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Gastroenterology Research

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https://www.readbyqxmd.com/read/28912916/acute-liver-failure-in-a-patient-travelling-from-asia-the-other-face-of-the-coin-of-infectious-disease
#1
Balen Abdulrahman, Mohamed H Ahmed, John Ramage
We present a case of a 63-year-old male who had travelled from South India to United Kingdom (UK) visiting relatives. He had developed episodes of diarrhea, vomiting and fevers while travelling and on assessment in hospital, mild abdominal distension was noted with rapid deterioration to hypovolemic shock. Initial blood test showed a low platelet count with deranged liver function tests (LFTs). It was noted that during admission to intensive care unit (ICU), blood continued to ooze from a previous surgical laparoscopy wound, central and arterial line access sites...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28912915/gastrointestinal-bleeding-successfully-treated-using-interventional-radiology
#2
Nobuhiro Takeuchi, Masakazu Emori, Makoto Yoshitani, Junichi Soneda, Masanori Takada, Yusuke Nomura
Gastrointestinal (GI) bleeding is an emergency medical condition that leads to hemorrhagic shock or circulatory instability if left untreated. A mainstay for treating GI bleeding is endoscopic therapy; more than 90% of GI bleeding can be staunched by endoscopic hemostasis. However, patients with unstable hemodynamics or GI bleeding that cannot be controlled by endoscopy require transcatheter embolization or surgical intervention. The development of several devices and embolization agents that are used in interventional radiology (IVR) leads to safe and accessible treatment via IVR...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28912914/intraductal-ultrasonography-as-a-local-assessment-before-magnetic-compression-anastomosis-for-obstructed-choledochojejunostomy
#3
Hideaki Kawabata, Misuzu Hitomi, Naonori Inoue, Yukino Kawakatsu, Yuji Okazaki, Masatoshi Miyata
Magnetic compression anastomosis (MCA) has been developed as a non-surgical alternative treatment for biliary obstruction without serious complications. A 70-year-old woman who had undergone pancreaticoduodenectomy with modified Child reconstruction for pancreatic head cancer suffered from obstructed choledochojejunostomy with no recurrent findings 4 months after the operation. Cholangiography using the percutaneous transhepatic cholangiographic drainage (PTCD) and fluoroscopy revealed complete obstruction of the upper common bile duct, and the length of the obstruction was 7 mm...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28912913/paraneoplastic-dermatomyositis-syndrome-presenting-as-dysphagia
#4
Emmanuel Ofori, Daryl Ramai, Mel Ona, Madhavi Reddy
Dermatomyositis (DM) is a rare autoimmune condition which predominantly affects females in the fifth and sixth decades of life. DM presents acutely or progressively as painless proximal skeletal muscle weakness and can be associated with a heliotropic rash around the eyes, and Gottron's papules on extensor surfaces of the hands. While the pathophysiology of DM is still unclear, abnormal T- and B-cell immune activity has been reported. DM has been associated with malignancy and has been shown to appear before, concurrently with, or after diagnosis of cancer...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28912912/splenic-abscess-an-unusual-complication-of-colon-cancer
#5
Rishitha Yelisetti, Madiha Khurshid, Areig Awad, Anand Kaji
Colon cancer is among the common malignancies. Common cancer-related complications are regional tumor extension, obstruction, and tumor perforation. Abscess formation is among the rare complications. We report a case of a 60-year-old female who presented with shortness of breath and left upper quadrant pain and was diagnosed with splenic abscess associated with colon cancer. This type of presentation necessitates an early surgical intervention.
