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https://www.readbyqxmd.com/read/28724302/efficacy-and-safety-of-vedolizumab-as-a-treatment-option-for-moderate-to-severe-refractory-ulcerative-colitis-in-two-patients-after-liver-transplant-due-to-primary-sclerosing-cholangitis
#1
Raúl Vicente Olmedo Martín, Víctor Amo Trillo, Rocío González Grande, Miguel Jiménez Pérez
Vedolizumab is a humanized IgG1 monoclonal antibody that selectively blocks the lymphocyte integrin α4β7 and prevents its interaction with endothelial adhesion molecules and subsequent transmigration to the gastrointestinal tract. The drug was approved in 2014 for the induction and maintenance treatment of ulcerative colitis and moderate to severe Crohn's disease that is refractory or intolerant to conventional treatment with corticoids and immunosuppressants and/or anti-TNFα drugs. However, inflammatory bowel disease has a variable behavior following liver transplant...
July 14, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28719966/safety-and-complications-of-interventional-endoscopic-ultrasound
#2
Monica Saumoy, Michel Kahaleh
Endoscopic ultrasound (EUS) has become an essential tool for the diagnostic and therapeutic intervention of gastrointestinal diseases. Beyond the drainage of fluid collections, it enables decompression of inaccessible bile and pancreatic ducts, the gallbladder, and the creation of anastomosis within the gastrointestinal tract using fully lumen-apposing stents. This review explored the safety and efficacy of these novel procedures and discussed the training pathway that is necessary to perform them efficiently and safely...
July 19, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28709930/particle-image-velocimetry-study-of-the-celiac-trunk-hemodynamic-induced-by-continuous-flow-left-ventricular-assist-device
#3
Francesco Scardulla, Diego Bellavia, Leonardo D'Acquisto, Giuseppe M Raffa, Salvatore Pasta
Whereas left ventricular assist device (LVAD) is the gold-standard therapy for patients with heart failure, gastrointestinal bleeding is one of the most common complications. LVAD implantation may remarkably impact aortic hemodynamics so that experimental and computational flow analyses can be used to study the disease mechanisms. Here we present an experimentally-calibrated computational model of the celiac trunk hemodynamic of a LVAD-supported patient who experienced bleeding after device implantation. Specifically, both particle image velocimetry (PIV) and echocardiography were used to measure and compare flow distributions in each branch of a phantom model of the patient abdominal aorta...
July 12, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28694665/pancreas-preserving-distal-duodenectomy-a-versatile-operation-for-a-range-of-infra-papillary-pathologies
#4
W Kyle Mitchell, Pradeep F Thomas, Abed M Zaitoun, Adam J Brooks, Dileep N Lobo
AIM: To investigate the range of pathologies treated by pancreas preserving distal duodenectomy (PPDD) and present the outcome of follow-up. METHODS: Neoplastic lesions of the duodenum are treated conventionally by pancreaticoduodenectomy. Lesions distal to the major papilla may be suitable for a pancreas-preserving distal duodenectomy, potentially reducing morbidity and mortality. We present our experience with this procedure. Selective intraoperative duodenoscopy assessed the relationship of the papilla to the lesion...
June 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28666493/sporadic-case-of-peutz-jeghers-polyp-in-a-14-year-boy
#5
Naheed Sultan, Rabbiya Ali
Peutz-Jeghers syndrome (PJS) is an autosomal dominant hamartomatous polyposis of the gastrointestinal tract, with pigmentation around lips, the buccal mucosa, and anal area. Patients have a strong family history. Patients of PJS present with abdominal pain, blood in stools, and occasionally melena because of polyps, along with classical mucocutaneous pigmentation. Very rarely a sporadic case of Peutz-Jeghers syndrome occurs in early childhood and adolescent. The case of a 14-year boy is reported, who presented with intussussception and bleeding per rectum due to jejunal polyp and a rectal polyp...
