection-of-a-cut-off-for-high-and-low-methane-producers-using-a-spot-methane-breath-test-results-from-a-large-north-american-dataset-of-hydrogen-methane-and-carbon-dioxide-measurements-in-breath
#9
Klaus Gottlieb, Chenxiong Le, Vince Wacher, Joe Sliman, Christine Cruz, Tyler Porter, Stephen Carter
BACKGROUND: Levels of breath methane, together with breath hydrogen, are determined by means of repeated collections of both, following ingestion of a carbohydrate substrate, at 15-20 minutes intervals, until 10 samples have been obtained. The frequent sampling is required to capture a rise of hydrogen emissions, which typically occur later in the test: in contrast, methane levels are typically elevated at baseline. If methane emissions represent the principal objective of the test, a spot methane test (i...
January 27, 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28130374/current-status-of-intestinal-and-multivisceral-transplantation
#10
REVIEW
Shishira Bharadwaj, Parul Tandon, Tushar D Gohel, Jill Brown, Ezra Steiger, Donald F Kirby, Ajai Khanna, Kareem Abu-Elmagd
Clinical-nutritional autonomy is the ultimate goal of patients with intestinal failure (IF). Traditionally, patients with IF have been relegated to lifelong parenteral nutrition (PN) once surgical and medical rehabilitation attempts at intestinal adaptation have failed. Over the past two decades, however, outcome improvements in intestinal transplantation have added another dimension to the therapeutic armamentarium in the field of gut rehabilitation. This has become possible through relentless efforts in the standardization of surgical techniques, advancements in immunosuppressive therapies and induction protocols and improvement in postoperative patient care...
January 26, 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28110300/irritable-bowel-syndrome-and-diet
#11
REVIEW
Piero Portincasa, Leonilde Bonfrate, Ornella de Bari, Anthony Lembo, Sarah Ballou
Irritable bowel syndrome (IBS) is a chronic functional disorder of the gastrointestinal tract and is one of the most commonly diagnosed gastrointestinal diseases. The impact of IBS on the general population is large due to its high prevalence, suboptimal medical treatments and significant economic burden. The pathophysiology of IBS is complex and treatments are often symptom-specific. The most common therapeutic approaches for IBS include education and reassurance, lifestyles (especially nutrition-based interventions), peripherally acting medications (which typically target motility), centrally acting medications (which target visceral hypersensitivity and pain) and psychological interventions (which aim to reduce the effects of stress or symptom-specific anxiety)...
January 20, 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28065885/endoscopic-retrograde-cholangiopancreatography-with-ampullary-biopsy-vs-ercp-alone-a-matched-pairs-controlled-evaluation-of-outcomes-and-complications
#12
Sunil Dacha, Saurabh Chawla, Jai Eun Lee, Steven A Keilin, Qiang Cai, Field F Willingham
BACKGROUND AND AIMS: Biopsy of the ampulla of Vater may be performed to evaluate for ampullary adenomas, suspected ampullary tumors and immunohistological staining for autoimmune pancreatitis. Ampullary biopsies are commonly performed at the time of endoscopic retrograde cholangiopancreatography (ERCP). Due to the well-established complication rate following ERCP, the contribution of ampullary biopsy as a potential independent risk factor would require a controlled comparison. METHODS: A matched-pairs, case-control analysis was performed for patients undergoing ERCP with or without ampullary biopsy...
January 8, 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28057712/embolization-of-blood-supply-artery-followed-by-surgery-for-treatment-of-mesorectal-castleman-s-disease-case-report-and-literature-review
#13
Guanyu Yu, Fuao Cao, Haifeng Gong, Peng Liu, Ge Sun, Wei Zhang
A 23-year-old male patient was diagnosed as having a hypervascular pelvic mass by ultrasonography and magnetic resonance examination. A pathology puncture showed vitreous vascular Castleman's disease. Because of concerns about tumor blood supply, embolization under digital subtraction angiography (DSA) was performed on the artery of the pelvic tumor before resection of the mass and surrounding rectum. Castleman's disease of pelvic lymph node (mixed type, mainly hyaline vascular type) was confirmed pathologically from postoperative biopsy...
January 5, 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28039168/correlation-of-the-rutgeerts-score-and-recurrence-of-crohn-s-disease-in-patients-with-end-ileostomy
#14
Vasutakarn Chongthammakun, Andre Fialho, Andrea Fialho, Rocio Lopez, Bo Shen
BACKGROUND: Recurrence of Crohn's disease (CD) can occur after surgery, including end ileostomy (EI). The Rutgeerts score (RS) was developed to predict postsurgical CD recurrence via ileocolonoscopy in patients having ileocolonic resection. The role of ileoscopic evaluation via stoma for assessing recurrence of CD has not been investigated. The aim of this study was to evaluate the role of ileoscopy for predicting disease recurrence in CD patients after EI with the use of RS. METHODS: A total of 73 eligible CD patients with at least two ileoscopies in our institution following EI were included...