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28912911/doxycycline-induced-acute-pancreatitis-a-rare-adverse-event
#6
Prashanth Rawla, Jeffrey Pradeep Raj
Doxycycline is a broad-spectrum antibiotic belonging to the tetracycline group which acts by inhibiting bacterial protein synthesis. It is considered to be a relatively safe drug. We report a case of doxycycline-induced acute pancreatitis (DIAP) in an adult female patient who was started on the usual therapeutic dose 1 week before for acne vulgaris. The WHO causality assessment was possible, and the Naranjo scale confirmed it as "definite" adverse drug reaction. A brief literature review on case reports previously reporting DIAP has also been summarized...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28912910/prognostic-significance-of-elevated-cardiac-troponin-in-acute-gastrointestinal-bleeding
#7
Umair Iqbal, Osama Siddique, Ayesha Jameel, Hafsa Anwar, Ahmad Chaudhary
BACKGROUND: Acute gastrointestinal bleeding (AGIB) is responsible for over 140,000 hospitalizations annually. Cardiovascular-related deaths account for 30% of the patients surviving the initial episode of AGIB. The purpose of this study was to identify the impact of elevated troponin on short-term mortality and length of stay (LOS) of these patients. METHODS: From July 2013 to July 2016, 290 patients admitted with a diagnosis of AGIB and who had cardiac troponin I measured within 24 h of presentation were retrospectively reviewed...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28912909/the-use-of-tranexamic-acid-for-upper-gastrointestinal-bleeding-by-medical-and-surgical-intensivists-a-single-center-experience
#8
Jason Chertoff, Grant Lowther, Hassan Alnuaimat, Ali Ataya
BACKGROUND: Tranexamic acid (TXA) may be beneficial in the management of upper gastrointestinal bleeding (UGIB). We sought to investigate how frequently intensivists at our academic institution use TXA for patients with UGIB, and to investigate whether the utilization rate of TXA differs between surgical and medical intensivists, and provide an updated literature review on the subject. METHODS: We performed a retrospective cohort study of patients admitted for UGIB to the surgical intensive care unit (SICU) and the medical intensive care unit (MICU) at our academic healthcare facility (University of Florida Health - Shands Hospital) from January 1, 2013 to December 31, 2016...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28912908/gastrin-releasing-peptide-and-glucose-metabolism-following-pancreatitis
#9
Sayali A Pendharkar, Marie Drury, Monika Walia, Murray Korc, Maxim S Petrov
BACKGROUND: Gastrin-releasing peptide (GRP) is a pluripotent peptide that has been implicated in both gastrointestinal inflammatory states and classical chronic metabolic diseases such as diabetes. Abnormal glucose metabolism (AGM) after pancreatitis, an exemplar inflammatory disease involving the gastrointestinal tract, is associated with persistent low-grade inflammation and altered secretion of pancreatic and gut hormones as well as cytokines. While GRP is involved in secretion of many of them, it is not known whether GRP has a role in AGM...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28912907/long-term-follow-up-of-autonomic-and-enteric-measures-in-patients-undergoing-vertical-banded-gastroplasty-for-morbid-obesity
#10
Neil E Crittenden, Hani Rashed, William D Johnson, George Cowan, David Tichansky, Atul Madan, Naeem Aslam, Teresa Cutts, Thomas L Abell
BACKGROUND: A multi-component model of autonomic and enteric factors may correlate with ultimate weight loss or gain after restrictive obesity surgery. This study aimed to determine relevant parameters to predict successful long-term weight loss. METHODS: Thirty-nine patients (four males and 35 females) with a mean age of 37.2 years were followed for over 15 years after vertical banded gastroplasty. Baseline adrenergic: postural adjustment ratio (PAR) and vasoconstriction (VC); cholinergic: electrocardiogram R-to-R interval (RRI) and enteric measure: electrogastrogram (EGG) were utilized by a discriminant function analysis to classify patients as a long-term loser or gainer...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28912906/constipation-is-related-to-small-bowel-disturbance-rather-than-colonic-enlargement-in-acquired-chagasic-megacolon
#11
Mauro Bafutto, Alejandro Ostermayer Luquetti, Salustiano Gabriel Neto, Felix Andre Sanches Penhavel, Enio Chaves Oliveira
BACKGROUND: Constipation is the main symptom of acquired chagasic megacolon. However, a number of patients with Chagas disease without colon involvement also have the same complain. This study evaluated the role of small bowel in constipated patients with Chagas disease with and without megacolon. METHODS: Orocecal transit time (OCTT) and oral glucose tolerance test (OGTT) in constipated non-chagasic and chagasic patients with and without megacolon were performed...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28725312/two-cases-of-pneumatosis-cystoides-intestinalis-with-intraperitoneal-free-air
#12
Kensuke Wada, Nobuhiro Takeuchi, Masakazu Emori, Masanori Takada, Yusuke Nomura, Akihito Otsuka
Intraperitoneal free air (IFA) is sometimes accompanied by pneumatosis cystoides intestinalis (PCI); therefore, proper diagnosis is essential for PCI management. We report two cases of PCI with IFA. A 70-year-old female taking anti-psychotic medication for schizophrenia presented with repeated vomiting and high-grade fever. Computed tomography revealed small, linear gaseous cysts in the intestinal wall along with IFA. Although there was no sign of peritoneal irritation, intestinal perforation was not excluded...