November 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28662525/colonic-histological-criteria-predict-development-of-pouchitis-after-ileal-pouch-anal-anastomosis-for-patients-with-ulcerative-colitis
#6
Toshimitsu Araki, Kiyoshi Hashimoto, Yoshiki Okita, Hiroyuki Fujikawa, Satoru Kondo, Minako Kobayashi, Masaki Ohi, Yuji Toiyama, Yasuhiro Inoue, Keiichi Uchida, Yasuhiko Mohri, Masato Kusunoki
BACKGROUND/AIMS: Pouchitis is one of the main complications after ileal pouch-anal anastomosis in patients with ulcerative colitis. The aim of this study was to determine whether the use of colonic histological criteria can predict the development of pouchitis. METHODOLOGY: We retrospectively reviewed 147 patients' clinical data and performed a histological evaluation of the resected total colon using Tanaka's criteria, which comprise the following 6 factors: ulceration (H1), crypt abscesses (H2), degree of mononuclear cell infiltration (MNCI) (H3), segmental distribution of MNCI (H4), eosinophil infiltration (H5), and extent of disease of resected colon (H6)...
June 30, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28660359/non-alcoholic-wernicke-s-encephalopathy-with-cortical-involvement-and-polyneuropathy-following-gastrectomy
#7
Wei-Chia Tsao, Long-Sun Ro, Chiung-Mei Chen, Hong-Chiu Chang, Hung-Chou Kuo
In this study, we present the clinical manifestations, brain magnetic resonance imaging (MRI) and concurrent polyneuropathies in two patients with non-alcoholic Wernicke's encephalopathy (WE) after gastrojejunostomy (Billroth II) anastomosis procedures. These patients developed sub-acute onset of disorientation and disturbance of consciousness following several weeks of poor intake. Peripheral neuropathy of varying severity was noted before and after the onset of WE. Brain MRI of the patients showed cerebellar vermis and symmetric cortical abnormalities in addition to typical WE changes...
June 28, 2017: Metabolic Brain Disease
https://www.readbyqxmd.com/read/28638427/colopharyngoplasty-in-patients-with-severe-pharyngoesophageal-corrosive-injury-a-complicated-but-worthwhile-procedure-to-restore-gi-tract-continuity-a-case-series
#8
Mahdi Zangi, Seyed Reza Saghebi, Ali Biharas Monfared, Seyedamirmohammad Lajevardi, Mohammad Behgam Shadmehr
BACKGROUND: Pharyngoesophageal strictures (PES) after corrosive injury impose a problematic condition for both physicians and patients in terms of their management and patients' quality of life. Colopharyngoplasty is a complex procedure, which is used to restore swallowing in these severely disabled patients. We describe our experience in treating nine patients with severe PES after corrosive injuries in a referral center. MATERIALS AND METHODS: A retrospective analysis of our database from 2009 to 2014 showed nine patients (seven men; age range: 18 to 47 years) with severe PES who underwent colopharyngoplasty ∼6 months (range: 4-10) after caustic material ingestion...
2017: Tanaffos
https://www.readbyqxmd.com/read/28634703/isoperistaltic-versus-antiperistaltic-side-to-side-anastomosis-after-right-laparoscopic-hemicolectomy-for-cancer-isovanti-trial-study-protocol-for-a-randomised-clinical-trial
#9
N Ibañez, J Abrisqueta, J Luján, Q Hernández, P Parrilla
BACKGROUND: It is believed that loosing ileocecal valve is well tolerated in patients who do not have short bowel syndrome or Crohn disease. From the hypothesis of colonic peristalsis and transit is regulated by that ileocecal valvular mechanism, we try to find out if the creation of a new pseudo-valvular mechanism as antiperistaltic anastomosis could be considered after right hemicolectomy can cause any short- or long-term changes in gastrointestinal habits. PURPOSE: The purpose of the study at primary endpoint is to compare early (occurring within 30 days of surgery) and late (occurring during the follow-up) postoperative complications between both groups The purpose of the study at secondary endpoint is to compare intraoperative and postoperative events between experimental and control groups in terms of operating time, first oral tolerance day, first flatus and faeces, length of hospital stay and orocecal transit; comparing rates of gastrointestinal life quality and comparing mortality rates between both groups...
June 21, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28616919/-effects-of-early-enteral-immunonutrition-on-postoperative-immune-function-and-rehabilitation-of-patients-with-gastric-cancer-and-nutritional-risk
#10
Chang-Bing Peng, Wen-Zhong Li, Rui Xu, Wen Zhuang
OBJECTIVES: To investigate the effects of early enteral immunonutrition on postoperative immune function and rehabilitation of gastric cancer patients with nutritional risk. METHODS: New hospitalized patients with gastric cancer were evaluated the nutrient status based on NRS 2002. The patients who scored between 3 to 5 points were randomized into two groups(30 cases for each group), and those in experimental group were given 7-d early postoperative enteral immune nutrition, those in control group were given normal nutrition...