December 30, 2016: Gastroenterology Report
https://www.readbyqxmd.com/read/28025227/rectal-cancer-restaging-using-3d-cube-vs-2d-t2-weighted-technique-after-neoadjuvant-therapy-a-diagnostic-study
#15
Wuteng Cao, Yanbang Lian, Dechao Liu, Fangqian Li, Pan Zhu, Zhiyang Zhou
OBJECTIVE: This study aimed to compare the accuracy of rectal cancer restaging after neoadjuvant therapy with 3D CUBE sequence with 2D T2-weighted fast spin-echo (FSE) sequence. METHODS: This retrospective study comprised 72 patients with rectal cancer confirmed by colonoscopy and biopsy. After neoadjuvant therapy, all patients underwent pelvic magnetic resonance imaging (MRI) examination at 1.5T MRI sequences including a single coronal 3D CUBE T2-weighted FSE sequence with 1...
December 26, 2016: Gastroenterology Report
https://www.readbyqxmd.com/read/28011862/esophageal-food-impaction-during-cultural-holidays-and-national-athletic-events
#16
Asim Shuja, Diana M Winston, Asad Ur Rahman, Roger D Mitty, Bertrand L Jaber, Thormika Keo
BACKGROUND: Although intrinsic risk factors contributing to esophageal food impaction are well established, whether social behavior affects its occurrence has not yet been examined. METHODS: We conducted a retrospective review of the gastroenterology endoscopy procedural documentation software for the period of 2001-2012 to identify all patients who presented to our emergency department for esophageal foreign-body removal at the time of national athletic events and holidays associated with dietary indiscretions...
December 23, 2016: Gastroenterology Report
https://www.readbyqxmd.com/read/28011861/an-unusual-case-of-gastric-outlet-obstruction-caused-by-multiple-giant-persimmon-phytobezoars
#17
Fengbo Tan, Hongbin Mo, Xiao He, Haiping Pei
A phytobezoar is a bezoar or trapped mass in the gastrointestinal system that consists of indigestible plant material such as fibers, skins and seeds. A persimmon phytobezoar (considered to be harder than other types of phytobezoars) is formed after frequent consumption of persimmons. The complication of gastrointestinal tract obstruction from bezoars was found to exist in the intestines but was rarely reported in the gastric tract because of its flexible volume. Here we present a 57-year-old man with persimmon phytobezoars, which ultimately led to gastric outlet obstruction...
December 23, 2016: Gastroenterology Report
https://www.readbyqxmd.com/read/27940604/rates-of-hospitalization-among-african-american-and-caucasian-american-patients-with-crohn-s-disease-seen-at-a-tertiary-care-center
#18
Caroline H Walker, Sumant S Arora, Lisandro D Colantonio, Donny D Kakati, Paul S Fitzmorris, Daniel I Chu, Talha A Malik
BACKGROUND: There is equivocal evidence regarding differences in the clinical course and outcomes of Crohn's disease (CD) among African Americans compared with Caucasian Americans. We sought to analyze whether African Americans with CD are more likely to be hospitalized for CD-related complications when compared with Caucasian Americans with CD. METHODS: We conducted a retrospective cohort study including 909 African Americans and Caucasian Americans with CD who were seen at our tertiary care Inflammatory Bowel Disease (IBD) referral center between 2000 and 2013...
December 10, 2016: Gastroenterology Report
https://www.readbyqxmd.com/read/27940603/a-rare-case-of-plexiform-angiomyxoid-myofibroblastic-tumor-in-the-stomach-which-was-diagnosed-at-the-earliest-stage-in-the-literature
#19
Xi Li, Shuangqing Li, Shenghua Xiong, Zhujun Wang, Hu Zhang
Plexiform angiomyxoid myofibroblastic tumor (PAMT) is a rare gastric mesenchymal entity with a peculiar plexiform pattern, bland spindle cells and myxoid stroma rich in arborizing blood vessels. Here we report a 44-year-old Chinese woman with PAMT. Initially she was admitted for removal of a gastric antral'polyp' found on a routine examination 5 months previously. Our gastroscopy showed a 0.8 × 0.8 cm polyp-like mass in the antrum which protruded into the lumen. Endoscopic submucosal dissection (ESD) was performed to remove this mass en bloc...
December 10, 2016: Gastroenterology Report
https://www.readbyqxmd.com/read/27899522/care-of-inflammatory-bowel-disease-patients-in-remission
#20
REVIEW
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
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