June 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28725311/nafcillin-induced-allergic-eosinophilic-cholestatic-hepatitis
#13
Mark V Guido, Warit Jithpratuck, Graham E Parks, Guha Krishnaswamy
A 71-year-old female with no history of liver disease or antibiotic allergy developed jaundice with elevated liver enzymes and eosinophilia following treatment with nafcillin for septic arthritis. Further workup demonstrated hepatocellular dysfunction and liver biopsy showed expansion of portal tracts by lymphocytes and eosinophils consistent with a hypersensitivity reaction. Nafcillin and related antibiotics were withdrawn, and her symptoms resolved 3 months later. We searched PubMed using terms of "nafcillin cholestasis" and "nafcillin hepatitis", and a review of the literature showed other reports of nafcillin-induced hepatitis and cholestasis...
June 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28725310/refractory-celiac-disease-successfully-treated-with-azathioprine
#14
Umair Iqbal, Ahmad Chaudhary, Muhammad Arsalan Karim, Hafsa Anwar, Nancy Merrell
Refractory celiac disease (CD) is a clinical diagnosis defined by the persistence of signs/symptoms, laboratory abnormalities or villous atrophy typical of CD despite strict adherence to a gluten-free diet for at least 6 - 12 months. It should be suspected when patients with CD fail to respond primarily or secondarily to a gluten-free diet, especially if there is significant weight loss. Differentiation between types is important both for management and predicting prognosis. Type I can be managed with mild immunosuppression with nutritional support...
June 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28725309/cronkhite-canada-syndrome-a-rare-cause-of-chronic-diarrhea
#15
Umair Iqbal, Ahmad Chaudhary, Muhammad Arsalan Karim, Hafsa Anwar, Nancy Merrell
Cronkhite-Canada syndrome (CCS) is a rare non-hereditary disease characterized by chronic diarrhea, diffuse intestinal polyposis and onychodystrophy. We present here a case of a middle-aged female who presented with chronic intermittent bloody diarrhea associated alopecia and loss of finger and toe nails. Labs were remarkable for microcytic anemia and severe hypoalbuminemia. Endoscopy showed numerous polyps scattered throughout the colon. She was treated with nutritional support and corticosteroid with complete resolution of her symptoms and endoscopic findings...
June 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28725308/a-case-with-vitamin-d-deficiency-induced-cytomegalovirus-enteritis-presenting-as-bowel-pseudo-obstruction
#16
Shou-Wu Lee, Chung-Wang Ko, Szu-Chia Liao, Chung-Shihn Chang, Hong-Zen Yeh, Chi-Sen Chang
Cytomegalovirus (CMV) infection in small intestines has rarely been reported. We report a 67-year-old woman with abdominal pain for 2 weeks. Abdominal computed tomography (CT) revealed wall-thickening of the segmental small bowel. Enteroscopy disclosed discrete ulcers at the jejunum, and biopsy histopathology showed positive CMV immunoreactivity. Laboratory tests showed positive blood CMV with a viral load of 9,400 DNA copies/mL and high IgG titer and low vitamin D level. After antiviral therapy and oral vitamin D supply, her symptoms improved...