May 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/28611969/anastomotic-strictures-after-esophageal-atresia-repair-incidence-investigations-and-management-including-treatment-of-refractory-and-recurrent-strictures
#11
REVIEW
Renato Tambucci, Giulia Angelino, Paola De Angelis, Filippo Torroni, Tamara Caldaro, Valerio Balassone, Anna Chiara Contini, Erminia Romeo, Francesca Rea, Simona Faraci, Giovanni Federici di Abriola, Luigi Dall'Oglio
Improved surgical techniques, as well as preoperative and postoperative care, have dramatically changed survival of children with esophageal atresia (EA) over the last decades. Nowadays, we are increasingly seeing EA patients experiencing significant short- and long-term gastrointestinal morbidities. Anastomotic stricture (AS) is the most common complication following operative repair. An esophageal stricture is defined as an intrinsic luminal narrowing in a clinically symptomatic patient, but no symptoms are sensitive or specific enough to diagnose an AS...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28567453/hemobilia-due-to-arteriobiliary-fistula-complicating-ercp-for-residual-bile-duct-stone-in-a-case-of-mirizzi-syndrome
#12
Surendrakumar Mathur, Vinaykumar Thapar, Vasudev Chowda
Hemobilia is a rare cause of upper gastrointestinal tract bleeding. Most cases are iatrogenic following medical interventions, most commonly liver biopsy and transhepatic cholangiography. We present a case of arteriobiliary fistula between the right hepatic artery and the common hepatic duct, in a case of Mirrizi syndrome, following endoscopic biliary stenting and presenting with hemobilia. The patient was treated by surgical disconnection of the fistula, ligation of the right hepatic artery, and bilioenteric anastomosis...
May 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28566386/cost-and-efficacy-examination-of-alvimopan-for-the-prevention-of-postoperative-ileus
#13
Zoltan H Nemeth, Dorian A Bogdanovski, Samantha R Paglinco, Patricia Barratt-Stopper, Rolando H Rolandelli
Opioid analgesics exacerbate ileus through peripheral μ-opioid receptor action. Alvimopan, a μ-opioid receptor antagonist, has been proposed to alleviate postoperative ileus, leading to decreased time to return of gastrointestinal function and hospital discharge. As opioid-induced motility issues are only one factor affecting postoperative ileus, continued examination of the cost of the use and efficacy of the drug is needed. Data for this study were collected retrospectively from the charts of 55 patients who received an anastomosis and were given alvimopan at Morristown Medical Center between 2010 and 2013 as well as from 58 appropriately matched controls...
June 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28538638/perioperative-use-of-nonsteroidal-anti-inflammatory-drugs-and-the-risk-of-anastomotic-failure-in-emergency-general-surgery
#14
Nadeem N Haddad, Brandon R Bruns, Toby M Enniss, David Turay, Joseph V Sakran, Alisan Fathalizadeh, Kristen Arnold, Jason S Murry, Matthew M Carrick, Matthew Hernandez, Margaret H Lauerman, Martin D Zielinski
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used analgesic and anti-inflammatory adjuncts. NSAID administration may potentially increase the risk of postoperative gastrointestinal anastomotic failure (AF). We aim to determine if perioperative NSAID utilization influences gastrointestinal anastomotic failure in emergency general surgery (EGS) patients undergoing gastrointestinal resection and anastomosis. METHODS: Post hoc analysis of a multi-institutional prospectively collected database was performed...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28537563/anastomotic-leaks-in-gastrointestinal-surgery-and-their-prevention
#15
Tomasz Banasiewicz, Adam Dziki, Paweł Lampe, Zbigniew Lorenc, Marek Szczepkowski, Jacek Zieliński, Grzegorz Wallner
Anastomotic leak in the gastrointestinal tract is one of the most important complications of resection. They are the main cause of reoperation, their occurrence worsens the prognosis of the patient, increasing the proportion of direct mortality, as well as being a significant risk factor for recurrence of cancer. The risk of leaks within the gastrointestinal tract is greatly varied, depending on the location and extent of the resection, but also on patient, disease or a surgical procedure, including surgeon...