June 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28725307/acute-pancreatitis-secondary-to-severe-hypertriglyceridemia-management-of-severe-hypertriglyceridemia-in-emergency-setting
#17
Ahmad Chaudhary, Umair Iqbal, Hafsa Anwar, Hafiz Umair Siddiqui, Madiha Alvi
Hypertriglyceridemia (HTG) is the third most common cause of acute pancreatitis (AP). The incidence of AP is around 10-20% with levels > 2,000 mg/dL. We present here a case of a 44-year-old male with history of uncontrolled diabetes mellitus and HTG admitted with severe abdominal pain. Labs revealed elevated lipase and amylase. CT of abdomen with contrast showed AP. He was found to have a triglyceride (TG) level of 6,672 mg/dL. Besides conventional treatment for AP with intravenous (IV) hydration, he was started on IV regular insulin along with dextrose saline...
June 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28725306/histology-and-glutamine-synthetase-immunoreactivity-in-liver-biopsies-from-patients-with-congestive-heart-failure
#18
Bela Horvath, Lei Zhu, Daniela Allende, Hao Xie, John Guirguis, Michael Cruise, Deepa T Patil, Robert O'Shea, John Rivas, Reyna Yordanka, Nan Lan, Xiuli Liu
BACKGROUND: Long-standing congestive heart failure can induce a constellation of histopathology changes in the liver that can range from mild sinusoidal dilation to advanced fibrosis and loss of normal perivenular expression of glutamine synthetase (GS). Liver biopsies might be performed to assess the perioperative risk of these patients or to determine the need of synchronous liver transplant. We aimed to assess interobserver agreement in recognizing these liver histologic features in patients undergoing evaluation for heart transplantation and to examine whether immunohistochemistry of GS will aid the diagnosis of cardiac hepatopathy (CH)...
June 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28725305/international-normalized-ratio-does-not-predict-gastrointestinal-bleeding-after-endoscopic-retrograde-cholangiopancreatography-in-patients-with-cirrhosis
#19
Abimbola Adike, Mohanad Al-Qaisi, Noemi J Baffy, Heidi Kosiorek, Rahul Pannala, Bashar Aqel, Douglas O Faigel, M Edwyn Harrison
BACKGROUND: Cirrhosis is often accompanied by an elevated international normalized ratio (INR) due to a decrease in pro-coagulant factors. An elevated INR in cirrhosis is often interpreted as an increased risk of bleeding. There are a paucity of data in the literature on the use of INR to predict risk of gastrointestinal bleeding (GIB) following endoscopic retrograde cholangiopancreatography (ERCP) in patients with cirrhosis. The aims of the study were to determine if there is a correlation between INR and GIB following ERCP in patients with cirrhosis, and to determine if there is a difference in frequency of post-ERCP complications in patients with and without cirrhosis...
June 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28725304/high-c-reactive-protein-and-low-albumin-levels-predict-high-30-day-mortality-in-patients-undergoing-percutaneous-endoscopic-gastrotomy
#20
Omer Karasahin, Pinar Tosun Tasar, Ozge Timur, Dogan Nasir Binici, Tugba Kiper Yilmaz, Adem Aslan, Sevnaz Sahin
BACKGROUND: Percutaneous endoscopic gastrotomy (PEG) enables long-term enteral feeding. The aim of this study was to identify biomarkers that may guide the decision of whether to perform the elective procedure of PEG. METHODS: The medical records of all patients who underwent PEG in our hospital from 2010 to 2016 were screened retrospectively. Patients with mortality within a 30-day follow-up period and those without were compared using the Chi-square test, and continuous variables were compared with the Kruskal-Wallis and Mann-Whitney U tests...
June 2017: Gastroenterology Research
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