April 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28537131/acupuncture-ameliorates-postoperative-ileus-via-il-6-mir-19a-kit-axis-to-protect-interstitial-cells-of-cajal
#16
Jingjing Deng, Shu Yang, Qing Yuan, Yuzhong Chen, Dandan Li, Haimei Sun, Xinghua Tan, Fuchun Zhang, Deshan Zhou
Acupuncture is a therapy effective in treating postoperative ileus (POI); its underlying mechanisms remain unclear. MicroRNAs (miRNAs) participate in inflammation and injury to the interstitial cells of Cajal (ICCs), both of which are considered to be contributors to POI. C-kit, encoding KIT, a specific marker of ICCs, is predicted to be targeted by miR-19a, an inflammation-related miRNA. Therefore, we investigated a possible link between inflammation, miR-19a, and ICCs in POI, as well as the mechanism by which these factors are affected by acupuncture...
May 24, 2017: American Journal of Chinese Medicine
https://www.readbyqxmd.com/read/28534326/-comparative-study-of-3d-and-2d-laparoscopic-surgery-for-gastrointestinal-tumors
#17
Fujian Ji, Xuedong Fang, Bingyuan Fei
OBJECTIVE: To evaluate the technical advantages of 3D laparoscopic and 2D laparoscopic surgery for gastrointestinal tumors. METHODS: Clinical data of gastrointestinal cancer patients undergoing 3D laparoscopic or 2D laparoscopic surgery from January 2015 to January 2017 in our department were retrospectively analyzed These patients included 93 gastric cancer cases undergoing laparoscopic radical resection (total gastrectomy, 48 cases in 3D group, 45 cases in 2D group), 45 rectal cancer cases undergoing radical resection combined with lateral lymph node dissection (27 cases in 3D group, 18 cases in 2D group) and 76 right colon cancer cases undergoing radical resection (37 cases in 3D group, 39 cases in 2D group)...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28533869/-rare-etiology-of-subocclusive-syndrome-inflammatory-fibroid-polyp-of-the-ileum-about-a-clinical-case
#18
Redouane Ahtil, Mustapha Bensghir, Mohammed Meziane, Abdelhafid Houba, Abelhamid Jaafari, Salim Jaafar Lalaoui, Charki Haimeur
Inflammatory fibroid polyp (IFP) is a rare benign lesion, originating from the submucosa in the gastrointestinal tract. It generally appears as an isolated benign lesion, rarely located at the level of the ileum. Its origin is controversial. Clinical presentation varies depending on its location; invagination and obstruction are the most common indicative symptoms when the polyp is located at the level of the small intestine. We report the case of a 22-year old patient with abdominal pain, nausea and vomiting and a personal history of intermittent constipation and a weight loss during the previous year...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28523325/synchronous-gastric-tumors-case-presentation
#19
Carmen NeamŢu, Bogdan Dan Totolici, Octavian Marius CreŢu, Casiana Stănescu, Andrei Ardelean, Oana Badea, George Ciprian Pribac, Mircea Ovidiu Ciobanu, GarofiŢa Olivia Mateescu, Stelian ŞtefăniŢă Mogoantă
Synchronous gastric tumors, and, especially the presence of an adenocarcinoma and gastrointestinal stromal tumors, are less frequent. We present the case of a 75-year-old patient, with no gastrointestinal pathology in the medical history, who was admitted for marked asthenia, nausea, coffee grounds vomiting, inappetence, dizziness, weight loss and periodical epigastralgias. The clinical and imagistic examinations highlighted an ulcerative, infiltrative, bleeding tumor formation, present on the anterior side and subcardially on the small curvature...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28492158/metachronous-metastatic-renal-cell-carcinoma-to-the-jejunum-presenting-with-massive-lower-gastrointestinal-bleeding
#20
Reem Al- Salamah, Hamad Hadi Al- Qahtani, Jaber Ali Alfaifi, Saleh Al- Harbi
Metastatic renal cell carcinoma (MRCC) is a rare cause of massive lower gastrointestinal bleeding (LGIB). We report a 51-year man who underwent left nephrectomy for renal cell carcinoma (RCC) 6 years ago. presenting with massive LGIB. Preoperative abdominal computed tomography (CT) revealed small bowel mass. Exploration of the abdomen revealed jejunal mass. Resection of the mass along with the jejunal segment with end-to-end anastomosis was performed. Histopathology of the jejunal mass confirmed MRCC. MRCC should be expected as a source of massive LGIB in a patient with history of RCC...
April 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
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